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Explosive rage: Does anger management training help?

Everyone has heard of road rage incidents wherein usually calm and responsible people “snap” and commit an aggressive or violent act. Turns out, that “losing one’s temper” can occur in many different life situations and cause serious emotional or physical harm to others. It is a pattern in which tension builds until an explosion brings relief, followed later by regret, embarrassment, or guilt. Called “Intermittent Explosive Disorder” (IED), it is defined by attacks of impulsive rage that seem out of proportion to the immediate provocation and has serious consequences such as verbal abuse, threats, property damage, assaults, and injury.

How common is it?

As reported in the September, 2006 edition of Harvard Mental Health Letter recent research on IED is showing that this condition is more common and more destructive than anyone had supposed. One study showed that people with more severe cases (at least three rage attacks in one year) averaged 56 life-time attacks resulting in an average of $1600 worth of property damage and 23 incidents in which someone required medical attention.

Who is most likely to have these episodes?

According to research, the percentages suffering from this disorder are about the same for men and women, blacks and whites. Only age made a difference. Younger people were more likely than older people to show these uncontrolled rage episodes. As you might suspect, persons who suffer from IED are more at risk for other emotional problems because of the increased stress in their lives.

What causes the attacks?

Behavior patterns such as rage attacks are complex and often are a combination of what is going on in your brain chemistry, what is occurring in your life and also what emotions your thinking patterns are causing.

Scientists do not yet have the answers as to what triggers rage episodes but it may have to do with brain chemistry problems as well as the outlook that people have about life as well as attitudes about how to handle life frustrations and stress.

What treatments help?

According to the Harvard Mental Health Letter, “Anger management through a combination of cognitive restructuring, coping skills training and relaxation training look promising.” This means that to control rage, people need to learn how to think differently about life events, and to learn specific skills to deal with common anger “triggers.” One of the recommended skills is that of learning to deal with stress through relaxation training.

Other skills that we our anger management clients have found to be extremely useful include:

  • Developing empathy toward others (seeing the world as they see it)
  • Taking charge of how you respond to stress, rather than just reacting instinctively
  • Changing self-talk to create different emotions in response to anger triggers
  • Learning to communicate assertively rather than with anger
  • Letting go of resentments, grievances and grudges
  • Retreating to think things over and calming down before blowing up in rage

How can you find a program for you?

Anger management programs are becoming more common across the country. The following resources provide directories of qualified providers, some of which teach the specific skills listed above:

In addition, there are a variety of home-study and online programs appearing on the internet. The quality of these programs vary a great deal, so it is prudent and wise to pick one that is authored by credible mental health professionals and is approved or certified by state agencies (although unfortunately most states do not approve or disapprove anger management programs) or other professional bodies.

How do virtual (Telehealth) anger management classes work?

Responding to the current Covid-19 crisis and the need for social distancing, The Anger Coach continues to offer live anger managment classes- but online instead of in person.

As far as we know, this option is also accepted by courts as an alternative to in-person classes.

When are our classes held?

Virtual classes are held on Tuesday nights from 7:30-8:30pm (Pacific Time).

How many sessions are in the program and what is covered?

The core program consists of 10 structured classes in which you learn the 8 basic tools of anger control. Each class is self-contained so you can join at any time, no matter what tool we are on in the sequence. The anger management tools you will learn are:

Tool 1– How to better deal with stress to be less angry

Tool 2- How to be more Empathetic to Reduce Anger

Tool 3– Learn how to Respond Instead of React to Anger Triggers. Learn how to “re-wire” your brain to better control anger.

Tool 4- Learn how changing your attitude and thinking patterns will decrease your anger.

Tool 5– Improve Communication skills and learn how to assert yourself to get what you need and deserve without getting so angry.

Tool 6- Examine and adjust your expectations to be more accepting and tolerant of others instead of irritable, verbally abusive and angry.

Tool 7– Be less angry by develop the skill of forgiving or letting go of hurts and injustices instead of holding grudges and needing to get even.

Tool 8- Learn the skill of immediately shutting down that part of your brain that creates your anger(your amygdala) when you are triggered- before it gets out of hand.

How Do You Enroll and how much does it cost?

Send an email to drtony@angercoach.com requesting enrollment. The start-up cost is $130 which includes registration, ebook used in class and the fee for the first night’s class. You will receive an invoice for this amount from Paypay which you can pay online with your card even if you don’t belong to PayPay.

Subsequent classes cost $35 each. After each class attendance, you will receive an invoice from Paypal for online payment of that class.

There is a special rate for couples: $150 initially for both; $50 for 2 ebooks and $50 combined class fee.

What happens next?

There are usually between 5 and 12 people in the class. Before each class you will receive an invitation from me to join the class through the online platform of zoom. You will need to download a zoom app to participate, but that is easy and you will receive instructions on how to do that. You can participate from any computer that has internet access. Or, you can participate through your smartphone (most participants have an iphone).

You do not have to reveal personal information in the class, although we do ask you to share from week to week how you are proigressing with your anger management.

Remember, this is a class–not therapy. The focus is on learning the anger management material and skills and how to apply these skills to your life. We take turns reading from the book and then learning from Dr Fiore about the topic at hand.

After completion you will receive a certificate of completion at no extra cost.

Couples in crisis: How couple therapy mitigates stubborn psychological defenses

Guest article by Dr James Tolbin. Edited slightly and reproduced with permission.

Why does a couple typically seek therapy?

Research indicates that by the time a couple seeks couple therapy and arranges an appointment, the partners have been at war for multiple years on a range of seemingly unresolvable issues.

Often a recent event is characterized as a “crisis” that sent the couple over the edge, finally leading them to pursue therapy. But the couple typically has been in crisis for so long that both partners have grown weary from, and almost immune to, the ongoing conflict and persistent tension between them.

What does the average couple expect will happen in therapy?

For most couples who finally begin therapy, they often anticipate that the therapist will be a kind of mediator and/or judge who will assess the problems at hand and the strengths and weaknesses of each partner. And then, from his or her expert vantage point, the therapist will articulate a solution that involves a critique of what the partners are doing incorrectly in their relationship and what they need to do to “be better.”

In my view, this approach to helping a couple rarely, if ever, works.

This is so because, underlying the expressed problems the couple faces, is a firmly organized set of psychological defenses  each partner has developed to cope with the issues of the relationship.

What is a better way to conceptualize marital troubles?

A physical metaphor for how defensive processes in couples work is the way the human back responds to the trauma of a car accident, for example. Impacted by the force of the collision, the general alignment and expansive musculature of the spinal cord shift and lock into a new position designed to protect the vertebrae, tendons, and ligaments that were stressed or damaged in the accident. The shifting and locking into place of the spinal cord and its musculature is a defensive process that protects underlying anatomical structures from further injury.

And it is usually the case, medically speaking, that what the body does to protect itself from further injury results in symptomatic pain, chronic inflammation, and reduced flexibility which, taken together over time, actually prevent healing! Autoimmune diseases provide another example of how the body may inadvertently hurt itself in an effort to protect itself.

The defensive processes that have evolved in a relationship work in a similar fashion.

A husband, for example, who has been hurt by his wife’s ongoing ambivalence about having a child, may unconsciously respond to this injury through the protective strategy of, say, over-working, i.e., becoming overly ambitious or taking on too much responsibility in his professional life.

This defense, in turn, gradually becomes injurious to his wife; she responds to her hurt by becoming self-destructive in some way, an idiosyncratic defensive style that she unintentionally and unconsciously employs to find relief and buffer her from further anticipated disappointments with her husband.

And, as you might imagine, her self-destruction further intensifies her husband’s need to protect himself, thus reinforcing his prioritizing of his workOn and one these insidious, mutually reinforcing dynamics evolve, tangling the partners in a web of toxic psychological tendencies that only strengthen their grip as the couple struggles against them.

What is needed for positive change to occur?

For positive change to even become a possibility for this couple, the defensive processes employed by each partner must be identified and reduced or entirely supplanted. The couple therapist functions not as a mediator or judge but more like a chiropractor, strategically intervening to unlock each partner from his or her chosen defensive style.

As this begins to occur, each partner can think and feel in ways that are more flexible and less oriented solely toward protection. Once partners feel less vulnerable, less gripped by the need and compulsion to defend, there is real potential for the achievement of enhanced levels of communication, mutual respect and understanding, and new pathways for attaining the kind of love each partner desires.

Download a FREE Worksheet PDF file called “Areas of Change” that will help you develop the techniques discussed in this article.

James Tobin, Ph.D. is a licensed psychologist based in Newport Beach, CA.

We Now Offer Teletherapy During the Covid-19 Crisis

Hello Everyone,

I hope you all are well and adjusting to all the new stresses that are suddenly upon us. In some cases, being at home with each other has been a positive experience. In other cases, not so much.

At any rate, here are some resources to help you:

Finally, I am happy to tell you that I now offer telehealth services (video conferencing) for individuals, couples and anger management classes. Now get therapy from your home at a convenient time for you.Many insurance companies are paying for telehealth services during the crisis. Just email me for details and set-up. Easy-Peasy, as they say.

Email me or, schedule a session yourself right now.

Stay  well,
Dr Tony Fiore