Anger warning signs

As therapists and mental health clinicians, helping clients understand their anger warning signs is crucial to supporting their distress tolerance skills. 

This guide to anger issues warning signs gives behavioral health therapists a brief overview of anger management, tips to help clients recognize their anger signs and triggers, and tips for managing anger effectively. 

You can also download a free anger warning signs worksheet to save to your electronic health record (EHR) for repeated use with clients.

What is anger management?

While anger is a natural and adaptive response to perceived danger, it can sometimes occur in response to triggers or maladaptive beliefs. 

Anger management is a process that uses specific techniques to help clients recognize and understand their anger warning signs and control anger adaptively and constructively. 

Managing anger effectively starts with self-awareness. Noticing triggers, anger warning signs, and stress levels are essential elements of anger management.  

The other key components of managing anger issues, warning signs, and triggers include:

Increase self-awareness 

Working with a therapist to identify anger warning signs and triggers can reduce stress and help clients develop more effective coping strategies so that they respond rather than react to the trigger.

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Improve communication skills 

Rather than reacting to anger or suppressing emotion, assertive communication strategies may help clients better express their feelings without causing conflict. 

Stress management strategies 

Addressing areas of stress may be helpful. For example, the client may have a very demanding job that requires extended working hours, which causes high levels of stress and resentment about always being at work.

Strengthening coping strategies 

Emotional regulation and distress tolerance skills help clients tolerate intense emotions and withstand difficult situations without reacting with anger.

Cognitive restructuring 

Through cognitive restructuring, therapists can help clients understand how their thoughts and beliefs impact their behavior and use strategies to achieve more helpful thoughts and actions.

How to help clients recognize anger warning signs

Working with a therapist is an excellent way for clients to identify their anger issues, warning signs, and manage them effectively. 

When clients know their triggers, they can recognize their anger warning signs and choose to respond instead of reacting. 

Typical anger warning signs include:

• Physical signs of anger: This includes clenching their fists, feeling hot or flushed, increased heart rate, sweating, headache or stomachache, dry mouth, shaking or trembling, tensed muscles, and rapid or shallow breathing.
• Emotional warning signs: Includes anger, rage, frustration, overwhelm, irritability, a sense of injustice, or resentment.
• Behavioral warning signs: Includes pacing, shouting, slamming doors, aggression, impulsive responses, restlessness, glaring, and throwing things.
• Cognitive warning signs: Blaming others, rumination, catastrophizing, thoughts about hurting others or seeking revenge. 

Working with clients to identify their anger issues, warning signs, and triggers can help them respond in a more beneficial way.

Tips to help clients manage anger issues/warning signs

There are several anger management techniques that can be helpful for clients, including:

Acknowledging feelings

Sometimes, anger is only a surface-level emotion, and exploring it further might reveal unmet needs, violated boundaries, resentment, or hurt feelings. 

Strengthen coping skills 

Distress tolerance techniques allow clients to endure and manage intense emotions, pain, or distress associated with anger issues warning signs 

These skills include:

• DBT distress tolerance tools, such as REST, radical acceptance, and safe place visualization, are helpful ways to manage emotionally-activating situations more effectively.
• Taking a time out involves stepping away from a triggering situation, enabling clients to take a breath, regroup, and respond calmly.
• Relaxation techniques include practices like deep breathing or progressive muscle relaxation, which can help reduce the intensity of anger and relax tense muscles.
• Somatic skills like shaking, jumping up and down, running, or working out are great ways to take the power out of anger and reduce stress. 

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Enhance emotional regulation skills 

Emotional regulation skills can help clients to recognize, understand, and regulate their emotional responses. 

Techniques include:

• DBT emotional regulation tools include STOP, Opposite Action, PLEASE, and positive self-talk.
• Distraction techniques help clients focus on something else. They include switching to a different task, leaving a conversation, asking to pause the conversation, or doing something calming, like painting, listening to music, or gardening. 

Cognitive restructuring 

Anger may be caused by maladaptive beliefs like thought distortions, and interventions, like cognitive behavioral therapy (CBT), can help clients better understand their anger warning signs and beliefs and behavior processes, and find more helpful ways to think and behave.

Communicate mindfully 

Rather than reacting aggressively or suppressing their feelings, assertive communication strategies empower clients to recognize their anger warning signs and express their feelings assertively without causing conflict. 

Sources

• American Psychological Association (2022). Control anger before it controls you. https://www.apa.org/topics/anger/control
• Ciesinski NK, Sorgi-Wilson KM, Cheung JC, Chen EY, McCloskey MS. (2022). The effect of dialectical behavior therapy on anger and aggressive behavior: A systematic review with meta-analysis. Behav Res Ther.
• Henwood K, S., Chou S, Browne K, D. (2015). A systematic review and meta-analysis on the effectiveness of CBT informed anger management. Aggress Violent Behav. 
• Reilly, P.M., Shopshire, M.S., Durazzo, T.C., & Campbell, T.A. (2019). Anger management for substance use disorder and mental health clients: Participant workbook. SAMHSA Publication No. PEP19-02-01-002. Rockville, MD: Substance Abuse and Mental Health Services Administration. 
• Zhan J, Ren J, Sun P, Fan J, Liu C, Luo J. (2018). The neural basis of fear promotes anger and sadness counteracts anger. Neural Plast. 

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