What Is Emotional Competence, and How Can It Help You Manage Chronic Illness?

Emotional competence involves feeling, expressing, and coping with emotions effectively. It can help reduce stress associated with managing chronic illness. Mindfulness can help you get there.

Making room for positive outcomes is an integral part of healing, but being real with yourself about what you’re going through is just as important.

This is especially true when it comes to chronic illness.

If that includes pain, anger, grief, and even resentment about getting sick in the first place, denying these feelings or glazing over them with positive thoughts is not a recipe for wellness.

However, there’s a middle ground between keeping your chin up and falling into despair. It’s known as emotional competence, a skill that can help you manage the emotions that come up while managing chronic illness — and life.

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What is emotional competence?

In his book, “When the Body Says No,” Gabor Maté, MD, stresses the importance of emotional competence, or constructively coping with emotions, as a way to combat stress.

Emotional competence involves:

• the capacity to feel your emotions
• becoming aware of when you’re experiencing stress
• the ability to express emotions effectively
• asserting needs and maintaining emotional boundaries
• distinguishing between psychological reactions that are based on the present vs. those that represent residue from the past

“Stress occurs in the absence of these criteria, and it leads to the disruption of homeostasis,” says Maté. “Chronic disruption results in ill health.”

When it comes to chronic illness, this can become a cycle if it isn’t interrupted.

“Persons with chronic illness may experience intense emotions related specifically to their chronic illness and disrupted ability to interact with the world,” says Bianca Busch, MD.

According to Headspace psychiatrist Virginia Dawson, MD, mindfulness is the first step to developing the emotional competence that can disrupt this cycle.

“Learning to mindfully observe our emotions allows us to have the power to choose how, when, and if we want to respond to them,” Dawson says.

The seven A’s of healing

Maté lays out a map for developing emotional competence that he calls “The Seven A’s of Healing.”

It involves several components of mindfulness practice, including:

• acceptance
• awareness
• (healthy expression of) anger
• autonomy
• attachment
• assertion
• affirmation

Acceptance

The first step to accepting difficult emotions is to notice that they exist in the first place. One way to do this is through mindfulness practice.

“Mindfulness, the practice of acknowledging one’s emotions, really is the antidote to repression,” says Busch. “If we can acknowledge the emotions that are repressed, then we can begin to process them. If we can process them, then they will have less of an unconscious impact on the way that we act and the way that we think.”

Dawson agrees.

“Mindfulness helps us alleviate the constant pressure of worrying about what’s ahead and learning to be present in each moment, accepting it for what it is,” she says.

After recognizing difficult feelings, the next step is to allow them to be there just as they are without trying to prevent or fix them.

“Learning to accept our circumstances doesn’t mean we are choosing to give up,” says Dawson. “We’re simply taking back control over how we would like to respond, which is so powerful.”

Awareness

Awareness is a natural offshoot of practicing mindfulness.

“Mindfulness can give us the potential to observe ourselves,” says Busch. “That is, to get out of our own bodies and minds and see ourselves within the bigger picture of life, community, and family systems.”

Awareness involves being nonjudgmentally aware of thoughts, emotions, bodily sensations, and how you respond to circumstances.

“Once we can learn to be aware of our thoughts and emotions, then we can choose how to act in ways that foster the kinds of thoughts and emotions that we intend for ourselves,” Dawson adds.

(Healthy expression of) anger

It may be surprising to hear, but anger has a place, too.

“Anger is a natural response. It’s not bad,” says Busch. “It’s harmful when that anger leads to destructive behaviors either toward yourself or toward the ones you love.”

Busch adds that anger is often a cover-up for other feelings that may be more difficult to face.

It’s “often a proxy for other emotions like disappointment, sadness, or frustration,” she says. “If one can take the time to explore that anger, there’s a lot that can be discovered about other feelings.”

Anger is a natural reaction, just like any other emotion. Dawson suggests being curious about anger when it comes up.

You can ask yourself:

• How does this anger feel in my body?
• Does this anger have a clear cause?
• Can this anger help me to better deal with this situation?
• Can I express this anger without causing harm?

Autonomy

The simplest way to understand autonomy is to recognize that you have a choice. You may not be able to choose your circumstances, symptoms, or feelings, but you can choose how you respond to them.

“Emotions are information,” says Dawson. “We can choose to use that information to guide our actions and … help us adapt to our experiences and environments.”

Exercising choice is an important step in developing healthy boundaries. By choosing your response rather than reacting, you get to decide who and what gets your attention and energy.

“Developing healthy boundaries really relies on you being aware of how you feel and how others make you feel,” says Busch. “With this knowledge, a person can make different choices about what they do, where they go, and who they are in company with.”

Attachment

Attachment has to do with how you connect to the world around you. This includes intimate relationships, your wider community, and whether you see yourself as worthy of love and affection.

Most people form attachment patterns early in childhood in their relationships with parents or caregivers.

“If parents can acknowledge their own big emotions and manage them, then they’re really able to model this behavior for their children, which can ultimately lead to more secure attachment,” says Busch.

This isn’t always possible and may result in difficulties with secure attachment as an adult. However, mindfulness can redirect the impulses of insecure attachment to more constructive behaviors.

Busch provides an example of a person who experiences anxious attachment, so they act out in anger if they fear their partner might leave them.

“If that person can shift to mindfulness in the moment, he/she may be able to see that the partner’s action isn’t a real threat,” says Busch. “That will decrease the likelihood of an angry response.”

Dawson notes the acceptance aspect of mindfulness can help you feel more secure in relationships.

“Mindfulness can help give us practice being more accepting of ourselves and our circumstances, and therefore can promote more security in our attachments and our relationships,” she says.

Assertion

Assertion is the sense that you have a right to exist as you are, to feel what you feel, and to act and express yourself in ways that are aligned with your sense of identity.

The opposite of assertion is the sense that you have to apologize for or justify yourself.

Mindfulness practice can help you become aware of your patterns around assertion. It can also be an opportunity to rewrite your inner script about how you see yourself.

Affirmation

If assertion is an inner sense that you have a right to exist, affirmation is its expression.

Maté refers to two types of affirmation:

• affirming your creative self
• affirming a connection to something bigger

These forms of affirmation relate to the need to express emotions (and anger) in healthy ways and to feel connected rather than isolated.

While creative affirmation comes from sharing your gifts with the world, the second type of connection comes from a sense of purpose.

To cultivate the latter, Busch suggests surrendering the things you can’t control to a higher power or the universe.

“The mental exercise of practicing this release can provide relief and help us to engage in the belief that there is something or someone who has a bigger purpose or intention for our lives,” she says.

Takeaway

Emotional competence may sound like a tall order, but the 7 A’s of healing break it down into simple components to help you get there.

By finding your inner voice, one that includes healthy anger, a sense of self, and a sense of purpose, you can engage with your emotions in a way that benefits yourself and others.