1.Mistakes are never acceptable. If I make one, it means that I am incompetent. This is overly generalized. Would you expect your best friend or your child nto never make mistakes? When they do, do you think they are incompetent? People make mistakes. Next time you make a mistake. Remind yourself that you are only human. A mistake does not mean anything negative about you, it means…you goofed. Try to find somthing to learn from it, like how you can avoid making that mistake again. Remind yourself how many other things you are competent at.

2.When somebody disagrees with me, it is a personal attack against me. Okay, sometimes this is true, especially on the internet. Nevertheless, WHY are they attacking you? Most often people lash out at others because they feel insecure. The other possibility is that you are at least partly wrong (See above). Be open to other people’s point of view. You do not necessarily have to agree. When you disagree with someone, are you personally attacking them? My guess is no. So why do you think they are attacking you?

3.To be content in life, I must be liked by all people.
Not everyone is going to like you. Get over it. If you like yourself, then it really does not matter if other people like and validate you. Many people will not like you because they are insecure or they have “stuff.” Are you really going to let their “stuff” bring you down. Take a personal inventory. Are you a good and nice person? Do people have a legitimate reason not to like you? If so, then do something about it. If you require other people to tell you you are okay, then you need to work on liking you. Take a personal inventory of all of your strengths and good qualities. Keep a journal of good things you do each day. When you start feeling bad, review your journal. Be as creative as you would like.

4.My true value as an individual depends on what others think of me. (See 3 above)

5.If I am not involved in an intimate relationship, I am completely alone.
There is a huge difference between being alone and being lonely. Even when you are not in an intimate realtionship, you are not alone. Make a list of your friends and family who love you. People who cannot stand to be out of an intimate relationship do not like to spend time with themselves. They do not like themselves. Make a list of all of the qualities you look for in an intimate relationship. See how many of those needs you can provide for yourself or get met with your friends and family.

6.There is no grey area. Success is black and failure is white.
See 1 above. We all make mistakes and rarely do we succeed perfectly at something. I remember having recitals and giving speeches in which I goofed up. My teachers always told me that if I kept going, nobody would probably notice. They were right. The speech or recital or whatever was still a success, even if I was not perfect. Part of success too is knowing your limitations. Successful people know when they need to ask for help, or simply say “I don’t know.”

7.Nothing ever turns out the way you want it to.
Well, that is a defeatest attitude. List 5 things that have turned out the way you wanted. List 5 more that have not turned out how you expected, but it turned out okay. We do not always get our way, but if we focus on what we do not have or did not get, we will always be miserable. What do you have? What positive came out of it.

8.If the outcome was not perfect, it was a complete failure. (See 1 and 6 above.)

9.I am in absolute control of my life. If something bad happens, it is my fault.
You cannot control the weather. You cannot control other people. All you can control is how you react and what you do. Bad things happen to good people. The question is, do you let it destroy you, or do you figure out how to deal with it and move on. Take responsibility only for the things that you do have control over.

10.The past always repeats itself. If it was true then, it must be true now.
The definition of insanity is doing what you have always done and expecting different results. You have the ability to change how you deal with things now. Similar situations will arise. Use your past knowledge to help you deal with them better.

National Institute of Mental Health Publications and Handouts
National Alliance on Mental IllnessAnxiety in children

Available CEUs approved by the National Board for Certified Counselors (NBCC), Florida Board of Social Work, Mental Health Counselors and Marriage and Family Therapists, Florida Board of Nursing and the National Association for Alcohol and Drug Abuse Counselors (NAADAC), also accepted by the Commission for the Accreditation of Rehabilitation Counselors and the Florida Certification Board for Certified Addictions Professionals (CAP).

There are many things that affect how a patient adjusts to cancer. It is difficult to predict how a person will cope. The following factors influence how a patient adjusts to cancer: The type of cancer, cancer stage, and chance of recovery.
The phase of cancer such as newly diagnosed, being treated, in remission, or recurrent cancer.
Individual coping abilities.
Friends and family available to support the patient.
The patient’s age.
The availability of treatment.
Beliefs about the cause of cancer.

Adjusting to a diagnosis of cancer is an ongoing process in which the patient learns to cope with emotional distress, solve cancer-related problems, and gain control over cancer-related life events. To add to the stress, patients are faced with many challenges that change as the disease and its treatment change. There are, however, certain predictable times when a patient is more likely to experience significant crisis. These include hearing the diagnosis, receiving treatment, completing treatment, hearing that the cancer is in remission, hearing that the cancer has come back, and becoming a cancer survivor. Each of these events involves specific coping tasks, questions about life and death, and common emotional challenges.

Patients are better able to adjust to a cancer diagnosis if they are able to continue fulfilling normal responsibilities, cope with emotional distress, and stay actively involved in activities that are meaningful and important to them. In counseling, patients can learn to develop coping strategies to change problem situations, manage emotional distress, and understand what impact cancer may have on his or her life. Patients who adjust well are usually committed to recovery and actively involved in coping with cancer.

Distress can occur when a person feels that he or she does not have the resources to manage or control the cancer. Patients who have the same diagnosis and are undergoing the same treatment may have very different experiences and ways of expressing distress. Anxiety and depression are common among patients with cancer. It is important, however, to ferret out whether the anxiety and depression are solely emotionally based or are caused/made worse by insomnia, fatigue, pain or side effects of medication.

Anxiety
Anxiety is a normal reaction to cancer and may increase feelings of pain, interfere with one’s ability to sleep, cause nausea, and interfere with the patient’s (and his or her family’s) quality of life. Persons with cancer will find that their feelings of anxiety increase or decrease at different times. Contrary to what one might expect, patients with advanced cancer experience anxiety due not to fear of death, but more often from fear of uncontrolled pain, being left alone, or dependency on others. Many of these factors can be alleviated with treatment. Helping patients identify their own cycles and plan for those times is a useful activity in therapy.

Patients may benefit from other treatment options for anxiety, including: psychotherapy, group therapy, family therapy, participating in self-help groups, hypnosis, and relaxation techniques such as guided imagery, or biofeedback. Medications may be used alone or in combination with these techniques. It is important not to avoid anxiety-relieving medications for fear of becoming addicted. A side benefit of many of the antianxiety medications is that they cause muscle relaxation which can often ease some of the aches and pains patients are experiencing.

Depression
While some patients become anxious, others become depressed, and even others are both anxious and depressed. Depression affects about 15% to 25% of cancer patients. Affecting men and women with cancer equally. People with cancer will experience different levels of distress. Issues which may contribute to depression in cancer patients include:
Fear of death.
Interruption of life plans.
Changes in body image and self-esteem.
Changes in social role and lifestyle.
Money and legal concerns
Guilt at not being around for their children
Regret for delaying diagnosis
Survivor guilt (If the patient survives and his/her friend does not)

People diagnosed with cancer will react to these issues in different ways and may not experience serious distress. It is also important to remember that patients and their family members or caregivers need to be evaluated for depression throughout their treatment. Children are also affected when a parent with cancer develops depression, and often develop emotional and behavioral problems.

There are many misconceptions about cancer and how people cope with it, such as the following:
All people with cancer are depressed.
People with cancer should be shielded from stress
Depression in a person with cancer is normal.
Treatment does not help the depression.
Everyone with cancer faces suffering and a painful death.
Depression and anxiety are always mental health issues

Sadness and grief are normal reactions to the crises faced during cancer, and will be experienced at times by all people. Because sadness is common, it is important to distinguish between normal levels of sadness and depression. An important part of cancer care is the recognition of depression that needs to be treated. This is depression that causes a person to lose pleasure in most activities more often than not for at least two weeks and can be accompanied by sleep and appetite changes, suicidal thoughts, confusion and difficulty concentrating. Counselors with a knowledge of cancer and cancer treatment can help people deal with their depression. Specific goals of these therapies include the following:
Assist people diagnosed with cancer and their families by answering questions about the illness and its treatment, explaining information, correcting misunderstandings, giving reassurance about the situation, and exploring with the patient how the diagnosis relates to previous experiences with cancer.
Assist with problem solving, improve the patient’s coping skills, and help the patient and family to develop additional coping skills. Explore other areas of stress, such as family role and lifestyle changes, and encourage family members to support and share concern with each other.
Ensure that the patient and family understand that support will continue when the focus of treatment changes from trying to cure the cancer to relieving symptoms. The health care team will treat symptoms to help the patient control pain and remain comfortable, and will help the patient and his or her family members maintain dignity.

When the depression or anxiety is being made worse by symptoms or medication, the counselor can advocate for the client, help the client communicate with his/her physician and educate the client about possible interventions.

Fatigue
Fatigue occurs in 14% to 96% of people with cancer, and has physical, psychological, and behavioral causes. People with cancer may describe it in different ways, such as saying they feel tired, sluggish, weak, exhausted, weary, worn-out, heavy, or slow. To be treated effectively, fatigue related to cancer and cancer treatment needs to be distinguished from other kinds of fatigue.

Fatigue can become a very important issue in the life of a person with cancer. It may affect the person’s self-esteem, his or her daily activities and relationships with others, and whether he or she continues treatment. Some of these treatments may include adjusting the dosages of pain medications, administering red blood cell transfusions or blood cell growth factors, diet supplementation with iron and vitamins, use of antidepressants or stimulants, exercise, and helping the patient identify a reasonable schedule so as not to tire too quickly.

Since fatigue is the most common symptom in people receiving outpatient chemotherapy, patients should learn ways to manage the fatigue. According to the American Cancer Society, patients should be taught the following:
The difference between fatigue and depression
Possible medical causes of fatigue (dehydration, electrolyte imbalance, breathing problems, anemia)
To observe their rest and activity patterns during the day and over time
To engage in attention-restoring activities (walking, gardening, bird-watching)
To recognize fatigue that is a side effect of certain therapies and medications
To participate in exercise programs that are realistic
To identify activities which cause fatigue and develop ways to avoid or modify those activities
To identify environmental or activity changes that may help decrease fatigue
The importance of eating enough food and drinking enough fluids
Respiratory therapy may help with breathing problems
To schedule important daily activities during times of less fatigue, and cancel unimportant activities that cause stress
To avoid or change a situation that causes stress
To observe whether treatments being used to help fatigue are working

Pain Management
Pain is another major cause of insomnia, anxiety and depression. Counselors can work with physicians and patients to create a comprehensive pain management plan.

Physical Interventions include:
Muscle/bone pain may be treated with heat (a hot pack or heating pad); cold (flexible ice packs); massage, pressure, and vibration (to improve relaxation); exercise (to strengthen weak muscles, loosen stiff joints, help restore coordination and balance, and strengthen the heart); changing the position of the patient; restricting the movement of painful areas or broken bones; stimulation; controlled low-voltage electrical stimulation; or acupuncture.

Thinking and behavior interventions give patients a sense of control and help them develop coping skills to deal with the disease and its symptoms. Beginning these interventions early in the course of treatment is useful so that patients can learn and practice the skills while they have enough strength and energy.

Thinking and Behavioral interventions include:
Relaxation and imagery: Simple relaxation techniques may be used for episodes of brief pain (for example, during cancer treatment procedures).
Hypnosis: Hypnotic techniques may be used to encourage relaxation and may be combined with other thinking/behavior methods. Hypnosis is effective in relieving pain in people who are able to concentrate and use imagery and who are willing to practice the technique regularly.
Redirecting thinking: Focusing attention on distractors other than pain or negative emotions including counting, praying, or saying things like “I can cope,” music, television, talking, listening to someone read, or looking at something specific. Patients can also learn to monitor and evaluate negative thoughts and replace them with more positive thoughts and images.
Support groups and religious counseling: Since depression tends to increase pain, and pain tends to increase depression, support groups help many patients. Many online support groups for patients and their families can be helpful for those patients who have restricted movement. Visit: http://www.acor.org/

Sleep
Finally, sleep problems can contribute to depression, anxiety and the patient’s ability to manage pain. Sleep disorders that are related to cancer may be treated by eliminating the cancer and side effects of cancer treatment. To promote rest and treat sleep disorders the following may be considered:
Create an environment that decreases sleep interruptions and promotes sleep by:
Lowering noise.
Dimming or turning off lights.
Adjusting room temperature.
Aromatherapy
Keeping bedding, chairs, and pillows clean, dry, and wrinkle-free.
Using bedcovers for warmth.
Placing pillows in a supportive position.
Encouraging the patient to dress in loose, soft clothing.
Encourage regular bowel and bladder habits to minimize sleep interruptions.
Increasing consumption of fluids and fiber during the day.
Taking medication for incontinence before bedtime.
Eating a high-protein snack 2 hours before bedtime.
Avoiding heavy, spicy, or sugary foods 4 to 6 hours before bedtime.
Avoiding drinking alcohol or smoking 4 to 6 hours before bedtime.
Avoiding drinks with caffeine within 12 hours of bedtime
Exercising (which should be completed at least 2 hours before bedtime).
Keeping regular sleeping hours.
Stretching before bed
Journaling to get closure on the day and “vent” stressors
Setting a regular routine so your body is “cued” to get sleepy
Massage
Medications may also be used to help relieve sleep problems.

As a clinician working with a cancer patient, there are many things you can do to aid him/her in leading the highest quality of life. It is important to remember that patients with cancer who are seeking counseling are often in crisis, so write down suggestions or interventions they are to try at home.

Terrifying experiences that shatter people’s sense of predictability and invulnerability can profoundly alter their coping skills, relationships and the way they perceive and interact with the world. The criteria for Post Traumatic Stress Disorder (PTSD) are 1) exposure to a traumatic event(s) in which the person witnessed or experienced or were confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others, and 2) the person’s response involved intense fear, helplessness or horror DSM IV p. 427-28). Gradual Onset Traumatic Stress Disorder can be caused by repeated exposure to “sub-critical incidents” such as child abuse, traffic fatalities, rapes and personal assaults.

Nevertheless, not all people exposed to trauma are “traumatized.” Why? In 1998, Pynoos and Nader proposed a theory to assist in explaining why people have different reactions to the same event. They asserted that people are at greater risk of being negatively impacted by traumatic events if any of the following are present: 1) they have experienced other traumatic events within the preceding 6 months, 2) they were already stressed out or depressed at the time of the event, 3) the situation occurred close to their home or somewhere they considered safe, 4) the victims bear a similarity to a family member or friend and 5) they have little social support.

It has been argued that officers, emergency service personnel, children of addicts and abuse victims experience traumatic events or threats to their safety on an almost daily basis. Being abused, not knowing when or if your parents will come home, repeatedly seeing children murdered, people burned in car fires and devastated victims starts to take its toll. People like idealistic officers who joined the force to change the world and protect the innocent begin to feel like nothing they do makes a difference, they cannot even keep their zone safe (criteria 3). This is especially problematic for officers who live in or near their work zone and often leads to frustration and burnout (criteria 2). Children start to feel that the whole world is uncontrollable and unsafe.

It is still not totally accepted within the law enforcement community for officers to discuss the impact of situations on them. Anger, humor and sarcasm are but a brief outlet for what many officers dream about at night. As their condition worsens, many officers withdraw, because they are fearful of seeking help or support for fear it is a one way ticket to a fitness for duty evaluation or will get out and be an obstacle for future promotions. Several studies in recent years have shown that Post Traumatic Stress Disorder (PTSD) is among the most common of psychiatric disorders.

Another thing that distinguishes people who develop PTSD from those who are just temporarily overwhelmed is that people who develop PTSD become “stuck” on the trauma, keep re-living it in thoughts, feelings, or images. It is this intrusive reliving, rather than the trauma itself that many believe is responsible for what we call PTSD. For example, I have worked with officers who have responded to child abuse calls and had a child of their own who was a similar age (criteria 4). In the course of daily life children get hurt and have bad dreams. As parents they have seen looks of pain and fright on their kids faces. This makes it just that much easier to envision the looks of terror and agony on the face of the child as their parent beat them. Sometimes this visualization gets corrupted and officers suddenly they start to see their child in their mental re-enactment of the trauma, obviously a much more powerful memory. These officers are much more likely to be “traumatized” by the incident and potentially get “stuck.”

Traumatized individuals begin organizing their lives around avoiding the trauma. Avoidance may take many different forms: keeping away from reminders, calling in sick to work, or ingesting drugs or alcohol that numb awareness of distress. The sense of futility, hyperarousal, and other trauma-related changes may permanently change how people deal with stress, alter thier self-concept and interfere with their view of the world as a basically safe and predictable place. In the example above, these people often became even more overprotective of their children, suspicious of others, and had difficulty sleeping, because every time they close their eyes they see the child.

One of the core issues in trauma is the fact that memories of what has happened cannot be integrated into one’s general experience. The lack of people’s ability to make this “fit” into their expectations or the way they think about the world in a way that makes sense keeps the experience stored in the mind on a sensory level. When people encounter smells, sounds or other sensory stimuli that remind them of the event, it may trigger a similar response to what the person originally had: physical sensations (such as panic attacks), visual images (such as flashbacks and nightmares), obsessive ruminations, or behavioral reenactments of elements of the trauma. In the example above, sensory triggers that triggered some of the officers memories were certain cries, hearing or seeing a parent spank their child, returning to the same neighborhood for other calls and, of course, television shows or news reports that involved descriptions of abuse.

The goal of treatment is find a way in which people can acknowledge the reality of what has happened and somehow integrate it into their understanding of the world without having to re-experience the trauma all over again. To be able to tell their story, if you will.

The Symptoms of PTSD
Regardless of the origin of the terror, the brain reacts to overwhelming, threatening, and uncontrollable experiences with conditioned emotional responses. For example, rape victims may respond to conditioned stimuli, such as the approach by an unknown man, as if they were about to be raped again, and experience panic.

Remembrance and intrusion of the trauma is expressed on many different levels, ranging from flashbacks, feelings, physical sensations, nightmares, and interpersonal re-enactments. Interpersonal re-enactments can be especially problematic for the officer leading to over-reaction in situations that remind the officer of previous experiences in which she or he has felt helpless. For example, in the child abuse example above, officers may be much more physically and verbally aggressive toward alleged perpetrators and their reports tend to be much more negative and subjective.

Hyperarousal. While people with PTSD tend to deal with their environment by reducing their range of emotions or numbing, their bodies continue to react to certain physical and emotional stimuli as if there were a continuing threat. This arousal is supposed to alert the person to potential danger, but seems to loose that function in traumatized people. This is sort of like when rookie officers start and a hot call is toned out, they usually have an adrenaline rush. After two or three years, the tones hardly have any impact on them. Since traumatized people are always “keyed up” they often do not pay any attention to that feeling which is supposed to warn them of impending danger.

Numbing of responsiveness. Aware of their difficulties in controlling their emotions, traumatized people seem to spend their energies on avoiding distress. In addition, they lose pleasure in things that previously gave them a sense of satisfaction. They may feel “dead to the world”. This emotional numbing may be expressed as depression, and lack of motivation, or as physical reactions. After being traumatized, many people stop feeling pleasure from involvement in activities, and they feel that they just “go through the motions” of everyday living. Emotional numbness also gets in the way of resolving the trauma in therapy.

Intense emotional reactions and sleep problems. Traumatized people go immediately from incident to reaction without being able to first figure out what makes them so upset. They tend to experience intense fear, anxiety, anger and panic in response to even minor stimuli. This makes them either overreact and intimidate others, or to shut down and freeze. Both adults and children with such hyperarousal will experience sleep problems, because they are unable to settle down enough to go to sleep, and because they are afraid of having nightmares. Many traumatized people report dream-interruption insomnia: they wake themselves up as soon as they start having a dream, for fear that this dream will turn into a trauma-related nightmare. They also are liable to exhibit hypervigilance, exaggerated startle response and restlessness.

Learning difficulties. Being “keyed-up” interferes with the capacity to concentrate and to learn from experience. Traumatized people often have trouble remembering ordinary events. It is helpful to always write things down for them. Often “keyed-up” and having difficulty paying attention, they may display symptoms of attention deficit disorder.

After a trauma, people often regress to earlier modes of coping with stress. In adults, it is expressed in excessive dependence and in a loss of capacity to make thoughtful, independent decisions. In officers, this is often noticed because they suddenly begin making a lot of poor decisions, their reports lose quality and detail and they are unable to focus. In children they may begin wetting their bed, having fears of monsters or having temper tantrums.

Aggression against self and others: Both adults and children who have been traumatized are likely to turn their aggression against others or themselves. Due to their persistent anxiety, traumatized people are almost always “stressed out,” so it does not take much to them set off. This aggression may take many forms ranging from fighting to excessive exercise or obsession about something—anything to keep them from thinking about the trauma.

Psychosomatic reactions. Chronic anxiety and emotional numbing also get in the way of learning to identify and discuss internal states and wishes. May traumatized people report a high frequency of headaches, back and neck aches, gastro-intestinal problems etceteras. Since the stress is being held inside, the body begins to become distressed.

Summary
After a trauma, people realize the limited scope of their safety, power and control in the world, and life can never be exactly the same. The traumatic experience becomes part of a person’s life. Sorting out exactly what happened and sharing one’s reactions with others can make a great deal of difference a person’s recovery. Putting the reactions and thoughts related to the trauma into words is essential in the resolution of post traumatic reactions. This should, however, be done with a professional specializing in PTSD due to the wide range of reactions people have when they start confronting and integrating the memories of the trauma.

Failure to approach trauma related material gradually is likely to make things worse. Often, talking about the trauma is not enough: trauma survivors need to take some action that symbolizes triumph over helplessness and despair. The Holocaust Memorial in Jerusalem and the Vietnam Memorial in Washington, DC, are good examples of symbols for survivors to mourn the dead and establish the historical and cultural meaning of the traumatic events. There are several events for survivors of traumas that officers can also take part in. These events remind survivors of the fact that there are others who have shared similar experiences. Other symbolic actions may take the form of writing a book, taking political action or helping other victims.

PTSD is real, and can be resolved with time, patience and compassion.

For more information on treating PTSD, see All CEUs

Approximately 19.1 million American adults in a given year, have an anxiety disorder.
Anxiety disorders frequently co-occur with depression or substance abuse.
Women are more likely than men to have an anxiety disorder.
Approximately 2.4 million American adults have panic disorder.
Approximately 3.3 million American adults in a given year, have Obsessive Compulsive Disorder.
Approximately 5.2 million American adults in a given year, have Post Traumatic Stress Disorder
Approximately 4.0 million American adults in a given year, have Generalized Anxiety Disorder
Anxiety is caused by many factors including a chemical imbalance in the brain, hyperthyroidism, hormones and situational factors (loss, grief, stress).
Additionally, things like substance use, poor nutrition and insufficient sleep can make the symptoms of anxiety worse.
Anxiety treatment can involve medication, cognitive-behavioral counseling, reducing caffeine and sugar, getting enough sleep, exercise, education about the disorder, developing social supports and using positive self-talk.

GENERALIZED ANXIETY
Anxiety is also called “stress,” “fear,” or “worry.” Most of us become anxious because of irrational thoughts. People with Generalized Anxiety feel “anxious,” “irritable,” or “stressed out” most of the time, for what seems to be no apparent reason. In therapy we often find that people with Generalized Anxiety put conditions of worth on themselves, set unrealistically high standards for themselves, fear loss of control, the unknown and rejection. All of these attitudes permeate every area of their life, thus making them feel “anxious” all of the time. Cognitive-Behavioral Therapy is very helpful with anxiety related to irrational thoughts. By helping to identify the unrealistic demands, improve self-esteem and identify the causes of their fears they can start using more positive self-talk and learn to cope with stress better.

TRAUMA
Some people who have survived trauma or abuse also have anxiety issues, especially hypervigilence–being over-aware of what is going on around them at all times. Trauma-oriented therapy is more effective at helping resolve this type of anxiety.

MEDICATIONS
BuSpar is an excellent medication for persons with Generalized Anxiety. It does not have the addictive properties of many of the traditional anti-anxiety medications (Benzodiazepines), but helps take the edge off. People typically find themselves getting into a crisis over everything, often find that, on BuSpar, they are much more moderated. Many of the new antidepressants such as Zoloft and Paxil also have antianxiety properties. It is necessary to talk with your doctor to find the right combination for you. (Hint: Many of my patients who take Paxil take it before bed instead of first thing in the morning.)

CEUs are available for professionals.

• Anger is a defense mechanism. It defends people against the six basic fears: fear of failure, fear of rejection, fear of loss of self-control/respect, fear of isolation, fear of death, fear of the unknown. 
• Anger protects people emotionally, physically and socially. Anger keeps people from feeling afraid. It gets them out of threatening situations (ideally). It alienates them from other people who could cause them to experience fear.
• Most people experience 15 anger situations per day
• Anger itself is a normal and adaptive emotion. It is when you over-react or hold on to anger instead of using it as a motivation to make positive changes that it can be harmful.
• Pathological anger can lead to aggression, impatience, low frustration, depression, high blood pressure, migraines, muscle tension, upset stomach and much more.
• Treatment for anger often involves identifying anger triggers, learning why they are triggers, learning how to identify when you are getting angry before it gets out of control, learning other ways to deal with anger and developing the tools necessary to implement those new coping styles
• The average person experiences 15 anger situations per day
• Anger reveals information about people’s values and personal constructs of importance
• Expression of anger for men and women is often dictated/indicated by their particular culture
• Exercise, venting and time-out are often good strategies to dissipate the adrenaline, but are not effective for coping with anger.
• Coping with anger requires people to recognize what caused the anger and modify that stressor or perceptions about that stressor.
• Good communication, fair fighting and self-awareness are all important components for anger management.
• People express anger in different ways. Some people hold it inside and develop physical problems, some people explode and some people are passive-aggressive.
• It is important for people to know their personal anger styles, triggers and most effective anger management skills.

Negative emotions include depression, anger, fear, and grief. What people often fail to realize is the interconnection of these feelings. Depression is the body and mind’s way of shutting down due to system overload. There is not enough energy to continue the behaving and/or feeling in the current manner. (Examples: chronic pain, sickness, chronic sleep deprivation). The body has not had enough time to produce sufficient serotonin to elevate one’s mood, because it is never allowed to rest and recover.
 
People subject themselves to minor (if not major) stressors every day. These stressors cause physical changes in the body that require the production of acetylcholine and other chemicals to calm down. If the body cannot rest, then it cannot divert the necessary energy to make the neurochemicals. Consider trying to do a simple task such as dishes. Do you think it is more efficient to do it uninterrupted, or while you have a child that is wanting attention, dogs that are needing to be fed and a spouse that is trying to talk to you about your day. The body experiences energy diversions in the same way. After it depletes it’s reserves of “happy” chemicals, it must make more. Unfortunately, people often use these chemicals faster than they can be made. The end result is depression, distress and irritability.

During these times of depleted happy chemicals, we tend to be irritable and take it out on others . The following is a partial list of causes of aggression. You know what they say, knowing your problem is half the battle.
 
Predisposing/vulnerability factors

Learned behavior
Family history of violence or aggression Experience of bullying at school
Experience of physical/sexual/emotional abuse
Peer influence
General environmental factors (cultural norms)
Rigid thinking (It MUST be just so)
Inability to solve problems
Irrational beliefs/rules

Once you have identified your anger triggers, ask yourself “Is this worth getting upset about?” “Will this matter 6 months from now?” “Will getting angry about this do any good?” Many things we get angry about cannot be changed, and getting angry serves no productive purpose. For many people, if they just ask themselves the above three questions, they will eliminate the majority of their anger. What is left over is the stuff worth getting angry about, but not staying angry about. Anger or anxiety are emotions that tell you that something needs to be done, fixed or changed. Instead of nurturing your anger, use that energy to find a way to fix the problem or prevent it from happening again.