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?

 

it’s not education, it’s preaching! is IDAP a form of thought reform?

I have been interviewing men who have participated in Integrated Domestic Abuse Programmes (IDAP) (UK) recently for three reasons

1. their voices have not been recorded in UK or USA research beyond a few sentences in a Home Office paper (Bullock et al, 2010) in which two men appraise the programme positively.
2. men coming to me for Empathic Anger Management would often need to debrief and process negative experiences of IDAP before we could begin the necessary therapeutic work. I was disturbed to hear them using phrases including

• feeling dominated and controlled
• it was the facilitator’s way or the high way
• felt bound and gagged
• I was brainwashed
• they messed with my head

Ironically, these are the very behaviours which the ideology of IDAP assumes that group participants will have been engaging in in their intimate partner relationships and aims to eradicate.

3. I attended an International Cultic Studies Association (ICSA) conference in 2010 and listened to       speakers discussing ‘the psychology of totalism’ and referring to Lifton’s (1989) eight components of ‘ thought reform’; as I listened, the men whom I had worked with and their stories came to mind and wondered if they had been subject to a form of indoctrination

So far I have interviewed a small sample of 3 men from London and the East and West Midlands; white males, two are white collar workers and one is blue collar; in the 35 – 50 age bracket.  I am going to map their experiences against the eight components of through reform  which are milieu control, mystical manipulation, the demand for purity, the cult of confession, the ‘sacred science’, loading the language, doctrine over person and dispensing of existence. I will briefly define each component and offer extracts of the men’s stories which, in my opinion, illustrate that a form of mind control or thought reform is at the core of this programme. These components co-exist, they are not discrete phenomena and my attempt to separate them out is somewhat artificial; they will inevitably overlap so for example, milieu control has to be present for all the other components to exist, the demand for purity is linked to the cult of confession and the sacred science is inextricably connected to doctrine over the person.

Milieu Control

This relates to the control of all communication within a given environment including both the individual’s inner communication as well as their external, inter-personal communication. Milieu control is maintained through structuring all group dialogue around the power and control wheel and the equality wheel. When these two models stand-alone they finely calibrate a wide range of constructive and destructive inter-personal behaviours which make a considerable contribution to our understanding of what constitutes harmful and unharmful relationships. However, those I interviewed described them being used in conjunction with a radical feminist ideology which holds a cynical stereotypical view of men who are all viewed as rapists or perpetrators of domestic abuse or potential rapists and perpetrators of domestic abuse.

The men I interviewed told me

• “make no mistake about it, we were left in no doubt that men are bad”
• “I was assumed to be a serial offender; you were not allowed to say “it only happened the once”
• “you knew that if you didn’t agree with them you’d be off the course; ‘off the course was code for ‘back to court’ or ‘prison’

These highly structured groups restrict participant discussion to the eight abusive behaviours on the power and control wheel and their eight non-abusive counterparts on the equality wheel. The men I interviewed told me that they were assumed to have committed harmful behaviours from each of the eight categories and were discouraged from saying

• “actually, I never sexually abused my wife”
• “I never financially exploited my partner”
• “I didn’t use the children to manipulate her”

Facilitators argue that ‘the driving force [of domestic abuse] is the hub of the wheel…. power and control – not alcohol, stress, drugs, poverty, bad childhood experiences or anger problems (REFERENCE).’ Each of the interviewees had reflected on their behaviour and all of them had a complex narrative of why what happened had happened; invariably they resolved that there were multiple personal and interpersonal factors that had contributed to the single, abstracted event, with the single explanation, which facilitators, magistrates and judges focus on. They quickly learned that these other kind of explanations would not be tolerated. When the milieu is being controlled individual autonomy becomes a threat to the group and those men I interviewed who challenged the notion that all men are bad, denied that they hadn’t committed a category of abuse or offered an alternative explanation from ‘the party line’ (participant) were told they were being

• disruptive
• unco-operative
• not engaging
• in denial
• making excuses

and were threatened with being removed from the group.

Lifton (1989) says ‘intense milieu control can contribute to a dramatic change of identity which I call doubling: the formation of a second self which lives side by side with the former one…… the boundary of the self is chipped away at, pressure on the internal milieu [participant’s inner life] to introject [swallow / take on board] the external milieu [the feminist ideology]’.

The research participants reported

• “presenting what they [facilitators] wanted to hear”
• “showing a false self”
• “telling others to keep their heads down, do what’s expected and don’t rock the boat”

‘When the milieu control is lifted, elements of the earlier self may be reasserted’ (ibid); participants described being more real in tea, cigarette breaks and in any contact outside of the group environment.

Lifton (ibid) describes how humans naturally ‘strive towards new information, independent judgement and self-expression’; all three men told me they were optimistic about learning something about themselves and relationships when they entered the group; milieu control thwarts this organismic process.

References

Bullock K,  Sarre S, Tarling R & Wilkinson M, 2010, The delivery of domestic abuse programmes: An implementation study of the delivery of domestic abuse programmes in probation areas and Her Majesty’s Prison Service, Ministry of Justice Research Series 15/10 July, London, Home Office

Lifton RJ, 1989, Thought Reform and the Psychology of Totalism, North Carolina, University of North Carolina

To be continued…………

 

 

a politically incorrect conversation: a non-gendered approach to domestic abuse

 

anger management in schools (and any organisation) is a shared responsibility

My earlier post argues that anger and rage are different and that it is rage (teacher/pupil) in the classroom that is the problem and not anger; in my opinion, where rage is involved it is not about the here-and-now (though it is always triggered by a here-and-now incident) and people are relating to one another as objects and not seeing themselves or others for the whole separate human beings that they are. Far too often these issues are personalised (pupil / teacher).
In my relational model…everyone has a responsibility for creating the emotional environment in a school or any other environment….teacher / pupil / managers & policy makers. Relationship and integrity between these agencies is the key…where there is relationship, connection, mostly shared values and goals and an environment which treats everyone as vibrant human beings and not as ‘heads on legs’ there is much more chance of an approximation to harmony.
Further…being realistic, where there is a one-size-fits all programme (curriculum/prescribed practice) which treats all members as the same….there will be a large number of students/clients who will be regulalry traumatised by it. Government ministers, policy makers, schools & other organisations have to be more imaginative about what constitutes education/service and how it is delivered.

That’s probably quite a way off! For now I think it is necessary to give as much attention to encouraging functional relationships between all parties in schools/organisations as is given to the curriculum; to build an optimum emotional environment where all human needs get met and where everyone experiences their natural organismic hunger and joy for learning . RELATIONSHIP is the vehicle for learning / change, not the curriculum/prescribed practice.

 

Hello world! Calling to folk who have a professional or personal interest in anger management

Welcome to my blog which is aiming to promote a different way of working with anger and rage, a way which is sensitive to an individual’s personal history, mental health, relationship dynamics and personal understanding of events.

Many of the mainstream approaches are ‘one-size-fits-all’ programmes; they deny a person’s individuality, personal account of the situation, any mental health diagnosis and most importantly, the trauma that underlies raging behaviour.

I am author of Anger, Rage and Relationship: An Empathic Approach to Anger Management, (Routledge, 2008) which differentiates between anger (positive and necessary for self-care) and rage (negative and destructive to self and relationships).

Rage is understood as a defence mechanism which is activated when a person cannot ‘process or come to terms with life’s events and experiences’; Empathic Anger Managment (EAM)  offers a deeper way of working with rage which addresses clients’ underlying trauma, listens to their previously untold stories and supports them to develop affect regulation (to manage their emotions).

I am, very keen to hear from anyone who has participated in other kinds of anger management programmes and to learn what went well and what was not so good about them.

I look forward to hearing from you!