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Coping with Pain: Anger Management

Anger 2

Chronic pain often makes people mad. Pain feels unfair. You don't deserve it. It gets in the way of life. It doesn't make sense. Other people just don't get what you are going through.  It's gone on for too long…

You may be angry and  you have the right to feel that way. Anger is a normal human emotion. But think about this: anger makes pain worse. In fact, anger brings its own pain.

  1. Research shows that negative emotions such as anger can increase sensitivity to pain, making you feel worse.
  2. Anger can increase muscle tension → muscle tension can increase pain.
  3. If you tend to suppress your anger and turn it in on yourself, you may feel depressed, your self-esteem may suffer, and you may feel hopeless and helpless.
  4. If you tend to turn your anger out at other people, your relationships with family, friends, co-workers, and your doctor may suffer.

 Anger Management

You might be shaking your head right new (perhaps in anger), thinking “Am I supposed to pretend like I'm not angry when I am?' or “Should I be a wimp and just put up with things?” or “Am I expected to just try to hide from my angry feelings?” No. It's rarely helpful to deny your emotions. But, you can learn to manage your anger.

A book by  Dr. Matthew McKay and colleagues,  “When Anger Hurts: Quieting the Storm Within”, is a very  helpful resource. It is easy to read, practical, and based on the science of anger management. The authors talk about anger as a two part process.

Anger has two components:

  1. Internal physical sensations of stress. Your body is telling you that something is wrong, that you are being expected to do something that you feel incapable of doing. Your stomach may be upset, your muscles may feel tense, you may feel jittery, your heart may be racing, you may have trouble concentrating. Stress reduction techniques such as exercise, daily relaxation, decreased use of caffeine and other stimulants are proven methods of reducing levels of stress.
  2. Triggering thoughts or beliefs. Dr. McKay and colleagues talk about two ca

    tegories of triggers: “blamers” and “shoulds”. Thoughts that some one else is to blame can make you feel like an angry victim. Thoughts that others are not doing what they should can trigger righteous anger. Let's talk a bit more about triggers.


The problem with “blamers” is that they assume that others are really in charge of you. You lose personal responsibility and control. You cast yourself as a victim. Here are a few examples.

“He made me stay at the mall too long and now my back really hurts.”
“The doctor was in a rush and I didn't get to tell her about the side effects to the drug. Now I'm stuck with it.”
“She stayed up too late with the TV blaring so I couldn't fall asleep. Without a good night sleep, I hurt all over.”
“He is so lazy, I have to do all of the housework. Now I have a migraine.”


Shoulds are difficult because they assume the other person knows and agrees with your “rules” about how they should behave. This is often not the case. Rather than assuming others share your beliefs, it is most helpful to talk with them about what you each want and need. Below are some examples.

“She should know not to put so much stuff in the suitcases. Now my back is killing me from lifting them to put them in the car.”
Why can't he ever make dinner when I have had a bad day? He should think about how I feel.”
“I feel so awful and my family acts like nothing is wrong. They should take better care of me.”
“My boss should give me flexible hours. It's so unfair.”

It is important to remember that once you have had a triggering thought, the anger seems justified and “right”. However, often when people begin to examine and question their angry “blamers” and “shoulds”, they begin to realize that there may be other ways to think about the situation. Take time to list your own blamers and shoulds. Try to identify the situations where you can take control and not be an angry victim. Talk to the important people in your life about your mutual needs and “shoulds”.

About the Author. Dr. Linda Ruehlman is a social/health psychologist and researcher, co-founder of Goalistics, and Director of the Chronic Pain Management Program, an interactive site that helps people with chronic pain to manage their pain and live richer, more effective lives.

DISCLAIMER: This blog is provided as an educational and informational resource only. It is not intended nor implied to be a substitute for professional psychological or medical advice.



  1. Damien Woodi says:

    The important role the mind plays in chronic pain is clearly recognized in the medical literature, as well as in the International Association for the Study of Pain’s definition of pain, which states that pain is always subjective and is defined by the person who experiences it.

  2. lisa says:

    dealing with the emotions of pain is harder than dealing with pain itself.its really hard to get family and friends to understand what a persons feels when there world is turned upside down.

  3. I agree with damien. everybody has a different level of pain. i am not sure if this has any thing to do with the bodies endochrine system. Ouch! That hurt!

    • Thom says:

      “,,not sure it has anything to do with the endocrine system…” In fact, acute and chronic pain significantly impact the endocrine system causing an outpouring stress hormones like ACTH and other cortisols. Over the short run, this can be helpful-even life saving but over a long run cause a lot of problems.

      I think another dimension in chronic pain is the difference between pain & suffering. Many times they are linked at an expected level but some individuals suffer more with similar pain states and some seem to suffer less. I do not place a value judgement on either attribute but perhaps such observations will lead improved PM strategies.

  4. Marilyn says:

    “and agrees with” under Shoulds is a chapter in itself. Interesting.

  5. Cindy says:

    Yes, pain is subjective because other people are not in your body and are not able to feel the pain you are feeling, so therefore they have no way to assess it.
    You are a whole person and of course what affects you physically will affect you psychologically. I found that the pain in itself causes stress. It is psychologically draining. It is distracting and makes it difficult to focus, my memory is affected. I get depressed and frustrated and discouragd. To try and push thru the pain is very mentally taxing and takes trememdous mental energy that it is hard to desribe how that makes me feel. I think it is the pain that has an affect on the mind, not so much the mind that has an affect on the pain, or maybe both and it becomes a viscous cycle………

  6. Richard Cowell says:

    I have yet to read further than the posts but suffer with anger put under stressful situations, sometimes it can be explosive though primarily I just feel stress at astronomical levels that unfortunately for me can make me very direct and because I am naturally confident and have high survival instincts my pain (and meds) can make me focus on agressive thoughts I would otherwise not have. I suffer with nerve pain from years of back problems, mechanically too. I was very aware of my loss of confidence when I first became poorly as my pain is acute as well as chronic, plus I lost all strength and confidence physically. before I had relied on my presence a lot but now found myself stripped of that general confident aurora. I am really looking forward to reading more and exploring for words that give acceptance and help understanding. Any negative emotion makes my pain flare so my life has changed much and good has come from bad (as it does!) and I am lucky to have a great family…thank you to anyone who has read this. Gonna post again after a good read..

    • Hello Richard,
      I hope that you will find many ideas that will help you here.
      Best wishes,

      • Richard Cowell says:

        They are good Linda, I am quite grounded and experienced so understand my life with pain and how to manage I would say more than most. My Doctor recently wrote that she had never met a more motivated and positive person, but nevertheless, acute pain kills off much and changes matters significantly both financially and emotionally. My wife is a carer and fantastic person, the best friend and nicest person I have ever met, widely acknowledged by our friends too, so guess I am very lucky to have such support. I wish you all the best with your work and will have a thorough read when the opportunity presents itself. I wish you luck with your situation also as I am aware you too suffer a life with pain. Good luck and well done with the site. Regards, Richard.

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