Pragya Shrestha
Gestalt Institute of Nepal
Why this topic?
Anger is much misunderstood as it is taken as negative
behavior in my country.
Many of us introject, retroflect or deflect emotions including
anger. Instead of talking about anger to the concerned person,
I see people (which I also used to) blaming about him or back
bite about him or be violent or act of suicide.
I want to support client through therapist to express anger in
different way. As anger can energize us, improve our
communication with other people, promote our self-esteem
and defends us against fear and insecurity (Gentry, 2007)
Outline
My personal experience
Research
Practical Implication with client
My Personal Experience
One childhood event:
Mother said something to me and I threw
glass on the wall.
Introjection: (Taking in opinion, like food)
Anger is an enemy (l/; zq' xf] ._
Retroflection:
I started to suppress anger and retroflect it
by being kind and nice to others.
Deflection
We deflect our anger by changing the
subject or avoid environment
I introject, retroflect and deflect anger
because….
As a child I was taught not express anger to
elders. It is considered as being rude and
with no respect to an elder.
Blessing from senior and respect from junior
Research
Aim:
To explore how counselors or therapists deal
with person anger and intervene anger of client
Research Process
 Selection of research questionnaire before actual research.
“How is it for you when a client expressed anger?”
“How did you deal with that?”
 Qualitative approach
 Semi-structured questionnaire with open and closed
questions
 In-depth interviews with 10 psychosocial counselors,
psychologists and therapists
Method of Data Collection
 Qualitative approach
 Semi-structured interviews
 Demographic data (e.g Age, Education) - Structured
questionnaire.
 Personal experience - Open-ended questions.
 Face to face with audio recorder
 Transcribed in computer
Data analysis
 Interview was transcribed
 Inter-coder agreement (with mentor through email
communication)
 Analyzed with the help of Open Code 4.02
 Data was divided into two theme (Therapist dealing
with anger and intervene the anger of client)
 Findings were compared with Gestalt literature
Research Findings
Main theme one: Dealing with anger (self)
Most of therapists “keep silent” or calm down (i.e. 6 respondents)
besides “deep breathing” (6); Shift from the place (5); “being
aware [feeling or body or mind]” (3); “counting [inside]” (3).
Some of them Assert (2); stay alone (2); analyze advantage and
disadvantage of anger (1); focus on another thing (1); being aware
of the situation (1) ; delay the reaction (1); shouting (1).
Research Findings
Main theme one: Dealing with anger (self)
Reponses of anger are through thought, feeling, bodily
response and behavior.
Thought “…saying to self what is my fault?”
Feeling “Do not talk, cry alone, …get irritated.”
Research Findings
Main theme one: Dealing with anger (self)
Bodily response
“I keep silent. Take a deep breathing…I watch the
situation and if I do not do any fault, my head get
hotter. Felt heavy head.”
Behavior
“Going around, sleeping,..making mind and body relax,
sharing with husband and friends”
Research Findings
Main theme one: Dealing with anger (self)
Few respondents (i.e 2) mentioned that anger is not
expressed to senior level (age or position wise). It is
rather suppressed.
One of the respondent said: “….For instance, I would
speak in loud voice or I would say NO. But, if the
person is S…(name of senior in the organization),
then one [I]cannot express anger outward.”
Research Findings
Main theme one: Dealing with anger (self)
The other respondent said: “It depends upon
individual. If the person is smaller [age wise,
position wise], I ask directly. Why are you
angry? If s/he is elder, I create distance. I
cannot talk to him/her.”
Research Findings
Main theme two: Intervene the anger of client
Many of the respondents mention that they intervene the
client anger by listening (3) at the beginning; Questioning
skills (3) such as “..What makes you angry?” “How much
angry he was?” and teaching mindfulness Or relaxation Or
deep breathing Or breathing technique (7) afterward; Give
Psycho-education (8).
Research Findings
Psycho-education:
 “Anger is an emotion”
 “Anger is normal”
 “Anger leads to reaction”
 “Express anger”
 “Not good to suppress the anger”
 “Mindfulness and deep breathing”
 “[Anger is] Not normal when violent and attack”
 “We need anger but in balance way”
Research Findings
Main theme two: Intervene the anger of client
 Other interventions: Encouraging them to release and
provoke (2); ask anger is right for him or not (1); ask to
drink cold water (1); observe at first (1).
Research Findings
Encouraging them to release and provoke (2 respondents)
 It is interested to know that the respondent who mostly
use Systemic approach or Gestalt approach provoke or
stimulate anger than those who use client or person
centered approach.
Rational for using Gestalt therapy
with anger
Most of the counselors of Nepal use Client-centered or
person-centered approach.
Different authors compared Client-centered or personcentered therapy and Gestalt Therapy.
The Gestalt therapist operates in a more dynamic and active
manner than that of a Client-Centered counselor who relies
primarily upon receptive qualities expressed through
empathic reflection of feelings. (Martin S. Fiebert, 2012)
A person-centered approach is not suitable for every
client in crisis, and it is important to provide
additional tactics for crisis interveners to utilize for
clients who do not respond well to a person centered
approach (Young & Lester, 2001).
Practical implication with client
 20 years young married lady attempted suicide and
rescued. She was in hospital for observation.
 She was diagnosed as Severe Depression.
 Therapist/client as “I-Thou” Relationship
 Awareness of anger using Empty chair (Yawning and
half close eyes)
 Psycho-education: Connection between What
happened? What do you feel or thing? What do you do
and What do you feel?
 Behavior Activation: Activity (dance) and mood
(happy), homework and keeping in daily routine
Outcome
 Talks a bit longer
 Smile of the face
 Future plan to continue her degree
Result and Conclusion
 Anger is taken mostly as negative emotion that leads to
behavior like screaming, hitting, suicide, and depression.
 Anger is either introject and/or retroflect and/or deflect.
These contact boundaries needs to be explored so that
anger can be expressed openly and clearly.
 While intervening the client anger, the first intervention
can be listening at the beginning and teaching mindfulness
or relaxation or deep breathing afterward. If provoking
anger can make positive change, then it make sense.
References:
 Young, L. & Lester, D. (2001). Gestalt Therapy approaches to
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crisis intervention with suicidal clients. Oxford University Press
Gentry, W. Doyle (2007). Anger Management for dummies.
Wiley Publishing, Inc.
Richardson, N (2007). The handling of aggression in therapy
from a Gestalt Perspective, University of South Africa
Lichtenberg, P (2012). Inclusive and Exclusive Aggression: Some
(Gestalt) Reflections, Gestalt International Study Center, 16
(2):145-161
Glancy, G. & Saini A. M. (2005). An Evidenced-Based Review of
Psychological Treatments of Anger and Aggression, Oxford
University Press
Thank you for listening!!