What is anger?

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Anger, a feeling of great displeasure and hostility toward others, has received modern research attention since the 1930’s. The emotion is due to mental and physical processes related to perceived attacks on beliefs, values, and expectations, as well as to psychiatric conditions such as paranoia. Anger responds to psychological counseling and medication.
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The modern definition of anger is a feeling of great hostility, displeasure, or exasperation toward other persons. The experience of anger is perceived as being beyond any conscious reason, because emotions are reflexive, involuntary experiences rather than purposeful acts. To be angry is not a conscious choice. It happens when an experience causes a change in biological and mental states. Anger is caused by both mental and physical stimuli. Its mental components are thoughts, beliefs, expectations, and values. Anger’s physical components are changed biostatus, such as increased heart rate and blood pressure. These stimuli will differ in extent from person to person.

Anger occurs in all people. Psychologically, two things must occur to cause anger: people must form a belief that others have committed misdeeds that have wronged them, and they must assign blame to others, who are targeted for retribution. Anger is therefore a reaction to the actions of others and a judgment of the cause of those actions. To become angry, one must see an action of another person as intentional mistreatment. Whether this is true is irrelevant; the perception of mistreatment causes the anger response. The causes and expressions of anger vary with age and gender. Most frequently, anger is based on feeling unable to right wrongs committed against one, perceived violation of one’s principles or values (such as honesty), physical or verbal attacks on one’s self-esteem, and actions preventing the attainment of goals that are perceived to be correct.

A great many situations can cause anger. Some are created by psychological disorders, while others are more normal but may become excessively severe. Anger in the case of psychological disorders includes the anger of paranoids and of some people experiencing depression. The more usual instances of anger include anger at a spouse, anger at an employer, anger at a friend, and anger due to a situation caused by a stranger (such as road rage and aggression). Manifestations of anger will range from rage responses to anger suppression. Rage leads to screaming at others, striking them, and destroying property. Suppressed anger can lead to depression. Rage and depression should be treated professionally.

The Biology of Anger

Biologically, human anger is a response of the nervous system to stresses, demands, threats, and pressures. When people are faced with a threat to survival, their nervous systems quickly, automatically meet it by raising body defenses in a fight-or-flight mechanism. The fight-or-flight response, identified by Harvard physiologist Walter Bradford Cannon in the 1930s, occurs whether life events require greatly changed lifestyle or are minor irritants. The nervous system does not await a conscious interpretation of an event, but simply reacts via the sympathetic nervous system, which is designed for immediate defense responses. The system trigger is the release of the hormone epinephrine (adrenaline), made by the adrenal glands located atop each kidney. Epinephrine causes dilation of the pupils, elevated heartbeat rate, increased blood pressure, rapid breathing, release of sugar into the blood by the liver, and movement of blood into the skeletal muscles.

These responses lead to arousal and readiness to fight or flee. Pupil dilation increases the ability to see danger and differentiate it from normal events. Increased heartbeat drives blood through the cardiovascular system more rapidly than usual. This hastens hormone and nutrient passage through the body, engendering swift signaling by hormones and bettering the readiness of skeletal muscles to be used in a fight or flight. The rerouting of blood and the increased heartbeat result in increased blood pressure, which, over the long term, endangers the body. However, if experienced infrequently and over a short time period, it is not dangerous.

Elevated blood sugar levels and rapid breathing are also related to anger. Elevated blood sugar content, circulating rapidly to all the tissues, provides the energy needed for skeletal muscles to engender the fight-or-flight response mechanism and better allows the brain to coordinate these actions. The increase in the breathing rate is essential to the use of the energy in the blood sugar, because sugar is converted to energy most effectively through respiration, a process that requires a large amount of oxygen. Respiration results in the production of carbon dioxide, water, and energy—the latter consumed by the fight-or-flight response.

It is crucial to find ways to handle or defuse anger, because, over the long term, mismanaged anger can lead to many disease conditions. These include heart disease, ulcers and other gastrointestinal disorders, frequent headaches, and susceptibility to microbial infection. The basis for such problems is the changed levels of hormones, other than epinephrine, caused by the experience of anger. Most often cited are the increased levels of testosterone in men and corticosteroids in both genders. Long-term elevation of these hormones increases occurrence of atherosclerosis (coronary artery disease). Excessive amounts of body corticosteroids (such as cortisol) depress the action of the immune system, damaging the body’s first line of defense against infectious diseases.

Problems related to epinephrine and its close relative norepinephrine are related to the fight-or-flight response’s ability to elevate heartbeat rates, raise blood pressure, release liver sugar into the blood, and enhance blood entry into skeletal muscle. When mismanaged or untreated anger causes these responses to occur too often, the liver is unable to remove blood cholesterol; this adds to the buildup of fat deposits in the heart and blood vessels (atherosclerosis). Elevated blood pressure results in a heart that overworks itself, becoming larger and less efficient.

Diagnosing Anger

Almost everyone is angry at times, regardless of gender or age. Some individuals are subject to such frequent rage that they seek—or are sent to—a physician or psychotherapist for treatment. However, many individuals do not recognize their anger and blame reactions caused by it on job dissatisfaction, unsatisfactory marriages, dislike of minorities, and other life problems. Often, such anger will remain unnoticed until they visit a counselor or psychotherapist for help in such matters and it is suggested that they need to treat their anger with psychotherapy or medication.

There are many schools of thought on diagnosing and treating anger. Although the tools used for treatment differ, diagnosing, measuring, and evaluating anger are most often accomplished by administering assessment forms crucial to devising treatment. Diagnosis of severe anger is often occasioned when an enraged or depressed patient is admitted to a hospital emergency room or psychiatric ward and queries by physicians lead to psychiatric evaluation. More often, an angry individual seeks counseling for reasons ranging from marital or work-related problems to tiredness and general mental malaise. Psychotherapeutic consultation will then lead to diagnosis of anger. Some patients visit psychotherapists or counselors because they themselves recognize that they are angry too often or excessively belligerent.

Anger Treatment Options

Anger associated with depression, extreme rage and belligerence, and the passive-aggressive state may be treated with tranquilizers, hormones, and antidepressants. In such individuals, medication is often followed by combined psychotherapy and medication as an inpatient in a hospital ward. More often, it is accomplished by means of medication and periodic outpatient visits to a psychotherapist or counselor.

There are many different schools of thought concerning anger treatment for people who are not overly belligerent, severely depressed, or in other states in which they will severely harm themselves or other persons. Some therapists recommend leaving the site of an anger outbreak until calmed down. Others suggest psychotherapy that identifies the basis for the anger (such as events in childhood) and gives curative insights. Still other psychotherapists, such as Albert Ellis and R. Chip Tafrate, propose techniques such as rational emotive therapy and similar methods that can often be applied by self-treatment. The suggestion that patients let out their anger to feel better and minimize aggressive tendencies remains highly debated. Psychologists have not reached a consensus regarding that and other treatments, largely because of the many and varied causes of anger.

The History of Anger Treatment

Human anger has been reported since the beginning of written record keeping. For example, the emotion was discussed by the ancient Greek physician Hippocrates, and practitioners through the Middle Ages used herbs and bleeding to handle the emotion by bringing down the patient’s blood pressure and “choler.” Until the twentieth century, members of the poorer classes who were encumbered with extremes of rage and other anger manifestations such as paranoia were chained in madhouses. In the twentieth century, development of modern psychoactive drugs and psychotherapy engendered treatment of afflicted individuals as described in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM).

Cannon’s work in the 1930s on the fight-or-flight response mechanism was essential to the conceptualization of appropriate treatment for anger. Hans Selye, in the 1970s and 1980s, proposed that Cannon’s fight-or-flight response mechanism was part of a general adaptation syndrome (GAS) used to handle all stresses a person encountered, from head colds to unexpected violence and anger. General adaptation syndrome was proposed to be nonspecific in humans, so the same basic reactions were deemed to occur due to good or bad news and regardless of the emotion currently being felt, whether fear, excitement, pleasure, or anger. The difference in the result, according to Selye, was not in the biology of the emotion but in the mind-set that accompanied it.

From the late twentieth century on, uncontrollable physical anger against one’s spouse, acquaintances, and others has been treated by combinations of tranquilizers, hormones, antidepressants, psychotherapy, and hospitalization, when needed. Much milder anger is treated by psychotherapeutic methods conceptualized and used by psychiatrists and psychologists who often term themselves "angerologists."


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