ebook img

Healthy Expression of Anger - Counseling and Mental Health Center PDF

62 Pages·2002·0.09 MB·English
Save to my drive
Quick download
Download
Most books are stored in the elastic cloud where traffic is expensive. For this reason, we have a limit on daily download.

Preview Healthy Expression of Anger - Counseling and Mental Health Center

Healthy Expression of Anger TI 084 A group treatment for individuals interested in developing more effective ways of expressing anger and handling conflict Victoria Beckner, M.A. & Kalina Brabeck, B. A. May 2002 The Clearinghouse for Structured/Thematic Groups & Innovative Programs Counseling & Mental Health Center The University of Texas at Austin 100 A West Dean Keeton Street 1 University Station A3500 Austin, Texas 78712-0152 512/471-3515 www.utexas.edu/student/cmhc/clearinghouse TI 084 – Anger The Clearinghouse – www.utexas.edu/student/cmhc/clearinghouse i Table of Contents Introduction to the Topic_________________________________________________ 1 Model for Treatment ____________________________________________________ 4 Phase I: Understanding the Anger Cycle & Points of Intervention___________________6 Phase II: Applying the Anger Cycle to Relationships______________________________7 Phase III: Termination & Continuation_________________________________________8 Group Format _________________________________________________________ 9 Population ___________________________________________________________ 10 Group Screening Interviews _____________________________________________ 11 Group Session Overview ________________________________________________ 12 Session 1: Sharing Experiences __________________________________________ 13 Session 2: Understanding Anger__________________________________________ 15 Session 3: Identifying Needs and Misinterpretations Underlying Anger __________ 17 Session 4: From Anger to Action _________________________________________ 20 Session 5: Putting it All Together; Improving Communication _________________ 23 Session 6: Anger Patterns in Relationships & their Origins ____________________ 25 Session 7: Under-Expressing Anger_______________________________________ 27 Session 8: Over-Expressing Anger ________________________________________ 30 Session 9: Clarifying Responsibility _______________________________________ 33 Session 10: Anticipating Resistance & Solidifying New Behaviors_______________ 35 Appendices ___________________________________________________________ 38 Appendix A: Pre-Group Interview Questions___________________________________39 Appendix B: Group Rules ___________________________________________________40 Appendix C: Clarifying Feelings Exercise______________________________________41 Appendix D: Daily Anger Log A______________________________________________42 Appendix E: Errors in Thinking Handout______________________________________44 Appendix F: Daily Anger Log B ______________________________________________45 Appendix G: Anger Cycle Reference Sheet_____________________________________47 Appendix H: Needs Underlying Anger Handout_________________________________48 Appendix I: Daily Anger Log C (final)_________________________________________49 Appendix J: Charlie Vignette ________________________________________________52 TI 084 – Anger The Clearinghouse – www.utexas.edu/student/cmhc/clearinghouse ii Appendix K: Communication Contrasts Role-play_______________________________53 Appendix L: Anger Styles Handout ___________________________________________55 Appendix M: Will & Tanya Vignette__________________________________________56 Appendix N: Bea Vignette___________________________________________________57 References ___________________________________________________________ 58 TI 084 – Anger The Clearinghouse – www.utexas.edu/student/cmhc/clearinghouse iii Healthy Expression of Anger Introduction to the Topic Anger is a frequent experience for most people, and often plays a significant role in their relationships with others and with themselves. Averill (1983) claimed that most people become moderately angry anywhere from several times a day, to several times a week. Anger is a signal, a message that we are being hurt, that our needs or wants are not being met, that our rights are being violated, or that something simply is not right. Our anger may tell us that we are avoiding an important emotional issue or that too much of our self is being compromised in a relationship. Anger can be a sign that we are doing or giving too much in a relationship, or else that others are doing so. In fact, anger can be quite helpful as a tool for change, when it challenges us to become more of an expert on the self, rather than focusing on others. It can be a means of getting in touch with our individual needs, thoughts, and feelings, (Lerner, 1985). Some people have difficulty expressing their anger in a way that meets their needs and maintains healthy relationships with others. For some individuals, anger is difficult to control, and they tend to let their anger explode. Overt anger can have a myriad of undesirable consequences, including negative evaluation by others, poor self-concept, low self-esteem, interpersonal and family conflict, verbal and physical assault, property destruction, and difficulty in work or school (Deffenbacher, 1992). Other people may bottle up their emotions and swallow their anger. Their needs and grievances never get adequately expressed. Suppressed anger is also associated with certain medical conditions, including essential hypertension, coronary heart disease, and cancer (Harbrurg, Gleiberman, Russell, and Cooper, 1991; Spielberger, Crane, Kearns, Pellegrin, and Rickman, 1991). This group treatment is based on a model, proposed by the manual authors, of the “anger cycle.” The cycle begins with an unmet need or injury to the self. Lazarus (1991) proposed that the ego identity, or self, is made up of set of beliefs, values, and commitments that a person deems important. This ego encompasses what people think of themselves and how they think they should be treated by others. We react with anger when another’s actions are perceived as insulting us, disrespecting our values and beliefs, or belittling who we are and/or what we deem important. We would take this a step further, and argue that underneath all of these thoughts and beliefs may lie a more universal need to feel like others care about us. We need to feel valued and liked. When TI 084 – Anger The Clearinghouse – www.utexas.edu/student/cmhc/clearinghouse 1 someone is insensitive or disrespectful, we are robbed of this fundamental need and our self is injured. It is, however, a person’s perception of an event, rather than the event itself, which results in feeling angry rather than some other emotion (Schacter and Singer, 1962). This is the second step in the anger cycle. While anger, the emotion, cannot be described in terms of “right” or “wrong,” the interpretations that precede the emotion may or may not be accurate. Beck (1999) noted several cognitive distortions that specifically are thought to cause emotional distress, including personalization, catastrophization, dichotomous thinking, selective abstraction, arbitrary inference, and overgeneralization. These errors in thinking can distort one’s perception of a situation, and it is that perception of threat to personal sense of wellbeing, competence, or security, that causes us to become angry. The resulting emotion of anger (the third stage of the cycle) is an uncomfortable affective state, and is accompanied by certain physiological reactions in the body. These reactions result from activation of the sympathetic nervous system that prepares the body for “fight of flight” or the “emergency reaction” (Canon, 1929). These physiological changes may include deeper and faster respiration; dilation of pupils; increases in heart rate, blood flow to muscles, sweat gland activity, blood pressure, and skin temperature; and/or decreases in flow of saliva. These bodily reactions together with the strongly negative affective state strongly influence the nature of a person’s behavioral responses, the fourth step of the anger cycle. For example, a person may feel so overwhelmed and intense that calm, rational conversation is impossible. Unhealthy behavioral expressions of anger can range along continuum from explosive rage (verbal and physical), to simmering, fuming, and silent discontent. Ineffective ways of expressing anger include blaming, venting, misdirecting one’s anger toward a neutral third-party, silent submissions, and ineffective fighting (Lerner, 1985; Finchman and Jaspers 1980). Angry action always has consequences, the last step in the cycle. The treatment is designed to examine how the behavioral response to anger affects oneself and others, in order to determine whether a given action is a “healthy” expression of anger. If the consequence of one’s actions perpetuate the original problem (one’s needs are still unmet, the conflict has not been resolved), then the cycle continues. Consideration of the consequences is thus essential to interrupting the anger cycle. Each person has his or her own unique anger cycle, with its origin in early relationships. People’s early attachment relationships with their primary caretakers shape TI 084 – Anger The Clearinghouse – www.utexas.edu/student/cmhc/clearinghouse 2 the internal working models they bring with them to other significant relationships (Bowlby, 1988). These early attachment encounters give rise to scripts that guide people’s reactions to unmet needs. Such scripts can also be described as “styles” of managing conflict in relationships. Two archetypal anger “styles” are the emotional over- and under-expresser. The over-expresser of anger tends to react to anxiety by seeking greater togetherness in a relationship, and to feel personally rejected when a significant other desires more time or space in the relationship. The under-expresser of anger, by contrast, tends to seek emotional distance or physical space when stress is high, and may cut off a relationship entirely when things get intense, rather than persevering and working it out (Lerner, 1985). When an emotional over-expresser and an under-expresser are involved in a relationship, the two positions mutually provoke and reinforce each other’s behavior. Thus, when one partner begins to alter her/his maladaptive patterns of relating, the behavior of the other partner, and therefore the relationship itself, will change. Changing one’s ineffective ways of expressing anger involves going to the source of the feeling, and identifying the underlying need and the (mis)interpretation that resulted in the feeling. Once one has defined a clearer sense of one’s self, the next step is to communicate these needs and feelings in a non-blaming way that focuses on the self, rather than criticizing, blaming, or telling another how he or she should feel. If the physiological changes that accompany anger are overwhelmingly intense, stepping back and taking a “time out” can be an effective way of cooling down, gathering one’s thoughts, and preparing for a level-headed, calm discussion. When ready to confront, one may use skills such as active listening, empathy, problem-solving, and communicating with “I” statements, to effectively communicate discontent. Fundamentally, establishing new ways of expressing anger and handling conflict in relationships with others necessitates continuous practice. Given that one’s anger management “style” likely finds its roots in early familial relationships, these styles are deeply entrenched within us and may operate at an unconscious level. The rehearsal of the old pattern has formed a linked network of thoughts or interpretations, physiological reactions, words spoken, and actions taken when angry. This reaction may happen so fast, it feels automatic. Thus, continually practicing new behaviors to create new ways of reacting is essential to change. Establishing new patterns of behavior also demands that one anticipate resistance from others and from the self and commit to maintain emotional contact with others, while at the same time asserting an independent sense of self. TI 084 – Anger The Clearinghouse – www.utexas.edu/student/cmhc/clearinghouse 3 Model for Treatment Treatment is designed to generate change in the individual. What kind of change is desired depends upon the goals of the treatment. As implied in our title of the group, our goal is not the reduction of anger—as is often the case in anger management interventions—but the development of “healthy” ways to express anger. Our assumption is that anger is a form of communication. Anger informs both the angry individual and others that an important need has not been met. For example, anger at a friend for arriving late may signal that one has a need to be a priority in her/his friend’s life, and does not feel that he or she is. Unfortunately, anger often drives behavior that undermines the individual’s goals. Thus yelling at the friend may result in alienation rather than connection. We define “healthy” expressions of anger as behaviors that result in positive consequences that facilitate resolving the problem and meeting one’s needs. The goals of the treatment are thus to increase awareness of unhealthy anger patterns, to develop a process for evaluating whether an alternative course of action is healthy, and to incorporate these new behaviors into one’s life and relationships. We conceptualize the change process during treatment as involving change in awareness, emotional responses, and behavior. Although an increase in awareness is generally the prerequisite to behavior change, each mode positively reinforces the others (see below). How Change Occurs During Treatment Increased Behavior change Awareness Emotion Thus (following the top arrows, the blue arrows), awareness through education provides the logic and motivation for the client to try new behaviors (talking about needs instead TI 084 – Anger The Clearinghouse – www.utexas.edu/student/cmhc/clearinghouse 4 of blaming). New behaviors and the responses they elicit from others (listening, understanding) generate emotion in the client (hope, relief, connection); this provides evidence for the educational component, reinforcing it and related behaviors. Awareness (following the bottom arrows, or red arrows), such as a change in how one interprets a situation), also leads directly to new emotions (hurt or compassion instead of anger). These “softer” emotions motivate new behaviors (talking instead of yelling), which also reinforce the new way of understanding anger. Our treatment was therefore designed to introduce new levels of awareness and related behaviors and skills with each session, rather than placing all of the educational material and awareness work at the beginning. The progression of the session themes initially follows our Anger Cycle (see below). Each conceptual “box” is introduced and explored, and provides different intervention points (new behaviors) at each point. The second half of the treatment applies the anger cycle to relationship dynamics. It is not expected that individual members will find all components of the Anger Cycle useful or relevant to their situations. Some may find the cognitive restructuring of interpretations particularly helpful, while for others, identifying needs underlying anger will be the most effective means of intervening in the Anger Cycle. For this reason, we encourage all intervention points (i.e. steps in the Anger Cycle) to be thoroughly explored during the treatment. Anger Cycle Interpretation Need (not met) Emotion Consequences: Response from others? Behavior Impact on others? Feelings toward self? Needs Met? TI 084 – Anger The Clearinghouse – www.utexas.edu/student/cmhc/clearinghouse 5 Phase I: Understanding the Anger Cycle & Points of Intervention The first phase of change involves understanding the Anger Cycle, and developing new behaviors to interrupt the cycle. The first goal is thus to deepen members’ awareness of how unmet needs and certain types in interpretations lead to anger, how anger leads to certain types of automatic behaviors, the consequences of those behaviors, and how those consequences often perpetuate the problem (and thus anger). The second goal is to have members develop a set of “criteria” for evaluating these consequences to determine whether a given expression of anger is “healthy.” The final goal of the first phase is to introduce several new behaviors that can “interrupt” the anger cycle, including a focus on oneself (to clarify one’s feelings and needs), cognitive restructuring skills, and effective communication skills. Step 1: Identifying Feelings & Interpretations The first step for initiating change in the treatment is to raise awareness about the nature of anger. This includes introducing the idea that interpretations generate emotion, and teaching members to identify the situations and interpretations that generate anger. It is emphasized that anger is adaptive as a “cue” that something is wrong and in energizing one for action. Members are instructed in self-focus in order to explore and clarify their feelings when angry (or in situations in which they should be angry). Step 2: Identifying Needs Underlying Anger The next step involves introducing the first three “boxes” of the Anger Cycle, and how they are related. Attention is turned to the concept that preceding one’s angry feelings and related interpretations are unmet needs. Group members are encouraged to explore the needs that may underlie recent anger episodes. This provides members the first point of intervention in the cycle: identifying one’s needs (and other feelings) enables one to get to the “heart” of the matter, and to approach communication in a more empathetic way. Members are then instructed in the common errors people make in interpreting situations and responsibility. Cognitive restructuring—the evaluation and revision of interpretation—is introduced and practiced. This provides members a second point of intervention in the anger cycle. TI 084 – Anger The Clearinghouse – www.utexas.edu/student/cmhc/clearinghouse 6 Step 3: Determining “Healthy” Expressions of Anger Having looked at the antecedents of anger, the next two “boxes” in the Anger Cycle is considered: behavior and consequences. The group, in exploring different ways of acting in response to their anger, are made aware of their choices and habitual ways of reacting. Focus then turns to examining the consequences different behaviors: 1) the response from others, 2) impact on others, 3) resulting feelings toward oneself, and 4) whether one’s needs have been achieved by the action. The group will use these consequences as the starting point for establishing evaluation criteria for determining whether a given action is a “healthy expression of anger.” Awareness of the complete anger cycle, particularly the consequences, provide members the logic and motivation for changing behavior. Communication skills are introduced, evaluated, and practiced. Phase II: Applying the Anger Cycle to Relationships The second phase of change takes new awareness of the anger cycle and skills for intervening at different points in the cycle, and applies these to relationship patterns. Members are introduced to the concept of “anger styles,” their origin, and how they are maintained in relationships. New behaviors aimed at changing anger patterns in relationships are introduced. Step 4: Identifying Anger Patterns in Relationships and their Origin Members learn that their behavioral response to anger is often a habitual way of coping with conflict and unmet needs. One’s anger “style” generally develops through family interactions and is maintained in adulthood. Members are encouraged to explore the origins of their style in expressing anger, and to recognize that unmet needs in childhood can often exert a powerful response to similar situations in adulthood. The anger cycle is used to determine whether current needs are being met, interpretations are correct, and whether the consequences suggest the behavior is “healthy.” Step 5: Developing Alternatives to Over-expressing and Under-expressing Anger Two fundamental anger “styles,” the “over-expresser” and the “under-expresser,” are introduced to explore in greater detail how anger patterns function in relationships. TI 084 – Anger The Clearinghouse – www.utexas.edu/student/cmhc/clearinghouse 7

Description:
11. Group Session Overview Session 3: Identifying Needs and Misinterpretations Underlying Anger ______ 17 Appendix A: Pre-Group Interview Questions
See more

The list of books you might like

Most books are stored in the elastic cloud where traffic is expensive. For this reason, we have a limit on daily download.