It’s all the rage: Don’t lose the plot when your anger boils over

Hot seat: Road rage may have little to do with another motorist's driving and more to do with an earlier upsetting incident at home or at work.

TRASHING your office computer, attacking your car or threatening a fellow motorist — YouTube is bursting with lurid examples of those who allow their rage to boil over.

One road rage clip, in which a cyclist is assaulted by a motorist, has got 388,000 views, another which shows a frustrated office worker smash his workplace computer has attracted 253,000 visits while another, in which a raging motorist tears apart his car, has been viewed by 133,000.

But what many of us don’t realise is that ‘losing the rag’ doesn’t just upset others, it can have serious health consequences.

People who lose their temper are up to five times more likely to have a heart attack and more than three times more likely to suffer a stroke within two hours of an outburst, according to the latest research carried out by the Harvard School of Public Health.

Anger is a useful and important emotion. It’s there to protect us, but it’s our response to our anger which causes problems, says Dr Keith Gaynor, senior clinical psychologist and mental health specialist with St John Of God’s Hospital.

“All human beings will feel anger, it’s like sadness, happiness fear or embarrassment — it’s a core emotion,” he says.

“It kicks in and the body becomes ready for action. Your heart rate increases. Your blood pressure goes up. Blood is pushed to your hands, feet and face and you blush/flush.

“Adrenalin levels go up and your eyes focus on whatever it is that’s making you angry.

“Your vision narrows to the trigger — for example, the guy blocking your progress through the traffic lights.”

At this point we can manage our anger — or we can let it get out of control.

“An unhealthy response would be picking a fight with the wrong person, or getting angry at traffic on the way home — that will only make you angrier and you start to brood about how unfair everything is which will stoke your anger,” says Gaynor.

If you’re continually losing your cool and don’t know why, it will cause more trouble than it solves, he adds.

The problem is, he adds, even though we initially repress our urges and push the anger down it can leak out — often inappropriately.

“We sit on it but then it pops up, and maybe at an inappropriate time — for example, over something small and you shout at the kids or your spouse. It might have been there since 3pm but it comes out later in the day.”

Though clearly not good for your health, there’s no firm evidence showing that increased anger or anxiety will cause a heart attack or stroke in a healthy person, says Gaynor. It’s significant that the Harvard study found the risk of cardiac arrest increased dramatically among people with existing heart problems who get angry many times a day.

A healthy response means recognising and acknowledging the cause of your anger, he says.

“We have to acknowledge it, tolerate it and allow it to pass — the key thing is not to react to it,” he says, adding that relaxation techniques meditation, exercise or even something like taking a long shower, can help.”

Another method of managing your anger is to safely ‘vent’ or express emotion to someone you are comfortable with.

“This is not about biting the head off your partner when you come home, it’s about explaining that you had an awful day or a terrible row with the boss and venting through explaining to somebody why you are feeling bad. This is much better than bottling it up.”

It’s what we do with our anger that is important, says Dr Abbie Lane, consultant psychiatrist and expert in stress management who works with the Dean Clinic in Sandyford, Co Dublin.

“Anger can affect our relationships,” she warns. “Verbally lashing out at people, being irritable and withdrawn can result in not interacting appropriately — that can have consequences in the workplace if someone is verbally aggressive or threatening and lead to people feeling bullied or harassed,” she says, adding that she has seen people who had been referred over difficulties with their behaviour in the workplace.

“A proportion of them would be anger-related,” she says adding that such people may be over-sensitive to criticism or verbally aggressive.

We’re all different, says Dr Sarah Brewer, a GP and author of Cut Your Stress, who says our personality type has an impact on how we express anger. So if your nature is that of an introvert or an extrovert, if your temperament is calm or choleric, it will have an effect on your response to the anger impulse.

However, anger can also be a learned response. “You learn as a child how to be angry and you respond in the manner that you have seen in the adults around you — you have been taught how to respond to anger.”

Repressing your anger can also have long-term negative consequences, warns Dr Brewer. “If you internalise anger you will turn it in on yourself. You will become anxious or depressed and you’re more likely to have time off work or experience lowered immunity or disrupted eating patterns — you may over-eat or not eat enough.”

It’s well recognised the problems that poor anger management can cause — the probation service, for example, provides funding to a number of community-based organisations which provide services including anger management programmes to offenders to help them address problem behaviour.

Generally, however, when it comes to comparing the sexes, women tend to be better than men at managing their emotions more positively says Gaynor.

“Men are more likely to react negatively,” he says, adding however, that often an apparently sudden outburst of fury, such as road rage, is not about what’s happening on the road at all.

“It’s about something that happened in the house before the person got on the road.”

Although it may seem to conform to stereotype, says Dr Brewer, males are generally more likely to lose their temper in ‘road rage’ incidents, whereas women are traditionally prone to be more ‘passive aggressive’, finding a quiet way to get back at you.

However, women’s approach to expressing anger may be changing. “Women are beginning to become more assertive so maybe males see their assertiveness as aggression,” she says.

There are lots of ways to tackle your urge to anger say the experts — diet, exercise, reducing your alcohol intake, meditation or Cognitive Behavioural Therapy.

CBT is central to two highly successful programmes being run by Aware, the national charity supporting people with depression.

The pressure the ordinary Irish person has been under in recent years as a result of what is increasingly being referred to as The Great Recession, is reflected in what Dr Claire Hayes, clinical psychologist and clinical director of Aware describes as the public’s “phenomenal” response to Aware’s Life Skills programmes, which, by Easter, will have been completed by nearly 4,000 of people since they began two years ago.

Based around the principles of Cognitive Behavioural Therapy — a therapy which focuses on thinking and behaviour and has been shown to be an effective treatment of mild to moderate depression and/or anxiety — the programmes look at, among other things, the issue of anger and how to manage it.

“Anger is a module in both programmes, and both programmes help people develop the skills to deal with anger,” says Hayes, who has sat in on a number of the groups.

“I find that people are extremely resilient, and while they have been affected, there is a sense that says ‘let’s get on with it,” she says.

The Life Skills Group programme is the brainchild of Dr Chris Williams, professor of Psycho-social Medicine at the University of Glasgow, and is delivered through Aware groups around the country. Also, an online version has been developed by Dr John Sharry at the Mater Hospital and UCD.

But if you’re looking for a quick solution, the next time you’re at boiling point try this: take a deep breath, count to ten and think about what losing control could do to your relationships, your career and even, your health. It could be the start of a new chilled out life.

nSee: www.aware.ie

FIVE ANGER TYPES

1. Explosive

Personality traits: You may be extrovert but lacking in empathy and self-control and tend to react instinctively to something that makes you angry. The response is disproportionate to the situation and may even involve violence.

How you react

You shout, slam doors and may be verbally abusive or even violent. You’re prone to road rage.

How to manage your anger

Counselling and relaxation techniques can help. Try counting to ten and concentrating on your breathing until it is slower, deeper and more even.

2. Passive/aggressive

Personality traits: This person is probably more inclined to be an introvert. You will bottle up your anger — you don’t express it but you may get your revenge by doing negative things behind the culprit’s back later on in a passive-aggressive way.

How you react

Although you don’t ever express your anger directly you will get your own back — for example by withdrawing a service or being disruptive. You are not dealing with your anger but simply releasing it in small, controlled side-swipes. A wife who’s angry with her husband might make him his dinner as usual — but not cook the things he likes, or burn it.

How to manage your anger

Counselling may help you confront your emotions.

3. Internalised

Personality traits: A perfectionist, you are conscientious and afraid of doing the wrong thing. You may feel angry with yourself as much as angry at the situation in which you find yourself.

How you react: Your anger turns inside and this can lead to depression — you are constantly afraid that something will go very wrong. You may suffer from insomnia

How to manage your anger: Cognitive Behavioural Therapy (CBT) may be helpful — it could help you see the big picture and realise that everything isn’t always about you.

4. Chronic

Personality traits: You are the kind of person other people tiptoe around. You always seem to be on a knife edge, and your anger may stem from low self-esteem and negative thoughts, as well as the inappropriate interpretation of incidents — you may continually interpret as criticism things that happen, or observations that others may make.

How you react: Your face can flush, you become loud and your body language may be aggressive. You may try to cope with cigarettes or alcohol.

How to manage your anger: Try CBT, meditation or yoga. Ask your GP about methods or treatments which could help reduce anxiety.

5. Controlled, calm

Personality Traits: You will approach things directly but in a sensitive way, without getting angry.

How you react: You consider the situation and approach the person involved, and may suggest how the situation may be resolved.

You calmly work out a resolution. You will not yell or slam doors — your approach is controlled.

How to manage your anger: Continue to express yourself in a calm controlled manner and ensure you get some down-time — see friends and enjoy gentle exercise such as yoga.

— Dr Sarah Brewer


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