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13th Jul 2022
Why are Expressed Emotions Important For Caregivers

How does Expressed Emotion Affect a Patient’s Recovery?

There has been a correlation between caregivers’ subjectively increased burden and reduced quality of life, loss, distress, depression, and a low level of social support. Expressing emotions becomes essential in the caregiver’s life. Please read on to know how emotions and communication impact the caregiver’s life as well as the one receiving the care.


Understanding Expressed Emotions

In various cases, caregiver attitudes and behaviours towards those diagnosed with a mental illness are classified into three categories: criticism, hostility, and excessive emotional involvement.

Research in England, which dealt with the effect of the environment on schizophrenic patients, led to the development of the term Expressed Emotions.  Critical patients with a family who are overly involved in their care are more likely to have relapsed than those who don’t. Post this study the term “expressed emotions” was further developed along with the relatively newer concept of semi-structured interviews. Semi-structured interviews have two major components, namely monitoring, and feedback. There are two types of feedback – positive & negative, both equally relevant to the result.

Several studies have established expressed emotions as a highly-reliable predictor of relapse in patients with psychiatric disorders. Patients in family environments with an extreme level of critical, hostile, heavily-involved, or intrusive behaviour put cared-for patients at an even higher risk of relapse, compared to cases without such family environments.


Expressed Emotions and Caregivers

It is crucial that all caregivers understand the enormous challenges of caring for and living with a patient with cognitive or physical illnesses. This might prepare the family members for a negative emotional atmosphere. The quality of a caregiver’s affection and relationship with the patient defines the emotional atmosphere. When the emotional atmosphere is clouded with criticism, hostility, or even over-involvement, both the caregiver and the patient will be negatively affected. An adverse family environment not only contributes to relapse and re-hospitalisations but also makes future improvement more difficult.


Challenges Faced When Caring For Severely Ill Patients

It is commonly found that caregivers categorise patients that are not performing daily tasks like bathing, house chores, or even just going from one room to the other, as lazy or self-indulgent. However, these are mostly alarming signs associated with ageing and related health issues, caregivers should keep this in mind to prevent them from worsening further. It is not uncommon for healthcare workers to internalise feelings of disdain for their patients, and think they are causing unnecessary problems or that they can control themselves but choose not to. This often results in hostile behaviour towards the patient involving acting out, yelling at the patient, and getting easily angered.


Caregiver’s Frustration and Expressed Emotions

Efficient caregiving depends on the caregiver’s perspective – one could be at the opposite end of this spectrum, and take complete accountability for all of the patient’s problems, believe everything is their fault, show extreme pity, and even disallow the patient to do daily tasks that are comparatively easier.

Studies conducted on patients with mental deterioration of different types show that such patients are more likely to exhibit breakdown symptoms when living conditions involve excessive yelling, constant humiliation, and high expectations. Such adverse caregiving is known to deteriorate the patients’ health even further.

A lack of knowledge about how to properly deal with illness results in negative behaviour: to avoid such behaviour, family members should be educated on how to deal with illness at the initial stages. Additionally, they must be aware of their emotions’ role in the deterioration or relapse of a patient’s condition.


How to Deal

A diagnosed illness does not imply a patient is nearing the end; it is increasingly possible for someone with cognitive impairment to continue leading a satisfying and meaningful life. While medical treatment is the primary necessity for the patient’s betterment, it is the role of the caregiver that provides a comprehensive support

system to them. Patients with severe mental impairment may be difficult, but they need caregiving the most, to have an enriched and comfortable life

One proven way to improve interpersonal relationships and reduce the risk of relapse is – Family Counselling. It will help enhance communication and social connections. Emotion coaching can help break down communication barriers, and express emotions appropriately.



Caregivers are integral to the improvement of their near one suffering from cognitive illnesses. How they express their emotions sets the tone for the journey of the patient, and so it must be kept in check at all times. While they must communicate basic emotions, and not keep anything to fester in their heart, it is essential to know how to do this communication. Keep learning new and better ways to support your dear one in this tumultuous phase of life.



When treating schizophrenia, why is it important to express emotions?

It has been empirically shown that higher levels of expressed emotion in a patient’s surroundings have been a robust predictor of schizophrenia, eating disorders, and mood disorders relapse. It has also been investigated to determine whether components of emotional intelligence contribute to the progression of bipolar disorder, dementia, and unipolar depression.


What is the importance of expressed emotion?

In our fight-or-flight state, our brains are often in overdrive when we struggle to express our emotions. In other words, this is a physical reaction caused by stress. As a result, our bodies go through a chain of events. In addition to increasing our heart rate, it slows our digestive system and makes us experience anxiety or depression.