Empathic Anger Management Session1. Understanding the Difference between: Anger and Rage.

1. Empathic Anger Management Session1. Understanding the Difference between: Anger and Rage. Maureen Davies. RGN. MA. MSc. UKCP Reg. Psychotherapist. BACP Registered Senior Accredited Practitioner.

2. Why understand this topic. • Anger and rage are endemic in our society. • Anger and rage affects everyone in their personal and professional lives. • It impacts us at a profound personal level involving close and intimate relationships. • Even though anger and rage can have a negative and destructive impact on us they are both essential to provide energy for survival, change and self care.

3. Setting the Scene. Boiling Point Report 2008. • 12% of the population in England, Scotland and Wales said they had trouble controlling their own anger. • 24% said they worry about how angry they feel at times. • 24% said they had ended a relationship or friendship with someone because of how they behaved when they were angry. • 64% either strongly agreed that people in general are getting angrier. • Fewer than 1 in 7 who had trouble with their anger had sought any help to address their problem. • 58% did not know how to seek help. (Conducted by MHF. On 1974 adults.)

4. Extent of ‘Problem Anger; in the UK • 50% reacted to computer problems by screaming at, hitting and screaming at or abusing colleagues. (Sunday Times Survey) • 45% of staff regularly loose their temper at work. • Almost 900 pupils a day are suspended in the UK for abuse and assault. 166,900 in 2010 (D of E 2010) • 3000 arson attacks on schools (mainly in Scotland and London. (Guardian. May 22. 2009) • Workers were subject to 310,000 assaults and 367,000 threats in 2009 / 2010 in the workplace. (British Crime Survey 09. 2010) • 64% of those domestically abused were female and 36% male and 20% of the men had suffered for over a year. • Britain is the top road rage country in Europe and the second in the world with South Africa, first.

5. Overview of UK Anger Management • GP’s have very few options for anger management referrals. • Increasingly, health authorities are not making provision for patients with anger issues. • Where services are available they are ad hoc and vary across regions. • Many schemes are run by statutory, voluntary and private agencies. • Where help is available, often have to wait six months for help. • Anger ‘Problem’ does not constitute a way in to psychological services even though it is present in many mental health problems.

6. Anger Appears the Poor Relationship in Mental Health Issues • Problems relating to anger and rage are both endemic in our society and despite serious concerns with it being markedly connected to mental health problems it is not really addressed in mental health settings • Anger management difficulties do not constitute a discrete mental health diagnosis in the DSM V but its presence or absence is a symptom of many of the mental health problems / disorders. • Yet, commissioning authorities and other institutions ignore anger as an issue in a way they would not ignore anxiety or depression

7. Anger& Rage and Mental Health Most mental health problems have a component of anger and rage. • Shame.. anger and rage are major components of shame. • Depression.. Ruminating and anger • Bi-Polar Disorder.. anger and rage • Anxiety.. Pre-occupation with ruminating negatively and anger. • Self Harm.. External and internal anger and rage • Eating Disorders.. External and internal anger and rage • Personality disorders (core injuries resulting in anger and rage are a common source and presence in those with personality disorders.)

8. Therapeutically • Empathic anger management is a different way to understand and work with anger and rage issues. • It offers a deeper more positive analysis of anger and rage and their therapeutic potential. • It acknowledges the human capacity for organismic self regulation for life and for processing life experiences. • It also emphasises the importance of positive anger and adult ‘rage’ in responding to social injustice.

9. What is Anger? • Hall defines anger as a ‘pure and natural emotion’. • It offers a vital piece of intelligence about the immediate environment. • It provides the energy and motivation for the sacred task of self care. • It operates as an emotional sensor in relationships making it possible for a person to navigate the delicate, tenuous, even treacherous at times, human and relational path between dependence and independence, self assertion and mutual respect.

10. The absence of anger • Is just as important to understand • It is more often experienced by women but increasingly seen in men. • The absence of anger means a person cannot and does not have the energy to stand up for themselves and they become vulnerable to oppression and exploitation in all relationships

11. Healthy and Positive Anger • Essential if individuation is to occur. • Important stage in the grief cycle. • Sets boundaries. • Signals an unmet need. • Provides reasonable force. • An antidote to depression. • Provides stamina and determination. • Provides energy for positive change. • Is the catalyst for being assertive, making new decisions and bringing about change.

12. Distorted Impact of Anger We don’t have to let anger control us, but it surely will if we prevent ourselves from feeling it. (Beattie: 1990) • Sulking Depression • Moaning to a third party Self harm • Saying yes when you mean no Apathy • Sarcasm Road Rage • Taking it out on others Verbal Abuse • Suicide

13. Rage Hall (2009) defines Rage as: Not being an emotion at all but a trauma related defence mechanism evoked when a person is overwhelmed by their experience and not able to integrate it. Samsel (2015) defines rage as: Not so much an emotion as it is an activation of the emergency defence system

14. Hot Rage Model • The lid flies off. • Shock Terror • Abandonment Jealousy • Anger Sadness • Humiliation Loss • Shame Hurt • Guilt Fear • Excitement

15. Rage • Is not just really intense anger • It is sudden • It is irretrievable • Loss of contact • Loss of Self • Loss of behavioural control • Rage may explain an action but never justifies them. • Rage hurts others

16. Cold Rage Model The lid stays firmly in place. Sadness Fear Anger Terror Jealousy Guilt Happiness Shame Joy Humiliation

17. Hall provides 4 reasons for this: • Rage is more severe than anger and it can be hot or cold. • It is a natural defence mechanism. • There is a universally agreed definition although it is a client’s inability to integrate these life experiences in the first place. • The most effective way of working with rage is to support the person to develop / and or recover the organismic ability to process life experiences and this is done by engaging in a compassionate and humane relationship where all feelings, sensations, thoughts and images are welcomed.

18. Comment This is a problem that affects all of us in our relationships, parenting styles, families, at home, at work, in our communities, churches. and cultures. We have a responsibility to understand our own anger process. For many that is so we can improve our mental health and relationships. In so doing we will learn how to utilise the energy of anger in a honourable, productive and assertive manner.