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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.
#1 Judgment Based on 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.
Cognitive Behavior Therapy: 3-Step Reframing Technique
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.
#2 Blame Placement
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.
CBT Technique: Inner Dialogue Technique
In Column A, George wrote down his inner monologue. For example, George wrote "My ex-wife is a whore."
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.
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