Monday, December 24, 2007

Breaking out of Anger

Have you ever wondered what causes anger to rear it’s ugly head so quickly? In our books I have talked about how expectations, self-talk and choices trigger and amplify anger.

Anger is ultimately a physiological and a cognitive response to certain triggers. It’s different for everyone. You might be able to shrug-off some triggers such as – a co-worker not listening to you but, fly into a rage when you can’t get your spouse’s attention.

What you tell yourself or the expectations you hold onto for other people and life goals will impact how you respond to those triggers. You then make the choice to act on the anger you feel.

How can you break out of this? How can you stop the yelling, sarcasm or hidden anger which entangles you in resentment and infects your relationships?
We teach the time-out skill as one of the best methods to stop anger from exploding or imploding.

“But, I don’t want to take a time-out when I feel angry”, you argue, “I want people to understand how they are wrong. I want to be understood. I want to get the problem solved.”

I hear these arguments from students and clients all the time. I can identify with these feelings when I’m experiencing conflict or disappointments.
The important aspect of this skill is that it stops anger from escalating. It stops the physiological fight/flight response we all have when someone or something triggers our anger.

When we take a time-out, we can implement some of the stress management or relaxation skills. During the time-out we can identify what is really happening and write out what we want or need. Maybe during the time-out we’ll discover that what we want is unrealistic or demanding. Or maybe we’ll find out that what we want is reasonable and necessary. Taking a time-out when we feel angry - can help us think through the issues and go back to the other person with one or two requests or with an apology or with some options for working through our differences or misunderstandings.

So, why not take a break when you feel anger rising inside you? A time-out will help you put a check on anger and check out whether it’s valid.

Listen to these podcasts: 4 Q’s to Disarming Anger
and Talk Yourself Out of Anger!

See all of the Quick Tips for Managing Anger podcasts at:

Here are some resources to teach you skills for managing your anger: What’s Good About Anger? .

© copyright 2007 by Lynette J. Hoy, NCC, LCPC. Lynette is a Marriage and Family Counselor with CounselCare Connection and National Certified Counselor. She is the co-author of What’s Good About Anger? and a speaker for community, women’s and church organizations.

Daybreak Counseling Service

Tuesday, December 18, 2007

Nurse May Face Charges After Elderly Abuse Allegations

Kansas City

A Shawnee nursing home has fired one of its nurses for elderly abuse, then the home reported him to police on the allegations.

The Sweet Life Nursing Home wasted no time. The employee in question was terminated on Friday, the same day the allegations were made by a co-worker.

Sweet Life cares for 150 elderly patients, many who need full-time care. Police said the fired worker is accused of slapping an 88-year-old man and roughly throwing him into a wheelchair.

On two other occasions the same nurse is accused of pushing an 81-year-old female in the stomach and the next day slapping her with a wash cloth and spraying water into her mouth. A female nurse reported the pattern of abusive behavior to managers who quickly fired the male nurse.

"We take any concerns with our residents very seriously," Executive Director Kim Ellis said. "We have a zero tolerance for any type of abuse, neglect or exploitation of our residents."

The Sweet Life is reporting the suspect's name to the Kansas Department of Aging, that way he'll be on a registry so that if he tries to apply for a job at a different nursing home, he'll automatically be red flagged even if he's never charged with a crime.

"It's my understanding that all nursing homes would check the registry to make sure that all associates do not have that on their file," Ellis said.

Police said elderly abuse can be tough to investigate. In this case, the victims suffer from dementia.

"They're non verbal, they can't express themselves when they are being abused and they may not even be aware of the fact that they're being abused," Ron Copeland with Shawnee Police said.

Detectives and Sweet Life managers said it was critical that another nurse stepped forward.

"They're one of the most vulnerable populations, completely because they rely on others to help make sure that good decisions are being made for them," Ellis said.

The wife of the male victim said she's thankful that Sweet Life acted quickly and charges are possible in this case once the prosecutor gets a look at the information.

Rob Low, FOX 4 News

Daybreak Counseling Service

Tuesday, December 11, 2007


By Carol A. Butler, MS Ed., RNC, for Wellness Reproductions and Publishing, LLC

Do you clench your teeth, tighten your muscles, and bristle when people complain, criticize, or condemn? Join the club! Angry clients and their families, going through the worst of times, often lash out at professionals who choose to help. Enable them to vent feelings, cool down, comply with requests, or resolve conflicts while you remain calm, compassionate, but unwavering when necessary.

Empower versus overpower them with these tips:

Overdose With Agreement

You need not agree with their views. Just validate their feelings. For example, you could say...

"It sure is an upsetting situation for you."
"Yes, it is very difficult for you."
"It does it seem terrible."
Don't try to reason with irate persons. Your goal is to calm, not persuade.


Ask Questions
Listening allows them to vent feelings. Have you ever fumed to your friends or family and received well-meant advice? Were you receptive? Initially, angry people want to be heard, not helped.

Empathizing conveys that you understand their concerns. Don't try to change their minds or impose your opinion.

Asking questions elicits their perspective. Avoid "Why...?" which fosters defensiveness. Ask "How...?" to determine their thoughts and feelings. Don't impersonate a detective or a judge!

Paraphrasing proves you've heard and understand. Repeat their concerns in your own words.

Summarizing provides a "snapshot" of the situation, laying the groundwork for later problem-solving.

Behavior Begets Behavior

Be calm, compassionate and respectful and your clients may model your behavior. Apologize for their inconvenience. Explain what you can do to help. Don't verbally attack the people or defend the institution, staff, laws, or yourself. Defensiveness appears argumentative and adds fuel to the fire. Ignore sarcasm or questions challenging your position or policies and redirect attention to the issues.

Spatial Relationships


Provide them extra personal space. Be approximately their leg's length away versus "toe to toe" or "in their face." Position yourself near a door, but allow them access to exit. Don't corner yourself or anyone else.

Body Language

Don't literally look down at them. Be at their eye level, stooping near the bed, sitting across from or standing at an angle, facing slightly sideways, palms up. Avoid authoritative stances with hands on hips or arms crossed.

Break Barriers

Unless you fear physical violence, do not sit behind a desk or stand behind a counter. Move to their side of the obstacle and, ideally, seek an area within earshot of help but away from an audience.

Paraverbal Communication

Tone, volume and cadence matter more than content as people escalate. Although we would not be making the following (defensive) remark, it illustrates how accentuating one word changes the message. Read the following statement aloud, emphasizing only the word in bold:

"I didn't call you stupid." (implies someone else called you stupid)
"I didn't call you stupid." (denies the accusation)
"I didn't call you stupid." (implies you really are stupid versus being called stupid)
"I didn't call you stupid." (implies I called someone else stupid)
"I didn't call you stupid." (implies I called you something worse)

Avoid Escalation Enhancers

Don't command, criticize, threaten, preach, placate, analyze, advise, debate, degrade, blame, lecture, label, stereotype, minimize, interrupt, use sarcasm, misuse humor, half-listen, tune out or try to be right. Don't "should" on them!

Expect Anger

Avoid taking it personally! Don't be unnerved by their crying or offended by profanity. Denial, anger, bargaining, depression and acceptance relate to the grief and loss associated with mental illness and/or substance abuse. Remember the person who is mad at the boss and kicks the cat? To clients and families upset with the disease, the doctor, law enforcement, the system, or whatever, you're the cat!

Tip Of The Iceberg

Angry words represent the tip of the iceberg...understand the underlying layers: fears of abandonment, loss of face, loss of control over a situation, sadness, guilt, and other factors. The current stressor may be the last straw on the overburdened camel's back.

Ignorance Is Not Bliss

Fear of the unknown generates anger. A lack of education, cultural or language barriers, and illiteracy can compound a client's frustration. Even highly educated people experience cognitive deficits during crises. Concisely communicate only what they need to know now.

Conflict Resolution

Here are some techniques to resolve your conflicts with clients:

Clear the air: "We need to talk."
Take time out: "Lets calm down for ten minutes, then meet."
Set ground rules: "No threats or violence...only mutual respect."
Listen first: "Please tell me your view."
Summarize their perspective: "You're upset about..."
Share your information: "The policy states...the procedure is..."
Provide options: "You may resolve it at this level or talk with the supervisor or file a grievance report..."
Brainstorm solutions: "Let's think of all the possibilities."
Compromise: "Let's meet halfway."
If all else fails, agree to disagree!

Assertion As Needed

If there is no room for compromise and your client must comply for safety's sake, use these techniques:

Make simple requests
Just say "no"
Be a broken record -- calmly, in one or two brief sentences, repeat your request or response each time they argue
Speak in positives
Repeat alternatives
Hot Versus Cold Threats

Hot threats are made in the heat of anger and pose immediate danger: "If you come closer I'll punch you out!" Cold threats are cunning, calculated efforts to control: "I'll get you fired!" or "When I get out of this program you better watch your back!" or "Don't take your eyes off your kids!" They pose future danger.

When dealing with hot threats, talk "down" escalating situations by calming the client down with the methods previously addressed.

When facing cold threats, talking them "up" is imperative for safety. People making cold threats use your traits or personal information against you. They comment about your appearance, sexual preference, age, family, or other sensitive issues or convey knowledge about the kind of car you drive, your children's school or your address. They often threaten via notes or phones. They thrive on secrecy. You must talk "up" to colleagues about the threats, despite embarrassment or fear. You and at least one coworker must confront the manipulation and discuss better ways to solve the problem. When necessary, report threats to the police, Child Protective Services or other agencies, and utilize restraining orders (and stalking laws if available).

Safety First

Intervene early at the first signs of escalation. Don't think that if you ignore them they'll go away!
Keep others away from angry people.
Alert staff members and security guards to be close by.
Avoid appearing to gang up on someone, but if necessary, a show of numbers usually fosters compliance.

Only one person should verbally direct the agitated person. However, additional staff provide support by their presence.
Allow angry people time and space.

Remember "fight or flight," and allow them a graceful way out.

Train staff members how to manage assaults for times when physical containment is required.

Realize that people with frightening hallucinations, paranoid delusions, and/or who are under the influence of substances, usually are not receptive to verbal de-escalation. Medication and special interventions may be required.

Daybreak Counseling Service

Wednesday, December 5, 2007

Anger In Home Affects Children

Dr. Tony Fiore-The Anger Coach

In a recent letter to “Dear Abby,” a distraught woman wrote that her Asian husband recently lost a great deal of money in the stock market resulting in “…the negativity in our house is so bad that even our kids don’t want to be in the same room as their father. I have considered divorce, but it’s not easily accepted in my culture, and I am afraid of being on my own.”

Continuing, she says ….”I have tried everything — offering to help him, be there for him, trying to appease him, giving him his space, etc. There is no relationship left.”

“…He was always arrogant, difficult to get along with and had a temper — but now it has gone from bad to worse. I don’t know what to do anymore.”

This sad letter illustates several things that we have often heard from our anger management clients:

1. The emotional cost of anger is high, especially in terms of how it affects the children and partners. The angry sullen person often sets the “emotional tone” of the house which affects all family members. Loss of affection and/or alienation of children is difficult to recover from.

2. The angry person must decide to change himself/herself. There are many resources of anger management that would help, including therapy, medication (for some cases), and anger management classes, but they usually only work when the angry person is motivated to change.

Anger management is a self-improvement process. Those who benefit the most recognize the damage their anger is doing to themselves and people they love, and want to do something about it!

Daybreak Counseling Service