Pathological Anger, Existentially Speaking

René J. Muller, PhD;

Pathological Anger, Existentially Speaking

May 26, 2009

René J. Muller, PhD

Publication

Article

Psychiatric TimesPsychiatric Times Vol 26 No 6

Volume 26

Issue 6

Anger is an emotion that is familiar to everyone. An episode of anger may dissipate quickly and harmlessly or evolve into a murderous rage. Between the benign and malignant end points in this spectrum, a seething, chronic anger may come to dominate a person’s thinking, feeling, and behavior.

Despite the universality of anger, psychiatry has not addressed this emotion as a phenomenon in its own right. Anger is mentioned in the DSM-IV-TR only as a symptom in personality disorders and drug withdrawal syndromes. There is no listing for anger in either the DSM’s index or the glossary of technical terms.

The instrumental, differentiated world of normal mood

In a slim volume titled The Emotions: Outline of a Theory, the French existential philosopher Jean-Paul Sartre parsed the meaning and structure of the common emotions, including anger.¹ To Sartre, anger, like depression, involved a pathological transformation of the instrumental, differentiated world of cause and effect, which underlies normal mood and is governed more or less by reason and the recognition that there is a connection between what happens to us and how we think, feel, and act.² In a differentiated world, we selectively respond to that world’s multiple invitations: choices are made, projects are undertaken, goals are set, risks are taken, a certain amount of frustration and pain is tolerated, and gratification is deferred.

In his memoir Dreams From My Father, President Barack Obama describes how he forged his personal and political identities in circumstances that were often adverse.³ From the following brief commentary on Obama’s efforts to define-and differentiate-himself, we can get a better idea of what Sartre meant by differentiation: “To say that [Obama] is constructing himself sounds pejorative, but he is open to the world in a way that most Americans have not had the opportunity to be. This is something that outsiders have to do. But, as he evolves, the African American pathway is the pathway to service, to success, and to a more complete self-definition.”^4(p72) During the 2008 presidential campaign, Obama signaled his commitment to working in a differentiated, instrumental world of cause and effect when he made it clear to his staff that there would be “no drama with Obama.”

Sartre was not the only existentialist to grapple with the concept of differentiation. To Karl Jaspers, differentiation meant “the breaking up of vague experiences into several well-defined ones, thus giving richness and depth to the total experience. Low-level individual phenomena differentiate into higher ones; the vague instinctive life gains in content. Increased differentiation brings increased clarity and awareness. Undefined intuitions and feelings give place to clear, definite ideas.”^5(p14)

Jaspers, like Sartre, believed that failing to differentiate one’s experience has dire consequences. “From an undifferentiated state of innocence,” he insisted, “emerge the innumerable contradictions and conflicts of our psychic life.”⁵ To Socrates, the unexamined life was not worth living. To Jaspers, the undifferentiated life was a lesser, pathological life.

Transforming one’s world through pathological emotion

The often implicit commitment to live in an instrumental, differentiated world of cause and effect is a contingent one and can be withdrawn at any time. In the face of disappointment, loss, betrayal, or defeat, a person may deem it too difficult to move forward in an instrumental way and find reasons not to take the steps that would lead to working through and transcending a negative experience by making what Sartre called a “magical transformation” of his experience. This changes the nature and blunts the acuity of the instrumental differentiated world that is a prerequisite for normal mood.

Sartre used the word “magical” to describe the de-differentiating, world-flattening transformation that drives someone who is in the throes of a negative experience toward a regressive and often childlike depressive response. “Magic” derives from the Greek for wizard, and implies trickery. Sartre believed that a “trick” of self-deception-the lie we tell ourselves-is at the heart of the depressed person’s transformed experience, as the unacknowledged refusal I won’t do it is converted to the belief I can’t do it.^6,7

The depressed person’s “attitude of excuse,” as Sartre called it, seems less inevitable once we recall the concluding words of Samuel Beckett’s novel The Unnamable: “I can’t go on, I’ll go on.”⁸ How do we really know what we are capable of doing when the chips are down? Psychiatry has had little to say about the inherent capacity of people-those whose behavior is within the normal range or those in whom mental disorders have been diagnosed-to use their free will to shape their experience. Psychoanalysts believe that depression entails a decathexis from the world, a notion that seems compatible with Sartre’s magical transformation. Emphasizing both the weakened grasp that depressed persons have on their environment and their implicit efforts to manipulate that environment, George E. Vaillant, MD, noted that “depression, like a child’s tears, is often designed to get someone in the dysthymic person’s environment to do something.”⁹ In depression, agency is always partially surrendered to others.

Depending on the strength of the magical transformation and the degree of de-differentiation associated with it, one could imagine episodes of depression spanning the spectrum of mild, to moderate, to severe, to treatment resistant. The magically transformed world can also be seen as fertile ground for the psychotic distortions, particularly paranoid delusions, which are sometimes experienced by those who are severely depressed.

The angry transformation

In the face of disappointment, loss, betrayal, or defeat, a person may choose (without necessarily realizing it) to become angry. Depression and anger are rooted in the power of a biologically sustained consciousness-the capacity of the self as active agent, making use of its freedom to choose one option over another to construct its own world-to replace rational instrumentality with magical thinking.

It is clear that what angers some people leaves others unaffected. Anger does not arise from situations that are inherently anger-provoking, but derives from the way a person constructs those situations. Shakespeare’s Hamlet recognized that “there’s nothing either good or bad, but thinking makes it so.” Anger lasts only as long as someone continues to construct a particular situation angrily or, put another way, as long as one refuses to stop being angry and continues to indulge in that emotional regression.

Everyone’s life holds enough disappointment and loss so that even the psychologically strongest people occasionally succumb to the pressure of transforming aspects of their experience into depression and anger. For brief periods, we all make use of magical transformations as we refuse to deal authentically with adverse events. This is why we transiently feel “down” or “pissed off.” When someone says, “I’m fighting depression,” it is likely that what is being battled is the altered, oppressing structure of the depressed person’s de-differentiated world. Those with sufficient psychological strength soon return to the instrumental world because, all things considered, life is better for them there. We all face a constant challenge to resolve depressed and angry feelings before these emotions reach a pathological stage.

The meaning and structure of anger

Sartre saw anger as an attempt to reduce the tension inherent in a difficult situation by redefining the situation so that a less demanding solution could be found.“It is easy to understand the fit of anger which seized me when I could no longer reply to someone with whom I had been bantering… It was a matter of carrying on the discussion on another plane: I was unable to be witty; I made myself formidable and intimidating. I wanted to inspire fear. At the same time, I used derived (ersatz) means to conquer my opponent: abuse and threats which were equivalents for the witticism I could not find, and, by the abrupt transformation which I imposed on myself, I became less exacting in my choice of means.”^1(pp38-39)

Anger changes the nature of the game. Going from the instrumental world of normal mood to the magically transformed world of anger involves what Sartre calls the “breaking of one form [the instrumental, differentiated world] and the reconstitution of another [the magically transformed, de-differentiated world].” Only consciousness, he insists, “by its synthetic activity, can break and reconstitute forms ceaselessly.”^1(p40) Clearly, the mind is calling the shots here, while synergistically, the brain’s neural substrate changes in response. (Sartre’s reference to forms brings to mind the self-schemata described by Helen Markus and colleagues,¹⁰ which others have called frames and scripts. Schemata are structural units of self-representation that include a representation of the world.)

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 Erikson¹³called 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.