Why emotional first aid?

Emotions are part of the movement of life. It often feels good to let this movement through. After a good cry or a well-directed explosion of anger, the whole organism may feel more alive. But we don't always let these emotions through easily. We often choke on our tears, or bottle up our anger. Another emotion, fear, stands in the way. We even hold back the most pleasurable emotion—joy.

First aid is temporary relief of distress. Sometimes it is rudimentary medical help before the doctor comes. But quite often this is enough: a bandaged cut will heal on its own, the massage of an injured muscle may start a spontaneous cure. Why emotional first aid? Because often emotion is experienced with distress. The first aid is not to relieve the emotion, or eliminate it as if it were a pain. It is to relieve the distress of the emotion pushing against a block: to let the emotion through. It is not therapy—or at least no more than the bandaging of a shallow wound is the practice of medicine. But just as traditional first aid uses simple medical techniques, emotional first aid uses simple techniques from therapy. Where emotional distress is extreme or long lasting, professional help may be necessary. But often emotional first aid (EFA) is all that is required.

The techniques of EFA are not widely known, and are almost never consciously applied. They are often applied intuitively, however, as when a mother comforts her child, or when we let a friend cry on our shoulder. The idea of consciously applied emotional first aid may even be obnoxious to many people: why use a cold, calculated technique instead of warm support? But the technique need not be cold. And there is a real problem: how often do we respond fully to our friends' emotions, how often do we feel our support is adequate?

We often face the emotions of others with an increasing sense of paralysis and distress in ourselves. We tend to take steps to help the other person's unhappiness go away. We tell the person to cheer up, we offer them something to eat, or make casual something that is, after all, being seriously felt. We often have problems with our own emotions. So we "tend to consider emotions themselves a problem. Even healthy activities such as jogging or dancing are often used to channel energy away from emotional expression into another kind of more controlled discharge. Or the beginning sensations of rage, fear, or grief are often kept dull by the use of tranquilizers. At worst, emotions may be held in so firmly that the result is physical damage-ranging from a tension headache to chronic psychosomatic disease. In the final analysis, many surgical operations cut out the physical results or the pain of repressed emotions.

Emotions are apparently still not officially respectable in the health sciences. For example, a 2,500 page Comprehensive Textbook of Psychiatry contains no systematic study of emotions and, in an index of some 20,000 entries, contains less than thirty entries under 'emotional' or 'emotions.' But many psychotherapists (psychiatrists, psychologists, counsellors) use techniques to relieve emotional distress. They may also try to induce emotions and intensify them. This is often manipulative, or even dangerous, since emotions can be 'dynamite.' Many psychotherapists, since unfortunately their training does not usually include work on their own emotional blocks, fumble just as much in the face of a patient's emotions as the man in the street would. Standard medical and psychological data come from a mechanistic analysis of human or animal behavior. 'Avoidance' or 'aggression' are discussed, rather than fear and anger, since much of the usual data originates in experiments with laboratory rats which must feel emotion but do not show it in ways we recognize as expressive.

Manipulation of the emotions also frequently occurs in the setting of therapy groups or training groups, where in many cases the original honesty of the encounter group concept has been lost. Experienced leaders can take advantage of people's lack of emotional experience by causing dramatic break-throughs which are in effect a breaking down of the person. The leader can then benefit from a surge of love and gratitude in putting the pieces together again. Since the knowledge of EFA is a knowledge of emotional functioning, it may, apart from its immediate value in relieving distress, also provide an inoculation against becoming the easy victim of emotional manipulation.

Most of the techniques used by those psychotherapists who are prepared to work seriously with the emotions derive ultimately from the work of Wilhelm Reich. Reich pioneered in leading psychotherapy away from mere listening and talking toward a more intensive contact with the emotional blocks expressed in various body attitudes-for example, a tight jaw that held back crying, or a puffed-up chest that held back rage. It was Reich who first used the phrase 'emotional first aid' to describe help he had given to his own young son who had been bottling up rage after being ill-treated by some other children. Reich remarked that 'teachers and parents should learn to do the same thing,' and 'One must also have a good relationship with one's child. One must have confidence and proper knowledge.'

The first aim of this book is to communicate basic knowledge of ways to relieve emotional distress. But this knowledge must be based on the understanding of how emotions function. The pioneer in this field was Charles Darwin. His book, The Expression of the Emotions in Man and Animals, published in 1872, is still the most complete available description of the details of emotional expression. He is best known for having broken the taboo against linking human and animal functioning in his theory of the evolution of man from ape-like ancestors. His later study broke another taboo, especially strong in nineteenth-century England, against discussion of the emotions. Darwin described some of his own emotions and some of his psychosomatic problems, used many photographs (in the first days of the camera) of his children in various emotional states, and gathered data through a questionnaire from all over the world. Essentially, he saw emotional expression as the channeling of energy, which he called 'nerve force.' Reich's emphasis, sixty years later, was even more on the actual movement of a biological 'life energy' in the body. Darwin's observations of detail in expression, and Reich's analysis of how emotions may flow or become blocked, are the reference points in this book's preliminary discussion (Chapter 2) of the dynamics of the emotions, what happens when a person is 'moved.'

Some simple methods taken from Reichian therapy will also be explained. These are not some kind of trade secret, since every patient who has been through therapy will know them. To take a proprietary attitude to such methods would be analogous to the medical profession trying to monopolize the use of bandages or preventing people from touching each other. The only methods from therapy that could be dangerous in themselves (any method can be misused) are those that deliberately intensify an emotional situation. In terms of energy, therapy will often attempt to charge a person, to increase tension and excitation. Emotional first aid works mainly in the direction of discharge, of release of tension that has already built up.

Having a good relationship with another person cannot be taught. But in the context of EFA, certain guidelines can govern the support to be offered, so that it does not become an invasion of the other person. Support without intrusion (see Chapter 3) can be achieved if intervention is limited by certain basic rules.

Confidence in the face of emotional distress also cannot be taught. But it depends on how much the helper accepts his or her own emotions. When someone else is moved, we are also moved. To give emotional first aid, the helper has to be able to manage his or her own emotions, to accept them, even to share them, while not intruding with them. This book, throughout, offers guidelines for emotional self help.

There may be some objections to this attempt to make emotional expression a more conscious process. It may seem as if this book prescribes behavior: the right way to cry, the right way to get angry. This would be as absurd as defining the right way to make love. But it is possible to discuss the basic process of emotional discharge and, by understanding it, to become more capable of surrender to it, just as it is possible for lovers to become closer to each other through an open discussion of their sex life. Of course, the content and rhythm of each person's experience is unique, but the basic emotions are still universal—if they are allowed to come through.