The role of anger in the vicious cycle of pain

What is anger?

We all experience anger now and again. It’s an entirely natural, although sometimes unwanted or irrational, emotion which has evolved as a way of protecting us from what we consider to be another’s wrong-doing against us or when things don’t go the way we want them to. In that way it can be a healthy and appropriate reaction, but if anger gets out of control it can become destructive.

People deal with anger in different ways and each of us may deal with it differently at different times. Sometimes the response to anger is instantaneous, erupting into verbal abuse and occasionally even physical violence. But often it’s suppressed; bottled up and simmering away to the point where a person may not even be aware any longer that they are angry.

Anger can fuel resentment and both can cause us significant stress; raising blood pressure, increasing muscle tension and, if you suffer chronic pain, elevating levels of pain.

Pain in itself causes anger and resentment

Pain, and particularly chronic pain, itself fuels anger and resentment – anger at your limitations, anger at people you perceive to be to blame, anger at not being able to work, anger at doctors for not having a ‘quick fix’, anger at family and friends for not being supportive enough.

It’s quite common for anger to be directed at something or someone when in fact the real cause of the anger lies somewhere else entirely.

Pain, anger and depression

Anger and depression often go hand in hand. In fact, psychologists sometimes describe depression as anger turned inwards. One study published in 2006 found that when it comes to emotional disorders in general, the presence of anger has “negative consequences, including greater symptom severity and worse treatment response.” The authors concluded that “based on this evidence, anger appears to be an important and understudied emotion in the development, maintenance, and treatment of emotional disorders.”

What is clear is that both anger and depression are major, and interlinked, players in the vicious circle of pain. Pain provokes anger, anxiety, fear and distress which further lowers mood, fuelling depression and increasing the perception of pain. When viewed in this way, it becomes clear just why it is crucial that pain management and rehabilitation programmes are multi-disciplinary in approach; addressing both physical and psychological symptoms in tandem. Only with that approach can there be a realistic possibility of breaking that vicious circle.

Patients are taught the purpose that anger serves, that anger is not something to escape from, but rather that it is a signal to be accepted as one of the body’s mechanisms for drawing a threat to our attention. Therapists work to help a person accept the huge injustice that life has thrown at them, after which it should be possible to work constructively against that injustice, transforming anger into more positive emotions.