Anger Management: A Cognitive Behavioral Approach > Chapter 3 - Events And Cues

EVENTS AND CUES
A Conceptual Framework for Understanding Anger

Outline of Session 2

  • Instructions to Group Leaders
  • Suggested Remarks
  • – Events That Trigger Anger
    – Cues to Anger
  • Explaining the Check-In Procedure
  • Homework Assignment

Session 2

Instructions to Group Leaders

This session teaches group members how to analyze an anger episode and to identify the events and cues that indicate an escalation of anger. Begin the session with a check in (following up on the homework assignment from the last week, namely, have group members report on the highest level of anger they reached on the anger meter during the past week) and follow with a presentation and discussion of events and cues. A more complete Check-In Procedure will be used in session 3 after members have been taught to identify specific anger-provoking events and the cues that indicate an escalation of anger.

After the Check-In Procedure, ask group members to list specific events that trigger their anger. Pay special attention to helping them distinguish between the events and their interpretation of these events. Events refer to facts. Interpretations refer to opinions, value judgments, or perceptions of the events. For example, a group member might say, “My boss criticized me because he doesn’t like me.” Point out that the specific event was that the boss criticized the group member and that the belief that his boss doesn’t like him is an interpretation that may or may not be accurate.

Be aware of gender differences. Women participants often identify relationships with their boyfriend or partner or parenting concerns as events that trigger their anger. Men, however, may rarely identify these issues as triggers.

Finally, present the four cues to anger categories. After describing each category, ask group members to provide examples. It is important to emphasize that cues may be different for each individual. Members should identify cues that indicate an escalation of their anger.

Suggested Remarks

(Use the following blocked or put this in your own words.)

Events That Trigger Anger

When you get angry, it is because an event has provoked your anger. For example, you may get angry when the bus is late, when you have to wait in line at the grocery store, or when a neighbor plays his stereo too loud. Everyday events such as these can provoke your anger.

Many times, specific events touch on sensitive areas in your life. These sensitive areas or “red flags” usually refer to long-standing issues that can easily lead to anger. For example, some of us may have been slow readers as children and may have been sensitive about our reading ability. Although we may read well now as adults, we may continue to be sensitive about this issue. This sensitivity may be revealed when someone rushes us while we are completing an application or reviewing a memorandum and may trigger anger because we may feel that we are being criticized or judged as we were when we were children. This sensitivity may also show itself in a more direct way, such as when someone calls us “slow” or “stupid.”

In addition to events experienced in the here-and-now, you may also recall an event from your past that made you angry. You might remember, for example, how the bus always seemed to be late before you left home for an important appointment. Just thinking about how late the bus was in the past can make you angry in the present. Another example may be when you recall a situation involving a family member who betrayed or hurt you in some way. Remembering this situation, or this family member, can raise your number on the anger meter. Here are examples of events or issues that can trigger anger:

  • Long waits to see your doctor
  • Traffic congestion
  • Crowded buses
  • A friend joking about a sensitive topic
  • A friend not paying back money owed to you
  • Being wrongly accused
  • Having to clean up someone else’s mess
  • Having an untidy roommate
  • Having a neighbor who plays the stereo too loud
  • Being placed on hold for long periods of time while on the telephone
  • Being given wrong directions
  • Rumors being spread about your relapse that are not true
  • Having money or property stolen from you.



Cues to Anger

A second important aspect of anger monitoring is to identify the cues that occur in response to the anger-provoking event. These cues serve as warning signs that you have become angry and that your anger is continuing to escalate. They can be broken down into four cue categories: physical, behavioral, emotional, and cognitive (or thought) cues.

Physical Cues. Physical cues involve the way our bodies respond when we become angry. For example, our heart rates may increase, we may feel tightness in our chests, or we may feel hot and flushed. These physical cues can also warn us that our anger is escalating out of control or approaching a 10 on the anger meter. We can learn to identify these cues when they occur in response to an anger-provoking event.

Can you identify some of the physical cues that you have experienced when you have become angry?

Behavioral Cues. Behavioral cues involve the behaviors we display when we get angry, which are observed by other people around us. For example, we may clench our fists, pace back and forth, slam a door, or raise our voices. These behavioral responses are the second cue of our anger. As with physical cues, they are warning signs that we may be approaching a 10 on the anger meter.

What are some of the behavioral cues that you have experienced when you have become angry?

Emotional Cues. Emotional cues involve other feelings that may occur concurrently with our anger. For example, we may become angry when we feel abandoned, afraid, discounted, disrespected, guilty, humiliated, impatient, insecure, jealous, or rejected. These kinds of feelings are the core or primary feelings that underlie our anger. It is easy to discount these primary feelings because they often make us feel vulnerable. An important component of anger management is to become aware of, and to recognize, the primary feelings that underlie our anger. In this group, we will view anger as a secondary emotion to these more primary feelings.

Can you identify some of the primary feelings that you have experienced during an episode of anger?

Cognitive Cues. Cognitive cues refer to the thoughts that occur in response to the angerprovoking event. When people become angry, they may interpret events in certain ways. For example, we may interpret a friend’s comments as criticism, or we may interpret the actions of others as demeaning, humiliating, or controlling. Some people call these thoughts “self-talk” because they resemble a conversation we are having with ourselves. For people with anger problems, this self-talk is usually very critical and hostile in tone and content. It reflects beliefs about the way they think the world should be; beliefs about people, places, and things.

Closely related to thoughts and self-talk are fantasies and images. We view fantasies and images as other types of cognitive cues that can indicate an escalation of anger. For example, we might fantasize about seeking revenge on a perceived enemy or imagine or visualize our spouse having an affair. When we have these fantasies and images, our anger can escalate even more rapidly.

[Question #13. The cues that occur in response to the anger-provoking event can be broken down into categories such as:]
[Question #14. The cues category that refers to the interpretations of a person in response to the actions of others as demeaning, humiliating, or controlling:]

Can you think of other examples of cognitive or thought cues?

Explaining the Check-In Procedure

In this session, group members began to monitor their anger and identify anger-provoking events and situations. In each weekly session, there will be a Check-In Procedure to follow up on the homework assignment from the previous week and to report the highest level of anger reached on the anger meter during the week.

Have participants identify the event that triggered their anger, the cues that were associated with their anger, and the strategies they used to manage their anger in response to the event. They will be using the following questions to check in at the beginning of each session:

  1. What was the highest number you reached on the anger meter during the past week?
  2. What was the event that triggered your anger?
  3. What cues were associated with the anger-provoking event? For example, what were the physical, behavioral, emotional, or cognitive cues?
  4. What strategies did you use to avoid reaching 10 on the anger meter?
They will also be asked to monitor and record the highest number they reach on the anger meter for each day of the upcoming week after each session.


Exhibit 2. Cues to Anger: Four Cue Categories

  1. Physical (examples: rapid heartbeat, tightness in chest, feeling hot or flushed)
  2. Behavioral (examples: pacing, clenching fists, raising voice, staring)
  3. Emotional (examples: fear, hurt, jealousy, guilt)
  4. Cognitive/Thoughts (examples: hostile self-talk, images of aggression and revenge)

Homework Assignment

Have group members refer to the participant workbook. Ask them to monitor and record their highest level of anger on the anger meter during the upcoming week. In addition, ask them to identify the event that made them angry and list the cues that were associated with the angerprovoking event. Tell participants they should be prepared to report on these assignments during the Check-In Procedure in next week’s session.

 
Anger Management: A Cognitive Behavioral Approach > Chapter 3 - Events And Cues
Page Last Modified On: April 18, 2015, 11:56 AM