Professional Documents
Culture Documents
Anger becomes negative when the person denies it, suppresses it, or expresses it inappropriately.
Possible consequences are physical problems such as migraine headaches, ulcers, or coronary artery disease and emotional problems
such as depression and low self-esteem.
Anger that is expressed inappropriately can lead to hostility and aggression.
Some people try to express their angry feelings by engaging in aggressive but safe activities such as hitting a punching bag or yelling.
Such activities, called CATHARSIS, are supposed to provide a release for anger. However, it can increase rather than alleviate angry
feelings.
Cathartic activities may be contraindicated for angry clients. Activities that are not aggressive, such as walking or talking with another
person, are more likely to be effective in decreasing anger.
Hostile and aggressive behavior can be sudden and unexpected.
Stages or phases can be identified in aggressive incidents:
1. triggering phase
2. escalation phase
3. crisis phase
4. recovery phase
5. postcrisis phase
PHASE DEFINITION S/SX
TRIGGERING An event or circumstances in the Restlessness, anxiety, irritability, pacing,
environment initiates the clients response, muscle
which is often anger or hostility. tension, rapid breathing, perspiration, loud
voice, anger.
ESCALATION Clients responses represent escalating Pale or flushed face, yelling, swearing,
behaviors that indicate movement toward a agitated, threatening, demanding, clenched
loss of control. fists, threatening gestures, hostility, loss of
ability to solve the problem or think clearly.
CRISIS During a period of emotional and physical Loss of emotional and physical control,
crisis, the client loses control. throwing
objects, kicking, hitting, spitting, biting,
scratching, shrieking, screaming, inability to
communicate clearly.
RECOVERY Client regains physical and emotional Lowering of voice; decreased muscle tension;
control. clearer, more rational communication;
physical relaxation.
POST-CRISIS Client attempts reconciliation with others Remorse; apologies; crying; quiet, withdrawn
and returns to the level of functioning before behavior
the aggressive incident and its antecedents.
ANGER ATTACKS Sudden intense spells of anger that typically occur in situations in which the depressed person
feels emotionally trapped.
It involve verbal expressions of anger or rage but no physical aggression. It is described as
an uncharacteristic behavior that is inappropriate for the situation and followed by remorse.
The anger attacks seen in some depressed clients may be related to irritable mood,
overreaction to minor annoyances, and decreased coping abilities.
INTERMITTENT EXPLOSIVE DISORDER Rare psychiatric diagnosis characterized by discrete episodes of aggressive impulses that
result in serious assaults or destruction of property.
The aggressive behavior the person displays is grossly disproportionate to any provocation
or precipitating factor.
This diagnosis is made only if the client has no other comorbid psychiatric disorders.
The person describes a period of tension or arousal that the aggressive outburst seems to
relieve. Afterward, however, the person is remorseful and embarrassed, and there are no
signs of aggressiveness between episodes.
Intermittent explosive disorder develops between late adolescence and the third decade of
life.
Clients with intermittent explosive disorder typically are large men with dependent
personality features who respond to feelings of uselessness or ineffectiveness with violent
outbursts.
ACTING OUT Immature defense mechanism by which the person deals with emotional conflicts or stressors
through actions rather than through reflection or feelings.
The person engages in acting-out behavior, such as verbal or physical aggression, to feel
temporarily less helpless or powerless.
Children and adolescents often act out when they cannot handle intense feelings or deal
with emotional conflict verbally. To understand acting-out behaviors, it is important to consider
the situation and the persons ability to deal with feelings and emotions.
ETIOLOGY: NEUROBIOLOGIC THEORIES