White Coat Syndrome

Dec 8, 2022

150mm over 90mm. This was the blood pressure measurement taken by the nurse at my recent physical exam. I explained that my readings at home were much more normal (i.e., 120mm/75mm).  The medical community calls this scenario “white coat” syndrome.

For years I have brushed this occurrence aside rationalizing that being in this setting creates stress I have no control over.

Most of my blood pressure readings at home are taken during times of low stress (mornings following a short meditation or after yoga).  I clearly have been deluding myself into believing my stress levels and emotions are well managed. Most of my day does not encompass being mindful and relaxed.

We do not often contemplate what stress can do to our bodies.

Stress creates an environment of “fight or flight” producing excess and ongoing cortisol in our bodies which, over time, can have harmful effects including heart disease, cancer, and other unwanted results.

What if simple tweaks to our emotions could give us an edge and reframing a situation in our minds could change how our brain processes an event (especially a stressful one)?

Knowing our stressors is a good start.  One way to increase self-awareness is to write about a positive experience in advance of a stressful or irritable event.

In a study at Yale Center for Emotional Intelligence, teachers were split into 2 groups with one group asked to write about a positive experience and the other group on something negative.  Afterward, both groups graded papers and the teachers primed to feel positive scored students’ work 2 points higher.  When the researchers asked if they thought their emotions impacted their decision making, 85% said “no”.

This shows that not only are emotions affecting us, but they are doing so without our own understanding and realization.

Therefore, recognizing your emotional state whether it is anger, stress or worry is key to reducing the occurrence of “fight or flight” mode.  When you say to yourself, “I am angry”, you access the rational part of the brain versus the limbic system (which releases the harmful cortisol).

Naming an emotion helps you tame it.

The second step is deciding what do next with your named emotion.

Following are some options:

· Coach yourself through it.  For example: “I know that being at the doctor’s office does stress me but it has nothing to do with my actual health”

· Talk to a friend.  Being heard and validated helps sort your thoughts to see your emotion and situation in a more positive manner

· Oftentimes are emotions are caused by our interaction with others.  This means we need to be able to notice others’ emotions in addition to our own.  The easiest way to do this is by looking at their facial expressions.  Tuning in to someone else emotions will ALWAYS make you more empathetic.  Compassion is another great way to avoid using our limbic system.

When our emotions are tied to interactions with others, as they most often are, the key is to be aware of our own emotions, the other person's emotions, and behaving in a way that takes BOTH into account.

I was recently speaking with a neighbor about a political matter and realized the conversation had quickly become heated.  I quickly changed the topic to something more neutral.

This is called a responsive strategy.

Another strategy for taking both parties emotions into account is called reappraisal.

I know that my wife is, at times, subject to my forgetfulness.  Rather than get upset she recognizes that it’s a sign that I am stressed overwhelmed or tired. By cutting me some slack she is reappraising or putting a different spin on my behavior.  This also helps to better understand and acknowledge your own shortcomings.

Self-awareness takes practice.  Recognizing and describing your emotional state will give you an edge in your mental and physical health.


People who are extremely confident of their emotional abilities are the most likely to be profoundly wrong.  John Mayer, University of New Hampshire
Your beliefs become your thoughts,
Your thoughts become your words,
Your words become your actions,
Your actions become your habits,
Your habits become your values,
Your values become your destiny.  Ghandi

Karl Choltus

Deep thinking Canadian sharing thoughts created in the shower.