ANGER IS NOT A FOUR-LETTER WORD

Robert E. Alberti, Ph.D., FAPA

112th Annual Convention of the American Psychological Association

Honolulu, Hawai'i -- July 30, 2004

 

Expressing your angry feelings in an assertive—not aggressive—manner is the healthiest way to express anger. To do this, you have to learn how to make clear what your needs are, and how to get them met, without hurting others. Being assertive doesn't mean being pushy or demanding; it means being respectful of yourself and others.
                                                                                                                           -- APA Website

There are dozens, maybe hundreds, of folks out there talking about anger as if they knew something about it.  The myths abound. I assure you that you can count on one hand (well maybe both hands) the number of researchers and practitioners whose ideas about anger you can trust.  You've just heard from four of them.  Let me add just a few more: 

            Carol Tavris, Ph.D., social psychologist, whose book, Anger: The Misunderstood Emotion is still the best overall examination of the topic.

            Donald Meichenbaum, Ph.D., clinical psychologist, distinguished professor emeritus, and a pioneer of cognitive behavior therapy, whose writings are legend and need no introduction here.

            Redford Williams, M.D. (psychiatrist) and Virginia Williams Ph.D., (cultural anthropologist), authors of the landmark book, Anger Kills.

            Michael Leeds, Ph.D., professor at University of Oregon, whose work may not be familiar to you, but will be.

That said, I'm going to elevate myself to that level for the next few minutes.  After that, you can decide whether my work deserves that lofty perch.  Maybe I get a few points for having been at it for 35 years?  

We've established that anger is a normal, and essentially healthy, human emotion. We know enough from brain research over the last twenty years to recognize that it is a universal, primary (not secondary) emotion that has had considerable survival value for our species over the eons. 

Physiologically, the brain researchers tell us, an anger-producing stimulus will have specific and rather predictable effects in the body.  (This session is sponsored by Division 42, so we won't take time to go into the neurophysiology here -- which is a good thing, because I really don't understand it fully myself!)  Check out the work of Antonio Damasio for an update on brain-behavior research. (Apologies to our colleagues who may be on the cutting edge in neuropsych -- Damasio is the guy who's getting his stuff out there.)

What really matters about anger is what you do with it. It is not always appropriate to express angry feelings!" Choose your battles" is a worthwhile slogan in this context.  And, for the record, so-called "cathartic" expression of anger is not healthy; we do not advocate it.

It's not too much of a stretch to say that one's behavioral response to anger is learned, and can be as habitual -- and therefore harmful or helpful -- as any other habit.  I don't have to tell this audience how tough it is to change habitual responses.  Ray and Howie and Chip and Jerry have given us lots of examples of that.  We can teach lots of new behaviors and strategies for anger management, but eventually it comes down to generalization and transfer of training.

What I'd like to do in the brief time we have left is to offer some specific techniques that I think you'll find helpful in improving your clients' ability to modify their cognitive and behavioral response to anger stimuli.  In short: to train them in effective assertive expression of anger, when it is appropriate to express angry feelings.  (As I mentioned, it's not always so.)  This is pretty basic stuff, folks -- it's not cognitive neuroscience (although much of it is informed by the cutting edge work in that field) -- but it will help you to have it pulled together in the context of this discussion of clinical tools for dealing with anger problems.

OK.  It's always good to start a discussion of anger with a deep breath…

Contrasting Styles of Behavioral Expression
Let me start with the framework that has served me well for thirty-five years. Building on the foundation laid by Arnie Lazarus and Joe Wolpe in the 1960s, Mike Emmons and I have written and talked a lot about the differences among non-assertive, aggressive, and assertive behavior. Briefly,
   +   non-assertive behaviors are self-denying, inhibited, unexpressive, conforming -- "You win, I lose"
   +   aggressive behaviors are self-aggrandizing, uninhibited, explosive, controlling -- "I win, you lose"
   +   assertive behaviors are self-enhancing, expressive, cooperative, equalizing -- "I win, you win"

In evaluating whether a response is assertive or aggressive, I've developed a simple useful schema I call the "CRIB":
            Content  -- what you say
            Response -- how the other person responds
            Intent -- your goals in expressing yourself
            Behavior -- how you say it

Cognitive Procedures
Now let's talk a bit about some of the cognitive procedures that are valuable for clients who are wrestling with anger issues. Inevitably, there are some overlaps with what you've already learned from Ray and Howie and Chip and Jerry. Here are four frameworks you may find helpful in providing a cognitive rationale to your clients:
   (1)  Is it worth it?  It is not always in your best interests to express your angry feelings.  Remember to take a deep breath, pause, reflect for a moment about how important it is to do something about the situation -- and what the consequences may be -- then, if it still seems right, to go ahead in an assertive -- not aggressive -- manner.
   (2)  Are your goals negative or positive?
            Negative Goals for anger expression
                        Hurt or Punish
                        Revenge
                        Hit back
                        "Teach a lesson"
            Positive Goals for anger expression
                        Express your feelings
                        Get the other to change
                        Establish limits
                        Model assertiveness (e.g., for kids)
   (3)  Can you express your anger assertively (i.e., not non-assertively or aggressively)?
            (See definitions above.)  

Behavioral Procedures
Now let me move to the behavioral side of the equation.
 
Behavior rehearsal, feedback, coaching, and behavior shaping form the heart of the process of developing appropriate assertive responses to an anger stimulus. The eventual goal is self-management, of course.
 
The first step is to sensitize the client to the specific components of her/his behavior.  Here's a list familiar to clinicians who have employed behavioral interventions:
            Components of behavior -- verbal and non-verbal
                        Eye contact
                        Facial expression
                        Body posture
                        Gestures
                        Distance and/or physical contact
                        Voice tone, inflection, volume
                        Fluency
                        Timing
                        Listening
                        Content (choice of words)

I'm reminded of a favorite story told by a professor of education at San Diego State University over thirty years ago.  Uvaldo Palomares, a Latino of relatively small stature, told of his teen years picking cotton in Southern California . The idea, of course, was to get as much as possible as fast as possible, since they were paid by the pound. His story went like this (not his exact words, of course):
"I would haul my bag up to a row of cotton which looked particularly full of the stuff, and, just as I started to pick, some guy about twice my size would beat me up and take over the row.  I decided I'd learn how to fight better so I could handle these guys.  I found out that Karate was the way to do that, since a little guy was not at such a disadvantage.  So I went to Karate school and learned all the right moves.  Finally, when I felt confident, I tried it out in the field.  Started up a particularly abundant row of cotton and, sure enough, the big guy showed up.  I took my most menacing Karate stance and went on the attack.  Within about fifteen seconds, we were rolling in the dirt and he was beating the tar out of me, just as before."  

Dr. Palomares' point, and mine, is that learning to mastery takes practice.  In a crisis -- and angry situations are often crises -- we automatically go back to the old ways, unless the new have become habitual.  Teach your clients the skills they need to express their anger assertively, and help them to build social support and self-reward for continuing to practice those skills until they become automatic -- so they're not rolling in the dirt when a crisis comes.  

References

Robert E. Alberti, Ph.D. and Michael L. Emmons, Ph.D., (2001). Your Perfect Right: Assertiveness and Equality in Your Life and Relationships (eighth edition). Atascadero, California: Impact Publishers.

Antonio R. Damasio, M.D., Ph.D. (2003). Looking for Spinoza: Joy, Sorrow, and the Feeling Brain. New York: Harcourt.

Jerry Deffenbacher, Ph.D. and Matthew McKay, Ph.D. (2000). Overcoming Anger: A Cognitive-Behavioral Protocol for the Treatment of Anger. Oakland, California: New Harbinger.  

Raymond DiGiuseppe, Ph.D.  Assessment, Diagnosis and Treatment of Clients with Anger Problems.  Mentor, Ohio: Lima Associates.

Michael Leeds, Ph.D., "Anger, Hostility, and Aggression." Presentation at the Annual FACES Conference, Seattle, Washington, May 21, 2004 .

Howard Kassinove, Ph.D., and R. Chip Tafrate, Ph.D. (2003). Anger Management: The Complete Treatment Guidebook for Practitioners. Atascadero, California: Impact Publishers.

Donald Meichenbaum, Ph.D., (2001). Treatment of Individuals with Anger Control Problems and Aggressive Behaviors: A Clinical Handbook. Clearwater, Florida: Institute Press.

Carol Tavris, Ph.D., (1989). Anger: The Misunderstood Emotion. New York: Simon and Schuster.

Redford Williams, M.D. and Virginia Williams Ph.D. (1993). Anger Kills. New York: Times Books.