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= Anger Management =

Introduction
Anger is within the normal range of human emotions. However it can at times become difficult to manage, and interfere with daily life. Anger management consists of a collection of techniques used to ameliorate excessive aggression. This article will address successful anger management therapies, and ineffective therapies. The defining characteristics of anger issues will be described.

History of Anger Management
Anger management today is built on the foundation laid by the understanding of anger. The study of anger began with people like Aristotle, Seneca and Galen. Anger was studied mainly by different observations; there was no testing or experiments completed to study anger. Seneca and Galen used observations from everyday life and people’s responses to anger in order to learn more about anger. Aristotle and Seneca formed theories that would be used in the modern study of anger and anger management.

The understanding of anger has not changed much in the 2,000 years since Aristotle’s time. One of the most important aspects of understanding anger is the cognitive approach and idea of anger and this is what is needed in order to understand the theories of anger management in the present day and also in the past. One of the similarities between the early anger management techniques and those used today is requirement of attention to specific details. For example the techniques rely on the specific situations that cause the anger on the client.

A difference between the old and present techniques is that the older approaches did not consider the dangerous effects of suppressing one’s anger. The older theorists did not pay much attention to how ignoring the anger problem could have detrimental effects on the person. Whereas in the present research there is more emphasis on the adverse effects of supressing one's anger. This is how different anger management theories came into place.

Another important difference to note between old and new studies are the differences in anger between genders. Even though there has not been extensive research done on anger and anger management in the present, there has been research done on the differences between how males and females deal with anger. Both Peter Stearns and June Crawford have both studied anger and gender differences.

During the Victorian era anger was seen as a driving force that helped men get more work done. In the twentieth century it was seen more as a restraint on work performance and it was necessary to control one’s anger. There has been a drastic increase in anger management groups in the work place that have taught people to deal with their anger in non-aggressive ways. This has led to many of the different anger management programs that have recently arisen.

Research has lacked an emphasis on observing anger management as a clinical treatment. This lack of research done on different anger management programs makes finding an effective treatment difficult for some patients. As anger becomes more of a clinical diagnosis it is hoped that there will be more empirically supported programs to better treat patients who need anger management.

Present anger management, for men, is based on education, training and application. Anger management is similar for women but there is an emphasis on assertiveness training.

Seneca
One of the first people to study anger and the control of anger was the Roman philosopher Seneca. He studied anger during his lifetime, c. 4 BC- AD 65, and from his experiences and observations he formulated ways to control anger. This could be considered an early form of anger management. Seneca noted the importance of how to avoid becoming angry, how to quit being angry, and how to deal with anger in other people.

Another theorist who came after Seneca was Galen, a Roman era philosopher, who built on the work of Seneca to formulate new ideas in the area of anger management. Galen stresses the importance of a mentor to help deal with excess anger.

Peter Stearns
Peter Stearns played an important part in researching the differences in anger between genders. Stearns concluded that there are similarities between male and females experience of anger. June Crawford came up with an opposing idea about how the two genders deal with anger. Her research concluded that men and women deal with anger by different means.

Raymond Novaco
Works from Raymond Novaco in the 1970s have contributed to many of the recent ideas on the management of anger. These ideas have led to the implementation of different anger management programs. An important idea from Novaco is the importance of looking at the situations that led up to the anger in order to have control over the anger. He stated that anger is a emotional response to situations. Novaco stated that anger occurs in three modalities, either cognitive, somaticaffective or behavioral. After discovering the anger there should be discussion and self-examination in order to relieve the anger. This process was thought to help the client identify the situations that lead to anger and deal with the anger depending on the step that the anger is occuring in. The client is able to use different relaxation skills to reduce their anger before it advances.

Characteristics of Anger Issues
Anger is a natural emotion. It can be expressed mildly or strongly. The expression of anger typically falls into one of three approaches: expressing, suppressing, and calming. The healthiest method is to assertively address the issue without aggression. Anger is not a problem if it is controlled. When anger escapes control, and becomes frightening It needs to be addressed.

What is anger?
Anger is an adaptive response to the environment. It engages and mitigates threats. Operant conditioning relies on a reward coupled to a behavior. When anger is experienced, and the adversity dissipates it is strongly reinforcing. Emotion is not a process independent of the body. It is influenced by a myriad of hormones and neurotransmitters: GABA, dopamine, serotonin, noradrenalin, oxytocin, and cortisol. These influence the sensations coming from the body. Conversely the body can affect mood.

The psychoevolutionary theory of emotion as proposed by Robert Plutchik defined eight primitive emotions: joy and sadness, trust and disgust, fear and anger, surprise and anticipation. There is also a bipolar component to each of the emotions. The eight basic emotions developed through the increased ability of the animals possessing them to respond to environmental stimuli. Those that were better able to react adeptly were more likely to survive. Anger is coupled to fear. This relationship can be explained with the fight or flight theory. When a threat is present the animal will either engage it, or flee. Each of the primary emotions can be experience with varying degrees of intensity, and can be simultaneously experienced to build more complex sensations.

Cognitive approach
The focus of cognitive therapy in anger management is to challenge dysfunctional cognitions. The process can involve problem solving and focusing on tasks in order to address the cognitive components of anger. This can help the client change their thoughts and remain calm when experiencing anger and anger cues.

Cognitive - Behavioral Overview
A way of treating anger within the frame of the cognitive-behavioral approach is through exposure to what provokes anger in the client. Exposure may be covert or overt. The cognitive aspect of anger must also be addressed. Often anger occurs through automatic thought and irrational beliefs. This poses a problem for treatment because the patient may respond too quickly to change the thought or behavior. This phenomenon is referred to as "hijacking of the cognitive system by the emotional system" (Wright, Day, & Howells, 2009). Self-management skills are developed through learning appropriate coping skills. The cognitive -behavioral approach can be challenging for those lacking in self-awareness.

Mindfulness Approach
This technique attempts to teach clients acceptance of bodily sensations and emotions. This method originated in Eastern spiritual traditions that practice mindfulness through meditation. Bishop, proposed a two-prong component of mindfulness that includes: self-regulation and orientation toward the present moment. The focus of Mindfulness is experiencing the present moment in a non-judgmental manner that is reflective of meditation. In practice, clients observe breathing, sitting and walking during meditations. The goal is for clients to understand their thoughts of anger are merely thoughts rather than reality. Mindfulness is also a technique used in the relaxation approach. This is because the technique reduces physiological arousal.

Rational Emotive Behavior Therapy
Rational Emotive Behavior Therapy explains anger through the client's beliefs and emotion, rather than the event itself. The concept involves clients interpreting events in a rational manner in order to avoid irrational thoughts that lead to anger. Delayed reaction technique is when a client attempts to uncover what is making them angry before acting out on their anger. This allows them to have time to change what is making them angry and increase time before the angry response to encourage thought on a more rational response. In addition, clients are also encouraged to avoid demands in order to avoid anger. An example of a demand placed on a client may be that, "I have to have this done by my standards".

Relaxation overview
The focus of relaxation is on the client’s emotional and physiological arousal. When the body experiences anger the hormones epinephrine and norepinephrine are released, which influence both cognitions and behavior. The process of relaxation can reduce cognitions and motivations to act out and through relaxation clients gain coping skills to better manage their anger. This therapy addresses various aspects of anger such as physiological, cognitive, behavioral, and social. These various aspects combined through the process of relaxation is what makes relaxation an effective treatment for anger.

Nontraditional anger treatment
Diet treatments, reflexology, and acupuncture are other methods of treating anger that have mental health practitioners skeptical. The diet or nutritional treatments are aimed at uncovering the problem that is at the source of their anger. The process of uncovering the problem is done by researching biochemical imbalances that have an influence on mental health. For example, an individual that consumes gluten rich foods may be negatively influenced because their body is unable to process gluten properly. This negative influence may result in an increase in aggression, irrational thought process, and ultimately anger.

Success Rate of Anger Treatments
Anger treatments success rates are difficult to estimate because anger is not a recognized disorder in the Diagnostic and Statistical Manual of Mental Disorders. This manual is used as a reference for mental health professionals. Some research does exist on comparing various treatments for anger, but they also describe methodological difficulties in making accurate comparisons. The most concrete evidence for anger treatment is that multiple techniques have proven to be more successful than a single technique. The relaxation approach had the highest success rate as a standalone treatment because it addresses the physiological, cognitive, behavioral, and social component of anger.