Part 3: managing anger

This section aims to help you understand:

•   How anger affects you and your pain

•   How chronic pain and anger are linked

•   How being angry can affect other people

•   How to manage anger better

How anger affects you and your pain

Anger, frustration and irritation are common feelings when you have chronic pain. People have different ways of showing, or hiding, their anger. People with pain, who used to see themselves as ‘easy-going’, may find that they have a shorter fuse. Other people who have always had a temper may find that it flares up more easily and more frequently when they are in pain, especially when the pain is persistant.

However, anger is not a problem for everyone. Some people find that they are happy with the way they express anger. Others find that they do not get angry very easily. If you think that anger is unhelpful, especially in the way you manage your pain, this section may help. You may also find it useful to look back at the ‘Challenging unhelpful thoughts’ section in Part 1 (‘Managing Depression’) and Part 2 (‘Managing Anxiety’).

This section discusses how anger happens, and how it can be expressed in a ‘healthy’ way. It also offers advice on what to do if you think you need to deal with your anger differently.

WHAT FACTORS MAKE YOU ANGRY OR FRUSTRATED?

Several of these factors may affect your moods in other ways apart from anger and frustration.

Tick any factors that are important for you:

   Relationship issues or problems

   Work or home stresses

   Life events, e.g. job change, divorce, moving house, family illness

   Managing bills and budgeting; debt problems

   Unhelpful behaviors, e.g. drinking too much alcohol, using drugs like cannabis or heroin

   Changes in how you think, e.g. becoming extreme and negative (‘all or nothing’) in your thinking.

   Frustration about reduced levels of physical activity

   Not being able to keep up with demands placed on you, by yourself or by other people

   Losses in your life, e.g. job loss, loss of fitness and good health, loss of confidence, loss of plans for the future

   Lack of sleep

   Tiredness, low energy levels

   Side-effects of medicines

WHAT ARE THE EFFECTS OF ANGER ON YOURSELF AND YOUR PAIN?

The person-centred model in the mind map on p. 233 shows how anger can affect the five parts of a person.

Think back to the last time you felt angry. Then circle any parts of the map that match your own experience of the effects of anger.

Case history: Steve’s angry moods

Steve was very irritable, especially on bad pain days when he was stuck in the house. He found himself thinking about how unfair it was that he could not cycle, go to work and had to take so many tablets. He had been much angrier ever since the accident, which was mainly the other driver’s fault. He was not awarded compensation for the back pain. This was because of an earlier episode of back pain, two years before the accident. He thinks a lot about his problems, especially when the pain is bad.

Steve had realized several issues about his anger:

Nicole had told him for several months that he kept

shouting at her and was more irritable.

He had yelled at his doctor’s staff when there was a mix-up with his drug prescription.

On one occasion he had thrown his teacup against the lounge wall, as he could not find the remote control for the television.

He got very wound up if he was kept waiting when out at the shops or at health centres.

He was often worse after he had been drinking beer to ease the pain.

HOW DO YOUR THOUGHTS OR BELIEFS AFFECT THE WAY YOU EXPRESS ANGER?

When you have chronic pain, the beliefs you have about yourself, other people and your life may not make sense any more. The model on page 234 shows the effects of anger on Steve, especially his thoughts and behaviors.