Anger Management For Physicians

One of the unpleasant emotions we have all experienced is anger. According to the Merriam-Webster dictionary, anger is “a strong feeling of displeasure and usually of antagonism”. Anger is an emotion generated when you feel that the outcome is different from your expectation – especially when the outcome is a negative one. Anger may arise when you think you are being treated unfairly.

Anger is more prevalent in certain situations or occupations. Among physicians, several risk factors increase the risk of feeling angry. For example, the stress factors in the work environment. The set requirements of patient load as perceived to be excessive. Or the pressure from administration. Or stress from managing and treating very ill patients or patients with conflicting views from the standard of care. Anger may arise from frustration toward different situations at work.

Anger builds up. The more times you are angry, or the longer you stay in anger, the easier you get angry. Anger increases your blood pressure, your heart rate and your respiratory rate. It causes your body to release adrenaline and cortisol, to prepare for a ‘fight or flight’ response. As in most situations, for social or moral reasons, you are unable to unleash your anger, it gets suppressed and accumulated inside. Anger is associated with increased risk of hypertension, myocardial infarction, stroke, atherosclerotic disease, migraine headaches, ulcers, skin diseases, and many other physical conditions.

One situation that anger may be helpful is when you experience anger in an unjust circumstance and you are motivated to find a solution to change that situation. This is a form of controlled anger.

Uncontrolled anger is the terminator of happiness. The response may be in some form of aggressive behavior, either physically or verbally. Chronically suppressed anger may translate to passive aggressive behavior. Some physicians may lash out at staff members or their patients. They may even be hostile. It may be challenging to have good relationships at work or outside of work. It may be hard to work well as part of a team. It is common to see more cynicism.

It is important to realize that it is not our circumstances which dictate our emotions. Anger is an emotion from our own response – not to the situation we are facing, but to the opinion of the situation we are facing. In other words, our emotion is generated by our thought about a particular situation. If you do not have an opinion about a situation, you will not have feelings about it.

We are responsible for how we feel. Even though it seems that our emotions are not controllable by us at times, and that they come up and we cannot do anything about it – we are the ones responsible for our emotions. As emotions are generated by our thoughts, our opinions, we are directly in charge of how we feel. Realizing this is a vital step to managing anger. Feeling angry is not something you can blame the other person or the situation; it is simply how you choose to react to what you are facing.

Take ownership of how you feel. Many situations happen and we do not have control over them, yet we can control how we think about them.

I used to be angry about my work situation. I used to think that there were too many patients to be seen and that I was forced into the situation. The thought that I did not sign up for this working environment further infuriated me. All the frustration, stress and anger came up as not having more meaningful relationships with my patients, outbursts of anger at home, and chronically miserable. All that was truly the destroyer of my happiness. Then I started to look at my situation differently. I explored the thought of my patient load was manageable and that I was capable. The emotion generated was hopeful and determined. With this practice, I was able to finish my clinic day more efficiently and was able to appreciate the person-to-person connection at a deeper level.

Anger is an optional emotion. It is not vital to our survival. There are many other more pleasant motivator emotions we can choose to use. To manage anger, it is best to avoid feeling angry in the first place. As we are responsible for our emotions, we can choose our opinion about a situation and the feelings from it.

If you are feeling angry, hit a quick pause button, take a step back and figure out what you are thinking that is causing you to feel angry. Keep in mind you are responsible for our emotions. You get to decide to react to the anger or not. Are you going to react by being mean to others? Are you going to hold the anger inside?

If you decide the latter, choose an activity that will release your anger – an activity that is not harmful to yourself or to others. Some ways to transfer your anger are hitting (such as the Whac-a-mole game), batting baseballs, kicking or screaming. When you release or transfer your anger, your blood pressure and heart rate decrease from the heightened state, and eventually the fight-or-flight mode dissipates. If you do not release your anger, it accumulates while you feel more other unpleasant emotions, until you explode – which is an outburst of intense anger.

Decide not to choose anger as your emotion. Choose peace or calm as your priority. Be light-hearted about your circumstances. Control what you can control. Whatever you cannot control or change, be curious and explore what you can do about it. Please do not hesitate to seek help – there are resources to help physicians with anger management.

If you decide in advance to have peace and be more neutral over anger, you will have more constructive relationships, better work and life experiences, and more happiness.