Sunday, July 14, 2013

Outsmarting Anger

First a Story

It doesn't help that between patients this morning, my mother tells me that she's still sick.  It started Saturday, a bug, nothing terribly serious. She looked gray yesterday with make-up.

In anticipation that she might be unable to eat today, before pedaling off to the office at 8:00 a.m. I stopped by her apartment to check her pulse and drop off breakfast, lemonade and jello. That's all any of us get in our family when we have symptoms of gastroenteritis, ala FD's expertise.  It's worked for us forever.

Mom is out cold when I get there early in the morning. After all, no place to go, except maybe the ER, and she doesn't appear to need that. Four various combinations of patient family members at the office later, it is time to check on her again.
Chicago Bike Path June 2013 Spring

How do we interpret the events so far?

I'm stressed, although keeping my cool, not hurrying or riding recklessly to get to the patient.  In my town, although it is considered a biker's town (read flat), if you don't ride cautiously you won't ride for long.

And it is a beautiful day, even at noon when it is ordinarily hot and humid in July. Miraculously, yesterday's humidity is gone and there is a lovely breeze coming from the lake.  I feel that superiority only people who ride bikes can feel-- it doesn't get any better. Runners and sailors feel it, too.

Then guilt sets in for enjoying myself, and I wonder whether or not I love my mother enough.  Shouldn't I  be worried about her falling in the bathroom?

How is it that we humans can feel two very different things simultaneously, worry and happy.  Worry, I posit, is the intellectual feeling of that particular moment. Happy is more sentient, the emotional or physical feeling at the time. We don't get that many great-weather-days in Chicago, so happy overrides worried.

Most of my ride is through parkland on paved paths. Mayor Daley, before Rahm Emanuel succeeded him, made sure bike riders, power walkers, buggy pushers, toddlers on Big Wheels, and he himself, a bicycling enthusiast, could traverse several miles without stopping at a traffic light. .

But once out of the park my last city mile is all traffic, and I have to be more careful, the Sunday drivers are out. Not that there aren't bike paths on the city streets, there are, so technically there should be no problem. Blocking a bike path warrants a steep hundred and fifty dollar fine. Even more, $500 and up, $2000, rumor has it, for those who (a) don't look before they open their car doors or (b) engage in the sport of picking off bike-riders this way. We are a sports town.

So imagine my surprise (not really) that the rules are violated. The first car that blocks my way sends me into traffic, but gets a pass. A few blocks later, a Chevy driver, his elbow hanging out of the driver's window, cell phone attached to his ear, hears me assert,
"You might get a big fine parking in the bike lane."
I'm not exactly a citizen-police type, and in more sane, less stressful moment would never have done this. Blogging about it, btw, one way of working it out. Ours is something like my exchange with the dog people in the park, the ones who used to let their dogs run loose. See that ecosystem post).  The Chevy driver, as I peak at him and ride off, isn't an elegant guy. His belly is hanging over his jeans and his tee-shirt is covered in sweat. Blurting to him is a mistake, we'll see.

He sneers at me as I pass,
"Shut up." A nasty guttural tone. 
I ride off, look back as he shouts the "B" word at me.

It's a beautiful day in the neighborhood, a beautiful day in the neighborhood, won't you be mine.

The crazy thing is that I even considered turning around to explain myself, wanted to tell him that this in his best interest, respecting the law.  But now I have to worry that he may vengefully come after me, veer into my space, knock off that little old lady on her way to take care of an even older little old lady.

I worried so much that I found myself looking back to the point of disorientation, danger, and at one point hopped onto the sidewalk, yes, a violation.

What you need to know:
Outsmarting Anger- Joseph Shrand, Leigh Devine

Occasionally we talk self-help here. It can't just all be about me.  Dr. Joseph Shrand and Leigh Devine, MS, authors of the lovely little book, Outsmarting Anger, might use the story as a teaching example. They would tactfully suggest that I sublimate anger, surely a character trait that will sabotage my sanguine nature in the end.  One day I will blow up for nothing, or displace my anger toward the wrong person, someone who did nothing wrong except maybe be in the wrong place at the wrong time.

Oh! That is what happened, although we might not call my suggestion to respect the bike lane a technical blow-up.

The doctors would be right, probably. But I'm too out of touch with my anger to say.

Anger, we learn from Outsmarting Anger, is the emotion that follows a threat. A threat is someone or something that might compromise our resources, residence, or relationships.  For this lesson alone, the book is on a Number One recommendation for anger management connoisseurs, and who isn't one.

The fellow in the dirty tee, by swearing, threatened my sense of safety, and my resources (the road). I feared for my life, too, my relationship with me.  As you know, fear, an arousal emotion, is a close relative of anger. Shrand and Levine explain how the two connect.  Unconsciously or consciously we fear a potential loss based upon our sensory perception. Then we recognize (cognate) the threat in the form of the other's anger. We respond to protect ourselves in the best way we know how, in kind, with anger.

What else do the Harvard researchers tell us about anger?

Those who can't control theirs have a somewhat immature prefrontal cortex. This makes sense to me, for I've always told my addict patients the same thing, those who can't resist the impulse to use substances, eat too much, gamble, or have lots and lots of sex, little else on the brain.  In those moments of caving to the urge we use a primitive part of the brain, the one that isn't thinking, that operates on auto. Like a dog to a piece of meat.

Stop and think, is the intervention. See yourself as a homo sapien before beginning another cocaine binge. It really, really wasn't fun coming off of it the last time.  But memory for addicts is like memory to women who want to get pregnant again. Not bad the last time, was it, that labor and delivery! A walk in the park.

If our problems with anger are all about an immature prefrontal cortex, how can we hasten its maturity? (This interpretation of scientific findings is rudimentary, but who can stop?!)

Think of another mantra around here, that adults who hate themselves but want to change, should take heart. Adults are quite capable of quick change, more capable than children who may not yet have the biological maturity to abstract, save and review. We have the physiology in place, only need to flex our muscles, establish lasting connections between the brain and the extremities.

Not so fast.

The subtitle of Outsmarting Anger, 7 Strategies for Defusing Our Most Dangerous Emotion refers to a deceptively simple but very useful 7-step treatment plan:

recognize rage, envision envy, sense suspicion, project peace, engage in empathy, and communicate clearly (I tried!).

This sounds simple, but if any of this were simple then we wouldn't have to worry, would we, about people shouting expletives from car windows, wouldn't have to feel that anxiety, disruption, that lingering upset that is bundled with anger, and for some of us fear, for the rest of the day.

We don't have bumper stickers on bicycles, but if we did, life would be so much more fun.

therapydoc 

3 comments:

Bridget said...

Another great piece. Very thoughtful and useful. Thank you, Bridget

Anonymous said...

not necessarily on topic, but what do you do with sorrowful feelings over a event that happened years ago--when ever you see the person you feel tremulously happy and loving but in the back is that nagging sorrow at times.

Anonymous said...

And how's your mom?

  Bring them home, the Homeland Concert There's not much to say. Wait, I take it back. There's SO much to say it is too much. There ...