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Anger Management - Cognitive Therapy Interventions
Anger Management: Cognitive Behavioral Interventions - 10 CEUs

Section 2
Emotion-Focused Therapy for Unresolved Anger

CEU Question 2 | CEU Test | Table of Contents | Anger Management
Psychologist CE, Social Worker CEUs, Counselor CEUs, MFT CEUs

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In the last section, we discussed the five methods for handling anger.  These are suppression, open aggression, passive aggression, assertiveness, and dropping it.

In this section, we will discuss how feeling controlled causes anger.  Some main ideas to consider in a cognitive therapy environment are why control occurs, how a client responds to control, and the acknowledgement of freedom.  As I describe these ideas, decide if any of these aspects of control are applicable to a client you may be treating.

How Feeling Controlled Causes Anger - 3 Considerations

♦ #1 Why Control Occurs
a. Let’s explore our first idea, why control occurs.  As you are aware, controlling behavior is shown in a variety of ways in your anger management clients.  Bossiness, criticism, stubbornness, and chronic rebuttals are all examples of active control.  Passive control can manifest as silence or apathy.  Does your anger management client utilize more active than passive control?  Have you told your client that although control is not always bad, excessive control clearly creates a negative atmosphere?  I have found there are three factors regarding why anger management clients are too controlling.  

These three factors are: performance takes priority, difference is threatening, and, obligation becomes mandatory.  Your client may be able to find out if performance is taking priority by having him or her think about their communication with others. Does it appear performance and actions, rather than feelings become the focus for control?

Here is an example:  Michelle, age 34, was showing anger toward her husband, Mike. Michelle stated, "Mike is always putting me down and telling me what to do.  The other day my schedule was hell and I got nothing done because of so many interruptions. The phone, the kids, getting the damn meal on the table!  I was so frustrated, but he didn’t care about that. All he said was "Write down your schedule and stick to it.  What’s so hard about that?"   Michelle’s feelings mattered less to Mike than her performance.  Michelle’s personal feelings were pushed aside, Michelle felt controlled by Mike. 

b. Secondly, the typical anger management client perceives differences in others as threatening.  Have you found that though clients give themselves credit for being open-minded, their lives don’t reflect this tolerance? Though they enjoy new and unique experiences, they gain composure from things that are familiar.  Thus the "Don’t think that way, it’s too different!" mentality can become controlling.

c. Third, controlling behavior may relate to a history of obligation instead of choice.  I have found that by asking a client a couple questions I can isolate mandatory obligation as the reason for control.  First I ask, "Can you remember receiving instruction on how to speak and act?" Then I usually follow this up by asking "How were you trained to make choices by your family?"  The client may recall receiving instructions from his or her parents on how to speak and act, however he or she may not be aware of how they currently make choices.

♦ #2 How a Client Responds to Control
How does your client respond to control?  As you are aware, a client may respond by submission initially and then explode later.  However, in relation to cognitive therapy I like to focus on the client’s counter-control. Anger causes clients to become particularly susceptible to the response of counter-control by inviting a power-play.  When a client engages in counter-control, both sides struggle to control each other.  Here is an example of counter-control. Angela, age 32 explained, "I wish I could stop myself from always lashing out, but something comes over me when I feel controlled and I get hooked into emotional warfare."

♦ Cognitive Behavior Therapy Technique: Untwisting the Twister
With Michelle and Angela I decided to try the CBT Untwisting the Twister intervention.  

a. First, I explained to Michelle she could look into a mirror for several minutes and then look at a photo of her husband, Mike, who was controlling.  I asked her to look at Mike’s photo for the same length of time she looked at herself in the mirror.  I asked Michelle to try to imagine how Mike feels about her and compare it to how she feels about herself.  Michelle wrote these comparisons down to evaluate with me later.  Michelle identified Mike’s disregard for her feelings and his emphasis on the appearance of their relationship. 

b. Second, we discussed the ways in which Michelle’s feelings about herself and her perceived feelings that Mike had were similar and different.  Michelle believed Mike loved and respected her, but put more importance on how others perceived their relationship.  You may find this technique can also help a client understand the reasons for control.  Michelle saw Mike’s emphasis on the appearance of their relationship as his desire to be as perfect as possible.  Michelle’s understanding regarding Mike’s control issues helped her manage anger more constructively.

♦ #3 The Acknowledgement of Freedom
In addition to why control occurs and how a client responds to control, we’ll explore the acknowledgement of freedom.  As you have probably seen, a client who has been controlled for several years may disregard their own personal freedom by not making choices on their own.  Instead, clients may completely succumb to another person’s control.  In my practice, I have noticed that if a client’s freedom is restored, there is a risk freedom can intermingle with selfishness to cause other problems in the client’s relationships.  

Clearly, it is important the client can distinguish freedom and selfishness.  Would you agree that the two healthy methods of handling anger discussed in section 1- assertiveness and dropping it cannot be used by a client who does not acknowledge their own freedom?  Clearly, reinforcing a sense of freedom can be difficult.  If I notice lack of freedom is the cause for a client’s anger, I begin to rebuild their sense of freedom over time.  First, I inform them passively of their freedom.  Next, I will educate the client on personal freedom.  

Over the next several sessions, I will support any desires for freedom the client may express and reassure the client if they act out their freedom.  This type of cognitive therapy intervention can go a long way in helping a client to acknowledge freedom.

In this section, we have discussed how feeling controlled causes anger.  The main concepts we considered are why control occurs, how a client responds to control, and the acknowledgement of freedom.

In the next section, we will discuss five myths that perpetuate anger.  These myths are history of rejection leaves a client with a feeling of impending rejection, letting go of anger means conceding defeat, no one understands the client’s problems, the client doesn’t deserve to be happy, and there is nothing to look forward to anymore.

Peer-Reviewed Journal Article References:
Diamond, G. M., Rochman, D., & Amir, O. (2010). Arousing primary vulnerable emotions in the context of unresolved anger: “Speaking about” versus “speaking to”. Journal of Counseling Psychology, 57(4), 402–410.

Diamond, G. M., Shahar, B., Sabo, D., & Tsvieli, N. (2016). Attachment-based family therapy and emotion-focused therapy for unresolved anger: The role of productive emotional processing. Psychotherapy, 53(1), 34–44. 

HarmonJones, C., Hinton, E., Tien, J., Summerell, E., & Bastian, B. (2019). Pain offset reduces rumination in response to evoked anger and sadness. Journal of Personality and Social Psychology, 117(6), 1189–1202.

Hawes, S. W., Perlman, S. B., Byrd, A. L., Raine, A., Loeber, R., & Pardini, D. A. (2016). Chronic anger as a precursor to adult antisocial personality features: The moderating influence of cognitive control. Journal of Abnormal Psychology, 125(1), 64–74.

Hewage, K., Steel, Z., Mohsin, M., Tay, A. K., De Oliveira, J. C., Da Piedade, M., Tam, N., & Silove, D. (2018). A waitlist controlled study of a traumafocused cognitive behavioral treatment for intermittent explosive disorder in TimorLeste. American Journal of Orthopsychiatry, 88(3), 282–294.

Kelly, E. L., Novaco, R. W., & Cauffman, E. (2019). Anger and depression among incarcerated male youth: Predictors of violent and nonviolent offending during adjustment to incarceration. Journal of Consulting and Clinical Psychology, 87(8), 693–705.

Steinmann, R., Gat, I., Nir-Gottlieb, O., Shahar, B., & Diamond, G. M. (2017). Attachment-based family therapy and individual emotion-focused therapy for unresolved anger: Qualitative analysis of treatment outcomes and change processes. Psychotherapy, 54(3), 281–291. 

Online Continuing Education QUESTION 2
What are three main ideas concerning how feeling controlled causes anger? To select and enter your answer go to CEU Test.

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