Anger management

Often clients come to Counselling and speak about want to 'control anger'. I have dealt with many clients with anger issues. The key thing in Counselling which is important is to remember that we do not in fact try to 'control our anger'. Trying to control an emotion is what leads to it becoming trapped and distorted and coming out at points in a way which may not be appropriate. It is important rather to look at the ways we 'manage our emotions' and in particular 'manage our anger'.

 

Anger is often a frowned upon emotion as seen as something we should control or in some way try to curb. Whereas abuse is always wrong there is nothing wrong with the feeling of anger or any other feeling. Throughout my work with clients working on this issue we often speak of anger to be seen like it is at the start of a hill. If you picture a hill and on one side of the hill there is anger which is absolutely fine. Any feeling of anger is okay, it's healthy and is nothing to be concerned about. An emotion like any other which is to be managed and used constructively. Anger can build however and if not managed well can go up over the hill and down the slippery slope of the other side and turn into abuse which is never okay.

 

In Counselling sessions we often look at this analogy and then work with the feeling of anger. I often emphasise constantly how the feeling of anger is absolutely fine and encourage clients to bring whatever anger they have to the sessions so we can work with it. Clients often feel enraged and notice how outside of sessions in the real world they are triggered by the smallest things. Exploring the emotions and what these things that trigger them remind them of can be key to getting to the root of the anger and rather than it become our enemy, be our friend we can embrace as part of our lives.

 

Anger can often be mixed with other strong emotions. Sometimes self therapy exercises such as writing or actual rigorous exercise and keeping an overall healthy balance can help us to keep our emotions well regulated. Through working with our emotions in therapy we can come to a state of greater balance. If we picture someone carrying buckets, one on each side, on a piece of wood over their shoulders. In the case of anger management we are often stumbling around and the water (symbolising our emotions) is pouring out and going all over the place. Through accepting where we are at and that there is an issue with the emotions pouring out and perhaps becoming abusive, we are able to create routines and explore the emotions to become happier and more balanced. Cognitive behavioural therapy can also help here in moving forward to make goals for the future.

Cognitive Behavioural Therapy

Cognitive Behavioral Therapy is a useful therapy I practice to some degree with almost every client I see. I studied this in my Psychology degree and Counselling diploma and am also completing a diploma specifically in this subject. CBT is based on the idea that it is our destructive thoughts about a situation which lead to us therefore feeling unhappy and unable to do the things we want to do. In Cognitive therapy we therefore examine what these thought patterns are which are causing us to feel unhappy or like we can't function and to challenge these to see how grounded in reality they really are. By doing this we are often able to take an edge off our anxiety to allow us to do more quite quickly, or to atleast take that step forward we need. It can easily be incorporated into therapy for various issues such as dealing with depression, grief counselling or relationship counselling. My putting things into a real clearer perspective and overcoming irrational thinking it can help us to understand that whereas things may seem bad now they often aren't as bad as they seem and even if things are really bad it doesn't mean that nothing will ever change.

 

The founder of CBT therapy was Albert Ellis. He referred to the process of us making these destructive thought patterns as 'awfulising'. When we are feeling anxious about a situation and examine the thoughts we are often able to see how irrational what we are thinking really is. For example, an anxiety around being in a crowded space when examined can expose itself through CBT as ultimately being a thought that we fear we may get crushed by the other people there. When truly examining the thoughts scientifically we are often able to see that there isn't a foundation in reality for that thought so consequentially the anxiety can decrease.

 

A common exercise I use with clients is to describe a situation and then to discuss the feelings associated with it and the percentage these feelings are dominating them in the situation. e.g. situation: going to the mall, feelings: anxiety, dread 90%. After this we then look at the thoughts associated with it. It is often difficult for clients to really get into the thoughts as we often go hard on ourselves and dont like to acknowledge that our thoughts are in fact irrational. In my practice I encourage that whatever it is we are thinking and feeling is real at that time for us and that is our reality and the only thing we can work with to make progress. By going into the thoughts they may be something like: 1. There are too many people. 2. People will walk into me. 3. People will get angry with me. 4. It is all too much. 5. I can never be in a mall. These thoughts may also be dominating the consciousness at 90%.

 

We take each of these statements and really look at them and what they actually mean and of their truly is any foundation. Starting with:

 

1. There are too many people.
   Our rational may be: - It may be very busy, I don't know yet. If it is very busy I can leave and come back when quieter. If I decide to go in there is no reason I wouldnt be able to leave at any time.
2. People will walk into me.
   Our rational may be: It is unlikely that someone would walk into me but if they did it wouldn't be the end of the world. Either one of us could say sorry. It is unlikely anything truly harmful would come of this.
3. People will get angry with me.
   Our rational may be: It is unlikely that anyone would get angry with me but if they did I would be able to leave or be calm enough to manage their anger. If it is really so busy where people will be bumping into one another I could choose not to go in and come back another day.
4. It is all too much.
   Our rational may be: If it truly feels too much I can leave at any time.
5. I can never be in a mall.
   Our rational may be: I feel like I can't be in a mall now but there is no reason why this would be the case for all of time.

 

After this we then re-rate the original emotions and the original thoughts

 

Often through doing some cognitive behavioural therapy at the start we are able to take an edge off and also in noticing the 'awfuling' thoughts we are often able to see where this has come from. In the case of the client above this could come from a memory for example of being in the mall on a very busy day near christmas with parents and being very crowded and being shouted at by someone for walking into them.

 

Through CBT we can realise what the dysfunctional thoughts are and challenge them to take the anxiety off. It can also enable us to go deeper as we realise where these thoughts may have come from. More work in Counselling can go into more emotional depth in talking about the original stress of where it came from. Through the supportive environment and empathy given clients are able to let go of this and move forward.

 

A challenge is CBT can often be clients stress of where they are at and where they want to be which can seem miles away. It is always important in the whole Counselling process to practice your own compassion for yourselves which often we have lost. It can be useful to think about what you would say to a good friend who is feeling this same way. It is really important that wherever you are at to be able to nurture yourself at that space and then to look what is the way forward to make that one step.

 

In CBT we often work on SMART goals. This is about making goals of where you would like to be in the future in different areas of your life. The letters stand for SPECIFIC, MEASURABLE, ACHIEVABLE, REALISTIC, TIME FRAMED. We can create goals in our therapy sessions and then break down to be able to make that first step. Everyone can always find a goal and make a first step to get there.

 

Sometimes people just don't know what they want or just come to Counselling with a feeling that things aren't how they want them to be and with that feeling we can more empathically explore it and look at what it means. Through these feelings we can find a deeper self understanding then over time perhaps link this understanding with CBT and more forward planning.

Sudden closure of Relationships Aotearoa.

I was shocked and saddened to see the news that Relationships Aotearoa was closing suddenly.  I did not just find the news saddening but the way it was all handled as being very concerning and brutal.  From the evidence I have seen through One News and the interviews I have found Anne Tolley's response to be totally patronising and demeaning towards Relationships Aotearoa.  I also find the action and the sudden end for clients without even giving two weeks notice as was expected by the spokesperson for Relationships Aotearoa just brutal. It showed a total disregard and almost pathological Narcissistic lack of empathy for the rights of clients.

As a Counsellor I know that the main indicator of good outcomes for clients is the trust and rapport between Counsellor and client.  The typical client will find this hard to build up due to bad outcomes in attempting this in their background leading to destructive behaviour towards others or perhaps this leading them into destructive relationships and behaviour.  It is common that the very foundation of Counselling is building this rapport to allow the individual to experience freedom and allow past conditioning to fall apart.  This can be a very slow, difficult, while rewarding experience for the client.

The action of an immediate end will in many cases have shattered this trust, maybe forever.  I don't want to be overly dramatic and I only hope for the clients best welfare but the action to suddenly end is just so incredible brutal and potentially devastating especially for those at risk.  Anne Tolley herself describes 500 urgent cases but yet seems to speak of these people as if they are objects or at best totally calm rational beings who are going to be fine with this change.  She seems to completely disregard or have no concept on how such a change could impact them.  These 500 'urgent cases' are now at a level (due to Anne Tolley) far far more urgent.  The clients are quoted as being at risk of suicide, homicide, also sexual offenders are now at higher risk in each of these categories

Client rights set out by the Health and Disability Commission says that clients are to be treated with 'respect' and that 'effective communication' is to take place.  Anne Tolley seems to sabotaged this from taking place.  She has broke the rights of the clients at Relationships Aotearoa.

Incredibly Anne Tolley went on to tell Relationships Aotearoa to 'calm down'.  A response as a mental health professional I found to be either totally stupid or a deliberate attempt to inflame since anyone is taught when dealing with people who are inflamed (which Relationships Aotearoa fairly are) is to tell them to 'calm down'.  A totally patronising and inappropriate response on her part. 

There were 7000 clients being helped by Relationships Aoteoroa.  It seemed an incredible action magnified even more by the fact that the people affected are those supposedly at the focus of the governments new community investment.  If we are really investing in the community and we are acknowledging that Counselling is part of that we need to understand these basic Counselling processes and the fact that we are dealing with people.  This does not just apply for Counselling but for any form of Social Care.  To not even allow the clients two more weeks as the spokeperson thought to create some kind of ending and gentler moving on for them could prove a key factor in their ability to ever recover.  Someone in Anne Tolley's position should know this and should have acted better.

I have been in contact with Relationships Aotearoa to potentially offer clients Counselling sessions at the same fees of Relationships Aotearoa and will be contacting the other agencies where the clients have gone to.  The further disaster following this was that the agencies referred to were more based in a social work framework although some of the relationships Aotearoa Counsellors have apparently moved on also to these same places which is some positive.  It seems unclear as to whether or not all these clients will be accommodated with new Counsellors at this stage.

Happiness, balance, and empowered choices

The simple reason people typically choose to go to Counselling is because they don't feel happy with their lives.  A feeling like something is wrong or missing somehow.  In Counselling and Therapy we work with the emotional reality of the client to help them to move towards a more constructive sense of themselves typically through an acceptance of their emotions which may have been blocked in the past.

One of my favourite self therapy books I have read is 'Life Works by Amanda Ferguson' which gives the following explanation of happiness and finding happiness. p26 - 27

'Happiness lies in learning to focus on ourselves as the source and to work through our own thoughts, feelings and problems.  We can then see any problems in other areas of our lives more clearly.  When we're content within ourselves we are better able to create the lifestyle and relationships we want.

If we are to be happy in life it's also important to realise that we can't have everything.  Society tends to promote the idea that we can - but realistically, of course, we can't.  The sooner we work out what we do want and become contend with giving up the rest, we can be happy.

Generally, there are some basic things that make all of us happy.  We need to feel safe and secure.  We need to feel confident that we can obtain the things that we need and want from life.  We need to be able to accept and like ourselves for the way we are and yet be able to identify and commit to making changes as we see fit.  We need to feel a sense of belonging to society.  We need to feel that there is meaning and value to our lives (Frankl, 1984).  Most of us know that these things are not as simple as they might sound.'

From a colleague I was recently drawn to the idea of writing a list of what we feel brings balance in our lives then looking at what may be missing, things we may like to add etc.  The concept of 'Imagineering' was discussed.  It can be useful to look at what is bringing us balance and things we may like to change then think of ways we can make steps towards the life we want more.  A great way to work on this is through SMART goals.

It's important to be true to yourself in this process and put yourself first and be willing to go against the grain of what society wants.  In working with clients in this area I have recently found the trend interesting of couples who for whatever reasons are choosing not to be parents but with parenthood being a way societal pressure typically pulls couples.  Here is a good book on the subject.  It is important to be willing to stand up for your own willingness to CHOOSE and what brings YOU balance.  This is a real test of our own relationship with ourselves. 

Are you a highly sensitive person?

As part of my personal development in my training to be a Counsellor I really enjoyed reading the book 'The Highly Sensitive Person' by Elaine Aron.  I found it quite affirming in being able to identify myself as also being a highly sensitive person.  I have often recommended this books to clients I have worked with.  The book is based on the idea that around 30% of people can be classed as highly sensitive in the sense of actually having a more highly sensitive nervous system. 

This highly sensitive nervous system has both positive and negative attributes it brings up.  It describes it as being how we categorise things.  A less sensitive person may only break things down into around 5 categories for example but a highly sensitive person may break the same thing down into 10.  The world can therefore seem more overwhelming for a highly sensitive person as society typically operates on an extraverted way of seeing things, therefore being highly sensitive can often be something that is discriminated against.

Why are you so sensitive? Don't be such a cry baby etc etc.  Whereas the world and mentality typically favours the more extraverted, the introverted are very much needed and typically exist more behind the scenes.  Counsellors, writers, movie directors etc would be careers more typically taken by the highly sensitive.

Aron affirms how it is not about making an elite out of being highly sensitive but rather just a standing up for our sensitivity, a restoring pride and a making equal.  Her book is useful to give figures in history who have been highly sensitive and to provide techniques for self support to be highly sensitive and to survive well in an extravert world.  She has written a series of books.

Being highly sensitive often involves needing quieter work spaces, preferring smaller crowds, needing wind down time.  It is important to look after yourself well as a highly sensitive person while also standing up for yourself as being highly sensitive and what being highly sensitive can offer to the world.  Carl Jung , Abraham Lincoln, and Walt Disney were people highlighted as being 'highly sensitive'.

Are you a highly sensitive person?

Healthy shame

Shame is an issue which constantly comes up in Counselling and Therapy sessions.  I have always found the book 'Healing the Shame that binds you' a great recommendation to clients to give an overview of shame can dominate our lives and stop our healthy connection with our authentic selves.

Shame is often described as being 'the master emotion'.  See this blog entry here which describes the power of shame and how it can control us.

Healing the shame that binds you gives a great distinction between healthy shame and toxic shame.  A healthy sense of shame is seen to be very healthy and very desirable to the human condition.  This is identified as the attitude of 'I made a mistake'.  It is often related to the healthy inner child and the idea of falling over or making a mistake and then getting back up and carrying on again and giving things another go.

Through upbringing however or conditions which may not have been favourable to us in nurturing this this state we often instil an idea of 'I am a mistake'.  This is where the authentic self is abandoned and rather a false self takes over and plays a role to fit in with the dysfunctional family system.  This is said to be a shame based role.

Shirley Smith in her book 'Set yourself free' gives a good discussion of different shame based roles we may take on board in the family.  In a shame based role we have totally abandoned the authentic self and have taken on board an idea of shame of 'I am a mistake'.  These two polarities are often worked with in Counselling through support and nurturing to help the client work with what has happened and create the distinction within themselves of 'I made a mistake' versus 'I am a mistake'. 

Here is a link particularly in relation to healing the shame of the inner child.  Here is another link particularly for romance in relation to shame in approaching women.  Although some of the authors writing I do not agree with the discussion around shame in this context I found excellent as he relates it to a fear of rejection and again links back to Healing the Shame that binds you.

A good question to ask yourself is if you operate in an 'I made a mistake' or 'I am a mistake' modality and what are you going to do about it?

Our relationships always adding something

Often due to some destructive past influences people in Counselling are often involved with people in their lives who are less than constructive for them.  What can happen is that we play out certain roles which we played perhaps for our parents in the past.  The idea is often discussed of 'replaying dramas' whereas in the past we were forced to abandon our authentic self in order to fit in with a dysfunctional family system and now continue to replay these same destructive patterns with others in our lives.

Our romantic relationships are identified as in particularly bringing up our deepest core issues.  Often we work in Counselling with what this situation is reminding me of from my past.  Often the same niggle we have with for example an overbearing and dominating partner can be traced back to our primary caregivers.  Healing this original wound can then provide a key foundation to becoming more assertive with our current partner and working towards a constructive way forward or perhaps finding a different relationship.

It is important to remember as adults that people in our lives should be adding something to our lives.  Playing the role of a support person for example is very positive in pockets but it is important to reflect back on ones boundaries and look at the role the other person is playing in their life and whether they are in fact adding something or just draining.  Friends should always add something and they should never be cruel.

A very simple boundary exercise to become more conscious can be simply to list people in our lives and write what we are and what we are not willing to do.  Getting this out there and making it clear and conscious can then help us to be more constructive.  If we are unable to act on these boundaries or for some reason feel obligated to be a certain way it is important to reflect on ourselves as to why this may be.

As adults we need to remember that the word 'should' is out.  Changing the word to 'could' and therefore looking at what we choose or choose not to do.