1. Anger Mangement Concepts
Meeting each
First and Third Monday of every month
7:00 PM until completed
Presenter:
Larry Epstein LMHC CASAC

2. Anger is a very complex concept
Anger is a very complex concept. I can only scratch the surface in a slideshow when talking about this state of being/emotion. I will talk about what I have come to understand as the basics of anger: what is it, why we feel it, consequences, the “Cycle of anger” and ways to minimize it. It is important to understand that no one concept, lesson, or exercise will make you “one and at peace”, eliminating anger.
Anger is a natural response to certain stimuli. It is OK to be angry. It is OK to feel anger at times. It is OK to “hold it in” at times and not others. It is OK to yell and “let it out” at others. What is not OK is when the impact your expressions have on yourself and your relationships with others is negatively impacted by anger. If you have a history of hurting other’s feelings, causing others to distance themselves from you, or you’ve lost jobs, relationships, friendships, and maybe even experience legal consequences, then anger is a problem… or a symptom of a larger problem.

3. What is anger?
I will be explaining this concept as I do to my clients. It is only one way of understanding anger, but it works best for me. The definition comes from a culmination of multiple sources and thus I can’t site where I get this from.
Anger, like so many emotions, is secondary to our experiences. It is customized to each person’s life.

4. Anger is normal.

5. Anger: Biology
So many of our emotions are based in biology. To understand what this means, one must understand a little about the human brain. To the right is a human brain. On the left is the Prefrontal Cortex (PFC). This is the part of our brain that makes us human. Rational thought, emotional regulation, thinking ahead, calculation and so much more happens here.

6. Biology: Continued
Where the PFC is the most recent and most complex part of the human brain, the Limbic system (seen right) is the oldest and most highly developed part of the brain. The “fight, flight, or freeze” response is activated here. It takes little effort as it historically keeps us alive. It controls heart rate, blood flow, perspiration, respiration, and many more automatic responses. It is our “animal brain.”

7. Biology: Continued
When you are calm, at peace, your PFC is in control. In an fMRI (functional Magnetic Resonance Imaging) machine, one would see the PFC gets the most of the blood-flow when you are a calm and rational human being. With the right stimulus, a threat, an insult, getting cut off in traffic, your possessions being stolen, bad news… your limbic system (again, the system that regulates the fight, flight or freeze response) is activated. Blood moves from the PFC to the Limbic system. This causes several responses in the body to happen and though each person is different as to the degree, the following can happen:

8. Biological responses (in no order, not complete)
Increased respiration
Increased perspiration
Increased heartrate
Blood flow to large muscles
Pupil dilation
Increased blood pressure
“Puffing out” one’s body
Increased body temperature
Decreased vocabulary
Decreased vocabular complexity
Hostile body stance
Raised Voice
Showing of teeth
Decreased Digestion
Decreased memory recall
Decreased fine motor skill

9. Why evolve this way?
Depending on how you define “in the wild”, when humans were evolving in the wild, like all other animals, we evolved to survive in our environment. Thinking in the wild can get you killed quickly. If a predator is charging you, remaining calm is more likely to get you killed than to survive. Reacting to a threat will “get the blood flowing” and you can run, fight, or freeze, which is more likely to keep one from becoming a predator’s meal. Evolution is slow process. Even if “in the wild” was 100,000 years ago, our biology has not changed much since then. But our culture has. Anger, as helpful and useful as it was “back then” has little place in our modern culture. It has yet to and may never be evolved out of our DNA.

10. Anger: Consequences in the modern era
As it stands, anger was once much more useful then than it is now. This is not to say it doesn’t have uses. Anger can intimidate others. As unfair as the idea is, “might makes right” can go a long way when you lack other means to gather resources, mates, or get others to see your point of view. If I can physically or emotionally dominate another, I get my way, I get what I want.
I’m not saying it is right, healthy, correct or moral, I’m just saying it is a fact. But using this behavior has consequences. It destroys relationships, lives, has legal ramifications, and prolonged anger increases Cortisol (the stress hormone) levels in the brain, decreasing immune response, life span, and increasing blood pressure and the risk of many physical maladies.

11. The Cycle of Aggression.
The model to the right emphasizes Aggression, the “fight” part of “fight flight or freeze.” I’m not saying all anger results in aggression, but the model works well in understanding anger and it’s predictable nature.

12. The Cycle of Aggression (continued)
Escalation
Explosion
“Going zero to 100” can take time for some and be instantaneous for others. Some are slow to anger, like “Pressure cookers” others “snap” at the slightest insult. It is during this phase blood is leaving the PFC and heading towards the Limbic system. Control, though not lost, decreases if not stopped.
This is the “lost it” phase. It is usually relatively short, seconds for most people. It is hard to sustain since it usually involves adrenaline and once that’s exhausted, one inevitably calms down. Few people can keep an explosion sustained for much longer.

13. Cycle of Aggression: Explosion, (continued).
Think back to the “symptoms” of anger described on slide 8. Some may show up in some form or another in the Escalation Phase, but they will be much more pronounced here. The ability to be rational is nearly impossible, some people report “blacking out”, the chance of violence increases, especially with substance use, and safety is of utmost concern. It is important to remember, staying calm and being ration when another is “Exploding” mean nothing if you are unsafe. When dealing with an exploding individual, make sure you have an exit strategy.

14. Post Explosion Phase
Biology is returning to a state of equilibrium. The blood in the brain is returning to the PFC and the Limbic system is relinquishing automatic responses in an effort to preserve energy and calories. A person can become calm, rational, and they usually report a “Whew” moment where a feeling of relaxation washes over them like a runner may report after having run a long distance.
This is also where consequences of anger become evident.
Hurt feelings
Legal consequences
Loss of relationships/employment
Financial repercussions
Damage to property
Physical harm to oneself or others

15. Post Explosion Phase (Continued)
Consequences of an explosion can last seconds to the rest of your life. I’ve heard horrible stories; because of a 30 second outburst that resulted in:
Physical consequences another will live with for the rest of their life
Monetary cost of lawyer fees and medical fees
Losing residence due to impending incarceration
Years spend incarcerated
Parole
Difficulty finding jobs because he is now a felon…

16. Is it worth it?

17. The only 2 reasons people get angry
I feel disrespected
I can’t control things
An insult
Rules not followed
Discourtesy
Rudeness
Passed over for a raise/promotion
Not being treated “like I deserve”…
Traffic
Weather
Stock Market
Faulty Devices/machinery
Credit card declined
The movie sucked
Traffic Ticket in the mail…

18. Why control anger?
In keeping with the theme of “improving relationships”, keeping anger in check and expressing it in a healthy manner means learning to be assertive without being aggressive. No one is a proverbial doormat. I do not suggest just “laying down and letting others walk over you.” There are ways to stand up for yourself without resorting to anger.
When one learns to express discomfort without resorting to name-calling, hostility, violence, intimidation, aggression, or other forms of maladaptive communication, stays calm, present, and keeps the blood in the PFC, one remains calm, recalls facts, thinks before speaking, keeps others’ feelings in mind, and is less likely to say something regrettable.

19. Multiple Anger reduction techniques.
Breathing
Counting 1-10
Asking for a “time out”
Distancing yourself from the source of anger
Distraction
Walking away with the intent to reengage at a later time
Saying “I’m angry and can’t talk about this now, can we talk about it in 10 minutes…”
The idea is when you feel your particular symptoms activating (red face, feeling warm, raising voices, clenching jaw…whatever is particular to you) you get the blood out of your Limbic System and back into your PFC. This isn’t quick. It’s not satisfying, one doesn’t use “might make right” and it takes time to get good at these skills. But unlike anger as seen in the “Cycle of Aggression”, the consequences are not usually as intense or long lasting.

20. A final word on Anger Management
This slideshow barely scratches the surface of anger. Its not meant to be a comprehensive, exhaustive review of the literature. It’s some of the basics of a 12 week anger management course I conduct at my job and in my private practice. The slide show I’ll post on a later date on “Speaker Listener” and “Active Listening” are excellent tools to reduce the intensity and frequency of anger with an decreased chance of escalation and potentially deescalating a situation. As I said earlier, Safety is first. Remain calm is the second. If these two conditions can be met, you can now control yourself and hopefully a situation. Remember, you cannot control another person or the situation, only yourself. Deescalate a situation, and one decreases the chances of negative consequences.