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Is There A Link Between Anger And Post Traumatic Stress?

Is there a link between anger and posttraumatic stress disorder (PTSD)?  One answer is that anger is a recognised part of posttraumatic stress and appears in both DSM-5 and ICD10 diagnostic criteria for PTSD.

In the context of PTSD, anger is known to arise spontaneously following any sufficiently traumatic experience and is likely to continue being a problem until the trauma is resolved.

Does that mean that anyone that becomes unreasonably angry is suffering from PTSD?  The answer is possibly, but not definitely.  The reason is that there's alot more to a diagnosis of PTSD than anger.  If we remove the word Disorder, however, then a link can be drawn that shows the similarities between PTSD and anger - and trauma is clearly visible in many people struggling with anger.

Angry People Have Often Been Traumatised

I've been working as a psychotherapist for over ten years and I have never yet worked with anyone that struggles with angry outbursts that hasn't been traumatised.  And that includes those suffering from complex personality disorders associated with anger and violence.

Symptom Similarities

The way that I understand what happens to people struggling with anger can be similar to some of the diagnostic criteria for PTSD, just not all of them.  For example, it is possible to see that what many working in anger therapy refer to as the 'triggers' for angry outbursts are the same thing as the 're-experiencing' referred to in trauma therapy: they are both intense or prolonged psychological and physiological distress/reactions to internal and/or external reminders of a traumatic event.

In the context of understanding anger, these 'internal or external' reminders could be anything - a look from a loved one, a threatened (or perceived) abandonment, a mess on the table, someone cutting them up on the road, or any of the other 'triggers' that set off an episode.

But if you are the person that becomes too angry, don't read this and say, ah, there's nothing I can do about this - I'm suffering from PTSD.  Even if that is so, you still need to deal with the problem, because PTSD or not, the anger will still destroy your relationships, your family, potentially your work/career and ultimately, it has the power to ruin your life.

Other symptoms for PTSD that are common among people struggling with anger include:

Persistent and exaggerated negative beliefs and expectations - usually about themselves but also often applied to others; persistent distorted beliefs about the traumatic event(s) that lead the individual to blame himself/herself; persistent negative feelings; feelings of being alone; irritable behaviour and angry outbursts towards people or objects; reckless and self-destructive behaviour and risk taking; and being unable to switch off or relax.

Childhood Trauma and Anger

I do believe that more or less every person I have met that struggles with anger has themselves been traumatised - most often in their childhood.  The main difference that most clinicians would argue is that the 'trauma' needs to be life threatening or extreme in some other way to meet the criteria for PTSD.  In my view, neglect, danger, constant insecurity, anger, physical and verbal attacks, threats, disinterest, use of extended silences and rejection, abandonment and so on, are all life threatening to a small child due to the child's complete reliance on their parent/s for care, nurture and survival.

Can Anger Be Treated As PTSD?

Within a well-rounded treatment plan, approaches that are similar to those used to help someone in post-trauma difficulty or even those suffering from PTSD could be used and these might include EMDR.

See here for a link to my page on PTSD and EMDR treatment on my main counselling and psychotherapy site for more information.