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Anger Management in Liverpool

Therapy for Anger management in Liverpool is hard to come by.  Primary care NHS mental health services will not work with Anger as it is, in itself not a “diagnosis.”  This means that people looking for Anger management in Liverpool can sometimes be referred to very generalised services who aren’t using evidence based treatment approaches and are not very effective, or might not get treatment at all.

Access CBT offers CBT and EMDR based Anger Management in Liverpool, Online via both secure Video and Text based services and by phone.  If you want help from us then please feel free to contact us at enquiries@accesscbt.co.uk or on 07887 701 176.

This article will be looking at how Cognitive Behavioural Therapy works as a therapy for Anger Management and providing an overview of what to expect from treatment here at Access CBT.  I’m quick to point out however, that this article is just a snapshot of what we can do for problematic Anger and I’ll be writing in much more depth on other areas of the site about how Anger is related to Depression, Anxiety and Trauma and how recent developments in CBT (such as Compassion Focused Therapy and ACT) and EMDR enable us to work at an even greater depth of Anger Management Therapy.  Look out for these articles as soon as they’re published.

Angry Emoji on a Mobile Phone

What is Anger?

Anger, like sadness, fear and disgust is an emotion and is hardwired into each of us through many, many years of evolution and, believe it or not, can serve a positive purpose.  Like the emotion of Anxiety, Anger is part of our threat response and evolved primarily as a way of keeping us alive.  Anger is part of our fight or flight response.

Fight or Flight is the term given to what happens in our bodies when a threat is present.  If we identify something that we believe to be a threat to us, our body equips us with the physical resources so that we can Fight the threat or Flight (escape) from it.  When we come across a threat that we believe will be too much for us to handle without injury, then we will experience anxiety and fear and escape from it.

However, when we experience a threat from which escape is not an option, either because it wouldn’t be possible or because to do so would result in some other negative consequence for us (for example, losing territory and resources or being pushed down the social hierarchy), then the Anger emotion gives us the physical resources to become aggressive quickly.  This was certainly an advantage for our ancestors –  being able to stand your ground increased the likelihood of you surviving and getting the chance to mate – and so evolution selected for the ability to become angry.

How do Anger Management problems happen?

So we understand that Anger can serve a positive function for us, but why does Anger become a problem?  Why at certain times in our lives does Anger seem like something that we don’t have control of?

A key part of Anger Management problems is the way that we think about our situations.  If we consider that Anger is part of our threat response, then we can start to think a little bit about what it is that we are thinking that makes us believe that certain situations are threatening to us.  Also, we need to think about not just why these situations are threatening, but also about why they are the type of threat that we think is appropriate to Fight, rather than Flight.

The types of thoughts that typically lead to Anger emotions are those in which we feel that our own needs are being transgressed in some way.  In plainer English, angry thoughts are those in which we feel that people are taking advantage, dominating us or otherwise not respecting us in some way.  In these cases, Anger activates Fight, which gives us all the physiological resources (increased heartrate, physical tension, faster breathing, tunnel vision) needed for us to engage in Aggressive Behaviour.  Aggressive behaviour increases the likelihood of our needs being met.

However, certainly in modern times, Aggressive Behaviour can come with significant negative consequences.  It can lead to violence, very often inappropriately, which can cost us our health, our relationships, our jobs or our freedom.  So we need to start looking at our thoughts in more detail.  This is where CBT Anger Management comes in.

CBT for Anger Management

The main assumption in CBT is that it is our thoughts about ourselves, other people and the world around us that leads to our emotions, our behaviour and our physical sensations.  When someone comes to therapy, we try to understand how they are thinking about events and work out whether how the are thinking is an accurate view.

As discussed above, in problem anger we often have the thoughts that people are disrespecting or beating us down in some way.  For instance, using the common example of Road Rage, we might have the the thought, “he did that deliberately to me” in response to someone driving discourteously.

But of course, we don’t know why they drove the way that they did.  They might just be a poor or a new driver.  They might be anxious or worried about something and this is affecting their focus on the road.  They might even be in a rush to see a loved one at the hospital.  We just don’t know.

But in Anger, as in many other emotions, we pay attention to the “negative automatic thought” and this is what creates the anger response.  The truth is there may be a million other reasons why our other driver is driving discourteously – It doesn’t mean they’re doing out of disrespect for you.

So, in CBT we aim to train you to notice the type of thoughts that are present when you are Angry, and then teach you how to consider alternative ways of thinking.  As we do, the range of thinking increases beyond those just associated with threat and new, more neutral emotions become available.  You can download the Anger thought record below to see how we would begin to challenge thoughts in CBT Anger Management.

Anger Management Thought Record

Downloadable template of CBT psychology tools Anger Management Thought Record

In addition to challenging our unhelpful thoughts, CBT for Anger Management also looks at the role that emotion, behaviour and physical sensations play in keeping your anger problem going.  We do this by breaking down the problem into parts and treating them one at a time, leading to improvement with the problem as a whole.

The diagram on the right – a 5 areas formulation – shows how we look at each of the areas of the problem in CBT.

So, let’s start with the emotion.  Emotions can typically be defined in one word.  “Anger” is an emotion, but other related emotions may be “Irritated”, “Annoyed” or “Frustrated”, etc.  We’d write this in the “Emotions” box.

Next, we want to think about all of the things that we experience in our body when we’re angry.  What do you experience?  As mentioned earlier, when we’re angry all of out Fight or Flight resources kick in and we’re full of adrenaline, our hearts pounding, breathing quickly and full of tension in our muscles.

We would treat these changes by using really simple techniques like controlled breathing, grounding or progressive muscle relaxation to lessen the sensations in our body that are telling our brains that we’re ready to fight.

5 areas formulation for use in CBT

Lastly, we have our “behaviours” box.  This is where we will write all of the things that happen when we are angry.  We might include things like shout, slam doors, hit people, throw things, or whatever it is that we do when the anger problem is there.

We would then also look at the role of behaviour in contributing to our anger problem.  Anger management treatment will generally include some type of assertiveness communication training.  This is based upon the fact that aggressive behaviour emerging from anger has the effect or aim of making others listen and do what we want, often ensuring that the others persons needs are pushed back in to second place.  But what if there was a way of changing our communication style so that both of our needs were met?  This is what Assertive communication is all about.  By learning techniques to speak up when we need to (rather than suppressing what we want) and also respecting the views of others, we are able to reach a compromise without resorting to angry aggression.  Imagine if you could do this in your problem situations – work, home, whilst driving etc – and how much easier things might be.

Of course, this is just a snapshot of what to expect from Anger Management training using CBT.  There are other tools and techniques that you will learn taken from “third wave” CBT approaches such as Compassionate Mind Therapy and ACT which are also fantastic anger management tools.  A typical treatment will last between 8 to 12 sessions.  For more information contact us at enquiries@accesscbt.co.uk or call us on 07887 701 176.

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