Happiness is happiness.

Anger is the sense of having been dis-respected or under-appreciated.

Sadness is the sense of loss.

Fear is the sense of impending harm.

Someone may ask: what is anxiety? What is disgust? What is frustration? These are secondary emotions that are derived from primary emotions. For example frustration can be the combination of anger and sadness. Anxiety can be the combination of sadness and fear. Primary emotions are primal. Primary emotions are derived from areas deep within the paleo cortex of the human brain. You can go to Russia, China, Czechoslovakia and look into the eyes of a man who's smiling and know that he's happy. You can go to Yugoslavia, Honduras or the Andes and look into the eyes of a man who's angry an know he's angry. Secondary emotions are generally considered learned or conditioned responses to situations or life event.

Understanding primary and secondary emotions is critical to understanding the behavior of the addict.

Addicts commonly live in anxiety, stress or panic. Addicts also tend to work diligently at helping other people with their emotions. Addicts also commonly choose inappropriate emotions in settings we're healthier primary emotions would be more fitting. Addicts often times work hard at “fixing” other peoples emotions. One of the most common things I encounter in my practice is when a person says “I just want to make people happy”. Here are two short, TRUE short stories to help illustrate my point:

About 15 years ago I was attending an elderly man who was having periods of altered mental status. He was having a great deal of difficulty with his cognition and it was up to me to find out why. We went through a wide array of tests which ultimately resulted in the necessity for cat scan of his brain. The staff came to retrieve him from his room to take him to the radiology suite when I notice there were some pills in his bed. After he left and was on his way to have his cat scan performed, I retrieved the pills from the bed and gave them to the nurse for identification. She came back from the pharmacy and told me that they were methadone pills. We scoured through his drawer at his bedside and found a whole bottle of methadone which another doctor had prescribed him. On returning from the radiology suite I confronted, let’s call him “Mr S.” and said quote you can't take medication that i did not prescribe you or that was prescribed from another provider without my knowledge. His response was this:

  “You taco bending piece of S#*%, get the f%&k out of my room and don't you ever come back ”.

Now at first glance most people would be taken aback and responded with angry, fear or sadness at this man's comments to me. Remarkably, I laughed. Yes, I laughed. One might ask “why would you laugh at something so heinous”. And the point I'd like to make from this story is in fact this man could not make my emotion, I chose the emotion of laughter. The truth of the matter is I laughed because I am of Hispanic descent but up until that time I had never bent to a taco in my entire life. That's where the funny part comes into play. As a very successful internist, I never considered myself anything else than a good man. So the notion that I was a Taco Bender appeared to me quite funny. This man could not make me angry or sad or fearful. I can only assume that emotion which if I saw fit. When an individual is reared in an environment with the idea that he/she can influence someone else’s emotion it's a very difficult thing to change. Mr. S didn’t make me ‘angry’, I chose happiness, or laughter in my response to his ugly comment. This made me feel good. You can’t make anyone “feel” a certain way. Humans choose their own emotion.

Lesson number 2: I had a patient, let’s call him “Scott” who one day was having terrible chest pain. He was a young man who was filled with struggle in his personal life. He had at the time a young 6 month old son. Scott was home alone with his infant son when he felt this sudden rush of pain in his chest and shortness of breath that scared him terribly. Scott was so overwhelmed with fear that he threw open his front door and screamed out “HELP”!!! No one heard him and of course and no one responded. He called his mother who did not answer. In his terrible state of pain, shortness of breath and fear he dialed 911 for help.

Since Scott was alone with his infant son and his fiancé (the baby’s mother, let’s call her Sarah) was at work, so he reached out to his ex-girlfriend, let’s call her “Linda”, who was on her way to bring his other son to him. Linda saw his distress; the ambulance was just arriving so Linda was more than happy to help take care of the children until Sarah could come and see about her son.

When Sarah finally arrived at the hospital, she was furious. She felt disrespected, unappreciated, she felt betrayed by her fiancé Scott. She was very angry! How could he call or even talk to Linda without talking to her first. After all it is her son. She could have left work and been home IN ABOUT 30 MINUTES!! How dare Scott turn that responsibility over to that wretched ex-girlfriend of his!! She felt so angry about his choice and the situation, her fervor lasted for days.

Thankfully Scott was fine. He was young, he simply had a panic attack. His father did die at the early age of 53 so Scott thought the worst of the worst. But it wasn’t his heart. It was his emotions.

So, what of Sarah. Did she have a right to be angry. Was she the least bit out of order with her rage? It did in fact last for days and she and Scott fought about his decision for days to come. What did Scott do right? What did he do wrong? Scott could not make Sarah's emotion, she chose her own. 

Think about the fact that you could be so overwhelmed with emotion the only thing you think about is how to get to safety. As we stand on the outside looking into this situation, most of us can empathize with Scott and Sarah in their emotions. But the healthy choice in emotion was to do what was best for the person who was suffering the most, in this situation of course that would be Scott. My contention is that Sarah, in an unhealthy way, chose anger over the situation when in fact she could have chosen a healthier emotion which could have been concern, fear or sadness. This is how our emotions can slowly destroy us. Only a person can choose their own emotion. 

Robert J. Hernandez, M.D. I'm an Internal Medicine specialist with a primary focus on addiction. I've been a physician for 30 years. I've practiced in Sherman, Texas for 20 years. I was board certified in Internal Medicine in 1996. I began to work in addiction in 2001. It started with weight loss, yes food because that is in fact a real addiction. The most important thing that I've learned is that the whole point to addiction, and some of you may disagree, is to hide. From 'what' you may ask? We hide from our emotional pain. Those who are addicted knows this. The emotional pain is so great most of us would do anything to get away from that pain. The main issues is how one finds a way to "hide from that pain". There are healthy ways to hide. But most of us are way more familiar with the unhealthy way for hiding. Examples of healthy hiding: golf, church, bowling. Unhealthy ways to hide: alcohol, gambling, illicit drugs, working even food. We feel different when we hide, never better. I can help you to change this.

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