30. 辅导因愤怒而困扰的人

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30 Counselling those troubled by anger

Counsellors will inevitably at times be invited to help a person who has trouble in managing anger. Bottled-up anger can be very destructive and also very dangerous because it may break out at some time or other and the person may do injury or damage to someone else. Many counsellors, in the early stages of their counselling careers, become quite frightened when a person who seeks help exhibits even moderate levels of anger. 1 his chapter has been included to provide new counsellors with some practical ideas about how to work with those people who have a problem with anger, in cases where it is not considered necessary to refer them to more experienced counsellors. People who are troubled by anger can often be helped to feel better if they are able to dissipate their anger without endangering others, and then to change some of their thinking patterns and behaviours. We will discuss two different and complementary ways of helping a person to dissipate anger. One way is to encourage them to release their anger verbally in the safety of the counselling environment, and the other is to teach relaxation (see Chapter 28). We will also consider ways to help a person to think and behave differently, so that hopefully they can deal with anger more constructively in the future. HELPING A PERSON TO RECOGNISE AND EXPRESS ANGER People who are not dangerous or violent can be allowed to recognise and express anger verbally in the counselling room. However, if an inexperienced counsellor suspects that a person seeking help might have the potential for violence, that person should be referred to a suitably qualified and experienced therapist. When, in a counselling session, a person starts to express anger you may choose to use the normal reflective counselling strategies if you wish. However, if the level of anger starts to rise then it's sensible for you, the counsellor, to take control and to ensure that the anger is directed away from you. As a counsellor, avoid allowing a person’s anger to rise significantly while they are talking directly to you, or you may end up in an unsafe situation where you feel threatened. Instead, protect yourself by using a method borrowed from Gestalt Therapy. (If you want to learn more about Gestalt ’Therapy read Clarkson and C a vicchia (2014), and if you like what you read, you may wish to enrol in a Gestalt Therapy training course after you have completed your basic counsellor training.) The method involves the use of an empty chair. USE OF THE EMPTY CHAIR Start by asking the person, ‘Who are you most angry with?’ Next, place an empty chair facing them a metre or two away from them. Tell them to imagine that the person who is the target of their anger is sitting in the empty chair. Say to the person something like, 41 don’t want to be the recipient of your anger, so 1 don’t want you to tell me how angry you are; rather, I’d like you to talk to the imaginary person who is sitting in that empty chair, about your angry feelings towards them’. Preferably you should now stand beside the person seeking help and join them in facing the empty chair. You can then 'coach' them in their expression of anger towards the imagined person. For example, it the person starts by saying, ‘Well, actually I’m very angry with Fred, because Fred has consistently offended me with his behaviour,’ then, as counsellor, you can say yourself, Tm very angry with you, Fred, because you’ve consistently behaved badly.’ Hopefully, the person will then pick up the way in which they are expected to address the imagined person on the empty chair, instead of talking to you, and they can then be encouraged to express their anger openly and fully. This method is useful for the person as it enables them to verbalise the anger, and avoids a situation where the counsellor becomes the recipient of the anger, because the counsellor is standing beside and joining with the person. If this method appeals to you, then after completion of your basic counsellor training, you may wish to train as a Gestalt Therapist and learn other powerful techniques for enabling people to release angry feelings.

WARNING! Remember that some people have great difficulty in controlling inappropriately high levels of anger. Among these are people who perpetrate violence against spouses, others, children or property. They must be referred to skilled psychotherapists and it is not appropriate for a new counsellor to attempt to help them. Moreover, rather than getting in touch with and expressing their anger they need to learn ways to manage and control it. If during counselling you suspect that a person has the potential to be violent, seek assistance from an experienced counsellor or other relevant professional. HELPING A PERSON TO CHANGE THEIR THOUGHTS AND BEHAVIOURS Once counselling has been effective in enabling the person to moderate their high anger level, the next stage is to teach them how to deal with anger in the future. You may find it useful to give the person seeking help a copy of the chart shown in Figure 30.1 and discuss it during a counselling session. Although the chart is fairly self-explanatory, it can be useful to work through it step by step. The first step is for the person to learn to recognise physiological cues. When we start to get angry, things happen to our bodies. What happens in your body when you are starting to get angry? We are all different: some people will notice their heart rate increase, others will breathe more rapidly, they may start to sweat, their muscles might tighten up or they might have an uncomfortable feeling in their stomach. Some people freeze on the spot and feel their hair standing on end. Because we are all different, each individual needs to identify for themselves what happens to them physiologically when they start to get angry. Once a person has learnt to recognise the physiological symptoms that occur as their anger starts to rise, they can use these as cues to indicate that action is required to take control of the anger. In fact, they have a choice: they can either let the anger take control of them and allow an angry outburst to occur or they can decide to take control of the anger, stop and respond differently. At times it may be better to allow controlled angry outbursts to occur, rather than to bottle up the emotion. Clearly, uncontrolled angry outbursts are dangerous, but letting off steam by occasionally having small controlled outbursts does enable anger to be dissipated. Unfortunately, people who continually behave angrily are certain to damage their relationships with others. THOUGHT-STOPPING An alternative to having an angry outburst is for the person to recognise the physiological cues that indicate a rise in anger, and to immediately say ‘STOP’ sharply but silently to themselves to interrupt their thoughts. The method is called thought-stopping. Once a person has interrupted the thoughts promoting anger, and stopped letting their thoughts hook them into an angry outburst, they can make the choice to step back from the situation, to move back in their imagination by 10 metres, so that they are, in effect, looking at themselves and their situation from a distant vantage point. 1 hey can then, if they choose, take a few slow, deep breaths and allow the muscles in their body to relax as they would when engaged in a relaxation exercise (see Chapter 28). As the person takes those few slow, deep breaths, each time they breathe out they can say silently ‘Relax’, and allow their body to relax. Clearly, part of the process of helping a person to learn new ways of dealing with anger involves teaching relaxation (see Chapter 28). They can then use the method described above. By learning how to relax and how to recognise their patterns of behaviour, they will hopefully be able to lower the intensity of their emotional feelings in future times of crisis and then be able to deal with their anger more appropriately. TAKING TIME OUT 1 he next stage in the process of anger control involves several options, as shown on the chart (Figure 30.1). The ‘time out' block shown gives the person time to cool off

CFigure 30.1 Anger control flow chart NOTICE PHYSIOLOGICAL CUES e,g. increased heart rate and breathing, muscle tension, stomach flutters, sweaty palms, immobility 4* STOP Step back from the situation I Take a few slow, deep breaths and relax the body I TIMEOUT Dispute irrational beliefs and use positive talk BE ASSERTIVE '1 feel. . . when . . (Make a CONCRETE statement of what I saw happening without interpretation! Listen to what the other person is saying and try to see the situation from their viewpoint Do nothing Build-up of negative feelings with emotional consequences 4* Look for a solution rather than aiming to win 4f: The possibility of a satisfactory outcome is maximised

EXAMPLES OF IRRATIONAL BELIEFS Other people should live up to my expectations! Other people should behave the way I do! Life is fair and just! I must succeed! I can't tolerate mistakes!and reduce their anger level before deciding what action, if any, to take. They may literally walk away from the situation and distance themselves physically from it. In order to do this, they may need to negotiate with some significant person in their life, so that the person concerned allows them space when they ask for it. After time out has been used to allow emotions to cool down, the emotional level may be further reduced by doing a relaxation exercise, by becoming fully absorbed in carrying out a task (such as putting full concentration into cooking a meal) or by engaging in physical exercise (like going jogging). For people who are not violent, and are not likely to become violent, another alternative is for them to dissipate their anger by beating up a beanbag, mattress or punching bag. This method can be very helpful for people who do not usually experience high levels of anger, but are angry as a result of a short-tenil life crisis. However, a word of warning: physically releasing angiy feelings in this way is not recommended for those people who are likely to become violent with either people or property. These people need to learn how to control their anger and should be referred to specialist counsellors and counselling programs. Teaching them to vent their anger by acting it out physically may be potentially dangerous because it could reinforce violent tendencies. MAKING A DECISION From this point in the anger control process the options are either to do nothing further or to move into the action described in the left-hand column on the anger control chart. Sometimes doing nothing is satisfactory. It may be that, as a result of time out followed by one of the anger-dissipating activities, the person will realise that they were overreacting and will feel OK. However, there is a danger in doing nothing at this stage as emotions may still be bottled up with a consequent increased likelihood of a future outburst. CHALLENGING SELF-DESTRUCTIVE BELIEFS If action is the preferred option, the first step involves disputing self-destructive beliefs and using positive self-talk. We all at times, when angry, give ourselves messages that are destructive because they make us feel even more unhappy and angiy. Such messages were discussed in Chapter 20 and include statements such as: 'Other people should live up to my expectations’, 'Other people should behave the way 1 do’, 'Life is fair and just’, T must win1, T must succeed’ and T can’t tolerate mistakes’. Statements like this are absurd. Why should other people live up to our expectations? Who said that other people should behave the way we do? We wouldn’t like other people to tell us how to behave and it is not rational for us to expect them to live up to our expectations. Life is patently not fair or just. Some people have lots of luck, and other people just don’t. It isn’t necessary or likely that we will always win. If we win 50 per cent of the time that would be pretty fair, and even that might not happen. So we need to remember that it is not necessary7 for us to win, it is not necessary7 for us to succeed every time and we can, if we wish, choose to tolerate other people’s mistakes. We can, if we choose, allow other people to behave in ways that are different from the ways in which we would behave ourselves. Once we have put aside our self-destructive beliefs, we can replace them with positive thoughts, which will help us to feel better. For example, when someone fails to live up to our expectations we could say to ourselves, 'He doesn’t care enough about me to try to please me. 1 just don’t matter to him.’ That would be irrational. It is equally likely that the person concerned is just a bit careless. A more positive self­ statement would be: 'Maybe that person is naturally careless. His behaviour may have nothing to do with the way he feels about me. For all 1 know he might think I’m a great person. What’s more, it’s not important what he thinks about me, because 1 know that I’m OK.' Table 30.1 gives some specific examples of self-destructive self-statements that are likely to make a person feel angry, together with examples of alternative self­ statements that are more likely to have a positive outcome. Once a person has translated the negative messages into positive messages, they are in a situation where they can make other positive choices. They might do nothing, at least for the time being. That is a valid choice and it may be a sensible one. Sometimes it is better to let things cool off before taking action. However, it is important to be sure not to allow negative feelings to build up as a result of inaction. If negative feelings start to build up, then these will need to be dealt with. In order to do this, the person concerned might need to confront the person who they believe has done something to upset them. Where confrontation is the choice, it needs to be done in a way that is likely to lead to a positive outcome with a minimal risk of damage to the relationship. BEING ASSERTIVE Constructive confrontation requires assertive rather than aggressive behaviour. An assertive person has the goal of wanting to be heard, but not the goal of definitely getting what they want. An aggressive person is determined to win at any cost and also is intent on hurting or punishing the other person. Assertion involves communicating as an equal, it involves respecting the rights oi the other person, and demands that the other person’s point of view must be respected. Consequently, two assertive people may well come to the conclusion that they have different opinions. They will, however, respect each other’s right to have a different opinion. It is sufficient for the assertive person to be heard rather than to win an argument by convincing the other person to change their mind. Sometimes we will not be heard and it is not rational of us to expect that the other person will necessarily be capable of i. .......... X .... . hearing what we have to say. We need to come to terms with that. One of the best ways to make assertive statements is to use '1 feel ... when ...’ statements, as explained in Chapter 18. An example is, ‘I feel frustrated when you interrupt me in the middle of a sentence'. By using the T feel’ statement, the speaker is owning their feelings rather than blaming the other person,

Table 30.1 Comparison of anger-producing self-destructive statements with positive self-statements SELF-DESTRUCTIVE ANGER­ PRODUCING STATEMENTEQUIVALENT POSITIVE STATEMENT If 1 don't get him to give me what 1 want, 111 be humiliated and made to look Like a loser.It's not reasonable to expect that 1 can make anyone give me what 1 want. 1 can feel proud of my ability to ask for what 1 want and accept that i may not get it. People should not let me down. When they let me down, 1 know that they don't respect me enough to want to please me.1 am a worthwhile person. It's not realistic to expect other people to live up to my expectations. When they let me down, it says more about them than me. 1 can't feel OK unless Bill agrees that I'm right.1 can't control the way Bill thinks. If he's illogical, that’s his problem, and I'm not going to make it mine. I'm OK. Marys behaviour is ruining my life. Unless she starts to do things to please me, km going to get very angry.If my happiness depends on other people's behaviour, 1 might never be happy. 1 can be happy if 1 accept other people, including Mary, the way they are and the way they behave. I've been victimised and that just isn't fair. I've got to get even.Life often isn't fair and it's unrealistic to expect that it always will be. 1 can get on with enjoying life, instead of harbouring disturbing thoughts of revenge. Note: For other examples of self-destructive beliefs, see Chapter 20. and consequently they are more likely to be heard. After the feeling statement follows a concrete statement about the behaviour that caused the feeling. As explained before, it needs to be an objective statement of behaviour, and not an interpretation of the facts. By contrast with an assertive statement, an aggressive statement would be one that began with the word ‘you\ and implied blame. For example, 4You are very mde because you deliberately try to annoy7 me by interrupting me’. Such a statement implies blame, makes an unjustified interpretation and is likely7 to lead to an argument. Another good way of making an assertive statement is to make a request that might lead to some common agreement. For example, 1 might say, 'Would you mind waiting until I’ve finished what I’m saying? If you do that, I’ll feel heard and will be more receptive to what you have to say.’ The goal of making assertive statements is to get a positive outcome. After making an assertive statement, the speaker needs to listen carefully7 to what the other person says in reply, with the intention of hearing and understanding their point of view, rather than with the intention of disputing what they say.

THE USE OF ROLE-PLAYING A good way of helping a person to practise anger control is by role-playing while using a camera to record the role-play on a DVD. By recording the role-play of a real situation that recently made the person angrxy they may be able to see how other people perceive them. Additionally, they may gain insight if they role-play both themselves and the other person, as explained in Chapter 27. They will need to continually change position and role to do this. A review of the DVD recording may enable the person to see how tempers become inflamed. The counsellor can then coach them in the anger control methods described, and in particular can teach ways to make assertive rather than aggressive statements. Remember that very angry people may be dangerous. As a new counsellor you need to be conscious of the need to consult with your supervisor and refer a person who is seeking help to another more experienced and qualified counsellor when necessary. EXTERNALISING ANGER A completely different way to deal with anger control is to externalise the anger, as explained in Chapter 21. The process of externalising separates the anger from the person so that the person perceives the anger as something that they have the power to manage or control rather than the anger being seen as a part of themselves that they are unable to influence. When using this approach for anger control, it can be useful to explore how anger influences and constrains the person’s life. Exceptions can also be explored to discover times when the person is in control so that they are able to recognise that they can, in fact, control the anger when they wish.

Learning summary Refer potentially violent people to experienced professionals. Encourage the person seeking help to direct anger to an appropriate imagined target person on an empty chair. Teach the person to use the process described by the Anger control flow chart (Figure 30.1), starting with the recognition of physiological cues. Teach the person how to replace irrational beliefs with positive self-talk, how to be assertive, how to listen to others and how to look for solutions rather than trying to win. Teach the person relaxation. References and further reading Clarkson, P. & Qavicchia, S. 2014, (iestalt Counselling in Action, 4th edn, SAGE, London. Davies, W. 2009, Overcoming Anger and Irritability, Robinson, London. Nay, R. 2012, Taking Charge of Anger: Six Steps to Asserting Yourself urithout Losing Control, 2nd edn, Guilford, New York.