1. UNDERSTANDING AND MANAGING ANGER Cyndie Franklin Northeast Iowa Family Medicine Residency June 26, 2013

2. Anger... is an emotional, affective, antagonistic response to a situation.

3. Typically, anger is experienced when someone is... n blocked n frustrated n abused n neglected

4. No situation or person can “make” us angry. Our anger is directly related to our perceptions of situations, persons and events.

5. Sometimes anger masks other feelings.

6. Sometimes other emotions mask anger.

7. How we recognize, label and express our feelings is largely learned.

8. Unhealthy ways of dealing with anger can be unlearned and healthy behaviors substituted.

9. Recognizing, labeling and expressing anger in a healthy way is vital to our mental health.

10. In and of itself, anger is a healthy emotion; Where we typically get into trouble is how we express our angry feelings.

11. Anger is healthy when: n It is treated as a normal part of life n It is an accurate signal of real problems in a person’s life n It is expressed in moderation so there is no loss of control n It is clearly stated in ways that others can understand n It is temporary. It can be relinquished once an issue is resolved.

12. Ways of Expressing Anger n Passive n Aggressive n Passive-Aggressive n Asssertive

13. Positive Aspects of Anger n Anger can give us strength and determination n Anger tells us that something is wrong that needs to be resolved n Anger can be a helpful way to express tension and communicate negative feelings

14. Negative Aspects of Anger n Anger interferes with our ability to think clearly and inclines us to act impulsively n Anger is physically upsetting n Anger is an antagonistic response that can lead to actions that harm others n Anger is unproductive in solving complex problems

15. There is a biological basis to emotion, in general, and anger, in particular.

16. Most researchers believe the limbic system is responsible for mediating the experience of anger. It may also play a critical role in the expression of anger.

17. The limbic structures seem to be clearly involved with aggressive/violent behavior. Stimulation, removal or infection of these areas leads to marked alterations in behavior on this continuum.

18. Major and minor neurological impairments are more likely in individuals with a history of violent or aggressive behavior.

19. Unhealthy anger (violence or aggression) has multiple causes in addition to biological factors.

20. Some of those causes include: n Childhood trauma n Personality disorders n Dysfunctional family dynamics n Socio-Cultural and gender factors n Temperament n Poor role models for anger expression n Mood disorders n Chronic Health problems n Substance Abuse n External factors n Internal factors

21. When is anger a problem? n When it is too frequent. n When it is too intense. n When it lasts too long. n When it leads to aggression.

22. Dealing With Anger When done effectively, anger control does not mean bottling it up or keeping a tight lid on it.

23. Anger management will involve several components: n Learning how not to get angry in the first place. n Keeping anger at a moderate level of intensity and expressing it constructively. n Using strategies to change problem situations.

24. You must become an “expert” about your personal anger reactions.

25. Inappropriate Ways of Dealing with Interpersonal Anger n Aggressive Behavior n Passive -aggressive behavior n Passive n Displacement n Scapegoating

26. A useful way of dealing with interpersonal anger is to use the assertive model.

27. The assertive model involves: n Identifying the specific behavior of the other person that has upset you. n Decide if the issue/behavior is worth fighting about. n Pick a time. Express your intention to discuss/fight. n Express your viewpoint using an assertive model of feedback.

28. An Example of the assertive model would be: n When: “When you buy expensive items using our savings,...” n The effects are: “I feel discounted and angry.” n I would prefer: “I would like for you to consult me on your intention to spend more than $100 from our savings.”

29. Intense anger may require additional approaches. n Psychopharmacological treatment n Cognitive re-structuring n Behavioral techniques n Address depression or other problems that are being masked by anger/rage