Trauma was always a word I associated with a catastrophic event: a car accident, a war experience, child abuse, or being a victim of crime. So, it was an “aha” moment to learn that symptoms of trauma, like depression, could be caused by suppressed anger from repeated instances of emotional disregard. Childhood emotional neglect comes in many forms and is more common than one would hope.
Below are a few examples:
Rachel, 8 years old, was scared to go to school. Her father repeatedly told her there was nothing to be afraid of and that she shouldn’t be a “scaredy-cat.” Dad didn’t ask what she feared or spend any time trying to understand Rachel’s fear from her point of view.
Johnny told his mother he hated his little brother and was sorry he was born. The next moment, a hard slap across the face stunned him. Johnny was told never to speak in such a hateful way again.
Barb, age 12, kicked the winning goal in soccer. She got in the car riding high with emotions like excitement, joy, and pride in herself for playing a great game. Her mother, instead of matching Barb's enthusiasm with a big proud smile, immediately pointed out the “ugly” red juice stain on her daughter's shirt. Barb was devastated.
When our emotions are invalidated, we experience a crushing insult. And, it evokes anger and even rage, depending on how young we were when the emotional neglect began plus how often it occurred.
David, a former client of mine, grew up with parents who bristled at emotional displays. As a child, when David cried, he was told he had nothing to be sad about or to “chin up!” When David was scared, he was told to stop being such a baby. When he was excited, he was told to "cool it!" When he was angry at his parents, they got insulted and left him alone. They never asked What’s the matter? How do you feel? or, Are you ok?
David, now 30, showed up in therapy with depression. Blaming himself for his anguish, he described a privileged upbringing with parents who provided well for him. Attending private schools and being given a generous allowance, he was truly grateful to his parents for their gifts. We soon discovered that part of what led to his depression was the conflict between positive and negative feelings for his parents. He found it hard to validate his "negative" emotions.
To push anger down, the mind enlists inhibitory emotions like anxiety, guilt, and shame. This category of emotions is very effective at keeping anger out of conscious awareness. But they also feel awful and undermine confidence and well-being. Furthermore, the cost of chronically suppressing anger with inhibitory emotions is depression. The energy needed for vital living and outside engagement gets diverted to keeping rage pushed down so that we don’t lose control or lash out.
Healing Depression by Learning to Safely Release Anger and Rage
One effective way to ease and even heal depression is by releasing the enormous burden of our visceral anger. How is this done?
Anger portrayals, a technique common in accelerated experiential dynamic psychotherapy (AEDP), are extremely therapeutic because they lead to a positive and lasting brain change. In a nutshell, anger portrayals guide a person in identifying anger in their body. Anger typically is felt physically as heat, energy, and tension in the jaw, back, arms, and legs. These subtle and not so subtle sensations reflect the body's way of preparing itself for a fight for protection against a perceived attack. By purely noticing and staying with the physical sensations inherent in the core emotion of anger, and without taking any action except breathing through it, impulses and images emerge like a movie. Allowing the movie to unfold in real-time, the person gives themself permission to envision vividly in their imagination exactly what the anger wants to do to those who hurt them. In this way, anger comes up and out and symptoms of depression remit.
Sometimes guilty feelings make it hard to validate and fully experience anger. In the beginning, when David first started to connect with his inner rage, another guilty part of him arose and stopped the anger from coming up: “But they did so much for me. I’m so grateful for all the good things they did."
Most people don't realize that we can be grateful to our parents for giving us life, financial security, and making sacrifices, and, at the exact same time, feel angry at them for not meeting our emotional needs. This understanding helps us embrace our complex and conflicting emotional worlds.
“David,” I'd say, “I hear you feel both anger AND gratitude. Let’s fully validate the gratitude and love you have for your parents, and, for just right now, can we ask for the gratitude, love, and any other feelings you have to step back while we tend to the anger inside?”
To demystify this process and see what processing anger and rage actually looks like in action, the following is an example from an AEDP session with David:
“Can we return to the scene in your bedroom when your dad teased you for being sad? Do you still sense the outrage on behalf of your younger self?” I asked.
“Yes. I feel the tension in my core. There is energy. I feel hot.”
“Great. Stay with the sensations and breathe.” His hands were forming into fists.
After several seconds passed I asked, “What do you notice your fists want to do?”
“Hit him!” He said.
“Can you let yourself imagine that? We are just honoring what the anger wants to do. I know you would never actually hit your father and that you love him, but the impulse of the anger is to hit. So let’s honor it and trust your body. Anger is programmed to want to attack back. It is fiercely protective of you. What do you imagine?”
“I want to punch him.”
“Let yourself imagine that. What do you see?” I was excited for him. I sat on the edge of my seat. My voice was stronger now, more energetic. I matched his angry energy so he wouldn't feel alone with it.
“Right in the stomach so he can see what it feels like.”
“Good! Let yourself feel the contact between your fist and his body. Make it vivid, like a movie.” I paused. “What’s he doing now?”
“He’s doubled over.”
“Look at him, what do you see?”
I wanted him to walk through this fantasy step-by-step until the end to activate lasting brain change. This was a new experience dictated by the feelings and impulses naturally emanating from his body. The body knows how to heal when we remove obstacles and let emotions flow.
David reported, “Dad is stunned. He looks confused.”
“Now check back into the anger in your body. What do you notice now?”
“Something in my upper chest,” he reported.
“Just stay with it and see if there is an impulse there.”
“Yeah! It wants to scream at him.”
“If we could hold a microphone up to that sensation in your chest and it could speak, what would it want to say?”
“THAT’S WHAT YOU GET FOR THROWING SOMETHING OUT THAT BELONGED TO ME!! YOU HAD NO RIGHT!!!” he said yelling
“What do you sense or see now?”
“His head is down. He looks ashamed.” There was sadness in his voice. The anger had shifted.
“How is it for you to see that?”
“I feel sad for him. He seems smaller. That actually feels good even though I now feel sad.” He took a deep breath and I could sense his tension melt.
“Let’s just check in one more time to notice if there is more anger inside. What do you sense?”
“It’s gone,” he answered.
“What is in its wake? If you just scan your whole body from head to toe. What do you notice now?”
“I feel calmer.”
Rage portrayals work because, as research shows, when it comes to processing emotions, the brain doesn’t really know the difference between fantasy and reality. Imagining what our rage wants to do and then carrying that out in fantasy allows the energy of the rage to come up and out. No longer are forces required to hold down that anger, so energy becomes available again for vital living. The best part about anger portrayals is that no one gets hurt because it’s all happening in the imagination. In fact, when we process the old and current anger and rage we feel towards our loved ones, it often paves the way towards more connection if that is what we want.
Depression is the beginning of a story, not the end. It is a symptom that tells us that something deep inside needs tending, be it anger, fear, sadness, or more. And when we tend to ourselves and our deepest emotional truths, we recover stronger and wiser. We no longer need to fear our emotions but can use them along with our logic and reason to meet life’s challenges in the direction of our deepest wants and needs.
Patient details have been changed to protect confidentiality.
Fosha, D. (2000). The Transforming Power of Affect: A Model for Accelerated Change. New York: Basic Books
Fosha, D., Siegel, D., Solomon, M. (2009). The Healing Power of Emotion: Affective Neuroscience, Development & Clinical Practice (Norton Series on Interpersonal Neurobiology). New York: W.W. Norton
Hendel, H.J. (2018). It’s Not Always Depression: Working the Change Triangle to Listen to the Body, Discover Core Emotions, and Connect to Your Authentic Self. New York: Spiegel & Grau
Levine, P. (1997). Waking the Tiger: Healing Trauma. Berkeley: North Atlantic Books
Pally, R. (2000). The Mind-Body Relationship. New York: Karnac Books.
Van Der Kolk, B. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. New York: Viking