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ADHD, Anger Awareness and Management

When I sat down to write this article, I realized that I wasn't clear on a definition of anger and I wondered, are you? My goal in this article is to collectively raise our awareness of anger by asking and answering the following questions: What is anger? Is anger useful? When is anger hurtful? How does it hurt? Then in Part 2, I will discuss ways to deal with your angry thoughts and feelings more effectively.

Take a minute and answer the following question:

Feeling angry is____.

1. Normal
2. Something experienced by everyone
3. Not something you outgrow
4. A powerful feeling, but one you can learn to manage with practice
5. Not the same thing as aggression, which is a behavior (such as hitting someone) that may result if you can't bring your anger under control
6. All of the above

If your answer was "F" you recognize that anger is a basic human emotion. You realize that we are born with the potential to feel and express anger. Anger is not a behavior; it is an emotion.

Anger is often confused with aggression, but it is possible, and preferable, to feel anger and not act aggressively. The difference between anger and aggression is that aggression is an action, a behavior, while anger is an emotion. We feel anger, but when we act out our feelings in a physical way (by hitting, loud shouting, door slamming, etc.), we are acting aggressively.

From time to time, we all experience anger. Some common causes of anger include frustration, hurt, annoyance, disappointment, harassment and threats. It is helpful to realize that anger can be our friend or foe, depending on how we experience it and express it.

Anger can be a useful, appropriate emotion that can be used constructively. Knowing how to recognize and express your anger can help you to reach goals, solve problems, improve communication, handle emergencies and even protect your health.

Anger can serve vital functions to protect and defend you. It can be adaptive and serve as a warning signal that something is wrong. Just as physical pain can be a warning ("Wow, this shower is hot! I better move!"), anger can warn you of impending emotional and physical pain. It can provide the energy to resist emotional or physical threats. Anger can help you mobilize your resources to set appropriate limits and boundaries. Anger can help in overcoming the fear of asserting your needs.

Anger is probably the most poorly handled emotion in our society. Even though anger is a part of life, our culture does little to teach us how to manage it. Generally, girls are taught to avoid feeling angry or to minimize events that make them feel anger. "So, sweetie pie, what's got your hair out of place?" "Doesn't she look cute when she's angry?" Boys, on the other hand, are often encouraged to display anger in overt and negative ways. "What do you mean? You're going to let him call you a sissy and not do anything about it?"

Failure to recognize and understand our anger may lead to a variety of problems. The impulse to lash out, that felt so right at the moment, so justified, later becomes a source of guilt and regret. What seemed so worthy of blame in another passes. What remains are the scars, the hurt, and the alienation.

When we do not understand how to effectively recognize and manage our anger, we often choose coping methods that are harmful. We may deny anger or repress it. Some of us like to keep our "nice guy/ nice gal image" and not "make waves." Perhaps we say to ourselves that the situation is not important and we should "swallow our anger." Depression is often caused by anger that has been denied. When anger is denied, you may feel that life is hardly worth the struggle.

Often, we will put off a situation that makes us angry, saying we will deal with it later. We are nice to people who make us angry, but then the anger seeps out inappropriately in our intimate relationships. For example, you were criticized by a co–worker at work and are angry but don't acknowledge it, perhaps out of fear of losing your job. You arrive home and one of your children has left something out that you trip on. You over–react. More than likely, you are really angry with the co–worker, but the child received the brunt of your anger.

Some who can't cope with their anger and fear expressing it, often choose to not feel at all. Women are particularly apt to choose this coping method, especially after a deep hurt with the resulting anger. They learn not to feel any emotion, except numbness—no joy, no anger, no guilt, etc. If they don't feel, then they can't be hurt.

Some of us use self–sabotage when we have managed our anger inappropriately. Perhaps you are angry with yourself because you didn't speak up when you should have so you unconsciously allow yourself to fail. You pay yourself back, in negative ways, when you are displeased with how you acted or failed to act. Individuals can also sabotage themselves by neglecting to practice good health care.

Loss of sleep may occur when some of us think or dream about another choice we could have made in expressing our anger. Ruminating about "I wish I had said..." or "How could they do that to me?" can cause many sleepless nights. Others may sleep too much to avoid thinking about the situation that is making them angry.

Drug and alcohol abuse is probably the worst method of coping with unexpressed anger. Taking a pill or drink to forget anger or to calm down emotions is not an effective way to handle anger–provoking situations.

"Over–doing" is based on the idea that if we really get into our work, our exercise, or our hobby, then we can forget about being angry. This method may cause fatigue or remove us from our family, but it seldom solves our anger problems.

If managed inappropriately, anger is likely to negatively affect our physical and mental health. Repressed anger can disrupt relationships, affect thinking and behavior patterns, and create a variety of physical problems, such as high blood pressure, heart problems, headaches, skin disorders, arthritis, and digestive problems. What's even worse is the correlation between the dangers of uncontrolled, aggressive anger and crime, emotional and physical abuse, and other violent behavior.

For many years clinical research centers followed hundreds of volunteers who struggled with chronic anger. They were given tests, trying to establish a pattern between anger and health. The results strongly indicate that chronic anger does kill in the long run. It is estimated that a person who is generally angry all through his life will die ten years earlier than a person who manages his/her anger and stress.

Chronic anger that is unexpressed is bad for you because it feeds on itself. Dr. Mathew McKay says that, "...chronic suppressed anger is damaging because it mobilizes the sympathetic nervous system responses without providing any release of the tension. The effect is the same as flooring the accelerator of your car at the same time as you are slamming on the brakes".

Inappropriate anger is an unhealthy habit, period. It doesn't matter whether it is expressed or suppressed. Feeling angry is a habit, however, that can be overcome with awareness and effort.

"Where do I start?" you ask. Buy yourself a small notebook; use your PDA or computer. Put whatever it is you choose to use someplace where you are likely to see it and remember to use it. Today and every day, until the next issue of ADDult ADDvice, make the following entries into your "journal." Learn what triggers your angry feelings and actions. Become aware of your responses. Each day record the following:

Date	Episode Number	Emotional Level	Aggression
Jan 1	1	6	8
	2	4	7
	3	2	5
Jan 2	1	8	5
	2	3	5
	3	5	7

Some individuals find that anger is a mask for fear, and once they understand that important distinction, they can move forward in making more healthy choices. When you are angry, ask yourself, "Am I really afraid of something happening, or not happening?"

It is normal for people to feel angry or mad, but it is also important for people to feel other emotions like sadness and joy. Don't let anger become an emotion that blocks the healthy expression of the spectrum of emotions you might feel.

Remember that anger is an appropriate emotion, but in our culture, sometimes it is overused. Use it carefully and it may help you achieve your goals. Misuse it and it will create difficulties that will keep you from becoming the kind of person you would like to be. If you feel stuck with your anger, it may be helpful for you to talk with a professional counselor about ways to effectively deal with and express your anger.

In the following section we will consider ways to deal with your angry thoughts and feelings more effectively. We will look at anger as a choice. Did you know that you can learn new ways to respond? Just because a problem has caused angry feelings in the past, it does not have to continue. You can choose not to become angry in a particular situation. Hopefully, the thoughts and suggestions presented in the next section will help you further explore when anger is helping you and when anger hurts you.

Part II

Anger is an emotion/feeling that you can learn to manage with practice. You have a choice in managing your thoughts, feelings, and negative self–talk, although it is not easy to change. How can we harness this sometimes powerful emotion and, perhaps for the first time, begin to use it to our advantage? A three step process follows:

Step 1: Awareness

Beginning to identify when we start to feel angry is the first step. Anger comes in degrees from mild to severe and is triggered by an emotional stimulus that provokes emotional responses that are tied to thoughts. If you pay attention to your body, it'll send you signals that you are about to react. Often, we'll jump past this cue or awareness and just react. Awareness and recognition of the physical sensations in our bodies will help us manage our angry feelings. Ideally, it would be wonderful to avoid all negative,over-stimulating environments. Often, however, that is not a choice.

Some of you, after reading Part I of this article, may have started to create an awareness of your anger by keeping an anger journal. Now, I want you to ADHD to what you record in this journal. Try recording the answers to the following questions daily for the next week. Often, seeing the process documented in your anger journal will reinforce your efforts:

Each day record the following:

• The number of times you got angry in preceding 24 hour period.
• Record on a scale of 1–10 how triggered you felt at your angriest (10 being most angry).
• Record on a scale of 1–10 how aggressively you acted when you were at your angriest.
• Record what it was that you said to yourself.
• What is the best guess about the underlying issue from the other person's point of view?
• What were your underlying feelings?
• What were your alternatives?

When you think back to anger–producing situations that you've recorded, it is likely that you recall experiencing intense feelings of anger. You may recall feelings of hostility or rage that may have overwhelmed you and led you to act in ways that did not improve the situation. Maybe you remember trying to control your angry feelings while in the situation and struggling to contain them all day. In order to better understand these feelings and bring them under your control, it is necessary to look at another aspect of the anger–producing situation: your thoughts.

Step 2: Examine the Thoughts You Had Just before the Angry Situation

The second step of the process is to identify your anger "triggers" and common situations in which they occur so you can be prepared to respond differently. Changing a long–standing pattern of thinking is no easy task. But it's absolutely necessary. If you don't find ways to combat your trigger thoughts, they will continue to ignite anger.

Thoughts, beliefs, and assumptions about a situation influence how you feel about the situation. For example, if someone offers you help you with a project, you may think: "Hey, this person is trying to be helpful." This thought may lead to positive feelings towards the person. On the other hand, the thought: "Hey, this person is trying to look good by volunteering" may lead to angry feelings.

Sometimes the thoughts we have are accurate and sometimes they aren't. It is important to carefully examine your anger–producing thoughts to see if they are accurate or somewhat distorted. Distorted thoughts are inaccurate or less adaptive ways of thinking about a situation. For example, if a person says something critical about you and you think, "This person is a jerk," you will likely feel angry and respond to this person in an angry fashion. You may learn, however, that this person just found out they lost their job. Labeling a person based on one interaction is an example of a type of distorted thinking called over–generalization. Listed below are some other types of distorted thinking and examples.

Labeling:

You put a fixed, negative label on others without considering that the evidence might more reasonably lead to a different conclusion.

Example: "He's an idiot." "She's two–faced."

Magnification:

When you evaluate another person, you unreasonably magnify the negative and minimize the positive.

Example: "I saw him rolling his eyes when he talked to her. He must be heartless."

Personalization:

You believe others are behaving negatively as a reaction to you, without considering other explanations for their behavior.

Example: "That guy is being cold to me because he thinks he's better than I am." (You are unaware that he just received some upsetting news from home.)

"Should" or "must" statements:

You have a precise, fixed idea of how others should behave and you overestimate how bad it is that these expectations are not met.

Example: "She should have called me by now. She must not care about our friendship."

Tunnel vision:

You only see the negative aspects of a situation.

Example: "My professor can't do anything right. He's critical, insensitive, and a lousy lecturer."

All or nothing thinking:

You view a situation in only two categories instead of on a continuum. Things are either good or bad; you are either perfect or a failure.

Example: "My friend doesn't agree with me on this issue, so he's completely non–supportive." "I just know I'm going to get an "F" on that exam!" (when a "B" is most likely).

Fallacy of fairness:

You feel resentful because you think you know what's fair, but other people won't agree with you.

Example: "Why can't my professor see that I deserve an "A"?"

Blaming:

You hold other people responsible for your feelings.

Example: "It's my roommate's fault I'm so angry."

Fallacy of Change:

You expect others will change to suit you if you pressure them enough.

Example: "If you just hear me out one more time, I'm sure you'll agree with me."

Being Right:

You are continually trying to prove that your opinions and actions are correct. Being wrong is unthinkable and you will go to any length to demonstrate your rightness.

Example: "I was totally justified in yelling at my friend for what he did!

Your assignment for week two is to create an awareness of anger triggers and identifying distorted thinking. Try using the chart below to confront your trigger thoughts and distortions in your anger journal. It's essential that you make a commitment to keep at this. It is tough work to keep examining your thoughts and to keep questioning what seemed so natural, so reasonable. But getting control of your anger requires that you become more and more aware of how trigger thoughts create upsetting feelings.

Date	Situation	Trigger Thought	Distortion	Outcome
Jan 1	Disagreed w/friend	He's non-supportive	All or nothing	Might end friendship
Jan 3	Spouse late to meet you	She doesn't love me	Personalization	Angry—won't accept explanation
Jan 7	Someone passes you on the right	What a lousy driver. I will show them.	Labeling	Road rage

As this becomes easier, you can better identify your thoughts when you are in a situation and begin to feel angry. By identifying distorted thoughts and replacing them with more adaptive ways of thinking, you can keep yourself from becoming overwhelmed by anger in difficult situations.

Step 3: Find More Adaptive Ways of Expressing and Managing Anger

The last step we'll look at is developing more accurate ways of expressing yourself. For each distorted thought you have written down in your anger journal, try a different way of thinking about the situation—one that is more accurate and does not make you feel as angry. This may involve exploring the positive aspects of a person or a situation, identifying other possible reasons for the person's behavior, or looking at "the big picture" rather than focusing on one relatively small incident.

Take at look at the example in the chart above. How could this person respond differently? The disagreement with her friend left her feeling unsupported and due to her all–or–nothing thinking, she had serious thoughts about ending the friendship. Perhaps she could consider a couple of other responses to the situation keeping the following in mind:

• Be specific, not global
• Be non–judging
• Punishment and revenge won't get you what you want
• Check out all assumptions
• You,and only you, are responsible for your needs
• Recognize that people do the best they can given their awareness at the moment of choice
• Recognize that people do what is reinforcing for them to do. You can only get them to change by negotiating for and reinforcing new behavior.

(McKay, M.,When Anger Hurts,.p.102.)

Remember, you have a choice in the way you respond to situations. It may take at least three months of consistent effort, monitoring and confronting your angry thought,s before you begin to feel the tide turn. Commit to creating an anger journal. Begin by creating an awareness of when you begin to get angry. Note your experience(s) in your journal. Use your anger as a cue. Become an expert at identifying your triggers and your pattern of filtering/distorted thinking. Remember that distorted thoughts are inaccurate or less adaptive ways of thinking about a situation.

Anger can be productive when it is expressed appropriately. When you're angry, have a plan. If you typically express your anger inappropriately, take a TIME OUT. That may mean leaving the situation and appropriately expressing your anger away from the people you might hurt or frighten.

Gradually, it will be less discomforting when the old trigger thoughts pop up. They will no longer sound so right, so convincing. In fact, you will begin to recognize them for what they really are—excuses to discharge pain, deceptions that trigger destructive aggression. You will find your new attitudes and beliefs beginning to take hold, and as you begin to accept more responsibility for your needs, you will move beyond anger to problem solving, negotiating and exploring the needs of others.

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Don Baker, MA, LMHC is a therapist in private practice in Seattle. His focus is almost exlusively on helping people with ADHD concerns. He has written a number of article for ADDult ADDviceas well as present at meetings and conferences sponsored by ADHD Resources. He is a Board member of ADD Resources. Visit his website at www.donbakerma.com or call him at 206–617–6206

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