The term emotional intelligence, coined 15 years ago (+1), suggests that emotional skills be considered as important as cognitive skills—though they are qualitatively dissimilar and perhaps require different pedagogical approaches. Mayer, Salovey, and Caruso described emotional intelligence as the ability to perceive and identify emotions, cognitively process emotions and use emotions to improve cognitive processes, and manage one’s and others’ emotions (+2). In the 1990s, Daniel Goleman’s bestseller (+3), Emotional Intelligence: Why It Can Matter More Than IQ, popularized the term, which the zeitgeist seemed to readily embrace. At least in part, this was due to fascinating advances in affective neuroscience that probed the neurobiological basis for everyday emotions. For instance, studies of various brain structures have shed light on different affective states: the amygdala on conditioned fear, the accumbens on craving for substances of abuse, and cortical-striatal-thalamic circuits on obsessive thoughts. Brain imaging technologies have allowed one to see activation of specific brain areas while a subject experiences sadness and happiness. What was science fiction only a few years ago has come true.

While neuroscience has added sophistication and its imprimatur to the study of emotions, much of the emotional intelligence literature has spring-boarded off studies in the business world. Some claim that, since the 1980s, success as a chief executive officer correlates more with emotional intelligence than traditional IQ (+3). Studies in industrial psychology suggest that emotional intelligence has become essential for business leaders. The top-down, hierarchical structure of 20th century corporations has become obsolete, because it cannot keep pace with business now accelerated by information technologies and globalization. Contemporary executives must be able to shift business strategies much faster; getting their behemoth workforces to follow along requires interpersonal skills and emotional intelligence. Many large corporations have now invested in training designed to increase the emotional intelligence of their executives (+4).

How is the literature on emotional intelligence relevant to psychiatric training? Certainly, much of a psychiatrist’s work deals with emotional problems. And, while cognitively fascinating, the day-to-day practice of psychiatry is often emotionally challenging. Psychiatrists must explore their patients’ emotional landscape, encouraging them to experience tears, confront fears, and verbalize anger. During this work, the psychiatrist also needs to manage his or her emotions and countertransference. While residencies have been teaching emotional skills to generations of psychiatrists, the authors are unaware of a substantive research literature concerning the method for teaching and assessing these skills. Many studies have attempted to measure and improve interpersonal skills and communication in trainees, but few have utilized tools designed to study the wider concept of emotional intelligence (+5, +6).

One major limitation of the emotional intelligence concept is that it is broad and hard to operationalize. It runs the risk of being one of those faddish terms that no one can quite define. Business researchers have divided emotional skills into two categories: those pertaining to oneself and those pertaining to others (+3). These skills may be defined as awareness of emotions and regulation of the same. Thus emotional intelligence involves both the awareness and regulation of one’s emotions and the awareness and regulation of others’ emotions. Most psychiatrists will be comfortable with this dual approach, especially since a principle of psychotherapy is that knowledge of oneself is essential to knowing one’s patient. In business research, skills relevant to the self have been categorized into self-awareness (emotional awareness, accurate self-assessment, self-confidence) and self-management (self-control, transparency, adaptability, achievement, initiative, optimism). Skills with reference to others have been described as social awareness (sympathy, organizational awareness, service) and relationship management (inspiration, influence, developing others, change catalyst, conflict management, teamwork and collaboration) (+3).

For the sake of discussion, in what follows, the authors focus on just one example of an emotional skill (reading emotions in others) and consider how innovative research might be devised. Some of what is described may seem farfetched, but it is simply meant to stimulate thought. Let us first take a reductionistic approach to reading emotions in others. Residents evaluate the affect of a patient in the mental status exam, but this is not really standardized and is generally limited to the detection of pathological states. Scientists have, in fact, studied the reading of emotions. Ekman and Davidson (+7) pioneered a now well appreciated literature on the reading of human emotions from facial expressions. The basic emotions, which, according to Ekman and Davidson, include sadness, happiness, anger, fear, contempt, and disgust, are each uniquely expressed by the many facial muscles. Fleeting contractions of facial muscles, lasting only a fraction of a second, often reveal emotions. These contractions are short enough to be missed by most of us, but long enough to give away an emotion, conscious or unconscious, to the trained eye. In one study (+8), Ekman and O’Sulivan videotaped people telling a lie or the truth and then asked psychiatrists, law enforcement personnel, judges, college students, and working adults to watch the tapes and detect the liars based on behavioral clues, like facial expressions. The only evaluators who scored better than chance were U.S. Secret Service agents, not psychiatrists. Ekman and O’Sulivan produced a compact disk in which the learner is shown multiple facial expressions briefly. After each one, the learner indicates which emotion was displayed and then receives the "correct" answer. This training is readily available and could be used in psychiatric education research. If one could improve the response accuracy of residents on the Ekman and O’Sulivan task, then one would have to determine if this translated into better patient care. In other words, improvement on the Ekman and O’Sulivan task would have to be correlated with detection of emotions in real patients in clinical settings.

For now, the authors need to be sure that psychiatry residents practice and learn to read the emotions of patients in real-life situations. Some have suggested that the most direct way to do this is with real-time supervision (+9), which necessitates that a teacher be in the room with the resident and patient throughout an evaluation. The teacher may observe subtle facial expressions, other nonverbal behavior, verbal intonation and prosody, and additional clues of affect with greater veracity than videotapes provide. Perhaps more importantly, where the resident misses affect, the teacher may try his or her hand at an intervention to reveal and confirm the patient’s emotions, in the moment. Thus the resident may observe the nuances of timing and phrasing of such detective work and its outcome. Whether teaching might be more useful or effectively provided during or after a patient visit is an empirical question.

Furthermore, as with the teaching of music, language may be an insufficient medium for teaching the reading of emotions. For example, music may be taught with language, by teaching how to read music and play notes. Eventually, however, the student needs to emotionally experience the music in order to more adequately interpret the intention of the composer. How are learners taught to emotionally experience or feel the music, and to play it from the heart? Perhaps learners cannot be directly informed about how to do this alone. Similarly, the teaching of reading of emotions may require more than direct instruction and include role playing, modeling, and correction. An even greater case for utilizing additional methods for teaching could be made should it be proven that emotional skills are learned implicitly, as opposed to explicitly. In any case, the educational outcomes of the presence or absence of different models for teaching should be empirically evaluated.

The teaching of emotional skills may require an environment that values and exemplifies these skills. One would imagine that playing music from the heart is easier in an atmosphere which fosters artistic freedom. In analogy, psychiatry departments which are run in an emotionally intelligent manner may better promote the teaching of emotional skills. Organizations and groups, like individuals, might be rated on their emotional intelligence (+3). Emotional Intelligence should be apparent from the top-down, starting with the department’s vision and mission. One example from the leadership of academic health centers and health care organizations concerns identifying, managing and preventing dysfunction. The tools required of leaders of these organizations include careful reflection, diagnosis of the cognitive, behavioral and ethical dimensions of the problems at hand, and the development of a transparent and rigorously argued set of responses (+10, +11).

The term emotional intelligence is just that, a term, and not much more. Yet putting labels on things, like helping one’s patients name emotions, can facilitate exploration and research. The concept of emotional intelligence is nothing new to psychiatrists, but the suggestion to label it as a subject worthy of scholarly research is the humble objective of this editorial.