Question: Hi, within the last few years I have noticed my anger has gotten noticeably worse. Especially when I'm after consuming alcohol. I've found myself saying awful and terrible things to my boyfriends and friends when I'm after alcohol. There has been three times that iv arrived home after a night of drinking and out of nowhere iv started verbally abusing my boyfriend for absolutely no reason saying horrible things that I wouldn't even dream of saying when I'm sober. the worst part is that I don't even mean the things that I'm saying yet i still end up saying them? My dad is quite an angry man who holds a grudge against everyone and iv always made sure that I don't end up like him by thinking positively and not being judgemental however when I'm drunk I seem to explode? And I don't bottle things up either because if myself and my boyfriend ever have an argument were both extremely open and honest with how we feel. I would appreciate any feedback as I don't want to put my boyfriend or my friends through this again and it scares me how I can turn into a different person and be so unpredictable without being able to control myself. Thank you

Dr. Mark Abrahams Says...:

What you are describing is all too common with people who react badly under the disinhibiting effects of alcohol. I do not want to bore or confuse you with a lesson neuroanatomy, but there are subcortical structures in our brains - parts of the brain under the surface that are responsible for basic mammalian emotions. In connection to one of these organelles, the Hypothalamus, my physiology professor referred to them as the  "Four Fs" - Feeding, Fighting, Fleeing, and Mating :-)  

 All humor aside, anger is a primal emotion that serves a survival need. Two of these 'Fs' have to do with the 'Fight or Flight response' which prepares us to defend ourselves or run away from danger, but for some people whose higher brain functions become overwhelmed by alcohol, these subcortical emotional responses surface when they don't need to. The anger that goes along with these unwarranted emotional responses can be tinged with paranoia, which when verbalized becomes all manner of false accusations and name-calling. 

The truth is that many people cannot tolerate alcohol. Perhaps their genetic disposition (which can be tested) does not metabolize the alcohol as quickly or efficiently as others, so that they (you) cannot under any circumstance match your drinking partner's rate of consumption. The harder truth is that you may realize that you should not drink hard liquor AT ALL. It is less likely that wine or beer will result in the same kind of abreaction as hard liquor, although if you consume those in large enough amounts the same negative results are likely to occur. 

Without intending to sound judgemental, I would nevertheless suggest that you reflect on why you are drinking to the point of drunkenness instead of a condition 'pleasant' inebriation. If you find that you are unable to control your alcohol consumption without negative consequences, you may have to consider complete abstinence, and if complete abstinence seems completely unacceptable, you will then have to consider the that you have an alcohol use disorder.

Question: I am doing this online program for anger management and there is something that I don’t really understand. One of the things that is recommended is to pay attention to what happens phsyyicaly and cognitively when I start getting angry. Then, once I get the hang of this, once I can recognize these things happening I will know my anger is going up and I can take steps to counteract this before I get out of control. It all sounds very good in theory, but I go from 0 to 10 in about 5 seconds so how am I suppose to bust out a progressive muscle relaxation exercise or imagery exercise within that exceedingly brief window of time? I see this technique of anger stopping gets taught all the time, so I feel like I am missing something basic here. How is this supposed to work in the real world?

Dr. Mark Abrahams Says...:

If you want to be able to employ basic breathing techniques when you need it, it has to be second-nature to you. One does not expect to behave as a martial artist when the occasion arises, if one has never practiced martial arts techniques in a dojo beforehand. One does not go into battle if one has never practiced fighting techniques, or breaking down and repairing a rifle in seconds, in the dark, in case your weapon jams in a fire-fight. 

Before one learns to balance on a bicycle, most children use training wheels which initially gives a 3-point stable position on the ground. Then, the wheels are raised incrementally. One learns to balance oneself on the bike without fear of toppling to the ground. With the training wheels an inch or so above the ground, there is just some wobble until balance becomes natural.

If you want to utilize classic breathing techniques in order to establish emotional balance, you need to practice before the need arises in a crisis. This is what sitting meditation is for. One practices sitting, often in a 3-point sitting posture (knees and butt), in a stable posture. One works with breath until unwanted thoughts evaporate, and consequently, with disturbing thoughts gone, there is nothing left for negative emotions to arise in reaction to. I think it is entirely unrealistic to expect meditative equipoise to arise when needed, if one is hardly acquainted with the state of mind. Therefore, it seems incumbent upon you to find a style of meditation with a proven history, that appeals to you, in order to accustom yourself to those states so that they are available to you when you need them. There are then other applications for the state of mind, say, waiting in a boring line, instead of indulging in cell phone addictive behavior. For meditators, meditation colors one's whole life if one wants it to, and it engenders great psychological and hence physiological health as a lifestyle.

Lastly, as a matter of bibliotherapy, I suggest reading the book The Power of Now by Eckhart Tolle. This is one book that has become a constant companion to me no matter how many other books I am reading because it helps keep my mind clear and calm like nothing I have ever read before. Just saying.

Question: I use methamphetamine and methadone (12 mil a day) every day, my wife recently quitted and is going to NA. She gets very angry at times and makes me angry too... I don't know how to control the situation. Could you please give me some suggestions

Dr. Mark Abrahams Says...:

Sorry, but it seems to me that your wife is in the process of reclaiming some control over her life. Going to NA is the best choice she could make. If her road to recovery causes a major rift in your marriage, the only sane recourse is for you to join her on the road to recovery, before you take the road to the morgue. Sound cold? It's not intended to sound cold, it's intended to sound like "tough love." 

I'm on the side of anyone who wants to be whole, wholesome, holy, healthy. These words all derive from the same root. Living between the extremes of stimulants and narcotics is a madness all of its own, like driving a car with the brakes on. It's inevitably gonna burn out and die. If that's what you want to do, don't take her down with you. If you don't care and want her on a death-trip with you, then let her go so she can live and seek the meaning of her life. 

"Peace, and long life."