WARNING: Anger Can Seriously Damage Your Health!

October 2nd, 2008

The recent transmission of the excellent two-part BBC2 documentary, Losing It presented by Gryff Rhys Jones is at last bringing this subject to an even wider audience. Anger at last appears to be receiving the attention it deserves.

The catalyst for the most recent foray into this complex and misunderstood emotion is the Boiling Point report published by the Mental Health Foundation in March this year. In the report, Dr Andrew McCulloch, Chief Executive, defined anger as a major social problem. The study suggests that people are getting angrier, with almost 1 in 3 of us having a close friend or family member who has trouble controlling their anger, 1 in 4 worried about how angry we sometimes feel, and 1 in 5 ending relationships with people because of how they behaved when they are angry. This report is serving to keep the subject where it needs to be at the forefront of public awareness.

Anger is a significant part of clinical practice, occurring in as many as one third of all adult psychotherapy cases, overlapping with as many as nineteen different psychiatric conditions, and concomitant with drug and alcohol misuse, interpersonal crime, anti-social behaviour, and physical health problems. Add to this the widespread acceptance of the effect that dysfunctional anger has on limiting an individuals personal opportunities, as well as the negative impact it has on the wider society; on education, health and the economy - all indicators of social exclusion, in itself a complex determinant of dysfunctional anger, and we begin to see the enormous impact out-of-control anger has on all of us.

However, problem anger does not only affect your relationships personal, social and professional - it also affects your physical as well as your emotional, mental and spiritual health. Anger produces the same physiological and psychological effects as stress. This means that dysfunctional or unhealthy anger can impact on every aspect of our life in exactly the same ways: fatigue, sleep disturbance, lowered sex drive, withdrawal, lowered tolerance threshold, increased alcohol, tobacco or drug dependency and weight issues (elevated cortisol levels cause a slower metabolism and weight gain).

Anger is a systemic phenomenon, with chronic anger having the potential to lead to disease and ill health in every bodily system. For example:

cardio-vascular: heart disease, stroke, blood pressure
musculo-skeletal: general aches and pains, rheumatoid arthritis, fibromyalgia
gastro-intestinal: IBS, ulcers, certain cancers
auto-immune: arthritis, lupus, diabetes

In the workplace, unmanaged anger disrupts productivity through low morale, interpersonal conflict and the individuals reduced ability to problem solve or retain information. Together with the associated costs of staff absences and increased staff turnover, unmanaged anger proves to be an expensive business.

Somethings Got To Give

Life goes at some speed. The frustrations of contemporary culture: the trend of instant gratification through consumerism, fast food and instant credit, and the pressures of modern working practices: hot-desking, long working hours and multi-tasking, make problem anger and stress almost impossible to avoid. Most recently, social anxieties: the credit crunch, immigration and global issues, only add to the lowering of peoples tolerance threshold. All of this leaves its mark.

Do You Have Anger Issues?

Problem anger is not only an issue for those who explode with rage, or those who are close to someone who explodes with rage. Anger is linked to low self-esteem and can be an equally debilitating issue for someone who finds it difficult to express their anger openly. Do you often compromise yourself to avoid confrontation? When you argue, do you ever feel sad rather than angry, or cry with frustration? If you answered yes it is likely anger is an issue for you. There is plenty of research that suggests repressed emotion causes physical blockages that can lead to health complications.

Using Existential Philosophy to Manage Anger

The existential concerns of freedom/responsibility, isolation, death and meaning are often experienced at times of major change, loss, or moral dilemma, highlighting the uncertainty of the human experience. It is not unusual that, during these times, an individuals sense of loneliness or emptiness may cause them to explore lifes big questions why am I here? what is it all for? what is my purpose? If dysfunctional anger is perceived as a contributing factor of these losses or dilemmas, it follows that it is at such times that clients will find their way to anger therapy.

Holistic existential therapy considers the four dimensions of human experience: the physical, social, psychological and spiritual, within which we make sense of our world.

The THREAT Programme for Anger and Stress

In a respectful and accepting environment, through a mix of group discussion, Socratic questioning and expressive techniques, an existentially-oriented approach helps clients to come to terms with the problems of living, raising awareness of how current anger behavior is the result of a maladaptive coping strategy with which to deal with those very human, natural and normal problems experienced by all of us.

THREAT psycho-educational anger therapy is a preventative intervention linked to good general health and wellbeing, as well as a treatment method for those coping with problem anger, either as the protagonist or the one to whom anger is directed.

Threat to both physical wellbeing and self-esteem are the two components to the anger reaction, whilst the concept of anger is viewed as a product of threat perception - and so THREAT seems an appropriate two-fold title, also being the acronym for Tailored Holistic Responsive Expressive Anger Therapy, reflecting its adaptability to suit a wide range of client groups in a variety of settings.

THREAT leans on the cognitive behavioural techniques of Stress Inoculation Training as well as relaxation, biofeedback, progressive muscle relaxation, cognitive restructuring, social skills training, assertiveness, and problem solving which many studies suggest help clients develop effective anger management coping strategies. Within a holistic existentialist environment, THREAT explores:

The clients freedom to make choices, to consider the consequences of those choices and to identify any areas of resistance

Resistance as a result of fear, perhaps due to previous failures, or even the fear of success (which also brings inevitable change): a major block to personal growth. Facing the possibility of losing an important relationship even a dysfunctional one - is a powerful motivator for standing still

With freedom and rights comes responsibility, and clients are encouraged to develop a critical awareness of their responsibilities to themselves and others

Group discussion reflecting on existential isolation, aloneness and the meaninglessness of life leads to the development of coping strategies with which to manage these very human anxieties that we all face as part of the human experience

A further existentialist principle is that, however much actions are determined by circumstances, human nature is intrinsically flexible and individuals have the ability to determine how they will respond, within the boundaries of human existence (ie physical or biological principles such as growing old, gravity and bodily needs). Whether they sink or swim, rise above their present difficulties or go under from the pressure is down to the individual, and the need to accept personal responsibility is fundamental to a successful outcome

A common concept in existential counselling and psychotherapy is that people determine the way in which they respond to a situation based on their perception of that situation. There is no single objective reality: we each determine our own reality based on personal rules learnt within a social context. Therefore, it is important to explore an individuals values to help identify and challenge any self-limiting anger beliefs and attitudes.
12 Guiding Principles summarise these existential values. The Principles were initially inspired by the philosophy of 12-step programmes that consider the physical, mental, emotional and spiritual health of the individual in a non-judgmental, unconditionally supportive environment. Developed through the observation of group dynamics, the Principles were originally produced as a time-conscious way of addressing the issues common in new groups: uncertainty, lack of trust and confusion. Designed to address orientation issues so that clients understand from the outset the direction the work may take, to foster an environment of trust and acceptance, and to encourage active participation, the 12 Guiding Principles are introduced as soon as possible at the start of the course and explored through group discussion. In brief, they are:

1. Anger is not evil
2. We are not mad or bad
3. Anger and stress affect our physical health (and our emotional, mental and spiritual wellbeing)
4. Acceptance of Personal Responsibility
5. There is nothing new
6. Do you want to be right or happy?
7. Personal commitment
8. Positive attitude
9. Mutual respect and acceptance
10. Keep safe
11. Expectations and change
12. Have fun!

Anyone wishing to know more about THREAT is invited to contact me at lindawolfenden@hotmail.co.uk

Further Reading
*Mental Health Foundation (2008). Boiling Point Report: Problem Anger and what we can do about it. London: MHF
* www.mentalhealth.org.uk
*Duerden, E. van (2002). Existential Counselling and Psychotherapy in Practice, 2nd Ed. Sage: London

For an extended reference list, please contact me