Seeing red

                                                                             Seeing red

Anger is a culturally censored feeling in this country, one of the ultimate taboos. To lose one’s temper, even more shockingly to be a person with ‘anger issues’ is almost by definition to be in the wrong. Yet, there are many circumstances where anger is not only the most appropriate feeling to have, but also that not expressing it can be openly harmful to oneself and others. I would say that the current state of the world and the endless politics of the pandemic generate plenty of opportunity to be furious.

            Perhaps, the main point about anger is not whether it should be expressed or not, but how and where it is appropriate to express it or even indulge in it. My week was marked by a shocking incident. I had an online consultation booked for which I did not receive the zoom link in advance as promised. More than fifteen minutes after the time of the appointment, the practitioner finally emailed me the link. I logged on instantly, but was reprimanded for starting late and told that he would try to accommodate me. When I responded that I had not received the link by his secretary despite several reminders, he replied that this was unlikely, as his secretary was very efficient. It was at that point that I saw red, but being aware of the cultural code of not expressing anger directly in this country, I tried to be very measured in my response, and only stated that this did not feel like the best beginning for our meeting and that it didn’t feel like I was treated fairly. At that point, the practitioner proceeded with telling me that I was a waste of his time and that he had many other ‘happy’ patients to tend to and he hang up on me, even though the appointment was fully paid well in advance! At least, he had no difficulty expressing his anger! Later on, his secretary wrote to me to apologise that she had indeed not sent the zoom link. I am somebody who very rarely makes formal complaints or reports unacceptable behaviour, even though there are plenty of triggering incidents in the world we live in, but I will make sure this practitioner’s behaviour is reported to relevant bodies, which I guess is an example of channelling one’s anger appropriately. But expressing anger in the way he did in a professional context is in my view totally inappropriate. Yet, as a patient, it is terribly important to feel safe enough to express one’s anger, even when this anger is not rational, and yet, people are terrorised that if they do, they will be punished and ostracised such as in the case above. Clearly ‘good patients’ never complain!

            Thinking about it, having a conversation about anger is quite a central premise in my clinical practice. It is said that depression is anger and rage turned inwards and from my clinical experience, I would very much agree with it. As I offer a bi-lingual practice in English and in Greek, and effectively a rather multicultural practice representative of the cultural diversity in London, I find that there is a clear cultural split and polarisation in relation to anger in particular. In the Greek context (and also in other Mediterranean and East European contexts) anger is a feeling one may have too much of. Many of my patients from the above cultural contexts have been traumatised by the constant conflict between their parents and by long term high tension and toxicity in their family life. Family life of course does generate tension, but parents who take it for granted that they can take it out on their children or their partners are ultimately harmful. On the other hand, in the Anglo-Saxon context, many patients present with an inability to express anger and the toxic effects of having to constantly repress it, for what may feel like a lifetime. Anger, like sexuality is ultimately a drive, and as such, it needs to find an appropriate avenue for expression. It is in my observations, a core part of clinical work to help people find a more authentic way of being in the world which entails finding a way to express a number of feelings including anger.

            I have no problem with feeling and expressing my own anger in certain contexts, yet in others, I will allow myself to feel it, but will be very careful not to show it. One such occasion is in clinical work, though there are exceptions of course. The reason is that I don’t consider the therapy relationship an equal one. Though there can be plenty of occasions, where a therapist may be provoked into anger, sometimes quite deliberately, I think expressing it directly takes away from the space a patient needs for their own feelings and can also be intimidating, as we have to accept that being in therapy is a position of vulnerability. So, for example, if a patient was late for an appointment and they complained that they did not receive a zoom link from me and that this has affected their experience, I would apologise first, even if I was certain I had sent the link, and then notice, explore and validate their feelings towards me, even if those were anger and mistrust. Some analytic therapists claim that to apologise is to deflect a patient’s anger, but I personally think that this is potentially code for getting into a power struggle. To apologise and to accept that it is normal that vulnerability generates anger in those who have found themselves in such a position one too many times, is not deflecting anger, it is allowing for a more nurturing and non-toxic relationship where anger can be expressed safely.