Emotional hijacking

By Kali Cyrus, MD, MPH, Johns Hopkins Medicine

I’d just sat down with my microwaved lunch at work when “Code Strong”  blared overhead, alerting staff to a potentially violent situation. Ugh. I took two giant bites—immediately burning my tongue—and ran down to the Emergency Department.

When I arrived, the room felt static. Staff seemed to be standing around while the patient yelled expletives and threatened to harm staff members. A few yards away, an empty urinal sat near a staff member’s feet, surrounded by the pool of urine it had contained moments earlier.

I took a breath and calmly said to the patient, “You catch more bees with honey. If you can lower your tone and speak respectfully, I’ll try to get you what you need.” It worked.

Walking back upstairs, my stress revealed itself through a cascade of negative emotions. I was annoyed that my food was cold again. I felt resentment toward the ED staff, regret over taking this job, and incompetence knowing my delayed note-writing would keep me here a couple of hours past my shift.

In that moment, I let those unmanaged emotions dictate my behavior: I decided I was done. I wasn’t writing any notes—not even the critical discharge report for a patient who had stayed 90 days and needed coverage authorized for his new facility.

My decision didn’t cause a life-threatening crisis, but it did delay patient care, burden my colleagues, and created a feeling of guilt that lowered my stress tolerance even further.

Looking back, here are five healthy ways I could have managed my emotional response before making that choice:

1. Acknowledge the emotional hijacking.

Recognize that raw feelings—not logic—were driving my impulse to avoid and procrastinate.

2. Change the scene.

Step away to clear my head—go outside, visit the cafeteria, or escape to that secret nook with the best view.

3. Phone zone (with caution).

Text a friend, vent to a colleague, or scroll through mindless, funny animal videos.

4. Practice mindfulness (the hardest one for me).

Close my eyes at my desk for 10 minutes, do a simple five-senses grounding exercise outside, listen to music, or take a reading break.

5. Interrogate the feelings.

Ask myself why I was directing so much anger at the ED staff and why I was jumping to extreme thoughts.

When stress peaks, we often react in the exact way we wish we hadn’t. As a psychiatrist, I see this frequently—stress hijacks the brain, making it feel nearly impossible to regulate emotions and choose the least harmful response. My immediate stress morphed into a narrative that everything was failing, which led to me giving up.

In my practice, much of my work addresses this cycle—stress triggers emotions and unexamined emotions drive undesirable behaviors. How you examine your emotions depends on how your brain works. My go-to strategy is to have a conversation out loud with myself. Technically, the conversation is between my rational front brain and temperamental emotional brain. I’ll say, “Emotional brain, why are you upset?” Then I’ll list all the triggers and why they make me worried. Then, the rational brain addresses each item on the list by validating the emotion and explaining why everything is going to be ok. I know it’s cheesy, but it works.

We can’t stop stress from happening or the feelings that it can cause. But we can learn to recognize and process those emotions in healthy ways.

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.