Anger Management

“Anyone can become angry - that is so easy. But to become angry with the right person, to the right degree, at the right time, for the right purpose, and in the right way - that is not so easy” (Aristotle).

ANGER MANAGEMENT

What's the first thought that comes to mind when you hear the word ANGER? Frustration? Yelling? Loss of Control? Violence? Maybe fear, silence or avoidance? All reasonable responses...Or are they? A bit one-sided, for my taste, that is, the "anger glass" appears "half empty." How about a "half full" perspective: confrontation, energy, power and tenacity? Or honesty and being real?

1.0   BACKGROUND:

Anger is a multidimensional construct, which includes:

·         Cognition – our present thoughts

·         Emotion – the physiological arousal our anger produces

·         Communication – the way we display our anger to others

·         The effect of anger on others – fear, hostility

·         Behavior – the way we act when we are angry

We also (if we are aware of it) feel the results of anger in our own bodies.

Because the experience of anger is essentially a personal phenomenon, its assessment relies mainly on self-report. In contrast, anger expression may be assessed by observations, teacher and parent ratings, and other behavioral indices. Frequent and intense anger is considered one of the key predictors of violence potential at school. Comprehensive intervention packages often include modules on stress reduction and coping, psycho-educational approaches such as learning about the physiology of anger, anger triggers, etc., cognitive restructuring such as learning alternative ways to interpret the actions and intentions of others, and behavioral skills training such as assertiveness training. Efforts to prevent anger-related problems assist in identifying and managing angry feelings, challenging anger-provoking beliefs and attitudes, and learning alternatives to aggression.

2.0   ANGER:

Anger is "an emotional state that varies in intensity from mild irritation to intense fury and rage," according to Charles Spielberger, PhD, a psychologist who specializes in the study of anger. Like other emotions, it is accompanied by physiological and biological changes; when you get angry, your heart rate and blood pressure go up, as do the levels of your energy hormones, adrenaline, and noradrenaline.

Anger can be caused by both external and internal events. You could be angry at a specific person (Such as a coworker or supervisor) or event (a traffic jam, a canceled flight), or your anger could be caused by worrying or brooding about your personal problems. Memories of traumatic or enraging events can also trigger angry feelings.

Anger is often defined as an emotional reaction (tension, stress and hostility) aroused by a wide variety of real or imagined insults, slights, threats, hurts or injustices.  Angry reactions range from avoidance of the cause to verbal or physical violence.  When a person’s anger leads to inappropriate behavior that infringes on the rights and safety of others, that person needs help.  Some of these people voluntarily seek counseling, therapy or treatment.  Others are arrested (e.g., assault or domestic violence) and some are remanded to “anger management” programs.  Anger management counseling often involves groups dedicated to helping people deal with their anger in constructive ways.  Other programs emphasize education, cognitive change, relationships, self-awareness, behavior modification, etc.  Regardless of where the individual is referred (individual or group counseling), anger management treatment effectiveness is greatly influenced by the “anger” assessment.

3.0   TYPES OF ANGER:

According to Abhishek Agarwal Anger is of different types, and can be classified into categories. Recognizing the classification of your anger will help you deal with it better in the long run.

1. Behavioral Anger: When a person experiences behavioral anger, he or she usually confronts the subject that angers them, which is usually another person. Physical harm may follow verbal rudeness. Such are the characteristics of behavioral anger.

2. Chronic Anger: A person that suffers from chronic anger does not always have a rational explanation of why he is angry all the time. Such people hate the world that they live in, hate themselves, hate everybody else and generally fly into tempers at the slightest motivation.

3. Constructive Anger: A person who deals with his anger by canalizing the anger into a constructive path such as self improvement is said to have constructive anger. This is often a result of self help and anger management courses.

4. Deliberate Anger: When a person deliberately poses as he has anger, often as a ploy to control subordinates, this type is called deliberate anger. It is usually a fake enacting of anger, but could escalate into other forms of anger occasionally. Deliberate anger also leaves quickly, especially when confronted.

5. Judgmental Anger: people suffering from this form of anger usually put other people down in front of gatherings, to try and make them look superior.

6. Overwhelming Anger: As the name suggests, this form of anger exists when the emotion has really got to the root of a person. People experiencing overwhelming anger just cannot stand the situation they are in, and often find destructive means of relieving themselves by self hurt or by hurting other people physically.

7. Paranoid Anger: The paranoid form of anger is totally without just cause. People often work themselves into a frenzy imagining that someone was against them. This is called paranoid anger.

8. Passive Anger: This is a somewhat controlled form of anger where the person experiencing it does not directly show his anger. Instead he resorts to mocking the person who angers him, in a sarcastic manner.

9. Retaliatory Anger: This happens as a result of another person’s anger towards you. When you retaliate in self defense in an angry manner, this is called retaliatory anger.

10. Self Inflicted Anger: Here, a person who is angry with himself punishes himself by inflicting pain upon his own body. This is a common phenomenon with drug addicts.

11. Verbal Anger: Here, the only damage that is done is verbal abuse to other people. This could often be the beginning of other forms of anger.

12. Volatile Anger: This could range from mild anger to an absolute fury, and leaves just as suddenly as it comes. The intensity and the time depend on how well it is controlled by the individual.

Common Reaction of anger:

• OVERT

• Threats

• Rudeness

• Prejudice

• Self harm

• Verbal abuse

• Caustic remarks

• Scapegoat

• Physical assault

• • COVERT

• Apathy

• Pranks

• Teasing

• Clinging

• Indecisiveness

• Gossiping

• Syrupy sweet

• Procrastination

• Ignoring person/situation

4.0   ASSESSING ANGER:

How does a client know when his or her anger is more of a problem than a help? Few formal assessments exist to quantifiably measure the level of one's anger. However, there are numerous qualitative indicators to review with clients to understand the extent of their concerns about their anger and anger management strategies.

• Is the anger chronic, long-lasting, too intense, or too frequent (Rhoades, n.d.)?
• Does the anger disrupt the client's thinking, affect the client's relationships (Rhoades, n.d.), or affect the client's school or work performance?
• Does the client exhibit frequent loss of temper at slight provocations, passive-aggressive behavior, a cynical or hostile personality, chronic irritability and grumpiness?
• Has the client begun to display low self-esteem, sulking, or brooding?
• Is the client withdrawing socially from family and friends?
• Is the client getting physically sick or doing damage to one's own or others' bodies or property?
• Is the client experiencing physical symptoms such as increased heart rate, increased blood pressure, or increased adrenaline flow (Controlling anger before it controls you).

5.0   SYMPTOMS OF ANGER:

Anger episode involve following symptoms

·         Tension or stress begins to build, e.g. we are easily frustrated, clenched posture

·         Breathing and heart rate increases

·         Blood pressure rises, e.g. flushed face and neck, veins standing out

·         Increases in hormones such as adrenaline and nor-adrenaline

·         The person may express their anger verbally, either directly or through emotions such as disgust, sarcasm, put-downs, blaming, criticism, resentment, argumentativeness, sullenness, insults and contempt

·         Violence, threats, temper tantrums

·         Explosive outbursts leading to physical attack or destruction of property.

·         Exaggerate hostility to unimportant irritants.

·         Rapid and harsh judgment statements made to or about others.

·         Use of body language such as tense muscles, clenched fist or jaw, glaring

·         Looks or refusal to make eye contact.

·         Use of passive-aggressive behaviors.

·         Social withdrawal due to anger.

·         Refusing to complete assignments on timely basis.

·         Refusing to follow instructions or rules.

·         Complaining about authority figures behind their back.

·         Refusing to participate in activities when this behavior is expected.

·         Authority is challenged or disrespected.

·         Verbal abusive language is utilized.

6.0   CAUSES OF ANGER:

Some common causes are:

• Frustration
• Hurt
• Annoyance
• Disappointment
• Harassment
• Threats

Events and circumstance alone do not cause anger. Anger results from how people view what happens to them (Ellis, 1977; Novaco, 1975). There are four types of thinking that typically create dysfunctional anger:

1. Inferential distortions such as mind-reading, fortune-telling, filtering, and emotional reasoning (Burns, 1980) lead people to misinterpret what is happening around and to them.

More important, misinterpretations are followed by self-defeating evaluations (Ellis, 1962):

2. Awfulising and discomfort-intolerance about unwanted events (often called 'cant-stand-it-it-is’). Anger frequently results from anxiety, and violence often represents an attempt to ward off perceived threats. REBT suggests that such threats may be of two types:

• perceived threats to well-being (discomfort anxiety);
• Perceived threats to self-image (ego anxiety).

3. Expectations that are held as demands. Demands typically lead to low-frustration tolerance - a key cause of dysfunctional anger:

• Moralizing about how people 'should’ or 'should not’ behave;
• Believing that the world or one’s circumstances 'have’ to or 'need’ to be a certain way.

4. Global rating of other people:

• Labeling a person as a 'bastard’, or some other all-encompassing label makes it easier to be angry with them.

7.0   EFFECTS ON OUR HEALTH:

In the case of chronic anger, long-term hyper-arousal of the autonomic nervous system can cause the following symptoms:

·         Headaches.

·         Stomach ache.

·         Skin rash.

·         Arthritis – anger produces uric acid in the bloodstream which may contribute to the onset of arthritis.

·         Circulatory disorders.

·         Aggravation of existing physical symptoms.

·         Emotional disturbances such as depression.

·         The physical effects of violence towards the self and others.

 

8.0   LINK BETWEEN ANGER AND MENTAL ILLNESS:

The prevalence of anger attacks (defined as irritability, inappropriate anger and rage, frequent outbursts and overreaction to minor annoyances) in patients with depression can be as high as 44%. (http://www.psychiatrist.com/supplenet) Also, people with bipolar disorder can have episodes or periods of irritability when hypo-manic or manic.

9.0   SHORT-TERM REWARDS OF ANGER:

Some people are anger junkies. They enjoy or need to experience the short-term pay-offs of aggression in order to get through their everyday life. Here are some of the short-term rewards of anger:

·         Creates an adrenaline rush

·         Provides a sense of power

·         Provides Excitement

·         Relieves boredom

·         Makes people listen to you

·         Enables you to avoid crying or showing vulnerability

·         Keeps you from facing feelings of sadness or fear

·         Gets people to do things for you through intimidation

·         Establishes superiority over others (“I’m better than you”)

·         Puts the blame on someone else, other than yourself

·         Shows other people that you are not a wimp

·         Scares other people into submission

·         Motivates you to get things done

If you are an anger junkie, try to identify the pay-offs you are getting out of it. Then think about the long-term effects of your aggressive or passive aggressive behavior (e.g. loss of relationships, opportunities, etc.). Now decide if the short-term benefits are worth suffering the long-term punishments.

10.0   WHEN ANGER IS GOOD:

Anger can serve very positive functions when expressed properly. Studies continue to show that anger can have beneficial effects on individuals' health, their relationships and their work. Socially, very positive changes can come from anger -- for instance, the civil rights movement of the 1960s or the women's suffrage movement in the early 20th century. On an individual level, scientists have shown angry episodes actually strengthen personal relationships more than half of the time.

Social scientists agree that anger can be beneficial when it is expressed constructively. One way to ensure this is through the use of feedback loops. Constructive anger expression involves both parties, not just the angry person. Ideally, the angry person expresses his or her anger and the target has a chance to respond. Oftentimes, simple expression helps to ease the situation, particularly if the anger is justified. Remember that this is not simply an opportunity for someone to "vent." It must be approached with the attitude of solving a problem.

11.0   WHEN SOMEONE ELSE REACHES THE BOILING POINT KEEP YOUR   COOL:

Don't answer anger with anger. Remember that anger can lead people to say things they really don't mean.

Be considerate:

If others are around, encourage the angry person to discuss his or her anger privately. This could prevent embarrassment.

Be a good listener:

Often, angry people just need someone to listen as they "sound off."

Consider the cause of the anger:

Think about whether the angry person might feel better if he or she had fewer responsibilities, more time alone, more rest, etc.

Don’t take chances:

Sometimes, anger can lead to violence. If your safety appears to be threatened, get help immediately.

Anger is a natural human emotion. Be sure that you:

• Learn to recognize anger in yourself and others.
• Understand the real reason for your anger.
• Find healthy, constructive ways to express your anger.

12.0   ANGER MANAGEMENT:

Remember, you can't eliminate anger—and it wouldn't be a good idea if you could. In spite of all your efforts, things will happen that will cause you anger; and sometimes it will be justifiable anger. Life will be filled with frustration, pain, loss, and the unpredictable actions of others. You can't change that; but you can change the way you let such events affect you. Controlling your angry responses can keep them from making you even unhappy in the long run.

Are You Too Angry?

There are psychological tests that measure the intensity of angry feelings, how prone to anger you are, and how well you handle it. But chances are good that if you do have a problem with anger, you already know it. If you find yourself acting in ways that seem out of control and frightening, you might need help finding better ways to deal with this emotion.

Why Are Some People Angrier Than Others?

According to Jerry Deffenbacher, PhD, a psychologist who specializes in anger management, some people really are more "hotheaded" than others are; they get angry more easily and more intensely than the average person does. There are also those who don't show their anger in loud spectacular ways but are chronically irritable and grumpy. Easily angered people don't always curse and throw things; sometimes they withdraw socially, sulk, or get physically ill.

People who are easily angered generally have what some psychologists call a low tolerance for frustration, meaning simply that they feel that they should not have to be subjected to frustration, inconvenience, or annoyance. They can't take things in stride, and they're particularly infuriated if the situation seems somehow unjust: for example, being corrected for a minor mistake.

What makes these people this way? A number of things. One cause may be genetic or physiological: There is evidence that some children are born irritable, touchy, and easily angered, and that these signs are present from a very early age. Another may be sociocultural. Anger is often regarded as negative; we're taught that it's all right to express anxiety, depression, or other emotions but not to express anger. As a result, we don't learn how to handle it or channel it constructively.

Research has also found that family background plays a role. Typically, people who are easily angered come from families that are disruptive, chaotic, and not skilled at emotional communications.

Is It Good To "Let it All Hang Out?"

Psychologists now say that this is a dangerous myth. Some people use this theory as a license to hurt others. Research has found that "letting it rip" with anger actually escalates anger and aggression and does nothing to help you (or the person you're angry with) resolve the situation.

It's best to find out what it is that triggers your anger, and then to develop strategies to keep those triggers from tipping you over the edge.

Treatment Procedure:

The overall aim of treatment is to help the client replace hostile dysfunctional anger (directed at people) with moderate, functional anger (directed at solving problems). Treatment involves raising frustration-tolerance through developing the client’s cognitive, physiological, and behavioral coping skills; then providing for the practice of these skills with exposure to regulated doses of stressors that arouse but not overwhelm the client’s defenses. The term anger management refers to a system of various different psychological therapeutic techniques that someone who has anger problems can use to control or reduce the triggers that affect or aggravate their anger. There are basic anger management techniques such as deep breathing and meditation, which are both commonly used, however each person’s case is different and thus their recommended form of treatment will be different as well.

Cognitive Strategies:

• Give the client reading to educate them about self-defeating thinking and how it can be changed.
• Help the client develop empathic abilities, using techniques like role-reversal.
• Help the client develop a task-orientated attitude to dealing with problems – that is, changing circumstances rather than upsetting themselves.
• Assist the client to increase their motivation to change by listing and weighting the advantages and disadvantages of their anger.

Cognitive Restructuring:

This means changing the way you think. Angry people tend to curse, swear, or speak in highly colorful terms that reflect their inner thoughts. When you're angry, your thinking can get much exaggerated and overly dramatic. Try replacing these thoughts with more rational ones. For instance, instead of telling yourself, "oh, it's awful, it's terrible, everything's ruined," tell yourself, "it's frustrating, and it's understandable that I'm upset about it, but it's not the end of the world and getting angry is not going to fix it anyhow."

Disputing irrational beliefs:

The most common cognitive method of REBT consists of the therapist disputing client’s irrational beliefs and teaching them how to do this challenging on their own. Clients go over a particular “must”, should”, or “ought” until they no longer hold that irrational belief, or at least until it is diminished in strength. These irrational beliefs lead to anger, irritability and anxiousness in life. For example, “if life doesn’t always go the way I would like it to, it isn’t awful, just inconvenient”.

Changing one’s languages:

REBT contends that imprecise language is one of the causes of emotional disturbance. Client learns that “musts”, “oughts,” and “shoulds,” can be replaced by preferences.   Instead of saying, “it would be absolutely awful if….” They can learn to say “it would be inconvenient if…”clients who use language patterns that reflect helplessness and self-condemnation can learn to employ new self-statement. They can assume personal power by replacing their “shoulds” and “musts” with non-absolute preferences.

Rational-emotive imagery:

This technique is form of intense mental practice designed to established new emotional patterns. Client imagine themselves thinking, feeling, and behaving exactly the way they would like to think, feel, and behave in real life (Maultsby, 1984). They can also be shown how to imagine one of the worst things that could happen to them, how to feel inappropriately upset about this situation, how to intensely experience their feelings, and then how to change the experience to an appropriate feeling (Ellis, 1998, 1999; Ellis & Yeager, 1989).

Role Playing:

There are both emotional and behavioral components in role playing. The therapist often interrupts to show clients what they are telling themselves to create their disturbances and what they can do to change their inappropriate feelings to appropriate ones. Client can rehearse certain behaviors to bring out what they feel in a situation.

Shame-attacking Exercise:

Ellis (1988, 1998, and 1999) has developed exercises to help people reduce irrational shame over behaving in certain ways. He thinks that we can stubbornly refuse to feel ashamed by telling ourselves that it is not catastrophic if someone thinks we are foolish. The main point of these exercises is that clients work to feel unashamed even when others clearly disapprove of them.

Using Humor:

REBT contends that emotional disturbances often result from taking oneself too seriously and losing one’s sense of perspective and humor over the events of life. Albert Ellis himself tends to use a good deal of humor to combat exaggerated thinking that leads clients into trouble (1986). Ellis typically uses humorous songs, and he encourages people to sing to themselves or in a group when they feel depressed or anxious. (Ellis, 1998, 1999). Humor shows the absurdity of certain ideas that client steadfastly maintains, and it can be of value in helping clients take themselves much less seriously.

Anger and Self-Talk:

One important part of an anger control plan is "self-talk". Self-talk is the conversation you have with yourself inside your head, in other words your thoughts in response to a situation. For example, if you are deciding whether or not to eat a fattening dessert, your self-talk might go something like this: "Wow... that sounds good ... I already ate way too much at dinner but I am planning on exercising tomorrow ... so I guess I'll go ahead and have it".

One way to change your behavior and your feelings about an event or situation is to change your self-talk. This is just as true about controlling anger and aggressive behavior as it is about changing any other kind of feeling or behavior. For example, to change your mind about eating that fattening dessert you might train yourself to think different thoughts. You might get yourself to remember something like "my doctor told me to lose weight,…. to cut down on fat…. and heart disease runs in my family" when faced with that kind of decision. This same strategy can be applied to anger that gets out of control or is inappropriate to the situation.

Certain kinds of thoughts tend to make you angrier, while other types of thoughts tend to lower your anger level. If you can recognize the thoughts you have that crank up your anger, you can try to replace those thoughts with calming, soothing thoughts that will bring your anger level back down.

Better Communication:

Angry people tend to jump to—and act on—conclusions, and some of those conclusions can be very inaccurate. The first thing to do if you're in a heated discussion is slow down and think through your responses. Don't say the first thing that comes into your head, but slow down and think carefully about what you want to say. At the same time, listen carefully to what the other person is saying and take your time before answering.

Listen, too, to what is underlying the anger. For instance, you like a certain amount of freedom and personal space, and your "significant other" wants more connection and closeness. If he or she starts complaining about your activities, don't retaliate by painting your partner as a jailer, a warden, or an albatross around your neck.

It's natural to get defensive when you're criticized, but don't fight back. Instead, listen to what's underlying the words: the message that this person might feel neglected and unloved. It may take a lot of patient questioning on your part, and it may require some breathing space, but don't let your anger—or a partner's—let a discussion spin out of control. Keeping your cool can keep the situation from becoming a disastrous one.

Time Out:

'Time-out’ is useful in the early stages of therapy, before the client has learned to deal with the underlying cause of their anger. The client prepares the scene by explaining to their partner what they will do and arranges their co-operation. When the client identifies the early stages of anger, they follow these steps:

1. Share with their partner that they are feeling angry, and say they are going to take time-out.
2. Leave the situation for about one hour. Avoid drinking or driving while angry, instead, do something physical (brisk walk, run, gardening, etc.), and/or do a self-analysis to deal with self-defeating thinking.
3. When the hour is up, return and check in with their partner and offer to talk about what happened.

Assertiveness Training:

This will teach you how to express your feelings and needs in a calm, considered way that is respectful of the other people around you. It may help if your problems are due to a difficulty expressing your anger constructively. The aim of assertiveness is for the client to achieve their objectives and gain a sense of control without using anger. It involves:

• Effective communication of feelings.
• Asking for what they want and saying 'no’ to what they don’t want.

Skill Acquisition:                                          

Teach the client how to use anger adaptively rather than destructively. The client learns to minimize the dysfunctional aspects of their anger, and instead engage in problem-solving behavior.

Problem-solving training:

Sometimes, our anger and frustration are caused by very real and inescapable problems in our lives. Not all anger is misplaced, and often it's a healthy, natural response to these difficulties. There is also a cultural belief that every problem has a solution, and it adds to our frustration to find out that this isn't always the case. The best attitude to bring to such a situation, then, is not to focus on finding the solution, but rather on how you handle and face the problem.

Make a plan, and check your progress along the way. Resolve to give it your best, but also not to punish yourself if an answer doesn't come right away. If you can approach it with your best intentions and efforts and make a serious attempt to face it head-on, you will be less likely to lose patience and fall into all-or-nothing thinking, even if the problem does not get solved right away.

Train the client how to use task-oriented, problem-solving strategies. They will then be able to deal with problems straight away rather than bottling up their feelings. As therapist, you help the client gain coping skills by:

1. Teaching techniques.
2. Modeling them.
3. Assisting the client to rehearse the techniques.

Relaxation:

Simple relaxation tools, such as deep breathing and relaxing imagery, can help calm down angry feelings.

There are some simple steps in relaxation technique.

•       Breathe deeply, from your diaphragm; breathing from your chest won't relax you. Picture your breath coming up from your "gut."

•       Slowly repeat a calm word or phrase such as "relax," "take it easy." Repeat it to yourself while breathing deeply.

•       Use imagery; visualize a relaxing experience, from either your memory or your imagination.

•       Non-strenuous, slow yoga-like exercises can relax your muscles and make you feel much calmer

Some Other Tips for Easing Up on Yourself

Timing: If you and your spouse tend to fight when you discuss things at night—perhaps you're tired, or distracted, or maybe it's just habit—try changing the times when you talk about important matters so these talks don't turn into arguments.

Avoidance: If your child's chaotic room makes you furious every time you walk by it, shut the door. Don't make yourself look at what infuriates you. Don't say, "well, my child should clean up the room so I won't have to be angry!" That's not the point. The point is to keep you calm.

Finding alternatives: If your daily commute through traffic leaves you in a state of rage and frustration, give yourself a project—learn or map out a different route, one that's less congested or more scenic. Or find another alternative, such as a bus or commuter train.

Writing:

Writing down your feelings in a journal, letter or poem can be an effective way of expressing and discharging feelings.

Physical Activity:

Walking, golfing, weightlifting, can be an excellent outlet for angry feelings. Don't let competition or personal limitations frustrate you. (Consult your health-care provider before starting an exercise program).

Hobbies:

Instead of flying off the handle, put your energy into a carpentry project, pulling weeds in the garden or any hobby you enjoy.

13.0   ACCOMPLISHMENTS OF ANGER MANAGEMENT:

         You can manage your anger and express it appropriately! Here is what you will accomplish once you learn how to manage your anger:

1.  You will view anger as an emotion and nothing more. You won’t see it as a precursor to violence and will be able to recognize both the negative and positive effects anger can have in your life. 

2.  You will use anger as a signal that there are problems you need to look after.

3.  You will take action, but only after you are aware of what is making you angry and why. You will be able to identify the type of anger you are experiencing – Present or Suppressed Anger.

4.  You will be able to identify the primary emotions that lie under the surface of your anger and use these emotions to communicate your needs. 

5.  You will not need to resort to violence, crime or verbal attack because of your anger.

6.  You will skillfully cope with interpersonal conflict. 

7.   You will state your needs clearly, in ways that others can understand.

8.   You will let go of your anger rather than hang onto it once you have expressed your feelings and resolved the problem.

14.0   GOALS OF ANGER MANAGEMENT:

• Developing better communication skills with the aim of improving relationships
• Developing an understanding of what triggers anger
• Developing strategies to deal with anger
• Developing listening skills
• Developing skills like ‘reframing’ negative thoughts about life situations
• Getting help to change your life circumstances, if necessary
• Anger management

15.0   CONCLUSION:

Although anger is considered a fundamental and universal human emotion, there are individual differences both in the disposition to experience anger and in the self-regulation of anger. Frequent, intense anger arousal impairs decision making and impulse control, thereby increasing the probability of aggressive behavior. Both outward expressions of anger through destructive behavior and inward suppression of anger may constitute anger problems. Such problems are, respectively, included among the externalizing and internalizing problems. Anger suppression may include anxiety and/or depression symptoms. Rather than a “one size fits all” approach, effective anger management programs target specific anger-related problems including chronically high levels of angry feelings, hostile attitudes toward others, and the tendency to express anger in destructive and/or hurtful ways.

Chronically high levels of anger and hostility constitute risk factors for health, interpersonal difficulties, and violent and aggressive behavior. Anger management training appears most useful in reducing incidents of spontaneous or “reactive” aggression as opposed to more deliberate, intentional or “proactive” acts of aggression. Although both males and females experience anger to the same extent, females tend to express anger in less direct ways, e.g., interpersonal or relational aggression. The most effective interventions employ cognitive-behavioral techniques including anger regulation and control, problem solving to learn alternatives to aggression as an expression of anger, and cognitive restructuring to change maladaptive thought processes.