On Anger Work

And the use of punching bags

I have been working with children, teenagers and adults for over ten years. In that time I have facilitated many anger management groups and face to face anger management/therapy sessions.

The nature of my work with clients develops in line with each individual case. The process of Anger Therapy proceeds in the best way any client might be able to do that work. There are several counselling modalities which I may use during sessions to achieve the best results. Some of these techniques include; Cognitive, Behavioural, Relational, Play Therapy (competitive transference's), Re Decisional (Gestalt) and Cathartic (Affective) modalities. The underlying modality in which my understanding of the client and the therapeutic relationship is via my Transactional Analysis background. Of course, the synthesis of my techniques are very much drawn from my experiential practice of these techniques. My own personal evolvement, empathy and genuiness with clients is paramount in the healing process.(Ongoing supervision and personal therapy helps).       

The first counselling session involves an interview designed to assess both parent and or child/person to a desired treatment plan. For example; a client may present with suppression like issues, periodic rage and other behavioural issues. Although working case by case this kind of anger issue requires building safety and trust so that the client may express their feelings comfortably.

Cathartic Artwork

Alternatively a client may present with overt anger (always angry) of which may be a “covering” emotion used as a defence to other feelings. In some cases the "covering" or expressed feeling and behaviour is not the desired feeling to work with in counselling. The client’s anger is still valid and causing dysfunction in their life however the anger is not the underlying or authentic issue. I will assess clients for the best therapeutic treatment plan in each case. In some cases there is more anger underneath surface feelings and the underlying feelings of perhaps sad and hurt. The latter client will usually need longer term therapy styles.   

Assessing the client’s resistance to working with certain feelings is usually the guide to which counselling style is best and which issue to begin with in therapy.   See article about Parent and Child assessment interview here, http://kabrahams.blogspot.com/2008/06/parent-and-child-interview.html

Some clients present with what I describe as an “unfathomable motivation” to resist all manner of techniques that might help them (defiant), however they still appear to enjoy going to counselling. Whether this particular type of client has mental health or personality issues it doesn’t really matter however the therapy in my view, must take a different path.   

With the more difficult type of psychological impasses the all important process is to connect with the part of personality (of the client) that is causing the behavioural issues. You may recognise this aspect in personality via incongruous behaviours and body language when compared to their current predicament. These behaviours are often the source of a clients “misunderstood life” and which seem to reinforce angry belief systems such as the incarcerated person or prisoner. Establishing a therapeutic relationship may take some time with this type of client or it may not be possible.

Such clients may express “gallows” laughter when the counsellor is direct and genuine in their questioning. All clients show a measure of resistance. Difficult clients usually show other ingenious and creative ploys to maintain defence mechanisms when invited to deal with authentic feelings.  

These kinds of resistant behaviours are best acknowledged in some way so that the client knows they are being understood by the counsellor. I often reflect a quality of the “genius” in this creative process even if the client has destructive or manipulative qualities. The client benefits when they can begin to differentiate aggressive and creative elements of personality. It is reasonable to say that this "sense of genius” may also render the therapeutic alliance unworkable! In some cases “no therapy” is the best therapeutic intervention to initially take.

Obviously there are creative ways in which to make client assessments without them disengaging from counselling. Clients prefer to engage after a well established rapport is developed. Some clients will resist anything that looks like a technique designed to effect change in counselling. Some techniques and cognitive activities are like chores to these clients and they sense, that in the end, it will only point out “more that is wrong with them”. Following this precarious track in counselling runs the risk of pathologising the client further. When working with anger issues and teenagers the Client Centred approach is a better idea than than reinforcing a client's potential negative attitudes towards authority.

I am familiar with a cathartic technique that I use in my sessions with clients. Its a  technique that can be very helpful with some clients. I will only use this technique with clients who I know, who have a reasonable cognitive process and who are ready to participate in cathartic work.

In some cases the cathartic technique can help children experience how anger can be okay. To experience anger in controlled situations where no one gets hurt, no one gets into trouble and nothing is damaged. If the client understands there is another way to deal with their angry feelings (safely) they usually show great relief. If the client can achieve such a revelation, they can be more open to other therapeutic styles in counselling  and cbe willing to attend further appointments.

My aim in the initial therapeutic setting is to establish a “contract” for change if that is at all possible. It doesn't matter that a contract is about "support" through the juvenile justice system or if the client is an unwilling participant. If the client is going to entertain the idea of "change" its a good idea if they have an understanding of their current emotional patterns and learn to visualise new models.    

“Where do you keep your anger and when does it come out”

Youths and adults who wish to devise their own plans for anger management must have some basic skills of the cathartic process and be armed with an idea about "practising different behaviours". The rules of engagement with regards to using punching bags are the boundaries and discipline involved in clients helping themselves. I advise against some mothers who suggest buying punching bags for use at home until the client has learned how the process works. I would prefer if the client practices the method in therapy at least a few times before disengaging from counselling (if that is their intentions).

If parents must buy a punching bag then I advise them to buy a tackle bag which is comprised of foam and plastic covering. The old boxing bag filled with socks and sawdust is too hard and could potentially injure the client. The foam filled tackle bags do not require the person to tie on boxing gloves to protect their fists when hitting the bag, the person can also avoid any delays in expressing anger.    

After the initial interview and if the client is ready to experience “Big Red” I will help the client pick a minor issue in their life where they experience anger. That is, instead of a complex parental rejection or abuse issue the client chooses a recent but identifiable issue that reflects their current concerns. The client may report that a particular person could “treat them better” or a particular situation is “unfair”.

 

The idea is to express anger whilst acknowledging (validating) the underlying feelings, such as “unfairness” (read as sad and hurt feelings). Slowly and methodically I will help the client approach the punching bag and to hold the batarcka stick with two hands.

I invite them to say a few words before expressing their anger on the punching bag. I may go back over the scenario they presented and pick the best cathartic statement for them to use when hitting the bag. I might invite them to say “its unfair” before hitting the bag. “BANG”. It may take a few hits to get in the swing of things however after some encouragement the client reaches a level of catharsis. Depending on what is going on for the client at this stage, I ask them to stop and invite them to reflect on what they are feeling in their body. All the while I am observing the client's body language for  signs of other feelings emerging. 

“What is going on” “what is happening inside” “is it a good feeling or unpleasant feeling”??

Usually it’s a feeling of joy and relief and the client is smiling. They report, “it’s a good thing”. I invite them to hit the bag a few more times and then reflect how they just proved to themselves that getting angry feelings out feels good. I ask them “did anyone get hurt”? “Did anyone get into trouble”? “Is anything broken”? They reply No! On many occasions clients swing their hips or bend over saying that they feel tired now.

I let them know again “That’s one way to express anger where it feels good and where no one gets into trouble”.

During group anger management sessions a client may develop confidence over time to express re decisions about themselves through cathartic techniques. If the client believes that they are unimportant (not good enough in the eyes of someone) they use the words “I am important” “I am good enough” before hitting the bag. The technique is useful in self esteem and assertiveness training where the client alleviates stressful internal or dynamic dialogues.  

I don’t often enjoy setting up therapeutic techniques to fail however if a particular client will not hit the bag and begins to cry or offer greater resistance to the idea, I will carefully back out by nurturing and acknowledging their bravery in attempting such a thing. In some cases the client may acknowledge feeling their "resistance" to the activity and that “it” stopped them from expressing what they thought they felt like expressing. The psychotherapeutic concepts in Potency, Protection and Permissions for effective therapy underpin my style of work with clients. In many cases children require therapeutic "permissions" to have feelings in counselling. Sometimes mothers are in the room during the session and I will ask her "is it ok if I show your child how to get some anger out".
 

In summary the cathartic technique is only a part of a larger therapeutic plan and is not to be considered the panacea for angry feelings or behaviours. In some cases, clients show behavioural improvements in the short term and gain a great deal from a few counselling sessions. Others may require further work, building trust and safety before expressing their feelings. Perhaps the way I work with catharsis allows the therapeutic relationship to develop further, while dismissing preconceived ideas about anger counselling? The person experiences feelings by putting their feelings into motion in safe and controlled settings. They learn to move stressful feelings outside of their body and gain a sense of empowerment by “doing something”. To begin taking responsibility for feelings and having a way that helps is empowering. Having a device that works in counselling in contrast to the fear of being out of control (rage) or helpless is a step towards expressing feelings appropriately.

Ken Abrahams

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