Anger Management Therapy
Emotional Regulation Therapy
Distress Tolerance Skill-Building
Anger management, distress tolerance skill-building, and emotional regulation therapy are rooted in learning how to respond effectively to urges rather than reacting in ways that lead to unwanted outcomes.
In my experience of counseling people with concerns in these areas, the biggest problem is a lack of awareness of what is happening both internally and in our social environment. That’s why I always begin this therapy with helping the client to increase their ability to notice what they are experiencing.
Lack of awareness is similar to walking down a path and falling into a ditch that we don’t identify before it’s too late. We are likely to get hurt, and we have to waste time and energy pulling ourselves out, dusting ourselves off, and getting back on track. If we are aware and see that pitfall ahead, then we can stop, go around it, or go over it. We have the freedom to choose an action that is consistent with our objectives and values.
How can I control my anger?
Anger is a natural emotion that we all experience at times as an outcome of events that occur. If an event conflicts with our sense of justice, such as a person mistreating another individual, then it is unrealistic to deny our natural response and to simply say, “Don’t be angry.” We experienced that anger for a reason, because an act occurred that was contrary to our value of human rights. If everyone’s response to mistreatment was “Ho hum, no big deal,” then we would live in a lawless, unsafe world. Thus, “controlling” anger is incredibly difficult and is probably not beneficial to us or society as a whole.
“Choosing our response to anger, however, is highly achievable and beneficial to everyone involved.”
Choosing our response to anger, however, is highly achievable and beneficial to everyone involved, and it’s what I help my clients to do. Using the example above, we could choose to respond to our natural anger by physically attacking the person who mistreated the other individual. This would lead to conflict, further violence, potential physical injury, lack of protection for the person who was attacked, and likely legal problems for us. Or we can take a step back, notice our emotions, observe what’s happening around us and internally, and decide then on the most effective response.
This approach may involve planning with the offended party, taking legal action, involving collateral supports, or linking the offender with resources to address their anger problem. The initial results may not be as immediately gratifying as physical violence, but they will be far more effective in addressing the issue and eliminating unwanted consequences.
What is the best therapy for anger management and emotional regulation?
The best therapy for anger management is, in my experience, Cognitive Behavioral Therapy (CBT). Granted, I am biased as a CBT/DBT (Dialectical Behavior Therapy) practitioner, but I believe it is so effective because it trains the person to be aware of what is happening, thus giving them the ability to choose helpful responses rather than simply reacting impulsively.
In CBT, we draw a distinction between external triggers (people, places, events, settings, situations) that are happening in our environment, and internal cues that occur within us. Examples of triggers include things like being lied to or ignored by a friend. Cues include cognitive (what we are thinking), emotional (feelings we experience), physiological (what happens in our body), and behavioral (actions we take) (SAMHSA, 2019, Anger Management for Substance Abuse and Mental Health Clients: A CBT Manual).
Our emotions tend to rise incrementally. So if we can catch the warning signs--triggers and cues--fairly early in the process, then we can redirect before impulsive action that makes the situation worse.
“Radical acceptance rests on letting go of the illusion of control and a willingness to notice and accept things as they are right now, without judging.”
Why do I get angry so fast?
There are many reasons why people may get angry very rapidly, ranging from physical to social environmental to genetic predisposition to many other factors. However, on most occasions anger does not escalate from “zero to sixty” in a few seconds nearly as often as we may believe. It typically increases gradually (think of a continuum from 0 to 100), so we can intervene before serious damage occurs if we’re aware the “dial is rising”.
What are some of the characteristics of anger or emotional regulation problems?
The characteristics of anger and emotional regulation problems are best defined by behaviors and sensations that adversely impact the person’s life, relationships, and social and occupational functioning.
Examples of these behaviors and sensations include losing temper, difficulty coming down from anger episodes, frequent irritability or agitation, raising voice, pacing, slamming objects, engaging in risky or impulsive behaviors with the potential to harm oneself or others or harm relationships or the ability to maintain employment, and elevated blood pressure, chest tightness, or other physical symptoms due to anger.
What are some strategies for emotional regulation?
Strategies for emotional regulation include both preventive and “acute care” techniques. Preventive care involves maintenance behaviors that build up your “emotional armor”.
Preventive care practices include:
attending to proper sleep, diet, and exercise
limiting “escapist” behaviors such as binge-eating, binge-watching
refraining from using alcohol or other substances to push away from emotions
doing things each day to maintain structure and a sense of accomplishment.
“Acute care” or in-the-moment emotion regulation and distress tolerance techniques are vast and varied. Some of the more common techniques include
grounding through the five senses
diaphragmatic breathing
counting to 10,
applying the DBT STOP skill (Marsha M. LInehan, 2015, “DBT Skills Training: Manual”)
asking for a time-out
using a previously agreed-upon code word or phrase
walking away
engaging in brief distracting activity, visualization, physical exercise, or mindfulness exercises
utilizing reality-acceptance skills
What is low distress tolerance?
Low distress tolerance is characterized by inability or limited ability to maintain focus on objectives or behaviors, or responding in unhelpful ways to stressful or frustrating events.
Is distress tolerance a skill?
Distress tolerance is a skill that can be learned. While we believe that both biological and learned components influence distress tolerance, I have seen many clients successfully improve their ability to tolerate difficulty events through therapy and consistent practice.