Perhaps this is one of the common greetings especially when we perceive that somebody is ill or in some kind of distress.  There is always a jokester that answers, “With my fingers, of course”.  But to return to the spirit of the question, it would take a long, long time to explain to a Martian what information is really sought by that question.  We would have to explain that by feelings we are really inquiring about the person’s emotional state.  We would have to explain that there are certain basic emotional states such as happy, sad, angry, guilty, hopeful, envious, etc., etc.  After watching Star  Trek’s Mr. Spock on television, one might conclude that Martians don’t even have emotions.  If we could convey the concept of emotion, the question then needs to be clarified to indicate we are inquiring about what the person’s emotional state is, not how they accomplished it or maintain it.

     As fuzzy as this question is, the spirit of the question impacts  on the interactions that follow.  You are going to act very differently to somebody depending on whether they tell you they are uncontrollably angry, feeling really sad, or really happy.  Your response of, “Hey, that’s great!”, is not going to work if they are feeling really sad because their dog just died.

     If the question, “How do you feel?” is considered by a mental health professional, it is really a different question than above.  Now the mental health professional is considering this from a chemical standpoint.  It’s known that adrenalin tends to be a mental activator making people excited.  It is known that serotonin is a chemical in the brain that tends to make people emotionally satisfied.  It is known that there are chemicals called endorphins and enkephalins in the brain that create sensations of euphoria and wonderfulness.  In order to help patients who are experiencing unpleasant emotional states, healthcare professionals try to manipulate these chemicals to improve the person’s sensation of well-being.  That is the reason we have medications to treat depression or anxiety or the occasional person who is maniac.  But the majority of our population rejects the idea of medicinal manipulation of their emotional state.  Most people believe that their emotional state is determined by external factors such as material wealth, the state of their health, their relationships with their loved ones or whether the Nebraska  Corn  Huskers won or lost.  Said another way, a person’s emotional state seems to depend upon whether their values, rules and expectations are being met.  When values are not being honored, rules are being violated, and expectations not met, people tend to have very negative emotional states.

    Multiple past columns have pointed out the critical medical importance of a person’s emotional state.  It has been pointed out that anger, hostility, and pessimism are associated with a shortened life span and that success is associated with less illness and a longer, happier life.  Thus from a medical standpoint, a person’s emotional state is more important than penicillin, digitalis, insulin or any other drug that you can think of.

     Now to get to the point of this column, it needs to be pointed out and understood that you create your own feelings and you are responsible for what you feel.  You do that based upon your values, your rules and your expectations.  It is not true that someone makes you angry, happy, sad, etc.  You create all of these emotions yourself  based upon your own values, rules and expectations.  Most generally, the world and everyone around you goes through life “doing their own thing”.  Sometimes someone may do something that they think you will like, with the hope that they can make you feel better. Then there are those few (perhaps many) who carefully do things that they know that you will not like.  But for the most part, people act in a manner for their own purposes not necessarily to create an emotional state in another person.  Whatever that emotional state might be, it is always the property of the person doing the feeling, not something owned or created by another individual outside that person.

    Every day I see patients in the clinic who are unhappy about one thing or another.  Very frequently, their negative emotional state is leading them to overeat, use alcoholic beverages excessively, smoke cigarettes, use illicit drugs, or yell and become angry at someone else.  These negative behaviors lead to serious adverse medical consequences.

     It is unusual that someone has the insight to recognize that their negative emotional state is created by their own values, rules, and expectations.  In order to change the negative emotional state, the person may have to change a rule, change a value or be more realistic in their expectation.  This sounds crazy but it is a requirement if the person is to improve their emotional state.

    “How do you feel?” is such an innocent question and yet so complex.  The rule to recognize is that you create your own emotional state and only you have the power to change it.