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Language of the Heart

Our hearts speak to us although we do not always recognize the language so we do the best we can to construct meaning with words. Not that words can’t and often do create confusion and misunderstanding but they are our most common method of communication. When it comes to “heart conditions” these words often carry emotional undertones:

A heart that is beating rapidly, at least so we notice, is a “racing heart.” Yet we seldom ask, where it is racing or from what?

A heart beating even more intensely becomes a “pounding heart”, like “my heart is pounding so fast I feel it could burst or jump out of my chest.” Perhaps we should ask pounding for whom or over what?

A heart that beats irregularly is a “heart that skips a beat.” Is this a heart in love or perhaps one in fear? Is “skipping” a warning sign or a measure of delight?

These are but a few examples as we listen to our own emotional and physical hearts but they do not exhaust the language. We use “heart words” to describe the behavior or motives of others as well.

He has a “good heart” often has no medical reference in our daily parlance. The same can be said for a “generous heart”, “full heart” or “wise heart.” Now it can be argued and research suggests that these attributes make for better overall health still we don’t usually use these descriptions for clinical reference.

On the other end of the continuum, without gender bias, we say that she has a “hard heart”, “unforgiving heart”, “heart of stone” or even “heartless” although we know that is physically impossible. In emotional conflagrations of a certain pitch we may become convinced we are dealing with a different species. Such individuals so described tend to have lives that are shorter and lonelier, which does not surprise many who have met their acquaintance.

The language of the heart extends further. Just as there are hearts identified politically as “bleeding hearts” we also know the “heart ache” of a lost love or the excitement of a “heart throb.” We know malice can be discovered by the “tell tale heart” and religious piety can found in the “Sacred Heart of Jesus.”

Then there are also hearts that reflect both physical and emotional reality. These afflictions of the heart include a “broken heart”, “weak heart” or “damaged heart”. When the heart gives out as we so often say it is a “heart attack.”

Now let me pause here to consider in more detail “heart attacks.” Why such a violent term? In the literal sense I am using we might ask is it an offensive or defensive attack?

Who is the enemy? On what grounds is this attack justified? What about the “silent heart attacks” that comprise one fifth of the total but the heart feels no pain? I wonder if the word “attack” is used because of the amount of explosive damage and even death that might result from severely blockaded arteries.

There is the physical pain which is often so intense but I also wonder if the aftermath isn’t equally intense but in different symptoms. Since 1 in 8 heart attack survivors develop significant mental health problems I think there may be more going on.

For survivors in their 40s’ and 50s’ but especially for those younger they can feel betrayed and cheated by their own hearts. They can fell attacked before they really got going with so many dreams unrealized and their sense of freedom so greatly altered. For those in their 60’s and older the attack might lead to experiences of depression as they consider their “golden years” will be spent in vigilance and on the defensive.


It is a sign of our times that the diagnosis of PTSD does not require the full clinical criteria to be understood. When we think of PTSD though we most often conjure up images of war, violence, abuse, kidnapping, shootings and so forth. It is in other words awful and coming from outside ourselves leaving us helpless and fearful. But there is a catch- not all episodes are done to us, they can happen inside us. One glaring example, largely overlooked is the hearts attacks we have been describing or more generally afflictions of the heart.

So what are some of the typical signs of PTSD regardless of the initial onset: angry outbursts, inhibitions like worry about expression of intimate feelings especially sexual,

panic episodes, excessive drinking or drug abuse including prescription medications, nightmares, fear of losing control, and withdrawal from life in general and loved ones in particular. With heart attacks this diagnosis becomes even trickier and include heart palpitations, pounding heart, sweating, trembling or shaking, sensations of shortness of breath or smothering, chest pain of discomfort and feeling dizzy or lightheaded. In other words these experiences mimic some of the initial signs of a heart attack. For this reason coordination between medical and psychological services are essential.


In addition to following the medical protocol for recovery talking out the fearful and confusing signs with others of similar experiences is helpful. Group therapy has been researched and demonstrates to be an effective and helpful tool for many. Being with people who “get it” because they have “had it” reduces the isolation and loneliness of carrying these burdens alone. Although not easy to do group therapy can make a huge difference in the quality of living and relief of symptoms.

Simple mindfulness exercises can also be extremely helpful in alleviating stress and anxiety.  One brief experience I use is called STOP. S=Stop whatever you are doing at the moment of anxiety. Consider it a three minute pause for refection. T=Take a breath. Actually take two or three deep breaths from your diaphragm. Feel your chest rise and fall making sure your exhalation is longer than inhalation. O=Observe your thoughts and feelings as they whirl by but without judgment or attachment. Just watch as these experiences ebb and flow. P=Proceed on with your activities with awareness and a modulated pace.

Richard Raubolt, Ph.D.