Can Anger Management therapy really work?


I’ve worked with several people lately who have come to me with Anger management issues.

Sometimes they had already lost people they love or jobs they really enjoyed because of their flashes of anger or uncontrollable and intimidating outbursts of physical or verbal abuse.

Others have arrived looking stunned and in a state of shock.  Often they’ve been told by a court or a partner that they have to seek out treatment to deal with their problem or suffer the consequences.  They often have only just begun to realise the devastating consequences of their actions.

Some people realise their problem; others are in denial, claiming that they just have a quick temper – “I just have an outburst and then it’s all over” – without realising the damage it is doing to the recipient of the outburst.

As I therapist I have no magic wand that tells me who’s telling me the truth about the extend of their anger or its true causes; all I can do is work with what I’m told at our first consultation and then explore possible causes arising from upbringing, life experiences etc.  as we progress.

Anger has many causes.  Sometimes an individual might have an ongoing psychotic mental health problem (paranoid schizophrenia for example) which requires specialist diagnosis and the help of psychiatric healthcare professionals who are able to create drug and therapy programmes designed to help patients control their illness and return to normal functioning.   I refer to this as a functional problem, and is beyond the remit of therapy to resolve.

In many cases, however, anger can be the product of emotional trauma, such as being betrayed by a trusted partner in business or in love, or the sudden loss a parent or child resulting in unresolved grief, or the outcome of a sudden traumatic event leading to creation of symptoms of (or even full-blown) Post Traumatic Stress Disorder (PTSD). 

In other cases it can be a learned behaviour – the result of being raised in a chaotic or combative family where aggression is the norm, or is the only way of protecting personal possessions or avoiding being picked on.

I therefore start therapy by taking a thorough Case History.  This is only a three page questionnaire but by the end I know everything I need to about the client’s life, family relationships and major life issues.  From this information I can begin to isolate and investigate those issues/events which might be driving anger.

In effect, what I do is identify “buttons”.  The buttons which get pressed by a partner, or an innocent customer standing in a pub.  The words which, when spoken, provoke an instant and frightening verbal or physical attack.

Couples who’ve been together for a while know all about buttons.  They know exactly what to say  to provoke an instant fight – “You’re lazy”, “You’re selfish”, “It’s no wonder the kids hate you”.  But while their arguments might be loud and unpleasant, most couples arguments don’t end up in the casualty department of a local hospital or in the police being called.

My job as a therapist is therefore to identify the buttons and then to help defuse them.  To drain off the emotional fuel which drives them so they no longer cause volcanic eruptions of rage. 

I therefore approach Anger Management in two main ways:-

i)  To straight away teach a client a number of methods for becoming aware of what drives their anger (the Buttons) and then fast ways of controlling rising anger – in effect, changing the response to the things which make them angry – thus teaching a client right from the outset how to keep themselves and others,  safe in stressful situations.

ii)  At the same time, I try to establish the reasons for a client feeling angry.  Often this is obvious; at other times it has been blocked and needs exploration before it emerges in conversation.  Either way, I look to deal with the emotions and feelings of frustration, fear, anxiety etc which have led to the anger emerging.  These unresolved emotions are the fuel for anger. If we remove the fuel, the anger just evaporates.

iii)  Having done this, I then help the client to see their lives in a new way. To notice the change in the response of loved ones, friends and workmates to this new calmer person.  How new opportunities arise in their lives.  How they become more secure, more loved and valued.

And the therapy need not take lots of sessions.  I have completed work with one client in five sessions – the last of which was a session to explain to his partner how we had managed to bring about such a dramatic (and hopefully) lasting change in his behaviour!

One last word.  To all those women who think they can change a violent or abusive man.  You can’t.  Leave the relationship and put the experience behind you.  Protect yourself and your children.  You must understand that you are a catalyst to your partner’s anger. Whatever you do, whatever you say, you are part of the problem. You will never be able to effect change alone.  Your partner needs to be evaluated to eliminate functional causes and then to work with someone independent of your relationship who can use the therapies needed to bring about change – if change is possible.  The best thing you can do for your partner and yourself is to remove yourself to a place of safety and to urge them to seek professional help and resolution before it’s too late. 

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