PTPC Emotive

Presentations to therapists for help with destructive anger seem to be increasingly common these days (Fauteux, 2010), with many clients coerced by workplace or family or mandated to come by the courts. Much of the time the problem anger occurs outside the therapy room and clients are at least minimally cooperative with their therapist in working to change how they deal with it. There is, however, another scenario in which therapists may be called upon to help clients deal with their anger. That is the situation in which the client gets angry in session and makes the therapist the target. While as mental health professionals we are trained to listen to clients who are expressing frustration, probably far fewer of us have been called on to de-escalate a situation in which a client is threatening violence to us. Would you know what to say or do in order to de-escalate from a client – or anyone – threatening to harm you if they don’t get what they want? Would you know – if all else fails – how to keep yourself safe in a violent situation? In this article, we share with you a set of responses for dealing with an angry person – safely – at each of seven levels of anger.

Fauteux’s scale of anger progression

Kevin Fauteux, Ph.D., social worker, and Clinical Director of the Derek Silva Community in San Francisco, has observed that encounters with angry clients seem to be more frequent and sometimes violent in recent times. He has developed a framework for managing such situations which identifies a progression of escalating anger and suggests responses which are appropriate at each level (Fauteux, 2010). We share his framework with you in the context of suggesting that, hopefully, you won’t have to call on it often (and certainly not on its higher levels of escalation), but that if you do, it is a way of responding which may best salvage an angry situation, returning to as calm and normalised an atmosphere as possible. Note that this framework is not for the purpose of long-term education and healing of clients with destructive anger who have agreed to work with you on their anger. Here we are only sharing responses that will help to calm a situation in which someone is spiralling out of control and keep you safe from physical violence.

The seven levels of escalating anger

Fauteux identifies seven levels, which we illustrate with the example of Felix, a 20-something client mandated to come do 10 sessions of anger management work with you instead of doing jail time for the assault of a fellow patron at a local bar. Felix is clearly given to understand that he must attend all ten scheduled sessions and cooperate with any homework or other tasks (plus adhere to several other conditions imposed by the court), or else his jail term (now suspended) will be reimposed. When Felix comes, he expresses gratefulness that he has been allowed to stay out of jail, and states that he does wish to handle his anger better, so he will try to work with you to learn what he needs to. You are delighted that he seems to be on board with what will happen, and you explain that the sessions are confidential, but not absolutely so. You add that, in this case, you are mandated to tell authorities – should they ask – the truth about Felix’s cooperation with the counselling; Felix states that he understands and accepts this condition.

All seems to be going well for three sessions, but then Felix unexpectedly misses both the fourth and fifth sessions, and does not respond to texts, emails, or calls. Shortly after his non-appearance at the two sessions, the corrections officer in charge of his case rings you asking if Felix has been attending all of the sessions. You are forced to admit that the last two have been missed. For the sixth scheduled session, Felix turns up. He has had a call from the corrections officer, who has informed him that, should he breach even one more aspect of his stay-out-of-jail conditions – no matter how small – he will be put immediately into jail, to serve the full term. Felix could present himself to you at any of the seven levels. Let’s see what his behaviour might look like – and what you should do in response – for each of them.

Frustration

If Felix comes in at the frustrated first level of anger escalation, he is angry and possibly yelling as a way of standing up for himself and ensuring that you see and hear his frustration. He is likely to feel that you slighted him or brought a potential jail term a step closer by telling the authorities that he skipped some counselling sessions. At this level of anger progression, Felix is not trying to control you; rather he is just “venting” frustration, so it is important for you to “get” why he is so frustrated. This means focusing not on the how of his expression of anger, but on the what. You need to validate him. This is not an admission that you think his shouting is appropriate or that you agree with it, only that you understand it; it is empathy: e.g., “I appreciate how upsetting this is for you, Felix, and I want to work with you to see how we can best deal with this situation”.

Defensive anger

The major shift in intensity of anger to this second level could be signalled by Felix – upon hearing your supportive acknowledgement (as noted above) – saying something like, “Screw your appreciation for how upset I am. Just sort it out for me!” Felix could be not only upset that he has corrections authorities threatening him with jail, but also that he may feel hurt or betrayed that you “put them onto him” by telling them that he skipped the sessions. So his yelling at this stage is not only because he is now in jeopardy of losing his freedom, but also because he feels somehow abandoned, disrespected, or betrayed. He thus uses anger to stand up to you in order to feel “bigger”. The person here has moved from shouting about frustration to yelling at you. Your job here is to listen to the “what” and the “how” of the yelling, and then to let the client know that you understand how they feel, but that shouting and/or swearing is unacceptable: e.g., “Felix, I know you’re really angry and that’s ok, but it’s not ok to yell at me.”

Difficult angry people

One group of angry people we sometimes deal with is constituted by those who are generally difficult: the ones that are always abrasive, argumentative, or obstinate. They tend to make unrealistic demands so as to always have something to complain about. Here the anger is about verbally “standing up to the other” in order to keep the other (meaning you) at an emotional distance; the consequent near-impossibility of relationship is preferable to you being able to hurt or disappoint them, which they see as inevitable. The main dynamic at this level is the person’s attempt to draw you into the anger, into a win-lose type of power struggle: a contest of wills and manipulation in which the client will feel in control.

If Felix begins to argue with you, saying – for example – that you screwed up his life with your “incompetence” and that you must “fix” it (say, by going back to the corrections officer and lying or something similar), your job is to recognise that defusing this level of anger happens first by you not getting dragged into it. Warning Felix that he won’t get what he wants if he keeps arguing with you inadvertently sets up a win/lose mentality in which you may believe you are refuting his difficult ways, but in actual fact, he has drawn you into his power struggle. If this occurs, you are likely to find yourself being compelled to win the argument rather than resolve the problem.

Instead, your goal will be to set up a win-win approach which does not make him feel like you’re trying to make him lose a contest of wills. You might here make statements like, “I’m sure we can sort this out, Felix, so let’s not argue about it.” You are able to take the wind out of the compulsion to compete with you when – despite what the person believed going into it – they find they are not in a contest with you.

Hostility

At this fourth level of anger, people are no longer merely using the angry energies to stand up for themselves; rather, they are now aggressively standing up against you. They may express less anger about what happened and become angry at you, cursing you not for what you do, but who you are. The maladaptive expression of anger as hostility is a verbal attack which is not trying to get you to listen; rather, it morphs from arguing (at the previous level) to bullying: from “you can’t push me around” to now “I will push you around”. It’s about control and about attempting to cruelly belittle or humiliate the other person (you), as opposed to earlier merely trying to compensate for the person’s felt humiliation. Here as anger defuser, you must walk a razor’s edge: not threatening the hostile person’s critical sense of control (making them think you are trying to take control from them), but also not allowing yourself to be intimidated by it. This is accomplished in two steps: 

1. You let the other person know that you understand the intensity of their anger and that you are not going to get them to stop bullying you simply by demanding it. Thus, if Felix follows up calling you an incompetent, uncaring “[enter insult here]” with statements that he won’t leave until you fix his issue by ringing the corrections case manager, your response is not, “I will not allow you to talk to me this way”. The first step, the recognising of intensity, goes more like, “Felix, I can see you really mean what you say!”
2. You let the other person know that, while you “get” the intensity of their feeling, you won’t be intimidated by it, nor can you be easily manipulated. You need Felix to understand both “I understand you mean business” and also that the hostility is unacceptable: “I get your message, but getting in my face won’t work with me”. You assert your control without making the client feel that you are trying to curtail their control.

Rage

At this fifth level, anger is not the problem; the problem is that it is uncontrollable. At earlier stages, a person might manage their anger by aggressively trying to control you. Now they explode in rage, losing all control. Where anger is not merely an extreme expression of a person’s angry feelings but an anger that the person can’t manage, it is rage. The DSM-5 refers to some people who are prone to rage as having “intermittent explosive disorder” (APA Dictionary of Psychology, 2020).

Weirdly, at this level the raging person needs your help to prevent their anger from spinning out of control. Thus, your task is to rein in their rage and restore the order that they cannot manage themselves, and you do it by staying in control yourself. Remaining calm demonstrates to the out-of-control person that you are not overwhelmed by the chaos of his anger and subtly sends the message that you will not let them be overwhelmed either. So if Felix should come to this level of raging anger, making statements such as that he “can’t take it anymore” or “This is making me crazy”, your approach is to: 1. Assure him that it’s going to be ok AND SO, 2. The rage has to stop.

This is not demanding that the person stop ranting. It’s more about letting him know that his out-of-control anger expressions can be and must be controlled. Thus, a statement to Felix might run something like, “Felix, this is manageable. We will work it out, but I need you to get hold of yourself.” Or alternatively, you could say, “I understand why you are angry, but I need you to control it a little.” Felix would need to understand that, without at least a bit of control, you would be unable to help him, and he might therefore lose all control.

Threats

If Felix’s anger, say at Level 5 (Rage) did not succeed in controlling you, he could re-double his aggressive efforts, possibly with statements such as, “I need those conditions rescinded or else I might just have to hurt someone” (presumably you). If pushing you around psychologically (as in earlier stages) didn’t work, he now could escalate to Level 6, where he threatens to physically push you around: mostly because he sees himself as being out of options to make you comply, apart from threatening. What should you do? Your list for de-escalation here consists of strong “do NOT do” actions as well:

You do not challenge Felix. A person in this situation would feel pushed into a corner upon meeting your aggressive response, and they would then have to follow through on their threats rather than “lose face” or look weak.

You do not want to look weak either, so your job is not to accept threatening behaviour. Rather, you acknowledge that you understand him: “Felix, I know you mean what you say . . .” – AND at the same time you let him know that you will not tolerate the threats – “. . . I also know you want this problem solved, so you need to stop the threats and let’s work on it.” Your job here becomes to help Felix see that he has choices, so you work with the side of him that can help engage in finding a solution before it’s too late.

You want to reinforce the idea that he has not reached a “point of no return”. You might say, “It’s not too late to settle this problem. You haven’t done anything wrong, so let’s put the gun away and figure it out.” You can also get him to think about consequences, such as by saying, “I know what you said, but think what would happen if you did it.”

You begin to look around. If you cannot de-escalate his threat, what objects in the immediate vicinity might you be able to use to defend yourself? Where are the doors and the windows in the room? You should try to position yourself so that you have access to exits and he is not between you and the best escape route.

Know that you do not have to wait until he attacks in order to call for help. Many organisations have a “code” phrase they can use so as not to alarm the threatening person into doing a rash action (such as firing the gun). Here you might say, for example, “Felix, I want to help you, but this situation is beyond my level of expertise/authority to deal with”. You then offer to summon a supervisor. Hopefully, your workplace/practice has a coded system, where you can use a non-alarming coded phrase, such as, “I’ll be late for my next appointment”: code for, “I need help here now!” One annual conference used to instruct attendees volunteering at the conference to call on the loudspeaker or in-room telephone, “Is NORA in the room?” NORA was an acronym for “Need Officer Right Away”, whereupon the hotel security would materialise immediately at the dialled-from location in the hotel.

You must keep calm, especially if you do not have the means to accede to the person’s demands. Thus you can say: “I want to help you, Felix, but guns make me very uncomfortable. Can you please put the gun away so that we can work at this calmly?” If you can’t de-escalate and you have to comply with his demands, so be it. Rewarding bad behaviour is preferable to ending up as a statistic. When all else fails, your primary concern needs to be safety.

Violence

Most angry people do not become violent. Hopefully, the strategies here will help de-escalate any angry client you might encounter before the encounter would escalate into physical violence. But sometimes anger does escalate into assault. The angry energies that, at earlier stages, energised Felix to stand up for himself now become energies which make him “stand up to knock you down”. In the first instance, the violence often has a goal: to get what he wants when nothing else will obtain it; he has reached a “boiling point” and when even threats do not work, he decides to hit or otherwise hurt you (which sometimes occurs with a warning and sometimes does not). At this level, you are about to be hurt; it is about to happen, and the situation is irreversible. De-escalation is no longer about defusing the anger; now it is about protecting yourself.

The first important thing is to remain calm (!@#!). If you can safely exit, do so. If you can call for help, do so. If you can do neither, what objects can you put between yourself and Felix? What barriers might protect you somewhat from the attack? If you are going to be hit, there are techniques – tactics from self-defence and other disciplines – that are helpful to know. Look into them now so that, should such a situation arise in the future, you are prepared to face it. Ultimately, you may decide to hit in return, as part of your self-defence. “Reasonable force” to protect yourself will likely be legal, but know that you will be hit back: probably much harder.

Conclusion

We don’t typically deal with such a grim, scary possibility as threats or violence to you from a client. We reiterate that most angry feelings don’t escalate into assault, and our sense is that many therapists will never need such information, as the vast majority of the time you and the anger client are probably dealing with tendencies toward anger which have manifested “out there”: outside of session. Beyond that, you may not agree with every detail of Fauteux’s progression. The general notion of escalation from frustration to violence is worth familiarising yourself with, however, in case you do find yourself, whether with a client or someone else, in a tense situation with the potential to explode.

Note: The material in this article is informational and does not show clients with destructive anger how to change their relationship with that emotion. Anger is a basic human emotion and a complex phenomenon; understanding how to re-calibrate the ways of dealing with it is essential understanding for both clinician and client.

References

• APA Dictionary of Psychology. (2020). Anger. American Psychological Association. Retrieved on 7 April, 2021, from: Website.
• Fauteux, K. (2010). De-escalating angry and violent clients. American Journal of Psychotherapy, Vol. 64(2), 2010, 195-213.

AIPC

It’s been over 2,500 years since Lao Tzu was around. His wisdom definitely stands the test of time, none more so than the 5 types of love.

The first 3 are ‘pathological contradictions’ of Love.

The last 2 are healthy expressions of it.

 

Possessive Love:

                

‘THAT IS, LOVING AN OBJECT BECAUSE WE ARE CAPABLE OF POSSESSING IT, OR AT LEAST BELIEVING WE POSSESS IT’

 

In the Tao they say that this is the lowest form of love, so much so it’s not really love at all. It’s the eternal quest for ‘things’ that we ‘must’ have. Be it money, material possessions or a partner. It’s the objectifying of people and things, think the Male chauvinist. This type of ‘love’ turns the pure, selfless act into a selfish and manipulative feeding of the ego.

 

We see this in the example of a Man and his ‘trophy wife’. He buys her things and says he loves her, but she’s merely a possession to him. Another sign of so-called ‘success’.

 

Codependent Love:

 

‘THIS IS ROOTED IN THE EXPERIENCE OF POWERLESSNESS AND EXPRESSES ITSELF AS AN ADDICTION TO CONTROL OR BEING CONTROLLED’

 

These relationships are far too common today. Think of the male who needs to control and know everything about his partner – where she is, where she’s going, where she’s been, who she sees, he checks her phone to see who she’s been messaging, he verbally abuses her and all her happiness and enjoyment must revolve around him. It’s possessive. 

Then from her side, she stays in the relationship because she’s become addicted to being controlled. She fears what will happen if she ever left, so she puts up with it.

 

It’s hard to see when she’s in it, but once she gets the courage to leave then we always hear “what was I thinking? Why did I stay so long?”

 

This is also a contradiction of love, but on a lesser level than the first, possessive type of love.

 

Romantic Love:

 

‘IT IS GENERALLY AN UNCONSCIOUS ESCAPIST ATTEMPT TO COMPENSATE FOR THE ABSENCE OF SELF-APPRECIATION’

 

This is the search for that ‘perfect’ mate. The one that will make everything ok in our world and make us ‘complete’.

These are two ridiculous notions. First, we’ll find someone who fits that ‘perfect’ image we’ve made up in our heads. And second, that we need someone to complete us.

 

We’re all perfect just the way we are. That imagined person in our head doesn’t exist so we’re just chasing a unicorn and trying to change people.

 

We’re already complete, just the way we are. So once we realise that we should set out to find someone that has also realised that they’re complete.

Then two complete people can come together and share their experiences of life. Not because they need that other person, but because they enjoy each other.

 

This is also a contradiction of love as it drives a wedge between the essential self and the imagined deficient self.

Subjective Love:

 

‘IT IS THE EXPRESSION OF A STATE OF LOVINGNESS. THERE ARE NO ULTERIOR MOTIVES, NO OBJECTS OF MATERIAL VALUE TO BE ACQUIRED. THE PERSON WHO EXPERIENCES THIS LOVE IS RELATIVELY WITHOUT ARMOUR’

 

This is the type of love where we’re not fixated on a single object or person. We’re not looking to possess, be co-dependent or change someone. Love is freely given and received.

 

This is a state of love where we start to live in harmony with all things. We start to love not just people, but plants, trees, rocks, animals, art, the sky, the stars…….the universe.

 

We don’t love with conditions, if someone doesn’t love us back that’s fine, we can still love them anyway.

Most of the time we have conditions on our love;

‘I’ll love you if you love me back’

‘I’ll love you if you’re there for me’

‘I’ll love you if you never leave me’

‘I’ll love you as long as you keep acting this way’

 

These aren’t real love.

When we drop the conditions we shed our armour, we live in harmony, we love everyone and everything just the way it is. We experience life in a loving way.

 

Become Love:

 

‘IT IS THE EXPERIENCE OF OUR TOTAL HUMANITY, STRIPPED OF EVERY SHRED OF ALIENATION, STRIPPED OF EVERY PREMISE OF AGGRESSIVE CIVILISATION. IT IS COMPLETE SELF AND SOCIAL ACTUALISATION’

 

This is the ideal state of being that Lao Tzu defines as pure love or the Great Integrity.

 

He describes it as a state that can not be reached as long as we live in an acquisitive society. Within civilisation, this pure love can only be dreamed of, sensed or tentatively experienced.

This type of pure love requires a transcendence of all the fragmentation that have defined our personal and social lives over the past millennia.

It is nothing less than the total liberation of each and all of us. For us to experience the universe on its own terms.

 

So according to Lao Tzu if we’re lucky we might get a temporary moment in time to feel the 5th love.

But the 4th is definitely attainable in this life and is something I feel we all should be aiming for.

 

LOVE YOURSELF AND OTHERS WITHOUT CONDITIONS.

 

Possessive Love:

                

‘THAT IS, LOVING AN OBJECT BECAUSE WE ARE CAPABLE OF POSSESSING IT, OR AT LEAST BELIEVING WE POSSESS IT’

 

This is the lowest form of love, so much so it’s not really love at all. It’s the eternal quest for ‘things’ that we ‘must’ have. Be it money, material possessions or a partner. It’s the objectifying of people and things, think the Male chauvinist. This type of ‘love’ turns the pure, selfless act into a selfish and manipulative feeding of the ego.

 

We see this in the example of a Man and his ‘trophy wife’. He buys her things and says he loves her, but she’s merely a possession to him. Another sign of so-called ‘success’.

 

Codependent Love:

 

‘THIS IS ROOTED IN THE EXPERIENCE OF POWERLESSNESS AND EXPRESSES ITSELF AS AN ADDICTION TO CONTROL OR BEING CONTROLLED’

 

These relationships are far too common today. Think of the male who needs to control and know everything about his partner – where she is, where she’s going, where she’s been, who she see’s, he checks her phone to see who she’s been messaging, he verbally abuses her and all her happiness and enjoyment must revolve around him.

Then from her side, she stays in the relationship because she’s become addicted to being controlled. She fears what will happen if she ever left, so she puts up with it.

 

It’s hard to see when she’s in it, but once she gets the courage to leave then we always hear “what was I thinking? Why did I stay so long?”

 

This is also a contradiction of love, but on a lesser level than the first, possessive type of love.

 

Romantic Love:

 

‘IT IS GENERALLY AN UNCONSCIOUS ESCAPIST ATTEMPT TO COMPENSATE FOR THE ABSENCE OF SELF-APPRECIATION’

 

This is the search for that ‘perfect’ mate. The one that will make everything ok in our world and make us ‘complete’.

These are two ridiculous notions. First, that we’ll find someone who fits that ‘perfect’ image we’ve made up in our head. And second, that we need someone to complete us.

 

We’re all perfect just the way we are. That imagined person in our head doesn’t exist so we’re just chasing a unicorn and trying to change people.

 

We’re already complete, just the way we are. So once we realise that we should set out to find someone that has also realised that they’re complete.

Then two complete people can come together and share the experiences of life. Not because they need that other person, but because they enjoy each other.

 

This is also a contradiction of love as it drives a wedge between the essential self and the imagined deficient self.

 

R. Hassan, TCFH

All human beings experience anger at least occasionally. It’s a natural emotion helping us recognise that we or someone or something we care about has been violated or treated badly. When we feel threatened or our goals are thwarted, anger is a coping mechanism that enables us to act decisively, especially in situations where there is little time to reason things out. It can motivate problem-solving, goal-achievement, and the removing of threats. It serves a protective function and is not always a problem (Lowth, 2018; Stosny, 2020; Zega, 2009).

But anger is a complex emotion, and all too often manifests maladaptively in peoples’ lives, when they perceive excessive need for protection, protect the “wrong” things, or use anger to thwart their longer-term best interests. The result is problem anger.

Perhaps because it is so multi-faceted, misperceptions about anger abound, and the question arises: how shall we regard anger? Folk wisdom often would say that the best thing to do is just let it all out, but is it? People complain that they cannot control it, that the tendency to be easily angered is inherited, but again, is there evidence for that? Here are common myths people tend to hold about anger, and factual statements following them identifying why learning to deal with problem anger is time well spent.

Myth 1: “Anger is inherited.”

This is the person that may try to claim that their father was short-tempered and they have inherited that trait from him, so there is nothing they can do. Such a stance implies an attitude that the expression of anger is a fixed, unalterable set of behaviours. Research shows, however, that expression of anger is learned, so if we have – say, through exposure to aggressive influential others, such as parents – learned to be violent in our expressions, we can also learn healthier, more appropriate, pro-social ways of dealing with it.

Myth 2: “Anger and aggression are the same thing.”

Fact: Nope. Anger is a felt emotional state. Aggression is a behaviour, sometimes carried out in response to anger, but not the same as it. A person can be angry, yet use healthy methods of expression without resorting to violence, threats, or other aggression. Anger does not always lead to aggression. In fact, some experts claim that most daily anger is not followed by aggression. When it does result in aggression the “I3 Model” (pronounced “I cubed”) is deemed responsible. This suggests that aggression emerges as a function of three interacting factors, which all begin with “I”:

Instigation, an event which instils an urge to aggress as a result of, say, being addressed rudely or learning that one’s partner has had an affair (or a relatively “minor” event, such as being cut off in traffic);
 
Impellance, meaning a force that increases the urge to act in response to an instigating stimulus. These could be strong hormonal releases or a belief system which says that the instigating event should not be tolerated, or even a sociocultural norm which demands that instigating stimuli be responded to immediately and harshly (such as punching back someone who has hit you);
 
Inhibition, referring to forces that typically work to counter aggression, such as cultural norms, awareness of negative consequences, or perspective-taking or empathy (Kassinove & Tafrate, 2019).

Myth 3: “Other people make me angry.”

Fact: How often in common parlance do we say things like, “He made me so angry!” or “You make me so mad I could kill you!”? Even though we may occasionally speak about people causing emotions other than anger, it is far more frequent to hear such statements in regard to anger. We can choose whether or not we let someone else’s behaviour make us happy, sad, or something else, but we often think and talk about it as if anger is caused directly by others. With the undiscerning listener, an angry person thus gets to use anger as an excuse for unacceptable behaviour. Ultimately, it is not the other person’s behaviour that causes our anger, and in fact, it’s not even their intention, though that may influence our behaviour. Being precise, we must acknowledge that it is our interpretation of their intention, expressed in their behaviour/language, which is causative.

Myth 4: “I shouldn’t hold anger in; it’s better to let it out” (either by venting or catharsis).

Fact: If by “holding it in” someone means that they suppress anger, it’s true; ignoring it won’t make it go away and squashing it down is not a healthy choice. Neither, however, is venting. Blowing up in an aggressive tirade only fuels the fire, reinforcing the problem anger. Ditto the use of pillow-punching or other means of catharsis; this may come as a surprise to therapists trained a few years ago, when catharsis was an anger management technique in good standing. Now researchers have found that, even though we feel better in the moment after hitting something, our brain notices, subtly changing its wiring. Then the next time we are angry it softly whispers, “Hit something; you’ll feel better”. The time after that, the wiring is stronger in the brain towards a hitting catharsis, and the angry-brain-voice speaks a little louder. Continuing in this vein means that eventually, we could decide to hit something more alive than a pillow. Rather than either angry venting or catharsis is the use of skills to manage the angry impulse.

Myth 5: “Anger, aggression, and intimidation help me to earn respect and get what I want.”

Fact: People may be afraid of a bully, but they don’t respect those who cannot control themselves or deal with opposing viewpoints. Communicating respectfully is a far superior way to get (most) people to listen and accommodate one’s needs. While the momentary power that comes with successful intimidation may feel heady in the moment, it does not help build the healthy relationships that most people coming to counselling yearn to have.

Myth 6: Anger affects only a certain category of people.

Fact: Anger is a universal emotion that affects everyone. It does not discriminate against people of any particular age, nationality, race, ethnicity, socioeconomic status, education, or religion. It is tempting for some people in the educated middle classes to believe that anger is more prevalent among the poor, or those who are less educated or lacking in social skills. Reality does not bear this out, although the expressions of anger do vary among different social groups. Remember, anger is just an emotion, one which does not make people “good” or “bad” for having it.

Myth 7: “I can’t help myself. Anger isn’t something you can control.”

We don’t always get to control the situations of our lives, and some of them may trigger our anger. In fact, we don’t (in the short-term) control whether we have angry feelings or not; they just come – although there are longer-term ways to work on them that sees them less easily provoked, and therefore less prone to have the experience of anger. What we do have is the short-term choice to control how we express that anger. Sessions with a therapist for the purpose of learning how to better handle anger means having more choices of response, even in highly provocative situations.

Myth 8: “When I’m angry I will say what I really mean.”

Fact: This is rarely true. Uncontrolled angry expressions are more about gaining control of or hurting others, not saying what a person’s deepest truth is. 

Myth 9: “By not saying what I’m thinking in the moment, I’m being dishonest and will be even angrier later.”

Fact: There is a strong pull to “speak our mind” when angry. But it is at this time that a person’s judgment is most severely flawed. To speak from anger is to allow the impulsive part of the brain to overrule the rational part. Better for relationships, career, and pretty much everything else to wait until that reasoning part can regain control.

Myth 10: “Men are angrier than women.”

Fact: The sexes experience the same amount of anger, says research; they just express it differently. Men often use aggressive tactics and expressions, whereas women (often constrained culturally) more frequently choose indirect means of expression, such as found in passive-aggressive tactics. This could mean getting back at someone by talking negatively about them or cutting them out of their lives (categories adapted from: Therapist Aid LLC, 2016; Segal & Smith, 2018; Morin, 2015; Morrow, n.d.; Better Relationships, 2021; Gallagher, 2001).

Thought for reflection

Anger has many facets to it, and we have introduced some information here that may seem either startling or counterintuitive. As you think back in what ways, if at all, might your views about anger have shaped how you behave? How you respond to others? 

And here’s the ultimate question: How might hearing these myths help you seek more adaptive ways to deal with problem anger? 

References:

1. Better Relationships. (2021). Common myths about anger. Anglicare Southern Queensland. Retrieved on 13 April, 2021, from: Website.
2. Gallagher, E. (2001). Anger. eddiegallagher.com.au. Retrieved on 13 April, 2021, from: Website.
3. Kassinove, H., & Tafrate, R.C. (2019). The practitioner’s guide to anger management: Customizable interventions, treatments, and tools for clients with problem anger. Oakland, CA: New Harbinger Publications, Inc. 
4. Lowth, M. (2018). Anger management. Patient. Retrieved on 7 April, 2021, from: Website.
5. Morin, A. (2015). 7 myths about anger and why they’re wrong. Psychology Today. Retrieved on 13 April, 2021, from: Website.
6. Morrow, A. (n.d.). Anger myths. Stress and Anger Management Institute. Retrieved on 13 April, 2021, from: Website.
7. Segal, J., & Smith, M. (2018). Anger management: Tips and techniques for getting anger under control. Helpguide.org. Retrieved on 9 April, 2021, from: Website.    
8. Stosny, S. (2020). Beyond anger management. Psychology Today. Retrieved on 9 April, 2021, from: Website.
9. Therapist Aid, LLC. (2016). Anger warning signs. Therapist Aid LLC. Retrieved on 7 April, 2021, from: Website.
10. Zega, K. (2009). Holistic Psychotherapy (159). Retrieved on 7 April, 2021, from: Website. 

AIPC

What is Loss?

Loss is being parted from someone or something that is really important to you. Loss can come
into our lives in lots of ways, and it affects each of us differently.

What is Grief?

There are a number of definitions about grief, including –
“… intense sorrow, especially caused by someone’s death.” ~ Google and Oxford Dictionaries
“… keen mental suffering or distress over affliction or loss; sharp sorrow; painful regret.” ~ Dictionary.com
“… deep sadness caused especially by someone’s death.” ~ Merriam-Webster

What Types of Loss can Cause Grief?

Honestly – any type of loss can cause grief as grief is a reaction to a loss.

Understanding and Managing Grief

There are a wide variety of ways to grieve that differ by the griever’s personality, beliefs, cultural background, and other factors as grief is an individual experience to a loss.

“The pain of the soul and heart is much more powerful that the pain of the body”

The Prophet

Understand and allow yourself the space to feel any or all of the following as they are feelings felt when grieving:

• A constant fog over your thinking
• Memory and concentration problems
• Trouble keeping track of belongings
• Fatigue, muscle pain, headaches, stomach trouble, chest pain
• Lack of initiative, inability to perform usual functions
• Irritability, mood swings, anxiety, anger and frustration
• Fear of performing even familiar activities
• Feeling hyped up, wired; exaggerated startle response
• Disorientation
• Nightmares, trouble falling asleep or staying asleep
• Unpredictable bouts of crying
• Avoiding friends and family, hiding out
• Despair, fears about a desolate future, helplessness
• Appetite changes
• Constant yearning, pining for what you have lost
• Sighing repeatedly
• Regret, guilt
• Feeling visited by a lost loved one
• Change in sexual interest
• Idealizing or waiting for return of a loved one
• And much more

Above all, if you experience thoughts or plans about suicide, call for help at once. 

What about the time-worn advice to let go and get on with your life, to shed your baggage and let go of your past?

You don’t have to. You don’t have to let go of who or what you are grieving. You get to keep the keep the parts you can and transform your relationship with the rest.

How can this work? 

In between face-to-face visits with loved ones, you carry around your experience with the person, and a deep knowledge that allows you to make predictions about what they would say to you about what is going on in any moment. In fact, you often hear their voices in your head even when you least expect.

There is no reason to give this up. 

There is no switch to pull that will make it all right. The job in grieving is to reassemble a life piece by piece until it starts to make sense. Including the imprint of who and what you have held dear will help provide continuity and meaning. 

Every day of grief can be a challenge, but it will be a better day for your effort to engage with it. Creating a set of daily practices will strengthen you to handle it in the best possible way.

Possible practices could be:

For your body – you need to become an expert in self-care. You already know what soothes you, so build it in to each day. Physical exercise can trigger chemicals that increase a sense of well-being, and when will you ever need that more? If it is too much to even get yourself out of the chair, recruit a member of your support team to join you.

​For your mind – do what you can to clear and calm it. Embrace mindfulness, or remaining in the present moment, no matter how you are feeling. If you feel sad, or quiet or blah, stay with it and let the present moment be what it is. It will move on and so will you. Meditate, spend time in nature or with a pet, garden, listen to music, watch firelight, or visit an art museum.

​To tend your emotions – which may be all over the place day to day, or even moment to moment. Talk with someone regularly, just to stay in touch. If you can manage at least one conversation each day, even just a brief check in, you will keep your connections open for the times when you most need them. There are great benefits to putting your feeling into words. For starters, your friend can listen and truly hear you, and you can hear yourself.​

For your spirit – practice expression each day, through writing, storytelling, drawing, painting or scribbling, or other activities that you might lose yourself in for a while. If you have religious practices that comfort you, set aside time for them.

Living with Grief

Resilience is a choice, and daily actions put it in motion. The more you can manage to take action, the more imagination, creativity and optimism you will unleash. Some days the initiative you need won’t seem to be there, and you may have to strong-arm yourself to act, or borrow the energy from someone else.

A profound loss also brings a new attention to various areas of your own life. Depending on which stage of life you are in, this will be expressed in different ways. Young people may find direction. Those in midlife may be moved to examine how they have lived while they can still make adjustments. Older people may take the opportunity to look back and make sense of their lives.

A loss reaction can occur, being able to acknowledge and accept the significance of a loss is important.

It is important to remember that grief and loss is complex and a few insights to remember are that we all respond to changes in our life in different ways – there is no right or wrong way to grieve. There is also no timeframe to grieving.

References:

Kübler-Ross, E. (1969). On Death and Dying: What the dying have to teach doctors, nurses,
clergy, and their own families. New York, USA: Scribner.
Worden, W. (2009). Grief Counselling and Grief Therapy – A Handbook for the Mental Health
Practitioner. New York, USA: Springer Publishing Company.

Waves of Grief & Habits for Wellbeing

All human beings experience loss of some sort; indeed, “suffering is part of the divine idea” (Beecher, n.d.).

Many of us also experience trauma, which is a deeply troubling and painful experience, such as involvement in a natural disaster, combat, personal violence, or the death of a child. Sometimes people can get through the various stages of grief and ultimately move forward with life after loss or trauma. But often, it becomes too much to bear without clinical help.

While many of the counseling approaches noted above are applicable, methods that are especially appropriate for treating trauma and loss are outlined below.

CBT is frequently used to treat loss, as well as trauma resulting in post-traumatic stress disorder (PTSD). For example, Prolonged Exposure Therapy was designed to treat PTSD.

With this approach, the therapist combines repeated in vivo and simulated exposure to enable the patient to experience trauma without the feared outcomes. This technique is considered by many clinicians as the best option for PTSD (Van Minnen, Harned, Zoellner, & Mills, 2012). Additionally, exposure that utilizes virtual reality headsets is also effective at treating PTSD (Powers & Emmelkamp, 2008).

Interpersonal Therapy is an additional option for those dealing with trauma and loss. Interpersonal Therapy examines symptoms related to loss through the lens of personal relationships.

Bereaved clients undergoing Interpersonal Therapy also may be guided in establishing new relationships (Wyman-Chick, 2012). Although often used to treat depression, research also has indicated that Interpersonal Therapy is a practical approach for PTSD (Rafaeli & Markowitz, 2011).

Another approach for treating loss, trauma, and PTSD is Eye Movement Desensitization and Reprocessing (EMDR). EMDR is based on the idea that psychological distress is the product of traumatic events that have been inappropriately processed.

The EMDR approach involves stimulating the brain’s information processing system while painful events are being recalled. Such stimulation may include eye movements, hand tapping, or listening to tones (Shapiro & Solomon, 2010). It is believed that the bilateral stimulation applied during EMDR enables the client to reprocess connections between memories and emotions.

Scientific research has indicated that the EMDR approach is valid for treating PTSD (Shapiro & Solomon, 2010).

Attending support groups is another approach that has the added benefit of creating a place in which clients are supported by those who can genuinely empathize with their feelings. Feelings of relatedness are often comforting for those who have felt isolated in their grief.

Support groups are not for everyone, as they do require the ability to interact with multiple people about painful life experiences. But for those who are ready and able to share in this way, they may enable participants to form deep bonds with others and benefit from multiple perspectives, as opposed to that of just one therapist.

Overall, these approaches only represent a few examples of counselling techniques designed to help people through stress, trauma, and loss. Various additional techniques are available (e.g., Spiritual Counselling, Hypnotherapy, Stress Inoculation Therapy, etc.) based on the client’s needs and preferences.

H.S. Lonczak, Ph.D.

Those who are completely happy have put themselves in that position because anything other than happiness just isn’t acceptable. They made sacrifices and worked hard until they reached the level of happiness they were striving for.

It all comes down to identifying what it is that you want, formulating a plan to get there and then working hard until you reach your desired goal. It has nothing to do with luck.

I am a great believer in luck, and I find the harder I work the more I have of it. — Thomas Jefferson

If you are unhappy, you currently have two options: You can complain about it and hope it magically changes, or you can set out to make a change. For the latter, here is a simple four-step plan to help you achieve happiness. If you are unhappy you owe it to yourself to make a change — life is too short to delay any longer.

1. Determine why you are unhappy.

There are several reasons why you could be unhappy — you could be working a job that you don’t truly love, working with people you don’t enjoy being around or doing something you are over-qualified for.

It might not be work related at all — you might be in a dead end or unhealthy relationship. There could be a million different reasons, and it’s up to you to identify them. Whatever they are, just know that you aren’t going to find true happiness until you first single out what the problem is.

2. Change your attitude.

The first thing I mentioned above was the “FML” and “Ugh, I hate Mondays” social media status updates we all see on a regular basis — that type of attitude sets the tone. If you are constantly filling your head with a negative outlook, what do you expect will happen?

Negative thoughts breed negativity and unhappiness, while positive thoughts breed positivity and happiness.

When it comes down to it we are all responsible for our own happiness. The only way you will be happy is by changing your attitude and understanding that you are in full control, and fully capable of changing your situation.

3. Create a plan to reach happiness.

When you know why you are unhappy and are armed with a positive attitude, you can start to devise a plan to achieve happiness. This is where many people hit a mental roadblock and self-doubt enters their minds.

“I’m not going to find a better job.”
“I wont find someone else.”
“I’m too old to start a business.”

Excuses are made to justify remaining miserable. If you are serious about truly being happy you need to push all self-doubt out of your mind and commit to developing a plan to become happy. Determine what your ultimate end goal is and reverse engineer the steps you will need to take to reach it.

4. Take action and don’t look back.

With your plan outlined it’s time to move forward and never look back. Simply taking action doesn’t guarantee results — your journey to happiness could include mistakes, rejection and disappointment. But if you don’t take action there is only one guarantee, and that is your situation will never improve and you will remain unhappy.

Happiness isn’t going to happen overnight — you have to continue to push forward, regardless of how difficult it may appear.

A pessimist sees the difficulty in every opportunity. An optimist sees the opportunity in every difficulty. — Winston Churchill

If you need a little motivation or a support group remember that surrounding yourself with like-minded people is key.

J. Long

The choice of therapy depends upon various other factors, such as the client’s specific symptoms, personality traits, coexisting diagnoses, family dynamics, a preferred way of interacting with the therapist, and treatment goals.

Depression

Several types of counseling are useful at treating depression, such as Behavioral Therapy, Cognitive-Behavioral Therapy, Interpersonal Therapy, and Mindfulness-Based Cognitive Therapy (Jorm, Allen, Morgan, & Purcell, 2013).

Behavioural Therapy for depression is a good fit for someone who needs help getting involved in activities and behaviours that are inconsistent with a depressed mood. The individual’s cognitions would not be the target of a behavioural intervention; rather, the client would be behaving their way out of depression.

On the other hand, a CBT approach would contain behavioral elements in addition to a focus on faulty beliefs and thought patterns contributing to depression. CBT is the most researched type of treatment for depression, with many studies supporting its efficacy (Jorm et al., 2013).

Mindfulness-Based CBT combines CBT with the element of present-moment awareness of how ruminative or wandering thoughts relate to depressed thinking (Jorm et al., 2013). Interpersonal Counseling involves working with the client to identify aspects of interpersonal relationships that contribute to depressive symptoms.

Overall, there are several effective approaches for treating depression, elements of which may be combined or modified to meet the client’s unique needs.

Anxiety

Anxiety treatment may also involve any of the above approaches; however, CBT is the most widely used approach for treating anxious symptomatology. CBT counselors working with anxious clients will tailor therapy to the individual needs of the client and make modifications based on their progress (Hazlett-Stevens & Craske, 2004).

CBT occurs in a variety of forms and may include different components.

Exposure Therapy is a type of CBT that is commonly used to treat anxiety disorders. This technique involves exposing the client to their feared object or situation. Such exposure is typically gradual, with the exposure beginning with less threatening stimuli and gradually working its way toward increasingly feared stimuli.

When systematic desensitization is used, gradual exposure also involves relaxation techniques as a way of pairing the feared stimulus with a state that is not compatible with anxiety.

Flooding exposure involves having a client confront their fears all at once (not gradually), based on the idea that without engaging in avoidance, the patient’s fear will be extinguished (Abramowitz, Deacon, & Whiteside, 2019).

Exposure Therapy also may include in vivo exposure (exposure to an actual feared object), simulated exposure (exposure to a proxy of a feared object), or virtual reality exposure (exposure to a highly realistic virtual space).

CBT comes in many forms, and it is generally regarded as a highly effective approach for treating anxiety (Butler, Chapman, Forman,  & Beck, 2006; Deacon & Abramowitz, 2004).

H.S. Lonczak, Ph.D.