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Personality Disorders and Anger

Introduction

Anger and personality disorder have one thing in common. People who suffer from either have no ability to empathize. When a person is angry, they defy empathy by developing severe anger. The person feels that the source of their anger is disparaging their suffering. Their anger, therefore, increases when the circumstances of their anger are brought to their attention. These same features are typical of personality disorder. Acute anger could therefore be used in place of personality disordered.

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Personality disorder and anger

Vaknin (1995) and Hall (2008) define personality disorder as a set of traits that work together to affect one’s life negatively. Vaknin goes on to say that there are many causes of personality disorders and that some of the disorders are easier to treat while others are not. Some of the recognized personality disorders include paranoid, schizotypical, antisocial, histrionic, schizoid, narcissistic, borderline, avoidant, obsessive, compulsive, and dependent.

A personality disorder consists of inflexible and maladaptive personality traits (Vaknin 1995). These traits get in the way of the daily functioning of an individual. It is also a way through which subjective unhappiness can affect an individual. Levin defines a personality disorder as long-standing means through which people cope with the world, personal as well as social relationships, getting a grip on stress and emotions among other things which often is not effective especially when the individual is under amplified stress or demands on their performance in their lives (Levin; Boeree).

Personality disorder has two sources. One is persistent and regular injustice while the other is a constant threat by internal and external factors. There are criteria that can be used to identify personality disorder (Boeree):

  • Patients have behavior that defies cultural expectations in areas that include emotion, cognition, impulse control, and social functioning.
  • Their problems are spread across a wide range of circumstances
  • They have significant trouble with their social lives
  • Their problems are persistent

According to Boeree, psychologists have divided personality disorders into clusters.

Cluster A

  1. Paranoid personality disorder- They have no trust in other people and are always suspicious of their motives
  2. Schizoid personality disorder-They detach from social relationships and restrict their expression of emotions in interpersonal settings
  3. Schizotypical personality disorder-Characterized by social and interpersonal deficits and acute discomfort. They stay away from social relationships and display cognitive distortions and peculiar behavior

Cluster B

  1. Antisocial personality disorder-They disregard and violate the rights of other people
  2. Borderline personality disorder- They show a pattern of instability in interpersonal relationships, self-image, and discernible impulsivity
  3. Histrionic personality disorder- These are excessively emotional and attention seekers
  4. Narcissistic personality disorder- Grandiosity, need for admiration and lack of empathy characterizes these people

Cluster C

  1. Avoidant personality disorder- Socially inhibitive, feeling of inadequacy and hypersensitive to negative criticism
  2. Dependent personality disorder- They have an excessive need to be taken care of and this often leads to submissiveness and clinging and fear of separation
  3. Obsessive-compulsive personality disorder- Preoccupied with order, perfection, and interpersonal as well as mental control. They are not flexible, open, and efficient

On the other hand, anger is Mills explains anger as a basic human condition which all people experience. Anger is often triggered by emotional hurt. Individuals experience anger, an unpleasant feeling when they think that they have been injured, mistreated, that their opinions which they have held on to for a long time have been rejected or opposed, or when there are obstacles, which stand in the way of achievement of a person’s personal goals (Mills). This experience varies depending on the circumstance. This means that the period of anger for one person is different from that for another person.

How often a person gets angry also differs from one person to the other, just like the intensity of anger in individuals. Mills notes also that some people tend to get angry more easily than others. This he calls the anger threshold. Others are comfortable with anger while others still feel angry more often. For some individuals, the feeling of anger is there but they are seldom aware of it. Others are very aware of the feeling.

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Anger is an experience we have daily. It is encountered in a number of situations in our daily activities. Anger that is short-lived and of low intensity could be of help to the person experiencing it. However, intense and persistent anger can be harmful and disruptive (Vaknin 1995). People with personality disorders are prone to anger. Nevertheless, this is suppressed most of the time. Other people’s anger is a transitory state.

One type of anger that a personality could suffer from is pathological anger. This is induced by external forces and is often directed at oneself. It originates from the inside. On the other hand, normal anger has links to other actions that concern the source. Pathological anger drives the patient to direct their anger at their lesser contacts or sulk, feel bored or even turn to drugs. When they can no longer hold it inside, they rage and later degrade themselves.

Dealing with personality disorders and anger for therapists

Doctors, as well as therapists, have a responsibility to know how to deal with conditions of personality disorder and anger. The therapist should show his stability to differ from the feeling of emotion and thinking in a client. Though therapists who deal with conditions like these are professionals in their field, some are often disgusted by their work as the work draws on several negative feelings from the professional. This happens because clients place heavy demands on the therapist which include constant signs of suicidal thoughts and behavior. Some even portray the possibility of self-mutilation. Therapists have difficulties working with these conditions (Levin).

For personality disorders and anger, psychotherapy comes in handy as the best treatment for the condition. However, prescribed medication helps to stabilize sudden changes in mood which are referred to as mood swings. Sometimes doctors prescribe too many drugs to people with this disorder that it becomes a matter of controversy.

Psychotherapy

This is a treatment of choice for both the client and the doctor which is aimed at helping people get over the problem. Medication is always good in helping the client get over some of the symptoms of the disorder. However, it can help a client learn new methods of coping and hence the need for psychological help. Psychotherapy helps to teach these coping methods. It is also a way through which a client can regulate their emotions and make important choices in their lives (Levin).

The beginning of psychotherapy is supposed to help a client get over thoughts of suicide. Therapists have a duty over their clients to ensure that suicidal thoughts throughout the treatment process are carefully assessed and that the client is monitored. They should also be the people to consider medication or even hospitalization if it seems that the suicidal thoughts in a client are severe (Hall 2008; Sweeny 2009).

Hospitalization

Patients suffering from personality disorder often find it an issue being hospitalized as they are often visiting the emergence room or in the inpatient for reasons of severe depression. The emergency room serves as a source of crisis intervention. The patients with this condition are a problem in the community and at the local health care center. The emergency room is a costly treatment. Visits to the emergency room are also not very advisable. Therapists should encourage social support within the community or contact the therapist. In case of need for immediate treatment, attendants in the emergency room should contact the regular physician first.

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The care facilities at the hospital should be designed to take care of the needs of the patient. They should seek to enlarge the independence of the patient. Hospitalization should help to decrease acting out and identify working with any observable inappropriate behavior as well as feelings which the clinician feels are out of the ordinary. The patient should be helped to accept the enormity of the task involved in correcting their condition. Therapists should also aim at encouraging more effective interpersonal relationships besides real and assumed relationships at the hospital.

Medication

There are specific medications to get rid of the condition entirely. However, some medications may alleviate some of the symptoms or associated disorders like anxiety, depression, and psychotic symptoms (Long). Low doses of high potency neuroleptics are said to be of help in taking care of disorganized thinking while depression might not take to this. These drugs are recommended for psychotic symptoms. Antidepressants are also helpful at particular stages of the treatment process. They are for instance good for a prescription to a patient who shows signs of suicidal thoughts. However, some situations are temporary and therefore medication should be avoided.

Self-help

This is often an area that is not considered by therapists and yet could be of great assistance to the patient. Few professionals are involved in the process. The patient should be encouraged to seek social support from the community. Social groups help to overcome whatever personality disorder one is suffering. Individuals are able to share their problems and experiences. The clients can be encouraged to learn cope methods from each other in the social groups so that they are able to cope well on their own. Exercise is a good way to release anger and regulate emotional mood swings (Bloomgarden & Mennuti 2009).

Marsha Linehan’s Dialectical Behavior Therapy

Levin suggests that Marsha Linehan’s Dialectical Behavior Therapy is the most successful approach to psychotherapy. He says that according to research, the method is the most effective in assisting people with the disorder to cope. The approach helps patients to learn how to take control over their lives, emotions and their bodies This is done through cognitive reformation, knowledge and regulation of emotions. The approach is often conducted in group settings and is recommended for people who learn new concepts easily.

Since personality disorders are ancient ways through which people cope with world, personal relationships and social relationships, handling stress and emotions among other things, which more often than not are not effective, treatment is likely also to take a long time (Levin).

Levin suggests other methods of dealing with the disorder. He says that some of the methods concentrate on social learning theory and conflict resolution. He says this method is not effective since they are solution-based and ignore the main problem that a client might be having. The main problem which therapists should deal with is the difficulty in expression of apt emotions.

Physiology of anger

Mills writes on physiology of anger and asserts that anger is an emotional process experienced in our minds and in our bodies. He says that there are several physiological occurrences in our bodies when we become angry. Emotions begin in the amygdale which is a part of the brain responsible for recognize threats and sending out alarm. The amygdale leads us to react before the cortex checks the reasonableness of the reaction. However, instead of reacting before thinking about the appropriateness, we are able to control aggressive impulses. We should learn to manage anger.

Anger makes the muscles tense up. Chemicals in the brain are released and make one experience a burst of energy for some moments. This is the energy that makes one want to take immediate protective action. The heart accelerates and blood pressure rises. Breathing rate increases. All attention is directed to the object of anger and one is ready to react. The prefrontal cortex of the brain is supposed to check emotional outbursts (Mills).

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Challenges in therapy

Often, clients tend to test the limits of the doctor with whom they are working. A therapist therefore has to set the boundaries of the relationship they have with their patients and this should be explained to the client at the beginning of therapy. In addition, a clinician may show their emotions during therapy. Therapists should deviate from showing emotions that are not appropriate. There is also a tendency to discriminate against individuals with borderline personality disorder as they are thought to be troublesome. This is a result of their disorder and they need slightly more care than the other patients. Therapy is aimed at life gains for patients towards functioning independently but not the complete restructuring of the individual (Levin).

Conclusion

Personality disorder and anger alienates friends, family and workmates. It could also lead to health complications and even early mortality. It increases one’s risk for early death besides social isolation. Learning to manage anger is therefore a good idea. Therapists are the vehicle through which this can be achieved effectively.

Reference:

Bloomgarden, A. & Mennuti, R.B. (eds). 2009. Psychotherapist revealedTherapists speak about self-disclosure in psychotherapy, Routledge Boeree, G.C. Personality disorders. Web.

Hall, Sue. 2008. Anger rage and relationship: An empathic approach to anger management, Routledge Levin, Cynthia. Borderline Personality disorder treatment.

Mills, Harry. Physiology of anger. Web.

Neenan, M. & Dryden, W. 2004. Cognitive therapy: 100 key points and techniques, Oxford University Press.

Sweeny, T. J. 2009. Adlerian counseling and psychotherapy: A practitioner’s approach, fifth edition, Routledge.

Vaknin, Sam. 1995. Rage and Anger – The iron mask: The common sources of Personality Disorders In Kassinove, Howard. Anger disorders: definition, diagnosis, and treatment, Taylor and Francis Publishers.

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