Rebecca Hardy 

Does anger management help?

More people than ever are seeking therapy for anger management. But does it help?
  
  

Couple arguing
'It is well established that anger can precipitate a heart attack'. Photograph: Denkou Images/Alamy Photograph: Denkou Images/Alamy

Mary knew she had a problem when she found herself screaming at her university professor. He had caught her having an aggressive argument with a woman on her course, and, after several complaints from other students, spoke to her about it.

"All my life I've had a temper," she admits. "I got into fights at school and university, and would lose control over little things." When the tutor said Mary would have to seek professional help or leave the course, she went to see the university counsellor. It was a turning point for Mary, who had arrived in the UK at the age of 10 while struggling to cope with the death of her sister.

"It changed my life," she says. "Suddenly I was speaking about things I had never talked about: how I was bullied at school when I first came to the UK because I couldn't speak English; how months before I had watched my sister die. My mother sent me back to school that day. We never spoke about it again. Now, if I get angry, I can talk about it."

Many are not so fortunate. "We suspect that anger in our society is reaching pandemic levels, but there's very little help available," says Mike Fisher, director of the British Association of Anger Management. This January, BAAM, which operates a string of clinics across the UK, received an unprecedented number of bookings for its courses, despite January traditionally being its quietest month. There has also been an increase in the number of website hits. "This could mean more people are seeking help, but we know that domestic violence is increasing: eight women on average are killed a month. Workplace stress is also rising, and where there's stress, there's anger," he says.

In particular, there has been a big increase in calls from people in relationships with rageaholics – a person who is addicted to the intensity of anger and the adrenaline released. "An alcoholic has about 17 people who suffer from their behaviour. Rageaholics are similar. Eighty per cent of our callers are people who are in a relationship with a rageaholic. They are desperate, and want to know how to convince their partner that they have a problem."

A recent BAAM study found that 84% of the 715 respondents had experienced verbal and emotional abuse in the last 24 months. "Twice as many women responded than men, with 36% more women appearing to be abused," says Fisher. "But both sexes report a disturbingly high percentage of abuses."

All of which doesn't bode well for the nation's health. "Anger can be useful, but out of control it can lead to family breakdown and health problems," says Kathryn Hill from the Mental Health Foundation. Its 2009 report Boiling Point showed 28% of adults were worried about how angry they sometimes feel, and 32% had a friend or relative with problems dealing with anger. "Chronic intense anger is linked with heart disease, stroke, depression, self-harm, substance abuse, colds and flu, higher stress levels and negative relationships, such as parental abuse."

Rachel Lampert, associate professor of medicine at from the Yale University school of medicine, agrees: "It is well established that anger can precipitate a heart attack and arrhythmias (heart irregularities) in people already at risk, although the exact pathways are not understood." Lampert conducted two studies; in the first she gave diaries to patients with defibrilators so they could rank their emotions whenever they had a surprise. "Anger was much more common in the period preceding the arrhythmias than in the control group." Then she asked them to recall rage-filled moments, measuring the heart's electrical activity. "We followed these people for several years and found they were more likely to have arrhythmias later. We need to take negative emotions seriously as a health risk."

But many experts say this is still not happening. "You can't go to your GP and say: 'I'm angry and need help.' It's not until you've committed a crime that you will be referred for anger management," says Hill.

Fisher says early intervention is crucial: "The government has announced £400m to modern psychological therapies such as cognitive behavioural therapy, but CBT doesn't get to childhood trauma, which is the root of serious anger problems."

Other experts say we need to learn how to express anger appropriately. "It's about expressing yourself effectively and calmly," says Phillip Hodson, psychotherapist and fellow of the British Association for Counselling and Psychotherapy. Common strategies include noting your arousal signs (headaches, foot-tapping, tension), and then counting to 10 and slowing the breath; and working out what you are commonly dwelling on in moments of rage and thinking about something else. Other tips include avoiding alcohol and drugs, practising relaxation techniques and getting daily exercise. "Exercise dissipates difficult emotions," says Hodson.

And dealing with someone else's rage? "Don't argue, listen, and when they have finished ranting, say calmly: 'Is there anything else?' Then you can talk." This, of course, excludes dealing with someone who is physically or mentally abusing you. "If you feel you may be harmed, you leave. And seek professional help."

Names have been changed.

 

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