Understanding And Treating Anger In A Clinical Setting

Tomas, a 34 year of carpenter, went to see his girl friend of six months at the end of a hard day. Noticing a strange car in the driveway, he peered into her window with some curiosity. He saw her having sexual relations with another man. Enraged, Tomas went home and returned with his shotgun. He killed them both and wound up in the penitentiary. Anger and aggression are often seen as a justified reaction to an unwanted event and, sometimes, it turns deadly. Although what Tomas saw was shocking to him, the outcome of his behavior took away his freedom for life.

Most clinical events do not reach the level shown by Tomas. Practitioners have typically not been specifically trained to deal with anger disordered patients. That lack of training stands in stark contrast to the daily experiences of clinicians who deal with angry patients on an almost daily basis.

Anger is defined as a negative, internally felt, psychobiological state. Thus, anger has both cognitive and biological elements, and angry states vary in frequency, intensity, and duration. For some folks, anger is experienced many times a day on the job, at home, in the car, and so on. The typical well adjusted adult, on the other hand, may feel angry only once or twice a month. Anger also has a specific intensity level. It is usually rated as a stronger feeling than annoyance and a milder feeling than rage.

In Tomas case, it reached the level of rage.

Anger may be associated with grudge holding that endures for years or it may pass quickly.

Overall, in a well adjusted person, anger is felt infrequently, is moderate in intensity, and does not endure. Anger becomes problematic when it occurs often and in response to many different triggers, when it is intense and disruptive to thinking or behaving, and when it endures because of ruminative thoughts.

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