Emotions!

For the next few weeks, these blogs will be about ways for caregivers to interact with their loved one that make life easier—for both people.

Meet Geroge, a composite of many of our LBD friends. As you read, substitute your own loved one’s name for his. As George’s reasoning ability wanes, his dependence on emotions increases. He will be very sensitive to your emotions, while his own emotions, unfiltered by reason, drive his thoughts, decisions and actions.

But let's back up and talk about emotions in general.

• That part of the brain where emotions are controlled is also involved with music and rhythm, and smell. Therefore, these tend to be all mixed together. A tune or a smell easily evokes emotions.
• The more intense the emotion you have about an event, the more important it is to you and the longer you will remember it.
• Positive emotions encourage us to relax and stay put, to enjoy what we have. They are calming and comforting, but seldom intense.
• Negative emotions are more intense and draw our attention more quickly. It is a safety issue. The cave man needed to react with strong physical actions when seeing something fearful like a saber-toothed tiger. Today, we react the same way to psychological fears. Negative emotions encourage us to react, make changes, move away from the discomfort they cause.
• Experts in critiquing say that it takes about six positive comments to equal one negative comment.
• An event usually evokes an emotion, which is tested by your reasoning ability, often before you are even aware of its presence. You gather information from your surroundings and from your memory to decide whether to accept the feeling at all.
• You also test for intensity, and decide how afraid or happy are you about this event.

For example: you see a dog and feel an instant jolt of fear. You see that he is wagging his tail and you know from your own history that tail-wagging means "friendly." But you also have a piece of information in your brain that says that a dog might feel threatened if you try to pet it and so you don't. You have judged your initial fear to be far too intense, but not completely inaccurate.

Now add dementia.

George sees the dog, feels the fear and start screaming. He is not able to test to see if the fear is appropriate or not. This is true for any event, hallucination, dream, TV show, etc. that elicits an emotion. He can't test for reality.

George also can't test for how fearful the situation is. He’s either afraid or I'm not afraid.

• George is a mirror. He will pick up whatever emotions you project, and mirror my version of them back to you.
• However, George’s version will center around him. He takes everything personally. And so to him, if you are angry, you are angry at him. If you are sad, you are sad because of him. If you are happy, that's because of him too.
• George will react to negative emotions with increased LBD symptoms, increased acting out and less cognitive ability. And because they tend to start out more intense, he will react strongly.
• George will react to positive emotions with fewer LBD symptoms, less acting out and more awareness.

George’s emotions are raw, unfiltered by reason. His damaged brain will make up stories to account for those feelings and he’s stuck with this. He can't test the stories for reality. This is his truth, his reality. He can't change that.

He can't initiate change, and seldom sees a need to do so. Why would he want to deny his truth? You CAN change. Instead of trying to get him to accept your truth, your reality, start with an acceptance of where he is. Then you can model a change of behavior that he can mirror. He will always believe his truth, but you can help him to move to more a more peaceful, comforting emotional space.

Next week, will be about acceptance and how to use it for a better quality of life for both caregiver and loved one.

For information about Lewy body disorders, read our books:

A Caregivers’ Guide to Lewy Body Dementia

Managing Cognitive Issues in Parkinson's and Lewy Body Dementia

For wonderful information and videos about interacting with a person with dementia, go to teepasnow.com

Helen and James Whitworth are not doctors. As informed caregivers, they share the information here for educational purposes only. It should never be used instead of a physician's advice.