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Dr. Lise Van Susteren: Emotional Inflammation: A Condi...

Dr. Lise Van Susteren is a psychiatrist in private practice in Washington, DC, and has served as an assistant clinical professor of psychiatry at Georgetown University. With her writing partner, Stacey Colino, she has authored the new book Emotional Inflammation: Discover Your Triggers and Reclaim Your Equilibrium During Anxious Times. In this episode of Insights at the Edge, Dr. Van Susteren joins Tami Simon to discuss the modern condition she calls emotional inflammation, the primary drivers behind it, and her innovative RESTORE process for coming back into balance and wholeness in our lives. (1 hour, 2 minutes)

The Power of Mapping Your Emotions

It’s in everyone’s best interest to learn to remove the emotional blinders and identify emotions accurately, both the uncomfortable and the upbeat ones. After all, unpleasant emotions are normal and natural, a fundamental part of being human. Emotions fluctuate on a daily basis, often several times in a given day. If you didn’t experience negative feelings now and then, the positive ones wouldn’t be as noteworthy or joyful; your emotional life would likely be unnaturally narrow. You would also be deprived of the opportunity to glean important insights into yourself. Feelings, both the good and the bad, are silent messages, alerting you to pay attention to something in your personal or professional life, in your behavior, or in the world around you.

Instead of separating emotions into categories such as good or bad, positive or negative, happy or sad, it’s better to view all your emotions as useful information, as “evolutionarily evolved responses that are uniquely appropriate to specific situations,” says Karla McLaren, MEd, author of The Language of Emotions. “When you stop valencing, you’ll learn to empathically respond to what’s actually going on—and you’ll learn how to observe emotions without demonizing them or glorifying them.”

Being able to recognize and express what you’re feeling helps you better understand yourself (leading to greater self-knowledge); validate your emotions and tend to your own emotional needs; and take steps to address those feelings directly by communicating and responding to them effectively. Having emotional self-awareness can motivate you to make healthy changes in your life, take action to improve the world around you, and become more psychologically resilient—that is, better able to cope with crises and rebound from setbacks.

Learning to Unpack Your Emotions

For some people, engaging in free association can clear the cobwebs from their minds, almost like opening the cellar door to a musty basement and letting in light and fresh air. To do this, you might take a break and consider how you’re feeling about what you’re doing, reading, seeing, or thinking every few hours throughout the day. If a general word comes to mind—such as stressed, anxious, or angry—dig deeper and ask yourself what other emotions you might be feeling (maybe fear or annoyance) along with it. If you do this out loud in unedited, private moments, you might find yourself blurting out what you’re really thinking or feeling, revealing the emotions that are taking a lot of energy to keep inside. This is really about unpacking your suitcase of feelings, or untangling the knot of emotions that is taking up space inside you.

When you think about this in the abstract, it can be hard to pinpoint how you’re feeling. You may just see a swirling mass of a feeling quality such as “dread” or “foreboding” rather than recognizing the specific emotions you feel. To get to the root of your feelings, spend five minutes looking at the word cloud below—no more than five so that you don’t have time to filter your responses—and choose the emotions that resonate with your mood-state lately.

If reviewing these words evokes other feelings for you or if words or phrases that apply to you were not on this word cloud, jot these down in the blank word cloud that follows. Give yourself another five minutes to think about your recent state of mind and jot down phrases, images, or words that occur to you. This is your opportunity to personalize it without any limits or restrictions. If you feel stymied or draw a blank initially, think about your recent responses to current events or situations in your personal life or on the world stage. Try to be as honest as you can by focusing on how you’re really feeling when no one is watching—free-associate without judging, censoring, or revising what you write down.

Once you’ve finished your list, look at the order of the words you wrote down: Did they progress from all negative to increasingly hopeful? Do they portray an internal tension or friction in going back and forth between various feelings? If all the words are positive, consider the possibility that you may be in some degree of denial, focusing only on the window dressing rather than the emotions that lie beneath the surface. Also, consider this: Is there a pattern of shallow, visceral reactions that came out initially, followed by more complex thoughts and feelings? If so, think about whether you’re giving yourself enough time in your life to reflect. If you came out with highly intellectualized words or phrases first, it might suggest that you put on a bit of a facade when engaging with the world, and you might benefit from striving for a deeper engagement or familiarity with your emotions.

This is an excerpt from Emotional Inflammation: Discover Your Triggers and Reclaim Your Equilibrium During Anxious Times by Lise Van Susteren, MD, and Stacey Colino.

Buy your copy of Emotional Inflammation at your favorite bookseller!
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What Triggers Your Emotional Inflammation?

It’s time to start unraveling the mystery of you by exploring your current state of mind. Think of this as an adventure, a path toward greater self-understanding and self-compassion—and an expanded appreciation of the complexity of you. To get a sense of the modern-world issues that tend to rile or upset you, put on your imaginary miner’s hat and head into the depths of your mind to see what lies below your conscious awareness. (You may want to do this with a trusted friend or partner.) 

Consider your true feelings about the following subjects, without letting preconceived ideas about the right or politically correct way to think or feel about these subjects guide you; simply let your real feelings flow out of you in a free-association style. 

Have a journal and a piece of paper ready. As you read the following words and phrases, jot down the first three to five words or phrases that come to your mind in response (don’t edit or change what occurs to you instinctively):

  • • Climate crises 
  • • Me Too scandals 
  • • Human rights abuses (on a grand scale) 
  • • Political corruption 
  • • Racial, religious, gender, or political discrimination 
  • • Environmental threats (toxins in our midst) 
  • • Volatile financial circumstances 
  • • Natural disasters (wildfires, floods, storms) 
  • • International threats 
  • • Social divisiveness in this country
  • • Hate crimes 
  • • Nuclear weapons threats 
  • • Gun violence 

If other current events are triggering emotional inflammation for you, write them down in your journal or on a piece of paper.

Don’t worry if you feel put on the spot, thought-tied, and unable to come up with the right words to describe how you feel in response to the prompts listed above. Take a deep breath, exhale, and peruse this sample response. Rather than letting this person’s examples sway or influence you, try to use them as inspiration to unlock the floodgates on your true feelings. 

Now it’s your turn!

After you’ve completed your list, assign a value to each of these concerns in terms of their potency for you on a scale of 0 to 3 (with 0 being neutral and 3 being intense). Do this quickly so you don’t have too much time to think about it or second-guess your instinctive responses. Once you’ve finished this, place these triggers into a hierarchical list from a potency of 3 to 0, based on how they affect or resonate with you. This will give you a sense of what is likely to get you riled up these days.

If you want to dig a bit deeper, think about the way you responded to the descriptions of certain triggers—that you felt disgusted, violated, sad, and threatened when you thought about Me Too scandals, for example—then consider whether any situations from your past have evoked similar feelings for you. As you may see, emotional injuries or reverberations from the past can make you vulnerable to similar insults and assaults in the present. It’s almost as if you have an emotional ember lying beneath your consciousness, and it’s predisposed to flaring up from time to time. If you hear a single piece of distressing news and find yourself reacting surprisingly strongly to it, think about what else may be crashing around you or whether the news has somehow opened Pandora’s box and exposed you to a deep abyss of other fears and worries. Or it may be that a more superficial emotional injury is on the way to healing but then the scab gets ripped off and the wound bleeds again when another upsetting event occurs. 

As it happens, we often experience emotions in our bodies, and sometimes our bodies register those feelings before our minds do. So if you have trouble pinpointing how you’re feeling with words, you may want to scan your body for clues. When researchers in Finland performed a series of cross-cultural studies with 701 people from West European and East Asian cultures, they had the participants view various words, stories, movies, or facial expressions, then color specific regions on silhouettes of bodies where they felt activity increasing or decreasing while they viewed each stimulus. This exercise in mapping bodily sensations in response to emotions revealed that basic emotions—including anger, fear, disgust, happiness, sadness, and surprise—were associated with sensations of elevated activity in the upper chest, which likely reflects changes in breathing and heart rate. Increased sensations in the arms and torso were associated with anger. Decreased sensations in the arms and legs corresponded to sadness. And increased sensations in the gut (the digestive system) and throat were found primarily with disgust. The most fascinating revelation was that these effects rang true among people cross-culturally. 

So if you have a mental block that makes it difficult to recognize your emotional triggers (which some people do, in a subconscious effort to protect themselves from emotional discomfort), paying attention to your bodily sensations can give you clues about what you’re experiencing. Even if you are highly attuned to your emotional reactions, sometimes they can sneak up on you, and you might experience a particular bodily sensation before you are aware of the actual trigger or your response to it. That’s because we all have blind spots to reflexive emotional states we’re susceptible to experiencing. 

This is an excerpt from Emotional Inflammation: Discover Your Triggers and Reclaim Your Equilibrium During Anxious Times by Lise Van Susteren, MD, and Stacey Colino.

Buy your copy of Emotional Inflammation at your favorite bookseller!
Sounds True | Amazon | Barnes & Noble | Bookshop

A Doctor’s Simple Tips on How to Get Better Sleep

Thanks to groundbreaking research, we have recently learned that every cell has its own timekeeper that can be thought of as a local clock. Deep within the brain, in the hypothalamus, lies a master clock that regulates all the local clocks, making sure that each one is set to the same time. This complex, coordinated process is in sync with the alternating cycles of day and night and with all the degrees of changing light that occur in a 24-hour period as Earth rotates on its axis. Called the “circadian rhythm”—from the Latin words circa, which means “going around,” and diem, meaning “day”—this internal process regulates the human body’s sleep-wake cycle, among many other functions. 

The master clock (think of it as circadian rhythm central) sends hormonal and nerve signals throughout the body, synchronizing the cells’ clocks to the day-night, light-dark cycle of life. On a continuous basis, the master clock can determine what time it is based on messages from photoreceptor cells in the retina that register light conditions outside and report these to the brain via specialized pathways. 

Meanwhile, the cellular clocks keep local time, making sure that various activities locally are timed right and are appropriately coordinated with other cells and organs. This is why, for example, key enzymes are produced at certain times, blood pressure and body temperature are controlled, hormones are secreted, the gut microbiome is populated with the right balance of bacteria, and gut motility is appropriate for the hour. 

Living in harmony with the way we have evolved brings physiological and emotional balance, creating a good fit between our bodies and minds, between what we’re doing and how we’re designed to function. Honoring our body’s natural rhythms helps stabilize our mood, become more resistant to stress, feel less physical pain, and generally feel and function better physically and mentally. It’s an essential step in cooling and calming emotional inflammation. 

The following are some ways you can adjust your habits so that they support your body’s inherent rhythms: 

  • Put yourself on a sleep schedule. Establish a regular sleep-wake schedule so that you go to bed at approximately the same time each night and wake up at the same time each morning. It’s fine to vary your bedtime by an hour or two occasionally, but don’t sleep in more than an extra hour on the weekends (unless you’re sick); otherwise, you will end up disrupting your sleep pattern for the next night. 
  • Identify your slumber sweet spot. Most adults need seven to nine hours of sleep per night to feel and function at their best. Once you figure out how much you need, determine what time you need to get up in the morning and work backward to set an appropriate bedtime; or, you can identify what time of night you typically feel sleepy and then set a wake-up time accordingly. 
  • Brighten your mornings. When you get up in the morning, expose yourself to bright, natural light to stimulate alertness, enhance your mood, and help calibrate your circadian rhythms. Take a brisk walk outside or have breakfast in a sunny spot. If you struggle to reset your internal clock to the “awake” setting in the morning, consider buying a commercial light box that emits 10,000 lux, which mimics a bright, sunny day. Sitting in front of such a light box for 30 minutes in the morning, perhaps while you have breakfast or read the newspaper or newsfeeds, has been found to stimulate alertness and improve mood. Alternatively, you could opt for a desk-lamp-style light box for your desk at work. 
  • Adjust your indoor lighting. Fascinating research has found that office workers who are exposed to greater amounts of light in the morning fall asleep more quickly at night. They also have better sleep quality and better moods, including less depression and stress, than those who are exposed to low light in the morning. 
  • Darken your evenings. There is another good reason to make sure that your bedroom (or wherever you sleep) is dark: When people are exposed to light during the night, their total daily melatonin production is suppressed dramatically, by as much as 50 percent. In other words, that nighttime light exposure throws the body’s 24-hour hormone production schedule off-kilter. It’s also wise to install a dimmer switch on the overhead light in the bathroom—or use a dim night-light—so that bright vanity lights don’t stimulate your senses and alertness while you’re taking care of bathroom business before hitting the sack or if you get up during the night.

Ultimately, honoring your body’s natural rhythms requires taking back control of your nights and days. It’s about putting time on your side and making conscious choices about the way you want to live so that you can restore your internal equilibrium, physiologically and psychologically. 

Yes, changing your behavior requires giving up the patterns you chose, consciously or not, in the past, and making the switch does take some effort and resolve. But if you make it a priority to stop upsetting your body’s internal rhythms and start living in sync with your body’s inherent needs, the payoffs will be well worth the effort. Your mood is likely to end up on a more even keel, and your energy will increase. Your physical health will probably improve and your emotional equilibrium will, too. Think of it this way: By respecting your body’s rhythms and doing whatever you can to maintain their regularity, you’ll be resetting your internal emotional thermostat, which will improve the way you react to and deal with the stresses and strains that are unavoidable in our modern world.

This is an excerpt from Emotional Inflammation: Discover Your Triggers and Reclaim Your Equilibrium During Anxious Times by Lise Van Susteren, MD, and Stacey Colino.

A Music Playlist for Better Sleep

To help you achieve the best night of rest, we recommend falling asleep to this relaxing music playlist, Music for Better Sleep, available through Sounds True on Spotify.


Lise Van Susteren, MD, previously served as a clinical professor of psychiatry at Georgetown University. She is a go-to commentator about anxiety and trauma for television (including CNN, Good Morning America, NBC, VOA, and Fox News), radio (NPR, Minnesota Public Radio, and others), print media (including the Washington Post, the Wall Street Journal, Newsweek, the Huffington Post, and CQ Magazine), and online outlets (such as Live Science, U.S. News & World Report, Global Health NOW, and many others).

As a thought leader and activist, Dr. Van Susteren addresses issues related to trauma and emotional inflammation through her roles at the Earth Day Network and Physicians for Social Responsibility. She is considered an expert in the psychological effects of climate change.

Stacey Colino is an award-winning writer specializing in health and psychology. In addition to her work as a book collaborator, she is a regular contributor to U.S. News & World Report and AARP.org. Her work has appeared in the Washington Post Health section, Newsweek, Parade, Cosmopolitan, Real Simple, Health, Prevention, Woman’s Day, Harper’s Bazaar, Parents, and Good Housekeeping, among other magazines and newspapers.

Buy your copy of Emotional Inflammation at your favorite bookseller!

Sounds True | Amazon | Barnes & Noble | Bookshop

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