Addicted to Anger?

Anger is an emotional response that we all experience regularly in one form or another for many reasons and for some of us it can become an addiction. In fact, anger can become so habit-forming that it becomes disruptive to our lives, relationships, career, which in turn can lead to incarceration, health problems, or legal and financial woes.

"We experience the feeling of anger when we think we have been mistreated, injured or when we are faced with problems that keeps us from getting what we want or attaining our personal goals" (Hendricks, Bore, Aslinia, & Morriss, 2013).

According to the (American Society of Addiction Medicine, 2019), “Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.”

Let’s take a look at that definition above to understand anger better before we move forward. For starters, addiction is a treatable chronic medical disease involving complex interactions within brain circuitry, genetics, environment, and individual life experiences. This information details how intertwined addiction is and how much it permeates into multiple parts of an individual’s life experience. One client’s manifestation of addiction in comparison to another can and in most cases will likely vary in how it looks, what it feels like to the individual, the consequences it causes, and so on. Point being, there is no template and there’s never going to be one that everyone under the sun will fit nice and neat under because of so much variability involved with addiction.

Secondly, addiction-prone individuals tend to use substances and/or engage in behaviors that develop into compulsive behavior(s) despite incurring harmful consequences the individual continues with this pattern of behavior. And that makes sense, think about it you find yourself in a situation where you initially were at risk to becoming addicted (for any number of reasons i.e., abuse, trauma, neglect, shame, guilt, depression, anxiety, etc.) and then to cope the individual pursues a form of self-medication (substance or behavioral) that provides a reward to the individual which in turn stimulates the production of dopamine in the brain. The more dopamine our brains produce the better we feel. If you get angry and note a sensation of pleasure derived from being angry you are experiencing gratification which reinforces the need to repeat this pattern of behavior; our brain feels pleased when we experience a reward so naturally, we will want to repeat that as much as possible.

“Dopamine is known as the feel-good neurotransmitter—a chemical that ferries information between neurons. The brain releases it when we eat food that we crave or while we have sex, contributing to feelings of pleasure and satisfaction as part of the reward system. This important neurochemical boosts mood, motivation, and attention, and helps regulate movement, learning, and emotional responses” (Psychology Today, 2020).

According to (Kim, 2015), “What happens is that anger can lead to similar “rushes” as thrill-seeking activities where danger triggers dopamine reward receptors in the brain, or like other forms of addiction such as gambling, extreme sports, or even drugs like cocaine and methamphetamines. Anger can become its own reward, but like other addictions, the final consequences are dangerous and real, and people follow impulses in the moment without regard to the big picture”.

I thought addiction was just for drugs and alcohol? Great question, unfortunately, this is not the case there are numerous types of addiction including (impulse control group) kleptomania, pyromania, gambling, and intermittent explosive disorder. Then there’s the (behavioral group) Food, sex, pornography, computers, internet, video games, work, exercising, spiritual obsession, pain-seeking, cutting, shopping, etc.

This author has treated clients struggling with addiction symptomology to love, sex, praise, relationships, acceptance, anger, video games and more. In cases with clients struggling with these types of issues, this author found that somewhere along the line the client experienced being muted or silenced, or prevented from expressing themselves, or made to feel unsafe. In these cases, they have a commonality of being suppressed by another individual, or a group of individuals, or an environment or a system which led to the suppression of these feelings and/or emotions which over time reached a limit hence the display of anger in their life.

“Overall, suppressing anger and over expression of anger can negatively affect significant relationships and lead to bad health. Accepting that you are angry, seeking to understand what your anger is about, and devising an action plan prevents repressed anger to turn into rage which leads to a complete loss of self-control. Repressed anger is also an underlying cause for both anxiety and depression. Managing anger effectively motivates individuals to adopt effective assertive skills and leads to an increase in life expectancy” (Hendricks, Bore, Aslinia, & Morriss, 2013).

Daniel Acosta M.A., AMFT is a Registered Associate Marriage and Family Therapist in Mission Viejo, California. He works in private practice with men, women, and adolescents and provides individual, couples, pre-marital, family and marital therapy for clients in Orange County. If you would like to schedule a session he can be reached at 949-943-7820 or via email: daniel.acosta@therapysolutionstoday.com

Does My Therapist Go To Therapy?

According to the (American Counseling Association, 2011), “Counselors working with trauma survivors experience vicarious trauma because of the work they do. Vicarious trauma is the emotional residue of exposure that counselors have from working with people as they are hearing their trauma stories and become witnesses to the pain, fear, and terror that trauma survivors have endured”.

If a therapist is going to therapy then something is wrong with that therapist right? Let’s think about that question for a moment. In fact, that question in itself infers if something comes up for a therapist to seek out therapy in the first place that (i.e., countertransference, case consultation, or vicarious trauma symptomology) by virtue of simply being a therapist in the first place they shouldn’t have to go to therapy to address said issue. Let’s put it another way, a therapist shouldn’t have to go to therapy because they should know how to deal with it because they’re already a therapist. Does that really make sense? Human beings (including this author) are all flawed; we all have character defects and areas of development and it is in that vein that reliance shouldn’t be based on clinicians doing the right thing because they should.

According to (Berthold, 2014), “Countertransference reactions can affect multiple realms of a clinician’s life and also negatively affect the professional’s relationship with the survivor they are trying to serve”.

What’s the motivation behind this post? As a member of this industry this author has been witness to actions and behavior that led to the manifestation of this writing. That is to say, it is imperative for us to do a better job caring for ourselves so we can in turn be in a better position as clinicians to conduct ourselves professionally which enhances the care of our clients we serve and by extension the public at large by virtue of the services we offer.

According to the (American Counseling Association, 2011), “Vicarious trauma can also impact a counselor’s personal life, such as relationships with family and friends, as well as the counselor’s health, both emotional and physical”.

This author feels it should be mandatory for all mental health workers: (administrative personnel, counselors, social workers, therapists, psychologists, psychiatrists, and so on) to go to therapy on a regular ongoing basis as part of a regulated self care plan to ensure compliance and as a result a healthier place of mind to focus on what’s most important in our line of work…the client.

“It is an ethical duty, above all, for health and mental health professionals not to do harm to their clients and patients. Therefore, it is essential that clinicians strive to become aware of, understand, and develop the skills to address or make therapeutic use of the information provided by their countertransference reactions” (Berthold, 2014).

It is this author’s experience that mental health practitioners with twenty, thirty, forty, and in some cases fifty years or more of clinical experience are some of the biggest violators of not going to therapy for self and instead become a number associated with the number of years of experience they have as opposed to making the right choices to ensure they are healthy in body and mind and there’s a price to pay for it unfortunately it’s the already burdened, wounded, and encumbered client who pays the heaviest price.

“Even individuals in the helping professions can benefit from meeting with a counselor, especially when they are experiencing compassion fatigue. A compassionate therapist can help put things in perspective and help identify additional coping skills” (Salazar, 2016).

When the mental health care provider is not caring for self they are by default passing it on to their clients in session either knowingly or unknowingly and that’s harmful, unethical, and dangerous. As clinicians we have to hold ourselves to a higher standard of accountability to support a consistent commitment to client care including caring for ourselves so we can be in a better position to care for our clients.

“Professionals who do not examine or attend to these issues and take care of themselves effectively not only harm themselves (including possibly developing health and mental health problems), but are at risk of engaging in incompetent or unethical professional behavior––perhaps not consciously, but they are at risk of this nonetheless” (American Counseling Association, 2011).

Daniel Acosta M.A., AMFT is a Registered Associate Marriage and Family Therapist in Mission Viejo, California. He works in private practice with men, women and adolescents and provides individual, couples, pre-marital, family and marital therapy for clients in Orange County. If you would like to schedule a session he can be reached at 949-943-7820 or via email: daniel.acosta@therapysolutionstoday.com

References

American Counseling Association. (2011, October 11). Vicarious Trauma. Retrieved February 26, 2020, from https://www.counseling.org/docs/trauma-disaster/fact-sheet-9---vicarious-trauma.pdf

Berthold, M. (2014, June 1). Vicarious Trauma and Resilience. Retrieved February 26, 2020, from https://vtt.ovc.ojp.gov/ojpasset/Documents/VT_VT_and_Resilience_Training-508.pdf

Salazar, W. (2016, June 23). Vicarious Trauma and the Value of Self-Care for Therapists. Retrieved February 26, 2020, from https://www.goodtherapy.org/blog/vicarious-trauma-value-of-self-care-for-therapists-0627164

How to Decide Between Family Therapy and Individual Therapy

This is an excellent question, as parents we all want to do what’s best for our sons and daughters and at the same time without the data to make an informed decision we may have difficulty determining which path might be the best to pursue individual or family therapy.

Family Therapy

In family therapy the focus is typically on the family system itself, breakdowns in the system that prevent the family from functioning, and so on, this can include families with members in the family struggling with addiction, defiance, and/or incarceration. In this arena as a clinician I want to understand the family history, culture, traditions, communication skills, beliefs and values, and how conflict is displayed and resolved in the home environment.

Individual Therapy

In individual therapy the focus is on the individual whether it’s an individual dealing with anxiety, depression, trauma, self-imposed isolation, addiction, and so on. In this type of therapy the focus will be on the individual and developing coping skills, cognitive reframing, acceptance, confidence building, and dealing with parts of our past that we haven’t healed/recovered from/grieved yet.

Picking between the Two

For this to happen the ability to look at self and the family system we are a part of without deniability is absolutely necessary.

Scenario One: Parents have an adult living at home in his 30’s he has no boundaries can do whatever he wants and talk to his parents in whatever manner he wants with no consequences for his actions despite living under the roof of his parents rent and responsibility free.

Scenario Two: Parents have an adult living at home in his 30’s he has a job, pays rent, helps with chores, projects around the house and talks to his parents with respect. Their son struggles with deep depression and social anxiety and won’t leave his room when he gets home.

Daniel's Take: In scenario one I would recommend family therapy because the family system in this scenario has broken down in communication, lack of boundaries, no accountability, and no consequences for inappropriate actions and/or behavior. This family system needs to go back to basics the mom and dad need to develop boundaries for their son, detailed consequences for inappropriate behavior, and the willpower to enforce them.

Daniel's Take: In scenario two I would recommend individual therapy because in this case the son is a functioning member of his community and society as evidenced by having and holding down a job, helping out around the house in the form of chores and various projects and healthy social interaction with his parents. This individual will benefit from identifying the root cause of his depression, and develop coping skills and build confidence to overcome these challenges.

Daniel Acosta M.A., AMFT is a Registered Associate Marriage and Family Therapist in Mission Viejo, California. He works in private practice with men, women and adolescents and provides individual, couples, pre-marital, family and marital therapy for clients in Orange County. If you would like to schedule a session he can be reached at 949-943-7820 or via email: daniel.acosta@therapysolutionstoday.com