Author: Lisa Feldman Barrett
This book is a powerful critique of the conventional views of emotions as inherent attributes which are readily recognisable when we see them, and which people everywhere interpret in the same way. Despite their ‘distinguished intellectual pedigree’, the author takes apart these core pillars of the scientific consensus on emotions, asserting that they are conclusions based on faulty studies and erroneous interpretations (page xii). The book demonstrates how detrimental these inaccurate but established scientific principles of emotions have been in many areas of human life. Building on ‘abundant scientific evidence‘, and scathingly dismissing many previously acclaimed studies, the book makes the case that emotions are not innate, but constructed, and they are not readily obvious in facial or bodily movements. Urging people to ‘give up the fiction that we know how other people feel‘, the author made many practical and life-changing recommendations which are relevant to individuals, groups, and society at large (page 195-197).
Perhaps the most important dogma the book sets out to overturn is the fallacy that emotions are readily discerned from facial or bodily expressions. The author attributed this traditional view, that emotions are distinct and readily distinguishable, to the studies done in the 1960’s by the psychologists Silvin Tomkins, Carroll Izard and Paul Ekman (pages 5-7). Categorically declaring that no emotion has a ‘consistent, physical fingerprint‘, she maintained that different facial and body movements can be used to express the same emotion, and, conversely, one emotion may be expressed in different ways (page xii, 9,11 and 13). As an example of how little physical features correlate with specific emotions, the author pointed out that happiness can manifest variously as smiling, sobbing, screaming, and even being ‘stunned motionless‘ (pages 92-93). This, the book argues, explains why many people are unable to distinguish between closely related emotions, for example between anxiety and depression, and between sadness, anger and fear (page 2). In the author’s view, it is the context, and not the facial or bodily expressions, which determine what emotions people are truly feeling at a time, and she demonstrated this point with many illuminating photographs, such as those of actor Martin Landau, and tennis player Serena Williams (pages 9, 10 and 42).
Another fundamentally flawed concept of emotions the book strongly repudiated is the idea that some emotions are universal and applicable to all cultures. On the contrary, she contended that people apply their own culture-based emotion concepts to interpret other peoples’ emotions, and they are unable to recognise an emotion for which they have no such emotion concept (page 141 and 50-51). To illustrate this, she referred to Eskimos who do not have a concept for anger, and to Tahitians who have no sense of sadness (page 148). Even more striking is her own discovery that the Himba people of Namibia do not categorise facial movements as emotions, but as behaviours (pages 48-50). The observation that emotions are not universal features naturally leads on to the author’s related assertion that emotions are not innate or built-in. She rather argues that, just like other mental activities, emotions are brain simulations which are assembled from sensory inputs and past experience, and which the brain uses to attribute meaning to bodily sensations (pages 24 and 27-31). The author added that the reason emotions seem to us to be triggered, and not constructed, is because the brain creates the simulations very quickly by predicting the sensory inputs even before they reach it (page 121).
To promote her theory of constructed emotions, the author had to invalidate many established neuroscience paradigms; prominent amongst these is the idea that there are ‘anatomical seats‘ in the brain for different emotions. A characteristic example of this which the book dispelled is the notion that the amygdala contains the ‘circuit of fear‘, and in doing this she referred to several relevant neurological disorders such as Kluver-Bucy syndrome and Urbach-Weithe disease (pages 17-22). Another concept the book witheringly dismissed is that of the triune brain, the idea that a rational neocortex sits atop an emotional limbic system which is unreliable, and an ancient reptilian survival circuit. Describing this as an ‘illusory arrangement‘, and as ‘one of the most successful misconceptions in human biology’, she counters this view by demonstrating the significant role emotions play in helping people make sense of their physical world (pages 81-83). The author extended her paradigm-busting campaign to the whole notion of cerebral localisation, particularly denouncing the dearly-held neuroscience concept, pioneered by Paul Broca, that the brain has specific language centres (pages 166-169).
The book explored the widespread societal ramifications of the concept of emotions as constructed, and not in-built. In healthcare for example, the author demonstrated how the recognition that emotional expressions are context-dependent can potentially reduce the risk of significant misdiagnosis, especially in women whose symptoms are frequently misattributed to anxiety (page xiv). In the legal system, the author showed how adopting the right concept of emotions may reduce egregious instances of miscarriages of justice which result when jurors and judges inappropriately condemn defendants whose facial expressions do not appear to reflect appropriate intent or sufficient remorse (pages 164 and 235). The author went on to outline five recommendations to reform the legal system in line with the right concept of emotions; these include reevaluating the whole idea of trial by jury, applying neuroscience to court proceedings, and basing judgments on degree of intentional harm rather than the emotion that was involved (pages 220-227, 246-253 and 229-231).
It is at the individual level however that the right concept of emotions has its greatest potential for change. In this regard, the book showed that the correct view of emotions as constructed will enable people to be better at controlling the influence emotions have on their actions and decisions (pages 75, 80 and 152-155). It argued that viewing emotions as modifiable rather than innate also empowers people to develop or enhance such positive qualities as resilience, and to improve their interpersonal relationships (page 175). The author advocated several strategies people can use to improve their emotional intelligence, and these include improving their emotional granularity, converting their negative feelings to positive ones, cultivating and keeping track of their positive experiences, and avoiding rumination (pages 179-183). She also urged people to regularly calibrate their emotions to reduce the risk of some disorders which she argues are internally constructed rather than imposed by events outside the body; these include chronic pain, anxiety, depression, stress, and, perhaps controversially, obesity and drug dependence (pages 202-206 and 217-218).
This book totally overturns the classical view of emotions as universally recognised traits. The author’s theory of constructed emotions is supported by what appears to be credible research. The concepts are not always easy to grasp but the author, by her repetitive style and by starting from basic principles, succeeds in simplifying what is a complicated topic. She makes her arguments in a rather combative style, but this perhaps serves to illustrate the importance she attaches to the subject. Her exploration of the mind in the last chapter felt long-winded and repetitive, and it added little to the theme of emotions. The argument the book makes, that a correct understanding of emotions will improve society generally, and health specifically, is however very well-made.
Emotions play a significant role in all human interactions, and this is particularly relevant in healthcare where they define or distort the manifestations of diseases, with significant effects on health outcomes. The effect of emotions on healthcare management is also profound, impacting diverse activities ranging from decision-making to the functioning of health teams. The book highlights the pitfalls of misinterpreting emotional expressions by healthcare workers, especially pointing out the consequence in terms of clinical errors. It also illustrates how recognising emotions as constructions which can be controlled, and not reactions that are inevitable, gives doctors a powerful tool in the care of their patients. The lessons of the book are invaluable, and I recommend it to all doctors.
Publisher, Place, Year: Pan Books , London, 2017
Number of chapters: 13
Number of pages: 425
Star rating: 5