Dr. Doug Berger, a psychiatrist in Tokyo Japan discusses anger and anger management for us.

1. How large of a role does stress play in anger?

We could look at anger as a so-called, “stress-diathesis model” wherein persons have differing levels of tolerance or a threshold to where they will feel but not show, or feel and then show anger to others. Diathesis means the predisposition or sensitivity someone may have to a certain feeling state or behavior. So, depending on the type of stress, and the intensity of the stress, some persons may be prone to feel and/or exhibit angry feelings. Regarding the type of stress, someone may for example get angry when they are ignored, but not when they are criticized or vice-versa. It all depends on the mix of an individual’s psychological issues and how they are wired neurologically.

2. Is society angrier than it used to be?

I can only really answer this regarding the two countries I am familiar with, Japan and the United States. Japanese society in general is not outwardly an angry country like the U.S. There are of course angry individuals anywhere, and certain groups with a specific political agenda, that are and have been angry for a long time. There is also considerable discrimination against non-Japanese but this has not led to many protests or incidents, is tolerated as “matter-of-fact” by the Japanese population, and the non-Japanese population as a whole seems to quietly accept and/or not fully understand the situation for various reasons perhaps too complex to discuss in this forum.

Regarding the U.S., specific social changes and demographics can inflame resentments and anger segments of the population. Lately racial tensions are at the forefront, however, each generation has its own memory and it can be easy to forget that tensions and anger were also very high during the civil rights era and other times past. The advent of radio, TV, and now the internet and mobile social media has allowed the fire of resent and anger to spread quickly through the population. I am not sure this means that society is inherently angrier than it used to be, although the spread of firearms in the population has probably led to an ease of expressing anger in a larger proportion of the population and in more dramatic ways.


3. What is the difference between mild anger and serious anger management issues?

The outcome of a serious instance of anger may be to become more aggressive, but the underlying reasons may be the same whether mild or serious. Besides the social issues discussed above, personal social stress can also lead to anger. Work stress and relationship stress are the most common causes. Resentment in these and other social situations are a common cause of angry feelings. Certain psychiatric conditions may also show irritability and anger as an expression of this irritability. Hyperactivity disorder, depression, manic or hypomanic states, certain personality tendencies, and drug use and withdrawal can show irritability.

4. How does one combat, alleviate anger in adults? In children and adolescents?

This naturally depends on the cause. Removing a specific stressor or conclusion of a stressful social situation can alleviate anger in any age group. If one suffers from a psychiatric condition such as those described above than specific treatment targeted at that condition is necessary. This may mean psychotherapy, medication, social environment changes, or some combination of these. We should not conclude that it is just “normal” for young persons to be angry in a persistent or intense manner.

5. Anger is often a sign of deeper problems can you explain how anger manifests in relation to mental illness, physical illness and situational stress?

In addition to mental illness and the situational issues covered above, persons with physical illness are also prone to become angry. Failure of medical care to alleviate pain and suffering, frustration with serious illness, medication side-effects, and family/caretaker stress are all common reasons for persons with physical illness to become angry. In addition, patients may become angry if a clinic or hospital is not run well or if the “bedside manner” of the medical staff is curt, rude, or negligent in some way.

There is no specific way to provide “anger management” in a “one size fits all” method. First the causality should be delineated, and then specific counseling, psychotherapeutic, family intervention, treatment of substance abuse, and care for psychiatric or medical conditions can be initiated as appropriate.

Read more on Dr. Doug Berger‘s comments as it relates to anger management here: http://www.megurocounseling.com/TF/2016/Feb_2016.pdf