By Dr Steve Last, Edinburgh
The basic hypothesis of Cognitive Behavioural Therapy, or CBT, is that our emotions are greatly influenced by our cognitions. Or, put in plain English, "we feel what we think".
Anger is, of course, a very common emotion and as such is not necessarily a problem. Getting angry occasionally can be entirely appropriate - I think we can all empathise with people who are angry because their car's been stolen or someone's spreading rumours about them. But anger can get out of hand - either through becoming too frequent or becoming too intense - and this certainly can be a problem.
And in today's hectic lifestyles, anger can seem to be on the rise. Whether or not it is (in reality) increasing, there is certainly plenty anger-related crime reported in the media, perhaps the most obvious being the notion of "Road-Rage". As a therapist in Edinburgh I see plenty of clients that have some difficulty in controlling their anger. Often the anger appears situational - often being related to a stressful working enviroment - but it can be more generalised as well. And yes, I have seen people with "road-rage". Even a beautiful city like Edinburgh can't avoid the rush-hour jams (especially not since the tram-works started...)
When anger is causing an individual problems (in their relationships, occupation, or with the police etc), CBT therapists will often call it "dysfunctional". The causes of dysfunctional anger - like any other emotional problem such as depression or anxiety - can usually be traced back to the way a person thinks. In CBT parlance, a person exhibiting dysfunctional anger will often show particular "Thinking Errors" that predispose him to anger.
Most people that have anger problems show "Inflexible Thinking". That is, they live by a varying number of rules that they've set for themselves and for others. These rules may not even be obvious to the person, but when they're broken they will feel intensely angry. An example of a rule might include "People must always drive as well and as courteously as me". Obviously it would be nice if everyone did drive like you, but they're not going to, so you're in for a lot of rule-breaking and hence a lot of anger! A CBT therapist would help the individual to identify this unhelpful rule, and help the person develop a more flexible way of thinking.
Having "Poor Frustration Tolerance" is another feature of dysfunctional anger. People can convince themselves that they can't stand any discomfort and inconvenience at all, no matter what it is or what the possible benefits in the long run might be. You may really want to see Madonna in concert, but the queue for tickets is "too long" and you "can't stand" queuing anyway. So you leave in a huff, and then kick yourself repeatedly over the next few weeks as your friends get more and more excited over the upcoming gig! A CBT therapist can help you learn to "frame" inconveniences and discomfort in a less emotive way, increasing your tolerance levels and lessening your self-defeating anger.
People with dysfunctional anger are often in the habit of "Labelling" others. That is, they are in the habit of describing (both to themselves and others) people or situations in just a few words - often just one! So a job is "irritating" and a work colleague "annoying". Whilst such a way of thinking and talking scores points for brevity, it must surely be inaccurate - is every aspect of the job "irritating"? Is the work colleague always, 100% "annoying?" Probably not. By labelling situations and people in such a way you can predispose yourself to anger problems as these situations and people are always in your "bad books", regardless of what they do. So a minor slip up here or there and you're primed to jump down their throats. A CBT therapist will endeavour to help you regard other people and situations as more complex than this, allowing them (and you) room for error without causing anger.
The above thinking errors are those that I've most commonly encountered whilst working as a therapist in Edinburgh. CBT is an effective psychological treatment for a whole host of psychological and emotional problems, ranging from Anorexia to Trichotillomania.
Dr Steve Last is a Psychiatrist who uses CBT techniques. He is based in Edinburgh. Please visit http://www.drstevelast.co.uk for further information about psychological problems and CBT.
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