Case Study: 1

Mariam, a young mother of two children is having anger management issues. She finds herself having frequent outbursts towards her children. She often shouts at them or beats them up for simple reasons like the house not being tidy and in order or if the children make a lot of noise while playing among themselves. After each episode, she feels guilty and sad that she behaved this way. She realizes that she is irritable and quick tempered, but is unable to prevent the occurrence of another outburst.

Mariam also feels angry when people argue with her and try to prove her wrong, especially. when she believes that she is in the right. She says she gets angry when people lie to her. Mariam loves her husband and children and they are a happy family, but Mariam’s anger has become a real problem. She is unable to control her anger and irritability toward the children and towards life in general.

Looking below the surface of Mariam’s anger problem, there is a family history of an overly strict, perfectionist father who could not tolerate any kind of disorder. He often projected his anger on the children and the mother. Mariam remembers many incidents of her father’s unreasonable expectations on the family and how he took pride in being a strict father. Mariam rebelled against her father’s attitude and finally ran away from home with the love of her life, a man, her father did not approve of.

Her father disowned her and now she has no relationship with her parents and has been cut off from her parents since her marriage. She suffers a deep sense of rejection ever since.

To understand, Mariam’s anger problem we need to understand the early experiences of her life.
Perhaps her need for approval and love from her father was never met. Her sense of rejection may have caused get back at her father by marrying a man he disapproved.

The lack of a happy relationship with her estranged parents may have caused anger, sadness and bitterness. These emotions have been long suppressed. However suppressed feelings of rejection, anger, disappointment can manifest in other forms of chronic anger and irritation.
To help Mariam manage her anger, the following may be helpful:

• The good news is Mariam is aware and acknowledges her problems in dealing with anger. This is half the battle won. Many people do not recognize anger as a problem; on the contrary they think they have a right to feel the way they do.

• Help Mariam get in touch with some core issues in her thinking and feeling pattern. Our feelings may not be right or wrong, however our thinking patterns may not be always rational. Mariam perception of life, her unpleasant experiences in her relationship with her father, may have a lot of negative bearing on her thinking and feelings. These issues need to be addressed and resolved. In her situation, the children’s behavior or loud noise etc are probably only trigger points to the real source of her anger. Overcoming these will be easy, once she realizes how to deal with the real reason.

• Reconciliation through a conscious act of forgiving the person against whom one holds anger will heal the pain of anger. Mariam’s need for a father’s love and approval is unmet and perhaps a restoration of the relationship will resolve the anger and bring happiness into her life The road to recovery may be long and the journey may involve a lot of going back and forth, but the destination will be reached if we make it the goal.

CASE STUDY: 2

Joe was a senior executive in a large corporation. He was in a very responsible and accountable role in the company, and under a lot of pressure at work. His job involved a lot of travel and change of location on assignments. Joe’s wife is a well-educatedwoman, who chose to give up her career for the sake of Joe and her two young sons. Joe was a very responsible fatheras far as providing for the family was concerned. He believed that a good father provides well materially and makes sure the children are well educated. He did not think it was important to be there for his wife and his young sons. The family would hardly communicate with one another.

Joe was a control freak and had a massive temper problem. At home, he was always short tempered and had very frequent outburst of anger, lashing out verbally to his wife and his sons. He would make all the decisions for his family without consulting either his wife or his sons.  His angry outbursts would happen even in public places, leaving his wife and children embarrassed all the time. His wife grew very fearful of interacting with him to the extent that she wished he would always be away from home. His two sons adapted to the situation by not communicating with the father.

Joe’s work added to his anger. Even after work hours he would constantly be on the phone with his colleagues getting an hourly update of the work. His frustrations at work would often be projected on his fearful wife, in the form of angry outbursts and verbal abuse. Everyone except him, realized that he was pushing himself over the brink. Soon he ended up having a massive heart attack which he survived, thanks to his wife who managed to get him in time to the hospital. However Joe had to quit his job. He was out of work for about a year during which time he recuperated from his surgery. His wife began to care for him diligently and got him back on track. In the meantime both the sons left home to join University. The older son grew up to be a very angry young man, while the younger one became very timid, anxious and insecure.  Joe was never there when the young boys needed him.His wife became very depressed.By this time, a lot of damage was done to the family, physically, emotionally and socially just because Joe was not willing to recognize, acknowledge, and manage his anger problem early in life. 

Let’s look at the Joe’s anger problem and see if there were any irrational thoughts and perceptions below the surface of his angry outbursts.

• Joe being a well-educated man was not able to recognize his anger problem.
• His need to perform well in his job seems to have taken precedence over the needs of his family.
•  His job more important than the emotional needs of his wife and sons.
• His wife‘s feelings did not matter, she was an object on whom he could target his anger.
• Providing materially for the family more important than meeting emotional needs.
• Family should be controlled and not loved.
• Joe’s anger could never harm his health.

As a result of Joe’s anger, not only did he need anger management therapy, his wife needed therapy for depression and so did his sons who were coping with the effects of their father’s anger on their individual lives. Each of their problems had to be addressed early so that they do not carry it forward in life.

Case Study: 3

Lilian, a 33 year old homemaker and the mother of four year old Robert, has been depressed and unable to concentrate ever since she separated from her husband three months ago. Lilian left her husband after a five year marriage. Violent arguments between them, during which Lilian was beaten by her husband, had occurred for the last four year of their marriage. The violence had begun when she was pregnant with Robert. There were daily arguments during which her husband hit her hard enough to leave bruises on her face and arms.

Before her marriage, she was close to her parents and many friends whom she also saw regularly. In school, she had been a good student, she had no personal history of depression and there was no family history of mental illness.

During the first year of marriage, her husband became increasingly irritable and critical of Lilian. He began to request that Lilian stop calling and seeing her friends and family members. He refused to allow his in-laws to visit their apartment. Despite her husband’s ill-treatment towards her, she decided to become pregnant. During the seventh month of pregnancy, her husband began complaining and began hitting her with his fists. She left him and went to live with her parents. Her husband expressed remorse and Lilian returned to her apartment. No further violence occurred until after Robert’s birth. At that time, her husband started drinking every weekend and often became violent when he was high on alcohol.
In the three months since she left her husband, Lilian has become increasingly depressed and miserable. Her appetite has been poor. She speaks slowly, describing her depressed mood and lack of energy. She says that her only pleasure is in being with her son. She is able to take care of him, but feels guilty because her own bad feelings prevent her from being able to play with him. She now has no contact other than with her parents and her son.

Let’s look signs and symptoms of Lilian’s depression and the possible causes for it:

• Feelings of helplessness because she is a single mother.
• Feelings of guilt of not being able to spend quality time with her son.
• She was upset because her husband constantly criticized her.
• She was physically abused by her husband.
• Her appetite was poor and her energy decreased.
• Despite being constantly physically abused, she chose to get pregnant as her need for love was not satisfied by her husband and therefore she was hoping that this baby would bring about change in the relationship.

As a result of this experience, Lilian has a lot of negative emotions within her, which require a space for her to vent. At the same time, she requires empathy and understanding from her therapist.

CASE STUDY: 4

Siddhartha, a 28 year old married man was brought to the de-addiction center by his wife. They fell in love and got married six years ago. He was a taxi driver and she was working as an HR professional in the same company. He accepted the fact that once he became drunk, he would become very violent and many times hit his wife. He said that all his friends used to tease him saying, “Your wife earns more that you”. Initially when they got married he loved her and this difference in the status was not an issue. Things started to get ugly after he realized that she was bringing in more money than he did, as she was a well-educated woman and he was not. In order to portray his power over her, he started drinking and abusing her. In fits of anger, he used to throw things at her and verbally and physically abuse her at the same time.

Even though he promised he would never hit her again, after a month of leaving the de-addiction center, he relapsed and went back to his old ways.

Let’s look at Siddhartha’s anger problem and the factors that contribute to it:

• Siddhartha felt the need to prove himself as a man.
• His self-esteem was hurt because his wife was more educated than him and brought in more money.
• He felt worthless because his friends pointed out the incompetence in him.
• He felt his wife didn’t understand him.
• He felt frustrated.

He has low self-esteem and therefore working on the strengths that he has, we would encourage and motivate him to find meaning and purpose in his life. Using anger management techniques and helping him find socially acceptable ways to express his anger is an option.