Patients who have severe anger and commit abuse or violence can be challenging to reach in therapy. Overcoming anger often requires acknowledging a patient’s most vulnerable feelings, which is antithetical to the emotionally detached, action-oriented persona they may have adopted to protect themselves. In order to feel in control and avoid their pain, they may throw their weight around, intimidating the therapist and making sure he or she is kept at a distance.
The therapist can aim to be persistent, patient, and avoid being provoked. With enough time, the patient can become comfortable enough to share vulnerabilities that may have fueled patterns of anger and abuse.