Children who are abused and molested sustain fundamental damage to their boundary and attachment systems, so that they are unable to either recognize or utilize the danger signals of anger. In addition, a child in a dysfunctional family may learn that it is not safe to express feelings of outrage, anger and criticism.
The buried layers of anger frequently emerge during adolescence in self-destructive and anti-social behaviours. If this cry for help goes unnoticed, the survivor will often enter adulthood with an internalized despair, and many go on to develop chronic depression or problems of drug and alcohol dependence. By the time therapy is begun, the underlying anger is usually deeply buried, especially in females. It is essential that the therapist recognizes and validates the survivor’s buried anger. The therapist must also draw attention to the ways the buried anger is being acted out in the present.
For most women survivors of trauma or abuse, anger is the most difficult emotion to deal with. But for male survivors it can still be very difficult to feel that their rage is acceptable. Most survivors, whether male or female, need help to learn how to express their anger in a safe and functional way.
Usually the most difficult part is to get started – to break through the barrier that prevents them feeling and then expressing their anger. But it is essential that you include the subject of the right and the need to be angry, in the treatment program or therapy plan. For a discussion of the issues behind the resistance to facing anger, I recommend the chapter ‘Anger: the backbone of healing’ in Bass & Davis, The Courage to Heal. It says pretty much all you need to know about the subject, and offers some good case examples of therapeutic strategies for ‘priming’ clients.
Bass & Davis use the term ‘priming’ and I think it expresses the spirit of the strategy. Many clients need active assistance to be able to start feeling and then expressing anger – first anger of any sort, and then anger firmly directed at the true source of their problems. If the therapist uses the traditional approach of therapeutic neutrality (ie, ‘just follow the client’s lead, do not direct or confront’), then the client will still suffer from an internalized anger, but will often not address it in therapy but will continue to act it out in their life.
Priming means helping the client get in touch with their anger. In my opinion, the visual art therapies are not very useful in this stage. Body centred strategies, ie, strategies that involve the physical body, work better. To start with, it can be helpful to get the client to feel angry about someone else’s hurt, and piggy-back those feelings onto one’s own hurt. Taking an angry posture, role-playing anger can prime the system to start being able to feel genuine anger. Movement therapy exercises, drama workshops, even writing exercises, such as listing all the ways the trauma has impacted your life.
Once the anger has been contacted, try to encourage the client to keep this lifeline flowing – not to dam up again. Encourage regular expressions of anger as part of the therapy regimen (say at least once or twice a month). How the client expresses their anger will differ with different people. Batting large stuffed toys or cushions, pounding the chair, screaming and raging, writing furious tracts or letters to the abuser, poetry, and fury-filled artwork, are some examples.
The job of the therapist is A/ to keep the client physically and emotionally safe during this anger work. On no account should a client be allowed to start hurting self (in the therapy room) as many will try to do – as many have been used to doing. Many survivors are terrified of their anger, and need to be taught that the anger will not consume them and will not destroy those nearby. However, it helps to explain to your client that while the feeling can be very intense, its physical expression in the therapy room will need to be contained within specified physical boundaries (eg, this area here on the cushions is for anger work. You may hit the chairs, but not over this side of the room where the desk and telephone are, for example. You may not hit me, instead direct those feelings onto the large teddy, etc).
B/ to help the client direct the anger where it belongs, and to take it off the objects that don’t deserve this anger. There may be a period where the client is angry at everything, and she/he will need your support in moving through this stage without being shut down and silenced again.
Be inventive, use your intuition and draw on the expressive therapies that you know. But if you find you are afraid of people’s anger, it might be useful to do some anger work for yourself, as that can give you a safer foundation for witnessing the anger of others.
Anger can be a very positive emotion when dealt with appropriately and initially in a safe environment. Anger is linked to a person’s sense of self. It is a motivator, and linked to the feeling “How dare you! I have a right…!” It is important to normalize feelings of anger as well as educating the person to express the feelings appropriately. Helping the person begin to express their anger is a vital step in helping them step out of the victim role. “Anger is the best anti-depressant on the market..” (Ross, 2009)