nhs controlling anger and frustration

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First Steps, Version 2, March 2013 - 1 - Controlling anger and frustration

A First Steps guide to

Controlling anger and frustration



First Steps - 2 - Controlling anger and frustration

“ Wound up”

“ Rage”

“ I can’t take any more”

“Frustrated”

“ Boiling over”

…are just a few of the words commonly used to describe anger.

Anger is a normal healthy emotion that is part of our body’s survival mechanism. However, attimes it can be triggered at a time when it is not helpful which can have a significant impacton a persons function, happiness, relationships and self-esteem. Anger and frustration are

often associated with loud and aggressive behaviour, but it is just as common for a person towithdraw and ‘bottle up’ their emotions. This booklet aims to give some information on angerwith self-help strategies that are known to be helpful in managing anger in a more positiveand helpful way.

In a recent survey for the Mental Health Foundation, 28% of adults said they worry abouthow angry they sometimes feel, and 32% have a friend or relative who has problems dealingwith anger.

Using self-help tools

The strategies/tools suggested in this handout and during this session are evidence basedmethods of managing emotions and reducing the effects the way that we feel has on oureveryday life. We are all individuals and respond to situations in different ways therefore notevery tool will work with everyone. For example, some people find meditation and readingreally relaxing, whilst for someone else this could be a cause of stress and their preferredrelaxation method is to go to the gym. There are no set rules for managing emotions. Ahelpful way of thinking about this could be to think “is my current method working for me?” If the answer is yes, then great, but if not, these strategies may be an alternative way that ismore productive for you.

As with any new skill, self-help can take time and practice. In the same way that reading acookery book will not instantly make you a great cook, simply reading this material will notmake you instantly happy and healthy. But with time, practice and exploration it is possiblefor everybody to experience emotional well-being. Self-help alone may not be adequate foreverybody. If you feel that you need more support, it is important to discuss this with yourGP. In addition please look at our website (www.firststeps-surrey.nhs.uk), or call our phoneline/email us for more advice.




What is in this booklet?

Page

Why do we feel angry and frustrated 4

What is anger 4

What causes anger 5

The vicious cycle of anger 7

What an angry episode does to our body 9

Becoming aware of the effects anger has on our physical health 10

Helpful facts about anger and frustration 10

The stress jug analogy 12

Beliefs about anger that can be unhelpful 13

Strategies for control ling anger and frustration 14

Unhelpful thinking styles 15

Challenging angry thoughts 17

Coping strategies 19

Distraction techniques 21

Relaxation techniques to help control anger 22

Lifestyle changes 25

Useful contacts 27




Why do we feel angry and frustrated?

Anger is a normal emotion that we all feel at times. Things that can make you feel angryinclude:

Feeling upset, sad or low in your mood

Feeling anxious or stressed

Being tired, hungry or in pain Losing someone you love (grief)

Feeling undervalued

Feeling misunderstood

Feeling threatened

Medical conditions or coming off certain medicines

Stimulants

Lack of sleep and/or feeling tired

Alcohol

Sexual frustration

Feeling out of control

Situations that feel unfair or unjust

What is anger?

Our levels of anger can vary from being felt as a mild annoyance or irritation to an extremefeeling of rage.

For some people, anger can get out of control and cause problems with relationships, workand even the law. Uncontrolled anger can lead to arguments and physical fights, butsometimes it causes people to ‘bottle up’ emotions and feel withdrawn. It can cloud yourthinking and judgment and may lead to actions that are unreasonable and/or irrational.Uncontrolled anger often leads to feelings of depression and low self-worth.




What causes anger?

When a person thinks of their cause of anger they often look for something that hashappened to them, a situation, event or other people’s behavior. We call these our externalcauses of anger. We also have a second cause of anger: our own thoughts, feelings andbeliefs and interpretation of the event or situation which we call our internal causes of anger.

The two are very closely linked and it is a combination of both the internal and external

causes that leads us to feel the way that we do.

Events There may be certain events or situations which are more likely to trigger an angry reaction. This will be different for different people and could include things such as debt, inconsideratedriving, rude behaviour or harm to a loved one.

Our thinking stylesOur interpretation of an event and thoughts that we have about the situation may account for

us feeling frustrated or angry. For example, a situation in which we feel wronged in someway can be particularly difficult. Or where we feel that an injustice has been made that wefeel is unacceptable. The way we think about anger may also influence the way we expressor control it. For example, we may we think that anger should be hidden or “bottled up” ratherthan expressed. This style of coping may be beneficial in the short term, but will often have along-term cost. Finding other ways to manage emotions in a more appropriate and sensitiveway will have a more positive effect.

Behavioural causes Throughout our lives we learn to react to events or situations in certain ways. This is shaped,

and continues to be shaped, by our role models and experiences from birth to the presentday. Our learnt experiences often account for the fact that some people seem better able tomanage their feelings of frustrations or anger in a constructive and helpful way, whilst othersmay bottle up their feelings or have unhelpful outbursts. As a consequence a learnt pattern of unhelpful behaviours can build up, which in the long term can become more and moredifficult to overcome. It could be that you may not have had the opportunities to learneffective ways of managing and expressing your emotions in the past, but everyone canlearn to constructively express their emotions in the future.

In reality it is likely that a mixture of all these causes will affect how someoneexperiences anger. However, in some ways it is more important to know what

stops us moving past anger, than what causes it




What are your common triggers for anger?

What maintains anger?

There may be a noticeable pattern of triggers to feeling frustrated or angry. For example,whilst driving, looking after the children or when you start talking about money. It might bethat our thoughts and experiences in these situation affect how we anticipate the outcome tobe in the future, which can cause people to feel ‘stuck’ in a vicious cycle.

There may be consequences which reinforce angry behaviour; both costs and benefits. Insome instances people learn that angry behaviour can achieve short-term gain. For example,

having others respect your status or getting your own way. It can also be associated withsignificant long-term costs, such as damaged relationships. Considering and recognisingyour own benefits and costs is important when looking for more helpful ways of managingfrustrations and anger.

When looking more closely at what prevents us from overcoming unhelpful anger, it becomesclear that our behaviour, thoughts, feelings and physical sensations all interact and combineto create a vicious cycle of anger.

Outside world (people, events, noise)

Inside world (thoughts, worries, memories)




The vicious cycle of anger

The diagram below illustrates the link between the situation, the thoughts we are having inthe situation, how we behaved, how our body felt and our mood. When we are angry we areusually aware of our emotions, “angry and frustrated”, however we are sometimes lessaware of the way we are thinking or feeling physically, which are often the things whichmaintains the emotion.

OUTSIDE WORLDDebts and practicalproblemsProblems with peopleNot enough time foryourself

INNER WORLD

THOUGHTSYou’re making a fool of mePeople think I’m stupidI’m not being heardI’m always being let down

I hate this place

EMOTIONSFrustratedAngryGuiltyLow

BODILY FEELINGS TenseShakingRacing heartChest pains

BEHAVIOURShoutingGetting into fightsSlamming doorsAvoiding situations

Bodily signs of anger can lead us to feel out of control and this can make our

mood worse. The angry “ hot” thoughts can make us feel even more enraged




Your own example

Does a similar vicious circle of anger happen to you? Using the cycle of anger diagrambelow, see if you can think of a situation in which you felt particularly angry and/or frustratedand identify the thoughts that you were having at the time.

OUTSIDE WORLD

INNER WORLD

THOUGHTS

EMOTIONS BODILY FEELINGS

BEHAVIOUR




What an angry episode does to our body

Anger is a last-ditch survival response, designed to help us survive when faced with a life-or-death situation. This response is called our ‘fight or flight’ response. Our bodies are notdesigned to sustain a prolonged period of heightened arousal. Hence constant anger in aperson can lead to physiological problems due to the strain on the body.

Other emotions that trigger this response include fear, excitement and anxiety. The adrenalglands flood the body with stress hormones, such as adrenalin and cortisol. The brain divertsblood away from the gut and towards the muscles, in preparation for physical exertion, whilstour heart rate, blood pressure and respiration increase, the body temperature rises and theskin perspires. The mind becomes more focused and alert.

Here’s how anger affects a person…

Dilated pupils

Flushed/pale face asblood is diverted tothe major muscles

Increased sweat

production tohelp to cool the

body

Increased breathing rate toincrease the body’s oxygen

levels

Palpitations and/or chestpains to transport

oxygenised blood to fuel themajor muscles and organs

Cold hands as blood isdiverted away from the

extremitiesShaking




Becoming aware of the effects anger has on our physical health

The constant flood of stress chemicals and associated metabolic changes that accompanyrecurrent unmanaged anger can eventually cause harm to many different systems of thebody. Some of the short- and long-term health problems that have been linked to

unmanaged anger include:

Headache

Digestion problems, such as abdominal pain

Insomnia

Increased anxiety

Depression

High blood pressure

Skin problems, such as eczema

Heart attack

Stroke

Helpful facts about anger and frustration

Anger can be a posit ive and empowering emotion if used construct ively. Anger is anormal emotional response which everyone experiences from time to time. The goal of effective anger control is not to eliminate anger altogether, but to learn to channel it intobehaviour that is productive not destructive. The use of more positive behaviours such asproblem solving and assertiveness can improve your life.

Aggression is a learnt behaviour that can be changed. Motivation and commitment tochange are essential to successful anger control. Although we may be born with thepotential to be aggressive, we learn different ways of behaving as we develop and mature,

which are influenced by those around us. For some of us this might mean we learn to beaggressive or to bottle up our feelings. However, in the same way as our body may havelearnt to react in an unhelpful way, we can teach our bodies to react in a more helpful,constructive manner.

The beliefs that we develop influence the way we understand people and situations. Our learnt beliefs affect how we see a situation and can lead us to behave in a certain way.Holding irrational beliefs can lead to irrational behaviour. This relates to long-term thoughtsand our views about how the world should be. For example, believing that life should always be fair inevitably leads to disappointment and frustration, and can ultimately result in

us taking our frustrations out on others. Recognising that life is not always fair can give us adifferent perspective on life.




An understanding of what we think affects the way we behave. This increases ourability to control ourselves. Recognising our thoughts and feelings about an event orsituation, and the impact they have, is one of the first steps to controlling our behaviour.Recognising patterns of thinking, such as the tendency to think in an ‘all or nothing’ way mayhelp you to identify your negative thoughts so that you can then challenge them. Learning tochallenge these thoughts by considering alternative explanations can reduce conflict and the

potential for aggression.

What you feel affects the way you think and behave. Positive and negative feelings arecommon to us all. The degree to which we experience these emotions affects ourperceptions of situations and also the way that we react. Recognising our negative emotionsand learning to reduce their impact on our thoughts can help us control our behaviour.

Anger has a physical component . An awareness of how the body reacts physically can beused as an early warning sign to help you calm down by using coping strategies before it istoo late. Symptoms such as increased heart rate and tense muscles can be alleviated

through techniques such as relaxation.

Aggression almost always resul ts in negative consequences for ourselves and others. Knowing the negative short- and long-term consequences of aggression reinforces theunderstanding that it is always better to manage anger and frustration. Managing aggressiveimpulses can result in better relationships, increased self-esteem and more positiveconsequences in general.

Knowing the specific factors that are likely to make you aggressive will help you tocope with them as they arise. Underlying factors such as negative life experiences can

influence the way that you view the world and make you particularly sensitive.

Loss of control is usually a result of a build up of small irritants that have not beendealt wi th. These, along with everyday pressures can work together to create an aggressivereaction that is out of proportion to the actual situation. Sometimes the final trigger or ‘laststraw’ can be a relatively minor incident.

An imbalance of chores and pleasures in your general li festy le could increase thelikelihood of feeling angry or frustrated. Looking after yourself and your needs will makelife more pleasurable and rewarding.




The stress jug analogy

As humans, we only have a certain capacity for managingstress. Imagine that all of your stress was in a jug. The fulleryour jug is, the greater the symptoms of stress will be. Oncethe jug is full, your ability to manage any situation that arises isgreatly compromised, which is why you may feel less able tocope with matters that would normally have no effect on you.

Some of your jug is already filled with the anxieties of life thatwe cannot avoid, (i.e. money, illness, family, not havingenough time for yourself, etc.). Therefore, if you have a largesource of stress in one area of your life that is filling your jug,your capacity to manage stress in the other areas will be

compromised. You may feel that you manage your stressful job very well, for example, butfeel that you are unable to cope with any stresses at home or vice versa.

If you partially empty your jug on a daily basis, you can avoid it ‘over-flowing’ which will helpyou to reduce your symptoms and to feel more in control. It may be that you are unable tochange the main contributor to your stress, but if you can do something about your othersources of stress, you will feel better able to cope.

You can empty a litt le out of your jug on a daily basis by using self-help techniques to:

Look at your stressors to see if there is anything you can do to reduce the level of stress they produce or if you could manage them in a different way

Identify if the stressful situation is really your responsibility. If not, could it bedelegated to someone else or could your energy be better used elsewhere?

Have time to relax. This may be by completing a relaxation routine, playing a sportor socialising, etc.




Beliefs about anger that can be unhelpful

There are many beliefs surrounding anger that only help to maintain feelings of stress andanger. The beliefs are sometimes held because of life experiences or personal values. Somepeople may have lived with these beliefs for a long time and have become to accept them astruths. It is important to question these beliefs and see how true they really are.

“ I’ve inherited my anger from my mother/father so I can’t do anything about i t”Although people can be born with tendencies towards being more emotional, it is the way wereact to our environment that is the cause of our anger and this is a learnt behaviour that canbe changed.

“ If I don’t let my anger out, I’ll explode”Whilst it is true that keeping your anger in can be bad for your health, it is important to makesure you release and manage your anger in a way that is assertive rather than aggressive.

“ Anger protects me”If you are feeling vulnerable or afraid, you may feel that it is safer to communicate in an

angry or aggressive way. This will only mask your anxiety, rather than allow you to addressthe situation and move forward. It often leaves you feeling more vulnerable in the longer termas relationships and support break down.

“ I have good reason to be angry”Anger is a natural reaction when we are mistreated or taken advantage of. Maybe at somepoint someone was unfair to you, but you must ask yourself how staying angry will benefityou in this situation. Is maintaining your anger really working for you? Letting go is animportant step to take when nothing can be done about a situation. It is not about acceptingor agreeing with the situation, rather just recognising that whilst it was unfair, continuing to beangry is not helpful to you or those around you.

Examining long term held beliefs about anger and then challenging those beliefsthat have been unhelpful in the past can help to improve the way we view a

situation




Strategies for controlling anger and frustration

So far we have looked at what anger is, the different parts of anger and what causes it. Thenext part of the booklet is looking at useful strategies to help you learn more effective ways of managing anger.

The good news is that whilst we can’t control the events that take place in our everyday life,

we can start to challenge the ways in which we respond to them, and in turn break thevicious cycle of anger.

Get to know the signs The first step to breaking the cycle is to become more aware of the ways that anger affectsyou.

Think about this and make some notes on when you’re angry:

The way you feel physically

The emotions you experience

The way you think

The things that you do

The second step is to t ry to break the cycle which can be done in a number of ways

Challenge any negative thinking Challenging unhelpful thoughts and the unhelpful thinking patterns and distortions

Learning personal coping strategies

Communicating your anger in a positive way

Change your behavioural patterns or actions Distraction techniques

Change your behavioural patterns or actions

Relaxation and lifestyle

Techniques to reduce the physical feelings of anger Lifestyle changes

Alcohol

Notes:




Unhelpful thinking styles

If we look back to the vicious cycle of anger on page seven, it becomes clear that if we canchallenge our angry thoughts and reduce the physical symptoms of anger then we can reallystart to control anger and avoid getting to the point were we behave in an unhelpful way.

Taking things personally

People can often take things personally which results in increased emotions includingfrustrations and anger. Do you often assume criticism is a personal attack on you or an

attempt to help you perform? Think about both at work and/or at home. Do you assume thatif a person doesn’t speak to you it is because they are ignoring you or that they may just beshy or have not seen you?

Ignoring the positive

People tend to ignore the positives in life and this can particularly be the case whensomebody is experiencing emotional distress. When people are frustrated or angry, theytend to focus more on the negative aspects of a situation, when there may be an alternative,more balanced perspective. This can increase their feelings of frustration.

Does this sound familiar to you? Can you think of times when you take things personallyand feel hurt or angry? Write down some examples……………………………………………………………………………………………………….……………………………………………………………………………………………………….…………………………………………………………………………………………….…………

……………………………………………………………………………………………………….

Do you sometimes ignore the positives? Write down any recent examples……………………………………………………………………………………………………….……………………………………………………………………………………………………….…………………………………………………………………………………………….………………………………………………………………………………………………………………….……………………………………………………………………………………………………….

Remember, some people find i t dif ficult to recognise their unhelpful angry thoughtsas they have become so automatic. If you feel that this is the case for you, it can behelpful to try to recognise any thoughts after the event or if th is is not possible just

recognise that these thoughts are there




Perfectionism

Sometimes anger can be caused when we expect too much of ourselves. When you set agoal, set a realistic target. Push yourself, but only within what you can realistically achieve.Otherwise, we set ourselves up for disappointment when we do not meet the targets, whichin turn can lead to anger directed at both ourselves and others. Using the “should” or “must”words puts unnecessary pressure on ourselves. “I should be able to do this”, for example,could be changed to “I will do my best”.

Black and white thinking

There are often shades of grey in life, or compromises to be made, but we sometimes seethings as if they are ‘black or white’, or ‘all or nothing.’ These can be pressures we place onourselves or on other people. If someone does not always keep to their word, for example,there are often reasons that the person has let you down. We have a tendency toautomatically blame people, but might be better served if we try to see things from the otherperson’s point of view. Black and white thoughts about our own performance may be “if Idon’t do it brilliantly, there is no point in doing it at all”.

Can you sometimes expect perfection from yourself or others? Write down someexamples……………………………………………………………………………………………………….……………………………………………………………………………………………………….…………………………………………………………………………………………….………………………………………………………………………………………………………………….

Do you sometimes think in black and white, ‘all or nothing’ terms without comprising?Write down some examples……………………………………………………………………………………………………….……………………………………………………………………………………………………….…………………………………………………………………………………………….………………………………………………………………………………………………………………….




Challenging angry thoughts

Once we learn to recognise our unhelpful thinking styles, we can then start to look atalternative ways of thinking.

What is the evidence?

What evidence do I have to support my thoughts?What evidence do I have that tells me that the thought is not true?

What alternative views are there?How would someone else view this situation?What would I say to my friend if they were in same situation?

What is the effect of thinking the way I do?Does it help me, or does it keep me from getting what I want? How?

What thinking distortion am I making?

What action can I take?What can I do to change my situation? Am I overlooking solutions to problems on theassumption they won’t work?

What is the worst possible outcome?

What is the worst thing that can happen and how bad would that really be?What is the probability of that actually happening?

What is the best possible outcome?What is the best thing that can happen and what is the probability of that actually happening?




Coping strategies

Self-calming statementsWhat we think affects the way we feel. Distorted thinking can increase the likelihood of negative emotions such as anger, while calming or challenging thoughts can reduce theimpact of these feelings. In effect we are balancing our angry “hot” thoughts with positive,calming thoughts.

Self-calming statements are thoughts that can be:

1. prepared in advance to anticipate and cope with a situation or trigger2. used to cope with the situation or trigger when it arises3. used to calm ourselves down after the situation or trigger has passed

For example:

Distorted thought “He’s getting at me”Self-calming statement “Don’t take it personally”

It is also important to note that distraction is a specific coping strategy for rumination andshould not be used to avoid dealing with and resolving situations.

Personal coping strategies

Try to thinking of some ways in which you can start to challenge your angry thoughts bycompleting the examples below.

A. Self-calming statements

Before a situation. For example, “Remember, stick to the issues and don’t take itpersonally”

During a situation. For example, “I don’t need to prove myself”

Coping with physical tension. For example, “It’s time to take a deep breath”




Af terwards

If the conflict is unresolved. For example, “I’ll get better at this as I get more practice”

If the conflict is resolved. For example, “I’ve proven I can do it”

B. Distraction

Note at least two ways of distracting yourself that you could use:

C. Rationalising

Note at least two things you can say to yourself to help you see the situation from anotherperspective:

D. Self-praise

Note at least two things you could say to yourself to reinforce your success:

E. Focusing on the task

Note at least two things you could say to yourself to keep you focused on what you aredoing:




Distraction techniques

These are not long-term solutions to anger or frustration, because they are not challengingthe root of the problem, but you may find them useful in the short-term. As with all strategies,some will work better for you than others

Take a walk

Take several slow, deep breaths Describe an object to yourself

Tense and relax your muscles

Call a friend, neighbour, family member for a talk

Try to find the humour in an angry situation

Think of what you may say to a friend. This will help you gain a different perspective.Keep in mind that we are all humans, subject to making mistakes

Take a “time out” – stop what you are doing when you feel your anger growing and walkaway until calm

Count to 10 (or even 100) Drink a glass of water

Do you have any useful techniques of your own?

Change your behavioural patterns or actions

Think before reactingPause before reacting.………… Impulsive reactions can be unhelpful and may lead tofeelings of regret. Giving yourself time to think helps you rationalise any automatic thoughtsand to think of any consequences to your actions.

Focusing on the task This technique helps us to focus on the objective or task that needs to be accomplished. It iseasy to get side-tracked into irrelevant and personal issues. Reminding ourselves of ourgoal (for example, getting permission to have the day off work or getting the car repaired) willhelp to detach ourselves from the negative feelings we may be experiencing in the situation.

Self-praiseAfter a difficult situation has passed, we may still be left with unpleasant feelings, particularlyif we have held ourselves back from losing control. Praising ourselves for remaining incontrol, for example, can help to make us feel better about the situation and ourselves, andincreases the likelihood of future success.




Relaxation techniques to help control anger

When we feel angry we may be very aware of how tense we feel, our heart may be racingand we begin to feel shaky. Trying to control these bodily reactions when we start to feelangry can help us to break the vicious cycle of anger. It can take time to learn these newrelaxation skills, but they can be very effective in reducing the physical symptoms of angerand to help you to stay in control.

Deep breathing

If you can restore you’re breathing to a slower, more even and calmer pace, your body willbegin to relax. As your lungs move rhythmically and gently in and out, there is a soothingeffect on the muscles of your whole body. This exercise helps to reduce the physicalfeelings associated with anger and also just as importantly distracts you from the hotthoughts that you may be thinking. Targeting the physical symptoms and the thoughts thatare causing you to feel angry will help to break the vicious cycle of anger.

How to control your breathing

Instead of using the upper chest area, you need to learn to breathe from the stomach area,using your diaphragm. Correct breathing will help to relax you. To learn to do this:

1. Sit back comfortably in a chair before beginning breathing control.

2. Become aware of your breathing. Breathe gently and slowly.

3. Place one hand on your upper chest and the other over your tummy.

4. Transfer most of your breathing to your tummy so that the movement occurs there. Your stomach muscles should rise and fall as you breathe. As you inhale yourstomach moves out slightly. As you exhale your stomach moves in slightly.

5. It will help to count as you breathe. Concentrate on the number three. Breathe in forthree counts and out for four counts. Maintain a steady, comfortable rhythm and try toavoid holding your breath in between each count.

6. Imagine that as you exhale you are breathing out tension from your body and letting itgo. And when you inhale that you are breathing in fresh strength and energy.

7. In order for this technique to become beneficial you will need to practice it regularlyso that your body can benefit from its value. Practice twice a day for 5 minutes at atime. Return to normal breathing if you start to feel dizzy.

When you are familiar wi th the exercise you will be able to apply i t routinely insituations where you notice the physical symptoms of anger starting wi thin you




Square breathing

This is a simple exercise that helps you to control your breathing whilst distracting yourself from your thoughts or the situation.

Look at something square or imagine a square in your head

Breathe in to the count of four. Imagine moving up along the side of the square

Pause briefly whilst you imagine moving across the top of the square

Then breathe out to the count of six, whilst imagining moving down the side andacross the bottom of the square

Continue as above

Visualisation

A quick way of getting away from a situation without physically leaving.

Imagine yourself walking to a door

Open the door and walk down the three steps, taking a deep breath for each of thesteps

You walk into an environment where you feel relaxed and calm. This could be afamiliar place, a happy memory, or somewhere in your dream.

What can you see?

What can you hear?

What can you smell?

What can you touch? Spend a few minutes in this place, enjoying the feeling of relaxation.

When you feel ready, start to make your way back up the steps, taking a breath foreach of the 3 steps. Make your way back through the door and back into the presentsituation

Breathe in

Pause

Breathe out




Muscle relaxation

Sit comfortably and take a few deep breaths. Now focus on your body, tensing and relaxingeach of the muscle groups in the following order:

Feet – point your toes away from your body, hold, then relax

Calves – bend your foot at the ankle towards you, hold, then relax

Thighs – push your knees together, hold, then relax

Bottom – clench your buttocks together underneath you, hold, then relax

Stomach – pull in your stomach muscles, hold, then relax

Hands – clench your fists, hold, then relax

Hands (again) stretch the fingers wide apart, hold, then relax

Arms – bend your arms at the elbow, bringing your hands up towards the shoulders,hold, then relax

Shoulders – hunch your shoulders up towards your ears hold, then relax Neck – pull your chin forwards on to your chest hold, then relax

Neck (again) stretch your chin up, pushing your neck back, hold, then relax

Jaw – clench teeth together, hold, then relax

Lips – press tightly together, hold, then relax

Eyes – screw up eyes tightly, hold, then relax

Forehead – frown hard, wrinkle forehead, hold then relax

In each case, as you relax the muscles feel the tension draining away. Notice the differencebetween tension and relaxation.

Unhelpful strategies

Constantly dwelling on a past event – you can not change history, but you can changethe way that it affects you now. It is not about accepting or condoning an event orsituation but is about finding a way of it not continuing to adversely affect your life not.

Keeping thoughts and feelings bottled up – this can cause anger and/or health problems

and sooner or later pent up feelings will have to be let out Blaming – taking responsibilities for your own actions and feelings (including positives as

well as negatives)

Using alcohol or other drugs to dull anger – they may mask angry feelings, but this willonly be short-term and won’t solve the anger




Lifestyle changes

Physical activity and healthy eating

There is a strong link between emotional well-beingand general good health. Your general emotionalwell-being is an important part of how well you get

by on a day-to-day basis. Feeling emotionally andphysically well may mean that you feel moreinclined to socialise and spend time with otherswhich can reduce feelings of low mood and loneliness.

We often say to ourselves that we will do what we enjoy when we feel better. More oftenthan not, though, we feel better when we do what we enjoy.

As part of this, it can be useful to look at your eating and activity patterns. A balanced,healthy diet can make you feel better about yourself as well as being beneficial to your bodyand immune system. A balanced diet will help your body and mind work more efficiently.

Regular exercise is good for us in many ways: it increases our confidence and self-esteem; itstimulates "feel good" chemicals in our bodies; it provides an outlet for tension andfrustration; it relieves anxiety; helps us relax; helps us sleep better and helps to preventphysical illness, such as heart disease and osteoporosis.

The type of activity that you do will vary according to your physical health, fitness, theamount of time you have and how much you enjoy it. It is recommended that you do 150minutes of moderate intensity activity across a week; this can include shopping, gardening,housework, etc. You might find that it is easier to break this into three ten minutes bursts, orthirty minute sessions, on five days of the week.

It is important to try to focus on things that you are able to do rather than the things that youcannot.

Healthy eating tips

Base your meals on starchy (carbohydrate) foods for energy e.g. wholegrainbread/cereal/pasta, brown rice, jacket potatoes

Eat lots of fruit and vegetables

Eat more fish – including 1 portion of oily fish per week Cut down on saturated fat and sugar – sugary and processed foods can increase

irritability and emotional fragility, plus reducing these foods reduces the risk of highblood cholesterol and cardiovascular disease

Try to eat less salt – 6g max for adults – the effects of excess salt, sugar andcaffeine can mimic stress responses

Drink plenty of water or other fluids

Cut down on caffeine as it can increase mood swings, symptoms of anxiety andinterfere with sleep – try herbal teas instead

Do not use alcohol, drugs or cigarettes to cope

Don’t skip breakfast




Alcohol

Alcohol is a depressant which can have a negative affect on how we feel too, it alsoincreasing our blood sugar levels, which alters our mood.

Alcohol can have a signif icant affect on how we behave.Alcohol can interfere with our ability to restrain impulsive behaviour and can cause us tomisread social cues. We can also overreact to situations which normally wouldn’t bother us,and our ability to accurately anticipate the consequences of our actions can also be impaired.As a result, some people may experience an increase in boisterous behaviour whilst otherscan become withdrawn. At the most severe end, inappropriate expression of anger andaggression can lead to abusive behaviour and violence.




Useful contacts

First Steps0808 801 0325 - Monday and Wednesday 10 to 4.30pm and Thursday 11 to 5.30pm. Thehelpline will be open on a Tuesday following a Bank [email protected]

The Samaritans08457 90 90 90 - 24 hour helpline

[email protected]

Relate01788 573 241 or 0845 456 [email protected]

www.relate.org.ukCounselling for adults with relationship difficultiesMen’s Advice LineMen’s Adv ice LineAdvice and support for men in abusive relationships including a telephone helpline and formen who are concerned about their abusive behaviours0808 801 03278 - www.mensadviceline.org.uk

Everyman Project

Helpline: 0207 263 8884www.everymanproject.co.uk Information and support for men who have anger management issues

Mind Infoline Tel: 03000 123 3393www.mind.org.uk Provides information on a range of topics: types of mental distress and where to get help.

National Debt Line Tel: 0808 808 4000 – www.nationaldebthelpline.org.uk Help for anyone in debt or concerned they may fall into debt

Surrey Domestic Violence Helpl ine01483 776822

Improving Access to Psychological Therapies (IAPT) services Surrey now has a number of services providing guided self-help and therapeuticinterventions for people with mild to severe mental ill health. All require a GP referral



Books

The Surrey County Council Library has a very helpful list of self-help books that can beaccessed from the following libraries:

Camberley, Dorking, Epsom, Farnham, Godalming, Guildford, Horley, Oxted, Redhill,Staines, Walton-on-Thames, Woking

You can find the list at www.surreycc.gov.uk if you search “Read Yourself Well”. Many of these libraries also have a self-checkout option, which means you can take out a bookwithout anyone knowing the book that you choose.

nhs controlling anger and frustration

Documents