November 24, 2004
What to do for Ron Artest - or does anger management work?
I originally posted this on my own web site - db's Medical Rants. I hope you enjoy this discussion.
db
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The recent Ron Artest outburst had many pundits discussing how he needed help. Some explicitly endorsed anger management. But, like everything else in medicine, we must hold anger management classes to explicit criteria. Do these classes decrease anger outbursts.
This NY Times article suggests that the classes may not help at all - Anger Management May Not Help at All
"Anger-management classes, I think, are a Band-Aid; they allow people to feel they've done something, but they haven't had any kind of real treatment," said Dr. Ray DiGiuseppe, a psychologist at St. John's University, where Artest played college basketball. "We have no organized treatment, no idea whether counselors doing the teaching have training in mental health. We're operating under this delusion that we're helping people when we may be just continuing the violence."
Until we understand better the physiology of anger outbursts, I doubt that we will consistently help sufferers. I did choose the word sufferers carefully. Most people with this problem have great regret afterwards. They do not choose to react so violently.
I suspect that there is some genetic predisposition here. Certainly men are more prone to anger outbursts than women. First, we need to have researchers explicitly study the problem.
Anger training is often mandated by courts for spouse abusers, violent criminals, bullying adolescents and aggressive drivers. The classes are based on a loosely defined set of principles and techniques thought to help some people settle or contain outbursts.
A pattern of hostile behavior is not considered a specific diagnosis by the American Psychiatric Association, something that limits research that could lead to effective treatment.
State and county programs have generally been set up without consulting research, experts say, and the result is an unregulated system without any agreed-on standards of what should be taught, when, and to whom. Recent studies suggest that the techniques can be helpful for some people, but that in many cases the classes have little or no measurable effect, and can potentially make the problems worse.
Until we define and study this syndrome we will depend on "feel good" programs. Sending someone for anger management classes absolves the courts (or employer) from responsibility. Anger management classes just seem like they should work. I fear they are junk psychology. We need data. But more importantly, Ron Artest and those like him need data, research and real hope.
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Mention is made of absolving the courts (or employer) of responsibility. So long as you are not advocating absolving the PERSON of responsibility, I generally would agree with your comments.
There is always a voluntary component and a choice to be made, whether there are other truly medical or psychological factors as well or not.
Posted by:
at November 24, 2004 11:01 AM
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10:50 AM