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Anger Management: Cognitive Therapy Interventions7 CEUs Anger Management: Cognitive Therapy Interventions

Section 7
Track #7 - The Rip-Off Artist: How to Combat Trigger Thoughts
with 'Inner Dialogue'

Question 7 | Answer Booklet | Table of Contents | Anger Management CEU Courses

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On the last track, we discussed the need for clients to make behavioral changes that support accountability.  Four behavioral change concepts we considered were setting goals, making amends, choosing positive communication, and being authentic.   

On this track, we will discuss combating trigger thoughts.  Do you agree that cognitive triggers for anger can fall into two categories? These two categories are judgment based on personal rules, and blame placement.  As I describe ways in which clients can combat these two cognitive triggers, see if you can apply this information to an anger management client you are currently treating.

Two Categories of Cognitive Triggers for Anger

Share on Facebook #1 Judgment Based on Personal Rules
4 Manifestations of Judgment Based on Personal Rules
a. The first set of methods for combating trigger thoughts will be directed at triggers established by judgment based on personal rules.  As you are aware, clients who judge others based on personal rules of conduct feel angry when those rules are broken.  Have you found this to be true?  To many anger management clients, this behavior seems like a deliberate assault on what is correct, moral, and intelligent.  However, others may have no way of knowing the client’s personal rules.  

b. Another manifestation of judgment based on personal rules is the entitlement fallacy.  I'm sure you've ran into this one often enough. Clients with the entitlement fallacy believe that because they want something very much, they are entitled to it.  For example, Ted, age 47, wanted his son to accompany him on a fishing trip.  Ted stated, “After all, I pay for his damn college and I’m his father.  He should give up a few days chasing girls to keep his old man company!”  Ted was in a rage after his son told him he would rather hang out with his friends.  Clearly, for Ted, his entitlement fallacy confuses desire with obligation.  

This concept is similar to the fallacy of fairness.  As you are well aware, some clients believe that all relationships should be fair and equal.  Clients with the fallacy of fairness tend to think there is some standard  of behavior all others should know and live up to.  

c. A third manifestation of judgment based on personal rules is the fallacy of change.  Clients with the fallacy of change assume that they can change people and gain actual control over the behavior of others.  Lisa, age 29, was married to Kenneth. Lisa told me, “I guess if I complain and get angry enough, he’ll stop being so preoccupied with his damn job and his hobbies and give me a little attention.”  I stated to Lisa,  "People usually only change when they are reinforced and capable of change."  

Kenneth was highly reinforced to remain preoccupied with his work and hobbies, and not spend much time with Lisa because her current strategy of getting angry made it more aversive to be with her.  We discussed that Kenneth may not change until Lisa made it more rewarding to spend time with her.   Later in this track, we will review a technique which helped Lisa see what she was doing. 

d. A final manifestation of judgment based on personal rules is conditional assumptions.  As you know, conditional assumptions are ultimatums which directly challenge one’s feelings. For example: “If you were a real friend, you’d help me patch my roof.”  Clients who use conditional assumptions are actually engaging in a strategy for manipulation.

Share on Facebook 3-Step Reframing Technique
I have found a good technique for dealing with anger management clients judgment based on personal rules is reframing.  

a. First, I asked Lisa to write down several conditional assumptions and then reframe them as equally legitimate needs.  Lisa wrote that if Kenneth really loved her, he would spend time with her.  Lisa wrote her legitimate need as being affection.  

b. Second,  Lisa worked with Kenneth to negotiate a process of compromise and accommodation.  By negotiating, Lisa was ‘reframing’ her expectations. 

c. In a future session, Lisa stated, “Kenneth seemed to listen.  He told me by complaining and getting mad all the time, I was pushing him away. So I'm going to work on that, if I can.”  As you know, reframing is a process of changing perspective. Would using reframing more often with your Lisa in a session be beneficial?

Share on Facebook #2 Blame Placement
In addition to judgment based on personal rules, the second method for combating trigger thoughts will be directed at triggers established by blame placement.  Of course, these triggers anger clients by placing the blame for negative emotions on another person.  As you know, blame placement leads to the development of negative cognitive sets in which a client interprets a person’s behavior in consistently negative ways.  As you will see with George, this negative cognitive set becomes more engrained and even neutral behavior is viewed as negative.  

Blame placement can manifest as assumed intent.  Assumed intent triggers anger when a client concludes their pain is the consequence of someone else deliberately trying to harm them.  George, age 36, stated, “ My damn landlord raised my rent again.  Like he needs the money.  The asshole’s got rental property all over town.  I’ll tell you what it is…  he knows I’m stuck and can’t afford to move.  What a jerk!.”  Another manifestation of blame placement is global labeling.

As you are aware, global labeling fuels anger by indicting an entire individual rather than simply disliking the person’s behavior.  Clients who use global labeling focus on a single characteristic or behavior yet imply that it’s the whole picture.  George stated, “Maybe I wouldn’t be so angry if I wasn’t surrounded by idiots.  My coworkers are imbeciles.  My roommate is neurotic and my landlord is a rip-off artist.”  George was using global labels to describe his relational contacts.  

In addition to assumed intent and global labeling, a third manifestation of blame placement is magnifying.  Are you currently treating a client who magnifies and makes things worse than they are.  As you know, these clients use extreme words, such as awful or horrendous, to describe a situation. Because, clients who magnify tend to over-generalize by using definitive words such as always or never, I like to use Aaron Beck's Inner Dialogue three-column technique.

Share on Facebook Technique: Inner Dialogue Technique
With George, I used the Inner Dialogue technique.  This same technique proved useful for Lisa and Ted, as well.  As you probably know, the Inner Dialogue  three-column technique was designed by Aaron Beck, one of the founders of cognitive therapy.  I told George whenever he was angry, he could divide a page into three columns.  

In Column A, George wrote down his inner monologue.  For example, George wrote “My ex-wife is a whore.”   
In Column B, George wrote what type of trigger he thought he was using.  In this case it was global labeling.  
Finally, in Column C, George rewrote his original statement so it no longer contained the distorted trigger thought.  George wrote, “My ex-wife resents me.”  As you can tell, in Column C George eliminated the trigger thought and held himself accountable for his anger.  Do you have a client who can benefit from the Three-Column Technique?

On this track, we discussed combating trigger thoughts.  Cognitive triggers for anger fall into two categories: judgment based on personal rules, and blame placement.

On the next track, we will discuss Alternatives to Anger.  Some alternatives to anger are analyzing accusations, acknowledging imperfections, and teaching others.

QUESTION 7
What are the two categories of trigger thoughts? To select and enter your answer go to Answer Booklet.

 
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