Anger management

What causes anger?

Human emotions are not just caused by circulating levels of hormones like adrenaline. Adrenaline levels are raised in anger because anger causes physical and mental (rather than sexually, although this can sometimes happen for some people) arousal. Adrenaline is the dominant hormone of all kinds of arousal. Known as the fight or flight hormone, it is involved in excitement as well as fear, happiness and desire as well as anger and stress.

We don't react to raised adrenaline levels in the same way every time. Our physical bodies may react in similar ways - with a thudding heart, sweating, fast breathing and so on - but our perception of whether we feel this as anger (or as another emotion) is affected by the thinking, processing and feeling parts of our brains, by our memories, by our moods and by our personalities.

Some of these processes can be consciously changed, some of them are very deeply ingrained, even automatic. They all flavour the way we experience high levels of adrenaline.

Why do some people get more angry than others?

Anger is something we feel at all ages, from small childhood to great age. How we deal with anger depends on how much it overwhelms our normal thinking and planning, on how we have learned to respond, and also on what we choose to do. Sometimes we act before we choose.

What are 'issues with anger'?

People sometimes talk about having 'issues with anger', meaning that either you or others are uncomfortable with or worried about your anger, or that you are seen as being angry more often than is 'normal'.

Issues with anger include:

• Feeling angry a lot of the time.

• Feeling stressed, tired and even physically unwell because of your anger.

• Having a 'short fuse' - reacting with anger quickly or disproportionately to things that distress or challenge you.

• Directing your anger the wrong way - for instance, at the wrong person, or at things rather than people.

• Displaying verbal or physical aggression, which may intimidate others.

• If you feel very angry but are unable to express it, you are likely to feel both physically and psychologically unwell. Symptoms like poor sleep, waking early, feeling agitated, experiencing nausea or heartburn, and a thudding heart (palpitations) are common.

Why won't my anger go away?

If someone deliberately treats you unfairly it is normal to feel angry. Often this kind of anger dissipates quickly, and you calm down.

Sometimes, however, the trigger for your anger isn't something that just happened, but something more general in your life or circumstances, or a past experience which is still causing you distress. When this is the case, you may seem to become suddenly angry about very small things, but the real cause of your anger is something deeper, and 'slow-burning'.

This kind of lasting anger can be difficult to deal with alone. It usually means you have not been able to resolve or come to terms with the cause of your anger. That might be because you have been treated unjustly, and it may seem that there is nothing that you can do to fix this. When this is the case it makes sense to get help. Counselling and talking therapies can help you understand your anger and the causes of your anger.

What makes anger worse?

Anger can be made more powerful by:

• Things which decrease inhibitions, like alcohol and recreational drugs.

• Things which affect overall mood, like fluctuating hormones, existing stress, anxiety and depression, disappointment and grief.

• Things that affect general well-being, such as tiredness and physical illness.

• Things that stop us expending physical energy, such as being 'trapped' at a desk all day.

• Repeated frustrations, when things keep going wrong.

• Feeling helpless. The urge to change things we cannot change can become anger, and not being able to change things which are unfair causes anger.

• Things which make life uncertain, risky or frightening, such as grief, fear, war, domestic violence, post-traumatic stress disorder, relationship breakdown and worries about financial security.

• Anger about previous experiences or harms, which can be 're-ignited' when something happens to remind you.

• Repeated provocation by others or by 'things', such as the car that fails to start or the computer that crashes.

• Depersonalisation of others - when you stop seeing the person you are angry with as another human being. This is seen in 'road rage' when drivers threaten other drivers in a way that they would not if they were not inside a car. It is also seen when people form gangs and start seeing the other gang as less 'human'. This is called tribalism. If we don't see others as human, this can remove the inhibitions which tend to stop us expressing anger towards other humans.

Dealing with anger can be made more challenging by:

• Lack of experience at managing anger.

• Negative experiences regarding anger, particularly childhood experiences.

• Learning in the past that anger is managed with violence.

• Being angry with things we can't change, like bereavement or physical illness.

• Feeling helpless to change things.

• If you have experienced violence before, you may have learned to fight back without thinking.

• Other mental health issues.

• Difficulties in communication.

• Lack of trusted individuals to talk to.
  

What is anger management for?

Managing anger involves learning techniques to put you back in control of your actions, so that anger does not control you. They include:

• Recognising anger.

• Learning to defuse anger.

• Learning to think before you act.

• Understanding and addressing the causes of your anger.

• Learning to use anger constructively.

This leaflet lists (below) some approaches to tackling these points.

You may also find it helpful to read the separate leaflet called Stress Management.

How do I recognise anger?

The first steps in anger management involve recognising the symptoms of anger.

These are:

• Feeling enraged. This seems obvious - but you may also experience anger mainly as something else, such as hurt, sadness, or feeling threatened, anxious or afraid.

• Physical symptoms: your heart beats faster and you breathe more quickly. You might notice tension in your shoulders, jaw or neck, or clenching your fists. You may be unable to keep still, and feel an urge to punch or kick something.

• Trembling or shivering.

• Nausea.

• A powerful urge to do something, particularly to frighten or intimidate someone, or to make a loud angry or frightening noise.

• Sweating, together with feeling suddenly hot or cold.

Anger is a stressful emotion, and many of the symptoms of anger are also symptoms of stress. Both involve high circulating levels of adrenaline.

How do I defuse anger?

Anger management techniques involve helping you manage and disperse your anger when it takes hold of you and might otherwise make you act rashly or harmfully. There are many techniques.

• Some are aimed at helping you to stop and think before you act.

• Some are aimed at using and therefore dispersing the surge of adrenaline that goes with your anger.

• Some are aimed particularly at young people and children, others work for all ages.

Different techniques will work better for different people.

Counting

Counting gives you time to cool down, so you can think more clearly and let your first impulse to react pass. Impulses are urges to act without thinking. Sometimes - for instance if you are a combat soldier - you need to be trained to act without thinking first. If you know your life is at risk then there may not be time to think. However, in civilian life there is usually time to think, and the end result of most things is better if you think before you react.

Breathing slowly

Take even breaths. Breathe out for longer than you breathe in, and relax as you breathe out. You automatically breathe in more than out when you're feeling angry, and the trick is to breathe out more than in, which will calm you down.

Sometimes, anger can lead to hyperventilation. This is the very opposite of calming breathing - ie when we hyperventilate, we breathe too deeply and too much and, as a result, feel increasingly anxious and unwell. For more information on hyperventilation, see the separate leaflet called Dealing with Breathing Problems.

Attending classes involving learned techniques like yoga and meditation can also help your ability to use breathing techniques to calm you down.

Time out

A few moments of quiet time might help you feel better prepared to find solutions. If you are involved in an argument and you feel anger taking over, suggest that you both take five minutes, perhaps have a glass of water or a cup of tea, and then talk.

During the time out, step back from the situation. Is the argument over something trivial or something huge? If you are on two completely opposite sides can you imagine any middle ground you can accept?

Do you want to stay angry with this person. If not, be prepared to tell them that you don't like feeling angry and would like to find a solution if they would too. It doesn't mean you have to give in - you may still have to agree to differ, but without anger.

Exercise

When you are angry you are full of adrenaline. Physical activity can help disperse this, and will reduce the stress that can cause you to become angry.

If you feel your anger building up, go for a brisk walk or even a run or a swim. Maybe the person with whom you are angry could do the same.

If you are involved in an argument consider taking tame out and using that for a short walk or run.

Generally, increasing your exercise levels on a regular basis will tend to defuse the adrenaline that keeps you angry, and will help you feel less angry in the long term. Some successful athletes say that they took up sport to help channel their anger as teenagers.

To read more about the benefits of regular exercise, see the separate leaflet called Exercise and Physical Activity.

How do I express my anger better?

Express your anger calmly

Once you have thought, express your anger in a calm non-confrontational way, ie say clearly and directly what it is that concerns you, without trying to tell others what they must or must not do.

Stick with 'I' statements rather than telling others what they have done wrong or blaming them, as this is then less likely to make THEM react in a way that increases tension and anger in you both.

Be respectful and be specific

For example: 'I am upset that you arrived home late when I was expecting to go out,' instead of 'you're always late and you don't care what I want.'

For example: 'I am tired and feeling overwhelmed by housework. I feel I am doing more than my share.'

Avoid accusations and try not to back the other person into a corner or make them defensive:

• Criticise behaviours not persons, so say 'you didn't tidy up', not 'you're lazy'.

• Try to avoid absolute words like always and never. For example: 'You never help with the housework.' 'You always answer back.'

• Try to avoid telling others what they should or must do.

• Don't say: 'It's not fair.'

• Try to avoid forcing them into saying what you want them to say. Try not to tell them you dislike, don't love, or hate them. If they are angry too, then they won't respond to these statements in the way you feel they should.

• Try not to tell them what you suppose their excuse is. For example: 'I suppose you're going to tell me you're too tired.' Try not to ask questions that are actually an accusation. For example: 'Why are you so lazy?'

• If you feel you need to make a demand, make it a demand that you try to solve the problem together, and set a time frame. For example: 'Later today, when we've both calmed down'.

Focus on trying to find solutions

Anger means that something needs to be resolved. Instead of focusing on what is upsetting, or what is wrong, focus on solutions. If you need to talk about the causes of the problems you can do that later, when nobody is angry.

Suggest that you are both angry and need to talk when you are calm. Take time out. Suggest a cup of tea and talking in ten minutes' time. Going for a walk can help disperse energy and make things less tense.

Don't hold a grudge

Forgiveness helps solve confrontations. So use apologies, if they are merited. You can apologise for losing your temper without apologising for being angry. It's fine to be angry, if the situation deserves it, but losing your temper is probably unhelpful.

If you can forgive someone who angered you, you can both learn from the situation and improve your relationship.

Use humour

Humour is a fantastic reliever of tension - that's probably why humour exists in the human race. Avoid sarcasm, which can be hurtful, or 'friendly' insults, which may be misinterpreted if the other person is still angry.

How do I stop anger from controlling me?

You can't always prevent anger, but you can prevent it from becoming overwhelming, and stop it from controlling you.

Learning how to control your anger involves learning to manage it when it flares, using the kind of techniques described above. You can also practise relaxation skills, so that they come more easily to you in times of stress.

Practise relaxation skills

Relaxation skills can be learned and you can use them when you feel anger building. They include breathing exercises, playing music, imagining relaxing places, meditation and hypnosis, and simply repeating a calming word to yourself.

In the long term you will be less angry if you:

• Increase physical exercise levels. Consider contacting your local gym and attending a class, or taking up a sport.

• Take up and continue a regular relaxing physical and mental discipline such as yoga, meditation or mindfulness.

• Use relaxation techniques and anger management techniques so much that they become automatic.

• Identify and address the kind of things that make you angry. If these are particular situations, you may be able to avoid them, or recognise them in advance and plan better ways of dealing with them.

• If your anger is linked to use of alcohol, consider seeking support. You can read more about services offering support for difficulties with alcohol in the separate leaflet called Alcohol and Sensible Drinking. Consider a self-assessment tool to reflect on your use of alcohol. A self-assessment test regarding problems with alcohol may be useful.

• Find a better outlet for your anger. This means using your energy some other way, either physically or in using your mental energy to try to change your life.

• If you are angry at an injustice then you might find relief by channelling your energies into finding a way to put things right. Could you find a way of preventing that injustice affecting others?

• If you are angry at something you can't change, like the loss of someone dear, it may help to talk to someone neutral about this, someone to whom you can reveal your real feelings. Grief can make us very angry.

Where can I find help with my anger?

Learning to control anger is a challenge for everyone at times. However, you should seek help for anger issues if your anger seems out of control, causes you to do things you regret or hurts those around you.

Your GP

The first port of call is usually your GP. They will want to try to find out what is making you angry, if there is an underlying reason for it, and you are able to identify this.

Your GP will want to talk with you to discover why you are angry, but also whether there are other factors contributing to your anger which also need to be addressed in order to help you get better. These other issues include mental health conditions like depression, anxiety and post-traumatic stress disorder. They include understanding whether drugs or alcohol are affecting your reactions.

Talking therapies

Counselling and talking therapies can help you in managing your anger. There is limited counselling available on the NHS these days, and there may be a wait for this. There are various types of counselling, including psychotherapy, Gestalt therapy, family therapy. Some therapists offer therapy aimed at helping you manage past experiences such as counselling for survivors of child sexual abuse or sexual violence.

Cognitive behavioural therapy (CBT) is a particular kind of talking therapy which focusses on how your thoughts and attitudes affect your feelings. CBT can be helpful in managing anger. See the separate leaflet called Cognitive Behavioural Therapy (CBT).

Anger management therapy

This is a specific sort of counselling aimed at helping you change the way you react to the situations that make you angry.

Anger management is often done one-to-one or in small groups. It can involve counselling and cognitive behavioural therapy. Some anger management classes are run over one day or a weekend; others involve regular meetings over a month or so. Your GP will know what is available in your area, but you can also contact private therapists for help and advice.

Relationship therapy

If your anger is always directed at the same person then this suggests that the interaction between you may be generating the anger. Relationship counselling or couples therapy may be helpful in order to help you understand why you are directing your anger at each other, and whether you are in fact not angry with each other but with something else.

Domestic violence

If anger in your relationship is making you scared, or you are or have experienced domestic violence, then consider seeking help. Organisations such as Refuge, Women's Aid or the Alternatives to Violence Project may be able to help you.

You can read more about this in the separate leaflet called Getting Help for Domestic Violence.

Self-help

There are many organisations, such as Childline, Mind, Moodjuice and YoungMinds, who provide advice on managing anger. See Further reading links at the end of this leaflet.

What is anger in teenagers and children like?

Anger in childhood and adolescence can cause difficulties in families, as the anger may be expressed in ways that parents find difficult.

This may include 'acting up' and oppositional behaviour, pushing boundaries and school difficulties. It can also involve withdrawal, isolation and self-harm.

Some young people struggle more than others to manage anger. Parents and families can help young people develop coping strategies.

To read about general issues affecting teenagers, see also the separate leaflet called Surviving Adolescence.

Finding the cause

If your child or teenager seems angry, sullen or withdrawn, try to find out how they feel. If anger is there it often simmers just beneath the surface, and you may see it expressed if you ask carefully. Try to work out what is making them angry, together.

• If they are not ready to talk to you, give them space but be ready to listen when they are ready. Consider whether there is anyone else they could talk to. Is there another trusted adult in their life? Would they speak to the school counsellor?

• Are they afraid? Does something in their life feel out of control? Young people may become angry because they are afraid. Anger is common in those experiencing bullying, in drug and alcohol use, and where there is peer pressure to do unwanted or frightening things.

• Whilst most children and teenagers who are angry do not have mental health difficulties, for a few - as in adults - anger can be part of serious mental health problems like anxiety, depression, panic attacks and self-harm.

• Consider the possibility of abuse. Most young people who are angry are not experiencing abuse, but anger can be a symptom of abuse in children and young people. Give them space to talk. If they don't want to talk to you, is there anyone else they could talk to? Make sure they are aware of Childline. If you are concerned that there is a possibility that your child has experienced abuse then it is crucial to seek advice.

To read more about safeguarding young people, see the separate leaflet called Safeguarding Children.

Find solutions

Make it clear that you have noticed their unhappiness and are ready to help but give them time and space to talk.

Help them to work out ways of channelling their anger. Consider the techniques above used in adults, particularly trying sport, relaxation techniques and creative time.

Consider counselling. This is usually provided through the school counselling service, at least initially, for those of school age.

How do I manage an angry child or teenager?

When your child becomes angry you are likely to feel distressed and rejected.

Try to set your feelings aside and to focus on them, your child, caught up in an emotion they can't handle well. They need your help.

• Respond to the anger, not the child or teenager. Be clear when you react, that it is your child's behaviour, not your child, that you don't like. This may seem obvious to you but it may not be obvious to them.

• Stay calm. Keep your body language relaxed. Don't shout.

• Acknowledge the anger: 'I can see you're really angry.'

• Consider using time out to give them a chance to calm down and then discuss things.

• Don't lecture.

• Don't patronise or tell them they're too young to know anything.

• Be ready to listen, and tell them they can say anything they need to say.

• Having given them that permission, don't take it personally.

• Verbal or physical abuse or violence from your child can be very difficult:

  • If you can do so safely, remove yourself from the room.

  • If not, and you feel that you or anyone else are at immediate risk of harm, warn the child that if the aggression does not stop you will need to ask the police to come and help you keep everyone safe. Whilst this is a very tough thing to do, it may be needed to keep everyone safe.

• Don't give in to angry demands. Be consistent. Keep your boundaries. If your child is angry with those, it doesn't mean they're wrong. Be ready to listen if they want to make a case for a different boundary, but unless you think they're right, stick to your rules.

Learning difficulties and anger

Children who have difficulties with speech and language, communication problems or other developmental difficulties may have particular difficulties in expressing their anger and may need specialist help. Your GP will be able to advise on this.

See also the separate leaflets called Autistic Spectrum Disorders and Attention Deficit Hyperactivity Disorder (ADHD).

Oppositional defiance disorder and conduct disorder

These terms are used for severe behavioural difficulties in children and young people, that may not respond to simple measures above, and that can harm children's prospects in life if they are not addressed.

If your child's angry and difficult behaviour has taken over their life, is severe and persistent, or is leading them into difficulties with the police, ask your GP about a referral to the Child and Adolescent Mental Health Service (CAMHS). Support and treatment should be available for you at home, in school and in the community.

For more information on conduct disorder and oppositional defiance disorder, see the separate leaflet called Behavioural Problems and Conduct Disorder.

Dr Mary Lowth is an author or the original author of this leaflet.