Behavior Therapy and Cognitive Behavior Therapy are types of treatment that are based firmly on research findings. These approaches aid people in achieving specific changes or goals.
Changes or goals might involve:
A way of acting: like smoking less or being more outgoing;
A way of feeling: like helping a person to be less scared, less depressed, or less anxious;
A way of thinking: like learning to problem-solve or get rid of self-defeating thoughts;
A way of dealing with physical or medical problems: like lessening back pain or helping a person stick to a doctor’s suggestions.
Behavior Therapists and Cognitive Behavior Therapists usually focus more on the current situation and its solution, rather than the past.
They concentrate on a person’s views and beliefs about their life, not on personality traits.
Behavior Therapists and Cognitive Behavior Therapists treat individuals, parents, children, couples, and families.
Replacing ways of living that do not work well with ways of living that work, and giving people more control over their lives, are common goals of behavior and cognitive behavior therapy.
HOW TO GET HELP:
If you are looking for help, either for yourself or someone else, you may be tempted to call someone who advertises in a local publication or who comes up from a search of the Internet.
You may, or may not, find a competent therapist in this manner.
It is wise to check on the credentials of a psychotherapist.
It is expected that competent therapists hold advanced academic degrees.
They should be listed as members of professional organizations, such as the Association for Behavioral and Cognitive Therapies or the American Psychological Association.
Of course, they should be licensed to practice in your state.
You can find competent specialists who are affiliated with local universities or mental health facilities or who are listed on the websites of professional organizations.
You may, of course, visit our website (www.abct.org) and click on "Find a CBT Therapist"
The Association for Behavioral and Cognitive Therapies (ABCT) is an interdisciplinary organization committed to the advancement of a scientific approach to the understanding and amelioration of problems of the human condition.
These aims are achieved through the investigation and application of behavioral, cognitive, and other evidence-based principles to assessment, prevention, and treatment.
In response to being criticized or ignored, or when overwhelmed with daily
hassles, people can feel irritated, annoyed, or angry. This is a normal reaction.
In fact, when anger is experienced and expressed appropriately, it can lead to
healthy coping and constructive change. On the other hand, frequent, intense,
and enduring anger can be quite harmful.
Anger is not limited to shouting and yelling. Angry individuals may become intimidating
and aggressive. They may hurt themselves, others, or property. Also,
some individuals feel bad about their anger, and that can lead to guilty reactions.
Uncontrolled and excessive anger causes problems in all areas of life. It can result
in relationship problems with friends, family, or coworkers. Extreme anger may
lead to problems with the law. But not all angry people show it. Angry individuals
may not show their anger outwardly. Rather, it remains inside and they harbor
fantasies of “getting even.”
There are many reactions to anger. Some reactions to anger are immediate.
For example, people are likely to avoid angry individuals since it is unpleasant to
be the recipient of anger. Angry individuals may themselves suffer from
headaches, stomach problems, and so on. Other consequences of anger may
emerge over the longer term. Angry individuals who keep it bottled up may withdraw,
sulk, and brood. They may experience anguish and inner turmoil. They
tend to develop lower self-esteem, more anxiety, and more alcohol and drug
abuse than people who are less angry. Uncontrolled anger may eventually lead to
heart disease, elevated blood pressure, and cancer, as well as to relationship and
Counseling or psychotherapy can help you (or others in your life) deal with an
anger problem. In seeking therapy, you may wish to consider several general
issues. First, realize that anger is a common and sometimes normal human emotion.
It is sometimes appropriate to be angry. But, when anger is exaggerated,
uncontrolled, or linked with dysfunctional behavior, it becomes a problem that
can affect all areas of life.
Second, note that angry behavior patterns are habits that are developed, repeated,
and reinforced over a lifetime. Fortunately, these habits can be changed.
Much anger is an automatic emotional response and, with practice, it can be reduced.
Thus, it is important to ask prospective therapists how techniques for
anger management will be learned and practiced.
Third, if you have concerns regarding the confidentiality of treatment, discuss
these issues with your therapist. Since laws vary from state to state, your therapist
would be in the best position to explain the doctor-patient privilege. You should
be aware that therapists, to prevent harm, may warn a potential victim of aggression
if a client intends to hurt someone. This is a normal professional procedure.
Approaches to Anger Therapy
There are many different approaches a therapist may use to help an individual
control anger. Some people may benefit from exploring their family backgrounds
while others may be helped with medication. You should know that
cognitive behavior therapy techniques have been shown to be very effective for
anger reduction and often represent the treatment of choice. Not everyone, of
course, will find every technique to be useful.
Therapists base the use of each
technique on a careful evaluation of the client’s circumstances and characteristics.
Several effective cognitive behavioral techniques are outlined below:
Enhanced Personal Awareness
Angry individuals often do not have a clear sense of their anger. They don’t understand
where it comes from or what is happening to them when they are
angry. There are many ways you can learn about the elements of anger episodes.
These include detailed discussions with your therapist, role-playing of angercausing
situations, and self-monitoring (making a record of) anger in day-to-day
living. Whatever approach is chosen, the goal is to help you become more aware
of the anger in your life, by addressing the following issues:
Where and when does the anger occur? Why does anger occur (what events or
situations lead to the anger)? What kinds of memories or images trigger the
anger? How do you feel when you become angry (emotionally and physically)?
What are you thinking when you are angry? How do you handle the situation
that made you angry? Do you always behave the same way? If not, why not?
What do others do when you become angry?
Answering such questions will help you become aware of the nature, reasons,
and results of anger. The answers will also eventually help you develop a greater
sense of self-worth and personal control, and the ability to use anger-management
and problem-solving skills. Although enhanced personal awareness is
rarely all that is needed, it is often very helpful.
Anger Disruption by Avoidance and Removal
These techniques lead to interruption of anger by removing you, mentally or
physically, from the situation. For example, it might be wise to simply get up
and leave a situation when anger develops. This might even be negotiated with
a spouse, friend, or business associate in advance. It might be wise to delay responding
by asking for time to think about angering issues or to gather additional
information before responding. It might be wise to seek an alternative
mode of response, such as a written or email answer, instead of an immediate
spoken one. These techniques may decrease or even prevent the anger altogether.
Doing a distracting non-angry activity is also an alternative. One mother, with
an anger problem, chose to plan meals and do the laundry instead of arguing
and insulting her teenage daughter about homework. Other individuals may
count to ten, or may provide themselves with a brief, nondamaging physical distraction,
such as pressing their fingers together very firmly or leaving to take a
shower or work in the garden.
These few examples are simple strategies that can disrupt anger and give the
individual some time and distance to calm down, then approach the situation
differently, at a later time. As with enhanced self-awareness, these strategies are
rarely sufficient alone, but are an important part of treatment.
Relaxation Coping Skills
Anger is often marked by increased emotional and physical excitement. Relaxation
coping skills target this excitement and can help you calm down when angered.
You can learn to become aware of the triggers for anger and you can use
relaxation to lower it. Relaxation skills include slow deep breathing, slowly repeating
a calming word or phrase, picturing a personal relaxation image, or focusing
on muscle tension and consciously letting it go. These skills are practiced
at home until you can relax quickly. Then, as you become better at using relaxation,
it can be used to lower anger within the therapy session. For example, the
therapist may ask you to imagine an angering event, experience the anger, and
then assist you in the relaxation skills to lower the anger. Over the course of a
few sessions, as the therapist’s assistance decreases, you can learn to handle increasing
levels of anger. If successful in the therapy sessions, you can begin to
use relaxation for anger management in daily living, freeing yourself to approach
situations more calmly.
Attitude and Cognitive Change
When angry, people often make bad situations worse by the way they think
about them. For example, angry individuals tend to demand that things should
be, ought to be, or have to be, their way—rather than just wanting or preferring
them to be a certain way. Often, they call other people insulting, sometimes obscene,
names. The problem situation is often seen as awful or catastrophic,
rather than simply difficult, frustrating, or truly disappointing. By thinking
about bad situations in this way, natural frustrations, hurts, and disappointments
seem much larger, leading to increases in anger.
Attitude and cognitive change techniques focus on identifying anger-producing
thoughts and replacing them with more reasonable ways of thinking. As with
relaxation skills, many different techniques may be employed. For example,
therapists could use careful exploration of thinking errors, role-playing, selfmonitoring
and self-debating strategies, and trying out new behaviors. You and
your therapist will work together in session using one or more of these techniques
to become aware of, and change, attitudes and images that increase
anger. Then, you practice the new and more reasonable thought patterns
(habits) for anger reduction in the real world.
Another cognitive change technique is silly humor. This does not mean that you
will be taught to laugh away problems. Instead, the goal is to use silly humor,
rather than hostility, as a partial cure. This is particularly helpful with certain
types of angering thoughts. For example, adult drivers may make themselves
angrier by calling other drivers “asses.” The client might be asked to define this
term correctly. This usually leads to a definition of burro. Then, they might be
asked to draw a picture of this definition and to picture this image when they use
the term. Rarely is silly humor the primary therapy technique, but it often helps
people chuckle at themselves, take a step back, and approach the situation in a
less angry way.
Acceptance and Forgiveness
Many things that others do simply can not be helped. For example, children spill
drinks; they commonly argue with each other, then pout or shout; and they are
always testing the boundaries of “no.” In industry, economic conditions sometimes
lead to layoffs. Spouses sometimes forget about issues that are important
to their partners.
But thinking that others have intentionally set out to cause problems is almost
always wrong. Thinking that they could have acted differently, if they really
wanted to, ignores other causes of behavior. Sometimes, for example, spouses or
colleagues just didn’t hear what you said, or your friend just forgot. Thinking
that the bad behavior of others is always intentional just increases anger and
does little to solve problems. Understanding that some behaviors are caused by
biology or genetics, or normal development, or economic stressors, is more realistic.
Acceptance and forgiveness interventions help you to understand these realities.
The goal is to improve relations with others, while reducing needless and
repetitive lecturing and blaming.
Some people experience anger because they do not have the necessary skills to
negotiate common interpersonal hassles and conflicts. They may fight with a
spouse because they don’t know how to communicate well about family budgets;
become furious and yell at a child because they don’t know how to handle the
child’s misbehavior; or become angry and intimidating when dealing with
coworkers because they don’t know how to be assertive. Anger escalates because
of insufficient skill at resolving the situation.
Although the needed skills vary greatly from individual to individual, skill
training can help you approach negative situations in a calm, direct, problemsolving
manner. You and your therapist identify the needed skills and rehearse
them during therapy sessions until you are comfortable with them. Then, you
work together to transfer these skills from the office into the real world. Over
time, you will learn general principles and strategies that can be adapted to
many anger-causing situations. This leads to a reduction in anger because the
skills stop or lessen conflict and tension with others.
Although frustration and a degree of anger are inevitable parts of life, individuals
don’t have to be victims of uncontrolled, intense, or frequent anger. A number of
effective cognitive-behavioral techniques are available for anger management.
No one is likely to need all of them. However, psychotherapy can identify how
these strategies might be combined to reduce anger in order to help you and others
in your life deal with this troublesome emotion.
For more information or to find a therapist:
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