Therapy Can Work

Katherine Rabinowitz, LP, M.A., NCPsyA

Licensed Psychotherapist & Psychoanalyst
Union Square, Greenwich Village, New York, NY

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Therapy Can Work

Katherine Rabinowitz, LP, M.A., NCPsyA

Licensed Psychotherapist & Psychoanalyst
Union Square, Greenwich Village, New York, NY



Anger is a basic, and normal, natural part of the spectrum of human emotions. It can range from mild irritation to uncontrolled, explosive fury. Used appropriately it conveys to others a dissatisfaction with the way things are at that moment. Something is amiss. It can be a motivating force in threatening situations, give us energy, add to a sense of control or power where you might otherwise feel helpless, and it actually discharges certain levels of tension.

Why is Anger a “Problem?”

When expressed in a healthy way, not overused or an automatic reaction to all frustrations, it’s not. It becomes problematic when it’s routinely unacknowledged, brushed aside or stuffed down, or when it’s either out of control or the default response to even minor annoyances. In these cases, it can lead to problems at work, in one’s relationships, cause accidents, and even cause long-term physical ailments and conditions, including hypertension and depression.

What is Anger?

Anger is an emotional state, but there are also physiological changes that can accompany it:


Anger is caused by both internal and external events or situations, and it’s a legitimate response to fear, and most often, frustration. Frustration is about not getting what you want, whether we’re talking about something tangible and concrete, like that great apartment, or a promotion (even a job) you hoped for, or something more abstract like support, approval, acknowledgement and love. Sometimes it’s the whole world that’s making you angry, because it’s just not fair. You get angry because:

You can make your own list. These are just common examples of typical scenarios that happen every day, understandably cause anger, but by and large are situations over which we have little or no control. And that’s frustrating.

Frustration Tolerance

Some people are simply born with a greater or lesser tolerance for frustration. You probably know some of them. The people who, no matter what happens, are cool as cucumbers, genuinely so, and everything just rolls off them. Or the ones who always seem to be cranky, griping about every little thing, or worse, erupt for no apparent reason.

While there are some people who are just born irritable or easily riled up anger as a typical response to frustration or disappointments great and small is usually learned behavior. Maybe it was in the home, at school, or in the greater community environment and came to be seen as acceptable behavior. People got angry and fought all the time, yelled and screamed a lot, and that’s just the way it was.

Or perhaps you got the opposite message: anger is most definitely NOT ok. And you learned quickly that not only should you not show your anger, you shouldn’t even feel it. So you learned to tolerate a lot of anger. You rationalize it (oh, don’t worry about it, it’s fine that you forgot to get me a ticket, I didn’t really want to go anyway), detach yourself from the feeling, withdraw from the situation, blame yourself, or suffer silently.

None of this is healthy, and can result in the consequences mentioned above. So let’s take a look at some of the patterns that become a part of someone’s way of operating that may have worked in the past, but aren’t working so well anymore.

Internalized Anger

This is what happens when we’ve learned that it’s not ok to be angry, whether by overt instruction, previous bad experience expressing anger, or instinctive fear. It gets

In all of these cases, the anger doesn’t get to be expressed. Since it has nowhere to go, it begins to accumulate. It doesn’t just go away, and often has unintended consequences. Sometimes it gets put onto things where it doesn’t actually belong (blowing up over little things, especially in a way that’s out of proportion to the reality of what’s going on), sometimes it simmers on a low boil resulting in chronic crankiness, lingering resentment or self-deprecation and self-pity, and sometimes it evolves into depression.

It can also be mal-expressed physically. Ulcers, skin conditions, headaches, some back pain, high blood pressure, muscle tension and several other common ailments sometimes have their source in repressed anger.

I am not a physician, and cannot determine whether your physical symptom is or is not a result of internalized anger. You should always have any symptom checked out by a doctor to rule out underlying physical illness or disease.

Anger That’s Out of Control

Though some people come into the world with a really short fuse hardwired, more often than not uncontrolled anger is behavior learned by example. You saw it somewhere, and absorbed that anger is an acceptable response to life’s frustrations. And maybe it worked before, got you what you wanted or was just a release, but the habit has gotten out of control, and now instead of getting you what you want, it gets you into trouble. It becomes an automatic, habitual response along the lines of

You’ll recognize patterns of aggression, victim mentality, blaming, entitlement, self-deprecation, and revenge. People who get angry a lot tend to have a need to be right all the time or are afraid of being wrong because they feel it means they’re devalued somehow. Or it’s about the need to be in control, and being wrong means being out of control.

Some people feel weak, or vulnerable if they’re wrong, and think the way to get approval is to appear tough. So rather than accept responsibility for being wrong, or recognizing that this is just how it is, they habitually get mad in unhealthy ways.

Unhealthy Internalizations of Anger

Unhealthy Expressions of Anger

You Don’t Always Have To Go There

Being angry all the time isn’t going to fix anything. So what can you do instead?

The most important thing to remember is that ultimately you are responsible for your choice to be angry. This can feel hard because it often seems like it’s not a choice – you can’t help yourself. It just wells up inside you and there’s nothing you can do. Except there is. There are many other ways to respond, but it won’t happen overnight, because whatever your pattern is (chronically internalized anger or chronically externalized anger) it’s been with you for a long time.

It won’t work to try to completely eliminate anger, because anger is normal and natural, and because you can’t get rid of the sources of what makes you angry. Life is unfair and stuff happens. You can’t control that, and you can’t control other people. But you can exert some control over your reactions and make different choices.

If you tend to internalize, minimize or dismiss anger you can learn to

If you tend towards having a “temper” or express anger involuntarily with no control you can learn to

It Is What It Is

“It’s the way of things”
The Tao of Pooh
~Benjamin Hoff

Whichever your style, learning to restructure your anger responses will require deeper acceptance of certain ideas that you may already know to be true: life’s not fair, some things will never change so you might as well stop fighting them, you can’t change other people, and sometimes, fair or not, it’s just the way it is.

Recognize your part in a conflict. If you look hard enough you’ll usually find one. Accepting responsibility rather than blaming will go a long way towards reducing unnecessary anger.

So will empathic understanding: being able to see something from the other person’s point of use. Get inside their head. Imagine what it’s like to be them, and to be on the receiving end of you.

You can use humor to diffuse the situation. Genuine funny, ha-ha humor, not nasty, biting sarcasm meant to hurt.

Let go of grievances. Holding onto them to punish someone later on gets you nowhere and serves only to let you feel self-righteous. Learn to forgive people’s imperfections.

And you can often help yourself by lowering your expectations. The world will never be perfect.

Healthy Expressions of Anger

All that being said, there are occasions where we are angry and do want to express it. It’s not always about not getting angry, but whether we choose to express it, and if so, how. Is it possible to do it in a non-hostile, non-retributive way?

The best way is to learn to be assertive rather than aggressive way.

And another alternative is to use the anger in a constructive way. Convert it to energy available to be used for other things like a really great workout, an outcome of a work project you’re surprisingly happy with, a creative endeavor.

If none of this works, consider getting professional help. There may be other factors playing into your anger, your style of dealing with it and ability to control it. Therapy can work.

To learn more
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