Counseling Today, Cover Stories

Disarming anger

By Bethany Bray September 23, 2022

Anger is personified in the animated Disney-Pixar film Inside Out as a stocky, red-faced character who is prone to mistrust and often takes things personally. He is easily upset and when he perceives a situation as unfair, he begins to yell and emit flames from the top of his head like a blowtorch.

Although the 2015 film was made with a younger audience in mind, many adults can easily relate to this character. The “flames” that erupt when Anger escalates may be figurative rather than literal, but it can feel just as real as depicted on screen.

Anger is one of a multitude of emotions that is a normal part of the human experience. Clients, however, sometimes avoid talking about their anger in counseling because it can be uncomfortable and hide emotions that may feel more vulnerable for them to reveal, says Kelly Smith, a licensed professional counselor (LPC) who has extensive experience working in the field of domestic violence, including helping perpetrators with anger issues. 

Counselors can play a key role in removing the barriers and stigma that keep clients from addressing their anger, Smith stresses. This includes making it clear that anger is a normal occurrence and something to address when dysregulated. If a counselor is qualified and open to helping clients who feel angry all the time, they should emphasize that on their professional website and bio information, she adds.

“People can struggle with feeling out of control. And sometimes that is expressed as anger,” says Smith, an assistant professor in the Department of Counseling at Springfield College in Massachusetts. “It’s important to normalize that this is something to get help for.”

Interrelated emotions

Anger can be such a complicated emotion that clients struggle to describe it or identify its nuances and connections. An essential first step toward helping clients understand their anger is guiding them to explore the full range of what they’re feeling, says Smith, a member of the American Counseling Association.

Several of the counselors interviewed for this article say they use an emotions wheel to guide clients toward understanding their anger more fully, including emotions that are interrelated. Smith says she uses it in every session as a discussion starter.

In addition to shame and embarrassment, anger can be connected to feeling threatened, overwhelmed, vulnerable, resentful, overlooked or unrecognized and a range of other experiences that clients may struggle to express or connect the dots, says Reginald W. Holt, an LPC in Connecticut and Missouri and a licensed clinical professional counselor (LCPC) in Illinois. 

Holt created and led an eight-week mindfulness-based relapse mitigation program that focused on emotion regulation, including anger management, with clients at an outpatient addictions treatment facility. Holt, along with Mark Pope, published the findings from this program in a 2022 article in the Journal of Human Services.

Holt says he noticed a common pattern of emotions among the program participants, all of whom were men on probation and parole. Many of the men would become angry — at their situation, at others or at the universe — when they experienced triggers, lapses or cravings for substances, he recalls. These feelings would often be intensified if the client was feeling unsupported because their family or loved ones had established firm boundaries or ostracized the client, which often happens within support networks when addiction and related behaviors cause problems, notes Holt, an ACA member.

When clients had relapses, their anger was often accompanied by feelings of remorse, powerlessness, frustration, defeat or fear that the rest of their life would be an unsuccessful, frustrating struggle to gain control over substance use, says Holt, a master addiction counselor, advanced alcohol and drug counselor and internationally certified advanced addiction counselor. This pattern would reoccur time after time until clients learned to recognize these interrelated concerns and respond, rather than react, to feelings of anger.

“Anger is the surface level, but if you dig down below that, it’s usually a sense of not having control and below that, a sense of fear,” he says. “It boils down, in some respect, to feeling overwhelmed, feeling helpless [and] feeling like it’s all too much.”

Exploring the origins

When a client appears to be struggling with anger, Smith recommends counselors conduct a thorough assessment for mental health issues that sometimes go hand in hand with anger such as substance use, domestic violence or abuse, posttraumatic stress disorder, borderline personality disorder, depression as well as medical issues such as brain injury or chronic pain. Clients who present with anger may need counseling work to address these other related issues first, either within the counseling sessions or in additional work with a specialist or in a group setting, she notes.

Anger can also be a “learned behavior,” says Toni Moran, an LPC and co-owner of a consulting and counseling practice in Denver. This was the case for Moran, who grew up in a household where there was a lot of yelling — and never an apology or repair. As an adult, it has taken a conscious effort to unlearn these patterns she saw as a child, she says.

Clients who, at an early age, witnessed caretakers, adults or even siblings default to anger and lose control of their emotions learn that it’s a way to connect, communicate, be heard and get one’s needs met. “It takes a lot of self-awareness and insight to say, ‘I probably could have handled that in a better way,’” Moran says, “And a lot of the people who are coming to me with anger problems weren’t modeled that in childhood.”

Moran and the other counselors interviewed for this article agree that delving into a client’s childhood and historical narrative can be a key way — for both client and counselor — to understand the context for their angry feelings and behavior.

However, Moran stresses that practitioners should use their “counselor intuition” to gauge how soon a client might be ready to talk about their childhood and the origins of their anger. Building rapport and trust with clients who struggle with anger should take priority, she says.

Alice Edwards, an LPC who specializes in helping clients with anger at her Houston private practice, agrees that questions about a client’s childhood can help shed light on the roots of their anger, as well as make it clear to the client that long-held patterns of anger and/or aggression will continue to plague them until they are processed.

Edwards begins these discussions by asking a client to remember the first time they experienced the type of anger that they struggle with now as an adult. She prompts them to recall how old they were, what was going on in their life at the time, how they felt and if the situation was ever resolved.

The counselor’s role, she says, is to guide the client with gentle questioning that can help uncover connections between past situations and patterns that occur in their adult life.

This was the case for a male client of Edwards’ who was struggling with problematic, angry feelings toward his work supervisor. Conversations about the client’s upbringing revealed that his father, who was in the military, had been absent a lot during his childhood because of work travel. And whenever the father returned home, he was extremely strict and often angry with the client. Exploring this history in counseling helped the client draw connections between his anger at his father and his anger at his boss and helped him move toward healing, Edwards recalls.

Diffusing anger

Humans express and present anger in different ways, which means each client will have unique needs and they may need to work on a variety of issues in tandem with their anger in counseling. These issues can include processing trauma, improving self-compassion, learning communication skills or conflict management, and working on better expressing their needs. And for some clients, it may be all of the above.

The counselors interviewed for this article, however, agree that clients won’t be able to delve into a treatment plan until they learn coping mechanisms to diffuse their anger in real time. They shared the following techniques to help clients learn to calm themselves, reflect and find ways to reroute their emotions to keep anger from escalating into problematic and negative patterns and behavior.

Breathing and mindfulness. Breathing techniques can serve as a useful and easily accessible way for clients to pause whenever they feel themselves becoming angry. Breathwork was the first layer of the mindfulness method that Holt used with clients in the relapse prevention program. Focusing on breathing often calmed the participants to the point where they could be mindful of their other physical sensations, range of emotions and five senses, which further helped them to slow down. The clarity of mind clients gained through this progressive mindfulness technique allowed them to reflect on the “rational and reasonable choices” they could make to replace anger as a response mechanism, notes Holt, an associate professor in the Department of Counselor Education and Family Therapy at Central Connecticut State University.

Breathing techniques work well as a primary and go-to tool for clients because they can bring the person out of fight-or-flight mode and reactivate their logical, problem-solving ability, Holt explains.

He encourages clients — and students, when teaching mindfulness as a counselor educator — to practice and hone these skills during mundane, everyday activities such as brushing their teeth, washing the dishes or taking a shower. Individuals can learn to focus on the temperature of the water or the taste of the toothpaste instead of letting their mind wander, he explains. And when it inevitably does, they can learn to gently lead themselves back to a mindful focus without self-judgment.

He challenges clients (or students) to gradually increase the amount of time they practice mindfulness, and then they discuss what did and didn’t work and what they learned when they debrief with him in session (or class). 

Safety planning. Creating a safety plan is a common and important practice in domestic violence work, but it can also be helpful for clients who struggle with anger, Smith says. The key is to create safety plans with clients before they need them and to have the client come up with the content. 

Clients can often identify how, where and why their angry behavior usually occurs, Smith notes, which makes them the best experts on ways that behavior can be diffused or curtailed. So the safety plan won’t have the desired effect unless the client, not the counselor, identifies the steps in their plan, she stresses.

For example, a client who has a history of physical expressions of anger might suggest removing the doors from the kitchen cabinets so they cannot be slammed or replacing metal or wooden drink coasters in their living room with cardboard ones so they cannot be thrown as easily, Smith says.

A client can also create a plan to use when they’re with a person or in a situation that usually makes them angry. Perhaps they come up with a signal to let a trusted friend or partner know when they’re starting to feel angry and need to take a break, she says. Then the client could go outside and take a quick walk or use other coping mechanisms to calm themselves.

Safety planning in this way ensures that clients have healthier alternatives at the ready to express themselves or release their anger, Smith adds.

Journaling. Journaling can serve as an outlet to document the strong feelings that clients who struggle with anger sometimes have trouble tolerating or understanding. Moran asks each of her clients to find or purchase a notebook for journaling as they begin counseling work together. Clients can often benefit from documenting their thoughts and tracking their progress in a journal, she says, but it can be a particularly helpful medium for clients who are working on anger issues. Moran sometimes suggests these clients turn to their journal after an angry incident to record the feelings and sensations they experienced and, in turn, reflect on what they learned.

Prompting clients to keep track of the events and interactions that happened before an angry episode, Edwards adds, can help them connect the dots between triggers and patterns that influence and lie underneath their anger.

Writing assignments, however, may not be a good fit for all clients. Edwards says that she sometimes encourages clients to record themselves (using audio or video) on their cellphones, which they can replay later.

Releasing through movement. Anger is an active emotion, so it helps to move one’s body to release it, Moran says. She sometimes teaches clients who struggle with anger a technique she calls “shaking leaf,” where they stand and shake their body to release tension, anger, frustration and related feelings. She says she often stands up and does this with clients to encourage them and illustrate the technique in session. Any movement that feels therapeutic to a client can be helpful in this way, she notes. Moran also finds that tapping and bilateral stimulation techniques can be useful for clients to process anger in the moment. 

Movement in the form of exercise played a key part in helping a client who once sought counseling from Moran after being written up twice at work for angry behavior, including throwing a chair. He had chronic stress that was unaddressed, and it escalated to a boiling point when co-workers were not completing tasks in a certain way, she recalls. He also felt intense shame about his behavior after the fact.

In counseling, Moran and the client found that a three-pronged combination of coping mechanisms —  physical exercise (walking his dog and riding his Peloton bike), journaling, and breathing and mindfulness techniques — provided the outlets he needed to release, process and reflect on the anger he was feeling. The client found it particularly helpful to do breathwork and body scanning in his car when he arrived at work each morning and at the end of his day before driving home, she says.

Moran counseled the client for two years and he was never written up by his employer again. By the end of their sessions together, he continued to journal regularly to process his feelings and thoughts, but the client no longer found work to be a source of frustration, she says.

Interjecting humor. Alison Huang, an LCPC with a private practice in Silver Spring, Maryland, often counsels clients who struggle with anger. When a situation seems unfair, clients who are prone to anger often take it personally, Huang says, so she sometimes takes a creative, humorous approach to help clients who react in this way to reframe the situation.

Huang often suggests that clients picture people who have made them angry as a minion, the yellow creatures who first appeared in the 2010 film Despicable Me. Loyal and loving, the minion’s childlike behavior and attempts to help often result in unintended mayhem.

Picturing the person who cuts you off in traffic, a difficult co-worker or your irritating neighbor as a minion makes it hard to get angry at them because they didn’t mean it and they don’t know any better, Huang explains.

She sometimes plays video clips of the minions for clients in counseling sessions as they talk through scenarios that made them angry. She asks clients: How would you feel and react if you were a bystander in this scene with the minions? How is it different than your reactions in real life?

Introducing the minions as a coping mechanism often makes clients laugh and instantly diffuses their anger, she says.

“Humor and reframing are a good combination for [addressing] anger. Having some laughs shifts their energy suddenly, softens their demeanor and increases their capacity for empathy for others and themselves,” Huang continues. “It’s very easy for those who struggle with anger to take things personally. [In counseling, try and] find ways for them to detach and keep from taking it personally — get out of that loop and find new thought patterns.”

Befriending anger

Anger is often viewed with negative connotations (both by clients and within society), but counselors can guide individuals to see that it is only negative when it’s dysregulated and results in unhealthy behaviors and patterns. When used in a productive way, anger can inform us, alert us and protect us — it can actually be a good thing, Moran says.

In fact, her goal, she says, is not to help clients get rid of anger — which is a normal human emotion and will always be present — but to help them learn to process it in a more constructive way.

Depending on a client’s needs and situation, Huang uses a combination of methods, including relational therapy, mindfulness, and acceptance and commitment therapy, to help individuals process anger and the deeper issues that sometimes underlie it, such as fear of abandonment.

According to Holt, the crux of helping clients overcome dysregulated anger is helping them learn to see it as an emotion to explore and learn from, rather than something to suppress or be overcome by. He aims to help clients rewrite their “automatic pilot” use of anger as a go-to response.

Offering the client psychoeducation on the nervous system and how anger can be connected to humans’ fight-or-flight response is an important first step in this process, Holt says, as well as teaching mindfulness techniques, such as body scanning, to help clients become attuned to how anger feels in their body and the physical cues that indicate it’s beginning to escalate, such as a clenched jaw or upset stomach.

“It can be an empowering experience [for the client] to acknowledge that ‘I felt angry and I sat with it, investigated it and realized that it didn’t have to overtake me,’” Holt notes. 

Drawing from psychologist Tara Brach’s RAIN method, Holt used mindfulness to teach the participants in the relapse prevention program to explore and learn from their anger. Brach’s acronym can be a helpful way to introduce clients to the idea of pausing to consider why they’re becoming angry and finding other ways to channel that energy, Holt notes. RAIN prompts users to:

Recognize what is happening

Allow and acknowledge that the experience is happening

Investigate it with curiosity

Nurture with self-compassion

Holt says the clarity that comes with this measured, calm response also helps clients to learn to take in the full context of an anger-provoking situation and assess whether it is a source of true harm or simply perceived harm.

It can be a hard thing to learn for those who have used anger to express themselves or react to uncomfortable feelings for a long time, Holt admits, and it will need to be repeated and practiced. It also requires them to be able to identify the full range of emotions that they’re feeling and deploy self-compassion.

This focus on exploring anger creates “an opportunity to slow down; become more intimate and familiar with your emotions as they rise, crest and fall; and be able to tolerate the discomfort of that in the moment,” Holt continues. And it introduces skills for “checking where the anger is residing in your body and befriending it, rather than being afraid of it and avoiding the impulse to discharge it immediately because it’s uncomfortable.”

Moran takes a similar approach with clients by using techniques to help them detach and separate themselves from their anger. For example, she says counselors can encourage clients to view situations that provoke anger with curiosity. It can be helpful for clients to consider why their anger is showing up now, she adds, and think through the events that led to these feelings by asking what activities they were doing, who they talked to and what happened earlier.

Slowing down to consider the potential reasons for and the context of their anger in this way can also help them identify needs that aren’t being met, and in turn, prompt them to communicate their needs instead of responding in anger, Moran says.

She also teaches clients who struggle with anger to rephrase their “I” statements. Instead of thinking or saying, “I am angry,” they can learn to describe it with language such as “I feel anger” or “Anger is showing up right now.”

It can be helpful to teach clients to view anger as a person who is coming to visit, Moran notes. “Have the client address it, [saying] ‘I see you and I feel you. What are you trying to tell me?’ It’s often trying to warn us that something’s not right. And when we ignore [its message], it gets to a boiling point.”

Anger’s aftermath

A final — and important — step for clients to overcome problematic anger is learning the skills to acknowledge when they have responded in anger or hurt others and apologize, when appropriate, Moran says.

She uses the repair techniques outlined in the Gottman method of couples therapy with clients — both individuals and couples — who struggle with anger. Depending on a client’s needs and situation, a person can work on repair individually by writing in a journal or recording their thoughts or collaboratively by speaking with others who were affected by their angry behavior.

Repair is helpful because it prompts the client to acknowledge what happened as well as its context, Moran says. “They can come back to the person or people who were involved and say, ‘I was feeling angry and this is why, and it wasn’t OK for me to do or say XYZ,’” she explains.

For clients, the process of making amends by verbalizing or writing how they felt and behaved during an angry episode can also help strengthen their skills of distancing themselves from their anger, separating facts from feelings and communicating their needs, Moran adds.

“When I see shame [in clients who struggle with anger], it’s often because their angry behavior resulted in hurting someone else or made them look bad,” she says. “I try and help clients separate themselves so they don’t see themselves as the emotion.”

Benjavisa Ruangvaree Art/Shutterstock.com

 

Clients who don’t see anger as a problem

Practitioners may encounter clients who describe angry feelings and behaviors in counseling sessions but don’t see them as inappropriate or problematic.

In some cases, anger has become such a go-to or automatic response for a client and a way to get their needs met that they don’t even recognize it as anger, says Kelly Smith, a licensed professional counselor (LPC). It can also be a learned and internalized behavior, especially when a person has not had examples in their life of people who deal with anger in a healthy way.

Smith, who has extensive experience working in the field of domestic violence, says this is not uncommon among clients who are perpetrators of abuse. She once worked with a perpetrator of domestic violence who mentioned in session that every time they were upset with their partner, they went into the kitchen and tightened all the lids on the jars so their partner would have trouble opening them.

This client described this behavior as playing “a joke” on their partner, recalls Smith, an assistant professor in the Department of Counseling at Springfield College in Massachusetts. They didn’t see it as an act of aggression or anger; they thought it was funny. 

“When working with perpetrators, they might not see themselves as angry, but it’s a part of their situation,” Smith explains. “They often minimize [anger], deny it or justify it to make it something other than what it is. They might say ‘I only did X …’ to make [behaviors associated with anger] sound smaller than what it was or deny that it was aggression or abuse in the first place.”

For example, one of Smith’s clients shared that in an attempt to leave an argument with their partner, they simply “picked their partner up to move them out of the way.” But the police report shared another perspective: This act of “moving” their partner resulted in a broken door. 

It may go without saying that clients who struggle with anger can benefit from learning coping skills to be able to calm themselves and respond in a less aggressive way. But, as Smith notes, individuals who minimize or ignore their anger may not be ready to learn these skills — let alone address the heavy issues that can dovetail with anger, such as substance use or trauma.

She recommends counselors find and focus on motivation to connect and prompt growth with these clients. For clients who minimize anger, this often takes the form of finding a reason to change besides wanting to avoid getting in trouble for their angry behavior (e.g., wanting to change because they love their spouse), Smith says. And, most importantly, these reasons for motivation to change must be concepts (or people) that the client, not the counselor, identifies, she emphasizes.

Clients may need to revisit these conversations and remind themselves of their motivation throughout counseling work for anger or aggression. Smith suggests that counselors prompt the client to talk about where they want to see themselves in 10 years: How will they behave? What will be different in their life? How will they handle things that have made them angry in the past? Then, have the client identify things they need to do one week, one month and one year from now to reach that 10-year goal, Smith says.

 

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Bethany Bray is a senior writer and social media coordinator for Counseling Today. Contact her at bbray@counseling.org.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

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