COVID-19 Q&A: Dr. Hans Steiner on Anger and Aggression

Anger is part of everyone’s emotional compass, helping us navigate the contingencies of life. Anger signals that we are being threatened, injured, deprived, robbed of rewards and expectancies. We must stand up and take care of ourselves and those we love. The Coronavirus pandemic with its extreme disruption of normal daily life and uncertainty for the future , compounded by several other crises (economic distress, racial tension, social inequities, political and ideological conflicts) puts us all to the test: we find ourselves immersed in a pool of negative emotions: fear, sadness, contempt, and yes, anger. What do we do with this forceful emotion, calling us to act on our behalf? Can it be managed to limit disruption to our well-being, or harnessed for a positive outcome? This obviously depends on our age. But generally, the answer is an emphatic “yes”: Anger should be one of our adaptive tools to deal with the most difficult circumstances. Sometimes it becomes an obstacle to our struggles, especially when it derails into aggression and even violence. But far more often, it energizes and motivates us to fix what is broken.

Dr. Hans Steiner

With decades of work around anger and aggression, Dr. Steiner is Professor Emeritus of Stanford’s Department of Psychiatry and Behavioral Sciences, sub-specializing in Developmental Psychiatry. He is the Director of the Psychiatry & the Law Program and Founding Member & Director of Pegasus Physicians at Stanford – a group of doctors who also write creatively. His special interests include creative writing as a tool for emotional activation and self-regulation and healing.

Are there positive as well as negative aspects of anger as an emotion?

Dr. Steiner: Anger tends to be the most undervalued and misunderstood of our emotions. From 1970 forward, new research focused on anger and showed that not only was it extremely common in everybody, but had an important task assigned: it signals that we are being threatened, in danger and need to protect ourselves, those we love and what is rightfully ours. Anger is also a prime motivator: when we feel that enough is enough, we usually find ourselves propelled into action.

How do we utilize anger in a productive way?

Dr. Steiner: Anger and its executive branch – aggression – have been preserved in us for thousands of years. This usually means that genetic conservation has kept something alive because it is adaptive and useful. But to become useful tools in our social context, both need to be pruned, shaped, and turned into a socially acceptable package. This process takes many years during childhood. It takes patient education and prosocial modelling to make this happen. The end result should be a multilayered smooth system for the regulation of social interaction when under attack.

How do we know if our anger is irrational and a sign of psychiatric problems?

Dr. Steiner: Summarizing a large body of research and clinical practice, maladaptive anger and aggression has the following characteristics: 1. It arises without any trigger, seemingly out of the blue; 2. It is disproportionate to its trigger in its frequency, intensity, duration and strength; 3. It does not subside after the offending person has apologized; 4. It occurs in a social context which does not sanction anger and aggression.

What questions can we ask ourselves to determine if the object of our anger is the true cause?

Dr. Steiner: In the heat of the moment, there is little room for reflecting on anger and aggression. But it is reasonable to expect such examination to take place after one has settled down. The younger the person, the more help is needed to answer these questions: what got me so upset? Did it surprise me or was it like an old adversary visiting me? Is there something special about this kind of situation or this person which has gotten me so hot under the collar? Can I think of other ways in which I could have reacted? Maybe I had a good point, but can I make it without yelling, screaming and threats or even aggression to make the points more powerful? And, what always helps is to have a pair of helpful ears which can follow our story, how everything unfolded and how it made us feel. Empathy (putting ourselves into someone else’s shoes) is one of the great teaching tools in shaping anger and aggression. Empathy induction is a healer of anger, fury, rage and feeling at the mercy of overpowering forces. This is true for almost all of us, whether we are children or adults.

What happens to unresolved anger without due attention or resolution?

Dr. Steiner: It turns into a hidden trigger point within us, a ticking time bomb which can go off when we least expect it. As that happens, we can become either victim or perpetrator. Its most extreme manifestations are violence against others and even ourselves.

Can anger be masking other emotions or mental health issues?

Dr. Steiner: The most common psychiatric illnesses manifesting with anger and aggression are Attention and Learning Problems; Mood problems, especially bipolar illness; trauma related illnesses, such as PTSD; and drug and alcohol problems. Suffering from any one of these can magnify anger and aggression. But we also need to remember that when any of these syndromes are properly treated, that also tends to heal problems with maladaptive anger and aggression.

When maladaptive anger arises within our personal and professional relationships, how do we handle it pro-actively?

Dr. Steiner: By its very nature, anger and aggression are quintessentially social. We are not just angry; we are angry at someone or something that someone has done. This fact calls for a socially based intervention (couples therapy, family therapy, co-counselling of business partners, etc.) The field has developed any number of anger management techniques and bundled interventions which are available in carefully assembled packages tailored to a whole host of social contexts. These encompass preschool, school age, adolescence, and adult versions.

What do we do with pervasive anger… at society, an ideology, a situation out of our control like COVID-19, mask-wearing, politics, just to mention a few?

Dr. Steiner: The COVID situation does present us with unprecedented challenges which interfere unrelentingly with all our lives. Social isolation may be the best tool to keep the virus under control, but this clashes directly with the need for social interventions helping us resolve anger and rage when being at the mercy of injustice and uncertainty. In such conflicts we need to remind ourselves that diatribes, lies and accusations will not move us forward; compassion empathy and the reminder that we are all in this horrible situation together will inspire us. Because in the end all of us can contribute to finding solutions to the problem. Such an attitude is also helpful in our homes, as we live in proximity to our loved ones which can weigh heavily on our familial bonds. Carving out our own space and time as much as possible reduces the load. Distraction, celebrating and savoring the life we do have help in this process. But in the end, all of us need a reminder that all animals, humans included, are vulnerable to crowding and competitive, irresolvable demands. In the face of these, anger increasingly loses its value as a signal to act on our behalf. We must control it to get us through this thicket in reasonable shape.

For more on Dr. Steiner’s work:

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