- trigger log: this is where you log every day as many times a day that you can, a brief statement of what you are doing and how you feel in your body and any emotions you feel. This log becomes even more powerful in changing behavior if you also including coping skills tried and how you felt before and after. It helps reinforce for the brain there is another path to feeling better than angry outbursts.
- trigger logs will help you to begin to recognize when anger starts to build and what triggers it. This will allow for better interventions before it's out of control.
- DBT distress tolerance skills. Check out DBTselfhelp.com and lots of good workbooks out there. DBT group therapy can help a lot too with this kind of ragefull impulsivity.
- CBT technique of urge surfing. This works really well for me - it took time to learn how to do but is the most effective thing I've ever tried.
- grounding skills. Things like holding ice, etc, work well not only for panic and dissociation, but rageful anger as well. Grounding skills work best when they are practiced many times a day when not feeling strong emotions. Then when they are really needed, they can be quite powerful.
- rexamining boundaries. Anger isn't bad in and of itself. Rage is the behavior to control, but anger is just and emotion and it often gives us valuable information that something we care about is at risk or a boundary has been crossed. Setting and keeping better boundaries may help. Keep in mind boundaries are not about changing others, but changing ourselves and what we allow into our lives and not.
- look into skills to reduce emotional vulnerability (also a DBT skill set) and this will go a long ways to help increase frustration tolerance
- challenge distorted thinking (and we all have this from time to time.) If you can't do it in the moment, then journal about it afterwards. For more info on this, use the search bar above to find many great threads and articles about common distorted thinking patterns and challenges to them. It can really be surprisingly powerful.
-address any perceived or real threats to safety. For someone with PTSD, rage is often a maladaptive coping skill to try to protect ones self from feared danger. It might mean reducing actual dangers. Things like developing strong safe place imagery can help too. Visiting any kind of imaginary (it really does biochemically work even if imaginary) or real safe places during the day long before the rage hits can really help reduce the 0-60 bursts of anger.
- remember its not just tolerating and managing the anger, but beginning to really work on reducing that fight or flight activation and connecting to the here and now
- mindfulness (also included in DBT and ACT therapy and therapy workbooks) can be really helpful too
- practice saying no and walking away from a situation when it's easy to do that and then when you feel out of control, it will becomes easier, more habitual to take a break from the interaction and walk.
- physical excercise
- apologizing or otherwise making any damage done whole again. It's not because you are bad or shameful, but it's a way to help your brain slow down and connect the behavior to a difficult outcome. If you are not ready to do this or it would create more exposure to triggers, skip it for now.
- positive affirmations. Really. Pick 5 positive affirmations to put on a Flashcards or into a smart phone to look at and read 5 times a day. They don't have to be over the top. They can be as simple as "I'm learning new skills." "I can advocate effectively for myself" "I can be more powerful and persuasive when calm" "I am perfectly imperfect" and so on --- you absolutely do not have to believe any of them. But reading them over and over will start to shift your thinking, and this will shift behavior over time. (I thought this seemed kooky at first but tried it out of desperation and it's so helpful.)
- inner child work. Rage is a somewhat regressed way of responding to the feeling of anger. Sometimes doing work to take care of the inner child can help a lot. Inner child and internal family system therapies have change my life in regulating intense emotions of all types. It helped me get through an awful flood of anger and fear just yesterday in a less bad way than in the past.
- reward yourself for every small victory. Even if the victory is that it took a little longer before the rage kicked in. This kind of positive feedback loop has been shown in studies to do a lot to help brains and behavior change over the long haul - more than just negative consequences (which have been shown by studies to only creat space to pause in the short term.)
- evaluate any medication changes if you are on any. Some meds can increase rageful outbursts
Those are a few things that have helped me. I hope you find what will work best for you! :hug:
