IMPULSE CONTROL AND ANGER MANAGEMENT:

Overview:

Note: Although the SOGIA does not currently have a specialist for specific impulse control disorders (e.g., pyromania, gambling, trichotillomania), clinicians are able to provide impulse control skills and therapy to support the underlying issues that contribute to impulsive behaviors (e.g., depression, anxiety, anger).

Impulse Control is generalized as the lack of self-control, meaning, the inability to control feelings and emotions and the potential action urges associated with them.  Some impulse control disorders are very specific and are diagnosed in childhood (e.g., intermittent explosive disorder, kleptomania—stealing). While others, may appear later in life due to emerging problems and do not have a specific diagnosis (e.g., emotional eating, impulsive buying). Additionally, other mental health diagnoses may have a lack of impulse control as part of the symptoms (e.g., attention deficit hyperactivity disorder). Left undiagnosed or untreated impulsive disorders or behaviors, especially those that are high-risk or even dangerous (e.g., driving at high speeds—road rage), can lead to lasting harmful effects.

Anger Management is the collective use of both internal and external skills that people can use to cope with and tolerate forms of anger (e.g., irritated, mad, enraged) or behaviors triggered by anger (e.g., yelling, fighting). Anger is an instinctive reaction to perceived threats (e.g., potential loss of resources or physical threat). Although anger has been considered a “negative” emotion, anger can be a catalyst for change that when tapped can propel one into action or support perseverance (e.g., not giving up on a difficult project). Anger does not necessarily mean you have a problem until you are unable to avoid problem behaviors, unable to manage or tolerate anger, has repeated unjustified high levels of reactive anger (e.g., screaming at a clerk for a simple mistake), or are angry for longer periods of time. Most people with anger management issues will later experience regret, embarrassment, shame, and guilt, which can later make them more vulnerable to reactive anger again.

The three types of anger are:

• Outward: Expressing your anger or aggression in an obvious way; shouting, cursing, throwing and breaking things, and/or being verbally/physically abusive towards others

• Inward: Expressing anger towards yourself; yelling at yourself, hitting yourself in the head, breaking things that are important to you, negative self-talk, denying things that make you happy, and isolation

• Passive: Using subtle or indirect ways to express anger; using the silent treatment, sulking, sarcasm, “accidental” destruction of other’s property, starting and spreading rumors about others, and snide remarks

Symptoms:

Although both disorders share the same inability to control feelings or emotions, symptoms may vary.

Impulse control symptoms may vary depending on which disorder is present. Some symptoms include:

• Physical injuries and scars

• More time than intended engaged in the impulsive behavior

• Stealing

• Isolation

• Sudden outburst of anger

• Feeling out of control

• Financial difficulties

• Difficulties with communication (interrupting others)

• Inpatient with others

Anger has the potential to cause emotional and physical symptoms. Many symptoms tend to be normal on occasion, however, a person who experiences symptoms more often should seek help.

Anger symptoms include:

• Out of control anger

• Relationships challenges due to poorly expressed anger/frustration

• Irritability

• Increased blood pressure

• Increased heart rate

• Temperature change (hot face, red ears)

• Muscle tension (clenched jaw, clenched fists)—can lead to fatigue

• Physically/emotionally hurting others

Causes:

Like most mental health disorders, the specific\ causes of impulse control issues are unknown, however, researchers have found links in genetics, environment and neurology—brain differences. On the other hand, anger management problems can be triggered by stress, family problems, and financial issues. For others, anger management issues can be linked with alcoholism, drug use, anxiety, PTSD, and depression.

Therapy:

Both impulse control and anger management problems can be diagnosed and treated with therapy. For example, Cognitive Behavioral Therapy can be used to support the client in understanding the relationships between thoughts, physical reactions, impulsive/angry behaviors, and emotions. Some strategies may include the development of delayed gratification skills, emotion coping skills, and reframing/challenging thoughts that contribute to problem behaviors. Additionally, Dialectical Behavior Therapy (DBT) has also been shown to have great success with the decrease in impulse control and anger management problems. This therapy is founded in CBT and adds mindfulness skills, distress tolerance skills, interpersonal effectiveness skills, and emotion regulation skills.