If one had to pinpoint the most significant developments that have taken place in society over the last 50 years, an obvious candidate would be our radically revised position regarding the expression of our feelings. Prior to the 1960s the infamous British ‘stiff upper lip’ was universally regarded as a virtue, but these days the repression of emotion is seen as the root of a host of psychological and physical problems.

The growing consensus that repressing your feelings is a bad thing has only been reinforced by reality TV’s love affair with characters whose appeal to the public lies not only in their larger-than-life personalities but their apparent lack of any kind of emotional filter. Jade Goody, who sadly died in 2009, was a prime example. Her utter emotional transparency in the Big Brother house assured her celebrity status. Every fleeting emotion, every high and low was writ large for all to see. Although she was sometimes treated as a figure of fun because of her poor general knowledge (‘Has Greece got its own moon?’) and some fairly spectacular malapropisms (‘They were trying to use me as an escape goat ...’), Jade Goody achieved cult hero status. Whatever her educational shortcomings, there was an emerging consensus that her unparalleled degree of emotional directness and expressivity was admirable, while it also made her highly watchable. What previous generations would have considered childlike or undisciplined was construed as a positive: it made Jade ‘authentic’, someone who was always truly and fully herself. Jade Goody’s fame was a product of a culture that views emotional repression as self-denial, surely the most heinous of modern sins.

And yet the story of Jade Goody is also a cautionary one for all advocates of wearing your heart on your sleeve. The Greek Orthodox church has a saying, ‘the greatest virtues cast the longest shadows’, and, ultimately, Jade’s lack of emotional restraint caused her downfall. Her inability to ‘bite her tongue’ and moderate an outpouring of frustration and resentment towards Bollywood actress Shilpa Shetty in a later series of Big Brother caused an international outcry. On this occasion it appeared that Jade’s unmediated emotions had unfortunately found expression in an outpouring of racist abuse, although Goody herself always denied that Shetty’s ethnicity had ever been either a cause or focus of those feelings. However, the overnight transformation of Jade Goody from popular folk hero to cause célèbre in the wake of Celebrity Big Brother in 2007 should have been a wake-up call to the potential hazards of giving such free range to the expression of one’s emotions.

So how have we all been sold this idea that we should be wearing our insides on the outside at all times? Once again the finger points accusingly at Dr Freud, whose hydraulic model of the mind constructed it as a closed system of opposing forces and pressures. In this model, buried emotions caused dangerous build-ups of pressure, producing leaks and ruptures between the different layers of the psyche that manifested themselves on the surface in the form of neurotic symptoms. Freud’s talking cure aimed to achieve catharsis, the release of pent-up emotional blockages by bringing repressed conflicts into conscious awareness. It is Freud we ultimately have to thank for phrases like ‘letting off steam’. Given this kind of analogy, it is easy to appreciate why the repression of emotion seemed like such a bad idea.

As we have begun to unpick the relationship between physical and emotional health, and especially the effects of chronic stress on the immune system, there is a growing body of research data indicating that the repression of emotion could indeed be a fairly dangerous pastime. Dr George Solomon from the University of California is only one of a number of medical academics citing convincing research showing that people who repress their feelings are more at risk of rheumatoid arthritis, infections and certain types of cancer.

Yet it’s not that clear-cut. How do we explain the fact that Japan, a collectivist culture in which the suppression of certain emotions is actively encouraged, is also one of the most physically healthy countries in the world? In Japan there is an important crucial distinction between hon-ne, which roughly translated means ‘honest feeling’, and tatemae, which means ‘polite face’. One Japanese blogger, reflecting on the origins of this distinction, speculates that in a nation 70 per cent covered by mountainous terrain, agricultural workers had to cooperate in order to produce sufficient food from very limited fertile land. Strong self-expression or self-assertion would have been counter-productive to survival. Yet despite this distrust of unguarded emotional display, citizens of Japan can expect on average to live up to the age of 75 in full health according to the World Health Organisation. Perhaps other factors are muddying the picture, but we should reflect on how this fits with the apparently strong connection between emotional repression and systemic illness in the West.

And even here in the Western world there is emerging evidence that letting it all out isn’t necessarily the best strategy for everyone. After the tragic destruction of the World Trade Center on 11 September 2001, a team from the University of Buffalo emailed over 2,000 people that same day, asking them to share their thoughts in writing about the events of 9/11. Three-quarters of the people surveyed wrote a response, while the remaining quarter ignored the request. Over the next two years the Buffalo team regularly contacted everyone in the sample, screening them for signs of emotional distress and physical problems. What they discovered ran counter to what we are conditioned to expect. Those who had not responded to the initial request to share their feelings actually did better than those who had written their emotions down, and in fact those who wrote the most also proved to be the most vulnerable to unwanted psychological and physical symptoms.

Now there are many caveats to be applied before jumping to conclusions. We don’t know, for example, that those who chose not to write anything down made that decision because the disaster made less impression on them: maybe there was less of an emotional response in the first place amongst this group, whereas those who wrote the most may simply have been the most powerfully affected by what had occurred. In other words it may not be the case that the key distinguishing factor between the two groups is necessarily their capacity to express their feelings, but the intensity with which they experience them in the first place. However, these findings do correspond with a study of heart attack survivors conducted by Dr Karni Ginzburg and colleagues. They found that ‘repressors’ were much less likely to suffer from post-traumatic stress disorder than those who dwelt on their brush with death. Some people, Dr Ginzburg concluded, naturally tend to repress their negative emotions, and for these individuals a repressive style enables them to cope better than their more emotive peers. Letting it all out may not be for everyone.

But surely we all know that anger is one emotion that it is better not to bury? In San Diego one businesswoman has even opened up a store in which her customers pay to go and smash plates in order to get things off their chest, but again several decades of research casts doubt on whether the theory that it is always a better idea to vent your fury is actually a very sound one. According to Professor Jeffrey Lohr, who has reviewed over 40 years of work addressing the issue, ‘In study after study the conclusion was the same: Expressing anger does not reduce aggressive tendencies and likely makes it worse’. Lohr argues that while indulging your angry feelings may be a briefly enjoyable thing to do, this kind of venting doesn’t even ultimately reduce the feelings of anger.

Perhaps before jumping on the bandwagon of free expression, we should remind ourselves of an observation made by Charles Darwin back in 1872 that ‘the free expression by outward signs of an emotion intensifies it’. In other words, by allowing what we feel to show through our behaviour we actually make the underlying feeling stronger. If the emotion you are expressing is joy or love then that wouldn’t necessarily be a bad thing, but if the emotions you are experiencing are less desirable ones (anger, jealousy, contempt) then reinforcing them through your behaviour might not be such a smart move.

Some backing for this was recently provided by a study in which moderately painful heat was applied to the forearms of subjects who had previously been instructed to assume either relaxed, neutral or negative expressions while the procedure was carried out. Those who adopted negative expressions reported higher levels of pain than the other two groups. Again this suggests that the very expression of emotion to some extent conditions our experience of emotion and that there is a feedback loop between the two domains. Maybe cultures like Japan, where people will sometimes default to a smile that may appear incongruent with their underlying emotions, or Thailand where complaining is considered uncouth and the expression of anger positively barbaric, have simply grasped this principle better than we have in the West?

The modern maxim that we must be true to our feelings at all times is based on an assumption that our feelings arise spontaneously within us, and that they are therefore more likely to represent the truth about us and our reactions. Seen in this light, expressing your feelings – whatever they may be – becomes an issue of personal integrity. What we forget though, is the extent to which we actively manipulate our own emotional lives and indeed have them manipulated for us by society. Arlie Hochschild, a Professor of Sociology at Berkeley, claims that the spontaneity of our feelings is often an illusion: she argues that whether we are aware of them or not, we tend to regulate our emotions according to implicit ‘feeling rules’ that tell us what to feel in a given situation, for how long and at what level of intensity. Thus in the United States the normal duration of grief after a bereavement is assumed to last between 18 and 24 months, after which you may find yourself being referred for treatment for an emotional state that starts to be considered pathological.

The outpouring of public grief following the death of Diana, Princess of Wales in 1997, is a more local example of how even authentic emotion can be cued, summoned and coordinated through cultural processes. We don’t normally have such a powerful response to the death of a relative stranger, after all. At such points it is as if normal people become accomplished method actors, self-inducing feeling so effectively that it is experienced as entirely genuine. And in a sense it is, although one suspects that people were drawing on other sources of more personal loss to cue the relevant emotions. However, without our ability to read and respond to expectations and permissions generated by society, one can’t help but wonder if the levels of grief expressed would have been quite so intense or universal?

We may therefore select the feelings we experience more than we think. If this is so, then a harmonious and civilised way of life requires us individually and collectively to choose wisely which feelings we encourage. I am not saying that the repression of feeling is a good thing, or that feelings we deny, bury or disavow don’t sometimes prove enormously damaging for our well-being. However, as a society what we do seem to have lost sight of is that there is a huge difference between owning and acknowledging the full range of our feelings and letting them all spill out at the drop of a hat. You can acknowledge your hon-ne while still preserving your tatemae.

The word catharsis originally comes from Greek tragedy, where Aristotle used it to refer to a purging of emotion to the end of restoring harmonious balance. The point is that in Greek drama this was a carefully orchestrated group experience conducted within a highly structured, ritualised setting. Similarly, in the therapist’s office the unmediated expression of emotion is sometimes encouraged because the therapist (rightly or wrongly!) believes that they can help contain those feelings and channel them in the interests of fostering your insight or healing. Both contexts are specialised arenas set apart from everyday life, and it is a mistake to assume that behaviour appropriate in your therapist’s office is necessarily the way to go in the high street.

Of course we must be prepared to acknowledge our feelings, and not only the positive, more palatable ones. It can be especially important to own the emotions that make us feel downright uncomfortable such as fear, disgust, anger and guilt. Repressed feelings can indeed do us a lot of damage, and I would be an irresponsible psychologist to suggest otherwise. However, precisely because emotions are not just harmless, affective froth, we need to treat them with a greater degree of respect and care. Like the infamous Brazilian butterfly whose beating wings ultimately cause a tornado in Texas, our feelings can be powerful forces that bring about unintended consequences, as poor Jade Goody discovered. When we put them out there we therefore need to be conscious of the potential impact that they can have. Our emotions would appear to well up from the most primitive and oldest parts of our brains, but let’s bear in mind that evolution has kindly given us a higher cortex so we don’t have to be at their mercy the whole time. There is a thin line between emotional expressivity and emotional incontinence. Let’s try not to confuse one with the other.