ANGER

When Pope Gregory put ira on his list, he was talking about the kind of anger that can turn a sense of justice into acts of revenge, denial, or spite. But even back then they must have known that anger, when used well, can transform the world.

Cooling Off Troubled Teens
Pop Culture: Mad as #$%!
Ire-Hardened Arteries
Witness to Horror
Recalling a Deadly Protest

 

Cracking Teen Armor
Fred Hanna has seen anger — the kind of red-hot fury that can transform a teenager's life and move him to do things he'll regret later — and he thinks he knows where it comes from.

Hanna is an expert on helping angry kids change their lives, and he has spent a career developing his theory — spelled out in his popular 2001 book Therapy with Difficult Clients: Using the Precursors Model to Awaken Change — about how to cool that anger off.

"We have to address that hurt," he explains. "And we have to realize that for these kids who have been ignored, they'd rather have bad attention than none."

In SPSBE classes and nationwide, Hanna teaches both graduate students and working counselors how to build relationships with kids (or "clients") and to help them let go of their pain.

To watch the 55-year-old Hanna — who looks and sounds more like the teamster, rail-yard laborer, and cross-country motorcycle traveler he once was — in front of a class, you can see how well he understands troubled kids. As he paces across the room, he booms out even doses of academic theory, simple technique, and anecdotes from years of working with kids in various settings.

His theory is straightforward — based on the idea that if you can find a wedge, exploit a crack, you can break through the thick emotional armor a kid has developed. And though his techniques are simple, they resonate with counselors (and counselors to be), who years later will let Hanna know how well they've worked. The basics:

Put kids at ease: Avoid desks and offices by taking a walk or meeting somewhere they feel comfortable. Talk knowledgeably about their music. Let them avoid eye contact and do something with their hands. Get them to laugh — just for a minute — and you've made a connection.

Choose your role carefully: Respect them and empathize, but don't feel sorry for them. Avoid being an authority or expert or offering insight they can't and won't absorb. Validate their surprisingly insightful perceptions, but remember that they are remarkably adept at spotting a phony.

Use what they provide: Tell kids that defiance is OK, but remind them that it also allows someone else to control them. Approve of their unrelenting apathy as a defense, but try to get them to talk about any small part of them that ever suggests hope or regret — and use any such confession as a path to change. Expect and accept verbal abuse, seething anger, and shocking statements, then search for ways to explore their roots. Tell them to hold onto their resistance; that turns resistance into a decision they make and can change, not a pose they can't back down from.

Adopt tried-and-true counseling techniques: Use a metaphor for their difficult side (calling it their "mean machine" is a favorite one), then let them take a step back and examine it from the outside. Let them write, do cartoons, or make a collage to get some insight. Push the buttons that stir the anger, then help them see where it comes from.

For these kids, anger is a source of pride, Hanna says, and they won't give it up easily. But for so many, if the hurt would go away, the anger might loosen its grip. —JP

 

Mad as &%#$# — But Why?
In his work as a professor of history at Hopkins' Krieger School, Ron Walters has studied the social and cultural history of the United States, with a special interest in 19th- and 20th-century American commercial popular culture. We asked him: What do you make of the prevalence in contemporary pop culture of anger?

There's an important way in which anger works in popular discourse: It privileges the person who's angry. Once somebody in the discussion says, 'I'm mad as hell,' immediately that person's making a claim to be the center. And it tends to cut off debate. It's hard to debate anger. One of the things that impresses me about anger in pop culture now is how many angry millionaires we've got in talk radio and other political commentary. When you look at guys like Bill O'Reilly and Rush Limbaugh, these are rich guys, guys for whom life has been very, very good. But they're mad as hell, and they're going to tell you about it. You or I can announce that we're angry and express our anger in the meanest possible terms, and nobody will care. For example, I could go into a major rant about how oppressive I think parking meters are and how this is an infringement on my Californian's God-given right to park anywhere, anytime. I could throw a major tantrum, and nobody would care. A reasonable response might be, 'Get a life.' That's not the response that the angry millionaires on network TV and radio get. They are tapping into something. I've gotta think the anger is not just at the things they say they're angry about — the government, illegal immigrants. The anger seems out of proportion to the target. Maybe they're trying to deflect attention from something else, or maybe they're not sure what they're angry at." —DK

 

Rage That's Heartfelt
Anger isn't just an ugly emotion. It can kill you. According to a 2002 study by Johns Hopkins researchers, angry young men are far more likely to suffer from heart attacks and cardiovascular disease before the age of 55 than their calmer counterparts.

Sound like obvious news? Not exactly. The study didn't just show that an angry person can blow up and "have a coronary," as the expression goes. It showed that being angry is related to heart disease that develops years, even decades, later. Guys who were angry in their youth were six times more likely to have a heart attack before age 55 and three times more likely to develop premature cardiovascular disease.

The results come from the Johns Hopkins Precursors Study, which has followed more than 1,000 men who graduated from the Hopkins School of Medicine between 1948 and 1964. While in medical school, participants responded to a questionnaire that asked them how they react to stress. The options they could check off included "irritability," "expressed or concealed anger," and "gripe sessions." Men reporting the highest levels of anger had a far higher rate of premature cardiovascular disease.

The findings were a surprise to Michael Klag, a study author and now dean of Hopkins' Bloomberg School of Public Health. "I thought if anger were related to heart disease, it would be through a trigger; that is, it would act in a person who already has coronary heart disease by triggering the heart attack," he says.

However, this study suggests that anger may actually be a cause of heart disease. "This long-term association of anger with the disease suggests that anger may lead to the hardening of the arteries," says Klag. Also, although the mechanism is still unclear, evidence suggests that angry people have stickier blood platelets, which increases the risk of clotting. In addition, catecholamines, chemical messengers including adrenaline, are released during anger episodes and lead to a higher heart rate and blood pressure. More forceful contraction of the heart, due to the higher catecholamines, can also cause an area of a hardened artery to crack, leading to clotting and a heart attack.

Lisa Cooper-Lucas, an employee assistance clinician for Johns Hopkins University and Hospital, offers a regular anger management seminar for faculty and staff. She believes there is a pathology to anger, just as there is for the health problems it causes. "Take road rage. We say that a person just went berserk. That's not true," she says.

Rather, people get angry only after repeated negative thoughts escalate their emotion. "The way we think becomes the way we feel becomes the way we behave," she says.

Cooper-Lucas works with clients on stopping the thoughts that lead to an angry response. Clients learn to manage stress, which often amounts to their allotting time to take care of themselves. She also recommends meditation, yoga, exercise such as walking, and breathing techniques.

Many clients, she says, don't even realize how much stress they are under and how angry they are. "People have approached me later and said, 'I didn't even realize what I was doing to myself. I had no idea that I could feel better.'" —KB

 

Witness to Horror
A 12-year-old is encouraged by his family to get even with another boy, whom he beats to death. Two children see their mom killed with a shovel. Five kids watch their parents fight viciously, then get hauled off to jail.

Major Rick Hite and Officer Essex Weaver, who together have nearly 60 years of experience with the Baltimore Police, talk about such violence with a detachment that grows from hearing too many stories that make the rest of us cringe. But their tone gracefully changes when they talk about a program that helps: the Child Development-Community Policing (CD-CP) program.

"There is an old saying: Hurt people hurt people," Hite says. "This program helps kids who have been hurt, and it makes sense."

Run by the Bloomberg School of Public Health's Center for the Prevention of Youth Violence, CD-CP targets kids exposed to violence, who are likely to be involved in chilling acts themselves later on. "We're just trying to do our job in some of these situations," Hite says of his work as an officer. "But for a kid, this is traumatic. This happened in front of them. This is their dad who is hurt or their mom in handcuffs. This [program] makes police aware of that."

The center in part grew out of an early experience of its director, Philip Leaf, who was then head of a large community mental health program and quickly saw the need to address the issue of violence. "We had opened a new mental health center at Monument and Central, and the second day our program was operating, a pharmacy next door was robbed and gun shots came through our walls. It was pretty clear that we couldn't separate violence from support of families in Baltimore."

The center gathers the best information about what new approaches to youth violence work, then gets people to use it and collaborate — the university, the police, mental health workers, and the community. Even the kids. The CD-CP program in particular trains police, including all new recruits, and residents to help kids who witness or participate in violent acts. It also offers additional training to "immediate responders" — members of a crisis response team that follows up when the violence ends and the dirty work of trauma begins. More than 2,000 people have been through the training, and 50 have become immediate responders.

Weaver describes a recent search at a home where the officers were necessarily speedy and thorough and slightly threatening, then eventually arrested a parent. Previously kids would have been ignored and left with burning images of a frightening police action. Instead, the officers involved talked with the youngsters empathetically, then the CD-CP response team offered counseling and other services.

"We have to recognize that the victim is not just the person who gets stabbed or shot, but the kids . . . and they may be really traumatized," says Weaver. "In a school, we would think about ways to help kids deal with violence, but we don't when it is right in their home."

"It's a different world," says Hite. "We are asked to do more socially, and we need to understand how. We need partnerships, and we are blessed to have this one." — JP

 

Seasons of Discontent

 
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