Active Compassion: The Best You Can Do for Your Partner and Yourself

“Would you mind setting the table?” seems like an innocuous request. It is truly amazing how difficult communication can be. Those same words spoken or misheard with a different tone of voice can become a command, or worse, a sarcastic, angry comment, full of disregard. Facial expression plays a huge role in communication, and if the person you’re speaking to isn’t looking at you when you talk, all that visual information can get lost and misinterpreted. These kinds of events are the precursors to miscommunication conflicts, which comprise eighty to ninety-five percent of all conflicts couples have.

 
Sue was astounded when Jim got belligerent in response to a question which was so simple. “Set it yourself,” he screamed, red-faced, as he stalked out of the room.
 
 Luckily, Sue was in a pretty good place. She had finally had some time away from the family that day, and was feeling good and relaxed. She didn’t get overly injured at Jim’s behavior. She was able to step back from her emotions about his disregard, and think about what had been going on for him.
    Sue understood that Jim had been maxed out from taking care of the kids all day after a night of little sleep. His work had been especially stressful that week, and then he had taken their two kids (3 and 5 year old boys) by himself all day, to give her a break. The reality of having a family with young kids is that, mostly, there is not enough time and energy to go around for everyone.

    Sue was practicing “Active Compassion.” It is one of the hardest, yet most rewarding practices a couple can do for each other. I define compassion as having the ability or finding the strength, in an intimate relationship, to think about your partner’s injuries when you have been injured by them.

   Most of us, when we are injured, either physically or emotionally, enter what I like to call the Hurt Child ego state. We are angry, scared and sad, and tend to focus in on our own emotional injuries. All we can deal with is our powerful emotions. This is actually a pretty normal response to being injured.
Usually, over time, we calm down and regain a more Adult or cognitive state, when we are more able to consider the facts as well as different points of view about what has happened. When we gain this perspective, it becomes easier to take into account what others may have been feeling. When we can do this, we begin to have the capacity for compassion.

    Active Compassion refers to a couple making an agreement that they will each work consciously to try and move out of the Hurt Child ego state and into the Adult ego state as quickly as they are able, and to think about their partner’s injuries. Additionally, if they are able to recognize their partner’s injury, they will attempt to show up as Good Parent for their partner. This means that they will attempt to take care of and address their partner’s injury.

    Using the example of Jim and Sue, let’s look at what that might look like. Sue, if she was able to contain the injury caused by Jim’s acting out in his Hurt Child, might go ahead and set the table. She might try and reconnect with him after about 15 minutes and check in and see if he was ready to discuss what had happened between them. If not, she would say something like “I can see that you’re upset, and I’m sorry. I didn’t mean to upset you. I’d like to talk about this when you’re feeling up to it.”

    If Jim is ready to talk, or when he is later, she can ask about what was upsetting him. It is always easier to resolve miscommunication conflicts when both people are in their Adult ego states. It’s never a good idea to leave two Hurt Children alone together and unsupervised. It almost never results in something good happening. Frequently things deteriorate, with the partners simply taking their injury and anger and tossing it back and forth while the whole situation escalates.
  
When Jim and Sue accomplished the first goal of having two adults to discuss what went wrong, their second goal was to figure out whose feelings were hurt first in this particular conflict. It is important that this be done without the idea or quality of looking for blame or fault. In intimate relationships, blame is poison. The goal is to restore function to the relationship and reestablish a solid emotional reconnection.

    Once Sue and Jim have figured out where the injury began, the person with the first injury gets the first apology from the other partner, acting in the Good Parent ego state. In this case, they agreed that Jim was in a state of being emotionally overwhelmed when she asked him to set the table.
It wasn’t Sue’s fault, but she could recognize the Hurt Child’s need for a guilt-free, blame-free apology. These apologies are like the ones a parent would give a child who falls and scrapes their knee and comes to their parent crying. The parent hasn’t done anything wrong, but their apology recognizes and validates the child’s injury while soothing it as well. That is what these apologies are really about.

Once Jim was able to receive and accept Sue’s apology, it was his turn for apologizing for his acting out behavior.

These types of interactions between couples who are committed to working through conflicts and practicing this kind of Active Compassion inevitably leave them feeling closer once their miscommunication conflict is resolved.

Active Compassion is not for the weak of heart. It takes a great deal of work for a couple to commit to and engage in this type of practice, and it usually takes a number of months of practice for it to begin to come to fruition.

In order to practice Active Compassion, a couple will need to commit to:

1. Noticing when conflicts begin
2. Stepping back (Timeouts) when awareness sets in
3. Actively working to recognize their own individual (and their partner’s) changing ego states
4. Working to think about their partner’s injuries despite having their own
5. Commit to following through on conflict resolution without blame.
6. If you begin work on this with your partner and find you continue to struggle, you would be wise to consult with a qualified relationship counselor. If you commit to doing all the hard work involved in practicing Active Compassion, you will find that the rewards more than balance all of the challenges involved in this practice.

Dealing with Anger due to Cancer

Anger and Cancer
by
John R. Rifkin, Ph.D.

One of the most frightening experiences for anyone is being told by a doctor that you have cancer. Although treatments for cancer have improved dramatically over the last forty years, many people still believe that a diagnosis of cancer is the equivalent of a death sentence. Whether the diagnosis you receive is a more or less life-threatening one, it is always a significant injury for anyone to not be healthy.
Injury, or pain, is always the primary of all of the negative emotions that people experience. Emotional injury is always followed by three secondary negative emotions: sadness, fear and anger. Sadness is defined as an honoring or grieving of an injury. I define fear as energy the body generates to avoid further injury. I look at anger differently than most people. I see anger also as energy the body generates in response to an injury that is meant to address or confront the injury. When you have been diagnoses with Cancer, you have to experience all of these emotions.

It is important to not look at anger as negative, even though it is a secondary negative emotion. The energy of anger can be highly important in healing of all types. Certainly this is true in almost all emotional healing, but it is also true in the context of physical healing as well. Bernie Siegel, M.D., author of “Faith, Hope and Healing,” and an expert on outlook and healing, says “Hoping means seeing that the outcome you want is possible and then working for it.” The energy that it takes to work for the outcome you want can come from the anger you have related to the injury of being diagnosed with Cancer. The outcome you want is to be re-diagnosed as being cancer-free.

In the practice of psychotherapy over more than 30 years, I have come to respect and believe in the healing power of the unconscious. The unconscious is what is left of you when you go to sleep. It is your body and the part of your mind that is intricately wove into your physical being. What we do in psychotherapy is consciously focus in aiding that healing process.

When I have worked with clients who have been diagnosed with cancer, the way we put that anger to work is though visualizing becoming healthy. Either through the use of meditation, imagination or Eye Movement, the client focuses on the cellular healing taking place in their body. This involves visualizing their body successfully seeking out and destroying the cancer cells in their body. This process is repeated on a regular basis, both in and out of treatment.

Francine Shapiro, Ph.D., the discoverer of Eye Movement Desensitization and Reprocessing (EMDR), talks about how she cured her breast cancer using this process. She envisioned her body’s white blood cells attacking the black, cancerous cells in her body and seeing them replaced with healthy pink cells. Over a series of months, she became cancer free.

The energy involved in confronting and fighting cancer in your body can be fueled from the anger and fear that are generated by the injury of receiving your diagnosis. In truth, that is exactly what that energy is meant to do: maintaining the confidence and hope to power your recovery.

Dr. John R. Rifkin, Ph.D. is a psychologist with over 30 years of experience and author of “The Healing Power of Anger: The Unexpected Path to Love and Fulfillment.” He has served on the Board of the Colorado Psychological Association and chaired the Committee on Private Practice. He does speaking engagements as well as having a general private practice in Boulder, Colorado. His websites are EmotionalSuccess.com and JohnRifkin.com.

DID: The XYZ of PTSD

By John R. Rifkin, Ph.D.

Probably you’re wondering what all of those acronyms mean in the title of this article. DID stands for Dissociative Identity Disorder, which was once called Multiple Personality Disorder. PTSD stands for Post-Traumatic Stress Disorder, and the XYZ is meant to imply that DID is the most intensive of the entire spectrum of Trauma from which therapists are challenged to help their clients recover.

DID does refer to someone who suffers from multiple personalities. Perhaps you remember The Three Faces of Eve, which was a book and a movie about a psychiatrist dealing with a client who had several personalities. DID is still considered quite controversial and rare in most research circles. However, most psychotherapists who have been in practice for an extended period of time have worked with someone suffering from this problem. Perhaps because of the huge amount of trauma in life, it is less rare than most people think.

Let me first clarify PTSD (Post-Traumatic Stress Disorder). This occurs when someone is exposed to a traumatic event where actual or threatened harm to the self or others occurred and the person experienced fear, helplessness and or horror. The traumatic even is re experienced in significant ways along with heightened arousal and avoidance of things that remind them of the event. Post-Traumatic Stress Disorder is quite common, and happens both in military situations and also in the context of modern life with situations involving abuse or violence.
The treatment of PTSD, in and of itself, can be quite complicated, and those who suffer from it, find it causes a great deal of distress in their lives.
DID, however, is another magnitude of difficulty.
In my book, The Healing Power of Anger: The Unexpected Path to Love and Fulfillment, I attempted to categorize the levels of damage we all experience in growing up. I started with Category One, where your parents try to kill you, and gradually descended to Category Seven, where you have good, loving parents, who still manage to cause some level of damage as a result of not being able to be perfect parents. Perfect parents would always show up emotionally for their children and never reverse the Parent-Child relationship by asking the child to meet their needs. At the time it was written, I believe that I was the first to begin to categorize the levels of damage in childhood.

Since having written the book, I have realized, through my work with some people who suffer from DID, that there should, in fact, be a Category Zero. This would be where a child is not only threatened with death, but is actually tortured as well. Sexual abuse may well be a part of the torture. It is these kind of circumstances that generate people who suffer from DID.
In the midst of torture, people are faced with absolutely untenable positions. You are being faced with a situation in which you are completely out of control and under the control of someone else who is intent on inflicting pain. There is no escape, and no likelihood of rescue, though rescue fantasies are common. The pain, frustration, fear and horror are pervasive and overwhelming.

In the face of this kind of situation, our brains use dissociation as a defense mechanism. Dissociation enables us to literally go away from the unbearable context by escaping inward. We “go away” from the reality with which we are faced by becoming unconscious of it. However, we do not entirely lose consciousness. Since our sense of self has withdrawn from this unacceptable reality and is no longer aware of what is going on, the consciousness that is left must now deal with the reality of the torture.
This is a process that is repeatable, and can happen very rapidly. In the context of a half hour of torture, someone may generate as many as hundreds of new “alters,” or new identities who are trapped into facing the ongoing process of abuse. This is especially true for children, who’s understanding of reality is as yet completely formed.

It is this dissociative process that escalates DID into the most serious of psychological diagnoses. People with DID have at least two identities or personality states, each with its own particular way of relating to the world.

Let’s look at the case of Mary. Mary was the fourth of seven children, living in a small town not far from a university in the southern part of the United States. Her father was working at building an insurance business, and her mother was overwhelmed with taking care of all the kids.

When she was three, with a one year old sister and an infant brother, her mother’s youngest brother, Mel, came to live with them in their basement. It wasn’t clear why he was living with them, but he was attending classes at the university.

Mary’s mother’s family had been a mess. Alice, Mary’s mother, was the oldest of six children in her own family, and her father was an alcoholic. Alice’s mother had worked as well as tended to the kids. Her father was physically and emotionally abusive to Mary’s mother, as well as to the other children in the family. Her youngest brother, Mel, had had significant physical problems as a child, and had been hospitalized and required surgery a number of times as a young man.

When Mel came to live with Mary’s family, no one was aware of how damaged emotionally he was. In fact, he was very bright, yet severely traumatized himself from having been left at the hospital as a child and having to undergo multiple surgeries.

Mary was exposed to Mel’s abuse in the basement on a number of occasions, since that was where the children’s play room was as well. He was quite sadistic with her. He was introverted and depressed. He was not in his right mind, though he did not show these issues to his sister or her husband. It was only Mary, who frequently drifted down to the basement to play, who was exposed to the nightmare of her adolescent cousin’s damaged psyche.

Mel quickly began to abuse Mary. It started out with his sexual abuse of her but quickly moved on to his threatening to kill her and her whole family if she told or didn’t cooperate with him. He physically abused her to where she would lose consciousness on a number of occasions. He constantly demeaned her and told her that she was really bad and deserved to be punished. Simply describing what he did to her doesn’t begin to convey how completely out of control he was with her and how terrified she was of him.

Mary, as a three year, with a mother who was out of touch and overwhelmed with her other children, was completely vulnerable. Though she was being terrorized, her family didn’t notice much other than that she was not very demanding and was quiet and withdrawn.

Mary continued to be quiet throughout much of her adult life. She went through a series of adolescent experiences with young men who forced sex upon her against her wishes. At times she was able to fend them off, but often she was vulnerable to their unwanted advances. It was all quite confusing to her.

Mary was so unhappy in her abusive marriage that she finally found her way into therapy. She had no idea that she was suffering from DID, and neither did her therapist. She would frequently become quiet in the course of her sessions, and appeared to be confused. Her therapist’s support both reassured and confused her, as well as upset her.

She attempted a brief round of marital counseling, but that simply established that she was really alone in her marriage. As Mary moved towards divorce, she became more and more unstable. Her therapist referred her to a psychiatrist, as he thought that the instability was related to her moods.

As Mary underwent a few different medication trials, she continued to get worse and worse. After a number of months, it gradually became clear to her psychiatrist and her counselor that there were significant dissociative aspects to Mary’s case. Eventually, Mary began to realized that she was suffering from DID. There were a number of events that took place where it was clear that she had broken things, but she retained no memory of these events.

Gradually, over time in treatment, various alters (alternative personalities) began to appear and participate in treatment. All of this was extremely upsetting for Mary. As it became clearer and clearer that she had alters, they began coming out more and more frequently, and all of them were completely terrified. There were several incidents where alters who were feeling suicidal appeared, and hospitalization was considered at many points.

Once the alters began to come out, it was like a flood. They would appear one after another until it seemed like an endless parade of new personalities, all of whom were traumatized and disconnected from themselves, their memories of the trauma, and from each other.

At this point, there were very few medications that were very helpful, other than occasional major and minor tranquilizers. Mary’s focus was on surviving and healing.

Over the course of the next five years, gradually the sense of overwhelm began to decrease. Mary started to accept her alters as parts of herself, which was really quite helpful. Each new one had to be calmed and oriented to all of the events of her life that had taken place. She described the initial realization that she had been so traumatized as a shattering of her self.

This same sense of shattering was associated with some of the early memories of trauma that gradually began to coalesce into a narrative. Little fragments of memories gradually built into little sequences that eventually connected with other sequences. All of these memories had been completely repressed, though some of them had appeared briefly earlier in her life during times of intense stress.

It’s difficult to portray the true level of suffering that had occurred to Mary, both in her past, and in her present as she began to reconnect to the reality of the emotional and psychological damage to which she was exposed. She would frequently spend weeks in bed, only getting up to work, eat, sleep or attend her psychotherapy sessions. She frequently would need almost daily sessions of psychotherapy. She cried enough to fill up lakes with her tears. Her anger would be overwhelming and threatening even to her at times. Her fears would cause her whole body to tense in ways that caused severe physical pain. Hours and hours of bodywork would hardly begin to relieve her suffering. At one point, she had so much tension in her jaws that her teeth began to crack and needed repairs.

Her therapist worked with each of her alters. She did her best to soothe and orient each of them to be able to relate to being in the here and now. For most of the alters, when they first appeared, it was as if it was literally the next moment to the last second of abuse before they had fled into dissociation. They were usually terrified and desperate to disappear. Trusting another person, specifically her therapist, was extremely challenging. Mary’s relationship with her therapist was tested many times over the years of treatment. Mary had learned that you could really trust or depend on no one in life.

Gradually, over the years, her trust in her therapist increased, based on the experience of her therapist’s consistent reliability. Also, as each of the alters developed more experience with being out and present in the here and now, each began to come to the realization that the actual trauma was over. Additionally, each alter had to work through all of the feelings about their particular aspect of the trauma. This would lead to increased continuity of the memories and a greater understanding of all that Mary had suffered.

The first stage of treatment was completed when Mary no longer suffered from being constantly emotionally triggered by the internal experience of recovering the memories and getting all of her alters out to the surface of consciousness.
The second stage of treatment was learning to deal with external triggers, things that that Mary would experience in daily living that would remind her of the traumatic experiences of her childhood. This stage is more similar to a normal PTSD treatment.

Throughout treatment, Mary and her therapist worked to help develop a co-consciousness between her alters. The treatment went better when the alters could become aware and accepting of each other. Frequently, when new alters would come out, they would be extremely mistrustful of the other alters. This was simply because they were others, and all of the alters had huge trust issues with deal with anyone who was “other.”

Mary was lucky to be able to afford her intensive treatment. She was able to work outside of an office environment most of the time, and never really lost her ability to work. This partly related to her innate intelligence and also to her incredible will to survive.

Her commitment to her healing process was, for her, a struggle between life and death. She showed an intense courage to keep pushing forward through round after round of the re traumatization of recovering memories which were like living in a horror movie.

Every person in therapy demonstrates a commitment to healing and recovery that is inspirational, but people like Mary, who work through the most terrifying and confusing events of early childhood trauma are an inspiration to all of us.
Mary had been almost completely isolated from everyone during the first stage of her treatment that lasted for five years. As she moved into the second stage, she slowly worked into developing a small, supportive social network. This was still a very fragile time for her, as she continued to be vulnerable to external triggers that were fairly innocuous for others, but could be terrifying to her.

Gradually, she became more comfortable in developing a life that included relationships with other people. She was hoping to accomplish the goal, eventually, of what is called integration. This is where all of the alters remain intact and available, but the amnesia related to dissociation gradually withdraws so that Mary could flow seamlessly between the alters who had been previously isolated.

The process of fully healing from DID is a challenging task that can require decades of psychotherapy and time. Those on the road to this healing deserve all of our admiration and support.

Fallacies of Family Intimacy

Fallacies of Family Intimacy-Revised John R. Rifkin, Ph.D.

How many times have you heard or said or thought “Our family is really close?” Many people have families that spend a lot of time together, at the holidays and even throughout the year. And many people believe that they have really close relationships with their siblings, parents or children.

Some of them actually have what would be considered an intimate relationship. Some friendships actually rise to the level of emotional intimacy. However, the reality for most people is that they only have true emotional intimacy in the context of their primary relationship.

Even in the contexts of marriage, or primary relationships, true emotional intimacy isn’t as common as most people think. Think for a moment about the number of couples that you know who seem to share a truly close connection, and you may find that there are fewer than you would have guessed.

Emotional intimacy occurs when two people agree to have a relationship where they commit to sharing essential emotional information. That doesn’t mean sharing absolutely everything. There is a difference between being essentially honest about emotions and being brutally honest. What it means to be essentially honest is to share any and all emotions that are important to both of the members of the couple. Brutal honesty, by contrast, means sharing feelings that might be really damaging to your partner, without any opportunity for these feelings to improve the connection that the two of you have.

So, for example, if one of the people in the relationship finds someone else to be attractive, he or she would have to consider if sharing this information with their partner would be helpful or hurtful to the relationship. If the attraction is serious, and a potential threat to the relationship and the commitment to being monogamous, then it probably should be looked at and shared, as it represents an indication that something is not working in the relationship. On the other hand, if it is simply the awareness of a fleeting emotion, bringing it forward may only be experienced as an injury by your partner, and serve no real purpose in furthering the closeness between the two of you.

When a couple has a good working emotional intimacy, they may have to go through an intense period of dealing with miscommunication conflicts. These are the vast majority of couples’ conflicts, where there is really no conflict underneath the hurt feelings, but simply a miscommunication. Even though there is not a real conflict in terms of wanting different things, it may be quite painful and take awhile to resolve. Couples that are emotionally intimate will take the time and energy to resolve these conflicts, and, doing so really works to build trust in each other’s commitment to the relationship. Frequently, especially early on in relationships, there is a significant period of time where these things have to be worked through. After trust has been built, the individuals in the relationship may find that some of the more minor conflicts can be overlooked, and only address the conflicts that truly seem to be important.

Perhaps, as I talk about all the hard work that goes into emotional intimacy, you begin to see the difference between closeness in a family context and true emotional intrimacy.

In the context of a Parent-Child relationship, complete emotional intimacy would be inappropriate on the part of the parent. Parents need to show up for their children emotionally, and not ask their children to support them emotionally.

Frequently, in sibling relationships, there is the inherent competition for the parents’ attention that can interfere in openness. Also, children need to learn about emotional intimacy with peers in growing up.

Family closeness is a result of growing up together, living in the same household, sharing blood ties, etc. Families may become particularly close when they are living in a hostile environment. An example of this might be a family of immigrants. When you move to a new culture and share a language and/or beliefs and traditions that are distinctly different from other families around you, there can be a tendency to be more tightly knit and less interactive than others around you. There can be negative impacts from this experience in terms of more of an “us against the world” mentality that this experience can develop, but it also can increase the familial bonds.

Having close family bonds, however, is not the same as having truly close relationships. Even in the context of a close parent child relationship, there may be many important aspects of the child’s internal emotional life that never gets expressed or experienced by the close and caring parent. A simple example of this would be the development of sexuality and personal sexual attractions. Many close parent child relationships would never discuss many of these important emotions; yet clearly these would be discussed in the context of a close committed relationship with a partner.

Sometimes, especially around the holidays, family closeness can mean demands and impositions on the children of families to keep to respecting the family traditions and the emotional needs of parents. An example of this would be the case of Karen. Karen came from a family where her parents had immigrated to the United States from England. She was their only child, and her mother was a doting parent, who felt isolated from the extended family that she had left behind in England. She was very demanding of her daughter, who was an extremely good child, and tended to appease all of her mothers’ needs and wishes.

I met Karen and her family one Christmas eve, when their family was in crisis. Karen was a young adult at this point, married to her husband, Louis. Karen and Louis had started their own family. Karen’s daughter, Cynthia, was the grandchild, and had become the center of attention for both Karen’s family as well as Lou’s family, who also lived locally.

The crisis was a huge confrontation that had developed between Karen and her mother. Her mother demanded and expected that Karen and her young family would spend Christmas morning at their house. Karen had done that forever, and also the previous year when her daughter was an infant. Now, however, her daughter was a year and a half old, and Karen had decided that she wanted to begin building their own family’s Christmas tradition, and to spend that time at their own home. The conflict had come to a head when Karen had told this to her mother.

Karen’s mother was very upset to “lose” her access to her daughter and granddaughter on Christmas morning. She became even more upset when Karen also refused to have her parents come over to her house early on Christmas morning.
The process where a child leaves it’s family of origin to begin to make it’s own life in the world is called “Differentiation from the Family of Origin.” This process is frequently stressful for both parents and children, and much of the adolescent rebellion is connected to this dynamic.

I didn’t really want to become part of their family’s Christmas tradition, but it did seem appropriate and helpful to meet with them, both on Christmas eve and on Christmas. The initial family therapy meeting helped when everyone was allowed to air their difficult and painful emotions in a safe context. As the feelings got discussed and sorted, we agreed to meet the following morning to try and build some new traditions for the family.

It was important for Karen’s mother to know that I could understand her feelings of injury, but supported her in protecting her daughter from those feelings so as to not reverse the parent-child relationship. Luckily, she responded well to having of someone outside of the family lend some triangulation to their difficulties. She was also aware that she was on the verge of losing access to her daughter and granddaughter, something that nobody really wanted.

Christmas early afternoon, we met again, this time to set up some agreements on holiday scheduling and expectations for the future. Louis’ family was taken into account as well, and decisions were made about how to handle the holidays and visitations to both families of origin, as well as to insure that Karen and Louis had the space to develop their own family holiday traditions.

Karen and Louis went on to enjoy a greater sense of boundaries in their relationships with both sets of in-laws. They found that the general idea of establishing their family boundaries carried over to the relationships throughout the year.

While the holidays add a whole level of stress to families, the expectations of closeness are often unrealistic. The expectations, especially without a good model of emotional intimacy in the parents, don’t help children to begin to understand the differences between family proximity and the meaning of true emotional intimacy found in couple relationships. The understanding of emotional intimacy in children may contribute much more to their emotional success in life than simply being in close proximity to their family of origin.

When a Loved One Explodes from Anger

This is one of the most recent articles by Dr. Rifkin, published in Going Bonkers Magazine.

The sound the computer made crashing into the wall was really loud. Sarah jumped out of the chair where she was sitting and reading a magazine. Her husband, Joseph, had just thrown his new computer across the room, causing it to put a hole in the wall and sending shards of plastic and hardware flying. Sarah's heart was racing. She had only asked him to go and check on their sons who were upstairs playing video games.
Yes, Joseph had been stressed lately with job pressures, but she hadn't said or done anything to upset him. She started to ask him what was wrong, but Joseph stormed out of the house. What would make Joseph explode with such anger?

Understanding Anger
Everyone has anger, whether they admit it or not. Anger is energy that develops in response to the injuries that we experience in daily living. When used effectively, it's expressed as healthy, assertive behavior. Despite its explosive bad rap, anger is an important and healthy emotion.

To understand anger, we must first begin with understanding the place anger holds in the context of our emotions. Emotions are electro-biochemical reactions that take place in our bodies and provide us with the information and energy we need in order to take care of ourselves, as we navigate and survive the world around us.

For example, after an emotional, physical or psychological injury, your body generates energy (anger) as a way to attend to or fix the injury. Likewise, it may produce fear, as a defense against being injured again, or sadness, as a way to grieve or mourn the injury.

Explosive Anger
People who explode with anger can hurt themselves and others. They use their anger energy to break things, or yell, or act in irrational and harmful ways. Sometimes, really intense angry explosions are caused by an underlying mood disorder, like major depression or bipolar mood disorder.

Major Depression
Major depression (or unipolar depression) is very common, and can be recognized by having at least five of the following symptoms for at least two weeks:
1. Depressed mood nearly every day, most of the day.
2. Loss of interest or pleasure in most activities.
3. Significant gain or loss of weight.
4. Being physically agitated or lethargic.
5. Being tired or not having enoughenergy.
6. Sleeping too little or too much.
7. Feelings of worthlessness or inappropriate guilt.
8. Inability to concentrate effectively.
9. Recurrent thoughts of death and/or suicide.
10. The severity of the major depression is related to how many symptoms the person has and how long it has been going on. Depression can be single episodes or a hronic condition.

Bipolar Disorder
In bipolar disorder there has been a history of both major depression and also some indication of a manic or hypomanic episode. One of the ways you can tell if someone is experiencing some level of mania is by noticing if they have an irritable, elevated or expansive mood for at least a week. During that time, they will have three or four of the following symptoms:
1. An inflated sense of self.
2. A markedly decreased need for sleep.
3. Being unusually talkative and hard to stop.
4. Racing thoughts or extremely loose connections in their thoughts.
5. Becoming highly distractible.
6. A significant and sudden increase in achieving goals or intense physical agitation.
7. Impulsive pursuit of pleasure without regard for the consequences of their behavior.
People who are suffering from bipolar mood disorder may have very intense and frequent fluctuations in mood. This condition can wear on them, and be part
of the injury that they experience.

Passive-Aggressive Disorder
A third common cause of explosive anger, beyond normal life stresses and injuries, is from difficult relationship dynamics. The most common of those is what I call a Passive-Aggressive/ Hostile/Dependent Relationship. In these relationships, one of the partners expresses their anger though passive aggression.

Passive-aggressive behavior is anger that is expressed, for example, by not doing something you agreed to do. This tends to draw anger at them from their partner. Since all relationships are based on agreements, passive-aggressive anger tends to break down and destroy relationships. The passive aggressive partner in a relationship may frequently ask, in a very pained tone,
"Why are you so angry all the time?"

Sarah and Joseph's story, continued…
While Joseph was obviously the angry, explosive partner, Sarah, appearing innocent as she quietly read her magazine, was the angry, passive-aggressive partner.

Joseph was stressed out with work and needed to work much of the evening to get a report out that was due in the morning. He had told Sarah this and was expecting that she would tend to the boys. Sarah had a pattern of not listening when Joseph would complain about his stresses at work. He had been so stressed for so long that she simply got tired of listening to him complain.

After crashing his computer against the wall, Joseph had cooled off by taking a walk around the neighborhood. Upon his return, Sarah approached him with disbelief. She genuinely wanted to know what was wrong and why Joseph had gotten so upset. When he explained that she hadn't seemed to hear his needs and concerns, Sarah got defensive and Joseph started to get angry again. Sarah told him that if he was wrecking the computer, he obviously had a serious problem with anger. She thought he should talk to a therapist and get help with anger management. Joseph couldn't deny that he needed help with his anger, since all Sarah needed to do was to point to the hole in the wall as proof. If he was exploding with such dynamic force, clearly he needed help. Joseph went to meet with Dr. Jones.

After completing a thorough history of Joseph, Dr. Jones uncovered his distant and demanding parents, who expected him to be the best in his class at school, yet were unavailable for any real emotional closeness or support. Dr. Jones also was able to rule out major depression or bipolar disorder as preliminary diagnoses. This led her to ask more about the nature of Joseph's marriage to Sarah, to see if she could discover the injury that had led to his explosive outburst.

She asked Joseph to invite Sarah to come in. Dr. Jones discovered that Sarah had
grown up as the only child of two alcoholic parents who had divorced when she was seven. She had lived with her mother through high school, always keeping her distance from her parents who were frequently drunk and easily angered. Sarah had learned not to need much or to give much emotionally, and to make her self scarce at home. Dr. Jones asked Sarah to begin to look at how the emotional dynamics from her childhood family had played out in her current family and marriage. Sarah could see that she had a history of maintaining emotional distance, and how she had been passive-aggressive in her marriage. However, Sarah still blamed Joseph for acting out his anger. Dr. Jones agreed that what Joseph had done was destructive and unacceptable. She made it clear to Sarah that she intended to continue to work with Joseph on learning to express his emotions to Sarah before they became explosive. But she wanted Sarah to understand that, in order for him to be able to make the changes he needed to make, Sarah would have to make changes as well, in regards to her passive-aggression and emotional withdrawal from their marriage.

Over the course of the next year, Sarah and Joseph continued to work towards an acceptance of each others' feelings, and towards becoming more responsible in understanding, owning, and expressing their own emotions in healthy ways.

Whether angry explosions are the result of major depression, bipolar disorder,
passive-aggressive/hostile dependent relationships or other life injuries, it's
important to remember that behind every explosion of anger is an injury. It's that injury that needs to be uncovered, acknowledged, and addressed.

Undoing Depression

This is an article that was featured in the magazine "Going Bonkers"

Undoing
Depression
What You Need to Know

By Dr. John R. Rifkin

Life is intrinsically hard, which means we all get injured during the process, in one way or another. “Life” injuries often cause anger, and anger turned inward, leads to depression.

Depression, known by therapists as major depressive disorder, is a problem for many people. Statistically, about one in six people will experience a major depression over the course of their lives, though many people believe that the incidence is much higher. The first step in undoing depression is to understand what it is, how it can affect you, and what causes it.

CAUSES OF DEPRESSION
Depression has no single cause, and often results from a combination of things. You may have no idea why you or your family member are experiencing depression.

Whatever its cause, depression is not just a state of mind. Depression is related to physical changes in the brain, and connected to an imbalance of a type of chemical that carries signals in your brain and nerves.

Your brain is a giant messaging system that controls everything from your heartbeat, to walking, to your emotions. It's made up of billions of nerve cells called neurons. These neurons send and receive messages from the rest of your body, using brain chemicals called neurotransmitters. These brain chemicals, in varying amounts, are responsible for our emotional state. Depression happens when these chemical messages are not delivered correctly between brain
cells, disrupting communication.

So why isn't your brain delivering your chemical message correctly?
Some of the more common factors involved in depression are:

Trauma and stress. We all know the effects that chronic stress and trauma can have on your physical health. Stress can cause physical changes in your body, including your brain, causing depression. Issues like financial problems, the breakup of a relationship, or the death of a loved one can bring on depression. You can become depressed after changes in your life, like starting a new job, graduating from school, or getting married.

Family history. Genetics play an important part in depression. It can run in families for generations.

Pessimistic personality. People who have low self-esteem and a negative outlook are at higher risk of becoming depressed. These traits may actually be caused by low-level depression (called dysthymia).

Physical conditions. Serious medical conditions like heart disease, cancer, and HIV can contribute to depression, partly because of the physical weakness and stress they bring on. Depression can make medical conditions worse, since it weakens the immune system and can make pain harder to bear. In some cases, depression can be caused by medications used to treat medical conditions.


Other psychological disorders.
Anxiety disorders, eating disorders, schizophrenia, and (especially) substance abuse often appear along with depression.

RECOGNIZING THE SYMPTOMS
Depression can severely disrupt your life, affecting your appetite, sleep, work, and relationships. Some people say that depression feels like a black curtain of despair coming down over their lives. Many people feel like they have no energy and can't concentrate. Others feel irritable all the time for no apparent reason. The symptoms vary from person to person, but if you feel “down” for more than two weeks, and
these feelings are interfering with your daily life, you may be clinically
depressed.

The symptoms that identify depression may include:

Constant feelings of sadness, irritability, or tension

Decreased interest or pleasure in usual activities or hobbies

Loss of energy, feeling tired despite lack of activity

A change in appetite, with significant weight loss or weight gain

Achange in sleeping patterns, such as difficulty sleeping, early morning
awakening, or sleeping too much

Restlessness or feeling slowed down Decreased ability to make decisions
or concentrate

Feelings of worthlessness, hopelessness, or guilt

Thoughts of suicide or death

TREATMENT OPTIONS
The good news is that depression is very treatable. Most patients, even those with severe depression, show improvement after they seek treatment. Your doctor will prescribe treatment based on the pattern of your depression, its severity, persistence of symptoms, and your history. While it is true that some instances of major depression may go away without any treatment, the risks of not treating outweigh the risks of treatment. Treatments may include psychotherapy, medication or both.

Understanding Anger
Some therapists define depression as anger that gets turned inward, against your self, combined with a feeling of hopelessness and/or helplessness. Most psychotherapy, therefore, is focused on helping people reconnect with their anger and turn it out of depression and into the two healthy uses of anger: self-nurturance or empowerment. This is what I call “unbending anger.” In order to “unbend” your anger, you must first be able to realize when you are angry. Part of what makes this difficult is that most of us think of anger as simply yelling and screaming, throwing things or breaking things. This is aggressive behavior, not anger. Anger is actually a secondary emotion, one of three secondary emotions, that follow a pain or injury. The other two secondary emotions are sadness and fear.

The other reality about anger is that it is energy -- energy that is actually
meant to fix what is hurting us. Learning to turn your anger outward, into healthy energy, is an important step in undoing depression. A therapist can help you learn how to do this.

Stop, Drop and Roll
No, this isn't a fire drill. In addition to the ongoing support that a client receives from their therapist, the therapist also supplies tools, or methods the client can use to help them combat their feelings of helplessness. The tool that I like to use for helping the client “unbend" their anger is what I call “Stop, Drop and Roll.”

“Stop, Drop and Roll” is a form of a cognitive behavioral therapy that is focused on helping the client to identify their dysfunctional use of their angry feelings and begin to utilize that energy for self-nurturing and empowerment. Before you can remember to "Stop, Drop and Roll", you must notice you are on fire. Negative thoughts create an internal fire, so notice when you have them.

Stop. Stop the thoughts as soon as you notice them.

Drop. Get grounded and figure out what the anger is all about, really. Roll. Roll forward and make a plan about how and where you can put the energy of the anger you are feeling.

Let's look at the example of Dora to help clarify how to work out of depressive thoughts and behaviors. Dora came to me as a 27 year old single woman who was suffering from a moderate level of Major Depression. She was the youngest of five daughters, and grew up in a family that was not very warm or emotionally expressive. Her belief was that her father, who was distant and involved in his work to the exclusion of his family, really wanted a son, and was disappointed with her being a female after so many failed attempts. That was her belief about herself: she was simply another failed attempt.

Dora had recently experienced the breakup and rejection of a relationship she'd had for three months with a boyfriend and, in spite of being very bright and having graduated from college, she was working at a job she didn't enjoy. What precipitated her coming in for therapy was that her supervisor had found her crying at work and sent her to the company's employee assistance program. They had discovered that she had been having suicidal thoughts and had referred her for psychotherapy. After clarifying her diagnosis and referring her to a psychiatrist for anti-depressant medication, we began to focus on trying to discover what Dora's depression, and her underlying anger and injury, was all about. We began to investigate how she was abusing herself in her own thoughts.

Dora was caught in the web of low self-esteem, constantly telling herself that she was unattractive, unintelligent and generally worthless. She believed that nothing would ever work out for her, and that she was doomed to an unfulfilling life. Once we identified these negative and self-destructive thoughts as problematic, we began to use "Stop, Drop and Roll" to intervene.These negative thoughts were examples of how she was catching on fire, and we agreed that she would begin to notice these thoughts.

Once she was able to notice these self-abusive thoughts, we worked to help her begin to intervene by stopping the thoughts when she noticed them. This was the "Stop" step. At the same time, we worked to help her begin to use the “Drop” step, to get grounded and begin to understand where the anger that she was turning inward, was coming from. She discovered that some of her anger was related to the real, here and now injuries of being rejected by her boyfriend. Some of her anger related to feeling stuck in the unfulfilling clerical job she had to go to day after day. As we explored her family of origin, she began to realize that she never felt that she had received the attention and appreciation from her father that she needed. She never felt valuable or appreciated. Old injuries had produced anger in her that she was
unaware of, and that she had been directing against herself.

It helped Dora to understand her depression. She also was helped by the impact of her anti-depressant medication, which continued to help improve her mood and functioning over the course of the first two months of treatment. She began to understand the emotional dynamics that had contributed to her mood sinking so low.

Once she understood the dynamics of her depression, she was more ready to begin the "Roll," or action step in completing the "unbending" of her anger. She began to have plans about how and where to put the energy of anger that had been previously fueling
her depression.

In terms of diverting that energy into self-nurturing, she began an exercise program that included running in the evenings. She felt that she didn't have the money to afford an exercise club, but she was able to begin to gradually work herself into running and getting into better physical shape. An added bonus from this process was that the exercise produced endorphins in her brain, which also have a natural antidepressant impact. She also began to treat herself to luxurious baths after her
runs. These self-nurturing activities were used to intervene in her previous
behaviors of ruminating about all the bad things that had occurred in her life.
Dora also began to work into more empowerment, or acting on the world so that the world would nurture her more effectively. One of the goal activities was to become more social, and eventually she decided to join both a running club and a hiking club.

Through these behaviors, she began to make more friends and to have a greater social support. She also decided that she wanted to have a better job, and began to look for
alternatives in the newspaper and within the company for which she worked. When nothing materialized right away, she decided to look into going back to school and getting a Masters degree.

At the end of treatment, which took most of a year, Dora was not depressed. She continued on her antidepressant medication for another year, which is the usual course of treatment, to insure that her depression did not return. She also continued occasional psychotherapy meetings during that year. Eventually she felt ready and was able to successfully withdraw from her medication without any relapse into depression.

LIVING WITH DEPRESSION
Dora's successful case is a good example of how most cases of major depression respond to appropriate treatment. The tragedies that you read about are usually because the person did not find help or did not find it soon enough. Almost all kinds of depression are treatable with medication and/or psychotherapy. Even after you've learned that you have depression and sought treatment for it, you may not feel better immediately. Depression can be frustrating, because recovering from it takes time. While you do have to be patient, there are still some steps you can take now to help yourself feel better.

HELPING YOURSELF
Every day can feel like a struggle when you're depressed. Medical care and therapy are the most important steps to recovery. But there are other things you can do to help yourself undo depression:
Realize that nothing comes out of the blue. Your depressed state has a root cause. Examine past troubling events or situations in your life, and talk to a therapist about them.

Feel Your Feelings. Depression is the suppression of feelings. Acknowledging those feelings often causes depression to improve. Recognize early signs. It's important to recognize and treat depression as early as possible, which decreases your risk of becoming depressed again. If you pretend the problem isn't there, it's probably going to get worse. Watch for the types of events that contributed to depression in the past, and be alert for early symptoms.

Set realistic goals. You may feel overwhelmed by everything you "should" be doing at home or at work. Try not to be hard on yourself. Remember that depression is an illness and that you can't force yourself out of it. Focus on small, realistic goals to ease yourself back into your work and family routine.

Do what you enjoy. Even if you don't really feel like it, set aside time to do things that you like. Get together with friends. Take a walk. Go to the movies. Take up a hobby that you set aside years ago.

Hold off on big decisions.
Since depression can color your outlook on everything, it's best to avoid making
any big decisions; quitting a job or moving, for instance, until you feel better.
Establish priorities. Direct your energies into what's most important to you.

Take responsibility ONLY for your actions. Depressed people often
feel guilty about things that they have no responsibility for (like the death of a
parent or the divorce of their parents).

Be generous. Helping others puts your own situation into perspective. Cultivate intimacy. Let down your defenses so people can see and accept you as you are. During depression, people often feel disgusted with
their true selves, and hide that self from everyone. Stop hiding and be happy
with who you are.

Gain Perspective. During this time, you may be overly critical and pessimistic. Seeing things in the proper perspective can heal a lot of inappropriate pain.

Getting Support. Even though millions of people are coping with depression right now, it's a medical condition that can make you feel completely alone. One way that some have found helpful to work through this feeling is to join a support group. Whether they meet in person or online, support groups offer a place to talk about depression where people can help each other. Keep in mind that support groups are not a substitute for therapy or medical care. They are also different from group therapy, since they aren't led by a professional.

Avoid alcohol. Although you might think it will help you feel better, alcohol can make your depression worse. Depressed people are at special risk of developing substance abuse problems, and alcohol interacts with many antidepressants.

Exercise. There's more and more evidence that exercise helps with mild to moderate depression. When you're considering an exercise plan, don't be too ambitious. Find an activity that you like, start slowly, and work up to exercising three times a week or more for 20 to 30 minutes.

HELP SOMEONE YOU LOVE
When your loved ones are depressed, they're not the only ones who suffer. Typically, many of those around a depressed person; friends, family, and loved ones, also struggle with the effects of his or her condition.

Watching someone you love
fight depression can be frustrating and frightening. Remember, you can't take responsibility for someone else, and the decision to get help is up to the person
with depression. But, there are things you can do. For many people with depression, a friend or loved one who cares can be their most important resource.

What can you do? Learn about depression. Educate yourself on the causes, symptoms and
treatments. Knowing about the condition will help you better understand what a depressed person is going through.

Do what you can to make sure that a person with depression gets medical care. Encourage your friend or loved one to stick with his or her therapy or medication. Offer to go with him or her to appointments as support. Be supportive and patient. Listen to what the depressed person has to say. Without being pushy, encourage your friend or loved one to do the things that he or she used to enjoy. See friends. Go to the movies. Take a walk.

If someone you know is thinking about suicide, don't ignore it. Do whatever you can to get help for that person. Get in touch with his or her doctor or therapist.

Helping a person with depression can be exhausting and overwhelming. Here are some things to keep in mind that can help both of you: Try to get other people involved in helping a person who's depressed, since doing it on your own can be difficult.

People with depression often resist attempts to be helped. It's okay to feel angry and frustrated, but don't confuse the person you love with the illness. Depression isn't anyone's fault. It is not possible to “snap out” of depression. No matter how overwhelmed you feel, take time for yourself.

What You Should Know About Psychotherapy

Psychotherapy, technically, is anything that a psychotherapist does in their office with clients. In reality, there is a great deal more to what psychotherapy is and what it is all about.

In contrast to what Managed Care has tried to tell clients for many years, it is not only for people who are extremely sick or for the "worried well." Most people can benefit from taking a look at themselves and the various difficulties which we all experience in our lives.

A good psychotherapist will help you to quickly sort out what types of difficulty you are having in your life and whether these problems are amenable to short or long term treatment. There are various techniques and clinical tools that therapists use, from hypnosis to EMDR to cognitive behavioral therapies to experiential therapies.

In short term treatment, specific, here and now problematic thoughts, feelings and/or behaviors are targeted and begun to be addressed by making them conscious and working directly to make changes. Frequently, even if these are very current problems, the therapist will want to know about your family history and any other dynamics which have impacted you significantly. These issues tend to be addressed more intensively in long term therapy.

Regardless of what type of treatment you think you may want or need, it is important for you to find a therapist with whom you can relate. In order to develop a trusting relationship with a therapist, they should be licensed or supervised by someone who is licensed. It is also important to talk with a potential therapist to see if their rationale or approach to therapy makes sense to you. If you are hiring someone to help you make sense of your life, you want to know that they make sense and have competency of their own.

While it may be obvious if you are having severe problems that it makes sense to seek help, many people do not. There is still a stigma in our society that frequently prevents people in need from seeking help. Also, those who aren't in severe need should realize that they don't need to wait until they are miserable to ask for help.

While most people will find a substantial improvement within three to six months of treatment, the more childhood damage and the more serious your diagnosis, the longer the length of treatment is likely to be. For some people suffering from chronic problems, ongoing treatment may be required to help them remain stable.

In general, research shows that most people make significant improvements in their lives and their functioning when they work with a clinician who is trained, experienced and empathic.

Anger Styles: Healthy Assertive Behavior

Assertive behavior is the use of anger to take care of yourself interpersonally. It's the part of the anger spectrum that is used most frequently. As a style, it is the healthiest. While there are appropriate times to be aggressive and to be passive-aggressive, in the normal course of social interaction, assertive behavior will usually serve best. There are three parts to being assertive. The first is that assertive behavior requires that you know what you are feeling. If you are not in touch with what you feel, it becomes very difficult to try and meet your needs. An example of this would be that if you don't know you are hungry, you won't seek food. While being in touch with feelings may seem simple, and is basic, many people have been trained by their family of origin to ignore their own emotions.

The second part of being assertive is to know that your feelings are ok by definition. That means that you don't have to defend what you feel, to yourself, or anyone else. You do have to accept them. Once you accept your emotions, you can figure out what you want to do about them.

The final piece in assertive behavior is to know that you have a right to express you feelings. That is different than having to express your emotions. Once you know that you have a right to make your feelings heard, you still have to decide when and where it takes care of you to express them. Some people aren't likely to honor the emotions that you might share with them. These people do not deserve to know what you are feeling, since that is intimate emotional information. We only share these feelings when we believe that there is a likelihood of having them accepted and taken into account.

If you have an assertive anger style, you may be wondering when it is appropriate to be aggressive and/or passive-aggressive. Aggressive behavior is appropriate in competitive sporting contexts, or when you are facing a situation where it is required to defend yourself or one of your loved ones in the face of some physical threat. Generally speaking, it's not appropriate to initiate threatening someone else. Passive-aggressive behavior is appropriate in getting rid of unwanted attention, positive or negative. Ignoring someone who is attempting to get your attention. It is also appropriate to use in specific ways when you are working for a problematic boss. You may choose to not respond to a boss who's behaving inappropriately. This way you get to avoid a confrontation that could threaten your livelihood, while maintaining your integrity.

It's great to have an assertive anger style. Remember you have a full spectrum of responses available to you.

Redefining Anger and Its Role in Psychotherapy

The emotion of anger has suffered from a bad reputation, probably forever. This is a result of the fact that people who hurt other people are often angry, and no one wants to get hurt. While there has been extensive research on the difficulties that anger can cause, recently more research has been done on the beneficial aspects of releasing anger in ways that are constructive. Unfortunately, anger is all too often treated as a dysfunction.

It certainly can be. If anger is constantly repressed, it can become explosive. When that happens, it certainly is problematic. However, anger is also central to the clinical definition of depression: anger turned against the self, combined with a sense of helplessness or hopelessness. It also plays a significant role in anxiety as seen through the paranoid projection of anger onto the world, making the world look more dangerous than it is in reality. In relationships, conflicts involving anger are the central piece of devolution.

I believe that much of the difficulty that we have in dealing with anger results from not having a good understanding of what anger is and how it needs to be utilized for a healthy psychological functioning. As with all emotions, anger actually make sense if you accept it and then try to understand what it is all about. This is because, while emotions are non-rational, they do make sense. There is always a reason why they appear.

If we define anger in a non-pejorative manner, we can look rationally at how its energy needs to be utilized appropriately to generate a high level of functionality. All problems begin with an experience of injury and pain, the primary negative emotion. Following injury, there are three secondary emotions. Sadness is a grieving of the injury, energy meant to validate and honor the experience. Fear is defensive energy the body generates to avoid further injury. Anger is the natural, healing energy that the body generates to attend to the injury.

Additionally, there is a spectrum of angry behaviors from which people choose. At the "hot" end of the spectrum is what we think of as aggressive behavior, which can be destructive. In the middle is assertive behavior. The "cold" end is passive-aggressive behavior, which can be just as destructive as aggressive behavior. There is a time and place where any of the behaviors on the anger spectrum may be functional and other times where the same behavior can become dysfunctional.

Unfortunately, there is a double bind people learn about anger when it is defined pejoratively as only "hot" end of the spectrum. The double bind is you can either express your anger as "hot" behavior and suffer rejection or not express your anger and not get the underlying injury attended to. The double bind can only be broken by finding functional uses for the energy of anger.

*In terms of treatment, the job of the therapist is to help clients to become more aware of their injuries and their secondary emotions, especially their anger. We also have to help clients to learn how to make good decisions about how to use the energy that their emotions generate. Anger, when defined with acceptance, becomes energy that is meant to be used to attend to your injuries. That means using it for either power or self-nurturance. Power is when anger is used to act on the world so that the world takes care of you. Self-nurturance implies acting directly to take care of your self.

Understanding and utilizing the client's injuries and resulting anger can help inform the treatment process. Once you have identified and accepted the anger that is there and helped the client to do so as well, it becomes a process of working on finding appropriate behaviors for the client in terms of transitioning the angry energy into self-nurturance and/or empowerment.

Anger and Good Parenting

Good parenting is composed of many things, and it is a challenging undertaking. This is especially true since there are no perfect parents. The best parents are the ones who are at least concerned with trying to be as good as they can.

Bad parenting is easier to define. Whenever we parent our children out of a place of emotional injury we are being bad parents. The reason for this is that when we are in a place of emotional injury, we need to be taken care of ourselves. We are, in effect, asking our children to take care of us. This is a reversal of the parent/child relationship, where the parent is available to take care of the child.

When this happens, we are eliciting a split that takes place in the child. There is an aspect of the child that knows that its parents, giants who have the power of life and death over them, that responds by taking care of their parent, so that they can survive. This is done out of fear. Simultaneously, there is another aspect of the child that knows intuitively that this is a reversal of the parent/child relationship, and is angry. This angry aspect feels rebellious. Whichever aspect becomes dominant, they are both likely present to some degree.

Parenting, even more so than life before parenting, is filled with injury. Children are dependent, and dependency is difficult to deal with. They start out completely and overwhelmingly dependent, and gradually gain more independence as they grow. As a result of all of the injuries that parents experience, from sleep deprivation to financial demands to the struggles of adolescence, parents also experience anger. Frequently the injuries intrinsic in parenting are compounded by the parents' own childhoods. Since there are no perfect parents, no one escapes childhood unscathed. It's only a question of how much damage you receive. When your own parents have been especially difficult, its inevitable that you may have some resentment for your own children, especially if you are making their lives better than your own was.

Injuries to parents, and, therefore, anger, are inevitable. The question becomes one of how to protect your children from your difficult feelings, given that you won't be perfect at trying to do this. It certainly helps if you made a conscious decision to have children, and didn't feel trapped into it or stuck with it.

One obvious piece is to try and give them as much positive love and caring as you can. Also, try and say "No!" to them as little as possible. That means it will only seem like you are saying it most of the time. Additionally, you'll need to be paying a lot of attention to your own emotional state when you're around them. If you notice that you're feeling injured, angry, or scared, then you have a chance to intervene and protect them from your own emotional needs.

It's a tremendously challenging yet rewarding experience. Good luck, and remember, when you do mess up and act out your own feelings, it's important to come back later and apologize!

Expressing Anger

Most people don't think about anger when they swat a mosquito. Most people wouldn't think that calling a friend when they are lonely or needing company as a use of their anger. They wouldn't consider that looking for a new job when they are unhappy with their current job as being an act of power. And how many people think that taking a bath to relax when they are stressed out is an angry behavior? All of these behaviors, and countless others, which seem innocuous, are actually effective expressions of anger when you look at anger as being the energy your body generates to fix what is hurting you. When you use that energy to act on the world, so that the world brings you the nurturing that you need, that is using the anger for personal power. When you use it directly to nurture yourself, that is self-nurturance. Either way, these are functional ways of expressing anger.

Most people think that expressing anger means yelling at someone, threatening them, or actually performing some violent act. While these kinds of behaviors are certainly angry behaviors, the reality is that anger is really much bigger than that. There is a spectrum to anger that ranges from the aggressive, red hot end which we normally associate with anger, through the middle part of what we consider to be healthy, assertive behavior, and moving eventually into the cold end of the spectrum. This cold end of the spectrum is called passive-aggressive behavior. It's called this because cold anger is actually expressed by not doing things that we've agreed to do. This kind of angry behavior actually draws the anger of others towards us. It's very important to be aware of your anger. If you aren't aware of it, it will likely go into some dysfunction expression. That can mean inappropriately explosive anger, depression, anxiety, substance abuse, etc.

If you are aware of your anger, you have the chance to choose how to express it. You may use it directly to address the injury that is hurting you. You have to make decisions about the appropriate use of your anger in any particular situation. There are times to be aggressive or passive-aggressive; however, usually the appropriate choice will be some assertive behavior.

There are also times when you can't use the anger to directly address what is hurting you. A possible example of this would be when you have a bad boss at work, but you still need the job. There may be many indirect things you can do with your anger to take care of yourself in a situation like this, but you may also want to direct it for self-nurturance. That might mean taking a bike ride and using the angry energy to crank up a hill you haven't climbed before. Whatever you choose to do with the energy of your anger, you want to make sure it is working to make your life better!

Living with Aggressively Angry People

Living with Aggressively Angry People The most important consideration in living with someone who is aggressively angry is safety. You need to be able to feel safe in your home. If the person you are living with has a tendency to be aggressive in ways that are threatening, you need to set clear boundaries about these behaviors. If those boundaries are broken, you need to call the police. It is important to note that calling the police is a significant intervention. I do NOT recommend doing this as a threat, doing it to have the upper hand, doing it to embarrass the person or doing it as payback. If you call the police, it will have serious consequences. It is likely someone will be arrested and go to jail. There will likely be significant financial and legal complications. It is frequently the beginning of the end (or the end of the end) of a relationship. However, if your safety is truly in jeopardy, do not hesitate!

Living with angry people is difficult. Since all of us are angry in some way, this means that relationships are usually difficult. The reason I mention this here is to emphasize the importance of getting away from blaming the person who is aggressively angry. The reality is that they are in a great deal of pain, and need help to deal with their pain and their anger as well.

One of the standard interventions I recommend for people dealing with a partner who is angry is to try saying the following six words: "What do you need right now?" In order to be able to do this, you have to be able to not be overwhelmed with your own injury. That's not always easy to do.

This question is especially effective because, in addressing the needs of the person who is aggressively angry, it goes underneath the anger. When this question works, you are saying, in effect, "I know that you are angry, and that is ok. I know that there is a reason that you are angry, and I know that it is because something is hurting you. I am concerned about your injury, and I would like to help attend to it." Isn't it amazing that you can condense all of that into just six words?

Now, sometimes an aggressively angry person will try and hold on to their anger for a while. They may have learned that they are safe when they are angry. It may take two or three times of repeating the question. If the anger doesn't start to get diffused when this is happening, then something else is going on. It may be using anger as manipulation, or they may just be unavailable.

Either way, this would be a good time to call time-out. In order to be effective, time-outs need to be time-limited and honored. Honored means that the time-ins happen as well.

Living with someone who suffers from aggressive anger isn't easy, but if you don't blame them, eventually that anger should dissipate. If it doesn't, seek professional help.

Anger Styles: Red Hot or Aggressive Anger

While all forms of anger are appropriate to use in some circumstances, the more extreme kinds can be problematic if they form a style, or a typical kind of response to injury. Mental health is about having a full range of options, knowing when particular type of response is likely to be most effective and being able to use your anger appropriately.

Aggressive anger is one of the more destructive interpersonal styles. This is what people think about when they normally use the word anger. Aggressive anger is characterized by angry outbursts and what is known as having a bad temper. People who have difficulty containing their anger get into trouble, in their marriages, at work and out in the world as well. It is destructive to intimate relationships, since partners of people who have aggressive anger as their style, intimidate others. Frequently you will intimidate others even when you don't mean to. It's hard for the people who love you to feel safe. If you have children, you are probably in danger of damaging them through your angry style.

The good news is that there's nothing wrong with your anger. The problem is what you are doing with it. Anger is meant to fix what is hurting you, and if you are overwhelmed by your anger, you probably don't understand that it is likely that you have an accumulation of injuries. If your response to a relatively minor injury results in an outburst, likely you've got old injuries from the past, adding to the pain you experience from the more minor upsetting events day to day.

Another possibility is that you may be suffering from a mood disorder. Both Major Depression and Bipolar Disorder can cause irritability. Also, another problem to be aware of is alcohol. If you have a problem with alcohol, it can cause irritability as well. If you think you are suffering from any of these problems, I recommend that you seek professional help as soon as possible.

Lets go back to the good news, which is that nothing is wrong with your anger. You will need to learn to be able to work to bring it under control. You need to learn what is hurting you and causing you to have so much anger. There are ways to release and ventilate anger that will not hurt you, or anyone else. The more you can learn to use the energy from you anger to empower you, to nurture you and attend to the injuries that are causing it, the more the angry outbursts will recede. The pressure will come off, but it may take a concerted effort. Don't give up. It's difficult to change your anger style, but the energy of your anger is meant to fix what is hurting you. Keep trying!

Anger Styles: Ice Cold or Passive-Aggressive Anger

While all forms of anger are appropriate to use in some circumstances, the more extreme kinds can be problematic if they form a style, or a typical kind of response to injury. Mental health is about having a full range of options, knowing when particular type of response is likely to be most effective and being able to use your anger appropriately.

Passive-Aggressive anger is one of the more destructive interpersonal styles. It is a behavior characterized by the phrase, "You can't make me!" The statement is undeniably true. We can hurt people; we can threaten them, or lock them up. But we cannot make people perform. People only perform out of a willingness to do so. Since relationships are built on agreements, if someone makes an agreement and then doesn't follow through, this is angry behavior that is based on not doing something. That aspect of "not doing" is what makes this kind of behavior passive-aggressive.


As a style of anger use, passive-aggressive behavior is incredibly destructive to relationships. It destroys trust, and the people on the other side of this behavior experience it as crazy making. They hear the words of agreement spoken, and continue to hope that agreements will be kept, only to experience escalating levels of injury, frustration and anger.

In this way, passive-aggressive behavior draws anger towards the person behaving that way. The partner, often called the "Hostile-Dependent," makes more and more accusations, all true, about the passive-aggressive partner's betrayal of trust though breaking agreements.

One of the main difficulties for someone who has a passive-aggressive style is that they are frequently out of touch with their feelings. They don't know that what they're doing is angry. Frequently they are puzzled and resentful of their partner's constant anger and disapproval.

Another problem in changing passive-aggressive behavior is that it has some of the dynamics of addiction associated with it. Doing what you want instead of what you've agreed to do feels good every time in the short term, even if it's destroying your relationship.


If you've identified that you have a passive-aggressive style, and you want to begin to change it, you'll need to do several things. First, you'll need to work hard to get in touch with your emotions. Second, you'll need to realize that no one is really trying to "make you" do the things that you agree to. Your partner wants your participation to be voluntary. Third, since fear of rejection often plays a major role in making agreements that you really don't want to keep, you'll need to find your courage to say "no" when you don't agree. Finally, don't give up. It's difficult to change your anger style. Keep trying!

Your Power, Global Warming and the Organic and Holistic Movement

A Speech by John R. Rifkin, Ph.D.
For the Second Annual OH Expo, 8/19/06

I want to start by thanking Stacy Plouffe and Carmelita Garcia, the founders and organizers of the Organic and Holistic Expo, for inviting me to speak to you today, and for their vision in bringing together people who share their views of the need to market Earth-friendly and ecologically sound services and products. I also want to thank all of you for coming out to the expo today and supporting the Organic and Holistic movement.

Normally, I do most of my talks about anger, power and relationships. Today, however, in honor of the OH Expo, I want to talk about your power, global warming and the Organic and Holistic movement.

The Organic and Holistic movement is ecological almost by definition. Practitioners of Holistic healing view the body as a whole system that is interconnected with the whole of the planet. Organic foods are grown and raised with a view that pesticides and artificial fertilizers may not function well within the context of either the body or the planet. Traces of these chemicals can cause harm to the environment and therefore to the people that live on the planet. There is plenty of evidence of pesticides negatively impacting our health.

I remember reading "Dune," by Frank Herbert in 1967, and discovering the concepts of ecology by reading a science fiction novel. Later, in the summer of 1971, after I had moved to Colorado , I studied with Buckminster Fuller's World Game, where we attempted to design the systems that would work best for us as a planet, disregarding politics and conventional boundaries. We did this, to some extent, by using Dr. Fuller's invention of the least distorted maps of the globe. He used a 20 sided solid, a duo decahedron, to collapse the globe onto. Then, since this is a figure that can be made flat in a number of ways, you can unfold it to have a picture of all the land surrounded by water, or of all the water surrounded by land. Using these innovative maps, it was easier to look at the most efficient transportation and energy systems. It was a stimulating and exciting time. It's work that still needs to be done for us to function efficiently as a planet of people.

Today, as we see the beginnings of climate change based of human activity, it is increasingly clear that changes are coming to how humanity will be able to live on this planet. It is clear that global warming is based on the increase in carbon dioxide in the atmosphere. Our responses to these changes will necessarily be based on our learning to develop technologies that are more and more green, more and more holistic and which use energy that does not generate carbon dioxide.

As I've come to look at where we need to be going in the immediate future, it's clear that we need to transfer directly from solar energy to electric energy. This technology is already available today! If you can afford to by the panels, which are rapidly coming down in price, you can live carbon free in terms of your home's energy needs. If you can afford to buy an electric car, you can drive carbon free.

Only the natural energies that come directly from solar energy are truly carbon free, and only carbon free energy can pull us back from the brink of disaster related to the build up of carbon dioxide in the atmosphere and the global warming that follows from this. Once we have carbon free energy, we can meet all of our transportation needs through electricity and its applications though electric cars and mass transit.

Earlier this summer I was buying some roses at an organic nursery in Boulder and they had a quotation that captured my attention. The quote was from Sir Francis Bacon, an author who is considered to be the father of inductive reasoning. To give this quote perspective, Francis Bacon lived in the late 1600's, and yet it has relevance even today: "Nature is only to be commanded by obeying her."

This quote by a great man almost four centuries ago seems like a great lead into my talk today. It is interesting in that it captures our need to be in charge and to be powerful, yet also captures our powerlessness in the face of the power of nature and the planet, all in the same short sentence. We are powerless in the face of floods and droughts, hurricanes and other storms.

I want to go back and talk a little bit about technology, which I mentioned a few minutes ago. The dictionary defines technology as "a capability given by the practical application of knowledge." Technology is using what we know to better our human condition.

The human condition is not easy, in spite of some of the ease we experience today in this country. Much of humanity is still in the process of trying to climb up out of the mud, to move from a poverty-stricken, subsistence quality of life to one of dignity and accomplishment. To move beyond that to a life of true fulfillment is still a distant dream to many of us.

Yes, life is hard for everyone, and even harder for those of us living at this subsistence level. Technology represents a way to improve all of our lives.

And yet our technology cannot command nature unless it obeys her. This is a lesson that the Organic and Holistic movement embraces. We are one planet, interconnected, needing a green technology to recognize and work within this concept. Our technology needs to work in harmony with Mother Earth.

We are moving, gradually, towards developing and utilizing ecological technology. Fuels whose only pollution is heat, recycling abilities that will eventually approach 100 per cent of all manufactured material and biodegradable technologies. As I said earlier, we need to capture solar power in all of the available forms it takes, hydroelectric power, wind power, and the direct translation of solar to electric.

In the meantime, how do we find our personal power to support this holistic process? How do we use our personal power to support the movement of civilization towards the goal of fulfillment in the lives of every possible human on our planet?

In my book, "The Healing Power of Anger: The Unexpected Path to Love and Fulfillment," I discuss in great length the process of individuals achieving their own personal power and recovery from psychological and emotional problems. I'll give a brief overview here to make sure we understand the role anger plays in empowerment.

All problems begin with injury. The two most primary human emotions are pleasure and pain. For the most part, we don't have too many problems with pleasure, though the human psyche is so creative that even pleasure can be pulled into the service of pain through addictions.

But the primary negative human emotion is pain or injury. This starts with the fact that we need a relatively constant temperature and an ongoing intake of potable water and nutrition. We need to be safe.

These needs cause pain or injury when they are not fulfilled. Three secondary emotions follow pain or injury. Sadness I define as a grieving or honoring of that injury. Fear is energy the body generates to avoid being hurt again. Finally, I define anger as energy the body generates to fix what is hurting you.

The central thesis of my book is that when you begin to look at anger as energy, it is easier to be more compassionate towards those who feel anger. Also, when you look at anger as energy, it becomes clear that it has to go somewhere. The energy of the anger that you experience from injuries every day will either be used functionally or it will go into some form of dysfunction.

There are only two ways you can use your anger functionally. Self-nurturance is when you can act directly on yourself, to nurture yourself. Empowerment is when you can act on the world, to get the world to nurture you. If your anger about your injuries isn't used in one of these two ways, it will go into some form of dysfunction.

This dysfunction can be acting out your anger in a destructive behavior to things or others, or it will be actively self- abusive. Either one of these choices will leave you feeling worse about yourself.

So, the question for today, and this talk, is how do we find ways of using our anger about the ways in which the world does not work functionally to use it for empowerment? How can we act on the world to move the social agenda forward in ways that are consistent with our beliefs in holism? How do we use our personal power to influence others and move us all closer to functioning within our interconnectedness with the planet?

The Organic and Holistic movement looks at the world as completely interconnected. My personal transportation utilizing fossil fuel helps to warm our planet which harms the home of the polar bear and threatens many species, which harms me and the entire planet. Yet I still need and desire personal transportation. Remember James Taylor's song, "Traffic Jam?" There's a great line at the end where he says "You know that I thought that I was cool, runnin' around on fossil fuel, 'til I found out what I was doing was drivin' down the road to ruin."

We have to have greener, non-carbon dioxide generating personal transportation. We have to have good, affordable mass transit. We have the ability to generate electricity directly from the sun. We have the ability to use this energy for personal transportation. Not doing this becomes a moral decision when the consequences impact the sustainability of our planet.

We all have innumerable decisions to make every day. Do you throw away that aluminum can or recycle it? It is becoming a moral decision. Do you watch someone else throw away an aluminum can or do you volunteer to recycle it for them? How about that plastic water bottle?

Just as I encourage my clients to not live in to depression or anxiety, and to take back their personal power in their own personal struggles to overcome their emotional problems and to thrive, I'm here today to encourage you to continue your fight to move us all forward to living in harmony with this planet. In the handout that is available and circulating, I have copied a list of ten recommendations from the Union of Concerned Scientists. These are things that you can personally do, right now, to immediately slow the amount of carbon being released into the atmosphere and slow or even reverse the rate of global warming.

Now it's clear, that we must all begin to use our personal power in the individual, daily decisions that we make. It is also clear that the problem is one that presents itself to the whole planet, and that systemic change is necessary to reverse global warming. We need the governments to all recognize, as many governments already do, that changes need to be made. We need the governments of the world to support the utilization of solar power and electric cars.

If the governments are supporting the utilization of this technology, the massive production of these technologies will dramatically bring down the costs. Every home needs to have photovoltaic panels and or shingles so that they can produce solar energy. Electric cars need to be the standard and their efficiencies increased. These things can be done. They are viable right now. And our planet is in peril if we do not get the word out to everyone.

Use your personal power! Vote! Vote at the ballot box for the people who will support moving us forward into green technologies! Vote with your dollars for products that support and live in harmony with this planet! Vote with your energy for recycling waste products. Vote by planting young trees to reduce the amount of Carbon Dioxide in the air. Vote by recycling as much as you can. Vote with all the daily decisions you make. Vote by not letting your car run when it doesn't have to. Vote by talking to others about the need to become conscious and aware of these issues. If you can afford it, vote by buying a hybrid or electric automobile. Vote with your work for Organic and Holistic endeavors that will continue to make this planet viable and support humanity as we grow past our adolescence and towards maturity as a species that recognizes our creativity, diversity and need for the fulfillment of each individual.

You, who are here, today, are the leaders! Your personal power will only continue to grow as our interconnectedness becomes a more and more obvious reality.

One last thought: if you haven't yet seen the Al Gore movie, "An Inconvenient Truth," do so as soon as you can. Recommend it to others.

Remember, "Nature is only to be commanded by obeying her."

Thanks and power and good luck to you all!