People recovering from a traumatic injury are under enormous pressure. They are often thrown into a life of chronic pain, isolation, financial burden, challenging rehab, and family difficulties. While it is normal to experience anger, it requires attention when it interferes with recovery and daily living.
When presented with the task of helping an individual with “anger issues” as a behavior therapist my first goal is to break down the label “anger” or “aggression”. Often clients will say “I fly off the handle at things that never bothered me before” or “I can’t control my temper”. While these are true statements, they don’t give me enough information to help in a meaningful way. I need DETAILS.
DEFINE
The first step to modifying anger is to operationally define it. In other words, what does an angry outburst look like in a specific individual? Operationally defining behavior is important since anger can be expressed in a multitude of ways. For instance, an individual may become extremely quiet when angry or they may express anger by yelling, hitting, or physical changes such as rapid breathing, and flushing.
STUDY
Once we have figured out what anger looks like we can begin to study it. Collecting ABC data (Antecedent- Behavior- Consequence) a pattern often emerges. A client is encouraged to report what was happening before: thoughts/ or actions (antecedent) the angry outburst (behaviour), and then what happened after (consequence). Family members or caregivers are often responsible for collecting this information. This information is helpful in identifying a functional relationship between the behaviour and its reinforcing properties.
EXAMPLE: An angry outburst occurs at a high frequency when a person is given a difficult cognitive task. The consequence of the angry outburst is avoiding the task.
The process of identifying when the behavior is most likely to happen is referred to as triggers. Being able to predict the environment of when behaviour will occur is crucial when applying treatment strategies. Possible triggers of anger could be frustration, fatigue and pain.
COPE
When the function of the behaviour and triggers are identified strategies can be introduced. Techniques such as Behavioural Skills Training proves to be very useful in helping reduce socially inappropriate behaviour. This training includes role-play, rehearsal and feedback. This process teaches new ways of dealing with frustration. When a person is aware of specific situations that “sets them off” they can problem solve and make a plans to stay in control. Plans can vary from simple to complex.
Relaxation Training is also a popular method of decreasing aggression. Progressive muscle relaxation, deep breathing and visualization can reduce the magnitude or frequency of outbursts. A person who becomes fatiguedwhen completing challenging tasks is encouraged to take mini-breaks using the relaxation tools.
BOTTOM LINE
People recovering from a traumatic injury are under enormous stress and there are many different reasons for “losing your cool”. Sometimes these reasons are not obvious and a closer look at ones’ surroundings is needed. Being mindful of the environment, identifying triggers and providing strategies are ways that a behavioural therapist can help manage aggression.
Behaviour therapists at GLA are highly skilled at helping clients to overcome anger. Please call us for more information about behaviour therapy or to make a referral.
Written by: Jennifer Phyper BSc, BST, Behavioural Therapist