Anger Management

Harry L. Mills, Ph.D. and Joyce R. Mills, M.S., M.Ed.

Anger is an emotion that is experienced by all people everywhere. Anger usually results from an emotional hurt. It is typically experienced as an unpleasant feeling that occurs when we feel injured, mistreated, or are opposed in long held views, or are faced with obstacles to attaining personal goals. Anger varies in its frequency, intensity, and duration. People also vary in how easily they get angry, their anger threshold, as well as with their comfort level with the emotion. Some people are always getting angry while others don’t even recognize that they feel angry. While some experts say that the average adult gets angry about once a day and annoyed or peeved around three times a day, those who work with people with anger management issues suggest that getting angry 15 times a day is average. In any case, anger is a common human emotional which we probably experience more often than we would like to admit.

It should be noted that anger can be constructive or destructive. When well managed, anger or annoyance has few detrimental health or interpersonal consequences; when mismanaged anger can be deadly. There is a difference in feeling angry and expressing your anger.  To feel anger is to be human. The feeling contains information that can be of value. Expressing your anger inappropriately or prolonging the experience of anger can be dangerous. Not only can out of control anger damage personal relationships, it can lose you your job, land you in jail, damage your health or even kill you. For example, recent research suggests that men who have poor anger management skills are more likely to suffer a heart attack before age 55 than their more mild-mannered peers. A separate study involving 774 older white men (average age 60) indicated that high hostility levels were more predictive of developing coronary heart disease than risk factors like high cholesterol, alcohol intake, cigarette smoking. Older men with the highest levels of hostility were at the greatest risk for developing coronary heart disease independent of the effects of BMI (body mass index), waist-to-hip ratio, fasting blood-sugar levels, triglcyride levels, and blood pressure.

Anger can alienate friends, co-workers and family members. Your expressed anger elicits anger in others as a defense.  Hostile, aggressive anger not only increases the risk for an early death but also the risk for social isolation, which is in itself a major risk factor for serious illness and death.

Meaning of anger

Anger is composed of the thoughts that trigger the emotion, the bodily arousal a person experiences, and whatever behaviors are exhibited, which are often culturally determined. The goal of anger is to protect or further our self-interests, or those of our loved ones, or uphold principles and causes we hold sacred. Instinctively anger often results in the desire to defend ourselves and strike back at its cause, often aggressively. Behind all anger is some form of pain, physical or emotional. It can start with not feeling well or feeling rejected, feeling threatened, or enduring a sense of loss. The type of pain does not matter; the point is that it is unpleasant and it makes you want to end the suffering. It is when these unpleasant feelings are associated with trigger thoughts that anger erupts. Trigger thoughts are assumptions, evaluations or your interpretation of situations that make you feel like you are being victimized or someone is deliberately trying to hurt you.

Many of our trigger thoughts have their roots in childhood. Often a person will overreact to a current situation because they learned earlier in life to be very angry when they experienced hurt, neglect or abuse. As an adult the person will have difficulty with situations and conflicts that threaten them with feeling unworthy, unloved or unsafe. Any time a situation “triggers” these old feelings of betrayal, the anger expressed will not only be about the current irritant but also about remnants of the pain felt before. When one of these old triggers is unleashed the degree of anger expressed is often excessive for the immediate aggravation. In addition if parental role models use anger to manipulate and control family members the children may learn destructive ways to manage anger. The children  learn not only to be extremely angry because of the mistreatment they receive, but also how to express their anger in an inappropriately aggressive manner.

In response to violation of boundaries

Two common causes of anger are a feeling of encroachment in areas we hold precious, and feelings of abandonment when we lose things we hold dear. If another employee gets the promotion that we feel we should have been ours, we can be very angry at that person for “stealing” our opportunity, or at our boss for being stupid and passing us over. If we are threatened by the loss of a close friend or spouse we can feel very angry at their “betrayal.” This second type of anger may contain holdovers from childhood when adults let us down, leaving us feeling abandoned. When we experience a current situation that suggests we are being unfairly abandoned it reinforces and justifies our sense of outrage.

As adults our feelings of protectiveness extend to family members or beliefs that we cherish. Sometimes this can flow into areas where a cool head would be more appropriate. If our child is passed over for an award or is not given enough time at bat we may feel angry because our loved one has been “mistreated.”

Thus anger can be considered:

• A response you learned early in life to help cope with pain and fear
• A temporary way to overcome feelings of lack of control or helplessness
• A habit you do not know how to break.

Anger can co-exist with other emotions

In spite of its frequent occurrence, anger may be considered a secondhand emotion. It is preceded by feelings such as fear or pain. In fact some experts describe anger as an afflictive emotion because of its association with pain, suffering, or injury. Moreover, some of the physiological responses to anger and fear are the same, even though we acknowledge different feelings. It is our psychological interpretation of the experience of an epinephrine rush that gives the experience meaning. Is that sinking feeling in your stomach, the sweat on your brow or the nervous palpitations of your heart a sign of fear or anger? Ask yourself: Does the present situation threaten you with personal or professional embarrassment? Do you feel like someone is taking advantage of you or preventing you from doing something you want or need to do?  Is there something about this situation that evokes one of your anger triggers?  If so then you are probably becoming angry in addition to whatever else you may be feeling.

Some anger is an alternative or substitute emotion

Anger can temporarily protect you from having to deal with threats suggesting personal weakness. Getting angry helps you hide from others that you find a situation frightening or that you feel vulnerable. An angry person feels powerful. However, angry outbursts only work temporarily. Anger does not resolve the problems that made you feel fearful or vulnerable in the first place. The challenge is to learn how to use your anger productively.

Physiology of anger

Our bodies let us know when we are angry. For example, when we encounter one of our emotional triggers we begin to feel tense. Hormones called catecholamines are released which cause us to experience a burst of energy.  This initial burst of energy lasts several minutes. Next hormones, such as adrenaline and nonadrenaline are released, which can keep us in heightened aroused for hours or even days. This is why a rather minor irritation can cause you to explode in anger if it is preceded by an earlier upsetting episode.  In any case, once we begin to experience these physiological changes our face flushes, our heart rate accelerates, blood pressure rises, respirations increase.

Although some major elements are the same in the face of fear and anger our interpretation is different. We say we are “hot and bothered” when angry and “cold and clammy” when afraid. This is because while our heart rate may go up in both instances, skin temperature changes are different.  Our skin temperature increases when we are mad which is why we feel “hot” or that we have “lost our cool.” In contrast, when we are afraid our skin conductance drops and we feel cold.

Polarizing effect of anger on attention, memory

When a person is attending to something they are interested in, such as watching a play or listening to instructions explaining how to do something they really want to do, their heart rate drops. Even babies show a heart rate drop when attending to something of interest to them. If a person is trying to concentrate on a problem and must block out distractions their heart rate rises. Thus if you are trying to block out your feelings about the guy that cut you off and nearly caused a wreck as you were driving to work, your heart rate will be elevated and you will have greater difficulty concentrating than if you were attending from a more neutral perspective.

In fact, epinephrine and norepinephrine fuel many emotions. These hormones help the brain learn and enhance memory, concentration and performance up to a point. However, when the body becomes flooded with epinephrine you become too excited and concentration and performance decline. If you become too aroused you are like a deer frozen in the headlights of an approaching car. This is why you cannot remember the details of a really explosive argument, although the person you were arguing with and who was not as angry has a clear memory of what transpired.

Motivational effect of anger

The physiological experience of anger energize us for vigorous action. Anger mobilizes actions to strike out at the threat. It gives us the determination to go forward.

Anger:

·        Gives a sense of power and control

·        May motivate a person to change a personal weakness

·        Defends a person against feelings of guilt, fear, grief, hurt, pain, sadness, and helplessness

·        Can help you get what you want, at least temporarily

·        Can point out social wrongs and motivates you to work to change them

·        Gives a sense of power

·        Minimizes a sense of inadequacy temporarily

·        Gives you the resolve to leave an abusive situation

·        Allows frustration to be vented and tension released

·        Makes you appear superior, or powerful

·        Makes you feel justified in your beliefs

·        Helps you see that you are  not getting what you want

·        Gets you attention from other people

·        Can be used to coerce people to do what you want them to do.

Type A Personality and the Type A Paradox

Type A people are described as competitive, goal-oriented, productive, ambitious, leaders in the making who are in a hurry. They are competent and determined to be successful—and frequently are. The problem is that they are also likely to be hostile and angry.

The specific aspects of a Type A individual that continue to be related to heart disease are explosive reactions, competitiveness, impatience, irritability and hostility. Lumped together these traits equal anger.

It is the tendency to be angry and hostile that results in the Type A paradox: the anger that drove you to triumph over all obstacles to reach professional heights is the same behavior that puts you at risk for serious illness and death. Closer examination suggests that the crux of the matter is motivation. Type As seek excellence to prove their worth. Type B people, on the other hand, can also achieve personal success but do so because the process is enjoyable to them. Type Bs feel secure inside and do not need hostility or competition to succeed.

While discussions about adrenaline and noradrenaline—two of the stress hormones associated with the sympathetic nervous system (SNS); its opposite, the parasympathetic nervous system (PNS) is less frequently discussed. This is unfortunate since the parasympathetic nervous system is vital for survival. When activated the parasympathetic nervous system released a compound called acetylcholine to any tissues served. Once inside of a cell acetylcholine has the ability to neutralize adrenaline. Most organs involved in the fight or flight response receive input from both the sympathetic and parasympathetic nervous systems. The PNS can put the brakes on the fight or flight physiological changes. It cools us down and calms us. It puts the brakes on anger.

In a series of studies carried out in Japan it was discovered that Type A men, especially those with high hostility levels, have weaker parasympathetic nervous systems than men with low hostility levels. An effective PNS can help counter the effects of the SNS which results in the heart working less hard and lowering the risk for developing heart disease.

There is also research that indicates that the immune system may be weaker in hostile people. The immune system is thought to play an important role in helping keep us cancer free, especially in the action of “natural killer cells” which can kill tumor cells that form in the body. A study involving low and high hostility scoring med students indicated a reduction in the natural killer cells in the blood of high hostility students during high-stress exam periods.

In summary, hostile Type A people are wired differently. Their SNS is activated at the slightest provocation while nonhostile people’s SNS show relatively small responses to even strong stimuli. The end result is that hostile people spend more time under the influence of an aroused nervous system which can set the stage for the development of heart disease because of repeated exposure to elevated cardiac demands, increased mobilization of cholesterol into the blood, and increased clumping of platelets while the immune system functions are decreased. This difference in exposure may account for the increased death rates seen in aggressive Type A individuals.

Heart disease

If your immediate impulse when faced with having to wait in traffic or in a long line at the grocery checkout, or dealing with a recalcitrant computer is to start blaming people, and getting angry you are slowly killing yourself. Your anger has turned into hostility and you are at increased risk from death from many causes.

Research indicates that high hostility levels in older men are strongly related to the development of heart disease. Hostility appears to be a greater risk factor than high cholesterol levels, smoking, and being overweight. Furthermore the older men in this study with the highest levels of hostility were at the greatest risk of developing heart disease. This increase in risk appeared to be independent of insulin levels, body mass index, waist-to-hip ratio, triglyceride levels and blood pressure. In other words, being highly hostile appeared to be more closely related to the development of heart disease than the more commonly thought of risk factors and the higher the hostility level the greater the likelihood of developing heart disease.

Constant chronic feelings of anger, hostility and aggression raise the risk of developing arteriosclerosis and coronary heart disease as much as five times the normal rate. Suppressing anger is not a major contributor to heart disease; over-experiencing and over-expressing anger is the villain.

Hypertension

Research has indicated that anger causes high blood pressure in hostile people in much the way salt increases blood pressure in people who already have high blood pressure.

Anger is a poison for hostile people. In a research study that examined the effect of harassment on men trying to perform a mental test, ONLY highly hostile men showed increases in blood pressure and blood flow to the muscles.  Men who scored low on the hostility scale did not demonstrate these physiological changes. The high hostility group also reported much higher levels of anger and irritation afterward than the less hostile men. In a second study the high hostility men were shown to also have a larger increase in stress hormones than the less hostile men. This closer connection between anger and physiological hyperactivity can be one of the explanations why hostile people have more health problems. Hostile people need to control their anger if they want to avoid increasing their risk for health problems.

Social costs of anger

It is no fun being around someone who is constantly angry. Hostile, angry people are not happy. Not only do hostilely angry people hurt their spouses but they also hurt their children. While they may not resort to physical violence, verbal abuse is common and extremely detrimental to the children. If nothing else anger can reduce the intimacy in personal relationships as your partner and other family members become more guarded in their interactions with you.

Hostile individuals also report more stress in the interpersonal aspects of work. They are less satisfied with their jobs and have a negative view of work relationships. In addition, an aggressive interpersonal style sabotages the goodwill of subordinates and lowers the probability of work goals being met. Colleagues begin to avoid the hostile employee resulting in the chronically angry individual feeling isolated.

Many hostile people blame everyone else for their social problems. This is unfortunate because lack of a social support system is one of the paths a hostile person can take to serious disease. Angry people frequently have cynical attitudes toward others and are unable to recognize or utilize support when it is available; especially if the offers for help are judged inferior because of their overly demanding expectations. When genuine attempts to help are shunned or ridiculed it only worsens the situation, pushing others further and further away.

Finally, angry people tend to drink, smoke and eat more than their less angry counterparts. Without a social network of people to dampen these tendencies the probability of serious health consequences seems inevitable.

Fear and aggression

Fear mobilizes us to defend ourselves. Our choices are to fight, flee or freeze and these choices are ushered in by several physiological changes. The circuits of the brain trigger a flood of stress hormones that put the entire body on alert. Blood rushes to the large skeletal muscles, like the legs, to make it easier to flee. Fear as an emotion is useful to help us mobilize our actions when there is no time for lengthy deliberations. In fact, heeding the call, to avoid a potentially damaging encounter, is often the wisest course of action, since problems can be solved much better when all parties are relatively cool headed.

When we elect to fight rather than run the motive is to strike out in an effort to eliminate a threat. Our heart rate and blood pressure and respiration increase as hormones such as adrenaline energize us for vigorous action. Unfortunately there are not very many places where physical aggression is appropriate, since most of us are not professional prize fighters, or football stars. Verbally assaulting your boss is also not a good idea, nor is jumping out of your car to attack a fellow motorist. Aggression may be a natural reaction to a perceived threat, but it is rarely an acceptable alternative, except in war.

Tension/Distress

Tension has been defined as the initial stage of anger. When we are tense and in a state of physiological arousal because of the pressures we are under we can be provoked more easily than when we are calm and relaxed. Mole hill annoyances grow into large mountains if the tension level is already high.

Physical or mental distress reduces our ability to deal with irritations and makes us more vulnerable to anger. If we are sick or emotionally upset we tend to focus more on ourselves and our own needs because of the pain that we are experiencing. Such distress saps our energy, reduces our patience and makes us more likely to get angry about things that we might ordinarily take in stride.

Isolation

People who do not or cannot control their angry outbursts are often isolated socially. Not having a social network increases a person’s risk for serious health problems, especially heart attacks. Since many hostile people generally mistrust other people they take the rejection as verification that other people are evil and not worthy of them. Some hostile people can even be considered phobic when it comes to trusting others. In realty some experts say that the extent of a person’s hostility may be a measure of how threatened and insecure that person truly feels.

Another area that causes hostile people problems is their intolerance. They tend to attribute people they see or read about with unflattering characteristics. People are stupid, lazy, morally inferior, unenlightened and obstinate. These attributions then justify their anger. 

Hostile individuals often assume that they know what everyone else is thinking and they act accordingly, often without giving the other person the opportunity to express what they are REALLY thinking. Many hostile people do not listen to what others say or notice much of what they do; their self-involvement is understandable given their level of cynicism.  While the hostile individual may feel virtuous and morally superior their judgmental attitudes are deadly for them, both physically and socially. The more righteous they feel the greater they distance themselves from others.         

Loss of employment or jail

Uncontrolled anger can result in loss of employment, loss of one’s family and even incarceration. Individuals who cannot get a grip on their disruptive, aggressive behavior are likely to suffer not only increased risks for health problems but serious social problems, including doing time in jail.

It is better to walk away from an inflammatory situation than to lose control and act in a socially irresponsible way. Unless aggression is necessary to battle an intruder or a bear at our campsite, we should not resort to its use. Instead of increasing our power, it will be diminished considerably. We should not fly into a rage at our boss, especially in front of subordinates. Not only will we probably lose our source of income but we have permanently damaged our relationship with our fellow employees whom we may need to work with again in this or another job. Even if our anger is aimed primarily at co-workers it will reduce our productivity, give us a reputation as a troublemaker, cause us to have poor job performance reviews and ultimately cause us to lose our job.

Hostile anger can also cause us to strike out at other people, physically and verbally. Road rage, abuse of family members, and getting into physical fights can all result in our getting in trouble with the law and may even land us in jail.

Knowing when you are angry

We get a number of internal and behavioral cues that we are becoming upset. You can learn to recognize this prior to your anger getting out of hand.

Some of the physical signs that you may be becoming angry are:

• Clenching your jaws or grinding your teeth
• A headache
• A stomachache
• Rapid heart rate
• Sweating, especially the palms
• Feeling hot in the neck/face
• Shaking or trembling
• Feeling dizzy.

Emotionally we may feel:

• Like fleeing the situation
• Sad or depressed
• Guilty
• Resentful
• Anxious
• Like striking out verbally or physically.

Behaviorally we may notice that we:

• Are raising our voice
• Rubbing our head
• Pacing
• Getting sarcastic
• Losing our sense of humor
• Are being abusive
• Have an urge for a drink or other substances
• Begin to yell, or scream or cry.

Initial cues

One of the most important things that you can do in an effort to learn to manage your anger is to recognize when you are becoming angry. Two valuable cues are physiological responses and the triggering of emotionally vulnerable areas. Physiologically an angry person becomes aroused. There is an adrenaline burst which elevates heart rate, and raises the blood pressure. Your head may hurt, your palms may feel sweaty, you may feel dizzy or shaky, etc.  These symptoms should alert to you that you are becoming upset. When you are angry there is a target for your anger. Emotionally your reaction to these physiological changes is indignation and animosity to whomever or whatever is trying to hurt you. Try to take a deep breath and determine if one of your anger triggers has been tapped. If so you should immediately try to determine what information you can get from your feelings. Then try to calm yourself down.

Executive Control

The seat of our emotions is a small almond shaped part of the brain called the amygdala.  There are two, one on each side of the head.  The amygdala is like a psychological sentinel that examines each event in our lives for its emotional meaning.  It asks basic questions like:  Is this demeaning? Do they intend to hurt me? Depending on the answer the amygdala sends out an alarm.  The amygdala can start our reactions in motion before the neocortex, or the thinking brain, can check on the reasonableness of our actions.  The amygdala can hijack the rest of the brain.  This has led neuroscientist Joseph LeDoux to point out that the emotional system can act independently of the neocortex. Some emotional reactions and emotional memories can be formed without any conscious cognitive participation at all. That often happens with anger.

Fortunately, the part of your brain just behind your forehead, the prefrontal lobes, can modulate these emotional impulses. The left prefrontal area can switch off emotions.  The thinking brain can serve an executive role.  Unfortunately executive control does not always prevail. The emotional brain can and does surge out of control.  Harmony between thought and emotion is thus lost. One of the keys to anger control is to develop and understand the best ways to facilitate that prefrontal executive control. There are two essential elements:

• Reduce the arousal level with relaxation
• Use cognitive control techniques

It is important, therefore, to improve your self-calming skills to avoid an emotional high jacking and learn to use your thinking skills to regain executive control.

Assertive expression

Many people have trouble expressing their feelings.  It may be because they do not feel entitled to do so or they don't really know how they feel.  Most often they just don't know this simple formula:

·        I feel.

·        When you.

·        Because.

All three elements must be included.  It is important that you finish the "I feel" with how you feel but without being aggressive.  For example "I feel you are a jerk" is aggressive not assertive. When you are effectively assertive you are explaining how you feel when certain things happen and why. Instead of “I feel you are a jerk,” how about, “I feel like you don’t think much of me when you know you will be late for dinner and don’t take the time to call because I don’t know what is keeping you and I worry.”

The most common times when people have trouble being angry rather than assertive are:

·        Stating a difference of opinion

·        Receiving and expressing negative feelings

·        Dealing with someone who refuses to cooperate

·        Speaking up about something that annoys you

·        Protesting a rip-off

·        Saying "No"

·        Responding to undeserved criticism

·        Asking for cooperation

·        Proposing an idea

One of the first elements in assertiveness is to learn to stop and reflect before responding.  The sequence should be:

·        Immediate stop (think of a big red stop sign)

·        Breathe and use a relaxing cue (e.g. like the word calm or cool )

·        Reflect and look for your emotional trigger

-         Am I responding to a real problem on my own distorted thinking?

-         Do I need to "win" in this conversation?

-         Am I afraid to show any sign of weakness?

-         Do I feel compelled to put this person down?

·        Choose how you want to respond

·        Respond

Even assertive people have trouble under pressure. When under pressure try these steps:

·        Make eye contact with the person.

·        Don't go on until you feel relaxed. If you need more time, buy time by saying "okay," or "all right."

·        If you are still unable to relax, it might be best to temporarily remove yourself from the situation.  Disengage with a polite statement, such as "I'm really upset now.  I'd like to return in a few minutes and talk with you about what happened."

·        Use "I" statements to express your feelings or make a request.  This is to simply let the other person know where you stand, not to give you power leverage.

·        Reflect the other person's response by using "and" statements, not "but."  For example, "I understand you are upset, and when you yell like that, I get very upset."  This kind of response, as opposed to the more negative statement using "but," creates an air of conciliation and allows for constructive discussion.

·        Assess your effect.  Did the person hear you?  If so, continue. If he or she was too angry to understand, restate or reflect in another way. If it seems that communication is impossible, disengage until another time.

·        State your needs and your common goals with the person.  This can be difficult when anger and defensiveness rule, but it is vital for creating an empathetic mood.  For example, "I would like to see your department as productive as possible and I know you would like us to try your plan.  Here is a suggestion I would like to share with you."

• Note, however, that if you need to leave the situation to compose yourself, then do so.  It is better to stay in control.

Aggression vs passivity vs passive aggressive vs assertive

There are four types of social communication ranging from aggressive to assertive and each has its own script:

·        Aggressive - a communication which says: "I count but you don't count."

·        Passive - a communication which says:  "I don't count and you don't count."

·        Passive‑Aggressive - a communication that says:  "I count. You don't count but I'm not going to tell you about it."

·        Assertive - a communication which says:  "I count and so do you."

Aggression is rarely appropriate and passive and passive aggressive responses are all too common. To learn to control anger you must learn to be assertive.

People who don’t understand assertiveness think that it is equivalent to passivity. It is not. Assertiveness is “anger in defense” to aggressiveness as “offensive anger.” Passivity invites an affront and may eventually lead to more anger.

An assertive response involves stating your thoughts and feelings calmly about a situation. Instead of blaming, or accusing or using threats or name-calling you calmly and rationally present your case. It is a much more powerful way to respond to conflict than flying into a rage.

For personal coaching on anger management contact us.