Anger Management

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anger is a normal human emotion that would handle appropriately and expressed assertively can provide an individual with a positive force to solve problems and make decisions concerning life situations.

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Anger becomes a problem when it is not expressed or when it's expressed aggressively. Violence occurs when individuals lose control of their anger. anger is an emotional state that varies in intensity from mild irritation to intense fury and range anger is accompanied by physiological and biological changes such as an increase in heart rate, blood pressure, and levels of energy hormones adrenaline and noradrenaline.

anger is normal healthy emotion that serves as a warning signal alerts us to potential threat or trauma.

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Anger continuum

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Anger is not a primary emotion, but it is typically experienced as an almost automatic inner response to hurt, frustration, or fear. anger is physiological arousal and instills feelings of power and generates preparedness. Anger and aggression are significantly different. The expression of anger is learned. The expression of anger can come under personal control.

anger becomes a problem when it is not expressed for example it can cause headaches, ulcers, colitis and even coronary heart disease. It can interfere with relationships. Inger creates a state of preparedness by arousing the sympathetic nervous system. which increases heart rate and blood pressure and secretion of epinephrine and increased glucose. The term anger often takes on a negative because of its link with aggression. Aggression is one way individuals Express anger it is sometimes used to try to force someone into compliance with the aggressors wishes but another time so the only objective seems to be the infliction of punishment and pain. In virtually all instances aggression is a negative function or destructive use of anger.

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Anger continued

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role modeling is one of the strongest forms of learning. Children model their behavior at a very early age after their primary caregiver is usually parents. how the parents Express anger becomes the child's method of anger expression. Whether role modeling is positive or negative depends on the behavior of the models. Much has been written about the bees child becoming physically abusive as an adult for example.

operant conditioning occurs when a specific behavior is reinforced. A positive reinforcement is a response specific behavior that is pleasurable or offers a reward. And negative reinforcement is a response to specific behavior that prevents an undesirable result from occurring. Anger can be learned through operant conditioning for example when a child wants something and has been told no by a parent they might have a temper tantrum. The parent then gives the child an ice cream cone the anger displayed during the temper tantrum has been positively reinforced. an example of learning by negative reinforcement follows.... a mother ask the child to pick up her toys and the child becomes angry and has a temper tantrum if, when the temper tantrum begins, the mother thinks, oh it's not worth all of this and picks up the toys herself the anger has been negatively reinforced the child was rewarded by not having to pick up the toys.

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Social economic factors

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high rates of violence exists within the subculture of poverty. Exposure to violence has been identified as having an impact on future tendencies toward aggression. Does violence occur because individuals perceive themselves as disadvantaged where does the violence occur because of the deprivation itself

Environmental factors... 3 environmental factors have been shown to increase risk for aggression which are crowding, temperature, and noise. All three of these environmental factors increase stress which has a multitude of effects on mood and behavior. 3 best predictors of violent behavior or alcohol intake, a history of childhood abuse, and a history of violent acts with criminal activity or rest. numerous other substances of abuse have been associated with aggression including cocaine, methamphetamines and amphetamines, bath salts, steroids, synthetic marijuana, PCP.

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The nursing process

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Assessment... Anger is often manifested in the following ways... frowning facial expression, clenched fists, low-pitched verbalizations Force through clenched teeth, yelling and shouting, intense eye contact or avoidance of eye contact, hypersensitivity easily offended, defense response to criticism, passive aggressive behaviors, why have control or controlled emotions, intense discomfort, continuous state of tension, flushed face, anxious tense angry facial expression.

anger is often described as a secondary emotion. For example it might be response to unresolved grief, depression, fear, anxiety, or unresolved post-traumatic stress. Ingersoll someone of the normal stages of the grief process because it's an expected emotion. some clients will not acknowledge that they are feeling angry because the word anger has a stereotypical negative connection. is important to explain to the patient that anger is a perfectly acceptable emotion it is not acceptable when aggression is involved

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Aggression

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Can arise my number of feeling States including anger, anxiety, guilt, frustration, or suspiciousness. Aggressive behaviors can be classified as mild such a sarcasm moderate such a slamming doors and severe such as threats of physical violence against others, or extreme which is physical acts of violence against others. Aggression may be associated with the following defining characteristics... Pacing, restlessness. Threatening body language. Verbal or physical threats. Loud voice shouting use of obscenities argumentative. Threats of homicide or suicide. Increase in agitation with Over reaction to environmental stimuli. Panic anxiety leading to miss interpretation of the environment. Suspiciousness and defensive posture. Angry mood often disproportionate to the situation. Destruction of property. Acts of physical harm toward another person.

Aggression is often differentiated as reactive vs. Proactive. reactive aggression is defined as fear-based and impulsive proactive aggression is defined as predatory and calculated. In both cases there is intent to harm another but the motives differ. Accidents that lead to unintentional harm or destruction are not considered aggression

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Assessing risk factors

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Prevention is the key issue and managing aggressive or violent behavior. The individual who becomes violent usually feels and underlying helplessness. The following three factors have been identified as important considerations in assessing for potential violence... past history of violence, client diagnosis, current behavior. diagnosis such as schizophrenia, major depression, bipolar disorder and substance use disorders have a strong correlation with violent behavior. In prodramal syndrome is characterized by anxiety and tension, verbal abuse and profanity, and increasing hyperactivity are escalating behaviors

Most assaultive behaviors is preceded by a. Of increasing hyperactivity. Behaviors associated with prodromal stage include rigid posture, clenched fists, defiant affect, talking in a rapid raised voice, arguing and demanding, using profanity and threatening verbalizations, agitation and pacing, and pounding and slamming are considered emergent and demand immediate attention.

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Diagnosis

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ineffective coping related to negative role modeling and dysfunctional family system evidence by yelling, name-calling, hitting others, and temper tantrums as expressions of anger. Risk for self-directed or other directed violence related to having been nurtured in an atmosphere of violence, history of violence

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Outcome

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is able to recognize when they are angry and seeks out staff support person to talk about their feelings, is able to take responsibility for own feelings of anger, demonstrates the ability to exert an internal control over feelings of anger, is able to defuse anger before losing control, uses the tension generated by anger in a constructive manner, does not cause harm to self or others, is able to use steps of problem solving processes rather than becoming violent as means of seeking solutions.

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Nursing interventions

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Remain calm when dealing with an angry client, set verbal limits on behavior clearly Express the consequences of an appropriate expression of anger and always follow through. Have client keep a diary of angry thoughts and feelings what triggered them and how they were handled. Avoid touching clients when they become angry. help client determine the true source of anger. Help the client find alternative ways of releasing tension such as visible outlets and where appropriate ways of expressing anger such as seeking out staff when feelings emerge. Role model appropriate ways of expressing anger assertively such as I dislike being called names I get angry when I hear you saying those things about me

observed client for escalation of anger call the prodromal syndrome which is increased motor activity, pounding, slamming, tens posture, define affect, clenched teeth and fist, arguing, demanding, and challenging or threatening staff. when these behaviors are observed first ensure that sufficient staff are available to help the potentially violent situation. Attempt to defuse the anger beginning with the least restrictive means. Techniques for dealing with aggression such as talking down for example Johnny seem very angry let's sit down and talk about it. another example of a technique is physical outlets such as exercise, using a punching bag, or engaging another activity that provides an acceptable outlet for energy offered to stay with the client during this activity. Medication is another technique call for assistance and remove self and other clients from the immediate area called violence code push panic button call for assault team. Seclusion and restraint if a coin is not calmed by any other methods. ongoing assessment as education decreases it says client's readiness for restraint removal reduction. To briefing is important when a client loses control for staff to follow up with discussion about the situation this discussion should occur among staff and the client when the client has regained control the staff should discuss factors that necessitate of the crisis intervention factors that contributed to the failure of less restrictive interventions and staffs thoughts about the safety and effectiveness of the intervention. when the client has regained control at the briefing should occur and which client is encouraged to discuss thoughts about the contributed to the crisis situation and about staff interventions and export strategies to avert a crisis situation the future