Many of us have felt angry at some point. Some of us are comfortable with the feeling, while others dislike it. Although anger is a valid emotion on its own, anger is sometimes referred to as a secondary emotion. 

So, what do we mean when we say anger is a secondary emotion? Anger can sometimes be the mask that hides our true underlying emotions. Often times, anger is viewed as a less "vulnerable" emotion and thus helps hide other emotions that one may consider make us "vulnerable".  Some of these "vulnerable" emotions can include hurt, disappointment, guilt, shame, sadness, anxiety, rejected, embarrassed, and scared (just to name a few).  

So why is it important to recognize when anger is a secondary emotion? Having this awareness allows us to process the actual emotion (or primary emotion) and helps us better understand ourselves. If we can understand ourselves and our experiences, we are able to communicate better with others (i.e. family, friends, partner, co-workers, etc.). After all, we cannot communicate something we do not know.

For many healthcare students, exams are one of the major sources of stress. Although some level of nervousness can help motivate one to perform well, too much stress can interfere with students' ability to prepare for and perform on exams.

Test anxiety can often consist of cognitive and physical reactions:

  • Cognitive: Excessive worry and thinking about failure; will often prevent students from preparing for exams and/or overthinking their answer choices
  • Physical reactions: heart pounding, sweaty palms, restlessness, increased heart rate

So how can we help reduce test anxiety?

Before the exam:

  • Develop a study schedule to review material: Creating a routine/schedule will encourage consistency.
  • Review exam material daily opposed to cramming before the exam.
  • Make studying a priority
  • Set specific study goals
  • Change your scenery (if needed) when studying: If you are beginning to feel unfocused or unmotivated, studying somewhere new can improve information retention
  • Take care of your mind and body: Make sure you are eating, sleeping, exercising, and engaging in self-care.

On test day:

  • Make sure you get enough sleep: Research on sleep recommends between 7-9 hours of sleep. Lack of sleep is actually associated with a reduction in concentration, focus, and memory.
  • Avoid caffeine: Although it may be tempting to consume caffeine before an exam, caffeine can actually increase anxiety.
  • Relaxation skills: If you begin to feel anxious during the exam, you may engage in the following
    • Deep breathing: It helps with lowering your heart rate and blood pressure. Sit back in a comfortable position and breathe in slowly through your nose for 4 seconds. Hold your breathe for 4 seconds, and exhale through your mouth for 4 seconds. Repeat the cycle as many times as needed.
    • Use positive self-talk: Can lead to positive feelings about testing and can improve test performance. Some examples are "I am going to do my best", "I can get through this", "Even though I am anxious, I can still do well", and "I am well-prepared for this test". 
    • 5-4-3-2-1 Technique: Focusing on the senses during moments of high anxiety can help ground us. In order to engage in this technique, you will use your 5 senses (Yes OT's, I know there are actually more than 5
      • 5 things you can see: Describe the objects you are seeing (color, texture)
      • 4 things you can touch: Describe how the objects feel; can be your clothes, pens, chair, scratch paper, etc.
      • 3 things you can hear
      • 2 things you can smell
      • 1 thing you can taste

For more resources on testing anxiety, please take a look at the following resource:

Attachment theory was developed by John Bowlby in the 20th century. It is a psychological theory that explains how individuals form and maintain relationships. The research on attachment was first conducted between children and their caregivers.

According to attachment theory, “children develop internal working models of attachment based on the quality of their early relationships with caregivers”, (Moore, 2023). These models of attachment that children develop will later affect their relationships in adulthood with others and will determine how they approach intimacy, trust, and emotional regulation.  The quality of their attachment is determined based on their caregivers’ responsiveness and sensitivity to their needs. Ideally, caregivers will provide a secure base from which a child can explore the world as long as they attend to the child’s needs. If they do not, the child can develop either an anxious, avoidant, or disorganized attachment style.

Although individuals may develop an anxious, avoidant, or disorganized attachment style, a new attachment style can be developed through having positive experiences in relationships and therapy.

For more information, please take a look at the following: