CBT and Anger Management, part 2

Anger and Acceptance and Commitment Therapy
Anger and Acceptance and Commitment Therapy

anger management and act

In the last post, we talked about how “standard”  CBT links angry outbursts and aggressive behavior with excessive expectations of others.  Angry people also become very tense physically.    CBT treatment helps clients to challenge their thinking patterns and learn skills that help them to relax, so that physical tension and angry thinking don’t interact and keep the anger going.

However,  learning these skills may not be enough for all clients.  If you grew up in a home that was abusive and inconsistent, or neglectful, or very deprived,  you learned that it’s unlikely that  your basic physical and emotional needs will be met.    Being vigilant about defending yourself  therefore makes sense.   This attitude can put jobs and relationships at risk if you misinterpret situations and think that other people are out to hurt you.  It’s difficult for you to challenge the type of angry thinking that’s based in childhood experience, but that thinking can cause major problems.

Acceptance and Commitment Therapy can help in this situation.  “Contextual” therapy for anger management introduces mindfulness to help clients “defuse” (get distance from) their thoughts, rather than struggling to change them.

Often, we think of “excessive” anger itself as the problem.  But in ACT, the client doesn’t have to “get rid of” anything. Anger is seen as a normal emotion.  We teach clients to recognize how they  became so angry, but then shift the focus to mindfulness, rather than dwelling  on the past.

Mindfulness helps you to notice your thoughts, and realize that they are not facts.

It’s not too hard to see that hostile, “cold” denial of anger/passive aggression is an attempt to avoid really feeling the anger.  But in ACT/contextual therapy,  not only hostility/coldness but also violence/verbal aggression are seen as attempts to escape the discomfort of “sitting with” feelings.

“Contextual”  treatment  also teaches the client to avoid rumination – going over and over hostile thoughts in the mind.    Rumination is just another escape attempt.  If you are brooding  about the “story” , you are in the past, or anticipating the future  – not here now.

I was once at a meeting with an expert in Mindfulness-Based CBT, who told us a story about a time when she was forced to be around a person with whom she was really angry. The way she got through it was by letting herself experience the anger without thinking about her “story”.  In the absence of the “story”, her anger was like a wave that was present and then passed.

What happens to people who can experience anger in this way?  They have more flexible thinking and behavior – no more “target” on the chest.

In ACT, we do teach people ways to soothe and calm themselves.  Everyone needs these sometimes.  But in general, people are taught to experience anger fully, even while moderating reactions to it. Avoidance should  be used rarely.

This week’s blog draws from the work of Frank Gardner and Zella Moore in “Contextual Anger Regulation Therapy”. (Routledge, 2013 – Kindle edition).

This ACT/contextual treatment model  does not apply to people with antisocial personality disorder, who use violence differently, in order to get something for themselves rather than to escape from feelings.