Working with anger in psychotherapy

To misquote Tolstoy, unhappy people tend to repeat their ways of being unhappy.

They repeat the same psychological moods and states.

Psychotherapy has shown me that attempting to avoid the problems we experience;

  • the difficult moods
  • the self-destructive decisions
  • the acting out of difficult emotions
  • the anger

tends not to get us very far.  Our difficult sides are part of us, they can’t easily be dropped.

Working with anger in psychotherapy, finding a new way of relating to others

An alternative is that we find a way to engage with our anger, our complexities, and embrace the more troubled and injured parts of ourselves.  Instead of avoiding painful truths and feelings like anger, we try to do the opposite and engage with them and see what’s going on.

But even then, things are often not so simple.  Often in psychotherapy clients will be initially pleased to meet me, to finally get to their session, then things start to become difficult.

So for example, they may start to miss sessions or turn up late or pay bills late, or do things that indicate that they think I’m second-rate.

And when they are with me, the conversation may feel rather adrift from the reason they wanted to come in the first place.  We are in the presence of a resistance to the idea of the therapy.  A resistance that can be tricky to approach without setting off more resistance and anger.

Working with anger and resistance

We know that part of the person is keen to be here, but we can also see (or I think I can) that there is a part of them that wants away.

At such times finding a way of enabling the work to develop or to open up the conversation, takes patience, often a great deal of it, particularly when the atmosphere contains hostility.

You may have to spend long periods of time working with the resistance.  As you do this you are going through a period of being tested.  In a way that may not be so clear, the client is testing the therapy to see if it is safe, to see if the therapist can be trusted.

What is the anger about?

One way of thinking about this is that in the past the client has experienced people letting them down at just the moment they were most needed, and the client has been left with a deep sense of mistrust in other people.  It looks like the client is a normal everyday person who can engage with people, but this is misleading.

The presence of this kind of resistance and anger indicates that something has gone wrong in terms of how the client relates to other people.  Instead of experiencing people as real and part of a shared relationship, these clients relate to people through their own projections.

So they are quick to project ideas about what people are like, and quick to see signs that their projections are correct.  They haven’t been able to reduce the projections to see and experience for themselves what other people are like.  They are not seeing the world that is there, they see the world they project.

D.W. Winnicott, attacks and anger in psychotherapy

Winnicott wrote elegantly about this, particularly in his last book Playing and Reality.  The essay, ‘The Use of an Object’ concerns how people can end up stuck in a way of relating based almost exclusively on projecting rather than being able to see what other people are actually like.

In Winnicott’s model the way out of this is through repeated testing of the therapy.  Winnicott called this; attacking, and wrote about the client’s need to use attacks on the therapist as a way of testing whether the therapist will attack back. It is necessary to work with the anger.

In Winnicott’s paper there may come a point where the client comes to realise that the therapist is safe, that there is more to the therapist than the destructive projective ideas the client had about them.

In therapy, if you get the chance of working with someone to the point at which they make this realisation, the experience is profound. You can feel the projections fall away as they see you, as you see each other for the first time. Suddenly the angry atmosphere is transformed into something more benign.

When this happens you are part of work that has taken someone beyond their old certainties and anger and into a new possibility for living.  What could be better work than that?