Monday, April 2, 2007

Anger has a biological as well as behavior basis

DEAR FAMILY: My brother has always had a temper but he's gotten worse in the last few years.


He is one of those people who always blames everyone else for making him mad. He has become very critical and negative about everything and everyone. He's had so many jobs I couldn't begin to count them and there was always the same story -- he would get mad at his boss or a co-worker over something he thinks they did to him. I thought that when he finally took early retirement that it would be better, but now he doesn't have any money because of them cheating him out of his rightful retirement.

His grown children avoid him. It was so bad for them when they were kids that both of them left home as soon as they graduated from high school, and his son never comes home. My sister-in-law is this quiet mousy woman who just looks totally beaten down. She was always quiet but now she just looks like she would break if you said the wrong thing. I have tried to be friends with her but she doesn't like to go out. I'm certain she never says anything to my brother about his temper.


Our elderly mother is in the last stages of her cancer and is dying. He has been saying ugly things about the doctors and has run off two of the women who were caring for her because of his mouth. I am worried that when she dies he's going to be even worse. I have enough on my plate without having to work around him, too. Is there anything that I can do to help him? I do love him but there are lots of times I just really don't like him or the way he talks and acts. -- STUCK ON ANGER


DEAR STUCK: Anger itself is a normal emotion; however, when it gets out of control, as you have described, it can be most destructive. I believe that anger management has to start with the questions, "Does your brother believe he has an anger problem?" and "Does he want to get better?" If the answer to both is "yes" then lots can be done to help him, but if the answer to either is "no" then nothing can be done to help your brother. Some people enjoy their anger and live a life wherein they use their anger to control and intimidate others. Of course, as you so clearly observe, they never "win" because normal people will avoid them.


Let us assume that your brother answers "yes" to both questions. I like to start by separating out that which is more biologically/genetically based from that which is behavior or "choice."


Was there alcoholism or depression in your family of origin? Were there others in your family of origin who were angry, negative, or who had a temper? Those are clues to a biological basis for anger. With or without a family history, anger in males is often associated with depression. That is, an angry, critical, negative male is often experiencing depression. Common symptoms of male depression include: anger and frustration; violent abusive behavior; losing weight without trying; taking risks (such as reckless driving and extramarital sex); loss of concentration; isolation from family and friends; avoiding pleasurable activities; fatigue; loss of interest in work, hobbies and sex; alcohol or substance abuse; misuse of prescription medication; and thoughts of suicide. The biologic sources are commonly treated with an anti-depressant. Your brother could see his family doctor for a referral to a psychiatrist for appropriate medication management.


That part of anger which is related to "behavior" is most efficiently addressed by a trained professional therapist who can help identify triggers and then help develop healthy appropriate responses. The counselor can also help him identify and implement coping techniques to help him calm himself before responding. There is lots that can be done to help with anger management if a person wants the help. Encourage your brother to seek help.

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