Friday, May 20, 2011

Typology of Anger and Health Effects

From my notes on a lecture by Dr. Hector Myers, in PSYCH 292 Biobehavioral Mechanisms of Stress and Disease:
"Anger is an adaptive response to provocation."
Anger is not evil, bad, wrong or the enemy!  As Rage Against The Machine so eloquently put it in a song, "Anger is a gift."

A mentor and recently retired Principal, used to say that what inspired him to do the work he did (school and community leader) was his anger.

Speaking of anger, I am also reminded of a 4th grade girl I was working with several years ago.  I told her that she had a right to her thoughts and feelings - that all feelings were normal and natural - that it was okay to feel angry.  The following week, she came to session stating that her aunt had told her that it was not okay to be angry.  We often confuse the feeling for the behavior - or vice versa. Feeling angry doesn't mean you have to do something that hurts yourself or others.  There is a difference between feelings and behaviors, although sometimes they are linked with lightning fast speed so we don't see their difference.  Slowing down the time between feeling and action - by reflecting on the thought that triggered the feeling in the first place (feelings do not bubble up out of nowhere) - gives us a chance to choose how we want to act, respond or behave.  In this way, we become the drivers of our thoughts, subsequent emotions and ultimately our behavior - responsible and powerful over our own lives.  Simple, but not easy.  Hard sometimes, but not impossible.  Like most things that are important to us, it takes intention and practice to hone the skill, the hope lies in the possibility.

I am also reminded of a 5th grade boy who was grieving the death of his father and teenage brother.  Initially engaged in counseling sessions, he soon reverted back to a cynical and defensive posture (which his teacher had been concerned about and one of the reasons she made the referral for counseling).  He would show up to counseling but refused to talk.  After a session of no talking (30 minutes long) and another where he complained of being "bored,"  I said I could understand how he might be bored if he refused to talk to me.  I decided that verbal sparring would get me nowhere with this smart young man.  So I sat silently again and prayed to God for some help - God, please help me!  What do I do with this young man?  How do I help him?  What do I say?  After my own anxiety, insecurity and feelings of incompetence subsided, the thought came to me and I said to him, this time with warmth and understanding instead of impatience - Oh, I get it, you're angry, of course, you're angry, you get to be angry, I'm not going to take that away from you, it makes sense to be angry, I would be angry too.  As I softened, so did he, his shoulders came down and he let down his guard.  He cried.  It's okay to cry, you are in a safe place, you can cry here, it's good to cry.

It also helps to know there are different types of anger with differential effects on our heart health.
"There are different types of anger expression observed.

'Anger-in' contributes to heart disease risk (hypertension) due to sustained physiological arousal prolonged by ruminating (going over negative or worry thoughts repeatedly).

There are two sub-types of 'Anger-out' expression:
1) Anger is expressed after a period of calm and after giving the provocation or situation some thought.  Put another way, you experience anger as a spike and then recover. 
2) Anger-reactive expression is cardiopathogenic (a fancy word which means 'risk factor for heart disease.' I would have just said that but I am a bit enamored with this new word at the moment).  Anger-reactive expression is characterized by a short temper and fuse, constant overreacting to everything - repeated spikes in which length of recovery is not ideal."
At lunch with another mentor, we talked about the challenge of managing emotions, whether it be passion or anger.  In a therapy session with a high school client, we talked about managing emotions in general.  No matter how old you are or what your station, it seems to be part of the human condition and an important part of our journey to struggle and become more skillful with managing our strong emotions. Cheers to healthy anger expression for good health!

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