Cope with Impulsive Aggression

Impulsive aggression, also called intermittent explosive disorder (IED), is an emotional condition associated with sudden, extreme outbursts of anger. These outbursts of anger can be shocking and frightening, since someone undergoing an explosive episode can become emotionally and physically violent. For the individuals themselves, the episodes are overwhelming, and may lead to destructive behaviors they afterwards find shameful. Understanding IED and preparing to identify and control the consequences of explosive outbursts is crucial for all involved.[1]

Steps

Coping With Impulsive Aggression in Others

  1. Recognize when you are in danger. While it is perfectly normal for someone to occasionally become angry, and even raise their voice, frequent outbursts of sudden, explosive anger are not normal, especially when that anger manifests in violent or abusive behavior. It is important for you to understand that their rage, and the violence it brings with it, is not in their control. [2] Explosive episodes, as opposed to normal expressions of anger, are characterized by being:
    • Abrupt, seeming to come out of nowhere.
    • Much more extreme in intensity than is warranted by the event or situation triggering it.
    • Violent and aggressive, either physically (e.g. screaming, invading personal space, or hitting objects, oneself, or other people) or emotionally (e.g. name-calling, threatening, or use of hurtful, insulting language).
    • Irrational, and seemingly impossible to calm with words.
    • Remember: your loved one's issues with anger are not your fault. Violence and abuse is never acceptable, and you have every right to take steps to avoid being harmed.
  2. Encourage your loved one to seek help. While you can certainly help a loved one dealing with impulsive aggression by supporting them and learning about their condition, it is crucial that they seek the additional, outside help of a trained mental health professional. Encourage them to consult an expert, and remind them that no one should have to deal with a serious medical issue like IED without the help of a doctor.[3]
  3. Tell someone you can trust about your situation. Having a neighbor, friend, or family member close by who understands your loved one's rage issues, and the danger it poses to you, can be of great benefit to you should you ever need help. Let the person know that you'll be relying on them, and make sure they understand your plan of action, and what they may need to do in the event of a violent episode. [4]
    • Be honest with whomever you tell, and resist the urge to sugar-coat your description of the explosive episodes in an effort to save face. A trustworthy confidant will not judge you, and will understand that IED and its effects are complex.
    • If you are responsible for children, coordinate with trusted friends or family to establish a plan for them, should you need help getting them to safety while you deal with an explosive episode.
    • If you are experiencing domestic violence, contact a domestic violence hot line, a women's shelter, or emergency services right away.
  4. Take precautions, and make a plan of action for emergencies. Decide where you will go should you need to escape an explosive episode. Remember that episodes can occur at any time, even very late at night, so the place you choose should be accessible to you at all times. If there are children or others living with you, discuss the plan with them, and consider practicing getting safely out of your home with them, so that you are all prepared should the need arise. [4]
    • It is a good idea to prepare a bag of essential items to take with you should you need to escape. Pack any important papers or documents you may wish to have with you, as well as extra clothes, house and car keys, money, and any medications you may need.
  5. Remove yourself from explosive episodes. Someone undergoing an episode of explosive anger will be unable to respond rationally to the situation they are in, and will behave unpredictably, and even violently. The best course of action for your safety is to remove yourself from the situation as quickly as possible. You should already have prepared a plan, and decided where you will go for safety. Don't worry about explaining yourself to your loved one: you'll have time to do that when they are calm. [2]
    • Removing yourself not only protects you from immediate danger, it also ensures that you won't be tempted to argue with, or retaliate against, your loved one. Retaliation can be a natural response, but can often lead to an escalation of the episode, resulting in increased danger for everyone involved.
  6. Contact emergency services for help. If you or anyone else is in immediate danger, or you are unable to escape a violent episode, contact the police immediately. If someone is hurt, go to the emergency room and explain your situation: the doctors and nurses there will treat your injuries, and help you find resources to keep you out of harms way. If you are frightened of being harmed by your loved one, and need a place to go, contact a domestic violence hotline, or a local women's shelter or crisis center.[4]
    • If you are in the U.S., you can reach the National Domestic Violence Hotline at 1-800-799-7233. The NDVH can connect you with local resources such as counselors, shelters and support groups.

Coping With Your Own Impulsive Aggression

  1. Talk to a mental health professional about treating your anger. Episodes of impulsive aggression are overwhelming, making it feel impossible to think or behave calmly or rationally. They strain personal relationships, and put you, and those closest to you, in danger of harm. You deserve, and will benefit from, the help of a professional while dealing with this difficult problem. Your therapist will help you to understand the root causes of your anger, and learn to recognize and control it.
    • If you aren't sure how to find a therapist, talk to your doctor about getting a referral. If you are on a medical insurance plan, you can contact your insurance provider for help finding a therapist.
    • No specific medication is prescribed for suffers of intermittent explosive disorder, your doctor may prescribe medication to help with some of the psychological symptoms of the disease, such as depression
  2. Learn to recognize the signs of anger. When an explosive episode begins, you may feel a mounting sense of physical tension. While this tension can be very unpleasant, learning to recognize them will provide you with advance warning of an impending episode. Once you learn to recognize these precursors of rage episodes, you can begin taking steps to control them.[5] Symptoms at the onset of an explosive episode can include:
    • Fast, shallow breathing.
    • Involuntarily clenched fists, or jaw.
    • Rapid heart rate.
    • Racing, difficult to control thoughts, often of an aggressive or violent nature.
    • Feelings of tightness in the chest.
  3. Learn to recognize what situations or events trigger your anger. While episodes of rage are sometimes unpredictable, others may be associated with specific sources of stress at home, in school, or at work. Avoiding triggering situations will allow you to begin taking control of your explosive episodes. [4] Frustration and stress of any variety can be the trigger for an explosive episode. Think about when you tend to experience moments or episodes of rage. Common examples of triggering events include:
    • Relatively minor arguments with your spouse, parents, or loved ones.
    • Feeling misunderstood, or that you aren't able to communicate your feelings effectively.
    • Feeling overwhelmed by responsibilities at work, at school, or with your family and friends.
    • Stress or pain from coping with another physical or mental illness.
    • Excessive use of alcohol or other mind-altering substance.
  4. Come up with a plan for what to do when you feel yourself getting angry. Do this with the help of your therapist, who has the experience and expertise to help you decide what actions to take when you feel the onset of an explosive episode. The simplest method of dealing with an episode of rage is simply to walk away from the situation causing it. Go somewhere you can feel safe, and focus on breathing deeply, and calming down.[5]
    • Some find it helpful to focus their mind on counting slowly to ten, or repeating a soothing word or phrase to themselves. This helps take the sufferer's mind off of the situation triggering their rage, and gives them time to calm down.
    • Remember that your explosive episodes are unpredictable, and can happen at any time. Think about how you will deal with your anger if an episode is triggered in public, or at work or school, not just what you will do if an episode occurs at home.
  5. Keep your loved ones safe by talking to them about your illness. Rage is an overwhelming feeling, and you may display violent behavior towards those closest to you while undergoing an episode. For their safety, as well as your own, it is essential that you talk to your family and friends about what you're going through. Be honest with them, and warn them that, despite the fact that you love them, your impulsive aggression could lead you to harm them. This will better prepare them for dealing with any episodes they may experience in the future. Understanding your condition will also help them lend more effective support to your efforts to control your anger.
  6. Avoid recreational drugs, including alcohol. Mind-altering substances can have unpredictable effects on the mood of someone suffering from impulsive aggression, increasing the risk that they may experience an episode of rage. If you are finding it difficult to give up using drugs, including alcohol, then you should seek help from your therapist, or another medical professional.[6]

Recognizing Warning Signs of Intermittent Explosive Disorder

  1. Identify IED risk factors. Individuals with a history of being physically or emotionally abused, especially as children, are more prone to suffer from IED, as are those suffering from a personality disorder or other serious mental illnesses. IED may also be linked with repeated traumatic experiences of violence or stress, such as the traumas experienced by active-duty military personnel.[4]
    • Other mental illnesses are sometimes linked to IED include personality disorders, such as antisocial personality disorder, borderline personality disorder, and disorders associated with disruptive behavior, such as attention-deficit and hyperactivity disorder.
    • Just because an individual displays one or more of these risk factors does not mean they suffer from IED. However, the presence of risk factors in addition to the characteristic symptoms of IED, explosive episodes of rage, should be cause for concern.
  2. Learn to differentiate rage from normal anger. Everyone finds themselves feeling or expressing anger from time to time, and it's perfectly healthy to do so. Rage, on the other hand, is a destructive emotion that can cause us to act in ways we normally would never think to. While anger may influence the way we behave while experiencing it, rage seems to utterly command our behavior and thought, leaving no room for anything else.[2]
  3. Recognize episodes of abrupt, unexpected anger. Explosive episodes seem to come out of nowhere. An IED sufferer may find themselves in a steady, or even pleasant mood, conducting their daily business when, without warning, they find themselves overwhelmingly angry, displaying uncontrollable, violent behavior.[2]
    • While explosive episodes are most likely to occur in private, often after dark, their unpredictable nature means that they may sometimes occur in places where loud or highly visible expressions of anger are inappropriate, such as at work or in public places.
  4. Judge the extremity and violence of any anger-related behavior. Sufferers of IED often become extremely violent, or even abusive, during their explosive episodes. Seemingly tiny arguments or frustrations can lead, in the blink of an eye, to extraordinary and uncharacteristic displays of physical and emotional cruelty. These displays are usually very sudden in their onset, making them unpredictable and dangerous for everyone involved.[4] Common examples of violent behaviors linked to IED include:
    • Shouting or screaming, even though the person being spoken to is not raising their voice.
    • Invading personal space, often by stepping close and getting "in the face" of those nearby.
    • Throwing, hitting, or breaking objects.
    • Shoving, grabbing, or hitting others.
    • Intentionally hurting oneself, such as by slapping or punching, beating one's head against a wall, etc.
    • Name-calling, or use of language intended to hurt or insult others.
    • Threatening others with violence.
    • While the specific behaviors displayed by an IED sufferer during an explosive episode may vary, they are always characterized by being disproportionate, or "way over the top", relative to the circumstances or events triggering the episode.
  5. Determine the length and after effects of episodes of anger. A true explosive episode can last for several hours before it dissipates naturally. After an extended episode of rage, the sufferer is likely to feel exhausted, and relieved that the episode has ended. Later, the sufferer may feel intense remorse, shame, and unease while thinking about the things they said and did while experiencing their explosive episode. These feelings can lead the sufferer to become depressed, irritable and removed[5]
    • An IED sufferer will also often experience much shorter episodes, during which they might momentarily "snap" at someone in conversation, becoming suddenly verbally or physically hostile before returning to normal.
    • Episodes occur irregularly, with gaps of days, weeks or even months in between.
  6. Seek the assistance of a mental health professional. Only a medical expert can diagnose someone with IED, or any other mental illness. Your first step, if you suspect that you or someone you know is suffering from IED, should be to consult with a psychiatrist, councilor or medical doctor about the symptoms and risk factors which are bothering you. Once any anger issues have been diagnosed, you and your doctor can begin exploring options for treatment.

Tips

  • If there are firearms, or other weapons, present in the house, they should be locked up or hidden away so that they are inaccessible to the person struggling with impulsive aggression.

Related Articles

Sources and Citations

  1. ↑ http://www.health.harvard.edu/newsletter_article/treating-intermittent-explosive-disorder
  2. ↑ 2.0 2.1 2.2 2.3 http://outofthefog.website/top-100-trait-blog/2015/11/4/raging-violence-and-impulsive-aggression
  3. ↑ http://www.healthline.com/health/aggressive-behavior#Treatment5
  4. ↑ 4.0 4.1 4.2 4.3 4.4 4.5 http://www.mayoclinic.org/diseases-conditions/intermittent-explosive-disorder/basics/coping-support/con-20024309
  5. ↑ 5.0 5.1 5.2 http://www.newhealthadvisor.com/Intermittent-Explosive-Disorder.html
  6. ↑ http://www.mayoclinic.org/diseases-conditions/intermittent-explosive-disorder/basics/coping-support/con-20024309
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