PTSD and anger have been shown to frequently occur together. Post-traumatic stress disorder (PTSD) can develop after an individual experiences a severe trauma. PTSD has many hallmark symptoms including vivid flashbacks, high anxiety levels, avoidance and re-living the event. What may also cause relationship problems, however, is PTSD and anger.
Anger is a completely natural human response to a situation which seems unfair, unjust or threatening, and is considered a survival response which focuses our attention on a threat. After a traumatic event many people will feel anger, but over time this will fade. For people with PTSD, however, they may become ‘stuck’ in this anger response to the extreme threat they have experienced. For instance, some Vietnam veterans suffering from PTSD and anger refer to their anger as ‘Jungle mode’. Becoming stuck like this can result in a constant feeling of PTSD related anger regarding the traumatic event and the surrounding circumstances. However, PTSD and anger may leak out aggressive outbursts, suspicion, rumination, tension, irritability and displaced anger (anger directed at the wrong individual for the wrong reasons).
A meta-analysis (analysis of many studies within one area) investigating the link between PTSD and anger found that there was a very strong relationship between the two, and that this was particularly strong for people who suffered trauma as a result of a military war experience. Therefore, treatment of anger may be a more pronounced problem for veterans with PTSD compared to those without combat exposure.
PTSD and anger are often triggered by the victim’s own thoughts, and we know that changes in cognitions and thoughts can help to reduce angry feelings and outbursts. Hence, our anger management treatments focus on the internal experience of anger as well as the external experience. Cognitive-Behavioural therapy uses therapeutic techniques to improve both cognitive and behavioural reactions to a trauma. Some techniques include relaxation, cognitive restructuring, problem solving, and stress-inoculation. Stress inoculation therapy is one very successful technique, which involves identifying triggers which cause anger responses, and then rehearsing positive ‘self-statements’ and relaxation techniques to cope with the anger response.
A meta-analysis was performed by Beck and Fernandez (1998) to assess the effectiveness of CBT for anger and it was found that clients who took part in CBT were better off than 79% of those who did not receive CBT treatment. This indicates that CBT can lead to very positive results for reducing anger.
Treatments for PTSD and anger may also involve helping clients to accept their anger rather than attempt to suppress it. This will allow them to respond appropriately to their emotions. Mindfulness-based therapies hold the mantra that becoming aware of one’s current situation is an important skill for coping with a vast array of situations. Mindfulness-based therapies may allow a client with anger to reduce their tendency to react to their anger (which can often lead to negative consequences) and to instead to learn how to tolerate their emotions without acting on them. It may also encourage clients to realize that their angry thoughts are just that; ‘thoughts’. They do not necessarily reflect real truths, beliefs or actions. Such acceptance reduces inner turmoil and strife over these angry feelings. Becoming more self-aware and non-judgmental regarding ones thoughts may also help to reduce ruminative behavior (re-living the trauma) which can ultimately lead to depression. By becoming aware of ruminative thoughts, attention can be redirected to other activities (even as simple as breathing) which will interrupt the ruminative process. Finally, by becoming more mindful, an individual suffering from anger will be more able to make more informed choices regarding their actions and behaviour.
Because our treatment for PTSD and depression relies on evidence based practices, our Intensive Outpatient Program shares many common methods with other successful treatment interventions. The foundation of our treatment program for relies on the principles of the stages of change, cognitive behavioral therapy, solution focused treatment, skills training and identifying repetitive dysfunctional behavioral relationship patterns to promote recovery from PTSD and anger, depression and other mental health disorders. In fact, our Intensive Outpatient Program in Memphis, TN that has been proven to be effective in the treatment of these disorders in six peer reviewed treatment outcome studies. Our treatment center provides services to those who need more treatment than one hour a week, but less than 24 hour care, by providing three hours of treatment per day, three to five days per week, in an intensive outpatient setting. If you or a loved one is showing signs of PTSD, depression or anxiety, they should be assessed by a trained mental health professional who can help design a treatment plan for depression that can result in recovery. Treatment for PTSD, depression and anxiety can be highly successful. Call us at 901-682-6136 to schedule an appointment.