Cognitive Behavioural Therapy (Brilliant Business) 1st Ed.

9. Taming anger

‘Anybody can become angry, that is easy; but to be angry with the right person, and to the right degree, and at the right time, and for the right purpose, and in the right way, that is not within everybody’s power and is not easy.’

Aristotle

As Aristotle’s words imply, there is a legitimate place for anger in our lives. Anger is a natural emotional response and serves us well in many ways: well-regulated anger helps us protect ourselves when attacked, can motivate us to act decisively or act as a pressure valve to let us restore our equilibrium. However, when it rules us, anger becomes a very negative force indeed.

CBT has proved extremely useful in helping many people who struggle with anger understand the links between their behaviour and the biased ways in which they view themselves and the world around them. Because anger can so quickly cause us to lose control, the process of challenging the thoughts and attitudes that ignite rage and modifying behaviours that fuel the flames is not easy. However, it can be done and CBT can help.

How to get yourself really worked up

The inner thoughts of angry people are usually littered with distortions, but two main features stand out.

Angry people are mind readers par excellence. They spend a great deal of time making assumptions about what other people are thinking, and the attributions they make often imply hostile intent, selfishness or neglect on the part of the other person.

On top of this angry people stay angry because they take everything personally: their beliefs tell them that the other person is out to get them, to cheat them, to ignore their feelings or hurt them in some way. They will use massively emotive language to give form to their thoughts. They then use selective perception to gather evidence to support their beliefs and the more plaus-ible their assumptions become, the angrier they feel.

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Look at the example below and see whether you can identify the thought distortions responsible for building this business traveller’s rage:

Malcolm has just got off the red-eye flight from New York and is at the airport waiting for his luggage to arrive. The baggage carousel has been churning slowly round for the past 20 minutes. Other people have collected their bags but Malcolm’s have yet to appear.

‘I’ve paid rip-off prices to travel business class for Pete’s sake: surely that ought to count for something. I shouldn’t be kept waiting like this…’

Malcolm can feel his temperature rising. In his mind he pictures the baggage handlers throwing his luggage around in a cavalier fashion so preoccupied with their discussion of last night’s cup final that they have sent his bags trundling off to Timbuktu.

‘It’s so bloody typical of this lame-duck company! That sour-faced cow who checked me in was really offhand as well. Would it have cost her to smile? And the slop they served up - no wonder I’ve got indigestion. People just don’t take any pride in their work any more. Nobody gives a damn. **@!! ing idiots! One thing’s for sure: someone’s going to pay for this…’

The knot in Malcolm’s stomach tightens as he feels resentment building inside him. The throbbing in his temples is becoming more and more intense.

‘And who’s that joker smirking at me behind his desk? Thinks it’s funny does he? I bet he just loves to see us all waiting around like stranded sheep. Well I’m not standing for it. Let’s see how amusing he finds it when I give him a piece of my mind… ’

Malcolm storms off to harangue the airport official who innocently smiled at him, oblivious to the fact that his bags have finally arrived.

Although you may feel reading this that our traveller’s anger is partially justified, those of you who have been paying attention will have noticed a number of negative assumptions and thought distortions at work in his inner rant that turn his delay from an inconvenience into a violation of his human rights.

Not only does Malcolm use highly emotive language and imagery to portray his experience but immediately starts seeking someone to blame for it. Underlying his response are rigid assumptions about what he is entitled to, and the hostile motivations of the ground crew. He searches around for evidence to support his belief (selective perception) that the airline is committed to providing a substandard service, generalising from localised instances of their apparent failings. Most of all, he makes liberal use of mind reading and fills in the gaps with his own negative attributions when little solid evidence about the intentions and feelings of others is available. So what is making Malcolm mad? The answer ultimately is Malcolm himself.

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On the same flight was Pierre, a more laid-back French executive of many years experience. He too has been standing round the carousel for the past 20 minutes but, unlike Malcolm, is in a calm and collected state. In fact he is in quite a good mood.

Can you speculate how Pierre might be framing the same situation to himself? How do his observations and explanations contrast with those of Malcolm?

Better out than in?

‘It takes tremendous energy to keep our instinctual life buried and the longer and more deeply it is buried the more demonic it becomes and the more energy is required to keep it buried.’

Hal and Sidra Stone, psychotherapists

Repression is seldom a very sensible strategy when it comes to your feelings and when dealing with anger it can be disastrous. Pent up rage seeps out into our lives in a variety of distorted forms.

Nevertheless, the supposedly cathartic venting of anger may not be the way to go either. In controlled studies researchers have found that giving yourself over to your anger and ‘getting it out there’ by beating cushions, screaming and other such techniques, in the long term tended to increase aggressive impulses and behaviour. CBT of course would suggest that if we allow ourselves to behave like an angry person then the chances are we will soon be thinking and feeling like one too, so this makes sense. However, given that the fight–flight response does gear us for action it does follow that some kind of physical release of anger may be beneficial once in a while.

The key, of course, to managing anger well is to articulate your feelings in a controlled way and preferably long before they take you to breaking point. One of the maintaining factors for many angry people is that they don’t address their feelings until way too late. Sometimes this is because they do not notice them. If you have learned to repress anger in childhood then you may brush aside small annoyances so automatically that you become unaware of the cumulative pressure building inside.

For other people their past experiences and beliefs about their anger – that if expressed it will bring the world crashing down, that they will lose control, or that they will be punished or shunned – act as a powerful brake on the expression of their feelings. The repression of feeling becomes a safety behaviour that ultimately leads to the very scenario it seeks to avert when the damn bursts.

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Are your beliefs about your anger holding you back?

Tackling your beliefs about your anger may be just as much of a priority as addressing the content of your angry thoughts.

How strongly do you believe any of the following?

□ I cannot control my anger. It is too powerful for me.

□ It’s wrong to feel anger.

□ Anger should never be expressed.

□ I must never upset other people.

□ If I say what I feel I will be punished in some way.

□ Anger is always unacceptable.

□ If I feel angry then it is probably my fault.

If you hold any of these beliefs use the techniques in Chapter 4 to consider alternative positions and evaluate them using Socratic reasoning.

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Inflexible people are more likely to snap

The other distinctive feature of angry people is the rigidity of their thinking. They tend to be very dogmatic in their attitudes and their inner world is governed by innumerable rules that are often expressed in the form of ‘must’ and ‘should’ statements. To the person prone to anger their beliefs often seem self-evident: of course people should never swear; it’s obvious that people who claim unemployment benefit are scrounging off the state; it stands to reason that there is always a right way and a wrong way to do most things.

Angry people are often highly invested in their rules and assumptions about how the world ought to be, and how it ought to treat them. Consequently, when their rules are ignored or violated by others they tend to feel assaulted. Polarised thinking feeds anger because it makes it hard for people who think this way to ‘agree to disagree’ or see things from another person’s perspective. Inflexibility predisposes people towards conflict and conflict inevitably fuels aggression.

Five beliefs you may need to challenge

There are some dysfunctional assumptions that crop up repeatedly when working with people who are victims of their anger. If any of these apply to you then take the time to work through them. Weigh them against any available evidence, consider how helpful these beliefs are for you and conduct experiments to see what happens if you stop basing your actions and responses on them.

·                  Everything should always be just the way I want it.

·                  All human beings are intrinsically selfish.

·                  People who don’t agree with me are wrong.

·                  I must never back down or lose face.

·                  Some acts are unforgivable.

The mind–body connection

Thinking angry thoughts puts your blood pressure up, releases adrenaline into your bloodstream and produces a keyed up state that your body interprets as proof of imminent danger. You may have suspected you were under attack in some way: now your body is confirming it for you. A feedback loop is set up almost guaranteed to keep the pressure building.

Lack of sleep, chronic stress, use of stimulants or a sugary diet that sends your metabolism fluctuating between unpredictable energy highs and crashing lows are all going to weaken your resistance to anger. Learning to relax properly (see Chapter 8) is probably one of the most helpful skills you can teach yourself if you are prone to sudden flare-ups.

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Learn to recognise your body’s anger signature

One of the problems with anger is that, unlike anxiety and depression that tend to have a longer lead-time, anger can be ignited almost instantaneously. Adrenaline is a fast-acting hormone designed to catapult the body into action in a crisis, so if you are prone to outbursts of anger you only have a few seconds in which to intervene if you want to stay in control. It is therefore particularly important that you learn to recognise the physical signals that let you know an explosion is imminent. Each person is different, but common warning signs include:

·        churning sensation in the stomach

·        field of vision closes in: ‘the red mist descends’

·        muscle tension - particularly in jaw, hands and shoulders

·        automatically adopting an aggressive body stance

·        hot flushes

·        throbbing in the temples

·        headaches

·        rapid blinking or fixed staring

·        accelerating heart rate

·        blood rushing in the ears.

Take a moment to think about how your own body responds when you get angry. Or next time you find yourself getting riled, try to observe anger’s physical effects. In particular, try to detect the very first changes, because these are the warning signs to which it will pay to be attuned.

Establish what pushes your buttons

Forewarned is forearmed and in the case of anger it is crucial to know what is likely to set you off. Keep a diary for a couple of weeks and see whether you can pull out common themes from the situations that appear to prime your anger.

·                  Do you get angry when you feel helpless?

·                  Do you get angry when other people don’t appear to be listening to what you have to say?

·                  Do you get angry when you make mistakes?

·                  Do you get angry when you feel threatened?

·                  Do you get angry with particular people? What is it about them that gets you going?

·                  Can you spot any other factors that predispose you towards anger? Are you more vulnerable at certain times in the day? When you’re tired? When you drink alcohol or use drugs?

Plan ahead

The point of familiarising yourself with situations likely to trigger your anger and the physical sensations and thoughts that accompany your rage is so that you can be mentally prepared when you encounter events and people likely to provoke you. You are much more likely to stay in control if you have already rehearsed how you will respond.

As you formulate and use the techniques in Chapters 2 to 4 to combat your anger-inducing attitudes you should naturally gain more spontaneous control. However, until that process starts paying dividends you might want to try some of the following more immediate CBT strategies.

The emergency anger toolbox

1 When you spot the signs make an excuse and find the nearest exit

Anger is a highly context-driven emotion. Take yourself out of the provoking situation and it is likely to subside. Rather than fight you will have beaten a strategic retreat, but either response is likely to satisfy the body’s fight–flight drive. However, you have to act fast at the first signs of trouble.

2 If you can’t physically remove yourself, mentally detach yourself

Decentre yourself by observing your own thoughts and the sensations that your boiling emotions create in you. Use your imagination to zoom out and give yourself a bird’s eye view of the situation from a corner of the ceiling or from a safe distance.

3 Make yourself untouchable

If another person is triggering your anger then rather than internally bracing yourself against them try visualising yourself in a smooth protective bubble while their barrage of annoying words glides effortlessly past as if you were standing in a slipstream.

4 Do a quick cost/benefit analysis

Consider the likely consequences of losing your rag at this juncture. Are you prepared to pay the price for losing control? Has getting angry been a productive response for you in the past? Will you feel more or less self-respect once the moment has passed? Not only will this process distract you from the immediate provocation but it will keep the rational side of you engaged so you won’t yield yourself completely to the primitive emotion-driven centres of the forebrain.

5 Suck on a sweet!

This is a tip I owe to a psychologist called Dr Doyle Gentry. Although it sounds ridiculous it often works quite powerfully. Your knowledge of CBT may give you some clues as to why. Firstly, the act of sucking gives you a sensate focus to direct your attention away from your fury. It’s a distraction and breaks cycles of aggressive rumination. Secondly, sucking is a primitive reflex associated with our earliest experiences of nurture and comfort. Because of the behaviour–feelings connection having something sweet-tasting in your mouth can activate feelings of wellbeing and relaxation that are incompatible with the emotions fuelling your annoyance.

6 Take some slow deep breaths

Very basic, but diaphragmatic breathing does trigger the parasympathetic nervous system responsible for calming you down when you are in a highly charged or agitated state. It doesn’t work right away though: you need to breathe slowly and calmly for a good few minutes before it will take effect. Counting can help slow your breathing down. If you hyperventilate your breathing will have the opposite effect biologically and emotionally and leave you feeling even more wound up.

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Why improved communication skills can help you stay in control

We will return to the principles of assertive communication in the next chapter that deals with low self-esteem, but angry people often benefit enormously from these skills. Learning how to express your annoyance before it turns into rage, and that it is legitimate to ask people to respect your feelings, often makes a huge difference. The benefits for the angry person are many:

·        Open communication can clear up misunderstandings and misconceived assumptions about what others are thinking.

·        Assertiveness skills are empowering and therefore help address one of the sources of anger.

·        Assertive people take responsibility for making themselves understood. This means they are less prone to irrational blame, another catalyst for anger.

·        Good communication allows sustained problem solving so more constructive solutions can be found to problems and tensions that could otherwise destabilise your mood.

·        You will be less likely to alienate people if you communicate assertively rather than aggressively. They will consequently be more inclined to give you what you want so your frustration levels will drop.

Getting to the roots of your anger

As we have seen anger can gather a momentum of its own but it often draws its intensity from the past. Much of the anger we express on a day-to-day basis is displaced emotion – in other words it may be attached to some immediate and usually trivial cause but it stems from somewhere else altogether. The attitudes and beliefs that drive anger are usually forged in childhood experience, although other formative life events may also be fuelling your rage.

Social learning theory makes the point that our own behaviour can be heavily influenced by the behaviour we observe around us. If you were brought up by role models who displayed excessive anger – even if not actively directed towards you – it is quite conceivable that you have unconsciously learned to imitate them. Of course the influence of the people and situations we expose ourselves to does not stop once we are older. The old proverb that we ‘become like the company we keep’ is psychologically astute. If you are surrounding yourself with other angry people it will be hard for you not to follow suit. Anger is a highly contagious emotion.

The other question to ask yourself is whether your anger might actually belong to someone else? People who, for whatever reason, cannot deal with or articulate their own rage are often capable of projectingtheir angry feelings onto others.

In social systems like families, the individual members tend to assume different roles. Certain group members may be assigned the job of expressing emotions that other group members have disowned. All this happens at an unconscious level but children can often find themselves cast into the role of the person who emotes the feelings that other family members cannot tolerate.

This can be confusing and disturbing, because of course the person who performs this role doesn’t really know why they are feeling as they do. However, once anger has a foothold in your life it can be hard to shake.

Anger can be a big and overwhelming emotion for children, an experience that can feel very threatening for them, especially if the anger is directed at a parent upon whom the child relies. Being possessed by rage can make a child feel dangerously out of control. Children are also very conscious that the adults in their world are bigger and stronger than them. On several counts, making an enemy of a grown-up can be an alarming prospect. As a result children often deal with significant anger by burying it deep inside themselves.

It is ironic that we often think of ‘problem children’ as the ones likely to be throwing tantrums, but on the whole children who feel safe enough to express their infuriation with the world when they are toddlers are less likely to fall prey to engrained anger problems as adults. It is indeed often the quiet ones that you need to watch.

So what do children get angry about? There are innumerable causes but here are some of the most common. As you reflect upon this list, ask yourself what kind of assumptions and core assumptions are these causes likely to foster?

Powerlessness

It is easy to forget as an adult how little real power you have when you are young. You are dependent upon those round you for your survival, and without their help you can do very little for yourself. If you are a grown-up in a situation you find intolerable you can usually do something about it but this is not the case for a child. Repeated experiences of being rendered helpless can form unhelpful core beliefs. Unpredictable or aggressive adults can reinforce a child’s sense of powerlessness and the frustration that accompanies this.

Violation of rights

Children very quickly develop a sense of right and wrong, and it is no coincidence that ‘it’s not fair’ is one of the most common complaints of childhood. Repeated exposure to situations they feel to be unjust (perhaps perceiving their sibling to be favoured above them) or in which they are subject to abuse or cruelty from others is likely to breed resentment and rage.

Traumatic experience

Anger is a self-protective instinct and is often the flipside of fear. When our survival or wellbeing is threatened, or our assumptions about the world are stood on their head by some unexpected trauma, the end result can be high levels of anxiety that can easily precipitate angry outbursts. If you don’t feel safe deep down, then your insecurity can make you prone to lashing out. If you haven’t dealt properly with the pain, distress and fear associated with such experiences then this is even more likely.

Constant criticism or neglect

Criticism, even if meant to be constructive, can feel like an attack. If you were a child exposed to constant disapproval and told either directly or indirectly you did not meet the standards expected of you, then the part of you that did not feel crushed may well have attempted to fight back with anger. However, if that anger was not deemed acceptable or put you at risk of further damage to your self-esteem you may well have had to repress such feelings.

Simply being ignored, or having your needs overlooked, can also feel like an assault to a child. A child who is not taken care of physically or emotionally is being given the message that she is undeserving of basic care. At some level she will register and resent this.

Narcissistic injury

It is entirely normal for children to go through periods of their development when they become extremely self-centred. During such phases they find it hard to put themselves into the shoes of others and appreciate other people’s points of view. A hallmark of such phases is a massive sense of entitlement: they believe that the world should run exactly as they want and when it doesn’t they feel outraged. They find it hard to tolerate any insinuation that they are less than perfect, or that the world is less than perfectly attuned to their needs and desires.

In fact such overblown conceit is usually the public face of underlying fears about not being good enough and the consequences that might follow from their imperfection. Narcissism is a brittle, anxiety-laden state characterised by many of the thinking errors linked to anger. For people who get stuck in a narcissistic position, possibly because their needs have not been adequately met, anger can quickly become a way of life.

Dealing with predisposing factors from childhood

You obviously cannot change the past, but you can do a lot to change its influence over you. In order to do this you usually have to change the meaning or significance of past events and for most people this is a gradual process of adjustment. This book would be doing you a disservice if it implied that this could be done quickly and easily because in most cases it can’t. You may even need the help of a suitable professional to help you unpack some of your childhood legacy.

If repressed feelings are driving your anger then even many years after the event it can still be surprisingly beneficial to express them. Sometimes it can be relevant and productive to express your feelings directly to the person concerned, but this becomes more complex if that person is now elderly or vulnerable in some other way, and it is not even always necessary. Writing a letter from the point of view of when you were a child is an exercise many people find genuinely helpful. Giving a voice to your repressed emotions, even on paper, can release something important. What you do with such a letter afterwards is up to you. It may or may not be appropriate to send it.

Do I have to forgive?

Clients often get to an impasse in therapy where they put themselves under enormous pressure to forgive some past hurt at a point when they still feel unable to do so. It is crucial to remember that forgiveness is not mandatory. See it rather as a power at your disposal, even if you are not ready to deploy it. Whether you ever choose to exercise that power is entirely up to you.

People often feel that if they forgive the offence against them they are somehow absolving the other person of responsibility, but this is not necessarily the case. What you are doing is resolving to stop mentally calling them to account for their crimes. You are choosing to direct your emotional resources elsewhere.

·        Try to focus on the potential personal costs of choosing not to exercise your power of forgiveness: if you hold on to and continually replay NATs that promote bitterness, distress and resentment then you are going to damage yourself. If any belief does not promote your wellbeing then CBT would suggest it should be modified or dispensed with. Choose not to amplify any harm that has already been done.

·        Try to describe the offender’s actions and their impact upon you in the least emotive terms that you can, without compromising the truthfulness of your account. It is hard to forgive when you are still using incendiary language that supercharges your resentment.

·        Make your forgiveness primarily about you and the person that you choose to become rather than the other person. Take responsibility for your own actions, even if the person who hurt you does not do the same.

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Believe it or not, most of us are doing our best

Every human being is driven in everything they do by the desire to get their needs met. Within this framework we generally make the best choices we can in the light of the knowledge we have available to us at the time.

This does not mean that we always make very astute choices, or that people don’t make choices that cause awful suffering to others. Sometimes we all act on the basis of priorities that in retrospect strike us as misplaced, guided by values that with the benefit of experience we may later completely repudiate.

Sometimes we are mistaken about what our true needs are, or the best way to go about meeting them: wars are fought, children are abused, terrible things happen in the world all as a result of misguided attempts to get needs met. Understanding this – while it may not excuse the harmful actions of others – can take us a step towards reframing past hurts in ways that are less psychologically damaging for us in the present. If you have made what you feel to be bad mistakes yourself, try to identify the underlying needs that you were seeking to meet at the time.



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