As I said in my last blog, anger is a complicated topic and I shall write numerous articles on it.  In this one, I focus on the connections between intense anger, rage, and violence, on the one hand, and the very vulnerable feelings of shame,  humiliation and mortification on the other.  It is an especially important therapeutic issue to understand and find solutions to in view of the increased incidence of  violence in our country.  

Rage is an issue numerous clients of mine through the years have experienced, resulting in a loss of control and acting out in ways that hurt and frightened others and, in the long run, hurt themselves. Therapeutic working  on it in therapy can have a number of positive results:  

     1.  People who tend to become enraged then can realize their rage is triggered by certain events rather just proof they are bad and, when worked through, can result in a lessening of shame and violent behavior.  

     2.  They begin to support themselves and feel the vulnerable feelings of shame, frustration and helplessness instead of acting it out in rageful ways. 

     3.  They begin to be more accepting of more moderate, controlled angry feelings in themselves and others, and more able to express anger in appropriate ways,  depending on the situation  in which they find themselves.  This usually means they are better able to assert themselves since being justifiably angry gives one a sense of strength, focus and entitlement.  

 I will own that erupting in rage is an issue with which I myself have dealt in the past, but my acting out was usually not at people but inanimate objects.   For example, I remember with great regret exploding with rage and yelling furiously  many years ago after tripping  on some rocks near a campfire I had built for me and my children while on a camping trip in the mountains of California.  It took my teenage son to tell me how inappropriate my behavior was and how upsetting it was to all my kids.  So some of my understanding of the problem of rage is partly the result of experiencing and working through my own issues when rage was triggered as well as having had many clients who struggled with this issue.   

Some of these clients got into legal trouble  because of their rage reactions and were forced to attend anger management groups.  They experienced, however,  little change in decreasing the intensity and frequency of their rage episodes.  This is because these classes have tended to focus on behavior rather than the underlying causes of their rage, which very  adversely affected them and the targets of their rage, especially their partners, friends, siblings  and children.  One ex-client of mine, a brilliant college professor, lost university jobs because of his uncontrollable outbursts of rage, mostly  directed at the  heads of the departments in which he was teaching.   

I can safely say that almost all of my clients’ rage reactions were triggered by experiences of humiliation and shame they experienced that were triggered by painful interactions with others or even inanimate objects.   The latter was true of me when I exploded after falling on the rocks by the campfire.  It was as if the rocks were sentient and had purposely caused my fall.  Of course I quickly realized my fall was caused by my own carelessness but, in the present moment, I was triggered into rage before I could access my rational mind and feel sad for myself.  As a result  I felt shame and helpless and almost instantaneously exploded.    

Shame tends to erase the individual’s sense of psychic worth.    It can also fragment the person’s cognitive functions so that enraged acting-out can occur before they realize they are triggered by shame. It can be in the moment, or it can be a chronic sense of worthlessness.  It is different from guilt, where the individual has an intrinsic sense of worth but has done something they feel is morally wrong.   With shame, on the other hand, one feels that one is wrong, in their very being.  The adaptive reaction to guilt is if possible, making amends.   The adaptive reaction to shame is withdrawal, a wish to disappear so as to protect oneself from shaming by others and to protect them from contamination by one’s badness.  The defensive reaction to shame is rage against that which one feels is the cause of one’s shame.  Fritz Perls made me aware of that many years ago.  Sometimes shame even  results in murderous behavior.   But in this article I am focusing on the situation where the individual has a general sense of (probably shaky) self worth but some event in the present triggers unfinished memories of past interactions where the person was continually shamed.   These events  almost always started in childhood, but can continue later in life as well.  

The outcome of childhood continual shame experiences is a propensity to feel shame when the current situation reminds them of the original experiences.  Such people are usually unaware of the similarity of the present stimuli to their past experiences, and the result is they tend to react with rage when they feel their basic self worth is under attack.  People labelled Borderline  Personality Disorder frequently fall into this category, and can be a huge problem for therapists who do not understand their exquisite vulnerability to inadvertent slights that threaten these persons’ sense of  worth.  

Sometimes the person treated this way as a child became enraged, even throwing temper tantrums.  Or they expressed their anger less intensely, but were forbidden from doing so.  In many cases they were  shamed for showing any anger.   I have often found this in the history of clients whose childhoods sounded pretty benign.  It was only through therapeutic exploration that subtle shaming had actually occurred.  These are some of the people whose shame is most resistant to working through.    In all of these people, however, the result is shame and resultant rage reactions to incidents that trigger shame.   They  usually have no idea that their expressions of rage are the inevitable outcome of the subtle or obvious abuse they suffered as children at the hands of parental figures, siblings or other children.  And they frequently feel ashamed that they react with rage in certain situations and paradoxically try to avoid  any angry feelings at all.  This is  because they fear they will become enraged if they allow themselves free experiencing and expression of anger.   .  

As an example of someone who erupted in rage when feeling shame was a young man in therapy with me many years ago in Los Angeles.  He had been sentenced to jail a number of times in his young life because of physically acting out his rage and was mandated to enter psychotherapy and ended up with me.  He was intelligent and handsome and showed some promise as an actor.  He was given medication by a psychiatrist who thought that his rageful outbursts were the result of a head injury but had not explored his history.  I learned that he had grown up in a neighborhood that was controlled and terrorized by gangs.  He was picked on by other kids because he was small and scrawny as a pre-teen, leading to feelings of shame, weakness and helplessness each time this occurred.  But he was eventually befriended by a gang of older boys and men and later became a member himself.  He also grew stronger and over a period of time was involved in a number of illegal gang activities.  He  also became involved in fights with other young men.  His beating someone to a pulp who had taunted him is what occasioned his being referred to me for psychotherapy.   

We worked for several months on his current issues and unearthing his history.  I tried to help him see that his rageful behavior was a result of the humiliating feelings he experienced when he felt insulted as a child and felt no support by his family.   He seemed to be making some progress in understanding his dynamics until an incident at the acting school resulted in his being incarcerated again.  He was attracted to a young woman in the class.  During a lunch break outside with her and other students, she was sitting on a brick wall smoking a cigarette.  He approached her and made some positive comment to her,  perhaps asking her out on a date.  Whereupon she blew cigarette smoke in his face and made a dismissive remark.  His reaction was to punch her in the face, breaking her jaw.  He was sent back to jail and I never saw him again.  In retrospect, he didn’t seem to see that his physically pageful reactions were a problem, only that he got caught and had to go to jail.  

A positive outcome of therapy was my work with a middle-aged man who was an executive in an entertainment company.  He had been an alcoholic but had managed with the help of AA to stay sober for many years.   He entered therapy to work on painful issues he was having at work and in his  relationship with his girl friend.  She was a very attractive, very popular, assertive,  professionally successful woman who lived in another state and would come to visit him for extended periods of time.  She had a habit of being late for almost all events that were scheduled  to start at a specific time, e.g., movies, dinners at friends’ houses, even plane flights.   As they were driving late toward these  events, he would become aware of being frustrated and angry at her for their lateness.  If he expressed any displeasure toward her, she would respond very dismissively, ridiculing him for being “petty.” At this, he would often become enraged, pound the steering wheel, yell at her and start driving very erratically and at high speed.   She usually then responded even more critically towards him.  Despite his frustration with her,  he stayed in the relationship with her because he felt fortunate  that such an accomplished, attractive woman was romantically involved with him.  

We worked together for about two years and managed to trace back his rage to the constant humiliating comments his father had made to him as he was growing up.  The comments were subtle, but they always had a belittling quality to them.  His father still treated  him this way even though he was a successful, well-functioning adult.  His mother had died several years before and his father lived in another state.  He always felt anxious when he was ready to go visit him, anticipating being humiliated by his father.  He had not gotten to the point where he could ignore his father’s passive-aggressive way of treating him and still needed his approval.    Because his father had shamed him for expressing any anger when he was growing up, he had learned to retroflect (turn against himself) his anger, telling himself that his anger was stupid, that his father was an old, well-meaning  man and that his negative comments shouldn’t bother him.  

 He felt obligated to visit his father on occasion and wanted the visits to be  cordial since his father was becoming old and he wanted to enjoy his visits instead of being anxious and fearful.    But he always felt uncomfortable beforehand about visiting him.  Before one visit,  I suggested he try to keep track of the interactions with his father, what he said to him, how his father responded and what he felt in his body at these times.  I said that if the old patterns still occurred that was still useful, that we could learn more about  his relationship with his father.   And by re-experiencing those events with me, we could make  progress in working through his relationship with his father and also learn more about his rage.  

When he returned from one trip, he related to me the subtle put-downs his father was continually directing at him during the visit.  And he felt the humiliation and sense of worthlessness that got triggered in him each time this happened.  He began to slowly realize that the way his father treated him mirrored how his girl friend treated him, especially when he expressed annoyance toward her.  Through working through the feelings of humiliation, shame and helplessness with both his father and his girlfriend, he came to understand why he felt the way he did and to communicate without exploding to both these people the anger he felt toward them when they belittled him.  He learned more about his father’s past history and was no longer triggered when the latter made his belittling comments.  He also told him calmly what he felt when his father made those comments and, although his father at first belittled him for feeling that way, he told him that he didn’t like the comments and wanted him to stop making them.   His relationship with him improved and he was better able to enjoy his trips to see him.  His girlfriend did not change her behavior toward him,  he realized the relationship was no longer worthwhile and he soon ended it.  By the time he had terminated, he was no longer subject to rage reactions and had formed a relationship with a woman with whom he felt very compatible.  

In the next posting I shall discuss in detail one of the ways I work with clients who tend to become enraged when they experience shame.