Struggling with Anger

Anger is a normal human emotion that induces both physiological and biological changes in response to feeling attacked. When one is angry, their heart rate and blood pressure often increase as well as the hormones adrenaline and noradrenaline which facilitate a behavioural response to their anger. Evolutionarily, the behavioural response to anger is to promote survival in the face of being attacked and is usually aggressive by nature.

Anger is often associated with aggressive behaviour and for some people this can create problems in their interpersonal relationships, causing great hurt to other people and not allowing the unmet needs underneath the anger to be addressed. On the otherhand, some people might experience intense shame when they feel angry, especially if they have been punished or scolded for feelings of anger. This can lead people to feel frozen, go quiet and unable to express their needs or feelings.

Often anger can be seen as the enemy, but imagine a world without anger. This might be world in which nobody fought against injustice or stood up for themselves In the face of oppression or violence. Anger serves an important and protective function. However, If anger leads to aggressive behaviour or to becoming quiet and withdrawn, unable to express your needs at all, then you may need help to respond to anger In a different way.

To express anger in a healthy manner, one needs to have a clear idea of their own needs and how to fulfil them without impacting negatively on their relationships and daily lives.

Possible causes of anger:

• Depression
• Anxiety
• Grief
• Substance abuse issues
• Obsessive Compulsive Disorder (OCD)

Behavioural symptoms of poor anger management:

• Shouting at people (especially in a setting where this is antisocial)
• Breaking things
• Starting fights
• Self-harming
• Withdrawal

Emotional symptoms of poor anger management:

• Fear (over one’s own reaction to anger)
• Shame
• Feeling out of control
• Isolation

Tips for containing anger:

• Treating underlying conditions such as depression, anxiety disorders and substance abuse can generally help with emotion regulation and reduce the intensity of angry feelings and overall irritability.
• Getting good sleep and reducing tiredness can also be an important first step.
• Relaxation techniques such as deep breathing and mindfulness (comment: this isn’t wrong per se, but with really angry patients, the suggestion can be met being told where to go and I don’t think I have ever used relaxation or traditional mindfulness with a very angry patient!)
• Using positive imagery to distract and calm down
• Exercise to redirect behavioural response
• Removing yourself from an anger-inducing environment
• Learning to recognise the underlying needs, hurts and pain behind angry feelings
• Taking time to soothe yourself so you can calmly (but firmly, when needed) describe your experience and articulate your needs and wishes

How is poor anger management treated?

Anger management techniques aim to reduce both the emotional feelings and physiological arousal induced by anger to achieve a state of calm or constructive action after an anger inducing event or thought.

Common therapies include:

• Cognitive Behavioural Therapy (CBT) including assertiveness training
• Schema therapy
• Medication to treat conditions that may be contributing to your anger – SSRIs

CBT challenges a person’s thoughts and beliefs and therefore, behaviours. Often anger causes irrational conclusions to be drawn that exacerbate feelings of frustration and increase the severity of the behavioural response. Tackling a flawed thought process by using reason and combating irrational thoughts should result in milder reactions and therefore better anger management.

Schema therapy may help you to Identity some of the unmet needs that may be driving your angry reaction. It may be that you are rightfully angry at ways that you have been treated but have not learned to become a good advocate for yourself. Or, perhaps you have developed a strong angry side to serve as your protector in the face of abusive or hurtful behaviours from others. Schema therapy, can help you to get In touch with more vulnerable and tender feelings that often lie beneath the anger, providing validation and helping you to give your needs the attention and care that they deserve. It also seeks to help you develop a strong healthy adult who is a good advocate and calm protector for you.

Outcomes of anger management therapies:

The main goal is to enable the patients to process and respond to anger in a healthy manner, preventing the negative emotions associated with causing harm to yourself or others. The hope is that your experience of anger is less negatively impactful on your day-to-day life and that you will be a strong and calm advocate for yourself so you can get your needs met more effectively.