Assessing and Treating Problem Anger

This article explores what anger is and explores some of the common treatment approaches for anger management issues.

Overview of anger management

Anger management refers to the process of learning to recognise and control feelings of anger, and to respond to situations in a healthy and appropriate manner. This process involves a variety of techniques, ranging from cognitive and behavioural approaches to relaxation and stress reduction techniques (related reading: Busting 10 Common Myths About Anger).

For mental health clinicians, a comprehensive understanding of anger management is crucial in helping clients identify and address the underlying causes of their anger, as well as in providing effective treatments for managing their anger.

One important aspect of anger management is the identification of triggers or situations that cause feelings of anger to arise (for more on the neuroscience of anger, read this article). This can involve exploring past experiences or events that may have contributed to the development of anger problems, as well as examining current stressors or relationship issues that may be fuelling anger.

Another important aspect of anger management is the development of coping skills and healthy responses to anger-provoking situations. This may include learning to identify and challenge irrational thoughts or beliefs that contribute to feelings of anger, as well as practicing stress reduction techniques such as deep breathing or progressive muscle relaxation.

In addition, anger management may involve addressing any co-occurring mental health conditions, such as depression or anxiety, that may be contributing to feelings of anger. This may incorporate the use of psychotherapy, medication, or a combination of both.

It is also important for mental health clinicians to work with clients to develop healthy communication and problem-solving skills, as these can be effective in reducing conflict and improving relationships. This may include teaching clients how to assert themselves in a respectful manner, or how to engage in active listening and compromise in disagreements. For tips on how to de-escalate client anger during therapy sessions, read this article.

Anger management is a complex and multifaceted process that requires an holistic and individualised approach. Mental health clinicians play a crucial role in helping clients identify and address the underlying causes of their anger, as well as in providing effective treatments for managing their anger.

What is anger?

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition Text Revision (DSM-5-TR – read more about the updates here), published by the American Psychiatric Association, does not include a specific diagnosis for anger.

However, it does include descriptions of various mental health disorders that may involve symptoms of anger or aggressive behaviour, such as Intermittent Explosive Disorder (IED), Conduct Disorder (CD), and Oppositional Defiant Disorder (ODD).

Intermittent Explosive Disorder is characterised by repeated, impulsive outbursts of aggressive behaviour or verbal anger that are out of proportion to the situation. These outbursts may cause physical harm to others or result in damage to property.

Conduct Disorder is a childhood-onset disorder characterised by persistent patterns of aggressive, destructive, and deceitful behaviour that violate the rights of others or societal norms.

Oppositional Defiant Disorder is a childhood-onset disorder characterised by a pattern of defiant, disobedient, and hostile behaviour toward authority figures.

Note that while these disorders may involve symptoms of anger or aggression, they may have different causes and require different treatments. As such, the definition of anger as it is commonly used in clinical practice often goes beyond the narrow definitions provided by the DSM-5-TR.

What are the symptoms of anger?

Anger is a normal and natural emotion, but when it becomes intense, frequent, and uncontrolled, it can be a problem. The following are common symptoms of anger:

• Physical symptoms: These can include increased heart rate, muscle tension, headaches, and a feeling of tightness in the chest.
• Verbal expressions: Outbursts of yelling or shouting, name-calling, or making threats are common expressions of anger.
• Aggressive behaviour: Physical expressions of anger can include hitting, throwing objects, or engaging in destructive behaviour.
• Irritability: Persistent feelings of frustration, annoyance, or being easily annoyed.
• Difficulty controlling emotions: Feeling like one’s anger is out of control and unable to be managed.
• Negative thoughts and beliefs: Thoughts such as I’m always being treated unfairly or people are always doing things to annoy me can contribute to feelings of anger.
• Avoidance behaviours: Attempting to avoid situations or people that trigger feelings of anger.

Anger is a normal human emotion and occasional experiences of it are not necessarily a problem. However, when anger is intense, frequent, and interferes with daily functioning, it may indicate an underlying problem with anger management that requires treatment.

How to diagnose when anger management help is needed

Anger management issues are typically diagnosed by a mental health professional, such as a psychologist, psychiatrist, or licensed clinical social worker. The process usually involves a comprehensive evaluation, which can include:

• Clinical interview: The mental health professional will ask the individual questions about their symptoms, experiences, and behaviours related to anger.
• Psychological assessment: The professional may use standardised questionnaires, self-report measures, or behavioural observations to assess the frequency, intensity, and triggers of the person’s angry outbursts.
• Medical evaluation: To rule out any underlying medical conditions that could be contributing to the anger, the mental health professional may refer the individual for a physical examination or medical tests.
• Mental health history: The mental health professional may ask the client about their past experiences, including childhood experiences, family history, and any previous mental health diagnoses.

Based on the results of these evaluations, the mental health professional can determine whether the person has anger management issues and develop a diagnosis and treatment plan. In some cases, additional assessments, such as neuropsychological testing, may be necessary to fully understand the causes of the anger and determine the best course of treatment.

Common treatment approaches for anger management issues

There are several effective treatment options to help clients manage their anger, including:

• Cognitive-behavioural therapy (CBT): CBT is a type of therapy that focuses on helping individuals recognise and change negative thought patterns and behaviours. In the context of anger management, CBT can help individuals identify the triggers of their anger, learn to regulate their emotions, and develop more constructive coping strategies.
• Mindfulness-based approaches: Mindfulness-based approaches, such as mindfulness meditation, can help individuals manage their emotions by increasing their awareness of the present moment and reducing stress and anxiety.
• Relaxation techniques: Relaxation techniques, such as deep breathing, progressive muscle relaxation, and visualisation, can help individuals reduce physical and emotional tension and calm down when they feel angry.
• Medication: In some cases, medication, such as antidepressants or beta-blockers, may be prescribed to help manage anger. However, medication should only be used as part of a comprehensive treatment plan and under the supervision of a mental health professional.
• Group therapy: Group therapy can provide a supportive and educational environment for individuals to learn about anger management and practice coping strategies with others who are experiencing similar challenges.
• Lifestyle changes: Making changes to lifestyle, such as improving sleep and nutrition, engaging in physical activity, and reducing substance use, can help reduce stress and improve overall wellbeing, which can in turn reduce anger.

The type of treatment that is best for the client will depend on the specific symptoms and circumstances. A mental health professional can help the person determine the best course of treatment for their anger management issues.

Key takeaways

• Anger management refers to the process of learning to recognise and control feelings of anger, and to respond to situations in a healthy and appropriate manner.
• Identifying triggers and developing coping skills are important aspects of managing anger.
• Mental health clinicians play a crucial role in helping clients identify and address the underlying causes of their anger, as well as in providing effective treatments.
• Common treatment approaches for anger management issues include cognitive-behavioural therapy, mindfulness-based approaches, relaxation techniques, medication, group therapy, and lifestyle changes.
• The type of treatment that is best for the client will depend on the specific symptoms and circumstances, and a mental health professional can help the person determine the best course of treatment for their anger management issues.