Tourette syndrome & anger management (PDF)

What is anger? Anger is a natural emotion that is as important as any other emotion. However, there may be bad consequences to losing your temper, and these may cause problems long after your original outburst. Also, as many young people with TS also have difficulty paying attention and are impulsive, this can make it even more likely that they will ‘blow a fuse’ and do something that is later regretted. Sometimes, losing your temper can be called ‘having a short fuse’. This means that a young person with TS might lose control in situations that seem small or insignificant to other people. This can cause a lot of worry, upset and frustration for the young person and his or her family. However, there are some very good strategies for helping you to keep you temper and to help your family deal with and understand it better as well. Thinking about your triggers A useful step is to think about what happens to your body when you start to get angry. Working this out is helpful not only for you but for the people around you. The sort of body- changes that might happen include fist clenching, going red in the face, sweating, teeth clenching, butterflies in the stomach, faster breathing, head hurting, sweaty palms or flared nostrils. Alongside the physical signs of getting angry are your thoughts. Thoughts are often very specific when you are starting to lose control. You could be thinking ‘this isn’t fair’ or ‘I want to get even’. Although these can be difficult to identify at first, the more you practise catching them, the easier it will become. Some people have described these body-changes and thoughts as like a volcano, ready to erupt. We know that anger attacks happen very quickly in young people with TS so you have to work extra hard to try to control it. Getting yourself out of the situation Another useful strategy is to think about what you can do when you start to feel angry. The best sorts of things are those that take you out of the trigger situation and take you to a different space. Think about the places or people who seem to make you angry the most easily. Making a list might be helpful. For example, do you get angry when your parents ask you to do something before dinner, perhaps when you are hungry and just got in from school? It might be useful Tourette syndrome & anger management Some people who have Tourette syndrome (TS) have problems in addition to tics. Getting very angry is one of the most common difficulties for people with TS, and it affects their families too. This information sheet explains how to change the way you think about anger and how to cope with anger attacks better. Great Ormond Street Hospital for Children NHS Foundation Trust: Information for young people and families Sheet 1 of 2 Ref: 2012C0027 © GOSH NHS Foundation Trust July 2012  Sheet 2 of 2 Ref: 2012C0027 © GOSH NHS Foundation Trust July 2012 to plan relaxing things to do for the first 20 minutes or so when you get in from school. If you find you are starting to get angry, there are lots of things you can do: n Leave wherever you are in the house and go to your room n Listen to some calming music n Play the drums n Wash your hands in cold water n Count to ten slowly The important thing is to control your anger before it controls you. Make a list of your own things to do and places to go when you feel like you are losing your temper. It can help to share this list and your list of triggers with your family so that they are aware of what sets off your temper and can try not to make things worse. Aggression versus confidence Think about the difference between being aggressive and confident. Imagine someone who is confident and think about how they look, talk, act and stand. Think about someone who is angry and how they behave. Which person would you like to be like? How can you practise being the confident person rather than the angry person? Remember to practise being confident in lots of different situations, such as school and out with your friends, as well as at home with your family. Talking about it It is always helpful to talk to someone about your anger. If you would rather not talk to your parents, you can always talk to a mentor at school, a counsellor, a friend or relative who is a good listener and could help you see another side of the situation. Further reading Shapiro L et al (2009) I’m not bad, I’m just mad: a workbook to help kids control their anger. New Harbinger Publications. ISBN 1 572 246 065 So, in short... n Try to understand the situations that make you angry and avoid them n Work out how your body changes when you start to ‘lose it’ n Understand the thoughts going through your head when you are getting angry n Think about ways to calm yourself down n Practise being an assertive person rather than an aggressive one n Talk to someone else to see if they have any other ideas n Praise yourself when you succeed in not getting angry Compiled by the Tourette syndrome clinic in collaboration with the Child and Family Information Group Great Ormond Street Hospital for Children NHS Foundation Trust Great Ormond Street London WC1N 3JH www.gosh.nhs.uk