Psychiatrists: Rage Comes From Accumulation

July 18, 2001 -- A good friend with a mellow personality was in an elevator awhile back when the door opened and a burly chap stepped inside.

"Good morning," my friend said, smiling broadly.

The other guy belted my friend in the face, shattering his jaw.

It turned out that it hadn't been such a good morning for the assailant. He had just been fired. My friend just happened to be in the wrong place at the wrong time, falling victim to anger that pushed a stranger over the edge.

Why do these things happen? Why do we see frequent outbursts ranging from an impolite gesture from another motorist to road rage that can lead, quite literally, to death?

More People, More Conflict

What's intriguing about so many cases of uncontrolled anger is that they often result from such trivial encounters. It's easier to see why a jealous spouse might take a shot at a mate found in a compromising position than it is to understand why road rage would compel someone to yank a small dog from another motorist's car and fling it into the path of oncoming traffic.

Why do we get so mad over things that don't really matter, like getting cut off in traffic by someone who's in too much of a hurry?

To find out I turned to Redford B. Williams, a psychiatrist at Duke University Medical Center, who has spent years studying anger and what we can do about it. It's a pressing issue these days because more and more research shows that if you can't keep your anger under control, it can kill you. Heart disease and strokes have been repeatedly linked to anger.

Anger results from our inability to deal with stress.

"It's more apt to happen in the world we live in today" because there are so many opportunities for conflict in an increasingly complex, crowded, and busy society, he says.

But why do we spend so much of our time angry over minor incidents?

Two reasons. Some people are just more hostile than others, and anger is often the result of cumulative insults, not a single event.

It's doubtful the kind of road rage that drives one person to the brink of killing another human being is the direct result of getting cut off in traffic, Williams says. More likely, it resulted from a whole series of events that, taken together, pushed someone just a bit too far. The traffic incident served as a trigger, releasing hostility that had been building up for some time.

In other words, someone reached a threshold and flipped out.

The Anger Sack

It's as though each of us carries a burlap bag around, storing the insults that have been hurled at us.

"You keep stuffing things into that gunny sack you've got on your back," and you get home and find that your mate didn't carry out an assigned chore, Williams says. "You try to put that in the gunny sack, metaphorically speaking, and the damn thing just completely bursts open and it all comes spilling out. It's not that particular thing, but the built up load of all the stuff you've been trying to get out from under."

Maybe the mate will understand, bring you your slippers, prop your feet up and tell you everything is OK. But it's quite likely he or she will react unpleasantly because these days, both marriage partners usually work, blurring the roles each is to play and introducing additional stresses.

And chances are one of you is more hostile than the other.

"My wife and I can be riding in the same car, and I'm sitting there going bonkers [over a traffic incident] and she's sitting there thinking what a nice opportunity we have to talk," Williams says.

If you tend to overreact while driving a car, he adds, perhaps you are a bit more hostile than you think you are. Maybe underneath it all, you're seething a good part of the time, and it has little to do with the jerk that just cut you off.

That's significant because uncontrolled anger can double your risk of having a stroke, according to a recent study by the University of Michigan School of Medicine. Researchers looked at 2,110 middle-aged men and found that those who were better at diffusing their anger had half the number of strokes over a seven-year period as those who were constantly "blowing off steam," according to psychologist Susan A. Everson.

"Losing your cool can be very hazardous to your health," she says.

Another study found that "hostility reduction training" among patients who had suffered a heart attack lowered their blood pressure almost as effectively as drugs.

Taking Control

Of course, none of this means anger is always bad. Sometimes, anger is a signal that we need to do something about a situation.

"If people in the past had not acted on their anger, black people in this country would still be riding in the back of the bus," Williams says.

So the key is not to eliminate anger, but to manage it. Williams and his wife, Virginia, have a counseling program in Durham, N.C., working chiefly with companies and governmental agencies, to help people take control of their anger.The first thing to do when conflict arises is make sure you've got your facts straight, Williams says. Once you know what's going on, he says, ask yourself four questions.

1) Is this important to me?

2) Are the thoughts and feelings I'm having appropriate to the facts?

3) Is this situation modifiable? In other words, is there anything I can do about it?

4) Would it be worth it to do what I have to do to change the situation?

"If you get a no to any one of those questions, you need to change your angry reaction rather than change the situation," Williams says. But if you get a yes to each question, you need to take some action.

"That doesn't mean blowing up or screaming or hollering or cutting somebody else off," he adds. What it means, he says, is "engaging in problem solving behavior."

If you can remember those four questions, Williams says, it will help you get a grip on your anger. At the very least, you will have time to cool off while you're asking them.

So maybe that advice generally attributed to "mom" is right after all.

If you feel yourself getting angry, count to 10.

Lee Dye’s column appears weekly on A former science writer for the Los Angeles Times, he now lives in Juneau, Alaska.