Archive for October 15th, 2011
How do anger disorders develop?
It’s hard for us as individuals to take a truly objective view of problematic anger and its causes. Anger and fear are primary, inborn emotions. We take them granted, as a fish takes water for granted. We have been swimming in these feelings all our lives.
Anger, aggression, and violence have plagued humanity throughout history. Philosophers, psychologists and legislators have struggled with the perplexing issue of anger from their various perspectives. Recent advances in neuropsychology, cognitive science, and evolutionary psychology have enhanced our understanding of the cause of anger issues. Clinical psychology has developed new strategies and techniques for the treatment of anger problems.
I would like to help you understand the natural as well as the psychological causes of anger from the modern perspective of psychological science. Accordingly, I will discuss the natural basis of rage and aggression in terms of the fight or flight response. We will list a number of significant etiological factors which have been observed by clinical psychologists and counselors working with anger management issues. Finally, we will outline neurological, cognitive behavioral, and psychodynamic process contributing to the development of an anger disorder.
Evolutionary psychologists inform us that anger and rage are behavioral tools of human survival. The fight-or-flight reaction is hardwired into the brain to help us protect ourselves and those who matter to us. Physiological psychologists have learned that when it is triggered, it causes us to be propelled into a highly focused, energized state.
The upside of anger and rage is that they enable us to better defend ourselves or to frighten off an aggressor. This automatic, protective reaction works well in nature or in war. It is appropriate and useful when there is an actual threat and something worth fighting for.
There is a very unfortunate downside of anger, however. Anger and rage reactions can create enormous problems, especially when we fail to realize when threats are merely psychological and the stakes are not worth fighting about. Here is an example.
James spots his wife, Sarah, just as two criminals are about to knock her down and rob her. She is clearly terrified, like a deer in the headlights.
James is immediately frightened for her safety. He is not a particularly impulsive, angry, or aggressive man. He is not large or athletic. However, in the briefest instant, he becomes completely enraged. He finds himself charging at them, his face red and ugly, roaring profanities, arms flying out to grab them. He scares them off. Sarah feels relieved and grateful.
Later that day, James has just calmed down, but Sarah is still agitated. She had never seen him so angry, and she is taken aback. He does not notice that she is still distressed. She senses this and feels alone in her lingering upset. She suddenly snaps at him and accuses him of foolishly exposing them to assault.
James is stunned. He feels rejected, hurt and criticized. He is like a deer in the headlights and can’t speak. Her reproach baffles and then angers him. He curtly dismisses her point of view. Now Sarah feels disregarded and unfairly attacked as well.
They quarrel in an escalating manner, talking past each other. They both feel resentful and misunderstood. James starts to feel helpless and flooded with emotion. He gets up to leave. Sarah feels like he is running away and rejecting her. She jumps up and blocks the way, refusing to let him go.
Now, James feels helpless, flooded and, trapped. Something in him snaps, and he erupts into righteous anger and rage. Sarah becomes terrified and tearful, and James instantly calms down. He is filled with remorse but blames her for his outburst.
When James was rescuing Sarah, he was in a frightening rage… and acted like a hero. An instinctive rage reaction provided the energy and courage he needed to protect his wife from an actual threat. However, a similar anger reaction, when directed at her, was clearly inappropriate and abusive.
This second incident has the potential to be as traumatizing as the earlier one. How can James have acted so aggressively towards the woman he loves?
Both of them were emotionally vulnerable: on edge and physiologically aroused. When Sarah reproached him, he felt disrespected and his sense of self worth plummeted. His emotional pain triggered the same rage response as a real life or death situation. He experienced her as a threat and reacted with anger.
In many cases like this, we mistakenly react out of a psychological hurt or a threat. Psychological triggers include fear of abandonment, rejection or humiliation. Subjective threats to our sense of self worth, pride, or emotional security can mistakenly spark the fight or flight response and cause anger, rage and harmful, aggressive actions.
Anger management psychologists identify a variety of key factors in the development of dysfunctional anger reactions.
- Negative attitudes towards our self, or negative expectations of others, can increase our sense of vulnerability.
- Fear of asserting oneself can cause resentment to build into passive-aggressive hostility or rage reactions.
- Under-developed emotional regulation (ER) skills (e.g., impulsivity) make it harder to contain mounting anger.
- A psychological history of being unloved, rejected, abandoned, or dominated can prime us for anger responses.
- A traumatic history of witnessing abuse or being abused can produce an automatic panic or rage reaction.
- Family or peer role models may teach us to use anger inappropriately: for control, power, payback, or status purposes.
- The failure of loved ones and friends to provide immediate feedback and appropriate consequences enables patterns of abuse to take root.
In general, any psychological state, physiological condition, or situation which increases stress or reduces self control can indirectly contribute to angry behavior or an actual anger management problem. Examples include alcohol and substance abuse, insomnia, illness, fatigue, emotional overload, overwork, or over-stimulation (flooding), unemployment, underemployment, and burn-out. Chronic pain and anger, depression, and a feeling of self-pity or helplessness tend to go with anger.
What is the developmental process by which we go from coping with occasional anger to suffering from an anger control problem or an anger disorder?
Anger management problems develop more easily when we live in a state of anxiety, tension, or depression. These emotions prime us to feel vulnerable. They get us ready to perceive a threat whether actual danger is there or not.
Anger produces a self defeating cycle of harm. For example, it most often starts when our pride is wounded, or we feel emotionally threatened or hurt by people who matter to us. We may react (or retaliate) with anger and inflict harm upon them in turn. This typically results in a negative reaction from others and an inner sense of guilt or shame.
Sometimes we try to justify ourselves by blaming others or circumstances for our behavior. This leads to further harm to our relationships and our self esteem. We feel worse and become angrier. This negative feedback process continues and escalates. From this point forward, hostility, rage, or violence can destroy relationships, marriages, families, and careers.
Why would anyone persist in such painful, self-defeating behavior? The psychology of developing an anger disorder seems convoluted and counter-intuitive. Isn’t it a rule of human behavior that we seek pleasure and avoid pain? True, but behavior that is driven by survival instincts appear to be the major exception to the rule.
I doubt that many species ever died off through being too careful, anxious, or aggressive. In the interest of survival, nature has biased us prey species towards fearfulness and caution. That is, when we are triggered, we tend to look too keenly for harm, and we tend to over react to signs of danger.
In discussing the psychology of rage reactions, we have seen how a false, subjective or psychological threat can trigger the fight response. So we can misread the significance of a possible threat, react impulsively and without considered judgment, and not recognize it at the time. Adrenaline is flowing and we are primed to run or do something aggressive, if only to scream. This is what can happen when we have a horrible fight with a spouse. Fear and/or anger hijack the brain, impairing our judgment, and skewing perception and memory.
We tend to have an impaired recall of what really happened because our cerebral cortex was briefly offline at the time. In the case of a rage reaction, we may not be able to recall details unrelated to our fear or anger. That makes it easy to deny or rationalize inappropriate and harmful things we may have said or done. Afterward, our anxiety, shame, pride or resentment may make it difficult for us to hear another person’s version of the event. So, we under-estimate and fail to appreciate the negative impact of our angry or aggressive behavior on others.
When we are upset, in emotional or physical pain, or feel frustrated or threatened, we are in a state of acute stress. When we are stressed like this, anger can temporarily make us feel somewhat better.
When we express anger, it lets us shift from feeling helpless, afraid, depressed, tired, or hurt, if only for a little while. We may immediately experience a sense of energy, relief, focus, or empowerment. This relatively good feeling reinforces the habit of anger.
Each additional instance of angry or aggressive behavior reinforces a mindless fight response. With each repetition of rage, anger reduces the likelihood that we will respond more thoughtfully next time. Self-pity, a form of self-nurturance gone wrong, gradually replaces self-reflection and self-worth. Thus, we make things worse for ourselves and get more and more dependent upon anger for coping with upset feelings.
At times, we may feel low, down on ourselves, or helpless. We may get bored, lazy, or passive. Some people need to get angry in order to get things done. For some individuals, anger can act like a stimulant drug that gets us energized, distracted or jazzed.
Anger can become a habit, but can we properly speak of an anger addition? From a functional point of view, definitely. Like a chemical addiction, addiction to anger:
- is accompanied by emotional release or relief
- is compulsive and hard to resist
- makes one feel better for a little while but worse latter
- weakens coping skills and self-esteem
- harms health, relationships, family, and career
- perpetuates itself through self-pity and denial
- is hard to give up
Drug dependency and addiction to anger both produce chemical and neurological changes in the brain and get people stuck.
Denial of an anger problem is evident when we refuse to acknowledge what is obvious to people who know us and even to unbiased observers.
We can’t solve a problem if we refuse to recognize it. Why do we tend to resist the demand for necessary change? The prospect makes us feel uncomfortable or helpless. For example, we may feel unequipped for the change, or we may be afraid to give up something and try something new.
We may resist facing reality due to a misplaced sense of pride. That is, we don’t want to admit that we are “wrong” or have failed ourselves or others in some way. Some people half-way admit to having problems with controlling angry feelings or aggressive behaviors. However, they may try to justify their actions and lay the blame elsewhere. Blaming puts the solution to a problem beyond our power to solve or heal.
We actually may resent legitimate demands that we change, even when it is in our interest to do so. Misguided self justification keeps our sense of injury in focus. Unfortunately, this self-defeating cycle eventually leads to rejection by others. This can lead to self-pity and a victim mentality which further fuels our anger.
Anger management counseling can provide the concepts and tools to replace denial, blame, and victimization with real solutions.
Read Full Post | Make a Comment ( None so far )Surprising Reason You Might Not Like Sex!
Do you find yourself so full of worries throughout the day that you can’t concentrate? Do you always fear that something bad will happen to someone you love? Do you consider yourself a “worrier”?
If your life is full of anxiety, your sex life will suffer mightily too. And you probably do not recognize the connection between your level of daily anxiety and your disinterest in sex.
Ask yourself, are you anxious, worried, or panicky. If so, take the time to make plans to get treatment for anxiety disorders which are ruining the quality of your life. There are many different anxiety disorders, and there are excellent sites on the internet which can help you decide if you have one.
GAD (generalized anxiety disorder) is characterized by long periods chronic anxiety and worry, which you can’t control. Sometimes, the anxiety has specific focuses, such as work, relationships, finances, looming deadlines, or potential problems in your life or the lives of others. Other times, you will feel anxious, but not be able to figure out what you are actually anxious about.
Generalized anxiety disorder affects four to five million Americans and research shows that it affects about two women for every one man (Brawman-Mintzer O, Lydiard RB, 1996), with the median age of onset occurring during the early 20s.
(Rickels K, Schweitzer, E., 1990.)
One of the little recognized side effects of GAD is the chilling effect it has on a woman’s sexuality. Typically, women with GAD do not even recognize that they have a psychological problem. They just think of themselves as “worriers.” They tend to come from families of “worriers” as well, so they tend to believe that their emotional lifestyle and their thinking patterns are normal.
In more than 30 years in clinical practice, I have never met a woman in a stable, long term relationship who has untreated GAD and who is able to enjoy sex! Generalized anxiety disorder is poison for women’s sexual pleasure.
There are several reasons why this is so. They are all related to the GAD- woman’s inability to control her own thoughts and to focus her positive energy toward her sexual self for a sustained period of time. Being a sexual person is not just a natural process. Many times it is a learning process, and it takes focus. Let’s take a look at how sexual relationships unfold for women without GAD and compare it to the process when a woman does have GAD.
In the beginning, the experience of being in love is the same for all of us, male and female, GAD-sufferers or not.
Many of us have had the experience of falling in love. In the early stages of being in love, men and women have basically become deluded. One of my friends used to say that people in love are in a psychotic state. We believe, insanely, that we have just found the PERFECT person, the person we were meant to be with.
We believe that IF we are united with that person for good, the rest of our life will be just as we wanted it to be. We feel we are destined to be with that person and with no one else. We are desperate when we are separated from them, and devour them greedily when we meet up again. We lose our appetite for food. Our appetite for sex with them is insatiable. We often can’t wait to touch them. We don’t know if they love us as much as we love them. We’re obsessed with the idea of being with them.
When we are first in love, powerful chemicals are released in our body, which make us crave our beloved’s touch and inflame sexual desire. (Fisher, 1992) This desire needs no coaxing—it just “is.” The process is so powerful it eclipses the worry process of GAD. Sex is great.
But eventually, for all of us, GAD sufferers or not, if we do wind up with the person with whom we were so besotted, we get used to them! Their newness wears off, chemically. Their newness wears off psychologically, too, and we see their little quirks and faults. At this stage, the phenomenon of unremitting sexual desire changes too, particularly for women.
As men and women know, or are learning, women’s sexuality is not exactly the same as men’s sexuality. In fact, it is quite different, especially in long-term relationships. Many men, especially young men, continue to have a sexual drive that has a mind of it’s own. Desire comes unbidden, sometimes in the midst of a flurry of other necessary activity (like getting ready for a vacation, or doing your taxes….), or in the middle of a time of little or no emotional connection between the two of you.
Past the falling in love stage, most women report that even if they love their partner madly, there may be less of an experience of intense, out-of-the-blue “lust” for their partners that pulls them out of their daily lives and demands to be satiated. At times, it is more as if desire appears on little cat feet, a soft feeling of psychological and physical anticipation of sharing pleasure with a loved partner. That desire and arousal needs to be nurtured psychologically, and it needs to be nurtured physically.
You might wonder what I mean when I say that desire “”needs to be nurtured physically.”
For many women, past the falling-in-love stage, arousal depends on a long period of non-genital touch. While men tend to like to have their genitals touched early in the lovemaking process, women often like to have other parts of their bodies caressed to have their arousal build. For instance, many women love to have their necks kissed, or have their hair played with.
Most women have non-genital areas of their body which they feel good about, which vary from woman to woman, but which hold a lot of potential for pleasure. Many women love the sensations they get from kissing and petting.
I have talked about touch (1998) as one of the primary “Milestones of Sexual Development.” Learning to enjoy sex is something we originally learn, if we are lucky enough to learn it, in our families of origin. Not by being sexual with our parents or siblings, of course, but by learning to associate safe, non-genital, affectionate touch with feelings of safety, relaxation, pleasure, trust and love (SexSmart, A.Zoldbrod l998).
Some of you readers did not learn to enjoy affectionate touch in their families, and you need to take steps to learn what kind of touch you like. (Zoldbrod, 1998; Heiman and Lo Piccolo, 1988). It takes time and being able to focus on yourself to learn what kind of touch you enjoy. Some women with GAD may be surprised to discover, in reading this, that they aren’t sure of what kinds of touch they like, because they can’t relax enough to touch themselves, or to enjoy exploring touch through massage.
Without an enjoyment of non-genital touch, the vast majority of women in ongoing, loving relationships will not be able to become aroused enough to orgasm. Genital touch alone doesn’t give we women the whole-body charge we need to really enjoy sex.
The tricky thing is, sex isn’t that simple. To have good sex with an ongoing, beloved partner, you have to be able to teach your partner where you like to be touched, and you, yourself, have to learn to relax, let go of control, and focus on the pleasurable sensations.
In Sex Smart, I call this process “floating,” because it is such a pleasant, altered, hypnotic sensation.
In order to build excitement, a woman needs to float and feel safe in her body and let go of control— to focus deep inside her body, to concentrate on sensation, and to let her partners’ touch build up feelings of physical and sensual pleasure.
Unfortunately, GAD women are too anxious to give up control. And the GAD prevents the sense of floating, because unbidden thoughts intrude and do not allow the focus on pleasurable sensations. Relentless thoughts such as: “ Did I lock the door?” “What is that pile of laundry doing on the floor?” “Do I look fat from this angle?” prevent a focus on building up pleasurable sensation.
In other words, all women have to learn to let themselves shut out the world and “float” to have sexual pleasure and intense sexual arousal. GAD prevents women from ever being able to get to the “floating” state to begin with.
All women are distractible sexually and GAD women can’t focus at all. In Sex Talk (2002), I talk about the fact that all women tend to be distractible sexually, and what to do about it. Even women without GAD who do know how to “float” can be distracted during lovemaking. It takes focus to stay in the floating state and build up a good sexual charge.
“Men and women are different sexually in some very important ways. One of them is that once aroused, men have what is called “the point of ejaculatory inevitability. “ That means that at a certain point in a man’s arousal, he will orgasm, pretty much no matter what else comes into his head. He could have a fleeting thought about his taxes being due, what a pain his boss is, his son needing lessons on how to drive a car, or his need for a fresh haircut, but these thoughts would not be enough to prevent him from ejaculating. This accounts for why more men than women consider sex to be “relaxing”. No matter how stressed men are, once the point of ejaculatory inevitability is reached, their physical release is assured.
“Women, on the other hand, are much more distractible. It can sometimes be more work for women than men to become aroused in the first place, and it is certainly more difficult for women to stay aroused. There is no point of inevitable orgasm for women. Instead, women can get distracted and lose their arousal at any point in the sexual encounter.
“Once arousal is lost, women need to start to build their arousal all over again from the beginning. This is why (I) always encourage women to think of pursuing their own arousal and orgasm as if they were “Taking a Great Dane for a Walk.”
“If orgasm is a woman’s goal, she has to take control of her sexuality and her thoughts and not let her unconscious wander. Just imagine that you are becoming very aroused and then visualize yourself stopping yourself from getting caught up in (….other thoughts…) You need to be talking sex to yourself and nothing else. You need to grab that Great Dane and yank it back on the path to sexual pleasure.”(pages 92-93, SexTalk).
By definition, women with GAD cannot control their fleeting thoughts of worry, distraction, and doom. Their minds always are full of a to-do list, and a “to-worry-about” list, that keeps them from even being able to get that Great Dane on a leash!
Because GAD women can’t “float” or focus on sexual thoughts or sensations, they never feel all that aroused sexually. Being with a loved partner might feel good in a psychological kind of way, or mildly pleasurable, like getting a massage, but it never feels electric or exciting. This is why typically, GAD women aren’t all that interested in sex. Without the true pleasure of high arousal and orgasm, the sexual experience might not be any more enticing than a nice day of gardening!
Perhaps you feel, in reading this, that getting over your GAD and learning to enjoy sex sounds like quite a lot of work. You believe that other people just “naturally” feel good about their sexual selves, that their ability to feel sexual pleasure just arose naturally. They didn’t have to “try” to be sexual, so why should you? Well, the big secret about sexuality is that it does take some work, and it does need to be learned. There isn’t a woman on the planet who likes sex who didn’t put time and effort into her own self exploration. And GAD is quite treatable. So why not put yourself at the top of your agenda and do something which will improve the quality of your life?
GAD responds very well to cognitive behavioral therapy, a very specific, dynamic psychotherapy which involves more than simply talking about the symptoms. Psychologists, most notably David Barlow PhD, have researched and developed specific treatment programs to help people with GAD learn to change the way they assess the world and change their anxiety-causing thoughts.
Treatment is an active process. As the patient, you must be fully committed to doing a series of exercises and to keeping journals of your thoughts for three or four months. If you are motivated, the CBT treatment is usually successful in that time period.
Sometimes medication if helpful for people with GAD, but for many people it isn’t necessary.
When shopping for a therapist, however, make sure that the professional has had specific training in cognitive behavioral training therapy for generalized anxiety disorder.
http://www.sexsmart.com/article_gads.htm
