Anger Management: 10 Session Cognitive Behavioral Therapy Protocol

Anger Management: 10 Session Cognitive Behavioral Therapy Protocol

hey there everybody and welcome to this 
counseling continuing education presentation   on a 10 session anger management 
protocol i’m your host dr donnelly snipes in this presentation you’re going to learn 
about anger and his functions explore early   warning signs figure out how to develop an anger 
control plan learn about the aggression cycle and how to change it review the abcdes and explore how 
prior learning influences current anger triggers session one in session one you’re 
going to learn about anger anger is an emotion triggered by a threat that 
prompts the fight or flight reaction this is what we call the hpa axis or what i call 
the threat response system and when this happens your body dumps adrenaline it dumps cortisol it 
dumps glutamate it dumps all these chemicals and hormones that are designed to give you the energy 
to check out if there’s a problem and if necessary fight or flee just like a smoke alarm 
tells you that hey there might be a fire your threat response system tells you hey there 
might be a threat it’s not saying there is it’s saying there might be and here’s a bunch of energy 
so you can get up and figure out if there is a threat and respond if needed hostility refers 
to a set of attitudes thoughts and judgments that motivate aggressive behaviors aggression is 
a behavior that’s intended to protect oneself by causing harm or energy to another person or damage 
to property what’s the benefit of aggression well if we’re feeling threatened and we want to 
fight or flee and in this case fight then the goal is to regain control to regain power in the 
situation so aggression serves to forcibly take back power many times what we initially 
perceive as a threat is actually not currently one but our reaction is based on outdated schema 
and schema are our brains cliffs notes if you will every time we have an experience our brain notes 
what happened you know just very short quick little uh summaries of what happened and that 
helps us predict the future we have schemas about going to work we have schemas about stoplights 
we have schemas about going to the doctor that way when we are getting ready to encounter 
one of those situations we know what to expect and our brain tells us okay been 
here done that this is what we expect   unfortunately schema are only based on prior 
experiences so if this experience is different the schema is not going to be effective it’s not going 
to work for you and that can cause you problems the cognitive triangle is a concept that 
we use in cognitive behavioral therapy that points out that our thoughts feelings 
and behaviors are all interrelated if you’re having angry thoughts you’re probably going 
to respond with irritability and you may have obviously feelings of anger if you are 
having feelings of anger or anxiety then you’re probably going to have thoughts 
that support that you’re going to be telling yourself that there’s a threat of some sort 
and you’re going to respond accordingly inaccurate schema and 
misperceptions are very common and the reason we have them is because 
as i said the brain does not integrate often the present moment it just kind 
of goes on autopilot going okay been here done that this is what to expect we need to actually 
disengage from our autopilot and recognize what’s going on in the present moment and evaluate 
whether the schema are accurate or not i already talked about the fire alarm when 
the fire alarm goes off it doesn’t always mean there’s a fire it means there might be someone 
not returning a text is another thing that triggers anger in people sometimes because they 
may feel that the person is being disrespectful or rude or rejecting them in some way we don’t 
know though we’re assuming and assuming as they say makes an ass out of you and me because 
we don’t have the facts in the current context my dog brewster was a foster dog and i have no 
idea what happened to him before he came to us but there was one day that my 
son and his best friend were out   practicing martial arts in the yard and brewster 
saw them and he didn’t realize that they were playing i mean they were practicing martial 
arts they weren’t actually attacking each other   aggressively and but brewster didn’t understand 
that so he formed a schema about elias that said this this dude’s no good and it took multiple 
exposures of brewster to elias and sean uh after that for brewster’s schema his understanding 
of the situation to change um it literally months before elias could come in and brewster wouldn’t 
get his hackles all up on his back if somebody has a history of abandonment then when they experience 
similar situations whether it’s the way somebody acts or the way somebody talks to them or even 
different microaggressions they may interpret as uh that they’re getting ready to be abandoned 
and it can trigger feelings of anger people who’ve been victims of crime and i use crime very broadly 
here when people experience trauma it strips their sense of safety and personal power or control so 
in the future when they feel like they are not in control of things when they feel like they 
are lacking power or they’re unsafe in some way it will trigger anger a lot more intensely because 
they’re reacting from oftentimes from that place in the past when they were victims and 
so they’re trying not to be one again anger initially has apparent payoffs like 
releasing tension controlling people getting   your own way but in the long term these 
payoffs often lead to negative consequences what benefits or payoffs does anger have for 
you now we don’t do things unless there’s a benefit so it’s important to recognize what 
benefits anger has in order to figure out is this a benefit that i need or that 
i want or that i want to get this way and is there another way of getting that benefit 
such as feeling safe is there another way to feel safe besides having to be angry 
and aggressive all the time when you get angry what are your responses what 
behaviors do you use what thoughts do you have what feelings do you have sometimes a lot of times 
people when they get angry underneath there’s also a feeling of anxiety or hopelessness and and 
the anger is protecting them from those fears anger is a natural normal emotion that’s designed 
to help us survive it becomes a problem when it’s felt too intensely too frequently or expressed 
inappropriately think about how anger affects you remember i said anger indicates that our 
threat response system has been triggered so our bodies dumping cortisol and adrenaline 
and all these stimulants into our system when we’re angry and we have these stimulants 
circulating through our system it’s going to   make it darn near impossible to get good quality 
sleep it can increase pain not only because of the muscle tension that we have when we’re angry 
but also because it alters our neurochemicals that are responsible for our pain threshold 
and we actually may start feeling more pain our gastrointestinal system can get disrupted when 
you are in fight-or-flea mode your body is saying yeah not going to devote energy to digestion 
so let’s just clear everything out of there additionally the stress response when it goes on 
for too long will impair immunity and it can also trigger auto autoimmune disease flare-ups 
uh crohn’s disease those sorts of things affectively or emotionally after people have an 
anger outburst they may also end up feeling regret or guilt or even helplessness because they’re 
trying to control their anger but they can’t   figure out how to actually do it cognitively when 
your brain is flooded with all those stimulating neurochemicals and you’re in fight-or-flea mode 
you’re not using your higher order thinking your prefrontal cortex you are in a very primitive 
reactive state lynehan talks about that as the emotional mind and in order to make effective 
decisions and respond in a different way it’s important to get into your wise mind which means 
de-escalating until you can think more clearly additionally when you are revved up when you 
are angry when you’re in an unpleasant mood you’re gonna notice the threats in the environment   and the negative things a lot more easily 
then you’re gonna notice anything positive i mean think about when you’re in a bad mood 
do you notice the birds and the little bunny   rabbits and the things that would make you smile 
or do you tend to just notice all the stuff that supports your current mood environmentally 
when people are angry you know how what how does it affect your environment do you break 
stuff put holes in walls throw out things   impulsively i remember back before computers we 
used to have pictures and it wasn’t it uncommon for people to tear up pictures impulsively 
when they got mad and then regret it later relationally when somebody is angry it creates 
an environment where other people may fear being around them they’re walking on eggshells because 
they don’t want to trigger this person’s anger so instead of being a relationship that’s 
based on respect and desire to support one another it’s a relationship based on fear 
where that person is just trying to keep you from exploding and this can negatively 
impact relationships for obvious reasons changing how you respond to anger triggers   takes a lot of work and energy and it’s important 
to figure out why do i really want to do this define your rich and meaningful life you know 
if you woke up tomorrow and you had this rich and meaningful life what people would be in 
it what would those relationships be like what things would you have what experiences or 
activities would you be using your energy for every time you get anger angry it uses your 
energy so you’ve got to decide do i want to use my energy for being angry about 
this or do i you want to use my energy to work towards something that’s important in my 
life and you may find a lot of people find that they waste a lot of energy being 
angry and nurturing grudges   when they could use it instead to nurture and 
enhance positive things in their life how does anger keep you from moving toward the 
things that are important in your rich and   meaningful life and what thoughts feelings and 
behaviors would be a better use of your energy at the end of session one we want to talk 
real quick about quick skills because when you experience anger i talked about 
getting out of the emotional mind into the wise   mind that means figuring out something you can do 
to help slow your heart rate slow your breathing the first one is what we call square breathing 
breathe in for four hold for four exhale for four hold for four when you do that sixteen count 
breathing or the foursquare breathing it actually forces your heart rate to slow down 
you’re manually overriding your nervous system some people prefer to go to the opposite end and 
instead of slowing their breathing they prefer to engage in something physically active so their 
body movement matches their heart rate and then when they start cooling down from whatever that 
activity is walking running sit-ups push-ups whatever it is then the heart rate starts to go 
down i encourage you to also develop a personal mantra when you’re angry just have a little 
little bit of what linehan calls a half smile and repeat the mantra to yourself in 
order to help you get through that initial 90 seconds five minutes where you’re in that 
adrenaline haze for me my mantra is it’s all good it’s all good and i i may even say it out 
loud and when my family hears me going all right it’s all good they know just give me a few 
minutes because i’ve gotten upset about something and i’ll come back and tell them about 
it later but that helps me not only down regulate my stress response but it also helps 
me block a lot of those other thoughts that would be contributing to fueling and stoking my anger 
you can’t have two thoughts at the exact same time so if you keep focusing on your mantra it’s all 
good then you can’t hear those other thoughts and that allows you to calm down a little 
bit so you can get into your wise mind and finally unhooking and this is a technique 
from acceptance and commitment therapy but unhooking means taking that feeling taking 
those thoughts and putting them out here i’m having the feeling that i’m angry 
okay envision it as a bubble or a rock or whatever you want to envision it as but it’s 
not part of you you’re having a feeling you’re having a thought what do you want to do with it 
do you want to hold it do you want to nurture it   and if it’s a negative feeling like anger you may 
even envision it like a hot potato you know do you really want to sit there and hold this hot potato 
what do you want to do with it you want to get   rid of it so um but envisioning it is something 
separate from you then you can decide what to do with it when you start saying it’s part of me then 
it’s harder to figure out how to get rid of it homework for week one keep a log of your anger 
intensity over the week keeping a log helps you become more aware of your triggers and see your 
progress on the top of each page put the date and use a different sheet each day i 
encourage you to use paper on a landscape orientation because we are going to add 
additional columns over the coming weeks make four columns with the following headers episode 
intensity duration and anger control strategy for the episode you’re going to describe briefly 
what happened the intensity scale from one to four mildly irritated moderately irritated angry 
or enraged the duration a one it was brief just a minute or two a two it was less than an 
hour but it still lingered for a bit three you felt that anger or irritation for a couple 
of hours or four it ruined your day and the fourth column what strategy did you use to try to 
respond to that anger to try to control that anger session two every session starts out with a 
review of the homework from the prior week so reviewing the homework from last week what 
was the highest number that you reached what triggered the most intense anger episode what 
strategies did you use to avoid reaching a four on that anger meter to to avoid reaching 
the level where you were enraged this week we’re going to start thinking about 
anger in terms of a habit a habitual response an autopilot response habits are things we do almost 
automatically in what ways is anger a habit for you and when something happens that triggers 
your anger do you stop and think i’m gonna   react with anger or do you just automatically do 
it just autopilot what other habits have you had biting your nails shaking your foot tapping the 
tapping the table what whatever habits you’ve had how have you tried to break those 
what has helped you break those habits and i’ll give you a hint becoming aware 
of the habit is the first step to doing it review your anger log from last week when you 
got angry did you consider other response options or did you just respond out of 
habit was it a knee-jerk response how can you use mindfulness to start to break your 
anger habit and i use the mnemonic beta or beta testing to help you remember what to do in order 
to start breaking a habit so b stands for breathe the first thing you need to do practice that 
foursquare breathing in order to get into your wise mind so start to slow your breathing when 
you notice your anger starting to ramp up when you notice you’re starting to get a little bit 
frustrated or irritable start breathing then don’t wait until you’re enraged before you try to calm 
the system down e stands for explore the situation mindfully and non-judgmentally acknowledge 
i’m angry okay what is the cause just be curious about what’s going on is this 
actually a threat to me at this time and in this context do i know this for a fact to be a threat 
an imminent threat to me at this time and in this context if it’s not an imminent threat then you’ve 
got time to figure out the best way to respond think t stands for think about the best response 
in the situation to help you achieve those goals in your rich and meaningful life you can hold 
on to the anger and nurture it and dwell on it and just keep dumping energy into it 
you can do that that is a valid choice you can let it go because it’s not worth your 
energy that person’s not worth your energy that situation is not worth your energy you can 
take constructive steps to change the situation whatever is making you angry so for example if 
you get really irritable or angry in traffic you can take constructive steps and say 
all right maybe i’m not gonna take the main roads to get to work i’m gonna take the back 
roads so i don’t have to deal with you know nearly as much traffic or are you going to change 
the way you react to the situation and and that can be easier said than done and then a is act 
tentatively choose how you’re going to respond to this situation and once you start responding 
if you get into it a little ways and it doesn’t seem like it’s working for you you can always 
back up and choose a different strategy that’s why we say act tentatively but a lot of times 
uh by the time you get down to this point you’ve gotten into your wise mind and you usually 
will make a much better choice for responding identify anger control strategies you’ve used in 
the past strength based approaches encourage you to build on what’s worked for you in the past so 
think about anger control strategies you’ve used which ones didn’t work and why you don’t want to 
keep trying to do something that doesn’t work a definition of an insanity is doing something over 
and over again and expecting different results if it doesn’t work for you that’s fine what 
are you going to do instead not every technique works for every person likewise which strategies 
have you used that have worked at least in some situations or to help reduce the intensity of the 
anger maybe they weren’t perfect but they helped envision one of your anger situations from last 
week if you had used a different strategy instead of automatically getting angry and erupting 
how might the situation have gone differently and and actually walk through in your mind’s eye 
or if you’re doing this in group actually discuss or explain what happened and how it might have 
gone differently had you used this different tool envision yourself in a similar situation next week and describe yourself using your hopeful skill 
to get through that situation so if road rage is one of your triggers you’re going to envision 
a road road rage incident from last week and describe how the situation may have gone 
differently had you used this different technique to handle your anger and then you’re 
going to envision being in traffic next week and having your road rage triggered and see yourself 
using your helpful skill how do you deal with it in a more effective way so you can conserve that 
energy for things that are more important to you week two homework very simple just 
continue your anger control log   you’re still getting to know what your triggers are and get a good picture you’re still 
compiling a good picture of your anger session three homework from last week what was 
the highest number that you reached on your anger control log what triggered that anger episode what 
strategies did you use to avoid reaching a four on the anger meter have you noticed a change 
in the frequency or how often you get angry or the intensity how intense your anger episodes 
are or the duration of your anger instead of ruining your whole day maybe it 
only lasts for a couple of hours when you get angry it’s because you’ve 
encountered something that’s made you feel   threatened anger is the fight part of the 
fight or flight response what are some general situations that make you irritable angry 
or enraged just make a list of them jot them down other examples to consider that i’ve compiled 
doing anchor management groups for about 20 years long waits at the doctor traffic 
jokes about a sensitive topic a friend not paying back money being wrongly 
accused of something by your spouse or your boss having to clean up after somebody 
like a roommate or your children   a loud neighbor being placed on hold 
forever rumors being spread about you having something stolen in gratitude 
somebody openly contradicting you not getting a promotion you expected that 
you are going to get or getting criticized many times specific events touch on what we call 
sensitive areas these sensitive areas usually refer to long-standing issues that can easily 
lead to anger it’s triggering those memories of distress from the past which brings up that 
fight-or-flight response in you in the present four main themes or fears that are associated 
with anger loss of control or powerlessness rejection or isolation death or loss of 
something that you care about and failure think about why each of these sensitive areas may 
make you feel threatened or trigger your anger and in what ways does anger help 
you feel safer or more in control for each common trigger that you have and that 
list of triggers what memories if any is the reaction related to what fears rejection loss 
of control failure or loss what fears is your reaction related to maybe when somebody your 
roommate doesn’t clean up after themselves and you have to do it it makes you feel rejected 
and disrespected and that triggers your anger is there an actual threat in the current context 
and remember there can be things that are disrespectful or unpleasant or are problematic 
but is there an imminent threat in the current context and if so what is it and identify at least 
two alternate ways of responding for example the roommate who doesn’t clean up after themselves it 
may not be because they intentionally are trying to disrespect you they may just never have 
developed good personal hygiene habits and they may not have the skills or really 
understand the impact it’s having on you homework continue keeping your anger control log 
add a column this week for fears rejection loss of control fair failure or loss so you’re going to 
continue using that chart that you’ve been using every day but you’re going to add this additional 
column for your fears because we’re going to start   looking for themes a lot of people have anger 
management issues that revolve around one or more of these fears and practice using beta testing 
or another strategy to respond to your anger session 4 again review your homework from last 
week what was the highest number you reached what triggered that anger episode is your anger 
often related to common memories or themes what strategies did you use to avoid 
reaching a 4 on the angry meter and have you noticed a change in the frequency 
intensity or duration of your anger now we’ve talked about anger in general we’ve 
talked about anger triggers now we’re going   to talk about early warning signs early warning 
signs are indicators that you are getting angry they can be broken down into four categories 
physical early warning signs are how your body responds with an increased heart rate 
tightness in your chest feeling hot or flushed behavioral early warning signs are what you do 
like clenching your fists or clenching your teeth raising your voice glaring at others what 
behaviors do you do where you’re posturing emotional early warning signs can 
include other feelings that may   occur along with anger including 
fear hurt jealousy or disrespect and cognitive early warning signs are what 
you think about in response to the event like hostile self-talk i’ll fix her little 
red wagon or she won’t get the best of me or even having images of aggression or revenge review your anchor log from last 
week and identify your common   early warning signs now you weren’t charting 
those you’re just going to think back and think what were my early warning signs 
before i actually had the explosion what strategies can you use to become more 
aware of and deal with these early warning signs as soon as they begin to appear   hourly mindfulness can be helpful set a alarm on 
your mobile device to remind you at the beginning top of every hour to just check in how am i 
feeling what am i thinking what am i needing another uh technique that i really like is getting 
a heart rate monitor and set it to alert when your heart rate goes above a certain level when 
we get stressed our heart rate increases now obviously when you get up if you’re going up and 
down stairs you might erroneously set it off but having it set so it goes off when your heart rate 
increases 10 or more beats a minute for example over your standard resting heart rate can help 
you notice earlier on when you’re starting to get stressed so you can intervene i also on 
my my garmin and i think a lot of the other fitness trackers have it it notices when it thinks 
i’m quote stressed and it reminds me to breathe continue keeping your anchor log and pick one   early warning sign that you have maybe 
you know i for me i grip my teeth pay attention to this throughout the week so 
you start becoming more aware of when you’re gritting your teeth earlier on so you can respond 
before you’re in a full-fledged anger outburst session five review your homework from last week what was the 
highest number reached what triggered that episode what were the early warning signs associated with 
the behavior physical warning signs behavioral affective and cognitive we want to start tracing 
it back so you can become more sensitive to when you are starting to get angry so you 
can intervene earlier just like getting   a cold it’s a lot easier to get better or 
to intervene if you notice the signs early as opposed to if you wait till 
you’ve got full scale pneumonia how effective were you at modifying your target   early warning sign you know for me i said 
grinding my teeth how effective was i at noticing when i was starting to grind my 
teeth and addressing that what strategies did you use to avoid reaching a 4 on the anger 
trigger anger meter and are there particular threat themes that are emerging remember failure 
loss of control rejection isolation and loss this week we’re talking about vulnerabilities 
they’re a little bit different than early warning   signs vulnerabilities are situations that make you 
more likely to respond with anger or irritability physically if your blood sugar is low if you’re 
under the influence of alcohol you’ve had too much caffeine you’re in pain you’re sick or you’re 
exhausted those are big vulnerabilities for a lot of people to respond more impulsively and feel 
angry easier affectively if you’re overwhelmed if you’re irritable about something else if you’re 
stressed out or feeling sensitive or vulnerable in some way then you may be more likely 
to respond with a stronger anger response cognitively if you’re expecting a negative 
outcome from a situation person or meeting or you’ve just got a negative attitude you’re 
more likely going to see the glass as half empty and respond with anger environmentally stressful 
environments and that can include a lot of things for me um i don’t like lots of noise and i 
don’t like um sudden loud noises or being interrupted a lot so if i’m feeling irritable 
if i’m feeling tired i will shut my door that way i don’t have people popping in 
constantly and interrupting my workflow   which tends to make me more irritable relationally 
being in situations makes that make you feel more on edge or around people that trigger anger or 
tend to be more negative themselves can also be make you more vulnerable to anger if you’re 
around somebody that’s going to feed your anger then it’s going to make it more likely that you’re 
going to be angrier what are your particular vulnerabilities and how can you best prevent them 
and when you can’t prevent them how can you best mitigate them or deal with them like i said when 
i haven’t slept well for some reason can’t always sleep well but when i haven’t one of the things 
that i always do is shut my door because i know that that is a vulnerability for me if i’m over 
tired i tend to be a little bit more irritable continue keeping your anger log and add a 
sixth column where you’re going to begin   identifying your vulnerabilities you want to start 
looking for trends and themes and patterns here but just add that sixth column to 
start identifying vulnerabilities session six review your homework from the last 
week what was the highest number you reached hopefully this number is going down 
what triggered that anger episode what were the early warning signs 
associated with the behavior how effective have you been at noticing your 
early warning signs what strategies did you use to avoid reaching a four on the anger meter and 
what vulnerabilities contributed to your anger this week we’re going to talk about creating 
an anger control plan an effective plan should include both immediate and preventative strategies 
so you want to prevent the vulnerabilities prevent the anger but also have a crisis response 
so to speak immediate strategies time out when might you use it and how might you do 
it and it’s important if you’re uh having difficulty if you’re a lot of your anger 
is triggered by interpersonal interactions that you are clear with the other person that 
when you need a time out that you will be back in 10 15 minutes whatever it is that you need 
but it’s important that they respect your boundaries and allow you to take that 
time out to get into your wise mind you during your time out you can distract yourself 
with activities like doing something different   going on a walk listening to music or even using 
guided imagery just to go to a mental vacation you can block the situation from your mind 
temporarily with thought stopping having alternate thoughts you can’t have two thoughts 
at the same time so you can use your mantra for thought stopping you can also use positive 
or what we call distress tolerant thoughts where you’re telling yourself i can get 
through this i’m not in danger right now   um whatever script you want to use and i recommend 
that you write it down and you have it on a file on your mobile device so you can just 
read it when you start feeling stressed and you don’t have to think about something practice 
mindfulness in threes what are three things that you see three things that you smell three 
things that you feel three things that you hear and practice that four four 
quadrant or four breathing in fours talk to a friend or journal you know maybe you 
need to just call somebody call a friend exercise and or radically accept and 
just saying it is what it is or it’s all good encourages you to radically accept 
the moment that means accepting the good parts of what’s going on or life with the 
fact that this part right now sucks preventative strategies what general things can 
you do to prevent or minimize vulnerabilities emotionally what can you do what can you do 
to increase happiness and decrease distress mentally what can you do to minimize those 
vulnerabilities can you and one of the things that can be helpful is spending 20 minutes a day 
focusing on what went right that day the other 23 hours and 40 minutes you can focus on whatever 
you want but 20 minutes a day focusing just on what went right and a lot of times i encourage 
people to do this at dinner with their family that way they feel during the meal is a 
time where they can be relaxed together physically what can you do to 
prevent or minimize vulnerabilities   healthy nutrition minimize stimulants get 
enough sleep all that stuff and socially what can you do to prevent or minimize vulnerabilities 
how can you set and maintain healthy boundaries how can you practice assertiveness how can 
you nurture your supportive relationships when you are vulnerable for some 
reason what can you do to reduce   the chances that you will get unnecessarily angry review your anchor log from last week what 
immediate strategies could you have used to help you take a time out to help you get into your 
wise mind what preventative strategies could you have used what could you have done to prevent the 
vulnerabilities that might have made a difference this week for homework maintain your anchor 
log and develop a plan to start reducing one   or two of your vulnerabilities each month and 
that’s realistic one or two a month you can do the more vulnerabilities that you eliminate 
the less things that you’ve got to worry about preventing or guarding against session seven review your homework from last 
week what was the highest number you reached what triggered that anger what were the 
early warning signs that were associated how effective were you and 
noticing your early warning signs   what strategies did you use to avoid reaching 
a 4 on the anger meter what vulnerabilities contribute to your anger and how effective have 
you been at reducing your target vulnerability an episode of anger can be viewed as 
consisting of three phases escalation   explosion and post-explosion during 
escalation the event and responses or early warning signs are are happening 
you know something happens and you start to get angry during the explosion phase 
the verbal or physical aggression emerges what can you do when you have the urge to be 
aggressive and that goes into those immediate strategies post-explosion this is when you are 
starting to experience the negative consequences of the anger emotional cognitive legal 
relationships or even physical health review your anchor log from last week 
and identify the event that got you most   angry or had the most negative consequences and 
identify what you could have done to prevent it to reduce the escalation or prevent the explosion cognitive distortions are unhelpful ways 
of perceiving things think about a time something happened and you thought it was one 
way but it turned out to be completely wrong there are a variety of cognitive distortions and 
i’m going to go over some of the most common ones personalization is taking things or interpreting 
things as all your fault or all about you somebody looks at you cross-eyed they 
you think that they are angry with you what are three other explanations for 
why they may have looked at you that way   were they even looking at you minimization of the positive identify 
when what good things have happened what is happening that’s good or 
what good could come out of this and the mental filter or only seeing 
what you expect to see it’s important   to look at all the facts if you expect to 
see negative you’re going to see negative but there’s also positive that you’re probably 
just overlooking so what are all of the facts sometimes it can be easier to do this 
by taking somebody else’s point of view exaggeration of the negative or catastrophizing is 
another cognitive distortion you assume the worst or you assume that the sky is going to fall it’s 
important to really ask yourself how likely is this to happen how likely is it that this mistake 
i made is going to result in me getting fired or that this person’s behavior is going 
to result in something negative for me all or nothing thinking you always do this 
or you never do this or i always do this it’s important to find the exceptions let’s 
take that sloppy roommate for example you always leave your dishes in the sink well 
are there exceptions to that finding the exceptions can be helpful because then you can 
reward the exceptions when they leave a clean kitchen and you see it in the morning and there’s 
no dishes in the sink you thank them profusely it’s more likely that they’ll do that again if 
they see that there’s a benefit to them they may not consciously know this but subconsciously we do 
things that are more rewarding the control fallacy a lot of times we feel like we have control or 
should have control over more than is realistic so what parts of the situation that are 
triggering your anger what parts do you actually have control over and what parts do you 
need to figure out how to accept or cope with and over generalization sometimes 
we expect that since we’ve been in   similar situations that this situation 
is going to work out the exact same way we assume that what happened once is going 
to happen again it’s important to explore not only how is this situation similar to 
the past situation but how is it different arbitrary inference is another   cognitive distortion where we assume that 
something is dangerous or fearsome because of one particular piece of information 
the news broadcasts a lot when there’s a plane crash it never gives us uh news stories 
about the 20 000 flights a day that take off and land successfully so if we assume that flying 
is dangerous because we saw a news story at some point about a plane crashing we’re not getting 
using all of the facts to make our judgment and emotional reasoning i feel angry 
therefore there must be a threat not always sometimes something can happen a smell a sight a 
sound that triggers a memory we may not remember the memory but it triggers that reaction and uh 
bessel vanderkult talks about how trauma is often remembered as a reaction not an actual memory 
so it’s important when we feel angry remember that’s our smoke alarm now we’ve got the energy we 
need to check and see is there a threat right now one model for dealing with our cognitive 
distortions is called the abcde model a stands for the activating event what happened 
b represents our beliefs about the event it’s not the event itself that often produces 
feelings like anger it’s our interpretation and beliefs about the event that’s why two people 
can be driving and experience the same rude driver one gets angry and develops road rage and 
the other one hardly notices it because they interpreted the situation differently 
they had different beliefs about the event c stands for the reaction or consequences as 
a result of your interpretations and beliefs so the person who perceived it as a threat got 
angry the person who just saw it as a inconve inconsiderate driver they didn’t get angry 
so the consequence of the same situation was different for these two 
people based on their beliefs d stands for dispute identify any unhelpful 
beliefs and reframe them in alternate ways identify the facts for and against your belief 
and we’ll stick with road rage this person is being rude they’re being disrespectful to me they 
have no respect for anybody else they could have killed me well how many of those are actually 
accurate maybe the person you were in their blind spot and they just didn’t even see you or 
they were distracted with something else and it wasn’t about you they weren’t trying to be 
disrespectful to you they just didn’t notice make sure you’re not confusing high and low 
probability events and identify and address thinking errors and cognitive distortions so 
you’re going to go through that list of cognitive   distortions the personalization minimization all 
that stuff that we just talked about and identify if any of your beliefs about the situation 
may be skewed in one direction or another e stands for evaluate your response 
and choose the response option that   gets you closer to those people and 
things that are important in your life so e basically is saying ask yourself is this 
worth my energy what is the best way to handle this and use my energy to move towards the things 
that are important in my rich and meaningful life reviewing your anger log identify 
the most intense anger episode   from last week and apply the abcde model review your anger log and identify the 
cognitive distortions that were in play and what common cognitive distortion or what 
cognitive distortions are common in your family cognitive distortions don’t usually 
come out of thin air we often learn them we hear our family using all or nothing language 
for example or personalizing being overly responsible for things so what cognitive 
distortions did you learn from your family homework continue keeping your anchor control 
log add another column for cognitive distortions and the rebuttal so remember finding the 
facts exam looking for exceptions etc session eight review your homework from last week and then start learning about assertiveness   the basic message of aggression is that 
my feelings thoughts and beliefs are very important more important than yours and your 
feelings thoughts and beliefs are unimportant the basic message of being passive the opposite 
of aggression is that your feelings thoughts and beliefs are very important but my 
feelings thoughts and beliefs are not assertiveness on the other hand says that   my feelings thoughts and beliefs are just as 
important as your feelings thoughts and beliefs communicating assertively starts with validating 
the other person’s thoughts and feelings i can see that you’re very angry about this 
situation right now or what i’m hearing is that your perception of this situation is xyz 
so you’re paraphrasing what you hear or see from the person you’re validating where they are 
so they feel understood and then you communicate in a way that ideally creates a win-win you 
know how can this situation be solved in a way that both of you get your feelings thoughts and 
needs validated and met in the best way possible what are some advantages of acting 
assertively when trying to resolve conflicts what might some of the drawbacks to assertiveness 
be and i’ll give you a hint when you’re assertive and not aggressive sometimes you 
don’t always get your 100 your own way the conflict resolution model get into 
your wise mind remember de-escalate   use your breathing identify the problem 
identify your beliefs about the problem find the facts for and against your beliefs decide 
whether it’s worth your energy to even worry about resolving the conflict if it is then address 
and resolve resolve the conflict assertively by validating communicating assertively your 
thoughts wants and needs in the situation and then determining the course of action review your anchor log for the last week 
and apply the conflict resolution model   to at least one anger episode continue keeping your anger control log and 
actively practice being assertive even when you’re not angry so actively practice stating 
your thoughts wants and needs and asking people about theirs and paraphrasing theirs so you’re 
more effectively communicating and you stop assuming and mind reading or assuming 
you know what the other person’s thinking session nine review the homework from   last week the highest number you reached what 
triggered that anger your early warning signs strategies you used to avoid reaching a 
four the vulnerabilities that contributed and your most common cognitive distortions 
and the restatements or rebuttals to them we learn a lot about how to interpret events 
and cope with distress by observing our family how was anger expressed in your family when 
you were growing up how’d your father express it how’d your mother express it were you 
ever threatened with or exposed to physical violence how are other people’s emotions 
such as happiness and sadness expressed in your family or were they not even allowed 
was emotional expression limited to feelings of anger and frustration or were many 
different kinds of emotions expressed what role did you take in your family in 
the addicted family we’ve got different   roles that actually have labels like hero this 
is the person who’s always getting the a’s and making the team the rescuer the victim the wall 
flower who just kind of blends into everything or the scapegoat the one that gets blamed for 
all the problems in the family so what role did you take in your family what messages 
did you receive about your father and men in general what messages did you receive 
about your mother and women in general did you feel accepted and loved or did you 
feel like you couldn’t do anything right and you were constantly being either rejected 
or criticized or threatened with abandonment how did your family deal with failure what 
feelings thoughts and behaviors carry over into your relationships today the ones 
that you learn from your family of origin what purpose do these behaviors serve today   and are there alternate behaviors that might 
serve the same purpose but be more helpful review your anger management plan from 
the past seven weeks eight weeks what progress have you made what still needs 
to change what strategies are working well and session 10. review your homework from last 
week this is the last week that you have to do this what was the highest number you reached what 
triggered that episode what were the early warning signs associated with it how effective have you 
been become at noticing your early warning signs what strategies are you finding 
most helpful to keep you from   reaching a level four or even a level three 
hopefully by this point on the anger meter what vulnerabilities are still contributing 
to your anger how effective have you been at reducing your vulnerabilities and what are your 
most common cognitive distortions and rebuttals using what you’ve learned over the past 10 
weeks dispute these anchor myths anger is inherited anger automatically leads to aggression 
you must be aggressive to get what you want venting anger is always desirable anger is 
a negative emotion anger is all in your head venting or ignoring your anger makes it go away and men are angrier than women 
it’s important to remember that   men and women get angry over different 
things and often express it differently the older you get the more angry you are   the data however shows that the angriest 
people tend to be 14 year old boys anger always results from human 
conflict sometimes yes sometimes no people can also get irritable or angry from 
being exposed to stressful environments remember we talked about all those different triggers 
foul odors pain hot temperatures none of those things necessarily involve the action of another 
person you can be all by yourself and get angry anger is a natural emotion it’s designed to 
alert people that there might be a problem when people are vulnerable or have learned 
maladaptive ways of dealing with anger   or simply never learned healthy coping skills 
they can experience anger management problems excessive anger negatively impacts people 
emotionally mentally physically socially occupationally sometimes legally and spiritually effective anger management involves preventing 
vulnerabilities being aware of and working on those sensitive areas or threat areas preventing 
anger and vulnerabilities whenever possible and developing immediate coping responses 
to deal with anger when it does occur

Dr. Dawn-Elise Snipes is a Licensed Professional Counselor and Qualified Clinical Supervisor. She received her PhD in Mental Health Counseling from the University of Florida in 2002. In addition to being a practicing clinician, she has provided training to counselors, social workers, nurses and case managers internationally since 2006 through AllCEUs.com #AngerManagement 10 Session #CognitiveBehavioralTherapy Protocol #NCMHCE Areas of Clinical Focus #grouptherapy
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NOTE: ALL VIDEOS are for educational purposes only and are NOT a replacement for medical advice or counseling from a licensed professional.

Learn about anger and it’s functions
Explore early warning signs
Develop an anger control plan
Learn about the aggression cycle and how to change it
Review the ABCDEs and
Explore how prior learning influences your current anger triggers
Effective anger management involves preventing vulnerabilities, being aware of and working on “sensitive areas” or “threat areas,” preventing anger whenever possible and developing immediate coping responses to deal with it when it occurs.

Video by Dr. Dawn Elise Snipes on integrative behavioral health approaches including counseling techniques and skills for improving mental health and reducing mental illness.

AllCEUs provides multimedia counselor education and CEUs for LPCs, LMHCs, LMFTs and LCSWs as well as addiction counselor precertification training and continuing education.
Unlimited Counseling CEs amd Social Work CEUs for $59
Specialty Certificates and #MasterClass starting at $89

AllCEUs courses for counselor continuing education are accepted in most states because we are an approved education provider for NAADAC, the States of Florida and Texas Boards of Social Work and Mental Health/Professional Counseling, the California Consortium for Addiction Professionals and Professions, the Australian Counselling Association, CRCC, Canadian Counselling and Psychotherapy Association and more.

Dr. Dawn-Elise Snipes teaches adults how to use cognitive behavioral therapy tools for building resilience at work, among staff and in children.

Many of the skills in the videos are the same ones that are taought in a basic counselling course and can be used as a CBT therapist aid. CBT techniques are helpful tools for self counseling for major depressive disorder, anger management, confidence, self esteem, anxiety, abandonment issues, self improvement

Dr. Snipes’ videos have been used by thousands for developing clinical skills for substance abuse counseling, cbt interventions for substance abuse, and skills needed for mental health counselor

Chapters:
00:00:00 – Introduction to Anger Management Protocol
00:07:09 – The Payoffs and Consequences of Anger
00:14:04 – Techniques for Anger Management
00:21:11 – Managing Anger in Daily Life
00:28:18 – Identifying Anger Triggers and Threats
00:35:07 – Vulnerabilities to Anger
00:42:02 – Strategies to Minimize Vulnerabilities
00:48:39 – Cognitive Distortions and Emotional Reasoning
00:55:24 – Conflict Resolution Model Implementation
01:02:03 – Effective Anger Management