ANGER MANAGEMENT
Reining in the rage
As anger management increases, so do questions about standards
and
effectiveness. Anger is practically a daily ritual of our lives. From traffic-choked
freeways to the pop culture scene, it seems we can't get to work without
someone flashing an inappropriate finger or to bed without witnessing
the latest celebrity fit or fisticuffs on camera.
Angry outbursts are now almost expected and encouraged as much for
their sheer entertainment as for their redemptive value. Most recently,
baseball great Pete Rose blamed his gambling and lying in part on anger
— something called “oppositional defiant disorder,” a condition
characterized by physical aggression and usually associated with
children.
Into this stewing societal caldron has come “anger management,” whose
aim is to teach people to handle emotions without losing control.
Courses lay out how to deal with anger in the moment — a strategy that
promises to improve relationships and lessen the chance of blowing up.
Employers, spouses and the judicial system are chiefly responsible
for channeling tens of thousands into anger-management classes. Every
time a celebrity — from boxer Mike Tyson to actress Shannen Doherty —
was ordered to attend anger-management classes, the program received a
boost, and many instructors noticed an uptick in clients. The program's national profile was heightened last year by the movie
Anger Management, which starred Jack Nicholson, who once smashed a car
windshield with a golf club during a traffic dispute.
In the past couple of years, more business and governmental
organizations have enlisted anger-management services to treat
employees. Postal workers, prison guards and business leaders — who can
pay more than $2,500 for one-on-one “coaching” — have taken workshops
and seminars. Some medical schools, such as the University of Miami's,
are putting students through special training to help them better cope
with their own — and their patients' — anger.
The judicial system has created the biggest demand for
anger-management training. Judges use the programs to ease crowding in
prisons and jails, and unclog courtroom calendars, said Pam Hollenhorst,
associate director of the Institute of Legal Studies at the University
of Wisconsin in Madison. Hollenhorst led one of the few comprehensive
studies of anger-management research. It may cost a county jail $50 to
$100 a day to lock up a defendant for road rage, physical assaults or
disturbing the peace. Or the courts can release the defendant and order
him to enroll in an anger-management course.
“For these kinds of offenses, I think the courts were finding that
putting someone in jail for two to six months wasn't doing the trick,”
said Jerry Deffenbacher, a professor of psychology at Colorado State
University who studies anger and anger management. “So (anger
management) developed as another tool to attack the problem.”
Most anger-management classes share basic principles of psychology
—
identifying and learning to control angry emotions, and employing
relaxation techniques to minimize the physiological responses to anger. Classes, usually led by instructors with backgrounds in social work
or counseling, help clients decide what is worth getting angry over and
what isn't. Programs, which can last from 10 weeks to almost a year,
cost $150 to $1,000. No standards govern what should be taught in anger
management or who is qualified to teach. Although precise figures are
difficult to come by, some estimate that about 7,000 people have been
trained nationwide to teach anger-related courses.
There is scant research to suggest whether these programs work. A few
small studies, mostly involving prison inmates and juvenile offenders,
have suggested the classes are helpful in discouraging aggressive
behavior, but there is no conclusive evidence that they do any good in
the general population. Mental health professionals aren't convinced the programs work. The
American Psychological Association has said such programs can be
beneficial. But the American Psychiatric Association has not taken a
position. “We don't really know enough about what type of anger-management
program is best,” said the University of Wisconsin's Hollenhorst. “Or
for whom it works, under what circumstances, or for how long.”
Without regulation, some advocates of anger-management programs are
concerned that the field won't be taken seriously. “There are as many ways to approach (anger management) as there are
people,” said W. Doyle Gentry, a clinical psychologist and director of
the Institute for Anger Free Living in Lynchburg, Va. “And it's created
a lot of confusing, even bizarre, methods that can't be taken seriously.
I mean, if they ask you to beat a mattress with a tennis racket (to work
out your anger), it's not going to do you any good.”
Further complicating efforts to regulate the profession is the
American Psychiatric Association's designation of anger as a symptom of
other, more serious, mental disorders and not a condition of its own,
advocates say. Without the kind of recognition accorded such disorders
as major depression, the field of anger research is unlikely to attract
much funding.
Darrel A. Regier, director of research at the American Psychiatric
Association, said anger-management programs lacked a body of research
demonstrating their effectiveness, adding that designing such studies
won't be easy. He said many people who go through anger-management
training likely have other conditions, such as bipolar disorder or
substance-abuse problems, that would predispose them to aggressive
behavior. That would pose a difficulty for researchers trying to
evaluate the programs. Beyond that, other critics contend that dozens of hours of anger
management cannot miraculously change years of negative behavior,
particularly if the person returns to the same environment that allowed
it to fester.
Advocates agree that one key area of research must be resolved: Does
anger management help people who are placed in such programs
involuntarily? Although no figures are available, anecdotal evidence
indicates a majority of participants go to classes grudgingly, as a
means to avoid fines, jail time or the loss of employment. “If you get a guy who is saying,
‘I don't have a problem, the world
just needs to get off my back,’ he's probably not going to change,” said
Colorado State University researcher Deffenbacher.
“If we're going to require (anger management)
interventions, we really need to find out if they work and under what
conditions.”
By Martin Miller
24 February 2004
http://www.azcentral.com/health/men/articles/0223anger23.html
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