Transcript Understanding and Resolving Problems with Anger and

Understanding and Resolving
Problems with Anger and
Impulse Control
NASW MI 2010 Annual Conference
Bob Van Oosterhout, MA, LMSW, LLP
An updated version of this handout along with other
information and video links are available at
www.bobvanoosterhout.com
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Problems with Anger and Impulse
Control are Distortions of Nature
• I do not believe that humans are naturally
aggressive or self-centered
– Aggression is a response to conditions and
history
– Rifkin – evidence human nature is empathic
• We are working with nature when helping to
resolve problems with anger/impulse
control
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The Nature of Human Emotion
• Universal Human experience
• Means of connecting with others
• Different than thought
– Few connections between limbic system and cortex
– Different developmental process
• Response to perception of the moment
– involves proprioception (muscle movement)
– tension blocks full experience
– resistance builds tension
3
The Nature of Human Emotion
(cont.)
• Regulates energy
– Anger, fear increase energy to deal with threat
– Sadness, hurt slow us down to facilitate recovery
• Tension increases intensity of reaction (sunburn
metaphor)
• Provides useful information but is only a part of
the picture
• Easily distorted by emotional tension (interpret
current situation based on emotions from the past)
• Experience is different than expression
4
Common Myths About Anger
• The truth comes out when we are angry
• We need to express anger in order to “let it
go”
• Hitting or throwing things discharges anger
• Playing violent games discharges anger
• Anger increases performance in competitive
environments
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The Nature of Anger
• Response to a perceived threat
• Function is to push away
• When level of anger exceeds the threat, it is
the result of built-up of tension (spring
metaphor)
• Anger is a secondary emotion –reaction to
fear, hurt, frustration, embarrassment
• Interferes with problem solving by
narrowing focus and blocking receptivity
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There is No Long-Term
Resolution Through Anger
• Anger tends to create defensiveness and anger in
others which in turn increases the likelihood that
they become more threatening
• Problems solved through anger produce
resentment and mistrust which undermines lasting
solutions
• Helpful advice regarding anger in relationships
– Don’t speak when angry
– Don’t listen to what is said in anger
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The Nature of Tension
Tension involves resistance
• Physical
– muscles working without moving
– develops into habitual patterns structured into body
• Mental
– narrowing and fixing of perceptions
– patterns of negative thinking that create physical
tension
• Emotional
– resisting the full experience of emotions through
breath-holding and patterns of physical tension
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Physical Tension
Regulated by Autonomic Nervous System (ANS)
• Sympathetic Nervous System (SNS -required for
activity) becomes over stimulated while the
Parasympathetic (PNS - required for health
maintenance) is suppressed (Fight or Flight)
• High level or intensity of tension stimulates release of
stress hormones which boosts SNS and suppresses PNS
• Creates a self-escalating process when more stress
hormones are released as tension builds, thus
stimulating the release of more stress hormones.
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Mental Tension
• The build up of physical tension is interpreted as
an indication of a threat, which
– Narrows focus and perception
– Leads the mind to ask “what’s wrong”
• Thoughts create physical tension when they
indicate a need for action but don’t result in
purposeful activity
• Asking “what’s wrong” from a narrow focus
builds tension, which further narrows focus on
“what’s wrong” creating a self-escalating process
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Emotional Tension
Specific muscle movements are associated
with different emotions
• Facial expressions are obvious but other muscle
groups move in response to specific emotions
• Resisting emotions involves restricting muscle
movement which creates physical tension
• Tension increases reactivity while decreasing
responsiveness
• Not necessarily linked with specific memories
(soup metaphor)
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Resolving and Preventing
Problems with Anger
Balance and Clarify
• Body
– Resolving tension provides time to make informed choices
• Mind
– See the larger picture more clearly
• Any conflict, misunderstanding or slight can be attributed to one or
more parties not seeing clearly
– Let go of patterns of thinking that build tension
• Emotion
– Able to respond rather than react
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Resolving and Preventing
Physical Tension
• Requires more than relaxation. Balance must be
restored to the ANS
• Rhythmic diaphragmatic breathing stimulates the PNS
and suppresses the SNS
– Precise rhythmic movement of the diaphragm stimulates the
right vagus nerve activating the PNS (proper rhythm is
critical)
– Regular PNS activation over time allows liver to remove
stress hormones from bloodstream restoring balance to ANS
• Grounding reverses patterns of tension while
developing awareness of tension habits.
13
Teaching Diaphragmatic Breathing
• Explain how and why it works
– Opposing parts of ANS prepare the body for activity or
maintenance
– Movement of diaphragm stimulates right vagus nerve which
activates internal organs and stops build up of tension
• Demonstrate slow, rhythmic, effortless movement of
diaphragm with hand on abdomen
– Fingers move out
• Watch for obstacles to diaphragmatic rhythm
– No diaphragmatic movement – use positioning, metaphors
– Inability to bring air to bottom of lungs –deep exhale
– Trying too hard – pair with rhythm phrase
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Teaching Grounding
• Describe need for balance between opposing muscle
groups and how to achieve “neutral”
• Feet width of hips apart, pointing straight
• Pelvis over feet (weight over ball of feet)
• Knees bent (explain “tensing up”)
• Observe from side, check that weight is supported by
skeleton
• Observe and correct for deviations from neutral in
head and shoulder positioning
• Sitting – make sure pelvis is back in chair and forms
a base to support the spine – feet flat on floor
pointing straight ahead, head supported by spine
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Patterns of Physical Tension
Evident in Restrained Anger
• Common terms describe patterns of tension
–
–
–
–
“Pulled up”
“Up in arms”
“Get your back up”
Need to “Settle down”
• Discovering natural neutral positions
resolves tension and increases awareness of
when it starts to build
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Resolving and Preventing
Mental Tension
• Clarify thoughts, perceptions, and effects of
behavior
– Identify nature of immediate threat
– separate short from long term issues
• “Rhythm phrase” & labeling block and
redirect negative mental habits
• Regular meditation develops mental
discipline and perceptual flexibility
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Perceptions that Work
Ways of viewing others that prevents anger
• Compassion
• Hope
• Personal Responsibility
• Humility
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Resolving and Preventing
Emotional Tension
• Accept emotion without resistance
• Let go of patterns of tension which restrict
emotion
• Respond appropriately to secondary
emotion
–
–
–
–
Fear – clarify nature and risk
Frustration – clarify expectation
Hurt – accept, mourn, assess risk and options
Embarrassment – accept, clarify options, don’t
escalate
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What Works When Dealing
with an Angry Person
• Calm undermines anger (removes threat)
• Clarify control issue (perceived lack of
control increases perception of threat)
• Empathize with secondary emotion
• Expand perceptual frame
• Present realistic options
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Demeanor and Focus when
Defusing Anger
•
•
•
•
•
Must be grounded
Safe but not aggressive or assertive
Non-threatening
Maintain calm
Able to provide full receptive attention with
intact peripheral vision
• Able to understand views and perceptions
• Able to think creatively
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Problems with Impulse Control
have Roots Similar to Anger
• Built-up physical, mental and emotional
tension
• Narrowed perceptions
• Emotionally based decision making
• Perception of lack of self-control
• Habitual response pattern
• Distorted self-image
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Effectively Dealing with
Problems with Impulse Control
Balance and Clarify
• Resolve physical tension –
– diaphragmatic breathing / grounding
• Provide tools to break up patterns of mental
tension
– rhythm phrase, labeling, clarifying, meditation
• Facilitate acceptance of emotion without
tension
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Effectively Dealing with
Problems with Impulse Control
(cont.)
• Set up temporary obstacles to obstruct
habitual patterns
• Clarify strengths, potential, opportunities,
• Clarify long-term goals and current
direction
• Clarify what works over the long term
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Summary: ABC Principles
• Three principles remove tension from
situation and get things moving in a positive
direction
– Accept – reality and person
– Balance – resolve tension and imbalance
– Clarify – what is true and important from a
larger perspective
• Usually easiest to start with Balance
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Hypotheses on Anger
1. Anger is a natural emotion experienced both by
humans and many higher level mammals.
2. Anger is a response to a perceived threat.
3. The function of anger is to push away.
4. If the level of anger exceeds the level of the
threat, the increased anger is caused by a build
up of physical, mental, and emotional tension.
5. Anger resulting from the build-up of tension is a
secondary emotion. It is stimulated by another
primary emotion such as fear, hurt, frustration or
embarrassment.
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Hypotheses on Anger (cont.)
6. Tension involves resistance. Physical tension is
a continuous contraction of groups of muscles
that tends to form patterns outside of normal
awareness. Mental tension results from patterns
of thinking and perceiving that create narrow,
inflexible and distorted perceptions and mental
habits that create physical tension. Emotional
tension results from attempting to restrict the
experience of emotion through muscle
contraction and breath holding. There tend to be
consistent patterns of physical tension that are
associated with resistance to specific emotions.
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Hypotheses on Anger (cont.)
7. Physical tension limits perceptual flexibility,
receptivity, and the ability to experience emotion
while limiting awareness and the capacity for
reflective thought. It leads to non-productive
negative thinking which builds additional physical
tension contributing to a self-escalating process.
8. When tension builds, it creates an imbalance in the
Autonomic Nervous System (ANS) where the
Sympathetic Nervous System (SNS), which
stimulates muscle effort is over-activated while the
Parasympathetic Nervous System (PNS) which
stimulates health maintenance and recovery is
suppressed.
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Hypotheses on Anger (cont.)
9. The build-up of tension triggers the
release of stress hormones which, in turn,
increase tension levels while limiting the
ability to recover, creating another selfescalating process.
10. Patterns of tension form habits of posture
and movement which build additional
tension on an ongoing basis.
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Hypotheses on Anger (cont.)
11. Full recovery from built-up tension
requires restoration of balance to the
Autonomic Nervous System as well as the
ability to accept emotions without
resistance, shift and reframe perceptions
and redirect and clarify negative thoughts.
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Hypotheses on Anger (cont.)
12. The clinician’s role in the recovery process
involves: 1) Creating an atmosphere where the
client feels understood, that their symptoms make
sense, and their emotions are a normal response to
perceptions of their experiences. 2) Identifying
obstacles to recovery including stress, relationship
or health issues, addictions, problems, and
conflicts while assisting in the process of
removing them; 3) Timing interventions to match
the readiness of the client to understand and act
upon them.
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Hypotheses on Anger (cont.)
13. Effectiveness of the clinician requires 1)
Balance, defined as the absence of tension, a state
of relaxed receptivity and perceptual flexibility; 2)
Emotional openness indicated by an ability to feel
and let go of emotions experienced by the client
without resistance or tension; 3) Receptivity to the
perceptions and emotions, and experience of the
client that is not blocked by ego, attachment,
judgment, or preconceptions.
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