Anger management
problems can stem from the brain injury itself, as well as from problems
with reduced self-control, impulsivity and lowered frustration tolerance.
It is important to be able to:
a) identify
potential triggers of anger
b) identify
'early warning signals’
c) understand
an emotional model of anger
d) recognise
your feelings and
e) have strategies
for managing clients who display anger.
a)
Potential triggers of anger following a TBI
Potential
triggers of anger following a TBI include the following:
Lack of Sleep
Pain/headaches
Noise sensitivity
Changed self
image
Feeling angry
about accident or injury
Worries about
future/finances
Coping with
change
Lack of understanding
from others (friends/family/medical professionals etc)
Frustration
(personal and/or sexual)
Feeling out
of control when organising daily life due to numerous medical/legal
appointments
Personality
clashes/changes to relationships and social activities
b)
Early warning signals
As a person becomes angry, changes occur at a physical, emotional and/or cognitive
level. If these changes are caught early enough (i.e. before a person loses
their temper) then they can be used as an ‘early warning system’.
The
following changes are often used as guideposts to alert a person
that they are becoming angry.
Physical
Emotional
Cognitive
Muscle
tension
Temperature
change
Tremor/shaking
Sweating
Heart pounding
Clenched
fists
Irritated
Frustrated
Moody
Unsettled
Feeling upset
Changes to
thoughts include:
Racing
Jumbled
Irrational
Jumping to
conclusions
c)
Principles of anger
To
better understand how to manage anger it is useful to understand
the principles of anger that include:
a scale of
anger - for example calm (no anger) to aggressive.
an anger model
showing triggers and responses
recognition
that anger can be a secondary feeling
Scale of anger
Anger
escalates in intensity if it is not monitored or managed. A calm
person can become angry and then aggressive, if triggered.
Triggers and responses
In
thinking about how people with TBI can change from being calm to
being angry or aggressive it is useful to think about triggers
and responses (both pre-injury and post-injury).
Anger
as a secondary feeling
Anger
can be a secondary feeling and so it is important to ask the
question: was there a primary feeling?
d)
Recognising your Feelings
Remember
that the behaviour is not necessarily directed at you.
Why
is the person angry with you?
Proximity
What are you feeling?
It
is important to recognise and identify your feelings.
What
to do in relation to your feelings?
Accept your own
feelings about the situation
Talk to family,
staff & friends and discuss how you are feeling
Recognise that
you are only human and that you can also be affected by stress, frustration
and anger
Use stress and
anger management strategies yourself
e)
Strategies for staff managing clients who display anger
In any difficult
situation it is important to maintain focus on the problem not the behaviour.
You can achieve
this by:
Remaining calm
Walking away/removing
yourself from situation temporarily (if safe/appropriate to do so)
to regain composure
Use non-threatening/relaxed
body language and tone
Take slow deep
breaths/use a deep breathing technique
Discontinue
a conversation/discussion that is eliciting a negative
emotional
reaction
in you or the client
Avoid compounding
the problem with the use of alcohol or drugs to ‘cope’
Requesting a
break from the client (either permanently or temporarily)
