Venting Does More Harm Than Good

VENTING ANGER MAY DO MORE HARM THAN GOOD

FOR years the popular wisdom has been that strong feelings of anger ought to be expressed. It was healthier, people were frequently advised, to let loose the reins of anger, to ''let it all hang out'' like so much laundry.

Anger was described by many psychotherapists as an explosive feeling that, if unexpressed, turned inward to cause such disorders as ulcers, heart attacks, headaches, overeating and colitis, not to mention the havoc that festering anger could wreak on human relationships. Women in particular, many of whom had grown up believing it ''not ladylike'' to get angry, were urged to express their anger without hesitation, guilt or tears.

A number of modern treatment techniques, epitomized by Primal Scream therapy (in which the client ''regresses'' to the moment of birth and rages against having to leave the warm safety of the womb), have been based on the notion that people must unearth and release their hidden anger to get rid of joy-robbing emotional ghosts.

Now, however, some experts are taking a hard new look at this powerful emotion and questioning basic assumptions about its significance to physical and mental health. Sparked in part by a controversial new book, ''Anger: The Misunderstood Emotion,'' by Carol Tavris (Simon & Schuster), the new view sees anger as often more destructive when expressed than when suppressed. This view prescribes a far more limited role for the ventilation of anger than is now popularly pursued.

A growing body of evidence suggests that exactly how anger is handled may be less important than the fact that anger is so frequently felt in the first place. While venting anger may help to head off some forms of illness, studies suggest it may actually contribute to others. More important, the effect of venting anger on social interactions is often devastating.

''Talking out an emotion doesn't reduce it, it rehearses it,'' wrote Dr. Tavris, a social psychologist who has gathered hundreds of research references to support her views. ''People who are most prone to give vent to their rage get angrier, not less angry.''

For example, she cited a study among laid-off engineers in San Diego, which showed that the men who were invited to ventilate their anger actually became more hostile toward the company or their supervisors than those who were asked to criticize themselves. In another study, third-grade children who were encouraged to express their anger toward a child who had frustrated them ended up liking that child less than children did who were not permitted to express anger.

In marital arguments as well, an angry outburst frequently erupts into a full-scale battle, Dr. Tavris noted, because one person's anger is threatening to another and can provoke its target to respond in kind.

According to Dr. Leo Madow, a psychoanalyst at the Institute of the Pennsylvania Hospital in Philadelphia, the ''get-the-anger-out, be-honest-with-each-other'' approach, inspired by the self-awareness movement of the 1970's, can be very destructive. He said, for example, that the 'T groups' held in many companies, ''where employees told each other how they felt about one another, nearly destroyed some companies.''

Dr. Madow added: ''Freud was one of the first to recognize that catharsis doesn't work. Anger is really a symptom. To deal with it, you have to get back into the unconscious and find out why anger is there.''

Dr. Willard Gaylin, a New York psychiatrist who is president of the Hastings Center in Hastings-on-Hudson, N.Y., calls the ventilation of anger ''a form of public littering.'' He explained in an interview: ''Even if ventilation did relieve everything, which it does not, it would still not be justified.''

Dr. Gaylin said not enough attention had been paid to the societal aspects of anger. ''The real problem is not so much the articulation of anger but the generation of it,'' he said. ''Many people are angry all the time, they have an inordinate capacity to generate anger.'' The source of all this anger, he believes, is our technological society in which people are alienated from the rewards of their activities at the same time that happiness is held up as the main goal in life.

Anger is a normal emotional response that occurs in all people from birth to death, regardless of their culture. But what provokes anger and how it is expressed, Dr. Tavris says, varies widely throughout the world. Some people express anger through the use of ritual curses (as in the Yiddish, ''May all your teeth fall out but one, and that one have a cavity''); the Kapauku Papuans of West New Guinea hold a culturally circumscribed ''mad dance,'' and the Mbuti hunter-gatherers of Zaire use humor and ridicule when reason fails to end an argument.

Physiologically, angry feelings are associated with the release of the same hormones, epinephrine and norepinephrine, that are produced under stress. These hormones stimulate the heart, raise the blood pressure, pour sugar into the blood, constrict the blood vessels to the digestive tract and generally create feelings of excitement and arousal. This has fed the theory that unexpressed anger can produce a host of psychosomatic reactions, ranging from hives and headaches to cancer and heart disease.

''Anger is a form of energy and you can't destroy it,'' Dr. Madow said. ''When it's not dealt with it can lead to such problems as headaches and depression.'' The analyst, who wrote a book called ''Anger: How to Recognize and Cope with It'' (Scribners), said that while the relationship between anger and illness was difficult to demonstrate in a test-tube, ''the consequences of repressed anger are seen clinically every day.''

Dr. Madow distinguishes between ''suppressed'' and ''repressed'' anger. Suppressing anger, he said, is ''perfectly fine if you do it consciously and for good reason. But repression leads to trouble because the person has no awareness of the anger.'' For example, he said, a man may knowingly suppress his anger at his boss for the sake of his job without untoward consequences, but repressed anger at being abandoned by parents early in life can lead to chronic depression.

According to Dr. Theodore I. Rubin, a New York psychoanalyst and author of ''The Angry Book'' (Collier Books), repressed anger is the primary cause of anxiety. ''Ninety percent of anxiety attacks represent a surfacing of vehemently repressed anger,'' he said in an interview. ''I'm not against suppression of anger; it's repression - not knowing that a person is angry -when the damage is done.''

Dr. Harvey Rich, a psychoanalyst in Washington, said: ''A woman who's been taught that she must bear the burdens of abuse may become a quiet alcoholic, or have an extramarital affair.'' She's always rationalizing that she is suffering. Her suffering stems from the lack of an avenue for expressing anger.''

Still, Dr. Rich agrees with Dr. Tavris that ''the gross ventilation of anger - mouthing off - is of no value. Anger is an inappropriate response in many cases.''

Dr. Tavris says studies have failed to show a direct link between suppressed anger and illness. ''The popular belief that suppressed anger can wreak havoc on the body and bloodstream has been inflated out of realistic proportions,'' she wrote. ''It does not, in any predictable or consistent way, make us depressed, produce ulcers or hypertension, set us off on food binges, or give us heart attacks.''

In fact, the newest studies of the relationship between anger and heart disease indicate that an excessively hostile attitude, regardless of whether that anger is expressed, increases the risk of disease. Dr. Redford Williams, an internist and psychiatrist at the Duke University Medical Center, studied 255 physicians who had taken a standard personality test 25 years earlier. Those who had scored in the top half of the hostility scale had suffered five to six times more heart attacks and a death rate from heart attack five times as high as those in the lower half.

Dr. Williams said the next step will be to examine the consequences of expression and suppression of conscious angry feelings. There is the strong suspicion, he said, that those who let their anger out may be more prone to heart disease and those who keep anger in face an greater risk of high blood pressure and possibly cancer.

Dr. Williams believes excessive hostility is rooted in feelings of being unloved. ''These people grow up feeling that they can't trust people to treat them right,'' he said. ''People with this attitude are more likely to experience the emotion of anger more often and to experience it more intensely.''

Dr. Rich, the Washington psychoanalyst, believes that people who are quick to anger have a ''basic sense of badness that stems from the time they felt responsible for everything that happened. Whatever went wrong, it must be their fault. This defensive character organization creates an intense primitive anger just below the surface. When something goes wrong, like the car doesn't start, they experience an infantile rage. It comes from the fantasy that you should be good, and if you were good, this wouldn't have happened.''

Under normal circumstances, Dr. Tavris says, the likelihood of an angry response is often determined by the pre-existing level of physiological arousal. She notes, for example, that noise, crowds, frustration or aggressive sports events do not by themselves generate anger, but they increase the general level of arousal and make it more likely that a minor provocation will trigger an angry response.

Thus, she says, aggression, aggressive feelings and other heightened emotional states can inflame anger as well as the other way around. Encouraging youngsters to play aggressive games as a ''healthful'' means of venting angry feelings is likely to backfire, she suggests.

Dr. Tavris does not believe anger should never be expressed. Rather, she limits the circumstances to those that satisfy three conditions: when anger represents a legitimate plea for justice, when it is directed at someone who is the cause of the anger and when it would result in a correction of the offense or, at the very least, would not cause retaliation. Otherwise, she suggests counting to 10.