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The Difference Between an "Anger Problem" and Abuse

I spent 11 years facilitating groups on anger management and for couples trying to overcome problems in their marriages.  I also facilitated groups for people (men and women) who were mandated to treatment for domestic violence. Although there are women who have what are called "pro-abuse beliefs," who act on them, the majority of people who are mandated to treatment for domestic violence are men.

During the course of working with people, I encounter individuals who are looking for help dealing with a family member who episodically behaves angrily, to the point that it frightens and disrupts one or more other family members, and creates an uneasy atmosphere in the home.  The anger may be expressed physically, as in the angry person damages property, throws things, or slams doors.  It also can result in physical assault. Sometimes the individual seeking help will excuse the behavior, saying, "He has an anger problem."  

How do we determine the difference between an anger problem and abuse? Does the individual often express over-the-top anger at work? Around and at people unrelated to him? In just about any setting? If so, he or she has an anger problem. He or she may have grown up in a household where no one taught other ways of meeting emotional needs. Often, but not always, a person who is triggered to anger with just about anyone in any situation feels remorse, embarrassment, and perhaps frustration with him or herself that they have no other way to deal with their emotions. They may be unaware of their own triggers until they express their anger. They are unaware of their own body cues that their agitation level is rising before it erupts. They have no coping mechanisms for dealing with hyper-arousal. Such an individual often would really like some help in dealing with these feelings and meeting their needs.  They are open to getting therapy, taking a class, joining a group, or learning new social skills.

On the other hand, abuse has a different quality. It is typically directed at someone close to the abuser. The motivation of the abuser is different from the person who has an anger problem. The abuser acts not out of pure frustration, but instead seeks absolute control over the people s/he abuses. The abuser is conscious of the choice to abuse. If your partner only has these outbursts with you, or in settings without witnesses, but seems to have good work relationships, and good relationships with others outside the immediate family, then the "anger" is expressed to create fear in you. Some of the group participants in the domestic violence program admitted that they sometimes "conjured" the anger, though they didn't really feel it, because it worked for them. It terrified their victims and drove the victims into complying with whatever they wanted.

The distinction between a genuine anger problem and abuse is important. Treatment to address them is different, and the motivation to improve is also often different. The abuser will often, at least in the beginning of a treatment program, believe that the treatment was imposed upon them. They may believe that they had no culpability or agency in the matter--someone else made them become abusive and someone in authority made them go to treatment. They were just in the wrong place at the wrong time. Abuse is generally much better addressed in a group within a program designed to specifically address the target behaviors and thinking behind it.

People with anger problems likely will also catch on faster in a group, but the problem may also be addressed in individual or couples therapy. A person with an anger problem will take some time to learn about body cues, and skills to deal with the emotional arousal, but they usually willingly implement the skills taught. The family will note gradually increasing peace, and other family members may benefit from the training as well.

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Therapy

Group Therapy

As a therapist, I believe in group therapy, because I have seen how much faster clients gain awareness and skills when in groups. They benefit from seeing other people who are dealing with the same subjective experience, and from the social support that group members offer each other. It is easier to watch a group member processing the same issue we have, recognize we have it too, and absorb the new information while someone else is doing the outward work. Group participants connect dots faster than they would in individual therapy.

Despite this, it can be difficult to fill groups, as potential clients have concerns about privacy and feelings of shame around whatever the target issue is that the group addresses. The first evening a group meets, all participants wonder if they are the only ones with the problem, or if how it manifests for them is worse than for other participants. Will the group members judge them and find them so aberrant that they won't belong? Of course the rational brain recognizes that this is not the case, but group participants must overcome their initial fear of exposure in order to join the group.

There are two ways that groups are structured: open and closed. An open group is one that meets on a repeating basis with no end date, and admits a new participant any time there is an open slot. A closed group typically meets for a finite number of sessions, and once the first or second session starts, is closed to any new members.

Closed groups typically rely on a curriculum that fosters cumulative learning and application of skills in an increasingly mindful way as the group progresses. Members of this type of group can form tight bonds by the end of the group because they were exposed to each other for the same length of time and shared the same group experience. 

An open group may change over time as old members leave and new ones come in. All groups take on various "personalities" depending upon the interaction between the different participant's personalities. New participants may be eased in by the more experienced participants. Topics are usually explored in a random way, instead of in a linear fashion. There is typically flexibility that allows time to address an emergent need in any one individual should it arise. 

Regardless of the type of group clients join, the group process produces real gains that might not occur for months to years during individual therapy.

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