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Psychiatric Times. Vol. 26 No. 6
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Commentary 

Pathological Anger, Existentially Speaking

By René J. Muller, PhD | May 26, 2009
Dr Muller formerly evaluated patients in the emergency department at Union Memorial Hospital in Baltimore. He is the author, most recently, of Doing Psychiatry Wrong: A Critical and Prescriptive Look at a Faltering Profession and Psych ER: Psychiatric Patients Come to the Emergency Room, both published by the Analytic Press/Taylor & Francis Group. He reports no conflicts of interest concerning the subject matter of this article.


 

Corrosive, debilitating, and destructive anger is a particularly appealing defense for those who live in what the existential psychiatrist Viktor Frankl11 called an “existential vacuum” or “inner void,” where life is meaningless and empty. Angry words and destructive acts are often used in a defensive attempt to fill that void.12 (One of anger’s roots is from the Latin angerere, which means to strangle.) Anger can also be used to create what Erik Erikson13 called a “negative identity”—if you cannot be good, at least you can be very bad—by someone who decides that it is too difficult to remain in a rational, instrumental mode. Anger is a fall from a higher state of being, a transformation that leads to the degradation of self and the abuse of others. Angry people acknowledge as much when they admit, “I lost my temper” or “I lost it.”

Anger is a heightened state and can energize someone rendered lethargic by depression. Anger has even been called an “antidepressant.” (In Mourning and Melancholia, Freud said that depression was anger turned inward.14) A depressed person might angrily lash out in an attempt to correct the first structural transformation (depression) with a second transformation (anger). Indeed, the pathophysiology of anger and depression appear to be distinct: persons experiencing anger show hypofunctionality in the ventromedial prefrontal cortex and the amygdala while depressed persons show hyperfunctionality in these areas compared with controls.15,16 Ultimately, the play-off of anger and depression fails to yield a normal mood as a person cycles through a spectrum of self-induced pathological emotions, which some clinicians wrongly diagnose as bipolar disorder.

Severe chronic anger can come to dominate a life. Alec Baldwin’s former father-in-law has said publicly that Baldwin’s almost constant anger was a factor in the breakup of his marriage to Kim Basinger. An angry voice-mail message that Baldwin left for his daughter, Ireland, after she did not return his repeated phone calls became media fodder. The actor later acknowledged his mortification over his loss of control and profusely apologized.

On February 29, 2008, while I was taking a break from writing this article, an 11 pm news program showed Kevin Borseth, University of Michigan women’s basketball coach, at a press conference that immediately followed the Wolverine’s 69-67 loss to the University of Wisconsin. The Internet posting for the story read in part: “[Borseth] started things off by slamming the podium and saying, “That’s how I feel.” Then he screamed into the camera, “I’m so damn sick and tired of getting out re-bounded.” Things went downhill from there.

To coach Borseth, at the time, other possible ways of processing this loss may have seemed more difficult and less gratifying than making a Sartrean magical transformation. Someone considering Borseth’s decompensation from the cognitive-behavioral perspective would probably conclude that the coach felt the game had not gone as it should have, that it ought to have gone his way, and that he was entitled to behave as he did—angrily.

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References

1. Sartre JP. The Emotions: Outline of a Theory. Frechtman B, trans. New York: Wisdom Library; 1948.
2. Fell JP III. Emotion in the Thought of Sartre. New York: Columbia University Press; 1965.
3. Obama B. Dreams From My Father. New York: Three Rivers Press; 2004.
4. Remnick D. The Joshua generation: race and the campaign of Barack Obama. The New Yorker. November 17, 2008:68-83.
5. Jaspers K. General Psychopathology. Hoenig J, Hamilton MW, trans. Vol 1. Baltimore: Johns Hopkins University Press; 1997.
6. Muller RJ. To understand depression, look to psychobiology, not biopsychiatry. Psychiatr Times. 2003; 20:41-46.
7. Muller RJ. Psych ER: Psychiatric Patients Come to the Emergency Room. Hillsdale, NJ: Analytic Press; 2003:3-10.
8. Beckett S. The Unnamable. In: Three Novels. New York: Grove Press; 1958.
9. Klerman GL, Vaillant GE, Spitzer RL, Michels R. A debate on DSM-III.Am J Psychiatry. 1984;141:539-553.
10. Markus H, Cross S, Wurf E. The role of the self-system in competence. In: Sternberg RJ, Kolligan J Jr, eds. Competence Considered. New Haven, CT: Yale University Press; 1990.
11. Frankl VE.Man’s Search for Meaning. Boston: Beacon Press; 1959.
12. Lahr J. Majestic moor: Chiwetel Ejiofor’s Othello. The New Yorker. January 21, 2008:84-85.
13. Erikson EH. Identity: Youth and Crisis. London: Faber and Faber, 1968.
14. Freud S. Mourning and Melancholia. Vol 4. London: Hogarth Press; 1917.
15. Blair RJ. Neurobiological basis of psychopathy. Br J Psychiatry. 2003;182:5-7.
16. Drevets WC. Neuroimaging studies of mood disorders. Biol Psychiatry. 2000;48:813-829.


 
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