Managing the Anger and Addiction Connection

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Anger and addiction connection

By:  Rick Fannin

Anger and Addiction Connection

When we come into recovery, many of us have been unable to feel genuine emotions for a long time. However, if there is one common thread among many addicts and alcoholics that they can admit they truly felt throughout their use, it is anger.

Frustration and anger may have contributed to why we used drugs or alcohol to self-medicate these painful emotions.  However, we must learn to express anger healthily; otherwise, we are likely to relapse.

What Is Anger

Anger is one of the five major categories of human emotion which includes mad, sad, glad, bad, and scared.  The American Psychological Association [1] defines anger as an emotion categorized by tension and aggression resulting from frustration and associated with someone or something you feel has done you wrong. This frustration can arise from real or perceived injury or injustice from another person or external force. Things that may lead to anger include situations at work, at home, with friends, or even strangers. Feeling unloved, misunderstood, helpless, exhausted, criticized, or unfairly treated can also lead to anger.

Furthermore, anger urges you to move closer to something positive or to move farther away from something harmful or painful. Anger is born out of perceiving that something you need is absent or that something you can't deal with is present. Therefore, anger is a barometer that tells the body that you need to deal with a problem. Anger can keep us safe, help clarify our boundaries, and challenge us. The anger issues come from misusing or ignoring our anger.

In other words, anger is your body's way of telling you to address a problem. Either you need to draw closer to something positive or move farther away from something painful.  Anger exists to clarify your boundaries, keep you safe, and challenge you to take action and effect positive change.

Anger and Addiction

Anger, aggression, and addiction are intertwined in many ways.  Anger has been implicated in relapse as stated in the language of Alcoholics Anonymous and as found in many research studies. For decades the self-help programs have warned those in recovery from addiction to avoid becoming hungry, angry, lonely, and tired.

These emotions are also a confounding factor in situations where another psychiatric disorder coexists with an addictive disorder.   For example, anger and aggressive acting out are symptoms of bipolar illness, paranoid schizophrenia, post-traumatic stress disorder (PTSD), attention deficit disorder, and personality disorders such as antisocial borderline and paranoid character disturbances.

Toxicity from stimulant drugs such as cocaine and methamphetamine leads to paranoia, hyperarousal, and often to violence, with violence being the number one cause of death for those addicted to stimulant drugs. Anger and rage can be viewed from another perspective. They are emotions that help the individual cope with early life chaos and abuse. In this regard, anger can be perceived as a learned coping strategy secondary to early life experience.

Anger may be linked to the addiction process.  Sever anger is generally associated with a lower quality of life and a higher risk for dysfunctional and self-destructive behaviors, such as substance abuse [3].  Research studies observed that drug users have significantly higher anger scores as compared to non-users [4].  Many individuals in recovery from addiction have problems dealing with the expression of anger in a healthy manner [3].  Studies found that higher anger at the beginning of addiction treatment was associated with poor outcomes at 12-month follow-up, greater risk of relapse, and difficulty controlling temper and behavior during treatment [2].

Much like addiction, anger also alters neuropathways within the brain.  These neurological and physiological changes that result from the combination of anger and substance use can compromise attention, problem-solving, information abstraction, planning, and emotional regulation [4].  For individuals in recovery from addiction, frequent and intense anger episodes create a significant risk factor for relapse [4].

Anger is often conceptualized as arising from either fear or pain. The ideas of "fear" and "pain" are defined very broadly. Fear includes not just fear of something physical but also psychological fear; for example, fear of losing face, fear of loss of esteem or regard, fear of being laughed at or appearing ridiculous, fear of being abandoned.  Pain is the same. It's more than just pain from being physically hurt. It includes emotional and psychological pain—feeling pain from someone's words or actions, the pain of loss of love or regard, feeling pain because of life's unfairness.

Anger can become a routine, familiar, and predictable response to a variety of situations. When anger is displayed frequently and aggressively, it can become a maladaptive habit. A habit, by definition, means performing behaviors automatically, over and over again, without thinking. The frequent and aggressive expression of anger can be viewed as a maladaptive habit because it results in negative consequences.

Habitual Anger

Does it seem strange to call anger a drug? We usually think of drugs as chemicals, like alcohol, cannabis, cocaine, and heroin. We talk about being addicted to a drug if we keep using it when the consequences are worse than good and find it hard to quit. People also behave addictively with activities like gambling, sex, eating, spending, work, and some emotions, such as anger. Addictive activities and emotions can cause as much trouble as any substance.

What do these things have in common? They can change the way we feel, quickly, on-demand. Physically and emotionally, we can use them to block pain or to feel great. We can become addicted to anything that makes us feel good quickly and easily.

Anger can feel good. If we're anxious or depressed, we may feel weak, uneasy, and ashamed. When we get angry, we feel strong and sure of ourselves. Anger also makes us feel more alert, awake, and energetic. So we may use anger to cope with uncomfortable feelings. Fear, anxiety, or shame can trigger anger so fast we may not realize the first feeling was there.

Like other drugs, anger has negative consequences. It leads to destructive actions. It damages the immune system and raises the risk of cancer or heart disease. In this exercise, you'll look at your anger to see if you've used it as a drug and to find better ways to handle painful feelings.

The Aggression Cycle

An episode of anger can be viewed as consisting of five phases: triggering event, physical response, buildup, explosion, and aftermath. Together, these five phases make up the aggression cycle.

The triggering event is what begins the aggression cycle.  This event may subconsciously remind you of previous events that made you angry.  You interpret this current event through the filter of your past and judge it against your underly core beliefs and core values.

The body responses to the triggering event that prompted the anger.  Your heart rate and breathing increase.  You may automatically clench your jaw and fist and begin pacing in response to the triggering events.

The buildup phase is characterized by cues that indicate anger is building. This buildup stage provides cues that you are about to blow your top.  Cues are warning signs or responses to anger-related events. If the buildup phase is allowed to continue, the explosion phase can follow.

A discharge of anger marks the explosion phase.  This angry outburst may be in the form of verbal or physical aggression.

The aftermath phase is characterized by the negative consequences from the verbal or physical aggression displayed during the explosion phase. These consequences may include going to jail, making restitution, being terminated from a job, being discharged from drug treatment or social service program, losing family and loved ones, or feelings of guilt, shame, and regret.

One of the primary objectives of anger management treatment is to stop you from reaching the explosion phase. This is accomplished by monitoring changing levels of anger, attending to the cues or warning signs that indicate anger is building with the anger awareness record and using the appropriate strategies from your anger control plan to stop the escalation of anger. If the explosion phase is prevented, the aftermath phase will not occur, and the aggression cycle will be broken.

Anger As a Learned Coping Survival Skill

Many alcoholics and addicts enter treatment with backgrounds of neglect and abuse. As a way of trying to cope with an unmanageable situation as children, they made conscious decisions never to let anyone get close or hurt them again. Generally, this decision is made between the ages of 8 and 14 years of age.  Anger becomes our automatic protector when this subconscious decision is made, and as a result, angry outbursts play out throughout our adult lives.

Coping decisions

These learned coping strategies can present in many and varied ways. Four strategies that can be observed are as follows:

 

  • Withdrawal— When situations arise where an individual feels out of control or powerless, they can turn away.  Some may withdraw using a reactive depression to avoid confrontation.
  • Avoidance— Still, others will turn to alcohol and drugs to avoid reality.  Individuals with narcissistic and antisocial disorders will utilize a narcissistic maneuver to keep others from getting too close
  • Attack self— Some may harm themselves when a real or perceived sense of abandonment exists. In response to the abandonment, these individuals experience increased anxiety and impulsive behavior such as cutting, burning, sexually acting out, or using food, alcohol, and drugs.
  • Attack others— To cope with a stressful situation, some may act in anger by putting others down to enhance their self-image. These put-downs can take the form of verbal defamation to sadistic behavior.  This attack of others can also come in the form of physical aggression.

Learning to Deal With Anger In A Healthy Way

When we deny our anger, it does not magically disappear.  On the contrary, it creates havoc with everything from our immune systems to our physical and emotional health.  It takes a lot of physical, mental, and emotional energy to keep all the anger below the surface.  Repressing anger is like pushing a ball under the water; it takes a lot of work. Our emotions have a natural buoyance and want to be acknowledged before they float away.

It is essential to be able to distinguish between and among emotions. Fear and anger seem very much alike in what our bodies experience when we have those emotions. Yet, they are not the same. The confusion is further complicated because several emotions get paired up in our experience of them. Sometimes we move so quickly from one feeling into another less distressing one that we don't even recognize or remember the original one. A common pairing is hurt and anger. We often experience anger along with other emotions. It is often just as important to communicate the other emotions (if not more important) than anger. So the first step in "working through" is to identify and appropriately label them correctly.

The second step is to own our own feelings, with "I feel." The distinction is important. With "I feel," you are taking ownership. When we say, "you make me feel," you perceive yourself to be a victim and at the mercy of others who are responsible for altering your affective experience. Since it is impossible for others actually to change our experience, we will be waiting a long time to be "fixed." In order to solve a problem, it must be ours to solve.

The most appropriate thing to do with feelings is to express them to the person they are associated with directly. Sometimes, however, it is not safe to do that, or it does not seem safe to do that. When that is the case, you have some options. It is important to have a confidante that you can talk with about your emotions. When unsure what you are experiencing, talking helps you sort it out. You may then be able to label your experience appropriately. You may then feel competent enough to discuss them with the party the emotions are connected to. That is the most effective course of action. If experience has taught you that talking directly with them will not achieve the desired results, try writing them a letter. If they read your letter, they will have "heard you."

Sometimes negative sentiments persist after you have expressed them. If they continue to plague you, then it is appropriate to make a conscious decision about what to do with them. They belong to you. They are your responsibility. You can take responsibility for them in several ways, including these:

  1. Taking direct steps to protect yourself, including deciding whether or not to stay in the relationship,
  2. Setting and maintaining other appropriate boundaries,
  3. Forgiving someone for something that happened in the past and letting go of it,
  4. Checking for whose problem it is, yours or "theirs,"
  5. Examining your beliefs or "filters" about the event and challenging any cognitive distortions,
  6. Changing your expectations of self and others,
  7. Examining your own part in setting yourself up to be hurt in the same ways repeatedly and changing your own behavior,
  8. Looking for the behavior characteristics of others that you dislike in yourself,
  9. Using the AA technique of praying for their health, wealth, and happiness to eliminate resentments.

References

[1] APA, "Anger," American Psychological Association, 9 09 2021. [Online]. Available: https://www.apa.org/topics/anger/. [Accessed 09 09 2021].
[2] K. Serafini, M. J. Toohey, B. D. Kiluk and K. M. Carroll, "Anger and its association with substance use treatment outcomes in a sample of adolescents," Journal of Child & Adolescent Substance Abuse, vol. 25, no. 5, pp. 391-398, 2016.
[3] P. Baharvand and F. Malekshahi, "Relationship between anger and drug addiction potential as factors affecting the health of medical students," Journal of Education and Health Promotion, vol. 8, pp. 1-7, 2019.
[4] H. V. Laitano, A. Ely, A. O. Sordi, F. B. Schuch, F. Pechansky, T. Hartmann, J. B. Hilgert, E. M. Wendland, L. Von Dimen, J. N. Scherer, A. M. Calixto, J. Narvaez, F. Ornell and F. Kessler, "Anger and substance abuse: a systematic review and meta-analysis," Brazilian Journal of Psychiatry, 2021.

 

 

 

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