Get the FREE e-Book, The Eight Tools of Anger Control from Dr Tony Fiore

Rage behind the wheel: Can we help it?

Recent headline: “Road Rage may be due to medical condition called Intermittent Explosive Disorder (IED)”

What is the science behind this?

The study, reported in the June (2006) issue of the Archives of General Psychiatry was based on a national face-to-face survey of 9,282 U.S. adults who answered diagnostic questionnaires in 2001-03. It was funded by the National Institute of Mental Health.

Results? About 5 percent to 7 percent of the nationally representative sample had had the disorder, which would equal up to 16 million Americans . That is higher than better-known mental illnesses such as schizophrenia and bipolar disorder.

The average number of lifetime attacks per person was 43, resulting in $1,359 in property damage per person. About 4 percent had suffered recent attacks. Many of these attacks violated both civil and criminal laws.

Is it real?

This study has created much controversy regarding exactly what is “medical” about road rage and how it differs from plain bad, inconsiderate behavior. Undoubtedly, criminal defense attorneys will be arguing in both civil and criminal courts that indeed it is a medical condition!

Take the two following headline which were published recently:

News Item #1: “Police search for shooter following road rage incident”
Date: June 10, 2006. City: Indianapolis, Indiana.
The event: At an intersection, two drivers were involved in a confrontation when one of them opened fire on the other at a stoplight.

News Item #2: “Man, 21, charged in road rage shooting.”
Date: May 21, 2006. City: San Antonio, Texas.
The event (according to news reports): “Around 3AM Samuel Hitchcock, 21, Daniel Pena, 17, and another man were driving when a pickup passed them on an inside lane, striking Hitchcock’s side mirror. Hitchcock followed the truck into a residential area to gather information and the truck made a sudden turn, stopping. Hitchcock pulled up next to the truck. Pena, who was in the front passenger seat told police the truck’s driver pulled a gun and started shooting at them, striking him and killing Hitchcock.

Are all cases like this due to Intermittent Explosive Disorder? Very unlikely! Some are and some are not. This is why it is important to have a professional assessment of each case of “road rage” to determine the underlying cause, such as IED — or some other problem.

Other causes that could come into play would include: alcohol or drug intoxication, stress, depression or bipolar disorder and, of course, bad, selfish or inconsiderate behavior. A good attorney will refer you to a doctor who specializes in diagnosing mood disorders to determine the specific cause in each situation of apparent road rage.

Road rage vs aggressive driving

The person who weaves in and out of traffic, tail gates, or cuts in front of you may not be showing “road rage” per se, but inconsiderate aggressive driving. He is not angry at you; he probably doesn’t even know you exist, being preoccupied with his own selfish needs.

IED seen in other life areas

It is also important to remember that persons who do indeed suffer from Intermittent Explosive Disorder may explode in many other situations besides road rage. Often they “blow up” at spouses, children, co-workers, or customer service employees.

Remedies for road rage

If road rage is indeed due to IED, there are two treatments that can help both adolescents and adults: (1)medications , and (2) cognitive training. The medications usually involve SSRIs (a type of anti-depressant). In my opinion, most people who show rage on the road do not need medication, but some do and will benefit greatly from them.

Cognitive Training means learning to think differently about driving, aggression on the road, and other drivers. Cognitive training is an important element in many anger management programs, which a few states now require for “road rage” behavior and/or aggressive driving.
Some anger management classes and programs teach specific cognitive and behavior skills to control aggressive, inconsiderate, and dangerous driving behaviors.

These skill include:

  • Managing life stress better, including time-management skills.
  • Developing empathy for other drivers.
  • Learning healthy “self-talk” phrases.
  • Adjusting expectations of others on the road.

Successful Marriage: Love ain’t enough says Dr Tony Fiore

What are these “thirds” that are destructive to a relationship?
A destructive third can be anything that prevents a couple from having a close bond, having each other’s back and prioritizing their relationship. Thirds can create havoc in a marriage, yet the problem is not strictly a marriage problem per se. The real problem is inability of a couple to successfully deal with an outside stress threatening the marriage.

Common thirds that I see in Couples Counseling in Orange County are:

  • Anger or poor impulse control
  • Parenting or Children Stress
  • Substance Abuse (including excessive drinking) by one partner

Anger or Poor Impulse Control

Contrary to popular opinion, marriage is NOT a place where you should always feel that you should be able to “be yourself.” Unbridled Self-expression is about getting things off your chest, without considering how your partner will react. This is not a good thing to do if you want a secure, loving relationship with your partner.

In fact, in one study in the United Kingdom, one in five of people (20%) say that they have ended a relationship or friendship with someone because of how they behaved when they were angry.

The main problem with too much anger is that hostility begets more hostility, once a couple starts to fight. According to famed researcher Dr John Gottman, 65% of men increase negativity during an argument. You push many people and they will fight back which does no one any good.

You poke the bear too many times or with enough intensity, you get consequences.

You do NOT need to say everything that’s on your mind when you are mad–at least not now. If you must get it out, wait for a better time after you both calm down.

Even If you apologize later, the damage is done. It erodes trust between you. It invites retaliation. It encourages withdrawal on the part of your partner sometimes physically, sometimes emotionally. It says you care more about your own selfish needs of self-expression instead of preservation of your relationship.

Parenting or Children Stress

Believe it or not, studies of marital happiness show that the time of least happiness for many couples is right after the birth of that little bundle of joy.

Successful couples find a way to still prioritize the relationship itself while unsuccessful couples often kind of forget about the relationship as they devote all their time, energy and resources to raising the kids.

Forward 20 years and they look across the kitchen table one morning at a stranger they used to be madly in love with and wonder what happened.

Things get even more complicated in today’s modern world of co-parenting and blended marriages. It takes much maturity, sound judgement, and balancing ability to be a good and responsible parent, yet make your partner feel that they are number one on your list!

Substance Abuse by One Or Both Partners

In most cases, I will not even attempt marriage therapy or counseling if there is a real issue of substance abuse including alcohol abuse (I do tolerate some instances of medical marijuana use, If done in moderation, the partner is accepting of it, they have a medical card, and they do not use where children can be exposed).

What to do about the situation depends on how much you can tolerate and the degree that his or her substance use affects your relationship.
Worse case scenario–it can completely destroy it. Most spouses do not want to live with someone who abuses alcohol regularly, to the embarrassment or detriment of either. In many relationships, excessive alcohol and refusal to get help is a deal breaker–and it should be. ?

Best case scenario–adjust your expectations and put it in perspective. For example, maybe most of the time your partner is fine and only occasionally abuses alcohol–and then is a sloppy drunk, but not a mean one. Put in perspective, maybe you can learn to live with it if appropriate boundaries are established and followed (e.g., two drink limit)

If you are on the fence as to discerning what you should do about a substance-abusing partner in your particular case, consult a professional who can help you sort things out.