At the Emotional Health Centre, Therapy House, 6 Tuckey Street, Cork city we help with anger Anger Management in Hypnopsychotherapy and Evidence-based Best Practice At the Emotional Health Centre Cork we specialise in evidence-based best practice in anger management. Also we explore with hypnoanalysis the root causes and triggers from childhood because anger is a learnt behaviour. • Triggers and early warning signs • Why am I angry? • Techniques to control anger • Self talk and helpful thinking • Assertiveness and practice • Releasing from anger • Anger and the “fear” connector Normal Anger Anger is a normal human emotion. Everyone feels annoyed, frustrated, irritated or even very angry from time to time. Anger can be expressed by shouting, yelling or swearing but in extreme cases it can escalate into physical aggression towards objects (eg. smashing things) or people (self or others). In some cases, anger might look much more subtle, more of a brooding, silent anger or withdrawal. In a controlled manner, some anger can be helpful, motivating us to make positive changes or take constructive action about something we feel is important. But when anger is very intense or very frequent, then it can be harmful in many ways. What Causes Anger? Anger is often connected to some type of frustration – either things didn’t turn out the way you planned, you didn’t get something you wanted, or other people don’t act the way you would like. Often poor communication and misunderstandings can trigger angry situations. Anger usually goes hand-in-hand with other feelings too, such as sadness, shame, hurt, guilt or fear. Many times people find it hard to express these feelings so just the anger comes out. Perhaps the anger is triggered by a particular situation, such as being caught in a traffic jam, or being treated rudely by someone else or banging your thumb with a hammer while trying to hang a picture-hook. Other times there is no obvious trigger – some people are more prone to anger than others. Sometimes men and women handle anger differently, but not always. Problems Associated with Anger Uncontrolled anger can cause problems in a wide range of areas of your life. It may cause conflicts with family, friends, or colleagues, and in extreme situations it can lead to problems with the law. But some of the other problem effects of anger may be harder to spot. Often people who have a problem with anger feel guilty or disappointed with their behaviour, or suffer from low self-esteem, anxiety or depression. There are also physical side-effects of extreme or frequent anger, such as high blood pressure, and heart disease. Some studies suggest that angry people tend to drink more alcohol, which is associated with a wide range of health problems. Do I have a Problem with Anger? Perhaps you have already identified that anger is a problem for you, or someone else has mentioned it to you. But if you are not sure whether anger is a problem for you, consider the following questions: • Do you feel angry, irritated or tense a lot of the time? • Do you seem to get angry more easily or more often than others around you? • Do you use alcohol or drugs to manage your anger? • Do you sometimes become so angry that you break things, damage property, or become violent? • Does it sometimes fell like your anger gets out of proportion to the situation that sets you off? • Is your anger leading to problems with relationships, such as with family, friends, or at work? • Have you noticed that others close to you sometimes feel intimidated or frightened of you? • Have others (family, friends, colleagues, health professionals) mentioned that anger might be a problem for you? • Do you find that it takes a long time to ‘cool off’ after you have become angry or irritated? • Have you ended up in trouble with the law as a result of your anger, for example getting into fights? • Do you find yourself worrying a lot about your anger, perhaps feeling anxious or depressed about it at times? • Do you tend to take your frustration out on loved ones or people less powerful than you, rather than dealing with the situation that triggered your anger? If you answered ‘yes’ to any of these questions, it may be that anger is a problem for you. It may be that addressing your anger can allow you to live a much more positive and rewarding life. How Can I Manage Anger Better? You may have heard about ‘anger management’ and wondered what it involves. Anger management can be addressed in groups or through individual therapy, and there are also a lot of self-help resources available. Anger management is not just about counting to ten before you respond (although that is often a good idea). it is about helping you to better understand why you get angry, what sets it off and what are the early warning signs, and about learning a variety of strategies for managing those feelings more constructively. Anger Anger itself is not a problem. How we express or suppress it is what counts. For most people, it is very difficult to find appropriate, effective, self-affirming ways to express their angry feelings. Too often, people vent their anger in ways that serve no real purpose, or hold it inside, where it festers. When we dump our anger out on others, it generally has destructive effects on them and on ourselves. Angry explosions tend to be short-lived power trips that take us nowhere. And virtuous efforts to deny angry feelings can store up inner tension that pops up later in the form of headaches, depression, irrational grudges, etc. Our culture gives us mixed messages about anger. Sometimes a soft answer does turn away wrath; sometimes it invites it by making us look like an easy target for hostility. If we value meekness (in hopes of inheriting the earth) and turn the other cheek (in hopes of encouraging mildness and love), we may find ourselves feeling guilty about our hidden, pent-up anger. If we mimic the counterculture of the 60s and strive to ‘let it all hang out’ in a simplistic and aggressive openness, we may find ourselves struggling with constant conflict and irritation. But over control of natural, legitimate needs and emotions may result in unexpected outbursts of misplaced ‘justifiable’ anger. Dwelling moralistically on our ‘right to be angry’, we try to make up for all the hurts and injustices we absorbed in the past. To vent or not to vent; that is the question. Are angry feelings best released in an explosive outburst or quietly suppressed using grit-your-teeth tactics? The debate rages on, even within psychological circles. Some experts challenge popular beliefs that suppressed anger is dangerous to health. Blowing your top can be far more damaging than keeping your cool, they say. For example, men who are at high risk from heart disease – the so-called Type A personalities – usually over express their anger. To support this theory, they cite an enormous research project, the Western Collaborative Group study, which followed 3,154 California men aged 39 to 59 for several years to gather information on heart attack-prone behaviour. Two aspects of Type A, competitive drive and impatience, were associated with the eventual occurrence of heart disease. The men risking illness were also more likely than healthier men to direct their anger outward and to become angry more than once a week. Another study, this one conducted at the University of Michigan School of Public Health, measured the effects of anger expression, suppression, and ‘cool reflection’ on blood pressure. Results, again, pointed thumbs down on hot heads. According to the researchers, the men who kept their cool – who acknowledged their anger but were not openly hostile, verbally or physically – had lower blood pressure than men who either bottled up their anger or became openly hostile. They further described the ‘cool reflective’ approach as one in which the provoker and provoked calm down first, then discuss the conflict reasonably with their goal firmly set on resolution. In other words, if you can get at the problem, you can solve the conflict. Their basic conclusion was that the psychological rationale for ventilating anger does not stand up under experimental scrutiny. Expressing anger makes us angrier, solidifies an angry attitude, and establishes a hostile habit. If we keep quiet about momentary irritations and distract ourselves with pleasant activity until our fury simmers down, chances are that we’ll feel better, and feel better faster, than if we let ourselves go in a shouting match. On the side of the ‘ventilationalists’ is Philadelphia psychoanalyst Leo Madow, M.D. In his book Anger: How to Recognize and Cope with it, he writes: “Anger can affect us adversely both physically and mentally. If we think of it as a form of energy which if repressed must come out somewhere, we must recognise that it can harm almost any part of or body or influence our emotions and eventually our minds if a sufficient amount is accumulated.” Dr. Madow, however, does distinguish between ‘suppressed’ and ‘repressed’ anger. the difference has to do with the conscious mind. If you consciously hold back your anger because you don’t want to start a fight, for example, that’s ‘suppression’. If, on the other hand, you have unconsciously harboured angry feelings towards your father since you were six years old, that’s ‘repression’. Of the two, says Dr. Madow, repression – not recognising that you feel anger – has the potential to cause greater damage. Research suggests that repressed anger contributes to gastrointestinal, respiratory, circulatory, and skin disorders. Some scientists even believe that this emotion may be linked to cancer. Conscious suppression may have its pitfalls, too. One researcher, examining the histories of more than 5,000 patients with rheumatoid arthritis, discovered that many of them shared certain personality traits, among them the inability to express anger. Another scientist discovered that patients with ulcerative colitis produced strikingly comparable data to that of the rheumatoid arthritics. Marjorie Brooks, Ph.D., research director for the Centre for Autistic Children and an assistant professor at Jefferson Medical college in Philadelphia, relates another study: “In the 1950’s, two researchers looked at the life history patterns of about 400 cancer patients”, Dr Brooks explains. “They found the patients had some very interesting similarities. Many of them seemed unable to express anger or hostility in defence of themselves. The patients could get angry in the defence of others or in the defence of a cause. But when it came to self-defence, they didn’t follow through.” Suppressed hostility was another significant factor appearing in some of the other patients. They seemed to lack the discharge mechanism needed to allow anger to surface, so they kept all of their anger inside. So in all of this, is there a common meeting ground that both sides can agree on that will allow the successful resolution of anger? Apparently there is. Both sides seem to agree that it is not enough just to express anger – these has to be a genuine resolution of conflict or else the tension continues to operate. Some people may suppress angry feelings for a long time, then suddenly explode over something, whether it warrants it or not. Experts agree that people must retrain themselves to accept anger as a normal emotion and deal with it accordingly. Expressing anger is necessary for good health but it doesn’t mean a brick over the head. That action only brings retaliation and guilt. Anger is a normal emotion that is a result of our genetics, upbringing, and cultural patterns. The biggest problem we face is learning how to discharge it in a manner that is both acceptable in society and healthy for the self. For an appointment please ring Therapy House, 6 Tuckey Street, Cork city on 021-4273757 or email us on