From the ISEP blog, we firmly believe that dedicating an article within our blog that deals with pathological anger and its strategies for channeling it in therapy can help you in your work.
Philosophers such as Aristotle, Seneca, or Plutarch defined anger as an intense emotion or passion provoked when people suffer or perceive that they suffer pain, insult, or injury that motivates a desire for revenge or another type of action to punish the offender or to have them make restitution (Sevillá and Pastor, 2016).
What is pathological anger?
Aristotle was precise in differentiating healthy anger from pathological anger by pointing out that “Anyone can get angry, it’s very simple. But to get angry with the right person, at the right time, for the right purpose, and in the right way, that, certainly, is not so simple.”
Rage arises when our dignity has been violated, we have been harmed, or our rights have been infringed. It is productive when energy is mobilized towards modifying the circumstances that harm us (Lizeretti, 2012). However, a person who gets angry too many times, with too much intensity, or for too long, may have symptoms of pathological anger.
What are the symptoms of pathological anger?
Specifically, in these individuals, the range of stimulating situations that provoke anger is very wide; they have a very low threshold for threatening stimuli, to which they react by approaching, instead of fleeing, with the aim of eliminating the danger. They present a relatively constant state of irritation and their acquaintances may define them as grumpy or bad-tempered. They present a very high psychophysiological alteration and, often, very rapid, leading them to externalize rage with disruptive and aggressive behaviors, from insults to rude words, through violence against objects, to physical aggression. Furthermore, their anger, after the offense, can last between days and weeks, seeming to be in a constant state of resentment, as if they could not process the triggering event, considering it unacceptable (Sevillá and Pastor, 2016).
Brain structures involved in the anger response
At a psychobiological level, it is important to know what are the brain structures involved in the anger response (Sevillá and Pastor, 2016):
The Raphe Nucleus
The function of the raphe nucleus is to send serotonin to the rest of the brain, proclaiming chemical messages of tranquility.
The Locus Coeruleus
Which sends noradrenaline to the brain, exciting it and putting it in a state of activation.
The Periaqueductal Gray Matter
The periaqueductal gray matter consists of neuronal circuits that control fight behavior, including the “freezing” response.
The Autonomic Nervous System
This system controls the physiological responses that provide the biological substrate for emotions (the sympathetic system innervates and provokes reactions, and the parasympathetic system restrains and reduces them, seeking balance).
The Hypothalamus
The hypothalamus affects sympathetic and parasympathetic activation, in addition to acting on the hormonal system through the pituitary gland.
The Pituitary Gland
It secretes corticotropin, in response to which the adrenal glands excrete cortisol into the blood, which produces an increase in glucose and provides the body with energy to face a dangerous situation, also increasing sensitivity to external stimuli.
The Amygdala
The amygdala is what directs and articulates the functioning of the rest of the structures involved in anger and aggression responses.
The Prefrontal Cortex
The prefrontal cortex is where the ability to think, evaluate, feel emotions, and be aware of them resides.
The Dorsolateral Cortex
This cortex allows for the planning and control of behavior through the analysis of past actions.
The Orbitofrontal Cortex
Its function is to ensure that a chosen option becomes a real behavior.
The Ventromedial Cortex
It is what makes us aware of our emotions and gives emotional meaning to our actions, facilitating self-regulation.
Anger and Psychology
In relation to our role as therapists, we encounter some difficulties in dealing with people who present pathological anger. The fundamental obstacle is the difficulty in creating empathy towards the client or even feeling fear towards them. It is not uncommon for a high percentage of therapists to feel uncomfortable with the anger behaviors that the patient exhibits daily, and this discomfort increases when these behaviors appear during the session, leading to different emotional reactions such as rejection, emotional distancing, anger, or fear (Sevillá and Pastor, 2016).
These emotional reactions depend on the therapist’s own personal learning history. If we accept the challenge of working with this type of person, the solution is to use the same strategies with ourselves that we teach them, keeping in mind Albert Ellis’s phrase, which states that “just because a person acts despicably, it doesn’t make them a louse.”
Useful strategies for channeling anger
Based on what has been said previously, some useful strategies for channeling anger are (Lizeretti, 2012):
1. Exposing psychological and power games to block them (manipulation, blackmail, intimidation by others).
2. Decreasing the causes of irritation, not allowing annoyances to accumulate. Prioritizing is useful for this.
3. Taking into consideration the point of view of others and not attributing unfounded intentions to their behavior.
4. After an aggression, it is necessary to allow a time for reflection, without acting immediately. It is always necessary to focus on the current cause of rage and not project past grievances onto the present.
5. Interrupting the interaction if we feel that we are losing self-control to avoid any type of violence.
6. Knowing how to forgive, accepting reconciliation after a while, or evaluating whether it is worth continuing in relationships that systematically harm us.