THE BOSTON GLOBE • HEALTH|SCIENCE • MONDAY, MAY 3, 1999

Beating Anger


By Judy Foreman


Blame it on Aristotle, who believed that watching tragic plays led to a healthy catharsis of emotions like pity and fear.

Or on Freud, who, at least in his early days, also took the hydraulic view -- that pent-up feelings, like steam in a pressure cooker, need release lest they cause hysteria or phobia.

Or on self-help gurus urging that anger be vented by yelling, pounding pillows or bopping people with hollow, plastic bats.

Wherever its provenance, the idea that vigorously expressing anger -- even getting carried away with it -- is both helpful and healthy has persisted for centuries, despite a stunning lack of evidence that it is.

Now, there's a series of elegant studies that ``ought to be a stake through the heart of the notion that every time you are angry, it's better to let it all out,'' says Dr. Redford Williams, director of the behavioral medicine research center at Duke University.

The research, published recently in the Journal of Personality and Social Psychology, shows that catharsis -- verbal or physical venting -- is ``worse than useless,'' says the lead author, Iowa State University psychologist Brad J. Bushman. ``Expressing anger produces harmful effects -- it increases aggression.''

Now, before you slam down the paper and mutter unprintable things about the mental health profession, take a deep breath. There's also solid research showing that anger should be expressed, but in ways that are constructive -- not destructive. Take a look, for instance, at the following:

- Road rage. One 30-year old New York lawyer, a patient of Raymond Chip Tafrate, a Connecticut psychologist, was a chronic tailgating, fist-shaking, horn-beeping driver. He'd leap out at lights and get into fist fights with other drivers. In therapy, he learned not to act on his anger by changing his thinking and understanding that most drivers who enraged him had not done so intentionally, and that he shouldn't take it personally.

- Workplace wrath: A verbally abusive businessman with his own company went to Colorado psychologist Jerry Deffenbacher in distress. He was a big, loud man -- intimidating by his presence but even more so by his outbursts. Two of his most senior people told him they were thinking of leaving because of his behavior.

In therapy, he learned to rate his rising anger on a scale of zero to 100, and when it hit 60, to tell whoever he was about to blow up at that he didn't want to say things he shouldn't and that he needed a ``time out.'' He then went into his office for 10 minutes, not just to cool down, but to rehearse mentally how to get his message across without being abusive.

He also invented an unusual trick that helped. An arch-conservative, he hated Bill Clinton. He promised himself that whenever he lost his temper, he'd wear a Clinton button for 30 minutes. Amazingly enough, it helped keep his anger from running away with him.

The new studies nail down the case against indulging anger.

In the first, psychologist Bushman used 360 male and female college students. Half were chosen randomly to read a fake newspaper article touting the benefits of catharsis; the other half read an anti-catharsis article. All were then asked to write an essay on abortion -- pro or con, depending on their beliefs.

Students were then selected randomly to receive either a positive response to their essays, with comments such as ``No suggestions, great essay!'' or negative ones like ``This is one of the worst essays I have ever read.'' The negative responses were geared to making the students angry.

Finally, all the students were asked to rank a list of 10 activities, including hitting a punching bag, that they would like to do later. (In this part of the experiment, they didn't get a chance to.)

The results were stunning: If people were not angered, they didn't want to hit the punching bag, regardless of whether they were primed to believe in catharsis or not. If they were angered, those who had read the pro-catharsis article were twice as likely as those who'd read the anti-catharsis article to want to hit the bag, suggesting that ``media messages can persuade people to vent anger,'' Bushman says.

In the second study, Bushman's team randomly assigned 600 college students, male and female, to read a pro-catharsis article, an anti-catharsis one or a neutral story. All were angered with negative comments about their essays and then given the chance to hit a punching bag.

Seven women declined, but all the others hit it. Each subject was then paired with an ``opponent'' (an experimenter) for a competitive task that offered the opportunity for aggression -- blasting the opponent with a loud, unpleasant noise.

The students who read the pro-catharsis article were twice as aggressive as the others ``and the more they liked hitting the bag, the more aggressive they were,'' says Bushman. This is the opposite of what catharsis theory predicts -- that venting should dissipate anger.

``People expect catharsis to work, they expect relief,'' says Bushman. ``But it never happens. In fact, people lash out more and more as if trying to get that relief.''

In yet another twist, the psychologists then took 100 students, primed them all to believe in catharsis and made them all angry. But this time, they were told to sit quietly for two minutes, instead of hitting the bag, before getting the chance to be aggressive in the competitive task. With just this two-minute time out, they ended up being much less aggressive than students in the previous experiment who had had the chance to hit the bag.

So what do these studies prove?

Just what many researchers, including social psychologist Carol Tavris, author of ``Anger: The Misunderstood Emotion,'' has been saying for years: Venting doesn't work.

``The biggest, fattest cultural myth, the elephant in our living room . . .is that catharsis is good for you,'' she says. ``All you have to do is go to another country and realize that the kind of excess we take for granted is considered loss of face in Japan, childish in France and rude and selfish in England.''

What yelling and punching pillows does is let a person ``rehearse'' anger, she says, which only encourages more anger. It's not much of a stretch, in other words, to imagine that rehearsing anger -- like writing violent threats on a Web site -- could contribute to the murders that tore apart Columbine High School in Colorado recently.

And mere venting means you never get to the bottom of things. Anger is often a ``defense against feelings of helplessness and depression,'' says psychologist Anne Alonso, clinical professor of psychiatry at Harvard Medical School. ``So when you encourage the defense, you put a greater distance between the real problem and the patient's ability to deal with it.''

Furthermore, indulging your anger can be bad for your health, especially if you're male, notes Williams of Duke. While some data suggest that women who hold their anger in may be at higher risk of death from all causes, other data show that men who express it outwardly have higher death rates, he says.

Growing evidence, in fact, shows that anger, like other strong emotions, can directly trigger heart attacks, says Dr. Murray Mittleman, director of cardiovascular epidemiology at the Institute for the Prevention of Cardiovascular Disease at Beth Israel Deaconess Medical Center in Boston.

In 1995, Mittleman's study of more than 1,600 heart attack survivors, male and female, showed that in the two-hour period after someone feels intense anger, heart attack risk more than doubles. Admittedly, this is a small effect because the baseline risk of a heart attack in a healthy 50-year old man is one in a million in any given hour; anger raises this to two in a million.

Another study of more than 1,300 male veterans showed that the most hostile had a three-fold higher risk of heart attacks than mellower men.

The bottom line, says psychologist Bushman, is to cool it. ``Counting to 10 is good advice. If you are really angry, count to 100.''

Venting, in other words, ``does not reduce the buildup of anger. Expressing anger only leads to further anger.''

SIDEBAR

Coming to grips with taming anger

People often think there are only two ways to deal with anger: venting or bottling it up. Neither works long term.

But there are things that do, says clinical psychologist Raymond Chip Tafrate of Central Connecticut State University, who has pooled and analyzed data on 18 studies of anger treatment, and by summer, will have analyzed data on 50.

The research clearly shows, he says, that catharsis not only doesn't work but ``may actually be harmful.''

``There is a kernel of truth in the expressive school,'' says Jerry Deffenbacher, a Colorado State University psychologist. Some inhibited, overcontrolled people may be helped by learning to be ``more noisily expressive,'' especially in therapy, and to learn that their anger will not make the world crumble. But then they must move on and deal with their anger constructively.

For that, several methods -- notably relaxation and cognitive-behavioral therapy -- have been proven effective in studies.

Some relaxation approaches are modelled on treatments for anxiety, says Deffenbacher. The idea is to practice relaxation, then imagine an angering situation with increasing intensity until you can counteract your arousal with relaxation.

In the heat of an angry moment, he adds, the tried and true remedies of counting to 10, taking deep breaths and simply relaxing your muscles can also help.

In cognitive therapy, you learn to defuse anger ``by thinking about your thinking,'' says psychologist Albert Ellis, head of the Albert Ellis Institute for Rational Emotive Behavior Therapy in New York, and co-author, with Tafrate, of the 1997 book, ``How to Control Your Anger Before it Controls You.''

Say that a co-worker frustrates you. If you think, ``I don't like this. She really frustrates me,'' you'll feel mildly angry. But if you keep fuming, ``She is screwing up my entire life,'' you'll fan the flames and make anger last longer.

The problem really, Ellis believes, is an irrational belief that the world owes you something and that the other guy is ``no good as a human being'' because he's not doing ``what I consider the right thing.''

While many people who are chronically angry may have shaky self-esteem, that's not always the case. Some research, in fact, suggests it's grandiosity -- inflated self-esteem and sensitivity to criticism -- that causes chronic anger.

And what of anger that once had a concrete trigger -- like childhood sex abuse -- but becomes a crippling way of life? The trick here, psychologists say, is to acknowledge the anger, but to move on with your life and not get stuck in the anger forever. Still mad at your parents after 40 years? The tough-to-accept reality is that you may well have reason to be, but you're only keeping your own life on hold if you focus on that, not forward motion.

Sometimes, of course, anger ``is a signal that you need to act,'' notes Dr. Redford Williams, director of the behavior medical research center at Duke University and author, with his wife, Virginia Williams, of the 1997 book, ``Life Skills.''

If she hadn't acted appropriately on her anger, he says, ``Rosa Parks would still be riding in the back of the bus.''

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