When people lash out, we often focus on the words they say or the behavior they show. But in moments of crisis, those reactions are rarely about what they seem. This story begins with a birthday cake, but it’s really about grief, fear, and the invisible weight people carry when their world is upended. In healthcare, advocacy, and everyday life, we encounter displaced emotion all the time. This piece explores what it looks like, why it happens, and how we can respond with grace. It introduces a framework called ABSORB to help us meet others with empathy, even when their reactions feel outsized or confusing.
When my son first got sick, they took away a number of foods: milk, eggs, chocolate, and others. His second birthday was just weeks away. I was still in shock, trying to understand eosinophilic esophagitis and how to keep him safe. The nutritionist met with me to talk about how to get him the nutrients he needed.
I’m Italian. Food is love. Food is comfort. Food is celebration. Suddenly, food was the enemy.
So when I tried to ask, “How do I get him enough nutrition?” what came out instead was: “You can’t take that away. His birthday is coming up. I have to make him birthday cake.”
You see, eggs and milk are in birthday cake. Chocolate was his favorite flavor.
The nutritionist tried to help. He offered a recipe with substitutes. But he missed the mark, because that wasn’t what I was really upset about. I didn’t need a workaround. I needed someone to see my grief.
I told everyone I knew about the terrible man who said I couldn’t give my baby birthday cake, my family, my friends, the people in the line at the grocery store. I even called his boss and demanded she fire him. Luckily, she was my friend.
She sat me down and said, “This isn’t about birthday cake, is it?”
And I broke. I shared all my fears—how I was going to help my very sick baby, how I felt like I was failing him, how I didn’t know what came next.
That moment taught me something I’ve carried ever since: When someone erupts, when their reaction seems disproportionate, when their words don’t match the moment, it might be their birthday cake.
Stress, grief, fear, and exhaustion change how we process information. They shrink our emotional bandwidth. They make small things feel enormous. And they often cause displaced emotion; anger or panic that shows up in one moment but was born in another.
What the science tells us:
“Fatigue impairs the ability to regulate emotions, leading to increased irritability, reduced patience, and a higher likelihood of reactive behavior.”
— Engen & Singer, Frontiers in Psychology (2018)
“Stress activates the amygdala and suppresses prefrontal cortex function, reducing impulse control and increasing emotional reactivity.”
— Tafet, Neuroscience of Stress (2021)
“High conflict behaviours are often driven by underlying fear, shame or trauma, and may be displaced onto healthcare professionals during moments of vulnerability.”
— Morris & Thomas, Postgraduate Medical Journal (2020)
When behavior doesn’t match the moment, don’t use your own lens to interpret it. Use theirs.
Take the time to get curious. Where might this be coming from? What might they be carrying?
Then respond with ABSORB:
Acknowledge the emotion you’re seeing
“I can tell this has been really upsetting.”
Breathe before responding and find your Balance
Pause to regulate your own nervous system.
Seek the story behind the reaction
“Can you help me understand what’s been going on?”
Offer support and clarity
“Let’s walk through what we can do next.”
Reassure them of your commitment
“I’m here to help. We’ll figure this out together.”
Build trust through transparency
“Here’s what I can do, and here’s what might take time.”
Not everyone will be their best self in crisis. But you can be the person who meets them with grace. Because the next time someone lashes out, it might not be about the form, the delay, or the tone.
It might be about birthday cake.
References:
Engen, H. G., & Singer, T. (2018). Emotion regulation, effort and fatigue: Complex issues worth investigating. Frontiers in Psychology, 9, 2794. https://doi.org/10.3389/fpsyg.2018.02794
Tafet, G. E. (2021). Neuroscience of stress: From neurobiology to cognitive, emotional and behavioral sciences. Springer. https://doi.org/10.1007/978-3-030-80374-3
Morris, R., & Thomas, C. (2020). Recognising, understanding and managing high conflict behaviours in healthcare. Postgraduate Medical Journal, 96(1133), 529–533. https://doi.org/10.1136/postgradmedj-2020-137468