Disproportionate anger

A third way in which anger can become disordered is when individuals experience and express anger in ways entirely out of proportion to the precipitating circumstances. In these scenarios, the fact that anger is an appropriate reaction to the precipitating events and interpretations is not in question; what seems disordered is the extent and force of the individual's anger reactions. In the American television series, and later Hollywood movie directed by Ang Lee, The Incredible Hulk, the mild-mannered Bruce Banner, often warned his would-be protagonists: "Don't make me angry, you won't like me when I'm angry." Those who foolishly ignored this warning then had to deal with a raging, towering green monster who was prepared to tear them limb from limb. While this is clearly an extreme example, we all know individuals with whom we feel the need to tip-toe around their sensibilities in the fear that the slightest provocation will elicit Hulk-like behaviour. Some have argued that "anger attacks"—extreme examples of the inability to control one's anger—may represent a discrete clinical syndrome (e.g., Fava, Anderson, & Rosenbaum, 1993) or be a variant of bipolar disorder if there is also a history of depression (e.g., Franco, 2003). Whether or not one agrees with this proposal, there is a widespread consensus that inability to control one's anger frequently presents as a problem at the clinic (e.g., Novaco, 1979) and this has led to the development of systematic therapeutic procedures to encourage anger control (see Del Vecchio & O'Leary, 2004).

As we have noted, the principal problem with disproportionate, uncontrollable anger lies in the related action potentials to retaliate and aggress. A famous example from the Maudsley Hospital in London, which was the subject of a television documentary, illustrates this point:

John [real name changed] was a man with a violent history. He had several criminal convictions for bodily harm and can recount times when he has nearly killed people in uncontrollable rages. At the time that John came into contact with mental health services he would only rarely leave his home and then he would be accompanied by several bodyguards—not to protect him from others, but to protect others from him.

In cases such as John's it seems clear that there are few holds on the full-blown expression of anger. Such behaviour seems most likely to be the result of a troubled, violent development in which anger and aggression are socialised as appropriate and acceptable responses to events, or can reflect the loss of inhibitory control from neurological damage if it appears later in life (e.g., Blair et al., 2005).

Clearly, the problems of anger and aggression are not merely interpersonal ones. At social and cultural levels they lead to large-scale war and violence. An excellent discussion of these issues is provided by Anthony Storr (1988), aspects of which we refer to above and in Chapter 1.

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