ANGER MANAGEMENT

Anger is an emotional state that varies in intensity, frequency, and duration. It is perfectly healthy and appropriate to feel angry when you have been mistreated or wronged. The feeling is not the problem—it’s what people do with it that can create difficulties. This is because Anger usually includes a blame component and may lead to unhelpful interactions with others. Although feeling angry can be unpleasant, it is healthy to feel Anger because it lets people know that something needs to be addressed. In contrast to healthy Anger, sometimes angry reaction may be beyond what a situation calls for. Although one might feel “better” releasing the anger outwardly, oftentimes, it comes with feeling a sense of guilt, remorse, regret, shame, or embarrassment afterward. Anger can at times become chronic and explosive and may warrant a diagnosis, such as:[1]

  • Intermittent Explosive Disorder
  • Impulse Control Disorder
  • Oppositional Defiant Disorder in children

Chronic Anger can have many negative consequences, including health problems, issues in close relationships, problems at work/school, and problems with the law. Anger is also associated with mood disorders, such as depression[2] and bipolar disorder,[3] as well as anxiety[4] and substance abuse.[5]

There are several ways that anger can be expressed:

  • Assertive Anger Expression: the person is aware of the anger and copes with it as it arises. He/she expresses anger at appropriate times, communicates effectively, and often problem solves effectively.
  • Indirect Anger Expression: the person expresses anger in a passive aggressive manner and/or engages in undermining/covert sabotage.
  • Direct Anger Expression: the person expresses verbal, facial, and body expressions directed at self or another.
  • Suppression: the person makes effort to control outward expression of anger or minimizes such experience. Person may end up holding grudges and does not resolve his/her issues.

Canadian Statistics

  • Anger can arise as a result of stress. Twenty-five to 30% of women aged 20–64 perceived that the majority of their days were moderately to extremely stressful.[6]
  • Women between the ages of 20–34 were significantly more likely to report life stress than men.[7]
  • Many victims of violent crime react with Anger after the incident. One in seven victims of violent crime reported experiencing the long-term effects of PTSD.[8]
  • Anger, frustration, and despair are the second-most common motives for homicides, at 20%.[9]
  • Anger, frustration, and despair are the most common motivators for a family member killing a senior person.[10]
  • Between 10% and 20% of the students in middle or high school are behaviourally at risk for issues such as aggression.[11]

Behaviours associated with Anger:

  • Yelling at your significant other for forgetting to pick you up
  • Being written up at work for arguing with co-workers
  • Cursing when someone cuts you off while driving
  • Slamming the door because your wife has stayed late at work again
  • Arguing with the store clerk about a pricing issue
  • Drinking alcohol in order to “calm down”

Feelings associated with Anger:

There is a general agreement amongst Psychologists that Anger is a secondary emotion.[12] In other words, feelings of Anger can arise to cover up more vulnerable feelings such as:

  • Sadness
  • Anxiety
  • Hurt
  • Fear
  • Guilt
  • Frustration

Thoughts associated with Anger:

  • “It’s her fault that I got into trouble for talking badly about my boss! She’s the one who started the conversation!”
  • “I would’ve had my best game of golf ever if he hadn’t been talking so loudly!”
  • “That guy is such a horrible driver! These people don’t know how to drive. They have no idea what they’re doing!”
  • “He’s such an awful boyfriend for forgetting to call me when he said he would!”

Anger and the Body:

Physical symptoms of Anger include:[13]

  • Feeling hot in the neck/face
  • Shaking or trembling
  • Increased heart rate
  • Headaches
  • Stomach aches
  • Sweating, especially the palms

Anger and the Brain:

The area of the brain that is most involved with Anger is the amygdala. The amygdala is involved in responding to threats and is strongly associated with Anger.[14] It registers threats similarly for internal threats (Example: having a negative thought or a panicked body sensation) and external threats (Example: Unleashed dog running toward you while barking or someone yelling at you). Anger is a normal reaction to an internal or external threat, and the amygdala always reacts at 100% capacity, regardless of how minor or major a threat feels. In fact, research has shown that you can have a predisposition to anger, and if you do, your amygdala may be especially reactive to others’ fearful expressions or even when others say the word “no.”[15] When you feel threatened and your amygdala activates, the normal reaction is to protect yourself and anger helps you achieve this (when you are angry, the threat may be driven away).

Does Psychology Work?

Feeling angry does not mean that you need psychological help. However, when Anger is chronic, when it feels out of your control, and when it starts to impact your daily life, it may be time to consult a Psychologist. Several of the most effective treatments for Anger Disorders are:

  • Cognitive Behavioural Therapy (CBT): The goal of CBT is to change your behaviours by first changing your thoughts. Multiple research studies have shown that CBT is an effective treatment for a variety of Anger issues. In a review of the psychological treatments for Anger, one study showed that CBT reduced anger by 76%.[16]
  • Mindfulness Therapy (MT): In relation to managing Anger, the goal of MT is to help you non-judgmentally notice triggers of Anger, and the associated changes in your thoughts, feelings, body sensations, and impulses.[17] Research has shown that people who are mindful tend to be less angry and hostile. MT is especially useful for targeting rumination. Rumination is the repetitive and uncontrollable thoughts about negative experiences. There is evidence that rumination can lead to anger, hostility, and aggression, and that MT can lessen rumination.[18]
  • Eye Movement Desensitization and Reprocessing (EMDR): EMDR has been shown to be an effective treatment for treating persistent Anger, especially when it is associated with a traumatic event. The treatment of Anger associated with Post-Traumatic Stress Disorder (PTSD) is especially important because Anger can reduce the effectiveness of therapy.[19]
  • Emotionally Focused Therapy (EFT): EFT focuses on changing attachment behaviors in order to improve distressed relationships between couples and family members. EFT can intervene in relationships where people are having difficulty communicating their emotions and coping with difficult feelings.[20] Feelings of Anger can serve as a mask for hurt, and EFT for couples can help solve emotions triggered by hurtful events in relationships. The results of one study showed that EFT is effective for decreasing marital distress and promoting forgiveness.[21] EFT has also been shown to help couples and families effectively manage their anger.[22]

Tips for Managing Anger!

  • Mindfulness: Anger can serve as a helpful indicator that something is wrong. Trying to figure out the source of your Anger is a practical step towards resolving it. You can better understand your Anger by answering the following questions:
    • What was the situation?
    • What was I angry about? How was it hurting me?
    • What was I thinking at the time?
    • How did I feel emotionally?
    • What did I feel in my body?
    • What did I do or say in response?
  • Exercise: Exercise can help reduce Anger by burning off energy[23] and by naturally releasing endorphins (the “happy” chemicals in your brain and body).[24] Try going for a run or doing a cardio exercise.

Everyone has felt Anger! It is not an inherently negative emotion although many people are intimidated by anger and/or are unsure about how to manage it. However, when anger interferes with your life and relationships, consulting a Psychologist may uncover what is behind the anger and help you deal with it. Anger is not a uniform experience for everyone, and treatment must be multi-faceted. At Hopewell Psychological, we provide a range of services so that you can choose the ones that are right for you. We provide evidence-based options to help you work on your anger, such as Cognitive Behavioural Therapy, Mindfulness Therapy, or Eye Movement Desensitization and Reprocessing. We also provide Emotionally Focused Therapy, which is an effective approach in dealing with your anger within a Couple or Family dynamic. This approach helps you understand and work through your anger while also helping you to improve your interpersonal relationships.

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*Psychologists are covered under Insurance Companies in Canada. You will need to check with your insurance company about the specific details regarding your coverage.

References

[1] DSM-5 “Disruptive, Impulse-Control, and Conduct Disorders.” American Psychiatric Association. http://dx.doi.org/10.1176/appi.books.9780890425596.dsm15.

[2] Besharat, Mohammad Ali, et al. “Anger and major depressive disorder: the mediating role of emotion regulation and anger rumination.” Asian Journal of Psychiatry 6 (2013): 35-41.

[3] Ballester, Javier, et al. “Is bipolar disorder specifically associated with aggression?” Bipolar Disorder 14.3 (2012): 289-290.

[4] Olatunji, Bunmi O. “Fear and loathing: a meta-analytic review of the specificity of anger in PTSD.” Behavior Therapy 41 (2010): 93-105.

[5] Battaglies, G., Caccetta, et al. “Cognitive-behavioral therapy for externalizing disorders: A meta-analysis of treatment effectiveness.” Behaviour Research and Therapy (2015): 1-12.

[6] Bushnik, Tracey. “The health of girls and women in Canada.” Statistics Canada (2016). http://www.statcan.gc.ca/pub/89-503-x/2015001/article/14324-eng.htm. Web. Apr. 2017.

[7] See 6

[8] “Self-Reported victimization, 2014.” Statistics Canada (2015). http://www.statcan.gc.ca/daily-quotidien/151123/dq151123a-eng.htm. Web. Apr. 2017.

[9] “Homicide in Canada, 2014.” Statistics Canda (2014). http://www.statcan.gc.ca/pub/85-002-x/2015001/article/14244-eng.htm. Web. Apr. 2017.

[10] “Highlights: Family violence in Canada–A statistical Profile.” Statistics Canada (2009). http://www.statcan.gc.ca/pub/85-224-x/2010000/aftertoc-aprestdm2-eng.htm. Web. Apr. 2017.

[11] Larson, James. “Angry and Aggressive Students.” Student Services (2008). Web. Apr. 2017.

[12] Seltzer, Leon F. “Anger – How we transfer feelings of guilt, hurt, and fear.” Psychology Today (2013). https://www.psychologytoday.com/blog/evolution-the-self/201306/anger-how-we-transfer-feelings-guilt-hurt-and-fear.

[13] Mills, Harry. “Recognizing Anger Signs.” MentalHelp.net (2005). https://www.mentalhelp.net/articles/recognizing-anger-signs/ Web. Apr. 2017.

[14] Carlson, J. M., Greenberg, T., & Mujica-Parodi, L. R. “Blind rage? Heightened anger is associated with altered amygdala responses to masked and unmasked fearful faces.” Psychiatry Research 182.3 (2010): 281-283.

[15] Blair, R.J.R. “Considering anger from a cognitive neuroscience perspective.” Wiley Interdisciplinary Review of Cognitive Science 3.1 (2012): 65-74.

[16] Saini, Michael. “A meta-analysis of the psychological treatment of anger: Developing guidelines for evidence-based practice.” Journal of the American Academy of Psychiatry and the Law 37.4 (2009): 473-488.

[17] Wright, Steven, et al. “Mindfulness and the treatment of anger problems.” Aggressive and Violent Behavior 14 (2009): 396-401.

[18] Borders, Ashley, et al. “Could Mindfulness Decrease Anger, Hostility, and Aggression by Decreasing Rumination?” Aggressive Behavior 36 (2010): 28-44.

[19] Stapleton, Jennifer A., et al. “Effects of three PTSD treatments on anger and guilt: exposure therapy, eye movement desensitization and reprocessing, and relaxation training.” Journal of Traumatic Stress 19.1 (2006): 19-28.

[20] Halchuk, Rebecca, et al. “Resolving Attachment injuries in couples using emotionally focused therapy: a three-year follow-up.” Journal of Couple & Relationship Therapy 9 (2010):31-47.

[21] Greenberg, Leslie, et al. “Emotion-Focused Couples Therapy and the Facilitation of Forgiveness.” Journal of Marital and Family Therapy 36.1 (2009): 28-42.

[22] Carlson, Jon, and Dermer, Shannon B. The Sage Encyclopedia of Marriage, Family, and Couples Counseling. Thousand Oaks: Sage Publications, Inc. 2017. Web. Apr. 2017.

[23] Eisold, Ken. “Anger and Exercise.” Psychology Today (2010). https://www.psychologytoday.com/blog/hidden-motives/201008/anger-and-exercise.

[24] Dinas, P.C., et al. “Effects of exercise and physical activity on depression.” Irish Journal of medical science 180.2 (2011): 319-325.

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