Introduction
Have you ever found yourself struggling to control yourself when you are angry? Do you feel as if anger is starting to impact you mentally and physically? Anger is an emotion that everyone experiences universally. Depending on how you express and feel anger, it can be both a good and a bad emotion for you. For example, anger can be a method to help you convey negative emotions. It may help address why you are feeling frustrated, and motivate yourself to seek solutions for challenges.
However, if you find it difficult to express and control anger or you find that the emotion is starting to impact your mental and physical well-being, it may need to be managed. Cognitive behavioural therapy (CBT) is a therapeutic approach to help address and mitigate the effects of anger. In this article, we will explore anger and CBT for anger management.
Understanding anger
Definition and components of anger
Anger is a negative emotional state and varies in intensity from a mild feeling of irritation to excessive feelings of rage. Depending on how you choose to express your anger, it can range in duration - you may feel this emotion from minutes to hours and even days in different intensities. Anger can be triggered by a variety of situations, circumstances, and multiple factors accumulating over time. For example, provocation, disrespect, perceived injustice, interpersonal conflict and stressful conditions.1
There are three main components:
- feeling anger
- expressing anger
- understanding anger
| Components | Explanation |
| Feeling anger2 | Anger is stimulated by unmet goals or needs. Seen as a crucial adaptive role in the context of survival over the course of evolution e.g., response to threat via fight-or-flight response. Physiological indicators in response to anger include increased heart rate, muscle tension, and changes in facial expression. Anger can be triggered through stimuli e.g., if you are feeling threatened, this signals the body and mind to confront this stimuli. |
| Expressing anger | In humans, changes in tone of voice, facial expression and body language play a role in confrontation. Displays of anger can include jaw clenching, crying, sulking, and physical, and verbal retaliation. |
| Understanding anger3 | When you are angry, what your body feels through physical indicators does not last very long, but dwelling on angry thoughts can extend the duration of the anger you feel. Anger can reduce the ability to process information clearly, which can impact cognitive processes and decision-making. There can be various processes and different factors that are involved and contribute to anger escalation. Strategies to control and regulate anger can include distancing yourself from the threat. However, this may not be possible in some cases where there is a strong stimulus of provocation, so bypassing cognitive processes and control leads to aggression. Furthermore, anger control can be difficult for some individuals with intellectual disabilities or neurodevelopmental disorders. In some cases, anger might not be the solution to every problem. It is important to understand the reason and mechanisms behind this to entrust yourself with the ability to control and manage your anger. |
It is essential to recognise how an individual feels anger, how they express anger, and understand their anger in order to help manage and promote a healthier emotional response, especially in individuals where anger is affecting life.
Basics of cognitive behavioural therapy (CBT)
Overview of CBT principles
CBT is a treatment that helps an individual change their cognitive thinking and behaviour - an individual’s way of thinking and their actions. The process involves exploring your thoughts, emotions, and behaviour and how all of these concepts are interconnected. CBT is a method that assists individuals by promoting and developing positive thoughts and behaviours that help reduce distress.4
Collaboration between therapist and individual
CBT can be described as a collaborative effort between a therapist and an individual with the aim of changing an individual’s way of thinking and behaviour, which can help to improve mood and way of life. Establishing a trusting relationship is important to implement appropriate treatment protocols for problems.5
Focus on identifying and changing negative thought patterns
One of the key principles of CBT is identifying and modifying negative thought patterns within an individual. By learning to recognise, understand and challenge these patterns, individuals can gain better control over their emotional responses, particularly in the context of anger.4,5
Key concepts in CBT for anger management
Automatic thoughts and cognitive distortions related to anger
Automatic thoughts and cognitive distortions are an individual's immediate thoughts and interpretations of events. Understanding automatic thoughts and cognitive distortions is crucial to address anger. CBT helps individuals to recognise and reframe these thoughts and distortions that contribute to anger.5
The ABC Model
The basic principle around CBT is the ‘ABC model’ that follows the idea that by acknowledging and modifying responses to the environment can help individuals to improve their mental well-being. A stands for activating events, such as a stressful situation, B stands for beliefs surrounding the situation and ourselves, and C stands for consequences - the emotional and behavioural consequences that follow. CBT uses this model to aid in identifying the root causes of anger in individuals. The ABC model helps individuals understand their problems and assists in developing alternative responses.6
Recognising and challenging irrational beliefs
CBT encourages individuals to identify and challenge irrational beliefs that contribute to anger. Individuals can acquire healthier emotional responses by replacing these beliefs with more rational ones, alongside practising mindfulness and acceptance.5
Skills and techniques
CBT can involve the following skills and techniques for anger management:4
- Relaxation techniques, for example, deep breathing to reduce physiological arousal associated with anger
- Keeping a daily log for self-awareness
- Cognitive restructuring to attempt to change negative thought patterns
- Assertiveness training for effective communication
Anger triggers and coping strategies
- Identifying personal anger triggers and the consequences
- Developing healthy coping mechanisms, for example, learning how to regulate anger expression
- Role-playing scenarios to practise new responses to replace aggressive reactions1,3
Goal setting and monitoring progress
CBT treatment involves setting a goal that is mutually decided by the therapist and you. With the aim of having productive and therapeutic sessions, specific and realistic anger management goals are established. ‘SMART’ goals involve the idea of goals being: specific, measurable, achievable, realistic and time-limited.
These also include regular self-assessment and reflection, and adjusting goals based on progress and challenges.1,4 Anger management in everyday life involves generalising skills to various situations, for instance, to overcome anger-provoking situations and developing a relapse prevention plan to guide challenges and maintain progress.4
Evaluating treatment progress
Evaluation of CBT for anger management involves:1,4,5
- Monitoring progress and setbacks through homework
- Regular assessments and feedback from both therapist and individual
- Adjusting treatment plan based on evolving needs
- Celebrating successes and milestones in anger management
Summary
- In summary, CBT is a therapeutic method that allows individuals to be counselled by a trained professional
- CBT for anger management encourages self-reflection and personal growth by helping individuals think about their thoughts and behaviour
- CBT sessions can use several skills and strategies for individuals to develop a healthy coping mechanism and response towards anger-provoking situations
References
- Sukhodolsky DG, Smith SD, McCauley SA, Ibrahim K, Piasecka JB. Behavioral interventions for anger, irritability, and aggression in children and adolescents. J Child Adolesc Psychopharmacol [Internet]. 2016 Feb 1 [cited 2024 Jan 17];26(1):58–64. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4808268/
- Alia-Klein N, Gan G, Gilam G, Bezek J, Bruno A, Denson TF, et al. The feeling of anger: From brain networks to linguistic expressions. Neuroscience & Biobehavioral Reviews [Internet]. 2020 Jan 1 [cited 2024 Jan 17];108:480–97. Available from: https://www.sciencedirect.com/science/article/pii/S0149763419302167
- University US. Helping children understand and manage anger [Internet]. [cited 2024 Jan 17]. Available from: https://extension.usu.edu/relationships/research/helping-children-understand-and-manage-anger
- Fenn K, Byrne M. The key principles of cognitive behavioural therapy. InnovAiT [Internet]. 2013 Sep [cited 2024 Jan 17];6(9):579–85. Available from: http://journals.sagepub.com/doi/10.1177/1755738012471029
- Chand SP, Kuckel DP, Huecker MR. Cognitive behavior therapy. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2024 Jan 18]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK470241/
- Psychology Tools [Internet]. [cited 2024 Jan 19]. Abc model. Available from: https://www.psychologytools.com/resource/abc-model
