The depressing consequences of anger arousal: Cognitive behavioral treatment of anger-related depression

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In response to the case of Mary, a moderately depressed woman who also reports frequent “anger attacks,” I suggest that Mary's dysphoric mood is primarily related to problems in managing her frequent and intense episodes of anger arousal. These episodes have resulted in social contacts reacting negatively toward her, employers terminating her, and a general feeling of sadness and dysphoria. Treatment would progress along four related dimensions. First, it is critical to establish a strong therapeutic relationship, which can be particularly difficult with angry patients. Second, Rational Emotive Behavior Therapy would provide her a set of cognitively oriented skills so she may help herself outside of the therapy sessions. Third, to address the escape conditioning aspects of her current problems, anger-related exposure techniques may positively affect aspects of her anger problem that are likely to remain immune to verbal persuasion attempts. Fourth, skill-building techniques that might foster more solid social relationships would also be applied. By focusing on her anger, she might be less prone to attack others with angry and verbally aggressive outbursts, resulting in a less hostile and more friendly context in which to achieve her goals.