Second opinion: Anger is a natural emotion: its healthiness depends on how it is expressed

The best way to respond to angry feelings is by being assertive, then verbalising it

Many people (mostly men) respond aggressively when they feel angry, using verbal or/and physical body language. Photograph: Thinkstock
Many people (mostly men) respond aggressively when they feel angry, using verbal or/and physical body language. Photograph: Thinkstock

Statins are often prescribed to control cholesterol and reduce the risk of cardiovascular disease and stroke. These drugs affect men and women differently. Recent research, published in PLOS one (Public Library of Science) in July, showed that "statins generally decreased aggression in men and increased aggression in women". In addition, the study found that women were almost as aggressive as men. Almost half the 692 males who participated in the study and 44 per cent of the 324 females demonstrated aggression during the previous week.

The study, which regarded "lower aggression as more favourable", used the Overt-Aggression-Scale-Modified- Aggression-Subscale (OASM) to rate patients' aggressive behaviour.

The 20-item validated scale measured four dimensions of aggression: verbal aggression; aggression against property; aggression against self, and aggression against others.

Verbal scale items included cursing, shouting, making offensive personal comments, temper outbursts and threatening violence. Aggression against property included door slamming, kicking or breaking furniture, and smashing and throwing objects. Auto-aggression items included hitting fists into walls and self-harming. Physical aggression items included making menacing gestures, grabbing at clothing, pushing and striking and attacks causing serious injury.

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Hostility

Aggressive behaviour is not good for men or women and is bad for health. There is very convincing evidence that

angry behaviour

and

hostility

increase the risk of heart disease and stroke.

However, angry feelings are not, in themselves, unhealthy. Anger is a natural emotion and its healthiness depends on how it is expressed. Along with fear, sadness and happiness, anger is one of the first emotions children learn how to feel. These feelings are necessary for survival and provide humans with information that all is well, or not, with the world. Anger is linked to justice and equality. Children have an innate desire for fairness and react angrily if they perceive they are being unfairly treated.

Unfortunately, few people are able to cope with anger in a healthy way. Parents feel uneasy when confronted by angry children, and either punish or ignore this behaviour instead of teaching them how to manage feelings appropriately. As a result, many people (mostly men) respond aggressively when they feel angry, using verbal or/and physical body language, and behaviours such as those described in the OASM. Others (mainly women) respond passively and become doormats. Passive responses are also unhealthy, and angry feelings will emerge at some stage, in the form of depression or other types of mental distress.

Manipulative or passive-aggressive techniques are also used by both sexes to cope with angry feelings, in the form of martyrdom or subjecting family and friends to the silent treatment which can go on for weeks or even months. Families tiptoe around each other because of suppressed anger.

Overall levels of societal aggression are becoming a big problem, both inside and outside the home. The 2015 Gender Equality Index shows that almost one-third of Irish women are subjected to psychological violence by a male partner at some stage during their lives and at least one in six is physically assaulted. No figures are given in the index for the number of men who are psychologically or physically assaulted by their female partners. This does not mean that men are not at the receiving end of aggression from female partners; it is just not recorded.

Social media is a huge source of aggression. Anti-social behaviour is part of everyday life in housing estates in most towns and cities. Society is literally buzzing with aggression.

Rapists

Irish people have plenty to be angry about. Rapists get fully suspended sentences. Wheelchair-using child abusers cannot be accommodated in jail. Irish Water has made such a mess of things that even people willing to pay for water are as mad as hell. Childcare is the most expensive in Europe and parents with two or more children are paying the equivalent of large mortgages in childcare fees. It is okay to feel angry. But to stay healthy, anger needs to be expressed assertively and not aggressively.

Intimidating water meter installers and violently harassing politicians is not the way to go. Instead anger can be used constructively to galvanise community action. The healthy way to respond to angry feelings is by being assertive which means acknowledging the anger, then verbalising it using "I" statements. This is not easy because so few people are able to talk about their feelings. Maybe we could all take statins instead. Making men less aggressive and women less passive might actually be a good thing. drjackyjones@gmail.com

Dr Jacky Jones is a former HSE regional manager of health promotion and a member of the Health Ireland Council.