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When anger is the drug of choice

July 16, 2012
by Brian Duffy, LMHC, LADC-I
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First, we should rename this article “When aggression is the drug of choice,” because that more accurately describes the problem we must address in our clients. Anger is a normal emotion. We all get angry—at ourselves, at situations, at others, at the universe.

Aggression, on the other hand, is a behavior, not an emotion. Often it is triggered by anger—and that’s the good news, because we can learn new ways to respond to those triggers. But first, let’s identify what constitutes aggressive behavior.

Sure, throwing fists, objects, etc., constitutes aggression. So too does yelling, threatening and pounding the table. But aggression can be a lot more than assaultive behavior. Simply glaring at another person, pointing a finger at someone when speaking, rolling one’s eyes or audibly sighing when the other is speaking—these are all aggressive behaviors. They can become bad habits that often lead to more dramatic confrontations.

What’s behind the anger?

In my personal and professional experience, anger usually emerges when we are facing uncomfortable feelings such as fear, shame, hurt, sadness, embarrassment, etc. It is often chronic and borne out of the fear that we’re not being understood, appreciated, loved or respected. For many, aggression is a mask that hides those uncomfortable feelings. Unfortunately, many of our clients grew up in households that catered to the aggressive person, allowing him or her to believe that this behavior is acceptable.

Then there’s the person who “discovers” his anger only after putting down his drug(s) of choice. I view this more as a switched addiction. (“I can’t drink, so how do I cope with all these painful feelings?”) For this person, angry outbursts can provide a sense of control, a rush of energy, maybe even some much-needed attention.

And how about people in recovery who have used passivity or helplessness as a survival technique? For them, the pent-up need for self-advocacy can burst forth with surprising ferocity.

Society harbors a popular misconception that we inherit our anger from one or both parents. This would be a nice cop-out, but the truth is that aggressive behavior is not genetic. We may have learned the behavior from our parents, but we didn’t inherit it. It is a learned behavior that therefore can be unlearned.

The “benefits” of aggressive behavior

Unfortunately, aggressive behavior can get our needs met, at least in the short term. It can be an effective way to manipulate others, even to earn a level of respect in certain communities (such as on the street or in jail). Being rewarded for our aggressive actions reinforces the habit. And the longer we cultivate the habit, the more ingrained it becomes.

Another potential benefit of being aggressive is that it can feel good. The adrenaline rush may release tension (momentarily), but the consequences usually outweigh the benefits.

The consequences

In the long run, the chronically angry person usually alienates family and friends, creating a backlash of resentment and, ultimately, an audience that no longer will tolerate the aggressive conduct.

The most obvious consequences of angry outbursts are arrests, jail time, injury to self and others, loss of important relationships, loss of employment, etc.  And then there are the emotional consequences of guilt and shame, exacerbating already low self-esteem. Just as with our drugs of choice, we find ourselves saying: “I did it again! How did that happen?”

Another consequence of chronic aggressive behavior is the detrimental effect on physical health. Keeping blood pressure and heart rates elevated over long periods of time (via the “fight or flight” response) creates stress that can lead to heart disease and hypertension.

An aggressive client doesn’t break the habit quickly or easily. A combination of cognitive and behavioral interventions can help the client challenge his/her thinking and, ultimately, change behavior.

Cognitive restructuring

From a cognitive perspective, we encourage clients to challenge their “irrational beliefs”—to ask themselves some questions, such as:

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