NJ-ACT - Howard Kassinove

Howard Kassinove On

Anger & Forgiveness

By Milton Spett

At the NJ-ACT workshop on October 5, 2008, Howard Kassinove described his therapy for anger and forgiveness. This therapy attempts to change emotion (anger), behavior (aggression), and the four irrational cognitions that trigger these reactions:

“This is awful.”

“I can’t stand this.”

“He or she shouldn’t talk this way/do this to me.”

“This person is bad.”

According to Kassinove, paper and pencil measures of anger are not useful because anger is idiographic and situation-specific. The first step in treatment is to determine what triggers anger in which situations for each patient.

Treatment then focuses on behavior rehearsal. The therapist identifies an insult that triggers anger in the patient and states this insult sixteen times. Each time the patient responds with a rational statement that counteracts one of the four dysfunctional cognitions. The first time the patient responds “What you are saying is unpleasant, but not awful.” The second time the patient responds “I can tolerate hearing this.” The third response is “I can’t get him [or her] to change, so I have to accept this.” The fourth is “This person is not all bad. He [or she] does some good things and some bad things.” Patients read each of these rational statements from a card -- each rational statement counteracts one of the four irrational cognitions that trigger anger.

This process is then repeated. The final eight times the therapist states the anger-triggering insult, patients give the rational response without looking at the card. The therapist should make the trigger statement in an angry tone, using angry facial expressions and body language. The behavior rehearsal is more effective if it initially elicits anger in the patient.

Forgiveness Training

1. Explain that forgiveness does not mean condoning or excusing, and indicates strength, not weakness.

2. Attempt to convince patients that holding on to their anger hurts their mental and physical health, not the person they are angry at.

3. Help angry patients to understand why people they are angry at did or said what they did. The other person may have acted partially due to their own problems or stressors.

3. Ask angry patients to do something for the people they are angry at, for example sending them a greeting card. Kassinove says that patients find this very helpful in letting go of their anger.

Patients are often referred for anger problems by family members or courts. Kassinove recommends beginning treatment of these patients with motivational interviewing.