neuroscience supports a relational approach to rage / abuse issues

We are born with the capacity to rage for a good reason; it is our first and most important survival mechanism…it’s an alarm….intended to summon help if our early environment fails and our needs are not being met.

We are NOT born with the ability to reflect on impulse rather than act on it, to think ahead, to connect, to be kind, to be empathic and to be concerned for ourself and others; NOR are we born with the ability to calm ourselves down when stressed, to be self-aware, to problem solve or to be creative and imaginative.

These capacities, which ensure our humanity, stem from a well functioning frontal-cortex; they have to be developed and can only be developed within the crucible of a loving relationship which validates our experience, is attuned to our affect, contains our feelings and soothes us (Kohut, 1971). Without this relational experience we cannot thrive; we cannot sustain relationships or begin to fulfil our potential and make our contribution to the world; instead, we will live our life, brain awash with cortisol, drifting in and out of various states of rage and hurting our self and others as a result.

Sixty years of psychotherapy outcome research has highlighted the importance of the therapeutic relationship in all successful therapy; and thankfully, as we know, the brain has an element of plasticity and can be influenced positively later on in life. This means that rage issues can be organically transformed in an empathic relationship which quietens the amygdala and stimulates the functioning of the frontal-cortex.

 

anger is the poor relation of other mental health issues

Outlook Southwest, the psychology services commissioned by Cornwall Healthcare Trust, has recently announced that it will no longer be commissioned to deliver their ‘Understanding Anger’ course or to accept referrals for one-to-one counselling where the client’s main presenting issue is anger.

This is hard to believe because anger problems affect a significant proportion of the UK population.

free download at  http://www.mentalhealth.org.uk/publications/boiling-point-report/

The Mental Health Foundation carried out a telephone poll involving 1974 people from all the regions in the UK, across the age groups and with a gender and social class balance. They produced The Boiling Point Report (2008) which found that

• 64% either strongly agree or agree that Britain is getting angrier
• 28% worried about how angry they become at times
• 12% reported having trouble controlling their anger
• 20% had ended a relationship with someone because of how they behaved when they were angry

I am concerned and curious about how a whole group of mental health patients can be annexed and deemed not worthy of a service. Interestingly I have come across this in The Prison Service as well where departments compete for funding and ring-fence their spending;  those with anger difficulties often fall between two stools and the prison mental health department will argue that anger problems are an educational issue and the education department will argue that it is a mental health issue.

Anger management difficulties do not constitute a discrete mental health diagnosis in the DSM V but its presence or absence is a symptom of many of the diagnoses. Why do commissioning authorities and other institutions ignore anger as an issue in a way they would not ignore anxiety or depression?