Rethinking “Anger Issues”
I often start intakes with children by asking the question, “Do you know why you are here?” This helps me assess how much they know about their reasons for being in my office, as well as how much they know about what my role is. Often, the child will respond with, “Because I have anger issues.” The reason I hear this so often is that most of the children who are referred to me are struggling with a combination of difficulties with emotional regulation and impulse control. In other words, things happen, they have big feelings, and big, often angry responses. The thing that is often being missed by parents, teachers, coaches, treatment providers, and other adults in their lives is that they actually don’t have “anger issues,” they have anxiety disorders.
We often talk about our stress responses, even naming them, “fight, flight, and freeze,” but then forget that the fight response is a stress response. On the surface, these kids look like they have anger issues, but in reality, they have anxiety issue. When their anxiety is triggered, they are going into a fight response. This distinction is very important as it often changes the way that others respond to the child, and will inform what response should be taken to support the them in increasing their emotional regulation skills. Before we talk more about this, let’s first talk more about the stress responses.
Our stress responses are instincts preprogramed into our brain to keep us alive in emergency situations. Think of a caveman walking through the woods and running into a saber-toothed tiger. He is either going to try to fight back when attacked, run away to safety, or will freeze up and the tiger may leave him alone because he doesn’t seem like a danger. These reactions are not good or bad; they are instinctive responses that are designed to keep us alive when we are in danger. The thing about the stress responses is however, we don’t just engage in them in emergency situations, we also will go into one of the stress responses when we have really big emotions. When we are really anxious, sad, scared, mad, etc., we will go into a fight, flight, or freeze response.
As a therapist, it is my job to help my clients find healthy ways to self-regulate. Usually in the therapy world, this means teaching deep breathing exercises, mindfulness activities, grounding techniques, and other things that often fall into the freeze response category. For someone who tends to go into their fight response, this simply will not work for them. Their brain is telling them “fight or die,” and so deep breathing, or counting to ten, is going to do very little to help. Instead, the person needs some kind of healthy way to simulate the fight response. Instead of grounding techniques, they need to go on a walk, bike ride, do push-ups, shoot some hoops, punch a punching bag, scream into a pillow, or something along those lines.
I often get pushback about this. When I discuss this in trainings, many will ask, “Wouldn’t this teach kids that it is okay to be physically aggressive?” The thing is, these kids are already physically aggressive. What I am doing is explaining why they are having this response, and giving them healthy alternatives to work through it. By taking this approach, I can take a child who is throwing kitchen chairs across the room when triggered, and graduating them in about 6 to 9 months. The reason this works is because I am helping them better understand themselves, and then giving them coping skills that actually work for the way that their brain is wired.
Let’s also consider that the fight response is necessary for survival. Two summers ago, there was a 13 year old girl swimming off the coast of New Jersy when she was bit in the abdomen by a shark. She fought back, hitting, kicking, punching, until the shark decided she wasn’t worth it, and let her go. She was able to get out of the water, received emergency surgery, and lived to tell the tale. Now imagine if she had been trained that her fight response was “bad,” so she no longer engaged in it. If she had gone into a flight or freeze response, she probably would be dead. So, let’s not train kids (or adults) that their fight response is something to be ashamed of and not do. It is an instinctive response that they might need someday, and in the meantime, they need healthy ways to engage in it. This looks like, “You can’t hit your sibling, but you can hit this punching bag all you want.” Giving people coping skills that works for their brain will lead to people who can more effectively self-regulate their emotions.
Photo: Young girl making an angry face, black and white photo
To learn more about supporting a child or teen who tends towards the fight response, check-out my book, What's Your Anxiety Level? Cognitive Behavioral Therapy for Neurodivergent Children and Teens with Co-Occurring Anxiety Disorders, available from Routledge Press.
To read more about the girl attacked by the shark in 2023: https://people.com/human-interest/13-year-old-girl-fights-off-shark-after-being-bitten-arms-leg-stomach/#:~:text=A%2013%2Dyear%2Dold%20girl,those%20things%2C%22%20Ella%20said.
