How to help clients reduce anger in therapy

A longstanding belief stemming from the days of Freud contends that venting about deeply repressed emotions provides a sense of relief. “Just let them out.” This idea has extended to expressing anger in all sorts of ways. But research from the late 1990s to more recently finds that venting and catharsis do not work. So how do we help clients find ways to reduce anger other than catharsis? 

Breuer and Freud (1895) proposed that a release of negative emotion, including pent-up anger, created an “abreaction”. For example, crying about something deeply upsetting or about repressed emotional memories will create relief. Some time later, this idea became popular for reducing anger. Examples include screaming in a field, smashing objects, or physical fighting.

What the research finds about venting anger.

Unfortunately, research from the late 1990s and a recent meta-analysis all found that catharsis does not work. But why is that the case? Shouldn’t expressing emotions let them out?

First, research finds that suppressed emotions do not get “pent up“ as stored or unresolved psychic energy. This comes despite what psychoanalysis originally proposed and many people in popular culture expect. So, technically, people are not really releasing anything that was ever pent up or stored. 

Second, expecting loud or even aggressive behaviors to release some emotion can actually teach or reinforce aggressive behavior as a way to cope with negative emotions. This is especially risky when telling children to do things like punch a pillow or stuffed animal when angry.

Third, intense or aggressive methods meant to release emotion often increase physiological arousal. Metrics like heart rate, blood pressure, or muscle tension can increase. We can imagine yelling it out or intense exercise raising blood pressure. Physiological arousal is included in what is now popularly referred to as “nervous system dysregulation”. Because anger increases physiological arousal, people attempting to vent in these ways are just keeping themselves and their bodies highly activated. 

What it means for how to help clients reduce anger in therapy.

So how do we help clients learn ways to calm themselves down from anger? Methods aimed at decreasing physiological arousal or “regulating the nervous system” can help to some degree. That is, breathing approaches can help decrease physiological activation in the moment. However, although popular, breathing approaches are limited because they do not get at why a given individual experiences emotional and physiological reactions. Without looking at the root cause of one’s reactions, they will continue to experience anger that needs to be regulated in the same contexts.

Conscious reflection and understanding about why someone experiences anger is important to get at the root of anger and decrease it in the long-term. CBT provides effective strategies for clients to reduce their anger in the moment and over time. It also helps them understand and evaluate beliefs that contribute to their anger. For example, “I never get what I want” or “No one wants to support me”. Research finds that when clients can evaluate and challenge these beliefs, they drastically decrease their tendency to get angry in the first place. 

Other effective strategies include behavioral activation. This helps clients learn to engage in enjoyable and meaningful activities that boost mood and focus attention away from negative emotions like anger. DBT also helps clients learn to regulate their emotions effectively using mindfulness and other strategies. Seeking social support is an effective method as well, but not because of verbal venting of anger. Healthy social support provides the sense that others are willing to support us, while also subjecting beliefs and biases to more balanced or objective ideas.

Anger can be a very difficult experience and can have negative impact on people’s lives. Although venting and catharsis are ineffective methods to regulate emotions and anger, evidence based therapy approaches can help clients understand and reduce their overall anger. Nothing to be mad about there.