The Angry Patient

Trust

  1. What is trust?
  2. How does it develop?

Game 1 – backward fall and catch: pairs or 2 small groups (red book S2)

Game 2 – verbal boxing: trios (red book S27)

Timer -= 30 seconds of bouts each

  •  Untrue insult barrage
  •  Longwindedness
  •  Gibberish: fear/gladness/sadness

Actor fishbowl

  • GPR volunteer – “raw material”
  • Start and stop – agree anyone can stop, like video
  • Rehearse other ways of doing it – swap seats

Issues to bring out

  • Don’t get angry back (instinct)
  • Don’t be logical / Logic defeats anger
  • Don’t grovel
  • Apologise for the specific
  • Patient is there, so still an opportunity
  • Teasing out the conclusions
  • Taking responsibility for what is wrong

Transactional Analysis

  • Recognise the emotion
  • From the child
  • Parent putdown
  • Doing it differently

Anger is natural

  •  Express
    Assertive not aggressive
    Get over your needs without hurting others
    Respect
  • Suppress
    Converted > redirected
    Stop and think, focus on the positive (danger that anger turns inward on yourself and expressed as passive-aggressive behaviour – cynical hostile put-downs criticism)
  • Calm
    Control outward behaviour PLUS internal response

What triggers our anger?

  • Anger is one reaction to an event that represents a stress, threat or loss to you
  • The stress, threat or loss can be real or we can make it up in our mind.
  • Anger reactions happen when there is a stress, threat or loss to our…
        • Body
        • Property
        • Self-esteem
        • Values
  • Or when we didn’t get what we wanted. Entitlement–‘I want it. You owe me. Give it to me now or I’ll get angry’
  •  Genetic
  •  Psychological
  •  Sociocultural

Where does anger come from?

  • Not accepting responsibility
  • The inappropriate expectation of others
  • Making judgements
  • Shame: a threat to personal integrity based on fear of rejection (eg critical parent) – “I am bad so hide it!” Being unworthy
  • Vulnerability
  • Guilt: a feeling that you did something wrong, not living up to values. Personal punishment that often hangs on
  • Feeling worthless (shaming and blaming the child)
  • Protection: avoids us feeling bad inside
  • Projection onto others / denial / repression

Dealing with anger

  • Relaxation
  • Cognitive restructuring
    Changing the way you think (NLP)
    Avoid NEVER, ALWAYS (black and white child)
    Avoid irrational thoughts “everything’s ruined”
    Getting angry won’t fix anything, logic defeats anger
    Anger may be caused by inescapable problems and not be misplaced > handle the problem.
    It is OK to be angry, it is what you do with it that counts
  • Communication
    Jumping to conclusions
    Don’t criticise, listen
    Don’t let anger disrupt the communication
  • Using humour
    Picture you or the person as an object
    Are you being unreasonable?
    Is it that important?
  • Change the environment
    Personal space
  • Be easy on yourself
  • Say sorry
    Forgiveness

Anger management – this page as a .doc file

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