Anger and depression co-occur about 50% of the time. By using hard logic to quell excess anger, you can protect yourself from resurgences of irrational fits of anger that can amplify, agitate and prolong depression. By asking and answering this question, you may get a clearer perspective on what is happening: When an anger evoking event is long past, what is likely to keep anger over that event, alive? Kingston, Ontario, Canada Psychologist Dr. Irwin Altrows gives his answer to the question and shows how to use rational emotive behavior therapy (REBT) to stop feeling so angry and lead a calmer life.
Sam was injured in a motor vehicle accident when a drunken driver unexpectedly slammed into his car. He suffered from multiple injuries and severe pain, and needed to take time off work. During the early phases of his recovery, he couldn’t get the accident out of his mind. He seethed about the event. He increasingly felt physically and emotionally worse.
When I first met Sam, he didn’t hold back about what he thought about the other driver. He told me “I’m furious with him for taking everything from me! It’s unfair that this happened to me.” Sam was obviously angry, and admitted to feeling depressed.
Sam’s response was predictable. In his suffering, he lashed out at the person whom he saw as the cause of his troubles. However, while he was sinking into deeper levels of negativity, his psychological condition worsened.
I listened to Sam and got to understand what the accident meant to him. I empathized with him. True, the accident was unfair, and the other driver was driving too fast while under the influence of alcohol. I recognized his severe injuries and severe pain. Sam knew that I understood to the best of my ability, and that I wanted to help him.
The ABC Method
Sam wasn’t going to get better without making some adjustments in his thinking. The ABC theory of Albert Ellis can help Sam rid himself of the double whammy effect, which is making a bad situation even worse.
Here’s the theory that I shared with Sam. Perhaps you will see a way to use Albert Ellis’ method when you are suffering from distress and want to stop feeling so badly.
1.There are aversive events in life (A) that are both sad and unfortunate, such as costly and painful auto accidents.
2. It isn’t so much the event that creates a persistently negative response, as much as what you Believe and tell yourself about the event. If you're stuck with seeing the event as highly unfortunate (a rational belief about a negative happening.), you’d understandably feel stress. In contrast, harmful irrational beliefs (B) are at the heart of emotional distress and dysfunctional behaviors. They add surplus meaning to the event. For example, if you repeatedly tell yourself that the other driver should suffer intensely, you may bring more suffering to yourself. Although you have a right to think this way, you also have a right to think in a way that brings you more peace.
3. In Sam's case, an emotional consequence (C) of Sam’s thinking is anger. His anger and his depression are intermingled, feeding each other.
How the ABCs Apply to Sam
Here is a brief segment where I show Sam how the ABCs might apply to him.
Dr. Altrows: “Sam, let’s look at A, the accident.”
Sam: “The sonofabitch T-boned my car and gave me pain. It shouldn’t have happened. He made me angry and depressed.”
Dr. Altrows: True, the other driver—or rather, his behaviour—caused this accident and this caused your injuries and pain. These events, taken together, are trouble enough for you.
Sam: Of course. So?
Dr. Altrows: Who needs more troubles, like anger, depression, and increased pain?
Sam: Not me. But, I didn’t ask for the anger and depression.
Dr. Altrows: True, but aren’t you giving yourself a double pain?
Sam: How’s that?
Dr. Altrows: The accident is your A. That is a highly unfortunate event. What you believe (B) about the drunken driver evokes the emotional consequence that you experienced at point C. For example, what you tell yourself at point B adds a layer of misery to an already bad situation. Blaming and condemning the other driver is a prescription for extra misery—for you.
Note: In an REBT session, a therapist will often provide educative information.
Dr. Altrows: What you believe about how you feel—especially about pain—can intensify what you don’t want to experience. Pain—real pain with a physical basis—is influenced by thoughts and emotions. Powerful negative emotions, such as a depressed mood and intense anger, can lead to increased pain. This is the research-supported gate control theory of pain. By tempering your thinking, you may take away surplus stresses that accentuate your pain.
Sam: “So when that sonofabitch T-boned me, the depression and anger that he gave me actually increase the pain he gave me?”
Dr. Altrows: You gave the anger to yourself. Neither you nor I can do anything about the accident or the inebriated state of the other driver. We can’t control the past. But, there is much that you can do in the present to help yourself develop a realistic perspective about the event, and to spare yourself from this double whammy effect.
A Gradual Awakening
Albert Ellis’ ABC theory shows how some of Sam’s deep-seated, fundamental beliefs—when activated by the accident and its sequelae—can lead to anger, depression and (as per the gate control theory) more pain. However, Sam didn’t buy into the ABC theory right away. Nevertheless, it made enough sense for him cautiously to try it.
Sam asked for some reasonable things: fairness, justice, and freedom from severe injury and pain. However, his problem is that he demands these reasonable things. When he doesn’t get them, he feels elevated levels of emotional distress. His transition point came when I presented a different way of looking at the power of thinking that is often attributed to Buddha: “Pain is inevitable, suffering is optional.”
We collaboratively identified Sam’s dysfunctional beliefs. The shoulds and musts that he placed on himself, others, and life, kept recurring. For example, he believed that the accident shouldn’t have happened, he shouldn’t be in pain, and he shouldn’t have to work to free himself from his mental pains over his physical pains. Sam gradually came to see that his shoulds and musts didn’t pass the reality test (because people and life are simply not totally fair according to his definition) or the utility test (because his negative thinking just made him feel worse).
Sam felt empowered. If he was smart enough to talk himself into anger and depression, perhaps (with some help from his clinicians and from Dr. Ellis’ theory) he could talk himself out of thinking in a self-destructive fashion. As he worked to develop new, realistic, and functional beliefs, Sam's anger abated. His depression lifted. He prepared himself to make the best of the rest of his life.
This blog is part of the Pioneer of the Mind series to celebrate the contributions of Albert Ellis, the founder of rational emotive behavioral therapy and the grandfather of cognitive-behavior therapy.
Albert Ellis Revisited (Carlson & Knaus 2013) is the Albert Ellis Tribute Book Series centennial book. The publisher, Routledge, offers a 20% discount on the book. Control click on this link: Albert Ellis Revisited. Type the code Ellis for the discount. The book qualifies for free shipping and handling. Bill Knaus’ royalties from this book go directly to the Denan Project charity. When you buy the book, you are helping yourself by learning ways to live life fully, and you are helping bring irrigation, crops, and health care to destitute areas of the world.
Special to this blog is A Blending of Emotions PhotoArt thumbnail image by Dale Jarvis, AreaOne Art & Design, Fayetteville, NC.
© Dr. Irwin Altrows, Adjunct Assistant Professor at the psychology and psychiatry departments of Queen's University and a psychologist in private practice at Kingston, Ontario, Canada.