Anger Management: Treating Road Rage

Narcissistic Personality
Like the evil queen in the fable Snow White, many people view themselves not just as "full fair" but as the "fairest of them all." They have an exalted sense of self that includes elements of both grandiosity ("I can be or do anything I want!") and perfectionism ("I must do no wrong!"). More important, they presume that everyone else shares their "special" view of themself and will, therefore, grant them license to behave as they please because of these qualities. In psychiatry, we call such individuals narcissists after the mythological Greek figure Narcissus, who fell in love with his own image while gazing into a fountain.

Narcissists value their own needs above those of all other people. As noted psychoanalyst Dr. Theodore Rubin put it, "the narcissist becomes his own world and believes the whole world is him." They believe "ordinary" people in the world are there simply to affirm and satisfy their special needs, whether emotional, financial, or relational. Other people are allowed to have and satisfy needs only in so far as their needs do not conflict with or take away from those of the narcissist. As long as the narcissist is satisfied, there is no problem.

What happens when others do not live up to narcissists’ unrealistic expectations or when some change in life circumstances (accident, disease, death, being fired, divorce) interferes with narcissists’ efforts to maintain their special status? They become angry—extremely angry— often to the point of uncontrollable rage. Sometimes this rage is directed outward. A beauty pageant queen, for example, angrily assaults her ex­boyfriend’s father after she is rejected. The leader of a juvenile gang critically wounds a college student in a drive-by shooting after being turned away from a party. A teenage girl kicks in her bedroom door when her parents tell her she cannot go on "beach week" with her friends.

Other times, the anger is directed inward. Barbara was sixty-seven years old when I first met her. She had been a feisty, energetic woman who worked on an assembly line in a local factory by choice rather than economic necessity. She had prided herself in being the most productive employee on the line and enjoyed the special recognition this afforded her. However, because of a work injury, she was no longer employed. Instead, she spent her days at home alone, complaining of pain, severely depressed, and threatening suicide. She was such a nice "little old lady"; who would have believed that underneath all that depression and disability was a cauldron of rage? "That’s not me!" she would angrily protest, mourning the loss of her former self. Barabara no longer saw herself as "special."

Not only is there an overemphasis on the self with narcissism, but there is also an exaggerated sense of entitlement. Narcissists do not simply prefer to have their way in life; they literally demand it. It is not enough to compete in an effort to win; the narcissist must be the winner. The narcissist must be adored by all, must be perfect in everything that she does, and must always be right or she will become consumed by anger.

Narcissistic anger is typically vengeful and designed to hurt the offending party. The wicked queen in Snow White demanded no less from the huntsman: "Take the child out into the woods, so that I may set eyes on her no more. You must put her to death, and bring me her heart for a token."

Cynical Personality
Cynicism reflects a pervasive attitude of mistrust regarding the motives of others. Cynics presume they will be treated unfairly and unjustly in most instances and have little faith in the inherent goodness of other people. Rather, they view the world as a dangerous place full of traps and pitfalls where one must constantly be on guard if one is to survive. Because they anticipate being victimized, cynics are always ready to re­spond in an angry, defensive manner.

There is a moral or righteous justification to cynical anger. Cynics believe people clearly deserve what they get! The cynic, after all, is the "good guy" who is simply trying to survive in a world of "bad guys."

A prime example of how a cynical attitude can lead to toxic anger and consequently poor health is found in the Type A personality. Cardiolo­gists Meyer Friedman and Ray Rosenman first coined the term Type A in the late 1950s to describe a pattern of pathological behavior that greatly increased the risk of heart disease.2 Their initial efforts were focused on the more obvious, observable characteristics of Type A behavior: time urgency, a slavish devotion to work, and a hard-driving orientation to life. However, Dr. Virginia Price, one of their colleagues at the Harold Brunn Institute in San Francisco, subsequently pointed out that cynicism characterized the core beliefs underlying Type A behavior. According to Dr. Price, Type A’s are motivated by fears that "good may not prevail" and "justice may not triumph," as well as the presumption that their "well-being is always in jeopardy."3 What others see as hostile, hard­driving, and achievement-striving behavior is, in effect, the Type A individual’s way of coping with cynicism. The anger seen in Type A peo­ple is typically vengeful. Type A’s are not just letting off steam or trying to exert authority or independence with their anger; they are attempting to ensure that justice will prevail. Once justice has been restored, they can relax, but only until the next injustice occurs!

Catastrophic Personality
I use the term catastrophic to refer to a great or sudden disaster; a complete misfortune or ruin. The person afflicted with a catastrophic mindset falsely presumes that all problems in life, all inconveniences, all unforeseen stresses, regardless of magnitude, are cause for great and grave concern. The alarm sounds, there is a surge of adrenaline, and the "catastrophic self" is flooded with emotion, in this case toxic an­ger. In his book Anger: How to Live With and Without It, psychologist Albert Ellis explains how people’s tendency to "awfulize" the everyday circumstances of their lives can lead to irrational and excessive anger. Many people, according to Dr. Ellis, "seem to have a tendency to equate unfair, inconvenient, or disadvantageous with awful." Clearly, it is fair to feel inconvenienced when the person in line ahead of you takes longer than you think is necessary to complete his purchase; however, to perceive this delay to be an "awful waste of my time" demonstrates the catastrophic mind-set. Whereas the former might lead to a feeling of annoyance, the latter will almost assuredly provoke full-fledged anger.

This tendency to catastrophize—embellish, magnify, or exaggerate the importance of a minor provocation—coupled with the tendency to "respond in kind" more than anything else determines the intensity with which anger is experienced. If the perception of harm is exaggerated, so too is the angry response.

Compulsive Personality
John, the ex-Marine discussed previously, is a man of strong moral and ethical principles. He believes in God, the sanctity of marriage, the Amer­ican way of life, and the value of hard work. He believes there is a right and a wrong way to do everything: cut wood, mow grass, fix a car. in his world, people are either good or bad. They are good if they see things his way, bad if they don’t. There is no middle ground!

John likes order in his life. He lives by strict rules, and he has little tolerance for people who do not see things his way. Those who know him best see him as stubborn and persistent. "He always has to be right, and, believe me, his word is final!" his wife said.

John hates change. He is always punctual. He is "tight" with his money. He knows how to work hard, but he has little experience just having fun. He likes cutting wood and doing "mechanical" things.

John is an example of a compulsive personality. By compulsive, I do not mean being busy all the time or always engaged in getting things done. In a psychiatric sense, compulsive refers to a rigid, narrow-minded way of thinking about and dealing with the world. Everything is either black or white; there are no gray areas. Although they are not cynical about life, compulsive people are far too serious for their own good. Work is essential; play is optional. Compulsive people lack spontaneity. Everything must be organized, planned, and on schedule. Any deviation from the plan, any interruption in the schedule, leads to frustration and anger. They are masters of detail, but they often fail to grasp the "big picture" of what is going on in their lives. A compulsive parent, for example, may become upset when his teenage child expresses views different from his own rather than seeing this as a logical first step toward independence and eventual adulthood. A compulsive employer may become upset if employees show initiative or creativity, insisting instead that they "just do as they are told." Compulsive individuals keep a tight rein not only on their finances but on their emotions as well. And when they do lose emotional control, it is typically expressed as irritation.

John, of course, is by no means unique. Dennis, the depressed middle-aged executive who worked his way up from the rank of accountant to president, also had a compulsive personality. Peter, the young man who physically abused his infant daughter because she would not stop crying, was compulsive as well. The man in the restaurant who chided his companions for laughing at his mistake also fit this personality type.
- Gentry, Doyle, Anger-Free: Ten Basic Steps to Managing your Anger, William Morrow and Company, Inc.: New York, 1999.

Personal Reflection Exercise #8
The preceding section contained information about the narcissistic, cynical, catastrophic, and compulsive personalities.  Write three case study examples regarding how you might use the content of this section in your practice.

QUESTION 15
What type of personality values their own needs above those of all other people? Record the letter of the correct answer the Answer Booklet.