How do I know if there is a problem with anger?

Interestingly, "anger" itself is not a diagnosable mental illness, except in certain cases. One of those is worth mentioning, Intermittent Explosive Disorder, or IED. Intermittent Explosive Disorder belongs to the greater family of impulse-control disorders and is characterized by the experience of impulses that are difficult - or even impossible - to resist, even if the impulses may be harmful to self or others. The aggression that goes with it is impulsive and totally disproportionate to whatever provocation may have been felt by the patient. Children that struggle with IED become dangerously violent, destructive, or otherwise explosive, oftentimes over relatively minor things. With IED, it's usually been going on for a while, is interfering with the child's ability to function, and isn't another disorder. IED is treated a little differently than regular "problem anger" (specific drugs have shown to be helpful) but many of the behavioral modification and individual therapy approaches are the same.

So what about plain old anger problems? What's left probably has more to do with ongoing (and problematic) irritability and a concern about occasional serious episodes. Basically, if you feel your child has a problem with anger, and the anger seems to interfere with your child's ability to function either in school, home, or society, then the answer is yes.

What can I do?

There are plenty of things you can do, actually, beginning with having a serious talk with your child. You might clearly point out that you're concerned. You might go over the last few episodes, sharing what you know. Your child might be willing to explain what happened, how it seemed to him or her, how it could have gone differently perhaps. Best case scenario, just taking the time to express your concern and letting your child know you're going to be watching carefully in the future might be enough. More likely than not, however, you'll have to consider the next step.

What's the next step?

The next step is to think seriously about treatment, or an intervention of some sort. Herkimer County is lucky to have several programs that help children who are struggling with anger management. The most prominent of these is called IMPACT and it's based at Family Services of the Mohawk Valley, on the south side of Herkimer itself. Their address is 249 South Main Street and their phone number is 866-8407. IMPACT arranges a variety of programs for youths who struggle with anger issues, most of which are group-based. They also have several means of outreach within the community and maintain close relations with the PINS unit.

What is PINS?

PINS is another intervention to consider. It stands for Persons In Need of Supervision, and is a sort of pre-probation program (although it's really several programs combined and expertly run, under Herkimer County's auspices). Designed for children who are at risk of hurting others, themselves, or - more specifically - breaking the law, or have already broken the law. They are located in the County Office Building at 301 North Washington Street and their phone number is 867-1317. Although they don't offer anger management training or counseling specifically, they are linked (directly and indirectly) to a variety of resources. If, as a parent, you're interested in placing your child on PINS, call first and expect to attend an informational meeting. Usually this is followed by an interview with one of the main players there and a determination of services.

What else can I do?

Ward Halverson is looking seriously into anger management groups at his office on 417 East German Street. It's likely these may be geared quite differently than the IMPACT program's approach at Family Services, mostly for fear of duplicating services. Ward is particularly interested in helping the families - read: the parents and guardians - of children who are struggling with anger, as it's a rare child who recognizes a problem. In the case of those who do, Ward provides both individual and group-based treatment for anger.

How does the treatment work?

That's a complex answer, but still one that's answerable, which will be kept as brief as possible: First of all, anger has to be differentiated from hostility or aggression. That done, it's important to note that anger is almost entirely about relationships. It has physical, cognitive (thinking), behavioral, and emotional parts, each of which has to be approached individually, just as treatment has to be managed as a whole - a relatively tricky problem that can, however, be overcome. It's important to know that, even as many qualities of anger are consistent from person to person, everyone struggles with it differently. Males and females deal quite differently with feeling of anger, which reflects in their behavior, while age, race, social class, and even the amount of education someone has received are all significant factors. For that reason, treatment is usually quite individualized.Ward Halverson

usually begins with the physical piece of the puzzle. A number of medications have been shown - in some cases but not all - to help reduce episodes of anger. These include the SSRI's that have had great success for a decade or so on mood disorders, particularly Fluoxetine (Prozac), Setraline (Zoloft), and Nefazodone (Serzone). Even the nicotine patch helps people, plus there are a variety of medications being studied that should have, in the future, even greater effects. Since Ward doesn't prescribe medications, he refers patients to a psychiatrist or qualified family practitioner for a thorough evaluation early on in the treatment process. This evaluation should include a complete physical, as the body has many ways of complicating our emotional state as humans. Along the same lines, Ward works closely with patients to regain control of their bodily state during times of perceived distress, or other anger-causing situations. Relaxation exercises, medication, significantly increased exercise, and even hypnosis might be part of the treatment.

Secondly, from a psychological perspective, Ward employs a wide variety of treatment approaches. These include systematic desensitization, cognitive behavioral strategies, recognition of trigger thoughts, de-escalation techniques, and solution-focused therapy. Understanding the role of anger in one's life is crucial to begin to regain control. Taking time-outs or personal space from trigger events, rechanneling energy into more appropriate channels, improving coping skills, and sometimes even changing an entire thinking style can be useful. Replacing stress and distress with "increased happiness" in a patient's life is usually the goal.

For more information, as usual, the best bet is to speak with Ward personally. His practice number is 868-1000.