Introduction
Here are two articles description options to help individuals cope with anxiety.
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Stress Management – Your Options: Anger Management
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Introduction |
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The Goal of Anger Management Therapy |
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Assertive Action Versus Aggressive Action |
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Group Therapy Strategies |
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The Negative Effects of Anger |
Social workers can be instrumental in helping people control their anger problems. Over the years, in my practice many individuals have attended 10-week group therapy sessions. They each have their own stories, but they each have paid a heavy price for their anger.
The were many reasons why someone might seek anger management therapy:
- Committing violent acts.
- Verbal abuse and short temper causing problems in a marriage.
- Problems dealing with one's in-laws.
- Court mandated anger management therapy resulting from neglect or abuse of one's children.
The Goal of Anger Management Therapy
The goal of anger management is not to eliminate the anger, but to use it as a signal that there is a problem or issue that needs to be addressed. Individuals in the group are taught how to slow down their arousal when angered, so that it can be processed and acted on in a proper way without the negative consequences when it is uncontrolled.
Often anger is secondary to other emotions like hurt, loss and disrespect. It is important to figure out what these underlying feelings are if a proper solution is to take place.
There are many triggers that can set off anger episodes. When anger is intense our ability to think is hampered. We often react immediately and worry about the consequences later. This can be dangerous and can make us feel ashamed and guilty later. Many times old immaturities from our childhood can be triggered. Reacting in anger just keeps us stuck in the past and decreases our ability to mature. Knowing what triggers anger can be useful so that we can attempt to avoid those triggers, or learn better coping skills to deal with them.
Assertive Action Versus Aggressive Action
An important aspect of anger management is to replace aggressive action with assertive action. Many people in the group are very confused about what effective assertiveness is like. Many have made anger a habit and cannot understand that conflict can be dealt with in a win-win scenario that is the hallmark of being properly assertive.
The group is taught how to discuss things verbally with others, and to use "I" messages in order to express to others in a non-offensive way what is bothering them.
Group Therapy Strategies
Members of therapy groups are often asked to complete homework assignments. There are readings that they have to do as well. Early on they are asked to complete an anger management plan for themselves so they can pinpoint what they need to work on. Plans are then revisited at the end of the group. The group members are also asked to complete an anger log of weekly events in order to increase their awareness of anger, and focus on their feelings, actions and thoughts.
There is a strong emphasis in the group on understanding the relationship between thoughts and anger. Often what we tell ourselves is what we believe to be the case. When it comes to anger we usually apply very illogical or unreasonable thinking, and often very unhelpful thoughts about the situations in which we find ourselves. We often have unreasonable expectations that may trigger our anger, and sometimes make what should only be our preferences into "shoulds" and "musts". The group is taught ways to challenge their angry thinking, and replace negative talk with positive and reasonable messages that are geared towards problem solving.
The Negative Effects of Anger
Anger can be very damaging to the body. Long episodes of stress from uncontrolled anger can have very negative effects. The group members are taught skills for relaxation as well as ways to express anger safely.
Anger that is not acted upon but rather accumulated can contribute to a passive-aggressive expression of anger, or even to depression. Parts of the lessons of the group are to find ways to improve self-esteem, and to endure what is often a very stressful and hectic life. The group discusses ways to learn greater tolerance, improve empathy, and to forgive when necessary in order to let go and move on.
Other important topics for the group include domestic violence, child abuse and road rage.
A key element to the group is the mutual support that each member provides to the other. Members often make very useful suggestions to others about what has worked for them and how others should appraise or deal with a difficult situation.
Each group is unique in many ways but I always find the experience rewarding. Many times the changes are dramatic and can be very beneficial. If families can come back together and marriages can prosper and if others can be kept out of jail than it has all been worthwhile.
Related Articles:
Depression – Your Options: Antidepressants: Love ‘Em or Leave ‘Em?
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Introduction |
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Reactive, Biological, and Mixed Depressions |
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Advances in Antidepressant Medications |
NOTE: The author is a licensed, clinical social worker who provides outpatient behavioral medicine services for children, adolescents, and adults.
Introduction
Some of the most frequent questions I am asked by clients involve the use of antidepressant medications. Clients often either think that antidepressants don’t really work (“They just give those pills to anybody!”), that they should be able to feel better without any medication (“I don’t need a pill to feel OK!”), or that antidepressant medications are somehow dangerous and/or addictive.
While not everyone needs or would benefit from antidepressant medication, some individuals have depressions that will only respond to medication. The benefits of appropriately treating these depressions far outweigh any potential risks. The key lies in being able to identify who needs treatment with medication and who does not.
Recent years have seen remarkable breakthroughs in the science of psychopharmacology – the use of medications in the treatment of mental and emotional disorders. These advances are especially evident in the treatment of depression. However, the effectiveness of antidepressant medication depends on the specific type of depression and symptoms experienced.
Reactive, Biological, and Mixed Depressions
Many individuals will experience what's generally thought of as a reactive depression at some point in their lives. This type of depression is a direct response to something that is obviously causing stress in a person's life. The depression can range in intensity from mild to severe, but basic physical functions such as sleep and energy levels remain relatively unaffected.
Others may experience a biological depression. With this type of depression there is obvious stressful or worrisome situation that can be identified as the cause of the person’s depression. This type of depression can result from medical illnesses, female hormonal fluctuations, medication and recreational drug use, or biochemical imbalances in the brain, which cause physiological symptoms.
These conditions can cause actual chemical changes in the brain, which affect specific areas of physiological function such as sleep cycles, appetite, energy levels, concentration/distractibility, and short-term memory. Attempting to “talk” or simply “will” these symptoms away is as incomplete a treatment as is attempting to control diabetes or high blood pressure without medication.
However, most depressed people suffer from a mixed depression. A mixed depression starts as a reactive depression. However, the person may soon develop the kind of physiological symptoms seen in biological depressions.
Advances in Antidepressant Medications
There have been significant advances made in recent years regarding antidepressant medications, and there are several effective and relatively safe alternatives available. All antidepressants work by altering levels of neurochemicals in the brain, but different "families" of medications act in different ways. (These medications are only available with a doctor's prescription.) Generally, the antidepressants affect one or more of the primary chemicals in the brain believed to be related to the symptoms of depression. These brain chemicals include norepinephrine, serotonin, monoamine oxidase, and dopamine.
One of the newer categories of antidepressants called selective serotonin reuptake inhibitors, or SSRI’s for short, have been widely used due to their relatively mild side effects and few drug interactions. The most common side effects of these drugs are nausea and an upset stomach, sleepiness, and problems with sexual function. However, these effects are generally mild and short-lived. None of the antidepressants are addictive, although there has been evidence of some people who abruptly stop taking their SSRI's rather than tapering off them experiencing some negative side effects for a relative short period of time (a few days).
A physician will prescribe an antidepressant based on a person's physiological symptoms. While antidepressant medication can be very successful in treating the physiological symptoms of a depression, it does not address any underlying sadness or sense of loss. For those symptoms, psychotherapy is the treatment of choice.
So, when my clients ask me about antidepressant medications, I try to provide them with the same accurate and complete information that I would expect to receive. I also tell them that, overall, antidepressant medications are safe and effective in the treatment of the physiological symptoms of depression and, when combined with psychotherapy, can often make all the difference in the world.
The opinions expressed in this article are those of the writer, and do not necessarily reflect those of the National Association of Social Workers or its members.
