Anger Management- A Step towards better Life

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What is Anger?
Anger is a feeling or emotion that ranges from mild irritation to intense fury and rage. Anger is a normal reaction. It can be good in a way that allows you to express your negative feelings but it becomes problematic when it turns destructive and expressed in the form of aggressive actions. Aggression is a behavior in response to anger, intended to cause harm or pain to others. This intense behavior can be verbal or physical. Aggression is usually exhibited in the following purposes:

Three Phases of Anger
Anger is not an unexpected response; it always passes through three phases. The identification of three phases helps in the effective management of anger.

Escalation Phase
In the escalation phase, the arousal systems of the body get prepare for a crisis after perceiving the trigger. The trigger (event) is a ‘Red-flag’ which increases hostile self-talk and that also results in bodily symptoms like headache, rapid heart rate, sweating, clenched fists, wringing hands, pointing, pacing, loss of eye contact or intimidating aggressive posture.
Explosion Phase
The explosion phase is marked by an uncontrollable discharge of tension in verbal or physical form. This may be less dangerous if there is only shouting, swearing or threat. But the violence and other major destructions in this phase, lead to irretrievable consequences.
Post-Explosion Phase
The post-explosion phase is the final stage in the aggression cycle. It includes the negative consequences of aggression during the explosion phase. The consequences may be relationship breakup, job termination, shame, guilt, regret or the above-mentioned payoffs.

Consequences of Anger
Intense and too frequently expressed anger can have serious social and medical consequences:

Termination from program or job
Financial costs
Loss of family or loved ones
Inability to develop a healthy relationship
Arrested or jailed

Four Myths About Anger
Anger is Inherited: Some people believe that anger is inherited and cannot be changed. This justification is fixed and is unalterable, has been proven wrong. Evidence from research studies suggests that the expression of anger is learned behavior rather than inherited.
Anger Automatically Leads to Aggression: This is a misconception that the only effective way to express anger is through aggression. However, anger can be communicated without being physically or verbally abusive. By changing negative and hostile “self-talk,” challenging irrational beliefs, and employing a variety of behavioral strategies, you can manage your anger before it gets burst.
People Must Be Aggressive to Get What They Want: Many people confuse assertiveness with aggression. The goal of aggression is to dominate, intimidate, harm, or injure another person—to win at any cost. However, by assertiveness, you can convey your message in a respectful way and may get what you want. Researches reveal that expressing your feelings of anger with assertiveness is more impactful.
Venting Anger is Always Desirable: The expression of anger is not a healthy way. Research studies have found that venting anger in an aggressive manner reinforces aggressive behavior. However suppressing anger is also not healthy, thus acquiring an effective way of channelizing these feelings is necessary.
How to Control Anger?
Anger control is important to avoid negative consequences. Before anger escalates, the following specific strategies have been proved to be effective in controlling anger:
A. Cognitive Strategies
Identification of Triggering Event
By looking at your daily routine, you may observe and recognize that what causes your irritable or angry feelings. It may be any specific activity, time of day, people, place or a certain situation. Following are the few examples that usually serves as the red flags of anger:
Long wait to see your doctor or line at the supermarket
Having a neighbor who plays the stereo too loud
Traffic congestion
A friend not paying back money owed to you
Having to clean up someone else’s mess
Identification of Anger Cues
There are certain signs and symptoms of anger, you may identify your own personal cues and take a step to manage your anger before it becomes out of control. The cues can be divided into four categories:

Cognitive/Thoughts: hostile self-talk, images of aggression or revenge
Emotional: fear, hurt, jealousy or guilt
Physical: rapid heartbeat, tightness in the chest, feeling hot or flushed, light-headache, sweating, muscle tension or intimidating aggressive posture
Behavioral: pacing, raising the voice, fist or teeth clenching, staring or avoiding eye contact
Anger Rating Meter: 1 2 3 4 5 6 7 8 9 10
For controlling anger, monitor and record the highest level of anger on the rating meter with the help of identification of cues. Points 1 to 10 are the feelings of anger where 1 is complete lack of anger or calm, and 10 is extreme angry & explosive loss. Rating anger on the meter will help you to identify the severity level and also to choose a moderate expression of your anger.
Labeling and Altering Thought Errors
The problem of anger is very much influenced by how we interpret an anger-provoking event. This interpretation is affected by the thinking patterns which are often illogical in case of anger.
A few of cognitive errors in anger are
Identifying the errors in your thought patterns enables the individual to alter them into more positive and realistic thoughts. This can be done by the use of various cognitive strategies such as questioning the evidence, cost-benefit analysis, etc. (For more details please see our blog on Cognitive behavior therapy)

B. Assertiveness Strategies
Assertiveness strategies are aimed at providing a healthier way to convey your feeling to others. The basic message of assertiveness is that my feelings, thoughts, and beliefs are important and that your feelings, thoughts, and beliefs are equally important. Assertiveness is midway between passive and aggressive behavior.

The following are some assertiveness strategies.

Broken Record: Be persistent and keep saying what you want over and over again without getting angry, irritated, or loud. Stick to your point. For example:
Yes, I know it’s important, but I don’t want to go…Sorry, but I don’t want to go…I realize what it means to you, but I don’t want to go.
Self-Disclosure: Assertively disclose information about yourself – how you think, feel, and react to the other person’s information. This gives the other personal information about you.
Fogging: An assertive coping skill is dealing with criticism. Do not deny any criticism and do not counter-attack with criticism of your own. For example:
I agree that there are probably times when I don’t give you answers to your questions.
Negative Assertion: Assertively accepting those things that are negative about yourself and cope with your errors. For example:
Yes, you’re right; I don’t always listen closely to what you have to say.
Workable Compromise: When your self-respect is not in question offer a workable compromise. For example:
I understand that you have a need to talk and I need to finish what I’m doing. So what about meeting in half an hour?

C. Self-help Strategies
Timeout: Timeout is considered the best option to avoid the anger burst. Separate yourself from the threatening situation and calm down your body, when you feel that your emotions are managed, come back in that situation and convey your point of view. The timeout can be in two forms:
Informally: Leaving the situation that is causing the escalation of anger or simply stopping the discussion that is provoking anger.
Formally: A timeout that involves an agreement or a prearranged plan. It is usually applied in situations where relationships are involved. These relationships may include family members, friends, and coworkers.
Relaxation Exercises. Please see our blog on Relaxation Training.
Positive Self-Talk. The positive self-statements will send a positive message to your body and make it calm. Such helpful statements may be:
Relax calm down; I am good enough to control it
It’s okay if someone makes a mistake.
I should understand others
Self-audit. The main aim of check-in procedures (self-audit) is to keep a track of your anger management. It will give an idea about:
How am I managing my anger?
Is there anything more I need to work about?
Is there still an event that provokes aggressive behavior?
Maintaining these diaries serves as a way of exploring more about your behavior and will motivate you to take a step each day towards a better life.

Treatment With medicine
The decision to start medicine is dependent on the underlying diagnosis. If the anger is due to an acute episode of psychotic illness, the medicines will be the first choice. As in the acute phase of psychosis, we avoid to directly confront the patient.
The anger issues usually resolve with the treatment of mental illnesses such as agitated depression, OCD, etc. The drugs that can be used are antipsychotics, antidepressants, mood stabilizers, and benzodiazepines.

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