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Wednesday, July 11, 2012

Anger Management

When Men Blow Their Tops
Step by Step, angry people learn how to control themselves
By Amy Fries
The Journal Newspapers


The room fills with participants of assorted color persuasions and ages. What they share in common, though, is that they're all men and each of them has uncontrollable anger. Whether it is road rage, spouse and child abuse or a chilly marriage, grouchy work environments and violent crimes have roots in unregulated anger. Unchecked anger also plays a role in heart disease, high blood pressure and depression. For these men, anger has played out in an event that landed then in a court-appointed rap session. To help people control their emotions, health professionals offer up these sessions where advice and self-revelations focus on how rage manifests itself and how people can put a lid on it. "All problem anger is caused by a temporary state of self-diminishment," says Maryland anger therapist Steven Stosny, Ph.D. "When people feel put down, anger numbs that pain and gives them a temporary sense of power."
While some anger management courses are open to both men and women, others are not. Often, it is a requirement made by a judge who mandates participation as part of a plea agree-ment, particularly in cases of assault or aggressive driving.
Feeling a threat to the self triggers the fight or flight response by releasing powerful chemicals to every muscle and organ in the body, says Stosny, whose methods of controlling anger have been implemented in community services programs in several counties in the region. "The problem is, fight or flight response was never meant to be used with families or in any type of negotiation, except with saber-tooth tigers," He says. As a result, anger is a crucial emotion to pay attention to, Stosny says. "It's a necessary condition for most crime."
According to Rita Smith, spokeswoman for the National Coalition Against Domestic Vio-lence, "Ninety-two to 95 percent of all domestic violence cases involve men battering women." Males also comprise the majority of aggressive drivers. A 1997 AAA Foundation for Traffic Safety study reported that 12,828 people were injured or killed as a result of aggressive driving between 1990 and 1996. While the study revealed there was no profile of an aggressive driver, "most are relatively young, poorly educated males with criminal records, histories of violence and drug or alcohol problems, and many have recently suffered an emotional or professional setback." Virginia's Fairfax County and Maryland's Prince George's County employ Stosny's anger management techniques as part of their community service programs. There are an estimated 260 men each year participating in the Fairfax program, 70 percent of whom are court-referrals, says Karen Koerselman, coordinator of A Men's Program, a counseling program operated by Northwest Mental Health Center, which is part of the Fairfax/Falls Church Community Services Board. According to Koerselman, Stosny's track record "an 87 percent success rate" was the reason that the program was used by the local groups.
Stosny's five-step technique, known as HEALS, is taught in four to 12 weeks for violent clients and in two to three sessions for nonviolent self-referrals. Essentially, the method teaches the client to develop a different response to situations that provoke their hostility. In the first step, the client must work up a low-grade state of anger arousal. When the client identifies the physical manifestations, like clenched teeth, a knot in the stomach or tight shoulders, he must identify the underlying hurt. Often, it's feelings of rejection and powerlessness, Stosny says. Then the client must express compassion for himself first and then for others. This process allows an individual to communicate and problem solve more effectively, Stosny says. The client repeats this a dozen times a day for four to 12 weeks. By then, Stosny says, the appropriate response is automatic.
"Anger works as a form of self-empowerment when someone feels diminished, so we have to teach them pro-social forms of empowerment." Stosny says.
Anger is not gender-specific, Stosny says. Men and women get angry for the same reasons and one gender doesn't experience anger more often than the other. The difference is in the way men and women are socialized to understand anger and respond to it. Men get physically aggres-sive or shut down emotionally, and women reach out or cry. "We do two separate numbers on the genders in our culture." Stosny says. "Men are not allowed to feel or express any emotion except for anger and women are supposed to feel and express all emo-tions but anger." Men are also more action-oriented when angry, Stosny says, which are caused by physiology. "Men go into a fight or flight at a much lower threshold and stay in it much longer." That's why Stosny says he trains men to unload the dishwasher or wash dishes when they're angry.
He says another difference between the sexes when it comes to anger is that women tend to cry when they're angry and men don't. Crying puts people in touch with their sadness, and men aren't allowed to feel such vulnerable emotions. "Men use anger to numb hurt, so it's an either or situation for them. If they cry, they won't be angry," he says. A low-grade anger arousal may help people do a job they don't want to do or help them concentrate on something that doesn't interest them. Stosny, for example says he works up a low-grade anger to do his taxes.
Though anger is a good motivator, it's a terrible regulator, he says. "Performance compe-tence goes way down when angry. Whatever you can do angry, you can do better not angry."
The best way to define problem anger, says Stosny, is that it makes you do something that's not in your best interest or keeps you from doing something that is. "That can be subtle, like putting a chilly wall between you and someone you love. It's not going to get you into immediate trouble, but eventually it can ruin your life."
While many people think of problem anger in terms of the dramatic - the disgruntled employee who shoots up the office, the man who drives his car into a video store because he was charged a late fee - most problem angers are more subtle. "I've had over 1,200 court-ordered clients, and less than a dozen were rage problems," Stosny says. When he does see clients who have "snapped," he investigates physiological conditions, like a brain tumor or schizophrenia, that may trigger an episode. But mainly he believes that people who act out a rage have intense resentment that builds up until they explode out of proportion to an affront. "When the self is at stake, it becomes life or death even though it's trivial," he says. Anger is catching, says Stosny. "It's the most contagious of emotions. If you're around an irritable person, you're going to get irritable," he says.
Some shy people use anger to help them get through uncertain situations, says Stosny. When these people go to a party, for instance, they'll get hypercritical. "They start to find something wrong with the music, the hostess' dress, the punch." That type of hypercriticism is low-grade anger arousal, Stosny says. "The problem with low-grade anger is it doesn't have the same built-in resolution that rage has. People can only rage for a few minutes, before exhaustion kicks in; low-grade arousal can go on for years." According to Stony, there are about 27 different forms of anger. Most of them are mild, such as feeling impatient, irritable or grouchy.
Resentment is the most common form but the most common stimulant for anger is a loud unexpected noise, like a lawn mower outside. "Most of the time that anger will go away in a second, but if you're a blamer, you say, those thoughtless inconsiderate people, they don't care about me."
Anger is also a response to physical pain. That's because anger releases epinephrine which numbs pain and gives a rush of energy. "That's how athletes play with broken bones and why wounded animals are so ferocious."
Bitterness is another form of anger used as a numbing agent for grief or sadness. "Everyone has someone in their family with attachment loss that they regulate with anger," Stosny says. "It could have happened 20 or 30 years ago. Every time they think of grandma, they'll think, Sally got her doily and I should have gotten that." The problem with that technique, he adds, is that, "anger works like ice on a wound, it numbs the pain but retards healing."
Some people have an opposite physiological response to anger. They actually calm down. They make up about 15 percent of the population and are known as vagal-reactors, Stosny says. "The vagus nerve puts the brakes on the respiratory system. Without it, we'd all die of a heart attack by the time we're 12." For most people, anger or other intense emotional experiences, such as the heat of competition, accelerate the heart and flood the body with adrenaline, making it harder to stay calm and think clearly. "Michael Jordan is probably the most famous vagal-reactor," Stosny says. "His heart rate declines during the game. It gives him enormous stamina. Instead of getting exhausted, he gets better." If you're a vagal-reactor and an athlete that can "be pretty wonderful," Stosny says. "But if you're a vagal reactor and a criminal, you're extremely dangerous." Criminals who are vagal reactors tend to have anti-social personalities, Stosny says. "They don't have the normal inhibition not to be violent or to stop violence once they hurt. They're entirely focused like cobras."

For information on anger management seminars, Steven Stosny, at (301) 921-2010; A Mens Program, Fairfax County, (703) 968-4000; Prince George's County Social Services, (301) 422-5000.

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