Module 6. Spreading curiosity

“Don’t just do something sit there!”

Yes you heard that correctly. Don’t just do something, sit there is a play on the common don’t just sit there do something phrase that we’ve probably all heard. Perhaps the don’t just do something sit there fits all of the stereotypes about psychiatrists. I heard a bunch of jokes in medical school about the different medical specialties. One of my favorites that I lovingly rib my dermatologist father-in-law with is: if it’s wet, dry it, if it’s dry, wet it. If you don’t want it, don’t touch it. The one-liner about psychiatry is that it’s the profession for “the lazy’s and the crazy’s.” Yes, the movies portray it pretty well: just sitting there doodling or daydreaming while your patient goes on and on about this or that could come across as pretty lazy. 

Don’t just do something sit there was definitely one of the best one liners that I learned in residency. Why? It speaks directly to the heart of the fix it habit loop. If my patient is suffering, and I jump to trying to fix them without really taking the time to figure out what is the right course of action, I’m doing them a disservice. Yet, it goes much deeper than that. The you don’t want it, don’t touch it saying might be a nod to the good old days when syphilis was all the rage and disposable gloves and penicillin weren’t at the ready. I’m not touching that! And today we know a whole lot more about contagion. We wash our hands between patients. We glove up against rashes. We mask up against airborne pathogens. We suit up when things get really crazy. But what about infections that can spread no matter how gloved, masked or suited up we are? Yes, I’m talking about social contagion, especially emotional contagion. 

Emotional contagion is the spread of affect or emotion from one person to another. Think about it. Someone smiles at you, and you feel happy. Someone posts outrage on Twitter, Facebook or Instagram, and suddenly you’re fired up, enraged as well, retweeting with a “This sucks!!!!!” or “These people are the spawn of Satan!” comment before you even realize your thumb has hit the button. Whether you are masked up or not, six feet won’t save you from someone sneezing on your brain via the internet. 

How is emotional contagion so infectious? Let’s start with some neuroscience. 

Emotions have a relatively short half-life compared to say glaciers. Ok maybe not the best example–given how we’re doing with climate change. Let me try that again. Emotions are relatively short compared to seasons of the year, or how long it will take to empty your email inbox. Yet, emotions don’t have to be long-lived to be spread. Think of emotional contagion as a mental sneeze: someone can sneeze fear or anxiety on your brain with as little as a look on their face, and you might catch it without even being aware of what is happening. 

Emotional contagion generally is spread through facial expression, tone of voice and other body language. We catch it by unconsciously mirroring these facial expressions, postures or vocalizations of that person, and by reflecting the other’s emotions. For example, if someone is smiling at you, you might instinctively smile back, and even start to feel the joy that comes with smiling. Emotional contagion links in with empathy, because it fosters emotional synchrony between individuals–your brain automatically puts you in their shoes or more accurately, puts you in their head or emotional mindstate via your face. By mimicking their emotions, you feel where they’re coming from. 

Even though emotional contagion generally relies on non-verbal communication, it is contagious enough that it can also be spread through other means. For example, social media is a perfect petri dish for rapid growth and spread. Outrage, surprise, kindness go viral for a reason. They are really contagious. Just think about how quickly fake news spreads on social media. As a relative comparator, a study in Science magazine showed that fake news stories are 70% more likely to be retweeted and spread 6x faster than real news. Yes, intensity is like rocket fuel. The more intense the emotion, the bigger the spark for that “post” or “retweet” button and the faster the message blasts off and is spread around the world.

Even though emotional contagion and empathy are linked, there is one important difference. With empathy, the observer is aware that this feeling is a result of perceiving emotion in the other. With emotional contagion, the emotion is captured but the observer lacks this awareness; when infected, the observer believes that this feeling is their own. Remember the over-empathizing habit loop? That’s right! Whereas empathy might be a helpful process, over-empathizing and totally getting lost in the story is more akin to an emotional virus infecting our healthy minds and turning things cancerous. Don’t worry, like HPV, there is a vaccine for it. We’ll get to this in a minute. 

First, there is one more thing to note about how emotional contagion can be toxic or even carcinogenic: in addition to catching someone’s “freak out” cold, we start unconsciously acting out whatever that emotion is –and spreading it. Veering into slightly less scientific territory here, emotional contagion is akin to zombification: you catch a mood from someone and then mindlessly spread it to others. According to some bad movies that I’ve watched, when you are bitten by a zombie, you quickly transform into one. How quickly? The closest case study I could find was from the game Minecraft. Apparently when in the overworld, piglins transform into zombies after 15 seconds. I think this is a conservative estimate for humans given what we see on social media. You read someone’s outraged social media post, and with little awareness of what happens next, thanks to your thumb and a handy retweet button, you spread that to other people. How fast does that happen? When your partner, friend or co-worker shakes you awake from your zombified re-posting or rant, trace it back. The onset of illness is pretty fast. And when it multiplies in your mind, you can get pretty sick, and spread it pretty quickly. 

Yeah, emotional contagion takes over our brains, provoking us to do all sorts of things. And it's not just humans. For example, dogs can smell the fear of someone in front of them, prompting them to feel fearful and threatened and react by attacking as a form of self-defense. Has this happened to you? Have you ever overreacted during a patient visit, or with a family member? Have you ever gone into an exam room calm and collected, and left feeling anxious, angry or incredulous –saying to yourself, “I can’t believe that just happened!”? Afterwards, you think to yourself, “That’s not me! I don’t know what possessed me to act that way!” Add emotional zombification or social contagion to your differential diagnosis. 

So how can you protect yourself when your patient, colleague, child, spouse or pet, calls, or texts or walks in the room and you see that “my head is about to explode” I’m so frustrated, angry, anxious or whatever emoji or look on their face? Ahh, psychiatrists are good for something, eh? Lean in. Listen closely. 

The research on emotional contagion is a bit thin when it comes to treatment. So here we’ll draw a bit from biology. We know that vaccines can help to minimize symptoms and prevent the spread of certain viruses. And we also know from biology that competition works very well. For example, if you keep your gut populated with the right microbiota, you can prevent yourself from getting c. diff or some other type of unhealthy bacterial overgrowth. Along the same lines, we also know from behavioral neuroscience that more rewarding behaviors will outcompete less rewarding behaviors. Bringing all of this together, we can see what grows best in the petri dish of the mind. 

Let’s do a thought experiment together. Imagine a patient walks in, sits down and starts spewing, not vomit, but anxiety. If you jump in and try to fix them, they might say they’ve already tried that, you don’t listen, or worse, look at you like you’re callous. Or, If you remember the ‘don’t just do something sit there’ koan, they’re sneezing anxiety right onto your brain, at close quarters, and you get anxious. 

Ok now the next part of the experiment. Take a deep breath or two and let go of any of that anxiety that you just caught. Now imagine if you could meet the anxious patient with curiosity. What might this look like? What does anxiety feel like? What does curiosity feel like? Which one feels better? Yes, curiosity outcompetes anxiety when it comes to which one is more rewarding. If you need some science here, my lab actually did this experiment. And yes, it wasn’t even a contest. In a study of several hundred people, they preferred curiosity; in a run-away victory, curiosity was the winner, much more rewarding, hands down.  

So now imagine meeting your patient’s, colleague’s or partner’s anxiety or whatever contagious emotion it is with curiosity instead of closing off to it or catching it. Yes, curiosity can be an effective mental vaccination, due to its ability to outcompete anxiety. As a bonus, when you have a high viral load of curiosity you are more likely to spread it to others. Curiosity is more rewarding and it too can be contagious! If you are aware, when your patient, co-worker, or partner sneezes anxiety, frustration, or anger on you, you can sneeze back with curiosity. Kindness and compassion work the same way. If your patient, co-worker, or partner sneezes judgment or criticism on you, you can zoom in on the fact that they are suffering, and watch yourself naturally  respond with compassion. If you judge yourself, kindness is the antidote. Hopefully you’ve already been playing with increasing your kindness titre, so that it is already outcompeting and replacing your self-judgment habit loops. 

With all of this in mind, you can probably see why I found the don’t just do something sit there so helpful. When my patients come in sneezing emotions, I can meet them with curiosity and kindness. These help prevent me from zombification (reacting with distance, fix-it or anxiety) and more importantly, help my patients calm down as they catch my curious interest and because I’m not habitually turning away from their pain, they feel listened to. Without the fear of contagion, we can connect.

Here’s a simple way to build your mental curiosity biota. Don’t worry, you’ve already got it. It may just be sitting latent in your brain. Now all you have to do is let it come out, and give it the right conditions so it can grow and multiply. Anxiety and anything that makes you feel closed down is a curiosity growth inhibitor. Curiosity is its own growth factor. Simply add a little curiosity to a situation, stir, and it starts growing on its own. 

So first, be on the look out for growth retardants or inhibitors. A simple diagnostic test is to listen to what these inhibitors sound like. That “oh no, this isn’t going well” voice in your head is the alarm bell, signaling that you are getting infected, or instinctually turning away as a self-protective mechanism. Now take the “oh” part of the oh no. What does it sound like when you’re curious? Ohh? Not the “oh, really?” of feigned or faked curiosity that really masks judgment or cynicism. I’m talking about that 100% pure grass fed curiosity that you had when you were outside exploring nature as a kid. Ohhh? That’s what I’m talking about. That open feeling that comes with the upward inflection of Ohhh?! 

If you’re not into Ohhing, try hmmming instead. What does it feel like in your body when you go hmmm, while asking yourself, “how do I know when I’m curious?” Hmmm. Good question. Might be worth exploring.

Here’s an example from a doctor from Kenya. “Spreading Curiosity reminded me of the time I was studying Psychiatry in the UK. I used to go around the place with a smile on my face. It is a miserably cold country during winter and one doctor asked me what I was smiling about. I read the anxiety and annoyance on his face. I did not catch his negativity or let it change my kind predisposition, so I continued with the habit of spreading the cheer around and was liked by many patients and colleagues. This confirms what the module taught me, that curiosity is also a contagion but is more rewarding than negativity which can be toxic.”

So play with this today. Keep an eye out for emotional contagion. It’s everywhere. The workplace. Home. Social media. Really. It is everywhere. Washing your hands or masking up won’t help with this public health crisis. Awareness can help, so give it a try. Notice when you’re being bitten by a bad bug. The kind of social contagion that zombifies you into spreading negativity, stress, outrage, disconnection and other social pollutants. Notice the tone, then see if you can clear the air with a deep breath and an Ohh?! Can hmmming and recognizing what your body is feeling with noting practice foster a growth mindset? Could Oh? help you by not only protecting you from cynicism, but building connection through compassion? Could curiosity even spread kindness? Hmmm, are you cynical that this actually works? If so, make note of which one feels better: spreading cynicism or curiousity. 

If each of the thoughts we breathe in and out colors the thoughtstream and the air we share with others, which are refreshing? Which ones taste terrible and spread ugliness in the world? Which ones freshen up the air instead of stinking up the world? This reflection provides a helpful growth medium so your brain supports the replication of curiosity and kindness. For a cleaner and clearer, better world for all of us. If you want to make hmmming a habit, think of it like washing your hands every time you enter an exam room. While you clean your hands, disinfect your mind by getting curious about your own mental state in that moment, hmmming at the same time. Make sure both your hands and your brain aren’t carrying anything into your next encounter. Onward! See you in the next module.

References:

Vosoughi, Soroush, Deb Roy, and Sinan Aral. "The spread of true and false news online." Science 359.6380 (2018): 1146-1151. https://www.science.org/doi/10.1126/science.aap9559

Hatfield, E., Cacioppo, J. T., & Rapson, R. L. (1993). Emotional Contagion. In Psychological Science (Vol. 2, Issue 3).https://journals.sagepub.com/doi/abs/10.1111/1467-8721.ep10770953