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Treating Male Suicide & Depression
Male Suicide & Depression continuing education psychology CEUs

Section 12
Feelings, Anger and Behavior

CEU Question 12 | CE Test | Table of Contents | Depression
Counselor CEUs, Social Worker CEUs, Psychologist CEs, MFT CEUs, Nurse CEUs

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In the early morning hours of January 7th, 43-year-old Derrick K. Miller walked up to a security guard at the entrance to the San Diego Courthouse, where a family court had recently ruled against him on overdue child support. Clutching court papers in one hand, he drew out a gun with the other. Declaring: "You did this to me!!" he fatally shot himself through the skull. Miller's suicide is symbolic of a frightening global trend. That trend is an alarming rise in male suicides.

On the last track we looked at the ABC's and a D as they can be applied to a depressed male client's anger control.

In this track we'll look at the "Anger Diary". As you listen, how I used this technique with Neil think of a male client you are currently treating and evaluate whether this technique would be beneficial.

As you are aware many depressed male clients do not realize they are depressed. As mentioned on a previous track, they often do not realize how frequently their depression results in anger and how their anger affects others. A good example of this is found in my client Neil, a 27-year-old advertising agent who had been dating his girlfriend, Maggie, for three years. During our first session together, Neil admitted to getting angry some of the time. I asked Neil to describe how much of a problem he thought his anger was. He stated, "I don't really see it as a problem. I just get kind of mad sometimes at Maggie."

Technique: Anger Diary
I told Neil to begin recording his anger experiences. "Every night before you go to bed," I told him, "write down all the incidents of the day that have made you angry and how you handled them. Here are some specific items to include in an entry: the date, time and place of each anger-provoking experience, the person and or condition involved, the external events that provoked the anger, both the negative and positive self-talk that you used before, during, and after the anger-provoking experience, and how you behaved in response to the provocation. Also, write down the intensity of the anger you felt and an evaluation of how well you dealt with that anger."

I told Neil that his anger diary would help him to get a better idea of how often and how intense his anger incidents were. Also, I told him that the anger diary would help me to see what kinds of things were provoking his anger. From there, we could decide the best way to go about treating his depression. At the beginning, Neil was skeptical. He knew that something was wrong, or at least that his girlfriend Maggie had told him he was too volatile. However, he didn't see his anger as a problem. When Neil came back the next week, he said he was surprised by what he recorded in his anger diary.

Neil told me that he hadn't realized how much he got angry. He began to recognize a pattern in his anger experiences. "I guess I got mad the most after meetings at work, especially meetings that were really non-productive. Then I'd get home and still be angry." He also noticed that he "lashed out" most of the time in response to his anger. I asked Neil what he thought of his anger diary. He said, "I had no idea how much of a problem this was. I think I'm beginning to see what my girlfriend was talking about."

Harmful Anger
In order to treat Neil's depression as a whole, we had to first work with and begin to reduce his harmful anger. After Neil's twelfth and final session, he had actually reduced the intensity of his anger, even when he felt frustrated by coworkers. Also, was doing less "lashing out" from anger in the past few weeks. Do you have a client who may be unaware of the intensity of his angry outbursts and how they affect the people around him? Consider sharing this technique with him.

In the next track, we'll look at systematic desensitization, another method you can use with angry male clients.

Peer-Reviewed Journal Article References:
Cole, B. P., & Davidson, M. M. (2019). Exploring men’s perceptions about male depression. Psychology of Men & Masculinities, 20(4), 459–466.

Davis, H., & Turner, M. J. (2019). The use of rational emotive behavior therapy (REBT) to increase the self-determined motivation and psychological well-being of triathletes. Sport, Exercise, and Performance Psychology. Advance online publication.

Grov, C., Golub, S. A., Mustanski, B., & Parsons, J. T. (2010). Sexual compulsivity, state affect, and sexual risk behavior in a daily diary study of gay and bisexual men. Psychology of Addictive Behaviors, 24(3), 487–497.

Lemay, E. P., Jr., Overall, N. C., & Clark, M. S. (2012). Experiences and interpersonal consequences of hurt feelings and anger. Journal of Personality and Social Psychology, 103(6), 982–1006.

McIntyre, K. M., Mogle, J. A., Scodes, J. M., Pavlicova, M., Shapiro, P. A., Gorenstein, E. E., Tager, F. A., Monk, C., Almeida, D. M., & Sloan, R. P. (2019). Anger-reduction treatment reduces negative affect reactivity to daily stressors. Journal of Consulting and Clinical Psychology, 87(2), 141–150.

Online Continuing Education QUESTION 12
What does an Anger Diary help a client see about his rage? To select and enter your answer go to CE Test.

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