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Anger Management: Cognitive Therapy Interventions
Anger Management: Cognitive Behavioral Interventions - 10 CEUs

Section 28
Selected Readings Bibliography/ Authors/ Instructors


CEU Answer Booklet | Table of Contents
| Anger Management
Social Worker CEU, Psychologist CE, Counselor CEU, MFT CEU

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Additional Readings

Bearding the Lion: Resolving Conflict and Managing Anger through Metaphorical Exploration. By: Leseho, Johanna. Guidance & Counseling, Winter2001, Vol. 16 Issue 2, p62, 5p; (AN 7280439)

Emotions and Our Minds


Biological theory tells us that the emotional centre in the brain reacts faster to stimuli than does our cognitive centre because of the greater number of sensory pathways to this area (Goleman, 1995). Although the emotional and cognitive centres are meant to work together, emotions experienced in response to environmental stimuli may “flood” the individual, who then acts without thinking of the consequences, indeed, without making a cognitive appraisal of the situation.
For primitive emotions like fear (which often lie beneath one's anger), the brain is constructed to respond even more quickly, particularly in response to what are perceived as potentially threatening events. Sensory input has been demonstrated to reach the amygdala, the emotional centre in the brain, two to three times faster than to the cortex, which houses the language centre (LeDoux cited in Goode & Schrof, 1991). These findings support the view that at least some emotional processes take place unconsciously and that cognition and emotion, although they interact, are separate systems in the brain.
Studies by psychologists Richard Davidson at the University of Wisconsin and Donald Tucker at the University of Oregon have gone further to indicate a hemispherical division of negative and positive emotions. Emotions such as fear and disgust activate right frontal lobes of the brain, while certain positive emotions like happiness and amusement increase activity in the left frontal lobes (Goode & Schrof, 1991). Recent psychophysiological investigations suggest that right-hemisphere functioning is closely associated with the system that sustains episodic, personal, and emotionally laden memories. Left-hemisphere functioning is responsible for the maintenance of semantic memories (Rotenberg & Weinber, 1999).
Such empirical evidence suggests the need for a process that does not rely on the activation of cognitions in order to at least initially manage intense emotional reactions. Language has long been considered to reside more predominantly in the left hemisphere. Therefore, in order to more quickly and effectively moderate an emotional response in the right hemisphere, it would seem prudent to use a process that engaged the right hemisphere rather than the left.
Mental imagery appears to be situated more significantly in the right hemisphere than in the left. Evidence comes from the use of computerized tomography scanning, which has shown that lesions in the brain of individuals who have difficulty with imagery are confined to the right frontal lobe (Guariglia & Padovani, 1993). Mental images that were associated with specific metaphors were, therefore, determined to be a viable avenue for managing anger responses.

Metaphors in Counselling


Many theories that inform counseling (person-centered, existentialist, gestalt, and narrative) have long used metaphors and externalization of the problem to help students deal with their reactions, responses, and approaches to difficult situations. Boone and Bowman (1997) explain how Freud, Erickson, Jung, Perls, Satir, and Ellis each used metaphors to illustrate their concepts or as a means for change.
According to Newton and Wilson (1991), metaphor serves three functions in counseling. Students who have difficulty in communicating their emotions or describing an experience literally may use metaphor to express their feelings. Similarly, resistant or defensive students may find metaphors to be a less threatening avenue for self-exploration or self-disclosure. Finally, “metaphor functions as a teaching and learning tool presenting meanings, perspectives, implications and directives for change in succinct and creative form” (Boone & Bowman, 1997).
Gordon (1978) described the therapeutic value of metaphorical stories in a counseling session. After hearing students explain their problems, Gordon tells them stories (mythological or realistic) in which protagonists deal with similar situations but are able to resolve their problems. Students discover avenues not previously apparent to them for resolving their own life stories.
White and Epston (1990) use students' personal narratives to support their transformation away from being passive victims. Students are helped to recognize the stories that make up their lives and those stories in which they are merely observers. They are then supported in rewriting these stories, or “dominant narratives,” with themselves as active agents. White and Epston objectify a problem by viewing it as a metaphoric opponent that can be challenged by the student. For example, they might ask a man who is chronically angry how Anger is using him. The student creates a new story for his life with himself as the victor in his fight against the opponent, Anger. This new story may now serve as a powerful metaphor by which the student may live.
In a similar manner, Kopp (1995) listens while his students tell their stories, extracting the metaphors they use or that are implicit in their descriptions. Together they explore the metaphors that are present in the narratives of the students' life situations. If it is determined that the metaphors are not supportive in creating the lives they want to be living, students are invited to transform their images, resulting in an empowering effect. Among students who were previously unable to motivate themselves to make the necessary changes in their lives, transforming their personal metaphors was the key that allowed them to do so. Each moved from being the victim to the director of his life script.
These and other uses of metaphors in the counseling process led me to consider how metaphors might be applied as tools in anger management and conflict resolution and to develop the model of metaphorical exploration that I now describe.

Resolving Conflicts with Students


A crucial requirement in resolving conflict is the ability to understand one's own role in keeping the conflict alive. Examining metaphors that influence a teacher's or counselor’s relationship with students is an excellent tool for discovering one's role. Attitudes, biases, and presuppositions may hide behind stated beliefs. For example, Reimer (2000) found that counselors who stated that their values should definitely not be a part of their work with students responded to a scenario with clearly judgmental and value-laden suggestions. Personal beliefs about homosexuality would be present in their counseling sessions, despite their insistence on being bias-free. Viewing students metaphorically provides insight into the deeper feelings that drive our actions.
The influence we have on our students may come in an even more subtle form, as our thoughts alone can influence others. One research participant, a middle school counselor, said that she was comfortable with her students' behaviours, even when they were angry or acted inappropriately. While engaging in the process of metaphorical exploration, she imagined an angry student as a marionette whose strings were being pulled by friends, teachers, parents, the media, and so forth. The next time this student “lost control,” the counselor evoked this image and found that “that extra 10% detachment, when coupled with affection, was experienced at a different level by the student.” She acted and spoke as she usually did; yet the adolescent “backed off quicker than she would have normally.”

A Process for Discovery and Change

Visualization

Begin by visualizing a session or incident with a student with whom you are experiencing conflict. Imagine all the sights, sounds, smells, tastes, body and tactile sensations, and particularly, the emotions that arose. Once you feel fully in the experience, mentally replace the student with something more abstract, such as a weather system, animal or inanimate object. Notice the student's actions and your responses (both physical and emotional) to these actions. You may also envision yourself in an abstract form. For example, remembering one incident with an angry child, one research participant saw the child as a windmill, its blades spinning wildly at the mercy of the prevailing winds. The windmill was large and the blades appeared extremely sharp and dangerous. The participant saw herself standing in the distance, simply watching the spinning blades.

Unpacking the metaphor

The next step is to “unpack the metaphor” (Mezirow, 1991). Ask yourself such questions as “What are the characteristics of a(n) …?” “How do I feel about a(n) …?” and “What's my relationship to a(n) …?” In unpacking the metaphor of the windmill, the participant discovered how nervous she was around this child. She was afraid to move too close to the windmill for fear of being injured by the force of the spinning blades. She also recognized that she perceived him to be something “cold and mechanical and unfeeling,” that he had no control over his reactions and behaviour. Her reluctance to step toward the windmill/child prevented her from offering assistance while the child spun out of control.

Examining the relationship between beliefs and actions

By examining the metaphorical images, counselors may recognize the incongruities between their beliefs and actions. The research participant described earlier had believed that she “offered students a safe haven, a place to feel accepted as they were” And was shocked to discover her true feelings for this child. The first metaphor led to others. In one image she saw herself “turning down the volume on a television.” In another, the child was an image from a photocopying machine being repeatedly reduced in size until he ceased to exist.
Exploring her personal metaphors of this child allowed her to alter her perceptions of him in a way that would facilitate intervention. She was able to view his behaviour as being driven by his need to be seen by her as well as by his susceptibility to external factors. This new understanding freed her to consider new interventions for altering the unwanted acting-out behaviours. She realized that helping the child required her to alter her own attitudes.

Summary


By perceiving students metaphorically, we are able to emotionally disengage, providing the distance that is sometimes required to more easily resist our biases and accept students with all their problems. The student previously viewed as annoying and disruptive may now be likened to a leaf blown about by the slightest breeze. Compassion and understanding may develop new avenues for interventions. For example, one counselor described her experience of a student who raged in her office. Through metaphorical exploration, she envisioned him tied to a flagpole, with a flag coming out of his mouth. He had tied himself there, and as he raged on, he was lifted up by the pole and became the flag being snapped by the force of the wind. This image helped her to replace her previous feelings of fear with compassion.
As we unpacked the metaphor, she determined that his anger was a manifestation of his need to be seen. Flags are not visible when hanging loose, but must be blown by the wind. The participant's immediate thought was to intervene when he first showed signs of anger (when he was still a person at the base of the flagpole) and ask “What do you need me to see (hear, say, etc.)?” She acknowledged being part of the wind that made him flap and decided to examine how she was playing that role.

Helping Students Manage Anger and Resolve Conflicts


Metaphorical analysis is especially beneficial for individuals who are not able to articulate their emotional state. With anger, this may include both managing one's own anger or dealing with the anger of others. Counselors may guide students through the following metaphorical exploration process to help them cope with anger.

Visualizing anger

Ask your students to think of a time when they were particularly angry or when they were especially uncomfortable being in the presence of an angry person. Ask them to re-experience the event by evoking all the sights, sounds, smells, tastes, body and tactile sensations, and particularly, the emotions that arose in one such experience. Instruct students to mentally replace themselves with something more abstract. The range of metaphors individuals have described is tremendous, including an avalanche, a frying strip of bacon, a robot, a rain cloud, and a distorted portrait by Picasso. Another approach to uncovering a personal metaphor of anger is to simply ask “If your anger was water, what form would it take?” The student will either choose a particular form, such as a raging river, an ice floe, or a waterfall, or might liken the anger to a volcano, a bomb, or a run-away train.

Unpacking the anger metaphor

Again, ask questions such as, “What are the characteristics of a(n) …?” “How do you feel about a(n) …?” and “What's your relationship to a(n) …?” Unpacking the metaphor helps the student and counselor understand the deep experience of anger. Don't assume that you understand the meaning of the metaphor; it is specific to the individual. For example, the woman who saw herself as a strip of bacon appreciated having someone turn on the heat under the pan as it “started her juices flowing.” However, when the other “turned up the heat” and then “refused to turn her over,” she found herself sticking to the pan and burning. She felt helpless to do anything but continue to burn, the juices splattering out of the pan, un-contained, burning anyone who came close. During discussion she explained how this metaphor described her experience of anger—she continually gave power over her own emotional state away to others.

Altering the anger image

Students can change their experiences or expressions of anger by deciding on a means of altering the metaphorical image. The woman using the bacon metaphor needed to take control of her feelings rather than let others do so (determining how high to set the temperature and for how long). She decided that as she felt herself become uncomfortably warm she would reach up and turn down the heat. (Since this is imaginary, anything can occur, even arms growing out of the side of the pan to do her bidding.) She also imagined a splatter shield over the pan to prevent “getting her anger on others.”
The student is then asked to again visualize the original scenario and observe the strip of bacon in the pan. The counselor wants to ensure the student is particularly aware of any bodily sensations associated with this experience (e.g., feeling hot). The counselor then asks the student to observe as arms appear to turn down the heat and place a splatter shield over the pan. What happens in the scene? What happens in the student's own body?
Ask the student to imagine a number of future situations that could provoke anger. As the student progresses through each scenario, she first visualizes the bacon burning and splattering and then feels herself cool down as she contains her emotions. Such proactive exercises prepare the student to act differently in the future. When she is aware of feeling the heat of anger, she imagines/experiences the burning strips of bacon, immediately lowers the temperature, and covers the pan. At this point she may be able to incorporate other strategies to deal with the emotion, such as deep breathing or coping self-talk.
Bodily sensations provide a cue to the student that it is time to bring forward the metaphor. The counselor may work with the student to increase her awareness of other sensations (e.g., tightening of the stomach or shoulder muscles) and anchor this awareness to the image of the frying bacon. With experience, the student will be able to manipulate the arms to control her temperature before it gets too hot.
The process is similar for students who are particularly uncomfortable dealing with the anger of others. The student may imagine himself as a small animal that runs frightened into its hole. While the student wants to remain firm and unafraid, he has never had the ability to do so. By bringing forward a different image, perhaps of an elephant, the student is able to feel secure and powerful, better able to state his feelings and needs in the situation.
Viewing the angry person metaphorically may also be a successful strategy, as it was for the counselors discussed earlier. Imagining someone as an angry bear can certainly be frightening. However, recognizing that the bear is angry because it is caught in a trap helps the student develop distance from the situation and makes the anger less personal and intimidating. The need to defend or retaliate often disappears. This change in perspective may facilitate a different form of interaction.

Conclusion


The narratives that counsellors construct about students or expressions of anger influence the counseling environment and the interpersonal relationships that occur. Thus it is crucial that counselors be aware of the narratives or metaphors that guide their practice.
The analysis of personal metaphors of anger has been demonstrated to increase self-awareness that facilitates issue resolution (Leseho, 1997). Metaphors offer a way of thinking about the relationships between events and give meaning to events that otherwise may not have inherent meaning (Belth, 1993; Fantz, 1983). Metaphorical exploration may also be used with students to make explicit the stories that are directing their behaviours. Essentially, analysis of personal metaphors of anger provides a strategy for altering perceptions of emotion and interactions with others.
For some individuals, metaphorical images may help them eliminate feelings of anger and allow them to enter into a process of conflict resolution. For others, metaphorical images may facilitate the neutralization of feelings necessary to allow individuals to access their self-talk script and any other cognitive strategies they have learned. As a flexible tool, metaphorical exploration provides an effective supplement to other forms of anger management and conflict resolution.

 

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- Anderson, Jared R.; Stith, Sandra M.; Johnson, Matthew D.; Strachman-Miller, Marjorie M.; Amanor-Boadu, Yvonne; Linkh, David J. Multi-Couple Group and Self-Directed PREP Formats Enhance Relationship Satisfaction and Improve Anger Management Skills in Air Force Couples. American Journal of Family Therapy. Mar/Apr2013, Vol. 41 Issue 2, p121-133.

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- Stimpson, Aimée; Kroese, Biza Stenfert; Macmahon, Pamela; Rose, Nicola; Townson, Julia; Felce, David; Hood, Kerenza; Jahoda, Andrew; Rose, John; Willner, Paul. The Experiences of Staff Taking on the Role of Lay Therapist in a Group-Based Cognitive Behavioural Therapy Anger Management Intervention for People with Intellectual Disabilities. Journal of Applied Research in Intellectual Disabilities. Jan2013, Vol. 26 Issue 1, p63-70.

- Sukhodolsky, Denis G.; Vitulano, Lawrence A.; Carroll, Deirdre H.; McGuire, Joseph; Leckman, James F.; Scahill, Lawrence. Randomized Trial of Anger Control Training for Adolescents With Tourette's Syndrome and Disruptive Behavior, Journal of the American Academy of Child & Adolescent Psychiatry, April2009, Vol. 48, Issue 4, p 413

- Walker, Julian S.; Bright, Jennifer. Cognitive therapy for violence: reaching the parts that anger management doesn't reach, Journal of Forensic Psychiatry & Psychology, April2009, Vol. 20, Issue 2, p 174

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