Healthcare Training Institute - Quality Education since 1979
Psychologist, Social Worker, Counselor, & MFT!!

Section 1
Track #1 - Interpersonal Costs

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Welcome to the Home Study Course sponsored by the Healthcare Training Institute, homestudycredit.com.  This course deals with Anger Management.

Our primary intent for this home study course is to provide quality education to foster your professional growth.  The Institute has provided quality education since 1979.
 
Hi.  My name is xxx.  I will be the narrator of this CD set.  We appreciate that you have chosen us as a vehicle for you to earn your Continuing Education Credit.

The purpose of the course is to assist you in increasing your knowledge regarding how to treat patients, clients, etc. dealing with Anger Management Issues.  As each case study is given, if the concepts seem to be applicable to your situation, I encourage you to turn your CD player off and make a few notes regarding the application of the principle to your setting.  However, these notes are for your purposes only and are not to be sent to the Institute.  Also each track is very content dense.  So feel free to replay the track to review the content either for your own purposes, or if you feel appropriate play the track in an individual or group session for client education.  Also permission is granted to reproduce this CD.  We encourage you to duplicate and give copies of this CD to colleagues, clients, etc. as you deem appropriate. We feel the information on our CD's is valuable.  Thus, we have an interest in distributing CD's in as many ways as possible, to benefit the greatest number of people, who have a need and are receptive to this practical information.

The questions in your Answer Booklet are sequential and deal with the section of content that preceded it.  For this reason, to facilitate the answering of each question, you might read the question from the Answer Booklet prior to listening to that CD track.  By knowing what the question is ahead of time, you will then know the content to listen for that contains the answer.  So just a hint, after you write down the answer to a question in your Answer Booklet, read on to the next question in order to give you a “heads up” to listen for the content that contains the answer to the next question.

Merely write the correct letter on the corresponding blank line in your answer booklet. Each answer is only used once. Keep in mind there is nothing tricky or hard about these questions.  They are merely intended to verify the playing of this CD.

For the purpose of brevity, most generally, I will use the term “therapists” or “mental health professional.”  However, don’t let these terms deter you from applying the concepts to your situations.  When you hear the word “therapists,” if your job title is social worker, psychologist, marriage and family therapist, mental health counselor, professional counselor, resident director, program assistant, etc. merely substitute the appropriate term that is the most meaningful to you. In short, don’t let my use of the term “therapists” cognitively set you off track from hearing the content because your job title is school counselor, for example.  I will also use the term “client” for the purposes of brevity.  However, if you deal with patients, residents, students, consumers, etc., transpose “client” for the term that is the most meaningful to you in your work setting. 

On this CD set we will discuss such topics as: interpersonal consequences, choosing anger, taking personal responsibility and six steps to responsibility.

So,  let’s get started.

On the rest of this track, we will discuss three interpersonal costs of anger: raising defenses, losing a sense of well-being and isolation.

#1 Raising Defenses
The first interpersonal cost is raising defenses.  As you are aware, what makes aggression damaging is that it doesn’t stop.  Energy is channeled into putting up barriers, rather than into communication and problem-solving.  As I stated to Jason, age 32, “Though barriers protect against pain for you, they make it impossible for you to reach the people you care about—even with genuine feelings of love or support.”  Jason’s anger was often met with defensiveness from his wife, Rosa.  Rosa’s defenses included numbness, judging, irritability, attack, withdrawal, revenge, and extreme restriction of response.  When Jason and Rosa’s pattern was set, Rosa became trigger-happy and was reluctant to switch from vigilance to trust and openness.  Rosa often fought Jason’s anger to maintain her boundaries and a sense of self.  Does your client raise defenses, thus putting up emotional barriers that shut out those they love?  Do your client’s loved ones react with a judgmental attitude or withdrawal?  At the end of this track, I will explain two techniques I like to use called Assessing the Cost of Anger and the Non-Defensive Attitude Technique.

#2 Losing a Sense of Well-Being
The second interpersonal cost is losing a sense of well-being.  In Jason’s case, his anger often led to helplessness.  His helplessness occurred in four steps.  First, he would recognize in himself, “I’m in pain; something is wrong or lacking.”  Second, Jason would think someone else—usually Rosa—should fix the problem.  Third, Jason would express anger with aggression.  Fourth, Jason was met with resistance and withdrawal from Rosa.  After step 4, Jason would feel frustrated.  The cycle then would repeat.  For Jason, a sense of entitlement would start the cycle: “I should never feel pain, but if I do, you must fix it.”  Jason put responsibility on others to meet his basic needs and gave up his own power in the process.  The problem got bigger when he used anger as his preferred strategy to make Rosa change.  As she increasingly resisted, Jason felt his life was sliding out of control, saying “Nothing seemed to work, no one seemed to care, and no one was good enough.”  Does a client of yours feel helpless?

#3 Isolation
The third interpersonal cost is isolation.   The price of Jason’s anger was isolation.  Rosa remained very distant for fear of being hurt.  Jason became very lonely.  Over the course of several sessions, I stated to Jason, “Loneliness can cut people off from social support in two ways.  First, a cynical attitude towards others can result in not recognizing that real support is available.  Second, unrealistic and overly-demanding expectations can make available support seem worthless and lacking.  In both cases, people cannot feel the support that exists around them.”  Does your angry client isolate him- or herself from social support?

Techniques:  Assessing the Cost of Anger and the Non-Defensive Attitude Technique
I asked Jason to assess the cost of his anger.  Using a scale of 0-4, with 0 being “no effect” and 4 being “major effect,” I asked him to rate the impact of his anger towards possible anger-triggers.  These included Jason’s responses toward authorities, his spouse and errors.  Over the course of this exam, Jason looked for patterns in his anger, and concluded that he felt angrier at home than at work, for example.  He chose to concentrate his efforts in rebuilding his relationship with Rosa.

A second technique I used with Jason was the Non-Defensive Attitude Technique.  I gave him five questions to ask himself when he felt his anger rising.
            1.)  Why do I have to be in control of the situation with Rosa?
            2.)  Can I allow her to control part of it?
            3.)  Can I share control with Rosa?
            4.)  If I lose control, what is the worst that might happen?
            5.)  Does this situation matter this much to me?

On this track, we have discussed three interpersonal costs of anger.  These included raising defenses, losing a sense of well-being and isolation.

On the next track, we will discuss Four Implications of Choosing Anger.  These include that there is nothing inherently right or legitimate about anger, anger is an expression of stress, forget displacement and anger is a choice.

QUESTION 1
What are three interpersonal costs of anger? To select and enter your answer go to Answer Booklet.