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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PSTEC – A powerful form of therapy


I am an Advanced Practioner in a therapy called PSTEC and am often contacted by people who find me on the PSTEC Register wanting to know more “from the horses’ mouth” as it were. So, here’s my take on it. Apologies to Tim Phizackerley who created this wonderful therapeutic tool for any misrepresentations I might appear to be making to the purist view of how PSTEC works and how it should be used. These comments are based on my own experience and my own way of working.

OK, PSTEC stands for Percussive Suggestion Technique. It has been around for a couple of years now and marks a real advance in tapping therapy technique.
Without going into tedious detail, tapping therapy came into public view with the growth of EFT – Emotional Freedom Technique. This is a therapy whereby repeating a mantra such as “Even though I eat like a pig, I still completely love and respect myself” whilst tapping a number of acupunture points around the face, neck, chest and hand areas, helps the mind to process negative thoughts and feelings. This in turn leads to the elimination of negative self beliefs and behaviours and leads to a change in behaviour (in the case of the example above, a change in eating habits to a more healthy and controlled attitude towards food and eating). EFT works, I’ve proved that on myself, but I have never been happy with the acupuncture pressure point explanation. Although medical science reconises that these points exist and that they can be stimulate through use of needles, the idea that tapping “roughly in the area” a dozen times or so three times a day can bring about change has always bothered me. It seems to be imprecise and haphazard, even though I know it works!

PSTEC also uses tapping, but combines it with a number of other very effective therapeutic techiques, to form a treatment session which lasts c.13 minutes.

It involves the client tapping right or left hands,or both, on a hard surface as instructed by a recording made by Tim. Its cleverness comes in the way in which the recording is constructed. The client responds to tones representing left, right and both hands. So their mind is busy trying to remember which tone represents which hand. At the same time they are instructed to recall the event/emotion which is causing them distress and to keep that event/emotion strongly in mind as they follow the tones. On top of this, they listen to Tim speaking very quickly, using a combination of Ericksonian confusional language, NLP reframing, CBT-style logic language and a host of other things designed to bombard the mind with ideas and concepts which alter the mind set of the client, their perception of their problem and emotional response to it.  All the while  they are also trying to remember which hand is represented by which tone and trying to follow the tapping patterns of the random and rapidly changing tones. If this sounds exhausting, it is! After 13 minutes, a client begins to feel fatigued and is only too glad to stop.  We might do two or three rounds of tapping, taking a new score at the end of each round, before using hypnosis to reinforce the gains made during the session.

The remarkable thing is, that it we score the anxiety/fear caused by the thought of driving a car again after a serious accident at 10 out 10 (zero = not at all worried about driving; 10 = too terrified to get back in the driving seat), after one 13 minute round, the fear will often have dropped to perhaps 7. After another round it might have dropped further to 4. And these changes are more or less permanent.

PSTEC works because the client’s mind has processed their negative thoughts and emotions and released feelings of fear/anxiety/anger etc, during the struggle to follow the instructions on the CD.  Tim generously allows anyone to download this great therapy to try it for themselves.  You can find it at http://www.pstec.org.
Whilst working alone, without a therapist, can work for a number of people, the calls I receive tend to be from people who’ve tried it on themselves and for whom it hasn’t worked. They understandably want to know what they are doing wrong.
The answer can take a number of forms – some are just being too impatient and not using it enough times or with enough frequency or enough energy to deal with their issues thoroughly. Others have not correctly identified the issues or the emotions which need to be dealt with (sometimes people are just too scared to approach the real deep underlying emotional problem and so focus on one they feel more able face. As a result, of course, the therapy doesn’t do what they want it to). Others just don’t want to lose their problem; they are identified by it; they get secondary gains from it – agoraphobia is an illness which stops sufferers from going out, socialising, visit friends and relations. It’s a horrible and suffocating problem. But for some, it also carries  the secondary, subconscious gains of not having to struggle to earn a living, deal with difficult people, deal with difficult situations. They are not CONSCIOUSLY doing this, It is simply their unconscious mind trying to protect the individual from harm or further stress. So it won’t let go of it without additional stimulus.
As a result, I usually recommend that people who have not been successful with PSTEC on their own find a local practitioner who can use PSTEC plus other therapeutic interventions in combination.]

With my own clients, I use PSTEC for anyone suffering from stress or trauma. But before we begin, we examine the causes and effects of the emotions and thoughts created by the trauma, sort through the mental debris left by the event and isolate the most powerful feelings. Often, these are not the one’s the client presented with at the beginning. Fear might become anger during discussion. Or anger might become regret. By identifying and dealing with the right emotion, PSTEC is a powerful weapon in the therapist’s armoury.
In three years, I’ve never had a negative reaction to it (though sometime I’ve had a reaction I didn’t expect!), and every time it has helped a client to lower their levels of anxiety, fear, anger, or whatever their life is being dominated by.