Over the past 30 years, I've spent nearly 25,000 hours counseling angry men, and until about two years ago, my enthusiasm was beginning to wane. If you've worked with angry male clients, you can understand why. These men are generally highly reluctant clients, who are often in your office only because they've gotten "the ultimatum" from their wives or girlfriends or bosses or sometimes court judges: "Get therapy for your anger or get out / you're fired / you'll go to jail." Many, considered by everyone who knows them to have an "anger problem," arrive in your office convinced that they don't have an anger problem: the real problem is their stupid coworkers, annoying girlfriends, demanding spouses, spoiled kids, or unfair probation officers. However, they arrive at your office with a shotgun at their backs, so to speak, and know they have no choice. They hate the entire situation because it makes them feel powerless.
No wonder they feel powerless: they're being coerced to lay down their anger, the only weapon they've ever had against feelings of powerlessness. They often trace their reliance upon anger to a childhood history of danger, trauma, shaming, and pain. Anger is the emotion they can trust, the one that might keep danger at bay. These men have become habitually angry. I liken their condition to the default option on a computer: their anger goes on automatically unless they consciously turn it off.
It'd be misleading to say that my most difficult clients are unmotivated. More accurately, they're antimotivated, committed to undermining any behavioral programs or specific anger management tactics I offer. It stands to reason that trying to argue such men out of their commitment to anger is pointless. I long ago realized I couldn't beat them in face-to-face combat; they're better at in-your-face challenges and making contemptuous remarks than I'll ever be. I needed a tool that allowed me to sidestep their oppositionality and create a therapeutic alliance.
Focusing on the Brain to Increase Motivation
About six years ago, I stumbled across the answer when I attended a session about the brain at the Networker Symposium in Washington, D.C. The controversial brain researcher Daniel Amen was just beginning his lecture when he mentioned in passing that he'd been browsing through the books on anger in the sales area. "None of them said anything about the brain," he noted somewhat dismissively. Now many of those anger books he was trashing were my books, so at first I was defensive. But by the end of the talk, I realized he was right, at least about the books I'd authored. I hadn't mentioned anything about brain processes for a simple reason: I didn't know anything about them. That led me to immerse myself in the subject of the brain, and as I did so, my enthusiasm for working with angry clients increased exponentially.
How can learning about the brain--particularly the angry brain and how it got that way--possibly influence clients who have a hard time taking in therapy or sticking with anger-management techniques? What I've found is that these men are fascinated by information about how anger develops in the brain and why it's so hard to control, and they consider it far more relevant to their lives than many standard therapy concepts. Getting to understand a bit of what happens "inside their heads" when they get angry resonates deeply with them. Hearing me explain how, by regular, committed behavioral practice of various anger-management techniques, they can literally change their own brain circuits, stimulates both hope that they can change and desire to begin. For the first time in their lives, they feel they might be capable of literally using their own brains to change their brains. It is a real revelation to many angry men.
A Man with an Angry Brain
Devron Johnson is a 40-year-old male who's been divorced for 10 years, partly because of his anger problems. An intelligent but not highly educated man, he works as a heating and cooling technician. He has two adolescent sons, with whom he barely converses and seldom visits. He's now in a new relationship with Sheila, a 36-year-old mother of three younger children who live with them. Although Devron has never been physically violent with the children, he often frightens them with his angry outbursts.
This man grew up in a tough part of Detroit, where survival was the name of the game. His parents separated and reconnected several times during his childhood. The family atmosphere was markedly hostile--full of negativity, accusations, and occasional violence. Devron said he hated his father because he was never there for him, not even when he became a star athlete on his high school's baseball team.
Devron sought therapy because Sheila had threatened to end their relationship unless he became much nicer to her kids. He added that he was also in trouble at work because "I gave the finger to my boss once too often."
Forging an Alliance
Like many angry clients, Devron came to counseling under duress--the "get help, or get out" final call. This isn't a formula for success, since such clients often arrive for counseling thinking that they'll more or less passively go through the motions to get the wife/boss/law off their backs, and then they'll be free to revert to previous behavior. By contrast, Devron was directly skeptical and dismissive--derisive, in fact. Instead of pretending to buy the package, he openly challenged me to prove I had something new to offer. It's uncomfortable to be sneered at by your client, but I've learned to recognize an open challenge as a positive indicator for success. Devron's disdain was a sign of energy that might be used in counseling, if I could develop an alliance with him.
"Actually, Devron, I do have something to offer you that you probably haven't run into before," I told him, "I can help you change your brain." I proceeded to explain with the enthusiasm and energy I usually feel when talking about the brain that he was actually capable of making fundamental, long-term changes in the way he thinks. "Devron, all it takes is commitment and persistence. I know you're capable of both of those things because you've told me how much you love Sheila and the kids--that's commitment--and how you've stuck it out with them when it would have been easier to walk away--that's persistence." I emphasized to him that he'd developed lifelong habits of anger that had become deeply rooted in his brain. I briefly mentioned such concepts as neuroplasticity and myleinization, but only as a tactical move, to assure him that I did, in fact, know what I was talking about. I told him I didn't just believe this brain stuff might work, I was absolutely convinced because I've seen many other angry people change their brains in just this way, and because I myself had changed my brain to become much more optimistic and generous.
As I spoke, I watched Devron's "show me" expression change to hope and wonder. "You mean I can really change the way I think?" he asked. It turned out that Devron's oppositionality obscured a deep sense of pessimism and hopelessness. He'd believed that change was impossible, in effect dooming him to a lifelong anger career. But now, maybe because of my own sense of conviction, he began to see possibilities. We talked a little more before the hour ended, and I asked him to think about how much he wanted to change his brain and in which ways. I also asked him what positive goals he wanted to pursue--for example, what other emotions he might be willing to experience if his brain wasn't dominated by anger.
Finally, I cautioned Devron again that real brain change doesn't come easy. I told him he'd need to make a strong commitment to practice new behavior for at least several months so he could build, improve, and expand new circuitry inside his brain while reducing the power of his negative brain circuits. I then sent him home with two pages of examples of possible brain change plans he could implement. One example was converting criticism and pessimism to praise and optimism. Another was to convert resentment into forgiveness. A third was to look for the good in people (and himself) instead of the bad.
When Devron returned a week later, he said he'd thought a lot about changing his brain and his life. He'd discussed it with Sheila, who'd told him she'd stick around for a while if she saw him really working to change his behavior. Now he was eager to make a six-month commitment to brain change.
Devron's Brain-Change Plan
Devron named his plan "Learning to Trust." I was tempted to add "and take in love," but Devron would have labeled that phrase unmanly. When I asked him how he planned to begin this plan, he suggested he could go to his father to see if he could learn to trust the man he most distrusted in the world. Needless to say, this was a palpably rotten idea: in all likelihood, his father would once again have demonstrated his complete untrustworthiness, potentially undermining everything Devron was trying to do. I talked him out of it with some difficulty by pointing out that he was betting his whole stake on one roll of the dice. "Besides, it's a bad bet," I said. "You'd be better off investing in a smaller stake, like letting yourself trust Sheila more." That reminded him of his real priorities.
He decided to open up emotionally a little more to both his family and a few trusted coworkers. For example, he told some of his history to two of his coworkers, the ones he felt most comfortable with, and they responded positively with their own self-disclosures. Then he took a bigger chance by admitting to Sheila that he had cheated on his first wife. Much to his shock, she told him she'd known about it for a long time--his ex-wife had thoughtfully given Sheila that information when she'd begun dating Devron--but she'd chosen not to mention it and trust that he'd be faithful to her. Shiela's disclosure and assertion of trust brought him to tears. At that very moment, his brain-change plan spontaneously expanded to include being trustworthy to others.
Devron's plan, then, began with developing some basic trust in the world, which led to being trustworthy himself, which morphed into increased empathy and actually caring about others. He quit working with me after approximately nine months. Our last session included Sheila, who affirmed that Devron had become much less angry, more caring, and far more present in their lives. She'd previously doubted his changes would endure, "But he's only becoming nicer," she admitted. "I don't doubt him any longer." Devron added that he now felt deep inside his soul that he could trust Sheila. He felt safe in a relationship for the first time in his life. "So now I have no reason to be mad all the time." Of course, he and Sheila still argue from time to time, as do almost all couples. But Devron controls his initial burst of anger far better than before, calms down quicker, and lets go of his anger sooner.
This blog is excerpted from "How to Heal the Angry Brain" by Ron Potter-Efron. The full version is available in the September/October 2012 issue, The Craft of Conversation: Kindling the Spark of Therapeutic Change.
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