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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 to cope with a loved one driving under the influence of impaired emotions

45 year old John terrorized his family when they were his passengers. He would yell at them if they complained about his driving.

He would ignore them when they showed signs of discomfort and even seemed to enjoy scaring his passengers with his maneuvers such as tailgating, weaving in and out of traffic, passing other cars dangerously, and pulling too far into crosswalks so pedestrians are unable to safely cross the street. He had no awareness that his driving was not legal, that he was breaking many laws, or that he was behaving like a criminal.

John would show aggression in other ways too — like insisting on choosing the radio station, controlling the volume of the radio, and controlling the temperature, the fan setting and where the vents are aimed while driving. He refused to stop for restroom breaks on long trips.

John was anything but “passenger-friendly” yet he did not see himself as the problem. Statistics show that while 70% of drivers complain about the aggressiveness of others, only 30% admit to their own aggressiveness.

John saw other drivers as “stupid,” his family/passengers as “whiney,” and the roadway as his personal terrain. Unfortunately, we all pay the legal and emotional price for this kind of distorted thinking.

High cost of aggressive driving

According to recent statistics, aggressive driving is at the core of numerous fatalities, injuries and dollar costs associated with accidents. More specifically, it is linked to:

  • Fatalities (425,000 per decade)
  • Injuries (35 million per decade)
  • Dollars (250 billion per year)

The cost to the emotional well-being of family members is also very high. Often, family members develop a fear of driving with the aggressive driver. While they may not talk about it, passengers may lose esteem, respect and affection toward the driver.

Younger passengers may also be affected later in life by being exposed to this kind of driving behavior. By watching and then modeling their aggressive-driver parent, the child may develop similar attitudes and driving behaviors when he or she becomes a driver.

Driving under the influence

At its root, aggressive driving is caused by poor ability to handle angry feelings. The aggressive driver is, in effect, driving under the influence of impaired emotions. Studies list many reasons why driving arouses anger in aggressive drivers. Some of the most common are:

Territoriality. The car is a symbol associated with individual freedom and self-esteem. Our car is our castle and the space around it is our territory. When other drivers invade our space the aggressive driver responds with hostility to protect his “castle.”

Restriction. In congested traffic, you are prevented from going forward. This can lead to frustration, anxiety and an intense desire to escape the restriction.

Multitasking. We become irritated at others when we see them driving poorly while talking on the cell phone, eating, or performing personal grooming.

Poor life planning. We don’t allow enough time to get to our destination on a consistent basis so we “press” to make up for the lost time and then become stressed and angry at other drivers who we see as frustrating our mad dash.

What can you do as a passenger?

While aggressive driving behavior ultimately must be changed by the driver himself, the following are some survival tips that may help until that occurs:

  1. Refuse to passenger with such a person until he or she changes.
  2. Share with driver how you feel when they drive aggressively. For example: I feel anxious about how fast we’re going (instead of “you are driving too fast”); I’m upset about the way you swore at that driver and I am fearful how it will affect our children who heard you; I feel afraid when you approach pedestrians too fast; I feel bullied by you when you won’t stop for a bathroom break.
  3. Encourage person to look at their “driving philosophy” and to develop more empathy regarding how others (like the family) are being negatively impacted by his or her poor driving behavior. That is, help him see himself through the eyes of his family.

This honest feedback from loved ones can be a powerful tool to encourage the aggressive driver to become a better citizen of the roadways.

Anger in the workplace – key management strategies

Joe, a 15 year city employee with a good record began missing work, and showing irritability with supervisors and customers alike. He then started to shout at customers who frustrated him.

As complaints mounted, his supervisors “wrote him up” but did not try to discover the reasons for his drastic change of behavior. Finally, when mildly teased by a co-worker, Joe attacked and hit him. At this point, he was suspended and ordered to anger management classes.

Dealing with angry employees is not only challenging for managers, but extremely expensive in terms of wasted employee time, increased turnover rates, mistakes, and high levels of personal stress and illness. By contrast, proper handling can promote personal growth in the employee, reduce employee stress, and promote increased workplace harmony.

How prevalent is the problem of workplace anger?

In 1993 the national Safe Workplace Institute released a study showing that workplace violence costs $4.2 billion each year, estimating over 111,000 violent incidents.

According to the Bureau of Justice Statistics, about 500,000 victims of violent crime in the workplace lose an estimated 1.8.million workdays each year.
This presents an astounding $55 million in lost wages for employees, not including days covered by sick and annual leave and a loss of productivity that has direct consequences for an employer’s bottom line.

Joe’s assault on his co-worker did not occur all at once. Anger storm clouds had been forming for quite some time. What signs should a supervisor or manager look for and how should it be dealt with? According to Workplace Violence, there are four levels of anger expression which need to be dealt with at the lowest level, to prevent escalation:

Four levels of workplace anger

  • Level 1 – Employee upset. Sensitive to criticism, and irritable. Displays “passive-aggressive” behaviors such as procrastination of work, expressing sarcasm, being late to meetings.
  • Level 2 – Behavioral symptoms escalate. Angry remarks are expressed. Employee is openly critical of others and the company. More emotional, less rational. Absenteeism and tardiness is common.
  • Level 3 – Escalating physical, emotional and psychological arousal. Raising voice, throwing things about, slam door, threats.
  • Level 4 – Assaultive behavior and or destruction of property.

Anger management training for supervisors and managers can help them as individuals and give them better skills to manage difficult employees, before the situation rises to a Level 4 crisis.

Key management strategies:

Strategy 1– Know your resources
Company resources include EAP (employee referral program), and HR (human resources). Community resources include psychologists, substance abuse programs, and anger management programs.

Strategy 2 – Assertive Communication
This means that you express your thoughts, feelings and opinions directly in an honest, open, straightforward and sincere manner. It also involves learning to actively listen to employees and being aware of non-verbal communication that goes beyond his or her words.

Strategy 3 – Set Limits
When you set limits with others in the workplace both parties know what they can expect from each other. When you clarify individual expectations, you avoid misunderstandings that can occur and thus avoid potential conflicts. For example, instead of asking support staff, “will you get this report to me as soon as possible?”, verbalize a specific time you need it.

Strategy 4 – Establish Consequences
In the real-world workplace, you may encounter conflicts with employees who are uncooperative or are unwilling to comply with the rules or policies of your company. As a manger, you may have to take an action that states to the employee the likely outcome of continuing problematic behavior.

Be sure to deliver consequences so they don’t sound like “threats,” but still get the message across.

Recognize stress before it turns into anger

After a stressful day as a computer programmer, Jim pulled into his driveway. The children’s toys were scattered on the walkway to the house.
He immediately began noticing slight tension in his muscles and apprehension in his stomach.

Entering his house, his wife ignored him while she talked with her sister on the telephone. His heart started beating a little faster.

Looking around, he noticed disarray; nothing was picked up, the house was a mess. Irritation and frustration started to settle in. Finally, as his feelings grew, he exploded and began yelling at his wife and children.

Stress may trigger anger

Stress is often the trigger that takes us from feeling peaceful to experiencing uncomfortable angry feelings in many common situations such as the one described above.

Stress is most easily defined as series of bodily responses to demands made upon us called stressors. These “demands” or stressors can be negative (such as coping with a driver who cuts in front of you on the freeway) or positive (such as keeping on a tour schedule while on vacation).

Stressors may external to you (like work pressure) or internal (like expectations you have of yourself or feeling guilty about something you did or want to do).

Whether the stressor is external or internal, scientists have discovered that the major systems of the body work together to provide one of the human organism’s most powerful and sophisticated defenses; the stress response which you may know better as “fight-or-flight”.

This response helps you to cope with stressors in your life. To do so, it activates and coordinates the brain, glands, hormones, immune system, heart, blood and lungs.

Avoid Jim’s destructive behavior toward his loved ones. Before your stress response turns into anger or aggression, use these strategies to get it under control:

Read your personal warning lights

Becoming aware of your stress response is the first step to managing it. This means listening to your body, being aware of your negative emotions, and observing your own behavior when under stress.

For instance, notice muscle tension, pounding heart, raising voice, irritation, dry mouth, or erratic movements.

What you see is what you get

For a potential stressor to affect us -stress us out – we have to first perceive it or experience it as a stressor.

Gaining a new perspective on the stressing situation can often drastically change the effect it has on us. Our stress response can indeed be a response (something we can control) instead of a knee-jerk reaction (which is automatic).

Examples: Cut off on the freeway? “It is not personal. That guy has a problem. I will stay calm.” Bullied by a co-worker? “If I react, he wins. Later, I will privately let him know how I feel about what he did. If that doesn’t work, I’ll discuss it with our manager.”

Stress-Guard your life

You can also make many life-style changes to reduce or minimize feeling stressed-out, even if you can’t change some of your actual stressors
For instance, manage your time better, establish priorities, protect yourself from toxic relationships, find a way to manage your money better, or consider changing your job or occupation.

Other stress-guards include those you have probably heard before, but maybe need to do more frequently such as:

  • Getting adequate rest.
  • Eating a healthy diet.
  • Avoiding excessive alcohol intake.
  • Living in a way consistent with your core personal values.
  • Developing social networks of friends and support.

Anger in The American family – How to stress guard your family

Joe and Emily live in Southern California with their three young children. Both work and must commute 2 hours daily on busy freeways, often not getting home until 7:30 PM, exhausted and depleted. Stressed, they have little patience for the antics of their young children resulting in constant shouting matches, defiance on the part of the children, continual yelling back and forth, and escalating family tension.

As this case example illustrates, stress is often an underlying cause of anger in family members. Sometimes the stress is caused by events outside of the family which family members then bring into the home; other times the behavior of family members causes stress and tension in the home. In either case, it becomes a problem when parents find themselves constantly yelling at their children or disagreeing with each other on parenting strategies. In the meantime their children continue to do what they please—or continue bickering and fighting with each other. Between the adults, stress can be a major factor in marital unhappiness and ultimately divorce.

How Stress can affect individual family members

Joe and Emily both suffered individual stress symptoms including fatigue, irritability, angry outbursts, headaches and a discontent with their lives. They began feeling increasing distant from each other. Their children were also stressed-out- being tired, irritable, cranky, and demanding of attention. They often fought with each other and actively did things to get each other in trouble with their parents.

Signs of the stressed family system

Just as individuals can become overloaded and stressed-out, so can families.
To understand how this can happen, we must remember that families such as Joe and Emily’s are the basic building block of our society – and of most societies. Families consist of two or more people who share goals and values and have a long term commitment to each other. It is through the family that children are supposed to learn how to become responsible, successful, happy, and well-adjusted adults. When this no longer happens due to stress, we can say that the family unit becomes dysfunctional in that it no longer serves its purpose fully, easily or consistently.

We can recognize the dysfunctional family by noting that parents and children no longer turn to each other for support, encouragement, guidance, or even love.

Such family members may continue to live in the same house – but often don’t feel emotionally attached to each other, perhaps start living independent lives, and unfortunately don’t view their family as a warm place to retreat from the stresses and demands of the outside world.

Five Tips to Stress-Guard your family

  • Tip #1 – Teach your children “resiliency” — the ability to handle stress and respond more positively to difficult events. Specific ways children can practice “bouncing back” include having a friend and being a friend, setting new goals and making plans to reach them, looking on the bright side, and believing in themselves.
  • Tip #2 – Institute family rituals to provide stability. Have a way to leave each other in the morning, and to re-connect in the evening; have a Sunday morning ritual or a Friday night family pizza ritual. Rituals create a sense of security and predictability – both of which are excellent stress buffers.
  • Tip #3 – Model and teach your children conflict resolution skills. Your children learn how to handle conflict partly by watching their parents. All couples have conflicts; better parents model good conflict resolution skills for their children. These skill include compromise, calm discussion, and focus on problem-solving. If there is much sibling conflict in your home, encourage your children to find a way to resolve their own conflicts rather than jumping in and punishing one or another child whom you think (maybe wrongly) is the troublemaker.
  • Tip #4 – Practice stress inoculation basics. This includes proper nutrition for family members, exercise, and adequate sleep each night. The family may also want to look at time management—and how better time management might reduce both personal and family stress.
  • Tip #5 – Minimize criticism and take time each day to be supportive to each other. Excessive criticism is extremely harmful to both children and marital partners, while emotional support by family members is an extremely important buffer to family stress.

The Anger-Damage effect on your heart: Guest blog from Dr Alan Levy

THE ANGER-DAMAGE EFFECT ON YOUR HEART

Guest Article by By Alan Levy, Ph.D.

How does anger do its damage and contribute to heart trouble? In this brief article, I explain the physiological and psychological mechanisms that are problematic ways of handling frustration and anger. I also present 8 helpful hints to better manage negative emotions and protect your physical and mental health.

How does Anger Affect our Bodies?

First, here’s how the physiological mechanism of anger works, according to the nation’s top heart-brain research centers, such as the Cleveland Clinic: Emotions like anger and hostility stimulate the “fight or flight” response of your sympathetic nervous system, releasing the stress hormones, cortisol and adrenaline.

These chemicals significantly speed your heart rate and your respiration. Your blood pressure goes up, and your body is hit with a burst of fight-flight energy. That’s often what triggers someone to fly into a rage, to
begin yelling and even throwing things.

This heightened state of physiological activation is designed to mobilize you for real emergencies, but can become habitual. Chronically high levels of stress hormones cause extra wear on your cardiovascular system.

Even the walls of your arteries can be damaged by the frequent anger response, because of the extra load of glucose and fat globules secreted into the blood stream.

The Good News

The good news is that anger and hostility as a risk factor can be changed for the better, just as blood pressure or cholesterol can be modified. Of course, stress can’t be measured as easily as cholesterol, but you can learn to take responsibility for your emotional responses and modify them for the better. Here are a few tips to interrupt storms of explosive anger or relieve yourself of self-damaging, imploded anger.

  1. Recognize, as early as possible, when you’re beginning to feel angry.
  2. Pause, before saying something or doing something impulsively. The time-worn advice– “count to ten”– is still wise.
  3. Put the situation into perspective. Ask yourself if this issue will matter 5 years from now.
  4. Say to yourself: “If this is as big a deal tomorrow as it is now, I’ll deal with it then, when I’ve cooled off a bit.
  5. Realize that, even though someone else’s behavior might have triggered your upset, blaming them for it won’t help you take responsibility for handling it well enough to regain your emotional balance.
  6. Understand that acting angry is not the way to show that you really care about something or someone.
  7. You may understand the nature of your problems with anger, but if you can’t put your insight into practice, it’s time to consult with an experienced therapist. Even a brief investment in counseling can
    produce remarkable results.
  8. Finally, remember to take this to heart: a change of heart comes from a change of mind about how you handle frustrating situations.

To sum it up, stressful reactions such as anger, anxiety, guilt, or mood instability can add up to increased risk for all kinds of medical problems, including heart trouble. Taking care of your emotional health will pay off with big dividends in maintaining your physical health and well-being.

Dr Alan Levy is an seasoned psychologist who practices in Costa Mesa, California. His website: alanlevyphd.com

Downloads

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

Angry Mothers: Learn Mindfulness. Then Teach It To Your Children!

Copy of assertive-arm and hand movements angry woman

The Problem
“I can’t deal with my own children,” lamented a young mother in one of our anger management classes.“They won’t listen, they do exactly what they want, they constantly fight with each other, and they won’t do their chores without a major argument.”

This young mother was ashamed that she was constantly angry at her own children. In response to their behavior, she would yell at them, call them names, and make empty threats of horrible consequences for non-compliance.But these responses did not seem to work; in fact, it made things worse as the children developed resentment and increased defiance toward their screaming mother.

The Solution As in an airline emergency, first put the oxygen mask on yourself. Then, put the oxygen mask on your children. You can’t expect your children to show good coping skills. and to handle stress well if you are impaired yourself.

Start by learning and then teaching mindfulness. to your children. It is amazingly simple, yet very effective over time. It helps mothers first deal with their own stress and anger and then gives her tools to teach to their children so that they can generally cope better with life. The positive effects of mindfulness has much science behind it and has many applications for both children and adults.

Mindfulness can be many things, but at its core, it is the skill of learning to focus on our present thoughts, feelings and body sensations without judgement. Many people associate this with meditation, but meditation is only one path to achieve mindfulness. It is very useful for relaxation, but it is much more than that. For children, it helps them become more attentive, balanced, and aware. For some, it has the potential to help kids see their lives more clearly, to become more positive and less tired, and to chose appropriate life paths.Learn more about this on CPR Classes Tampa.

As a first step toward helping our stressed client deal with her own stress, we taught her various tools of anger control. As a starter, we introduced the concept of mindful meditation consisting of simple breathing exercises. Mindfulness helps both mother and child calm down, to re-focus on what is important, to become more reflective, and to perhaps teach both to respond in different ways to family stress. Research shows that mindful practices over time increase “emotional intelligence” in children as they better understand how their brain works and how to develop more self-control with that knowledge.

Following are some simple breathing meditations that mother and child can practice together, taken from a book called “The Mindful Child” by Susan Kaiser Greenland :

Counting 1-1-1-1-1-1. When you breath in, let your body relax. When you breath out, silently count one, one, one, until your lungs feel empty. Repeat by relaxing again as you inhale and silently counting two, two, two, two, two, as you exhale. Repeat once more by relaxing as you inhale again and silently counting three, three,three, three, for the entire out breath. Continue this exercise in sets of three breaths (counting 1 on the first exhale, 2 on the second, and 3 on the third), until your mind quiets and you can rest in the physical sensation of breathing without counting.

When teaching this to your child, be aware that it takes time for them to accept the idea. Don’t force the issue, or another power struggle may develop, making things worse. For younger children, you may have to start with a 1 minute exercise, then gradually expand the time as your child progresses and sees the benefit. Don’t force them to close their eyes; some people prefer to keep eyes open.

The actress Goldie Hawn has written a delightful book on mindfulness called “10 Mindful Minutes.” which I would recommend to all parents. Among the wise nuggets of information is the followng: “Mindful parenting involves recognizing and nurturing our children’s unique personalities and not seeing them as projections of ourselves. There’s simply no cookie-cutter standard for how to treat our children.”

In our anger management classes we teach parents to respond instead of react to the behavior of our children that is troublesome. Hawn, in her book, amplifies this approach by saying that “reactive parenting can be very detrimental for our children. Yelling at them for forgetting something or doing something we don’t like only frightens them – it doesn’t make them stop.” We can gain control over our anger by understanding that our higher thinking has been hijacked by our emotional state; hence, we’re no longer in control.”

Once parents learn to respond differently to their children – not just react in knee-jerk fashion- the next step is to teach their children the same. Children need to understand how their brain works and how to deal with anger and frustration that all people experience. Hawn explains this simply as follows: “The anger and frustration that we feel in such moments is simply our Guard Dog amygdala {section of the brain} responding to the perceived stressful situation and taking over our emotions. Once we understand this, we can learn to recognize when we’ve been hijacked and accept that the path back to clear thinking is mindful awareness. ….”

In summary, a mindful approach to parenting quiets the minds of both parent and child, reduces stress, and puts both of you more in control of your emotions. Doesn’t that sound better than living in a family with constant yelling, screaming, negativism, and fighting?

Reduce Anger by Asserting Yourself

This holiday season, you may find yourself in groups or gatherings that make you feel uncomfortable. Sometime you can change it without offending anyone, yet standing up for our rights or opinions. We call this “assertive communication.”

When the tone of a social gathering becomes too confrontational, negative, lewd, insensitive, prejudiced, or otherwise distasteful, you needn’t remain at the mercy of it. You can usually find a way to but speak up,so that
things back move back into positive territory.

Speak your mind (in a nice way) by letting others know how you are feelings in response to what is going on. Offenders may be taken aback, but those who share your discomfort will welcome the intervention.

Too often we let situations deteriorate beyond what we find acceptable and may be hesitant to address it. But silence often only helps to condone the behavior and may create resentment and stress in you.

Anger At Work Linked To Stress

Some people say they know just what to do when their jobs becoming too stressful, but others feel stuck and frustrated. There are tears and confrontations which can lead to poor productivity, abuse of sick days, stealing supplies, and irritability or depression.

Sometimes the stress and anger are due to home problems which the employee brings with them to work. In other cases, it is the work setting itself which is causing the problem. Too much workload, perceived lack of recognition or appreciation by management, and conflict with co-workers or supervisors are often involved.

For more information on tools to deal with workplace stress and anger (sometimes called “desk rage”), click here.

Anger May Trigger Heart Problems

If you have heart problems and are on a ventricular fibrillator, try to stay calm!

Boston researchers are reporting that bursts of anger may trigger potentially fatal heart rhythm disturbances. The hotter the temper, the higher the risk appears of ventricular fibrillation.

“The old conventional wisdom is that, if you know someone has a heart condition, don’t get them upset,” said Dr. Chris Simpson, medical director of the cardiac program at Kingston General Hospital in Kingston, Ont.

There have been hints before that emotional events can cause disturbances in heart rhythm and the balance between our innate “fight or flight” response, Simpson said. But this is the first “direct, solid evidence that an episode of anger can immediately precede a dangerous arrhythmia” said Simpson, a spokesman for the Heart and Stroke Foundation.

Learning to manage anger involves eight core tools including learning to deal with stress, and learning different “self-talk” to take the stress out of potentially stressful situations. Deep breathing, meditation, and better time management can also greatly reduce stress in many people’s lives.