We have personal protective equipment (PPE) for our body – but what about our mind? University of Utah Health Huntsman Cancer Institute nurse educator Cassidy Kotobalavu leads training on the concept of emotional contagion – how good (and bad) emotions spread. Here are Cassidy’s expert tips (with slides) on managing emotional contagion in health care.
Emotional contagion is the idea that we really can and do “catch” emotions from the people around us. This quote from an article in New York Magazine by Melissa Dahl (2015) describes the phenomenon of catching others’ emotions like a “nasty office cold.” We need to watch out for those contagious emotions that are negative and deflating. Think for a minute, which germs are you spreading? Do you ever feel like you need to wear a haz-mat suit to protect yourself from the emotional contagion in your workplace?
Emotion, as we know, is a state of arousal that typically involves facial and bodily changes, brain activation, and feelings. Emotion is shaped by the cultural rules and norms that surround us.
Facial expressions reflect our inner feelings, influence our inner feelings, and can generate emotions in other people! We call these “secondary emotions.” If I tell you to SMILE, your facial muscles send a message to your brain about the basic emotion being expressed and your brain interprets this as actual emotion, so you tend to feel slightly happier than before.
Emotions are highly “contagious.” If you catch the “bad bug,” there are consequences. We can learn a lot about a person by paying close attention to their emotional reactions. Facial expressions, gestures, body language, voice tone, rate of speech. These are all cues to help us figure out how a person is feeling – angry, sad, nervous, afraid. While we focus in on the emotional state of others, we don’t always pay attention to something equally, if not more, important – OUR OWN emotional reactions to these social encounters. We can experience secondary emotions that stem from another’s emotions and behaviors.
Just as second hand smoke can have the same or worse effects on the health of nonsmokers around, negative second-hand emotions can have significant, long-lasting effects on the health and wellbeing of those experiencing them.
Negative second-hand emotions can play a role in developing serious physical and emotional symptoms, such as muscle tension, fatigue, low energy, insomnia, depression, or second hand stress which can lead to increased risk of asthma, diabetes and heart disease. Second-hand depression or anger can lead to a dysfunctional and draining atmosphere that sucks up all the positive energy and replaces it with stress and unhappiness.
“Emotional contagion” is the idea that we really can and do “catch” emotions from the people around us. It’s the phenomenon of having one person’s emotions and related behaviors directly trigger similar emotions and behaviors in other people.
There is actually a lot of scientific evidence behind this idea! A 2008 study (James H. Fowler and Nicholas A. Christakis of UCSD and Harvard) showed that happiness spreads throughout a social network sort of like an infection. When a nearby friend of yours becomes happy, it increases your own chance of happiness by 25 percent. This study also showed that happiness of one person can actually ripple out and cause happiness in people up to three degrees away.
Mostly, the research has focused on the cheerier, pro-social consequences of emotional contagion, because feeling what the people around us feel seems to increase empathy and understanding, thereby improving communication, according to research. However, the contagion effect isn’t always a positive thing, particularly when the emotions you’re catching are negative. Some research has touched on this aspect, too, suggesting that college students whose roommates are depressed are more likely to become depressed themselves.
The Framingham Heart Study was initiated in 1948 when over 5,000 people from Massachusetts were enrolled in a “cohort” and studied over time, including their offspring. In general, the study showed that happiness is more contagious than unhappiness. Data analysis shows that we have the ability to effect people’s emotions more than we give ourselves credit for. In fact, this study showed that the power of positivity far outweighs the power of negativity in any given situation. Our happiness, to some extent, depends on the happiness of others with whom we are connected.
The research also shows us that each additional happy friend in our life boosts our good cheer by 9% while each additional unhappy friend drags us down by only 7%. To put this into perspective, let’s compare this to past research where it had been found that an extra $5,000 in income only increased the probability of being happy by about 2%. (Carter, S. 2012).
If happiness and unhappiness are both spreading, then on average, you’re going to be catching the happy waves more often than you catch sad waves. Moral of the story here is that catching the “happy” bug from those around you is contagion that you should try to catch. Being around other positive people can be energizing, motivating, and inspiring. It is likely to help you work more effectively and efficiently.
Another study in the literature comes from researchers Fredrickson and Losada (2005) where the P/N ratio is discussed. The P/N ratio measures instances of positive incidents versus negative incidents. It has been found that teams with a positivity ratio greater than 3:1 were much more productive and efficient. Research shows that there is an upper P/N ratio limit, as well, of 13:1, where performance actually worsens. This is likely due to potential blind optimism and excessively cheerful environments that are not grounded in reality. We call this a “Pollyanna” environment.
Through this evidence, we know that teams must have a balance of positive and negative.
John Gottman, who is an American psychologist out of the University of Washington who pioneered research on marriage and relationships, has actually suggested the “magic relationship ratio” of 5:1. Successful relationships have a balance between positive and negative feelings and actions. According to his research, this ratio is essential for success in any team (marriage, work team, etc.) Gottman observed 15 minute video interviews of 700 newlywed couples and was able to predict with 94% accuracy the married couples that would end up in divorce when his team checked 10 years later.
This ratio can be used as a guide in the workplace, as well. Through this research, we know that we must routinely provide praise to our coworkers as well as provide them with constructive feedback to help them learn and grow. Overall, leaders should provide more positive than negative feedback.
To review, the scientific literature defines “emotional contagion” as the process in which a person or group influences the emotions and affective behavior of another person or group. Many studies have demonstrated the powerful impact it can have on our relationships, friendships, partnerships and groups of all kinds. However, interestingly, we often don’t realize how much our OWN emotions are influenced by the emotional states of others.
The important question here is in what direction are your emotions being influenced?
Emotions are contagious! What you broadcast to others is what they will eventually begin to pick up. This not only effects YOUR reputation, but it will affect their wellbeing as well.
Remember, this goes both ways and can be a good thing or a bad thing. Our attitude can bring people up or tear them down depending on what we are projecting. We have all been around people that have brightened our day just by being around them. We have also all been around people who have darkened our day by simply being around them.
Negativity distracts us and takes us away from the task at hand. As healthcare providers, we are taking care of people and their lives are in our hands. We must be sharp and on our game. We can’t be distracted with negativity that is occurring in our workplace.
Emotions can easily go “viral,” especially in a group setting. Think of a social media post that suddenly goes “viral” online! It’s the same concept. Thousands of people either really like or dislike a video and continue to share it, over and over. Before you know it, that video is all over the internet!
I love this quote from Ganhdi. Our thoughts can easily become our actions, which can lead us down a slippery slope of negativity if we aren’t too careful. We must be aware of the contagion we are spreading, positive or negative.
When looking in to this topic, I kept asking myself - Are some of us more vulnerable to this emotional contagion than others? Let’s think about this for a minute.
Literature has found that those who are most vulnerable to ”catching” others emotions are those who tend to be more attentive and sensitive to the emotions of others, value interrelatedness over independence, and those whose emotional experiences are heavily influenced by others feedback. Introverts are more likely to be affected by others’ positive emotions whereas extroverts tend to be more affected by others’ negative emotional expressions. Also, women have been shown to be more vulnerable than men.
If you’re wondering how vulnerable YOU are to emotional contagion, there is a questionnaire known as the “Emotional Contagion Scale” that was designed by researcher Elaine Hatfield and her colleagues to assess people’s susceptibility to “catching” emotions. It helps you gauge your vulnerability to either positive or negative emotional contagion. (Hatfield, E., Cacioppo, J., and Rapson, R. L. (1994).)
As individuals who have chosen a career in the healthcare field, clinical or non-clinical, we are innately vulnerable to emotional contagion. We work in a people-focused organization and we are here to help people. We are compassionate and caring and WANT to HELP others. This is our greatest strength! Yet, creating compassionate connections with others is also our greatest vulnerability. We can experience negative emotional contagion stemming from patients, their family members, and even our coworkers.
So, is there a way to protect yourself from feeling what the people around you feel? Or from spreading the negativity and making it worse? Is there an antidote to emotional contagion? How do I avoid catching a bad case of “the emotions?”
There are lots of strategies for managing emotional contagion that have come out of the literature. Today, we’ll focus on a few of them and learn more about how we can protect ourselves from the negative aspects of emotional contagion.
The first strategy we’ll focus on is “be on guard.”
First, we must be on guard! We must protect ourselves again toxic attitudes that will contaminate our wellbeing. When we (as healthcare staff) are around sick patients, we wear personal protective equipment (PPE) - a mask, gloves, gown, booties, etc. We do this to protect ourselves and others. We too, need a theoretical “protective covering” over ourselves for when we get into negative situations and toxic environments.
We do not need to completely isolate ourselves from those that are toxic, but we DO need to insulate ourselves from the contagious poison that can come from wrong attitudes. This means when people are gossiping about others, we DO NOT jump in and reinforce the poison, but instead become the ANTIDOTE. When people are talking about how their job is horrible, their life is falling apart, etc. – we don’t continue to rip them apart by agreeing with their misery. Don’t allow these negative behaviors to infect your outlook.
We cannot blend in to the negative crowd. We must stand out in the crowd with contagious positivity, motivation and kindness. Don’t be afraid to stand out!
The next strategy that we’ll focus on is “be the catalyst.”
What is a catalyst, you might ask? Well. by definition, a catalyst is “an agent that provokes or speeds significant change or action.” Instead of reflecting the situations around you, be a catalyst to change the situation. You have the POWER to promote positive change!
Think for a minute what the difference between these two objects is.
The thermometer simply reflects the conditions around it, while the thermostat has the ability to actually CHANGE the conditions.
Don’t be a thermometer just reflecting the conditions around you – become a thermostat by “changing the temperature” of the environment around you. Broadcast positivity, motivation, kindness, determination and drive to those around you. Have a positive attitude and it will be contagious. Try to reverse the negative emotional spiral around you – smile often, be happy and positive even when others around you are complaining or angry. Over time, your tenacity may lead to a reverse infection of positivity, causing the pattern to break. Remember – positive emotions are contagious too. It may take time to turn things around, but it’s time well spent.
Your actions are the display of your heart. What we do is a result of who we are. Be someone that brings LIGHT to a dark place. Be someone that brings comfort to a tense situation. Bringing a little light into a dark place has lasting impact beyond what we see. You have to trust that the light inside of you is greater than the darkness around you.
Also, we need to have AWARENESS. We need to pay close attention to our feelings in different settings and when we’re with different individuals and groups. Identify the people or groups of people who regularly bring you down, drain you, or make you feel angry, frustrated or stressed. The best way to do this is to tune in to changes in your mood and consistent mood change patterns. This will help you identify hot spots of contagion. For example, if you get to work in a good mood, but that mood quickly dissolves into sadness, frustration or anger, that’s a good clue that someone or something in your work environment may be contagious. Being aware is one of the first steps in protecting yourself. We can’t always remove these people or things from our environment, so we need to learn how to either work around them or influence them.
Also, be aware of the emotion that you are broadcasting to others! Sometimes our intent is good, but the way we are received is not. Be aware of the way others perceive you and remember that unintentional body language may be misinterpreted at times.
There are typical “points of exposure” that we always think of as healthcare staff, including absorption, inhalation, ingestion, and injection. Working in the healthcare field, we are all very good at protecting ourselves from the PHYSICAL contagion. We wear personal protective equipment (PPE), wash our hands, and get our flu shot every year. We’ve been trained to handle these types of situations.
On the other hand, we are not as good at protecting ourselves from the EMOTIONAL contagion in the workplace!
HOW do we protect ourselves? Let’s get a little abstract for a minute. If we could theoretically put on “PPE” to protect ourselves from the negative emotional contagion, what would that look like? What were our actions be?
First, let’s put on our theoretical protective gown. By doing this, we can use our non-verbal behaviors to communicate emotional contagion. Remember that non-verbal behaviors account for 90% of the emotional communication that is retained by others, so let’s pay attention to our body language as we communicate our emotions. For example, you may be crossing your arms because you are cold, but the people observing you will likely believe you are defensive or angry, automatically mimicing your arm crossing, and beginning to feel that way as well.
Next, let’s put on our theoretical protective gloves. Strategies that can be used here are re-evaluating our electronic communication before hitting SEND. We can transmit negative emotional contagion just as much electronically as we can face-to face. We cannot retrieve a hastily sent email or RL6 that will be a permanent and digital reminder of our bad mood.
Think before you act – is NOW the best time to give someone feedback? Feel out the situation before making any hasty actions.
Next, create a “Stop Doing List”. Jim Collins once asked thousands of entrepreneurs, "Does everyone here have a To-Do list?" All hands go up. Then he asks, "How many people in this room have a Stop-Doing list?" Few hands go up. Jim’s “Stop Doing List” idea is useful in minimizing stress that affects our mood. It also helps us identify and set a goal to STOP doing things that might be adding to negative emotional contagion. For example, complaining when asked to complete a certain task.
Now, let’s put on our theoretical protective mask. With this, we can avoid gossiping and speak directly with others when we have feedback for them.
We also must stop and think before we speak. Be consciously aware of our own mood! If it’s not one that will be useful to your team, change it.
Take a deep breath and re-set! Give yourself breaks.
Provide others with constructive feedback and be willing to accept feedback from others, as well.
Let’s put on our theoretical protective booties. With these, we can remove ourselves from the negative situation. We don’t need to participate!
Don’t walk through the mud and spread it! By this, I mean, don’t walk through a negative situation and spread that negativity further.
Trace your emotion to the original source! If you’re feeling down or unhappy, think for a minute, am I unhappy because I’m truly unhappy? Or is it because of contagion that I experienced today?
Always practice self care! Give yourself time to reset and re-energize. Stay active, exercise, eat healthy, and spend time with people you enjoy.
Let’s put on our theoretical protective goggles. With these, we can be aware and observe the situations that we are in. Don’t be an innocent bystander! If you see negative emotion happening around you, be brave enough to stop it!
When providing feedback to others, always make direct eye contact and don’t lose sight of the bigger picture. When giving someone constructive feedback, always remember that they have a majority of positive things about them, as well. They wouldn’t be here at U Health if they didn’t have positive qualities to be proud of.
Also, recognize what type of emotion you are focusing on, negative or positive. There will always be positive and negative. Which are you focusing on? What you focus on will encourage more of the same, so notice where you’re putting your energy and attention. Adjust if needed!
Last, we can “neutralize” the situation. When cleaning up a hazardous drug spill, we use what is known as Surface Safe (or alcohol pads) to neutralize the spill. We can theoretically use our “neutralizer” to influence a negative team member and launch a positive counter attack. Maybe you can change their mood!
Talk to that person, because people don’t often realize how negatively they are being perceived, or how their negative emotions are influencing the team. Speak to that person directly to eliminate gossiping and avoid blame.
Just like in the clinical environment when working in direct patient care, we must wash our hands and face after an exposure. When talking about emotional contagion, we must do the same thing! We can “wash ourselves” from that exposure and move forward. We must use the strategies that we’ve talked about to eliminate that exposure from our life and continue focusing on the positive.
So to summarize, it’s important to once again ask ourselves, how vulnerable are we to emotional contagion? What “PPE” do we have on currently? What “PPE” do we need to put on next time we come to work?
I love this quote from my one of my favorite philosophers, Friedrich Nietzsche. Working in healthcare can be a tough job, and we can battle with “monsters” from time to time. However, we must see that our work does not turn us into monsters. If you gaze long enough into the abyss of negativity, that abyss will gaze back into you.
Thank you for your time today! I hope you’ve found this topic of emotional contagion interesting. In summary, my hope today is that we can all be aware of the impact of our words and behaviors, and be brave enough to speak up when we see negative emotional contagion occurring in our workplace. We can be the CATALYST for positive change and we should STAND OUT in the crowd for our contagious positivity, motivation and kindness.