Anger Management

A Summary of Stress Inoculation for Anger

Anger Photo courtesy of CTRI [Crisis & Trauma Resource Institute]Opens in new window

Anger is one of our most familiar emotions. Although anger has the potential to be constructive, motivating us to stand up for ourselves or for others, sometimes anger can become toxic. Thus it is necessary to learn how to control this emotion.

A classic text on anger and anger management was published in 1975 and authored by psychologist Raymond Novaco. He described stress inoculation training, which is also used for management of anxiety and related conditions, as a method for managing anger.

Stress inoculation training for anger involves five main steps.

Step #1

Step one is learning how to relax with deep relaxation techniques. Examples of recommended strategies are progressive muscle relaxationOpens in new window, in which one progressively tenses and relaxes muscle groups throughout the body, and visualization of a special place in which you can relax (e.g., the beach, the woods, on top of a mountain).

For stress inoculation to be effective, it is important that one master these relaxation techniques. For instance, in visualizing one’s special place, one should be able to conjure it up rapidly in a stressful situation and thereby reduce one’s stress. Mastery may take a few weeks.

Step #2

Step two is developing an anger hierarchy. The individual with the anger issue is instructed to write down at least 25 or 30 anger-inducing situations on a piece of paper.

She next gets out a new piece of paper, selects the least anger-inducing and the most anger-inducing situations on the list, and places them at the top and bottom, respectively, of a new list. She chooses between 6 and 18 of the other items to place between these 2 so that an anger hierarchy with approximately equal anger increments between each item is created.

Step #3

Step three involves producing stress-coping thoughts for anger. According to McKay (1992), two types of thoughts tend to trigger anger: should statements and blaming statements. Should statements are based in the notion that someone else has done something wrong or has violated rules or norms. Usually, the person who is angry or somebody who she cares about was on the receiving end of the wrong act.

  • One problem with this assumption is that people often disagree about what is appropriate, correct, or fair.
  • A second problem, according to McKay, is that people often do what is right for them—what is in their self-interest—rather than what they should do.

McKay suggests a number of statements one could say to oneself to cope with this idea of should, for instance, “My desire doesn’t obligate you to meet it,” “People are doing what they want to do, nor what I think they should do,” “I may not like it, but they’re doing the best they can,” “Nobody is right and nobody is wrong; we just have different needs,” and “People only change when they want to.”

Blaming statements may also lead to anger. When a person produces blaming statements, s/he believes that the pain or frustration s/he is feeling is caused by someone else. Also, s/he may believe that the other person is malicious, hurting her or him on purpose.

Some examples of coping statements to deal with blaming include the following: “Blaming just upsets me; it doesn’t solve the problem,” “They’re not out to get me; they’re just pursuing their self-interests,” and “This is not personal.”

Step three is an important part of stress inoculation, which must be personally tailored. Davis, Eshelman, and McKay (2008) provide many examples of possible coping statements and more detail about how to create personalized coping statements and what to do with them.

Step #4

Step four involves putting together the skills developed in steps one through three and using them in one’s imagination.

  • First, the individual uses relaxation techniques, such as progressive muscle relaxation or imagery or both, for 10 to 15 minutes.
  • Second, she selects the first item on the anger hierarchy (least anger inducing) and vividly visualizes the stressor. All of the senses should be actively engaged to feel like one is in the situation, intensely feeling the wrongness and unfairness. Both psychological and physical tension should result.
  • Third, the individual practices coping by inducing the self-relaxation (e.g., imaging the special place) and repeating coping thoughts while continuing to imagine the anger-inducing situation. This should be done for at least a minute.
  • Fourth, the individual rates anger level on a scale of 0 (no anger) to 10 (extremely intense anger). If the rating is 2 or above, the same situation should be repeated (imagining least anger-inducing item, etc.), this time trying different coping statements to relax. If it is one or zero, the individual may continue to the next event on the anger hierarchy and repeat the process. Eventually, all anger-inducing events on the hierarchy can be managed in one’s imagination.

Step #5

Step five involves using coping skills in real-life situations. In some cases, it is possible to anticipate a situation that could make one angry or frustrated. For example, an individual may intend to ask her boss with whom she has sometimes had interpersonal difficulty for a raise.

Coping statements could be prepared in advance. Before meeting with the boss, the individual could engage in a relaxation technique and repeat coping statements to herself. If spontaneous anger-inducing situations occur, the individual is now better able to handle them (it is hoped).

The preceding description is a summary of stress inoculation for anger. Several excellent books provide more detailed instruction, including Davis, Eshelman, and McKay’s (2008) The Relaxation and Stress Reduction Workbook and McKay, Davis and Fanning’s (2007) Thoughts & Feelings: Taking Control of Your Moods & Your Life.

Research has indicated that stress inoculation can be effective for decreasing anger. For instance, in a review of research, Sprague and Thyer (2003) reported that stress inoculation is helpful for treating children and adolescents with a disorder that involves anger as a primary symptom: oppositional defiant disorder.

See also:
  1. Davis, M., Eshelman, E.R., & McKay, M. (2008). The relaxation and stress reduction workbook (6th ed.). Oakland, CA: New Harbinger.
  2. McKay, M. (1992). Anger control groups. In M. McKay & K. Paleg (Eds.). Focal group psychotherapy (pp. 163 – 194). Oakland, CA: New Harbinger.
  3. McKay, M., Davis, M., & Fanning, P. (2007). Thoughts & feelings: Taking control of your moods & your life. Oakland, CA: New Harbinger.
  4. Novaco, R. (1975). Anger control: The development and evaluation of an experimental treatment. Lexington, MA: D.C. Health.
  5. Sprague, A., & Thyer, B. (2003). Psychosocial treatment of oppositional defiant disorder: A review of empirical outcome studies. Social Work in Mental Health 1, 63 – 72.