Their anger is always sudden, raging, frightening and without an apparent provocation by an outside agent. It manifests itself only when the person's defences are down, incapacitated, or adversely affected by circumstances, inner or external. We have pointed at the psychodynamic source of this permanent, bottled-up anger, elsewhere in this book. The anger, however, was a justified reaction to abuses and mistreatment. The patient was, therefore, left to nurture a sense of profound injustice and frustrated rage.
Healthy people experience anger, but as a transitory state.
Pathological anger is neither coherent, not externally induced. Still, upon closer scrutiny, the cause is likely to be found lacking and the anger excessive, disproportionate, incoherent. The first layer, the superficial anger, is indeed directed at an identified target, the alleged cause of the eruption. The second layer, however, is anger directed at himself. The patient is angry at himself for being unable to vent off normal anger, normally.