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Sunday, February 01 2015

For professionals & educators

CompassionPower: Beyond Anger Management Reviews

When Men Blow Their Tops
Step by Step, angry people learn how to control themselves

By Amy Fries
The Journal Newspapers

The room fills with participants of assorted color persuasions and ages. What they share in common, though, is that they’re all men and each of them has uncontrollable anger.

Whether it is road rage, spouse and child abuse or a chilly marriage, grouchy work environments and violent crimes have roots in unregulated anger.

Unchecked anger also plays a role in heart disease, high blood pressure and depression. For these men, anger has played out in an event that landed then in a court-appointed rap session.

To help people control their emotions, health professionals offer up these sessions where advice and self-revelations focus on how rage manifests itself and how people can put a lid on it.

"All problem anger is caused by a temporary state of self-diminishment," says Maryland anger therapist Steven Stosny, Ph.D. "When people feel put down, anger numbs that pain and gives them a temporary sense of power."

While some anger management courses are open to both men and women, others are not. Often, it is a requirement made by a judge who mandates participation as part of a plea agreement, particularly in cases of assault or aggressive driving.

Feeling a threat to the self triggers the fight or flight response by releasing powerful chemicals to every muscle and organ in the body, says Stosny, whose methods of controlling anger have been implemented in community services programs in several counties in the region.

"The problem is, fight or flight response was never meant to be used with families or in any type of negotiation, except with saber-tooth tigers," He says.

As a result, anger is a crucial emotion to pay attention to, Stosny says. "It’s a necessary condition for most crime."

According to Rita Smith, spokes woman for the National Coalition Against Domestic Violence, "Ninety-two to 95 percent of all domestic violence cases involve men battering women."

Males also comprise the majority of aggressive drivers. A 1997 AAA Foundation for Traffic Safety study reported that 12,828 people were injured or killed as a result of aggressive driving between 1990 and 1996. While the study revealed there was no profile of an aggressive driver, "most are relatively young, poorly educated males with criminal records, histories of violence and drug or alcohol problems, and many have recently suffered an emotional or professional setback."

Virginia’s Fairfax County and Maryland’s Prince George’s County employ Stosny’s anger management techniques as part of their community service programs.

There are an estimated 260 men each year participating in the Fairfax program,70 percent of whom are court-referrals, says Karen Koerselman, coordinator of A Men’s Program, a counseling program operated by Northwest Mental Health Center, which is part of the Fairfax/Falls Church Community Services Board.

According to Koerselman, Stosny’s track record—an 87 percent success rate—was the reason that the program was used by the local groups.

Stosny’s five-step technique, known as HEALSTM, is taught in four to 12 weeks for violent clients and in two to three sessions for nonviolent self-referrals.

Essentially, the method teaches the client to develop a different response to situations that provoke their hostility.

In the first step, the client must work up a low-grade state of anger arousal. When the client identifies the physical manifestations, like clenched teeth, a knot in the stomach or tight shoulders, he must identify the underlying hurt. Often, it’s feelings of rejection and powerlessness, Stosny says. Then the client must express compassion for himself first and then for others. This process allows an individual to communicate and problem solve more effectively, Stosny says. The client repeats this a dozen times a day for four to 12 weeks. By then, Stosny says, the appropriate response is automatic.

Anger works as forms of self-empowerment when someone feels diminished, so we have to teach then pro-social forms of empowerment." Stosny says.

Men, women and anger
Anger is not gender-specific, Stosny says. Men and women get angry for the same reasons and one gender doesn’t experience anger more often than the other.

The difference is in the way men and women are socialized to understand anger and respond to it. Men get physically aggressive or shut down emotionally, and women reach out or cry.

"We do two separate numbers on the genders in our culture." Stosny says. "Men are not allowed to feel or express any emotion except for anger and women are supposed to feel and express all emotions but anger."

Men are also more action-oriented when angry, Stosny says, which are caused by physiology. "Men go into a fight or flight as a much lower threshold and stay in it much longer." That’s why Stosny says he trains men to unload the dishwasher or wash dishes when they’re angry.

He says another difference between the sexes when it comes to anger is that women tend to cry when they’re angry and men don’t. Crying puts people in touch with their sadness, and men aren’t allowed to feel such vulnerable emotions. "Men use anger to numb hurt, so it’s an either or situation for them. If they cry, they won’t be angry," he says.

Stosny acknowledges that not all men are violent or aggressive when they’re angry. "We tend to hear a lot about the 25 percent who become aggressive, but 75 percent of men tend to withdrawal. In a typical marriage, the wife will complain about the man not having emotions at all. That’s really an anger response," he says.

The alarm bell
A low-grade anger arousal may help people do a job they don’t want to do or help them concentrate on something that doesn’t interest them. Stosny, for example says he works up a low-grade anger to do his taxes.

Though anger is a good motivator, it’s a terrible regulator, he says. "Performance competence goes way down when angry. Whatever you can do angry, you can do better not angry."

The best way to define problem anger, says Stosny, is that it makes you do something that’s not in your best interest or keeps you from doing something that is. "That can be subtle, like putting a chilly wall between you and someone you love. It’s not going to get you into immediate trouble, but eventually it can ruin your life."

While many people think of problem anger in terms of the dramatic—the disgruntled employee who shoots up the office, the man who drives his car into a video store because he was charged a late fee—most problem angers are more subtle.

"I’ve had over 1,200 court-ordered clients, and less than a dozen were rage problems," Stosny says.

When he does see clients who have "snapped," he investigates physiological conditions, like a brain tumor or schizophrenia, that may trigger an episode. But mainly he believes that people who act out a rage have intense resentment that builds up until they explode out of proportion to an affront.

"When the self is at stake, it becomes life or death even though it’s trivial," he says. "Anger is catching. It’s the most contagious of emotions. If you’re around an irritable person, you’re going to get irritable." 

Some shy people use anger to help them get through uncertain situations, says Stosny. When these people go to a party, for instance, they’ll get hypercritical. "They start to find something wrong with the music, the hostess’ dress, the punch."

That type of hypercriticism is low-grade anger arousal, Stosny says. "The problem with low-grade anger is it doesn’t have the same built-in resolution that rage has. People can only rage for a few minutes, before exhaustion kicks in; low-grade arousal can go on for years."

According to Stony, there are about 27 different forms of anger. Most of them are mild, such as feeling impatient, irritable or grouchy. Resentment is the most common form but the most common stimulant for anger is a loud unexpected noise, like a lawn mower outside. "Most of the time that anger will go away in a second, but if you’re a blamer, you say, those thoughtless inconsiderate people, they don’t care about me."

Anger is also a response to physical pain. That’s because anger releases epinephrine which numbs pain and gives a rush of energy. "That’s how athletes play with broken bones and why wounded animals are so ferocious."

Bitterness is another form of anger used as a numbing agent for grief or sadness. "Everyone has someone in their family with attachment loss that they regulate with anger," Stosny says. "It could have happened 20 or 30 years ago. Every time they think of grandma, they’ll think, Sally got her doily and I should have gotten that."

The problem with that technique, he adds, is that, "anger works like ice on a wound, it numbs the pain but retards healing."

Some people have an opposite physiological response to anger. They actually calm down. They make up about 15 percent of the population and are known as vagal-reactors, Stosny says. "The vagus nerve puts the brakes on the respiratory system. Without it, we’d all die of a heart attack by the time we’re 12."

For most people, anger or other intense emotional experiences, such as the heat of competition, accelerate the heart and flood the body with adrenaline, making it harder to stay calm and think clearly.

"Michael Jordan is probably the most famous vagal-reactor," Stosny says. "His heart rate declines during the game. It gives him enormous stamina. Instead of getting exhausted, he gets better."

If you’re a vagal-reactor and an athlete that can "be pretty wonderful," Stosny says. "But if you’re a vagal reactor and a criminal, you’re extremely dangerous."

Criminals who are vagal reactors tend to have anti-social personalities, Stosny says. "They don’t have the normal inhibition not to be violent or to stop violence once they do it. They’re entirely focused like cobras."

Psychology Today, April, 1998

"Why do women stay?" That question haunts anybody who has observed domestic violence. But a far more practical question is, How can the men be stopped? Steven Stosny, Ph.D., has developed a remarkable and effective treatment program for battering men. Even a year after treatment, an astonishing 86 percent have ended the physical abuse, and 73 percent have stopped the verbal and emotional abuse. The national dropout rate for battering programs is one out of two; Stosny’s is only one out of four.

Treating batterers is something that most therapists shy away from. How did you get into it?

I became interested in spouse and child abuse at the age of two. I grew up in a violent family, where we had police and ambulances coming to the door. It took a while for me to get up the courage to go into this field, and when I started a group with severe batterers, I wanted to learn how they got that way, to learn how to prevent abuse. I was surprised when they stopped being abusive.

So how do you approach batterers?

Our program is based on the idea that most batterers can’t sustain attachment, and because of this, they become flooded with feelings of guilt, shame, and abandonment, which they regulate with aggression. We teach them a five-step technique called HEALSTM. First, we start with the concept of Heal. Our clients learn that blame is powerless, but compassion is true power, and has the ability to heal. Next, you Explain to yourself the core hurt that anger is masking: feeling unimportant, disregarded, guilty, devalued, rejected, powerless, and unlovable. All abusive behavior is motivated by these core hurts. Then you Apply self-compassion. Let’s say your wife calls you a brainless twit, and you feel she doesn’t love you. You want to punish her for reminding you that you’re unlovable. We teach men to replace this core feeling with self-compassion. "She feels unloving, but she still loves me. My instinct might be to call her a filthy slut, but she said what she said because she’s hurt and feeling bad." Then you move into a feeling of Love, for yourself and your wife. And finally, you solve the problem by presenting your true position without blaming or attacking the other person: you say, "I care about you, but I have a problem with you calling me a brainless twit." You are healing your core hurt through love rather than anger.

So you’re saying the batterer is really trying to heal his hurt core, and he can do it with compassion instead of abuse. Still, how can someone used to physical aggression learn to be so rational?

We call it teaching Mr. Hyde to remember what Dr. Jekyll learned. These men have to learn emotional regulation and the rewards of change based on compassion. We ask them to remember an incident that made them angry; to feel the anger again, and follow the steps of HEALSTM 12 times a day for four weeks. It almost works like a vaccination. You feel the core hurt for five seconds at a time when you practice, and you develop immunity to it.

Why is your dropout rate so low?

It’s a 12-week program, and if they don’t do their homework, they go to jail. We have surprisingly little resistance. I also say " If you don’t feel much better about yourself, we’ll give you your money back. You’ll like yourself better when you’re compassionate." I’ve treated over 1200 abusers in my career, and even the antisocial ones – no matter how justified they felt at the time – never felt proud of hurting someone they loved. Our group is about becoming proud.

Does this work even for the true sociopaths, the ones Jacobson and Gottman call Cobras?

These people are not afraid of the criminal justice system and they don’t usually come to treatment. Most people in treatment are different. They’re the dependent personalities who only hurt ones they love, and who get over-involved in the relationship. If sociopaths and people with antisocial personality disorders do come into treatment, they don’t learn compassion. But they do learn to use emotional regulation techniques to keep from getting upset. Some of them use this as another form of superiority - you’re going to get hysterical and I’m not – but it’s better than beating up their wives in front of the children. It’s a form of harm reduction.

Why does this treatment work better than traditional treatments?

Most treatment programs focus on how men’s domination causes domestic violence. We say that the real gender variable is that culture doesn’t teach men to regulate their negative emotions, or sustain trust, compassion, and love. Numerous studies have shown that. We socialize girls and women to have an emotional vocabulary, and this has nothing to do with education level. We look into the eyes of little girls and reward them when the cry or express other emotions, but when a little boy expresses emotion, we call him a sissy. Boys are taught to keep vulnerable emotions submerged, and don’t develop and emotional vocabulary.

And if you can’t tell sadness from loneliness from disappointment from rejection from being devalued, the bad feelings get overloaded easily. The strongest emotion is anger.

What about the women? Do you counsel them at all?

We put the safety of the victim first. We say, "We’re sure you’re not going to be abused any more, but it’s very unlikely you’ll have a good relationship with your abuser." We tell the women that there’s more to life than not being abused. And we have a higher separation rate than the average. While 75 percent of women and children in shelters to back to their husbands, out of 379 couples to go through our program so far, 46 percent of them have left their spouses.

How do you treat substance abusers?

We conduct our treatment simultaneously with substance abuse treatment. Even though this hurts our treatment outcome – 98 percent of our recidivism is from alcohol and drugs – it’s important because the nervous system bounce makes a person more irritable when coming off a drug, and I prefer they have some skills first.

Roland Maiuro, Ph.D. of the University of Washington has been conducting a controlled study using the antidepressant Paxil to treat abusers. Maiuro found that abusers had consistently low serotonin levels, which were perhaps rendered even lower by their negative patterns of behavior. Have you seen Prozac-like drugs work with batterers?

I always tell abusers to try antidepressants. Anything that increases serotonin will reduce shame. And shame causes anger and aggression. I’ll bet money that when studies like Maiuro’s come out, we will see a significant reduction in violence. The problem is getting them to take it.

They’ll take any illicit drug, but they won’t take Prozac. But Prozac and HEALSTM will work best. It may even get the sociopaths.

How can we prevent domestic violence from happening in the first place?

If you treat in the early stages you can prevent murders from happening. But you can’t do this with a gender war. Community meetings against domestic violence have one or two men, and few minorities. Saying you’re against domestic violence scares off people, and attracts the ones who really believe in the battle of the sexes. By demonizing the batterer, it makes him more isolated.

But if we make community organizations about being for the creation of safe and secure families, they will have a much broader appeal.

Psychology Today March/April 1998

Love Without Violence: Helping Parents Build the Powerful Self
A Workshop with Steven Stosny Report by Patience Mason

I’ve mentioned Steven Stosny’s HEALSTM acronym in this newsletter several times, and I finally got a chance to go see him talk about it and demonstrated it at a workshop put on by Children’s Heaven of Orange Park, FL, a non-profit organization dedicated to helping break the cycle of child abuse and neglect.

Dr. Stosny had a lot of interesting information on how the brain works. We tend to file things we learned when we are in one emotional state with other things learned in that emotional state. That’s why when you are depressed, life seems to always have been depressing, when you are mad at your spouse, you can remember every bad thing he or she did to you since day one of your relationship. It is all filed together.

Because of the brain’s filing system pain is stored in a different part of the brain than the information about behavior that caused the pain. That’s why hitting kids is ineffective in the long run: if you ask your kids about recent spankings, they will remember them clearly, but not the reason for them…except maybe one of them. Rather than teaching them right from wrong, hitting teaches them to be sneaky.

Because the brain is a better-safe-than-sorry system, developed when all predators were bigger and faster than us, it would rather blow up a hundred times mistaking your spouse for a saber tooth tiger than make the mistake once of thinking a saber-tooth tiger was your spouse and getting eaten. That’s why living in the anger file is dangerous. You can wind up hitting people without a moment’s hesitation and deeply regretting it.

How do you tell you are living in the anger file? If every problem in your life is someone else’s fault, if people are always trying to put you down and push your buttons, you are probably living in the anger file. Stosny offers a way to get yourself out of the anger file so you can feel good about yourself.

"The more you blame, the more POWERLESS you feel and become," Dr. Stosny said. "Other people are pushing your buttons. HEALSTM is designed to put your buttons so far inside of you, no one can push them."

He teaches that when you are accessing the "I know how to do this/How can I grow from this/What will help me get through this?/Poor guy/gal, s/he’s probably had a bad day" type of files, life is just plain easier. He calls these the Power Modes.

By their very nature, people must empower themselves when they feel bad. They can do it from within—which Stosny teaches in the workshop—or by the more common methods of trying to manipulate others to make themselves feel better (punishing, nagging, etc.), or through avoidance/dismissal ("denial, alcoholism, workaholism, or "Who needs this!")

To change within you must identify and understand what core hurts you are feeling: disregarded/unimportant, accused (guilty, untrustworthy or mistrusted), devalued, rejected, powerless, or unlovable. When we feel those we often feel helpless, we become dependant, try to force or manipulate others into helping us, get depressed because their help is never enough, and become destructive to ourselves and/or others. These are the Weak Modes of self, although destructive mode feels like power when you are in it. Anger and other destructive acts will give you a momentary sense of power, followed by depression and defensiveness.

The true Powerful Modes of self, competent (not perfect, he was careful to say: competent people are not afraid to make mistakes) growth oriented or creative, healing and nurturing, and compassionate make life a lot easier. The big question is how do you get in powerful modes and stay in them?

Practice, practice, practice!

If you are thinking, "why bother?" think about the difference in the way you might handle locking the keys in your car in a weak mode and a powerful one. In weak mode you start calling yourself an idiot, agonize over why you made a mistake, maybe even try to shift the blame onto your spouse or kid (if you hadn’t distracted me…) and wind up yelling at everyone. In powerful mode, you call AAA, competently seeking help, think how you can learn from this (check if I have the keys when I’m distracted), tell your kids every one makes mistakes, that’s how we learn, and comfort them if they were worried. It is a totally different experience and you feel better and more powerful than you would if you had yelled and carried on.

Everyone is competent at times, so Dr. Stosny developed the HEALSTM acronym not to train you in skills but to teach you to move on a deep level from Weak Modes to Powerful Modes.

If you can change how you think about yourself deep inside, no matter what happens, you can regulate your emotions because you decide what the experience means to you. For example, if someone is rude does that mean you are not a valuable person? Of course not, although in a weak mode it will feel that way or worse and perhaps send you into a rage. It means they are having a bad day or week or year. In a strong mode this is easy to see. The worst it can mean about you if someone mistreats you is that you made a mistake. Everyone makes mistakes.

Dr. Stosny recommends practicing HEALSTM on small issues first and working your way up to things that really make you mad.

Using HEALSTM within the family is really important because those we love "serve as mirrors of the inner self." We tend to rate our value and lovability by how they treat us. "A distressed or misbehaving child can make one feel like a failure as a parent and thoroughly unlovable. A raging or withdrawing parent can make a child feel inadequate and unworthy…" We wind up punishing the other person not so much for the behavior as for the way they made us feel. But if you punish the mirror, you are accepting the reflection as true even when it isn’t.

Dr. Stosny teaches a very healing system. His court-ordered 12 week Compassion Workshops for batterers have an 87% success rate by victim report. He also teaches his methods to parents, to mental health professionals and to people who have trouble holding jobs.

Shadows of the Heart: A Treatment Tape for Male Batterers, Intermedia, Inc. 1300 Dexter N., Seattle, WA, 98109, 1-800-553-8336. $198 by itself, $175 each if bought with Compassion.

This 20 minute tape is used in Steven Stosny’s program for batterers. It comes with a training manual and facilitator’s guide. The tape is designed to overcome the "formidable resistance" common to batterers who are ordered into treatment. (They don’t think they have a problem; you have the problem; the wife is the problem; the court is the problem!) Beyond overcoming resistance, the video also is meant to stimulate compassion in abusers. It opens with an abuser talking to the people he’s being forced to see for court ordered treatment. He’s a really angry defensive guy and dismisses everything they say. The video suddenly switches from "therapy talk" to a very emotional scene of spouse abuse as seen through the eyes of the child. This succeeds in sliding past the intellectual resistance with most clients. The client is also offered a new paradigm for feeling powerful. Replace hitting with compassion for the child, for yourself, and finally for your own wife and kids.

Watching this is a moving experience. It comes with discussion questions and homework. Highly recommended!

Compassion: Activating Compassion in Spouse Abusers, Inter-media, Inc, 1-800-553-8336. $198 by itself, $175 each if bought with Shadows of the Heart.

This 10 minute tape shows an argument between an husband and wife. The husband stops the escalating argument by going and getting Steven Stosny’s list of core hurts, reading it, identifying each one, giving himself solace: "I may feel disregarded, but I am regarding myself." It is an empowering thing to watch him work through his feelings and take responsibility for healing his hurt instead of blaming his wife.

Highly recommended!

THESE TAPES are meant to be sold to organizations that work with abusers. If there is one in your community, do them a favor and send them a copy of this review. Urge them to get Dr. Stosny’s book and these tapes.

Reprinted with the permission of Patience Mason at Patience Press/The Post-Traumatic Gazette, Volume 2, Number 1 May/June 1996 edition.

You will find them at:


Research shows that the most dangerous thing we can do is love. We inflict more physical and psychological harm on children, spouses, and parents than any other developed society. Divorce, affairs, abuse, alcoholism, over-work, anger, depression, absent parents, gangs, loneliness--all point to an epidemic of emotional disconnection in American families. Most people go into therapy because, in one way or another, it hurts when they try to love.

Creating the Miracle of Empowered Love is a new training program designed to end the terrible and unnecessary damage that emotional disconnection inflicts on families. The program focuses on healing wounds through personal growth, compassionately restructuring family ties, deepening emotional connections, and ending our massive confusion about love.

Confusion about love and danger in loving come from contradictory human desires to be independent yet connected to others. The growth and transformation of Creating the Miracle of Empowered Love provide higher levels of individuality and connection. The program helps remove the impediments to loving deeply and strongly without hurt or threat.

Skill-building sessions also include anger and resentment regulation and empowerment techniques to prevent power struggles. The workshop replaces blame (focus on damage, injury, defects, and weakness) with focus on inner strengths of resiliency, competence, growth, creativity, healing, nurturing, and compassion.

The program teaches the dimensions of love: depth, strength, dynamics, styles, and types. Miracles come from the enhancement of compassion, interest, enjoyment, trust, passion, intimacy, and commitment.

Steven Stosny, PhD, teaches classrooms full of court-mandated abusers to love themselves - and turns their anger inside out.  The abusers attend the twelve-week Compassion Workshop and complete weekly homework assignments as an alternative to going to jail.   They don't want to be in jail - or in these workshops.  An observer notes that attending these sessions felt like sitting inside the cage to watch the lion tamer work his magic. 

They enter angry.  Roaring.  They feel misunderstood, blamed - with their lives out of their control.  They leave less like lions - more like pussycats - competent, growth oriented men and women in charge of their feelings.  Stosny's method is to teach them a kinder, gentler view of themselves.  Instead of blame - he says they know hitting is wrong - he holds up a different mirror.  One they haven't seen.   A mirror with special powers that accentuate and expand their loving, compassionate features and crowd out their feelings of ugliness and inadequacy.  And anger.

Participants arrive defensive - full of explanations that they are only there because they care too much, love too much - it is their loving side, their sensitivity that got them in trouble in the first place.  As they are allowed to hold onto - and expand - the view of themselves as loving, compassionate parents and partners they are immersed in discussion, rehearsal, and new, more precise working definitions of compassion.  What does compassion look like?  What behaviors does it include?  Exclude? They come to understand - and believe- that as loving, compassionate people they would not , and can not, hurt their loved ones- can not and would not even so much as hurt their feelings.  

And they don't.  Follow-up research on more than 260 graduates found that a year later 87% were violence free (defined as pushing, grabbing, or shoving) and 72% were even free of verbal aggression - of hurting their feelings.  This based on interviews with the previous victims. 

The approach, based on attachment theory, explains away the mysteries and contradictions which go unanswered in the prevailing politically correct, gender-based violence paradigms.  If it¹s all about testosterone and male oppression:
  • Why do lesbian and gay domestic violence rates surpass those of heterosexuals?
  • Why do both moms and dads use violent and abusive tactics against their children more often than husbands abuse wives?
  • Why does this approach which changes the focus to one of positives and which emphasizes compassionate, pro-social characterizations have lower recidivism rates than those that reinforce negative, punitive, anti-social concepts such as "batterer" or "offender treatment."

—Coalition for Marriage, Family and Couples Education.