Many people would probably use the well-known phrase “anger issues” to describe themselves or someone they know. As counselors, we often find utility in addressing a client’s anger in session as part of the healing process. Anger, along with anxiety, seems to be one of the few emotions we are supposed to “manage” versus enjoy, explore or simply experience. This is probably because people have done some truly horrible things while being angry, so we possess an innate, ancestral understanding that an angry human is a potentially dangerous one. So anger is deeply connected to danger in our minds.
We also understand that people get into trouble not because they feel angry but because they behave or act in unsafe ways. Even for experienced clinicians, sitting with an angry client can be frightening. We are often inherently worried not about what clients feel when they are angry but what they will do, so we tend to focus our strategies on behaviors. After all, it is the behaviors that do the damage we can see and feel.
This focus on behavior in treatment is rational, but it may also be based in part on our collective, societal anxiety about anger, which is betrayed in the English language itself. Words such as rage, livid, fury, wrath and apoplectic are evocative and bring to mind many negative connotations. I think we can all agree that being near someone in a rage sounds scary. We pay close attention to anger because it can become a threat to us. These synonyms illustrate the different qualities and textures of anger that we can feel. To be irked is quite different than to be enraged, for example.
Anger is a special emotion not only because of all the different words we have for it but also because of how afraid we are of it. People are often so scared of their own anger that they don’t act on it. They fear what they might do. Will they lose control and say hurtful things or commit a crime? They truly don’t know. So they go to great lengths not to act. Others are stuck in cycles of overreaction and harmful behaviors, which can be a terrifying experience. And for some people, being angry is the same as feeling out of control. Thus, regaining control is often an important part in helping people to navigate their anger.
Just because anger has the potential to become dangerous behavior, however, doesn’t mean that it always will. In counseling sessions, we can begin to identify ways in which our clients’ anger is protective, and then help them navigate their anger with greater skill when it shows up.
Not all anger is bad
Understanding the connection anger has to danger is important when we are trying to help clients who are struggling with this issue. Anger can also be deeply connected to the protection of ourselves and our loved ones. Anger has been used in warfare, combat and defense since the dawn of time to give people courage, energy and motivation when they need it most — in survival situations. It has been the precursor to violence for so long that they are often intertwined in our psyches.
It has also been the precursor to numerous positive and deeply consequential social movements and changes throughout history. Anger has sparked revolutions and removed despots and tyrants from power. So how do we know if our clients are experiencing the kind of anger that hobbles them or is powering them to change something for the better? We won’t, of course, unless we are actively talking about it. It is important that we try to figure it out with them. It will be difficult for our clients to recognize or let go of anger if they feel they are in danger (real or perceived) and view anger as a form of protection.
Most of the people coming into therapy for help with anger management have likely experienced numerous negative consequences because of their anger, but some have also experienced positive outcomes. I had a client who was a middle-aged man, and he was furious at his father because he had abused him terribly as a child. His anger compelled him to stay away from his father for decades, so there could not possibly be a physical threat. He feared that if he “softened up” and let go of this anger that he might let his father back into his life. His anger formed the core of his resolve to not have any contact with his father.
In his case, the anger had served an incredibly valuable purpose: It protected him from receiving any more abuse from his father. But the following things were also true. First, he had been physically safe for many years now. He lived hundreds of miles away from his father, and he was much stronger and in better physical condition than his father. Second, he was getting tired of being angry so often.
It is challenging when we encounter people who have greatly benefited from their anger. This client’s anger was almost like a transitional object — it had brought him some comfort but now was starting to feel restrictive. For him to be able to move on, he first had to realize that he didn’t need to be angry to maintain a healthy boundary with his father. He figured out he could maintain this distance with equanimity. He hadn’t seen his father in years and didn’t plan or expect to. We used cognitive behavior therapy to help critically examine his beliefs around his anger being protective. Was he really in danger or was he safe now? This helped him realized that he was in a good position and could relax a bit.
Of course, he still felt angry at times about the past abuse, but he no longer had to constantly exist in that state. He didn’t have to achieve complete ease with everything that had happened to him; he just needed not to be consumed by his anger over it anymore. And when he felt his anger returning, he used his own self-directed internal dialogue to calmly remind himself that he was safe.
Be curious about anger
Because there is a lot going on beneath the surface when people get angry, counselors can help clients explore these underlying reasons in session. For example, anger can stem from a long history of being abused, and that type of anger will look and feel different from the anger that comes when someone is experiencing institutionalized racism or sexism. Someone else might feel angry because their spouse is having an affair, and sometimes people feel angry without knowing why. Thus, the texture and history of one’s anger is critical to our understanding and approach to it.
Anger arises from an infinite number of situations, but we can zero in on two main conditions that often make people angry:
- Something is happening that they think should not be happening.
- Something is not happening that they think should be happening.
It’s also important to note that not all anger is based on our cognitions. The anger that arises in survival situations is not really based on any conscious beliefs; it is a way to access instantaneous energy for attack or defense. Our expectations are not really coming into play because there is no time for that. It is our survival system activating, just like it’s supposed to. This does help us to survive but becomes problematic when deployed too broadly.
As counselors, we need to be curious about clients’ anger. For example, a person who has anger management issues may perceive numerous threats in their environment. These threats need to be identified. Is it a person? A place? A memory? It may take some digging, but if we bear in mind that a client is keeping a huge reserve of energy and resolve ready to go whenever they think about that person or situation, then they must see the person or situation as meriting that level of response. That’s significant. They are signaling to us that their anger is necessary for something in their environment. Clients will sometimes identify threats and, in the process of identifying them, quickly realize that this particular thing is no longer a threat. Many perceived threats have been carried into adulthood from childhood, but adults are often no longer afraid of the things that scared them as a child.
Counselors can ask clients, “How do you know when you are angry?” or “What would I see in you if you were to get angry?” I often ask clients how often they get angry, how long it lasts and what patterns they have noticed with their anger. The goal is to get them to self-evaluate and search for the sensations and movements that accompany the anger. It can also be helpful to have clients rank the intensity of their anger on a scale from 1 to 10, with 1 being not angry and 10 being very angry. Counselors could ask, for example, “At what number would you say you lose control?” This exercise prompts further self-evaluation, provides a feedback mechanism and delivers an opportunity to establish a window of tolerance.
In addition, counselor must consider the diagnosis and presentation of the anger. For example, anger resulting from posttraumatic stress disorder could require a different approach than anger stemming from a relationship conflict or a social injustice.
Creating a sense of safety
I believe that the establishment of safety — real physical, emotional and spiritual safety — is the primary task of counselors working with clients who are angry. When anger is protective, we cannot expect people to remove their armor if the arrows are still flying. People are often living in chronically unsafe situations, and they do not always feel safe enough to let go of their protective anger. It is important to note that we cannot always help clients achieve full safety in their homes or work; people live in an endless variety of complicated situations, most of which are beyond our reach in the hour we get with the client each week.
So what kind of safety can we reliably provide? We can certainly ensure the safety of the therapeutic space itself, in both the physical and virtual spaces in which we meet with them. The therapeutic alliance also plays a central role in creating a sense of safety. If we can achieve even an hour of physical, emotional and spiritual safety, then we have done a great service in helping clients work on the anger issue. It’s difficult to feel angry when we feel safe, and this calm state also makes it easier to access underlying factors of the anger.
I am a huge proponent of facilitating calming and relaxation exercises for clients struggling with anger. I use these exercises in nearly every session, including the initial ones. Early on, I like to incorporate deep breathing or box breathing, mindfulness and/or meditation, depending on the client. The goal is to try to reduce the intensity of the anger, and clients often respond well to repeated, focused attempts to calm themselves down. Focused breathing gives us an immediate and familiar task that not only provides our bodies with plenty of oxygen but also helps stimulate the parasympathetic nervous system, which reduces anxiety and slows our heart rate. As the mind and the body start to calm down, and our attention is diverted from our thoughts to our direct sensory experience, our awareness rises. Tuning into our senses is our best shot at perceiving and responding to our actual reality, at least what we perceive as a reality. This is a great position from which to assess and make good decisions.
Counselors cannot control the external factors in the clients’ lives, but we can demonstrate to them that with practice, they can gain control of their responses. Since anger is often about protecting oneself or about summoning a great amount of energy and determination all at once, we want them to have a distinct feeling of what it is to be calm and relaxed as a counterbalance to that anger. Some clients are not used to feeling this sense of calm or they do not experience it often, so it can be helpful to have them practice entering this calm state during session. Counselors can help them become familiar with what their resting heart and breathing rates feel like. The more time clients spend in that safe, calm state, the easier it will be for them to return to it when they feel themselves becoming angry. This knowledge allows them to be proactive in their response to those changes.
Regaining control
Counselors should encourage clients to express their anger in safe and healthy ways within the therapeutic space. Learning about what makes them angry provides counselors with an opportunity to normalize and validate it. Counselors can also teach clients alternative ways to express their anger without the typical behavior of yelling or hitting, for instance. Counseling provides them with a space to talk about their anger and give voice to their experience. They get to feel the anger but this time without any negative consequences or judgment.
Some clients feel relief simply by expressing their anger. Allowing clients to explore their anger in this way helps them gradually untangle it from danger or their past experiences a little bit more. Counselors can also help clients discern when there is an active threat that warrants anger. This can help them realize that being angry at common annoyances, such as when someone cuts them off in traffic or when a co-worker doesn’t return their email, may not be worth it. There is no strategic or adaptive advantage to becoming angered by those situations. In fact, there is a decisive disadvantage because for many people, anger reduces functioning in daily life.
People who are overwhelmed by their own anger often experience unintended negative consequences in their relationships and careers. They know better than most that there is a heavy burden and cost associated with this anger.
It is also important for counselors to help clients understand that anger itself is not a bad thing and there are safe, nonharmful ways to express their anger. Feeling freer to explore their anger enables them to safely address it more often in their lives, which results in fewer negative consequences. Eventually, this feedback loop creates its own momentum. They will want to practice the calming skills the more they see the tangible benefits of the methods. This means counselors can’t let them slack off in this regard. Probably the time I am most directive in session is when I am trying to get clients with anger management issues to practice mindfulness and relaxation exercises. I usually tell them that if they are resistant to taking three deep breaths a few times throughout the day, then they owe themselves five. When a client is resistant to doing even basic anger management work, even though they have come in for that, I become more interested in the secondary gains they get from being angry, which can be difficult to identify but they will be there.
Clients also benefit from functional alternatives to being overwhelmed by anger. Now instead of “flying into a rage,” the client is beginning to take some deep breaths, listening to their own heartbeat, assessing the level and intensity of their anger, reviewing their own expectations and beliefs about the encounter, and determining if it’s a threat in the present moment or if they are responding to something from the past. These techniques help slow them down, engage their prefrontal cortex, and give them something positive and constructive to focus on instead of simply allowing them to be flooded and overwhelmed by their anger.
Mastering the moment
When we believe that we or others are being wronged in small or large ways, our anger can be incredibly effective at giving us the energy to make a change. A client who is angry about a social justice issue may not need to “manage” the anger as much as channel it. Understanding the context of the anger as clients see it will greatly inform counselors’ course of action in session.
And we can also decide how upset we want to be when our friends, families, and co-workers offend or anger us. We can use the energy to do whatever is necessary, which may include reasserting boundaries. We can also choose sometimes to let it go because we know that we have wronged people as well and we all make mistakes. That is a learned skill — one that requires empathy and a desire to understand another person’s context before rushing to judgment. We don’t have to be swept away by the other myriad interpersonal situations we encounter that can cause our anger to arise.
Sometimes helping clients regain control of their anger boils down to helping them master a small but very difficult moment. Some of our worst impulses in moments of anger last for mere seconds before they pass. To act on them may be to court calamity, and so to not act on them is a very great power. There are lots of people who will have a much higher quality of life if we help them pause and process the situation before determining if and how they want to respond to their feelings of anger. For this reason, mindfulness and emotional regulation techniques from dialectical behavior therapy can be effective because they lend themselves quite naturally to this specific endeavor.
Cognitive behavior therapy has also been known to be effective in helping clients manage their anger. So much of anger starts as a cognitive process. If someone is driving and another person cuts them off, for instance, they have two choices: Get angry and yell, “Hey, that jerk cut me off!” or shrug and say, “He must be in a hurry.” These two ways of processing this situation are diametrically opposed. In the first instance, the person may become enraged and behave impulsively. In the second, this event is just an ordinary occurrence that is hardly worth mentioning.
Our self-talk makes an astonishing difference. And when the client’s defenses are down even a little, we can help them examine their thoughts and make changes where appropriate. We help them choose the self-talk that gets them the desired emotional and behavioral result they are seeking. Cognitive behavior therapy also allows the counselor and client to work backward and consider what the client needs to think or do to stay calm in situations that make them angry. In the previous example, the counselor could ask the client, “If you were to feel calm when someone cuts you off in traffic, what would you need to be thinking?
Most of the cognitive work has to come after the establishment of safety. Clients need to have a clear road map of the place they are trying to get to. They will still get angry and sometimes do impulsive things that create unpleasant consequences for themselves and others, but we can compassionately help them deconstruct the event and its precipitating factors and gently remind them there are other healthy options for expressing anger.
When safety is present, the client’s protective armor of anger can be removed. With the armor gone, we as clinicians may see the injury more clearly, and in turn, the client will be free to walk through the world less encumbered.
Peter Allen is a practicing therapist in Richmond, Virginia. Contact him at peterallenlpc@gmail.com.
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