Anger: The Mismanaged Emotion

Sandra P. Thomas


Dermatology Nursing. 2003;15(4) 

In This Article

Research-Based Anger Management Strategies

The cardinal principles of anger management are (a) taking constructive action on the precipitants of anger whenever possible, and (b) when no constructive action is possible, finding healthy ways to discharge the strong physiologic arousal of anger through exercise, laughter, or calming techniques such as meditation (Thomas, 2001). Habitual anger suppressors (often female) may need to learn that honest expression of feelings need not damage relationships. Habitual anger venters (often male) may need to learn that judicious use of assertive behavior gets better results than yelling or cursing. Research shows that there are notable health benefits of simply talking over an anger incident with a supportive listener, even if the individual cannot talk directly to the provocateur because of status differences (supervisory personnel) or because of situational constraints (inappropriate time and place). Individuals who regularly discuss anger episodes with a confidant have lower blood pressure and better general health status (Thomas, 1997). Anger discussion is correlated inversely with stress (Thomas & Donnellan, 1993) and depression (Droppleman & Wilt, 1993); in other words, less stress and depression are experienced when the individual discusses anger rather than harboring it and ruminating about it. Additionally, Ausbrooks, Thomas, and Williams (1995) found that anger discussion is positively correlated with a stronger sense of self-efficacy and optimism. Talking out anger incidents with a confidant yields other benefits as well. Insight into the dynamics of the interaction may be developed from a review of the incident, and after doing so, a plan may be generated to solve the problem (Thomas, 1998).

Increasing personal skill in conflict resolution is valuable both for an individual nurse and for the organization in which the nurse works. A critical analysis of research on nurses' conflict-management strategies revealed that the two predominant strategies were avoiding and compromising (Valentine, 2001), although the most effective strategy would be collaborating (Marriner-Tomey, 1995). Valentine attributed nurses' underuse of collaborating to (a) their perceived power differential with regard to physicians and administrators, and (b) their lack of self-confidence. She also speculated that nurses may doubt that conflict presents an opportunity to learn to resolve issues.

Many nurses could benefit from developing increased skills in assertiveness, bargaining, and negotiating. Classes at a community college in speech or debate techniques can be helpful in learning how to mount an argument and deliver it persuasively. Such classes frequently involve videotaping so the individual can learn to minimize distracting mannerisms that undercut personal effectiveness. As always, new skills must be practiced; professional organizations provide the perfect opportunity to do so. An added benefit is joining forces with other nurses who care about the same workplace issues, such as unsafe conditions and ill-conceived policies.

Counseling is recommended for individuals whose anger is intense and chronic. There is empirical evidence that cognitive-behavioral therapies are efficacious in reducing irrational thoughts and ineffective response patterns (Deffenbacher, 1995). Individuals whose gender role socialization inculcated dysfunctional anger management patterns may want to avail themselves of women's groups or men's groups that assist in exploring new conceptualizations of femininity and masculinity. When grievances are of long duration, as in the case of the nurses whose management did not support them when they experienced a patient assault, it may be time to relinquish the resentful feelings through forgiveness. Forgiveness does not mean condoning the wrongful actions of another; it means liberation from carrying the heavy burden of old anger, bitterness, and sadness (Thomas, 1998). Significant reductions in long-held anger have been achieved by highly structured small-group forgiveness interventions (Thoreson, Luskin, & Harris, 1998). There are a number of healing rituals that individuals can undertake on their own as well (Thomas, 1998).


Once educated about anger and empowered to act appropriately on behalf of his or her rights as a human being, each nurse has a vital obligation to the profession. Each has a part to play in creating a more humane and satisfying workplace, and ultimately, a more powerful profession. Anger and conflict will always be present in the stressful health care delivery environment. However, intelligent management is possible -- and indeed, urgently needed.


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