John* was a likeable, and successful lawyer in his late thirties who studied photography on the side. As he sat across from me in the chair in my office he spoke quickly as though in a hurry, yet his eyes were tired, his skin thin and faded. His body appeared hunched over on itself as he propped his head up on the arm of the sofa in my office. He came to me because of an anger problem and sleep disorder that was “messing up” his life.

Though he had admittedly always tended to hold a grudge, his anger quickly got out of hand when his serious girlfriend of four years left him to be with his best friend.  That was two years ago. Though he had thought that he had gotten over it, the anger flared up once again when he found out through a mutual friend that they had become engaged. That’s when the sleep problems started.

The Vicious Cycle

No matter how much he tried to calm himself and get a good sleep, he could not. During the day he would do just fine. There was enough going on at work that he could put his mind on other things, and almost forget about it for a while. But the thoughts and rage seems to flare up again as soon as his head hit the pillow. The next day at work he was tired and irritable. Even the littlest thing would set him off. It was to the point that it was starting to affect his work performance.

John did not want to be so tired and angry all the time, but he felt powerless to do anything about. He was caught in a vicious cycle and needed out quick. Not only was he angry at others but he was angry at himself. How could he have let things get this bad?

Mind Trap

He felted betrayed by the two people in his life he thought he could trust and was plagued by violent fantasies almost daily. The fantasies frightened him and contributed to his poor sleep which set of a vicious cycle of dependence on sleep medication and alcohol in order to “calm down and get to sleep”.

He wanted out of his own mind. Or at the very least not to be plagued by violent fantasies. He wanted to know if I could offer him some techniques to manage his anger and also to get a good night sleep.

The Roots of Anger

Suspecting that anger had been a problem for him long before the issue with his Ex, I asked some questions about his history. I wanted to know if anger was a problem for him in other areas of his life. How had he been managing up until now? Did other family members also struggle with this issue?  He described his father as a “rageaholic” that would often be verbally abusive. This was disheartening but also not a surprise. There has been a fair amount of researching documenting the negative affects of parental verbal abuse on children’s brains. Also, a strong connection often exists between excessive anger and  depression. This is especially true for men. So much so, that some people actually don’t make a distinction between the two. The affects of both anger and depression can also have a long lasting impact on families for generations.

In his own family, john was clear he did not want to follow in his father’s path.  As a teenager, he  had watched his father, a successful business owner, lose everything to a combination of rage and alcohol. He was terrified that he too was on this same trajectory. It turns out that anger had also cost John a job and was the main reason for his self-employed now. An avid Kick boxer,  he had successfully channel this anger into his sport  for a period of time. But now he wondered if it was actually making things worse. Also, as he got busier attending kickboxing classes was less of an option.

Taking The Edge Off

I also evaluated his strengths: He had a good relationship with his mother and felt that this was a relationship he could trust. He also had begun to practice a mindfulness based mediation practice that had helped him “take the edge off” from work stresses. We evaluated his sleep medication use together and determined that it was actually a helpful support right now in order to get the sleep that he needed to be less reactive and this was being monitored by his doctor. We both agreed that getting good sleep was an essential part of anger management. And once the pattern had shifted for him, tapering off the sleep medication would be a secondary goal.

What is healthy aggression?

My initial goal with his was to help him understand the difference between healthy and unhealthy aggression. I made it clear: our goal was not to get rid of anger: that would be impossible. Anger is one of the five basic emotions wired into us. We can’t help but get angry from time to time. What he needed was not to “manage” his anger to try to control or stop it, but rather to transform it. Before he can transform anger he first recognize the difference between anger that’s unhealthy and the healthy kind. A lot of people get confused about anger. They thing all anger is the same. And it’s all bad. But it’s not.

Anger gets such a bad rap, most people can’t tell the difference between the healthy and unhealthy kind.

From Thought to Action: A Bottoms up Approach

Traditional approaches of working with anger often involve cognitive interventions. This can be helpful. However, for many people, cognitive interventions along are not enough. That’s because when we are truly angry, our cognitive abilities actually go offline. It’s seems our brain is wired to have a physical response immediately, before the slower moving rational part of our brain even has a chance to kick-in. This is why a body-based (often called “Bottoms Up“) approach is often helpful when it it comes to dealing with states of stress. Including traumatic stress states such as anger and rage.

Letting the Body Be the Guide

Once john understood the difference between healthy vs unhealthy anger, at least intellectually it was time to learn how to access the healthy kind. He had to learn how to embody it. Many approaches focus on going for the jugular. The idea is to leap right into the fire pit of anger and expose your self to it, but use mental tools try to think or see it differently. In my experience, while these kind of experiences can be catharsis, they are often short lived. For this reason, I held off on doing any kind of trauma work initially. Instead, we let his body be the guide.

I knew that John was trapped in a paradigm of unhealthy aggression that touched everything. It seeped into his view of himself and the world, and also how he experienced these relationships. As he walked around my office I noticed how this paradigm played out in his physiology. He had a stiffness and rigidity in some parts of his body, yet other parts were collapsed and disconnected from the whole. I knew that if we started to connect these parts one by one, he would start to experience himself differently. He would began to not only feel different, he would actually be different. He would embody, perhaps for the first time, a healthy side of himself that he did not know existed.

A Better Foundation

I have many toys and tools in my office. One of them is called the Smovey Ring. A ring shaped tool filled with ball bearing. I worked with John’s posture initially to help him establish a sense of support that was neither rigid nor collapsed. Then guided him to move the rings in a way that established a rhythmical pattern. John laughed initially at the ridiculousness of it. He was expected to do “serious work” and to “confront his demons”, but this felt more like play.

I assured him that we would be addressing his demons, but in order to do that he needed a better foundation. Without that foundation, I predicted, he would end up in the same place, once stress got high enough. He agreed and was game. When he got good at this we added some sounds. Initially a low open sound that he held out for a length of time and then we added some other sounds to stimulate different parts of his nervous system.

A New Dance

It took several months of both play and hard work but eventually I noticed John start to hold himself differently. His movements were more integrated and smooth and his professional relationships were starting to change for the better. One day john shared with me that had successfully handled a conflict with a colleague. What normally would have “sent me over the edge” and resulted in more resentment, broken trust and an even larger problem, now was something all entirely different.

John had stood his ground and had successfully addressed his concerns, yet he had been able to do so with a flexible, open posture that invited more of a back and forth conversation. Unlike  the past, when john might have lashed out, or quickly shut down, he was  doing a different dance. He had learned the dance of healthy aggression. This changed everything for John. Both his relationships with himself and others felt different. They were sources of connection and possibility rather than loss, betrayal and disconnection.

Building Trust Over Time.

Of course there were times when the betrayal and old wounds still got triggered. John still had occasional nights of bad sleep, but he was less worried about them. He knew he could recover and find his balance again. He had earned a sense of basic trust with himself.  It was a trust that he could depend on more and more. This is what some people in the field of psychology call “healthy dependency”.

Once this healthy dependency grew, he realized he was ready to let go of the unhealthy kind of dependency. It was time to let go of his use of sleep medication and alcohol to sooth his nerves. After consulting with is doctor, he began to taper off both.  A new chapter of his life was beginning to unfolded so were new possibilities. He started dating again and eventually became serious with a woman with whom he felt a strong connection. Friendship with other people that he had abandoned in his “angry withdrawn phase” needed to be repaired. And thankfully now he had the energy to do it. Not everyone was receptive, but many were. Finally, the support they he most needed and wanted in life, was there. He was learning to trust others again, but more importantly he was learning to trust himself.

*The names and characteristics of the people in this story have been changed and some details have been altered to protect privacy and confidentiality. This story has been written with full permission and consent. Any characteristics or identifying information that appear to resemblance real people either in or outside of the therapy office of Danielle Kiesler, LMFT is strictly coincidental.

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