I’ve needed to do quite a lot of thinking recently about anxiety and anger, which I had always seen as discreet phenomena. My patients tell me otherwise so it seems wise to do some reading and thinking. This blog is a summary of my thoughts so far. Anxiety, angst, anguish and anger all have a common root, the Latin angere meaning to choke, dread, panic, anguish. These certainly seem to describe the feelings we associate with both anger and anxiety.

This is fine as a piece of semantics. I always like finding the root meaning of a word. It sheds light on what gave rise to the word but does it do anything more? In this case I think it does. Angere conveys the sense of destruction. Choking, panic, dread make me think of drowning or any experience that threatens to destroy me and end my life. (People who talk about having a panic attack will say they thought they were going to die.)

A psychoanalytic understanding of anxiety is given by Charles Rycroft as being to ensure that primary anxiety is never experienced. And this in turn is described as “the emotion which accompanies the dissolution of the ego.” Or psychic death. Who would not want to avoid that? (Think of how we feel when we’ve had a near miss in a car or as a pedestrian.Relief is quickly replaced with fury. Both are a reaction to near death.) In clinical terms anger and anxiety are both responses to threat – the well-known Fight or Flight reaction which is much more difficult when the threat arises from within us rather than from an external threat. Which is why those who are permanently anxious or angry can be so hard to be with for any length of time, because they project their fears into those around them. We become the enemy. So, the wife who is experienced as always critical may stand for her husband’s critical super ego (that voice in our heads that is forever running us down, telling us how stupid we are etc.) The wife who is always angry at her  family may very well be following the same path. Putting her own insecurities into others so they become someones else’s problem-not  hers. What is being projected is the internal battle raging in that individual’s psyche. Their own fear of being overwhelmed by their feelings are transformed into feelings of being attacked by outside forces. Hence racism, sexism, homophobia and the like.

The more difficult part is what to do about these thoughts and feelings. Cognitive Behavioural therapy is increasingly popular. This teaches us how to manage our thoughts and feelings. So, in the face of anxiety we might teach simple relaxation techniques. Anger might well be “managed” in a similar way. Google “Anger Management” and there will be pages of techniques, courses, exercises and the like. My own approach is to try to understand the links between anger and anxiety. To help my patient see who or what  is the source of their distress.Frequently something was missing in their experience of growing up. Parents who were preoccupied with their own concerns. Parents who, somehow, failed to pick up the messages their child was giving them about their needs. (Which is not to blame parents or criticise their parenting skills. Simply to observe that there can be a mismatch between what a child might need and what a parent is able to give.)

Medication has its place. Prozac is so popular because it works! We get relief from the misery of depression, anxiety and anger. Which in turn can give us the necessary energy to do the talking therapy that will allow us to change and grow.The actress Amanda Seyfried put it succinctly “Anxiety, it just stops your life.” (Replace “anxiety” with anger, depression, or something similar. It still works.)