In healthcare, we often find ourselves supporting emotionally distressed patients, families, or colleagues through intense and overwhelming experiences. It’s not uncommon for people to appear distressed, overwhelmed, fearful, or panicked. In these moments, their ability to process information, evaluate options, and make sound decisions is often significantly impaired.
When emotions run high—whether it’s anxiety, defensiveness, frustration, anger, or defiance, people shift into what’s known as the survival zone. They’re trying to regain control of a situation where they feel powerless. That can show up as “lashing out,” shutting down, or withdrawing completely.
But this response isn’t just emotional—it’s biological.
When someone becomes emotionally overwhelmed or “flooded,” the body activates the fight, flight, or freeze response. Cortisol levels spike, and the brain shifts from the frontal cortex—the area responsible for reasoning and creative thinking—to the amygdala, which drives instinctive survival responses. Psychologist Daniel Goleman refers to this state as an amygdala hijack. In this state, people literally can’t think clearly. They struggle to listen, process, or make reasoned choices.
In these moments, our role is not to correct, advise, or provide more information because they won’t hear it.
Instead, our job is to create a Thinking Environment.
This is where the RAGE model can help.
Supporting emotionally distressed patients, their relatives and colleagues using this simple strategy can help you feel in control and help create a thinking environment:
Recognise the emotion (Internally, you name the emotion you are observing)
Acknowledge it openly (“I can see you’re angry”)
Gather information and active listen
Empathy/Emotions – stay present, observe emotional shifts
A senior nurse shared how, during visiting hours, a patient’s daughter became visibly angry and raised her voice, upset about a change in her father’s medication. Instead of defending the clinical decision or correcting her, the nurse paused, softened her tone, and said, “I can see how upsetting this must feel. You weren’t expecting this change.”
As the daughter began to cry, the nurse simply sat beside her and listened. Over the next few minutes, her tone shifted, and she was able to ask questions calmly. Only then did the nurse explain the reasons behind the medication adjustment. This time, the daughter was able to take it in.
By staying calm, using a gentle tone, and (if appropriate and safe) sitting with someone, you help co-regulate their emotional state. As emotions settle, the brain begins shifting back toward rational, creative thinking. It’s in this space that people can begin to listen, reflect, and act.
Whether you’re delivering difficult news, supporting a colleague, or guiding someone through change, holding space for thinking rather than reacting is one of the most powerful tools we have. It builds trust, reduces emotional reactivity, and leads to more compassionate, effective care. When used effectively, it can save you a lot of time and personal frustration.
