Avoiding emotional contagion: staying regulated with GEMS states

Step 1: Pause and take three slow, deep breaths before you respond. When you notice your own tension rising—clenched jaw, shallow breathing, racing thoughts—stop. Place your hand on your chest or belly and breathe in for four counts, hold for four, exhale for six. This activates your parasympathetic nervous system and gives you a moment to choose your response instead of reacting automatically.

Step 2: Ask yourself the 'Where is this coming from?' question. In that pause, silently ask: 'Is this agitation coming from my loved one’s disease, or is it about me? Could they be in pain, hungry, thirsty, or overstimulated? Is this a reaction to a change in routine or a noisy environment?' This mental shift moves you from feeling attacked to being a detective, which reduces your emotional charge.

Step 3: Use a calm, low, slow voice. Speak in a tone that is slightly lower and slower than your normal speaking voice. Avoid high-pitched or rushed speech. Say something like, 'I can see you are upset. Let’s take a moment together.' Your voice becomes a cue for their nervous system to down-regulate.

Step 4: Match their emotional energy at first, then gradually lower it. If they are very agitated, do not try to immediately force calm. Instead, briefly acknowledge their feeling with a matching tone: 'I hear you. This is really frustrating.' Then, after a few seconds, lower your own voice and slow your pace. They will often follow your lead.

Step 5: Offer a simple, low-demand distraction. Once you have acknowledged their feeling, redirect their attention to something soothing or familiar. For example: 'Would you like a drink of water?' or 'Look at this photo—do you remember this day?' Keep the activity simple and within their cognitive ability. Avoid asking open-ended questions that require complex thinking.

Step 6: Physically step back or to the side to reduce perceived threat. Do not crowd them or stand directly in front of them. Give them space. If they are pacing, walk alongside them at a slight distance rather than blocking their path. This reduces the sense of being trapped or pressured.

Step 7: Use a 'safety object' or soothing ritual. Offer a familiar blanket, a favorite stuffed animal, or a fidget toy. Sometimes the simple act of holding something soft or repetitive can calm both of you. If you have a calming ritual—like making tea together or playing a specific piece of music—use it as a reset button.

Step 8: If you feel yourself escalating, excuse yourself for 60 seconds. Say, 'I need to get something from the other room. I will be right back.' Step into another room, take those deep breaths, splash cold water on your face, or do a quick grounding exercise (name five things you can see). Return only when you feel your own nervous system settle. This is not abandonment; it is self-preservation.

Step 9: After the episode, reflect and regroup. Once the agitation has passed, take a few minutes to think about what triggered it. Was it the environment? A specific request? Your own mood? Write it down if helpful. This reflection helps you anticipate and prevent future episodes. As one expert advises, 'Take time to think through that interaction—was there something wrong with them, something wrong with me, or something in the environment that I need to fix next time?'

Step 10: Practice letting go of the emotional residue. Your loved one may forget the incident within minutes, but you might carry the tension for hours. Remind yourself: 'They are not doing this on purpose. They are not doing this to me.' Smile, even if you do not feel like it—your facial expression can influence your own mood. Let the emotion pass through you like a wave, then release it.