From Anger to Serenity: Psychoanalysis and CBT in the Integrated Treatment of Anger

"And when Ares, the god of war, saw his son Ascalaphos fallen on the battlefield, a wave of rage overwhelmed him. Taking up his spear, he roared like a wounded lion, making Olympus tremble and the mortals who witnessed his fury."
( Iliad , free adaptation)

Introduction

Anger is an emotion as old as humanity itself, and its power can transform mundane moments into decisive events. From classical mythology to the most modern studies in psychology, anger has been portrayed as an indomitable energy, sometimes destructive, sometimes laden with potential revelations about the human psyche. What makes this emotion so fascinating is its complexity: it is not merely an impulsive response, but a reflection of internal conflicts and thought patterns that can consume or rebuild those who experience it.

Stoicism, with its emphasis on reason and self-control, viewed anger as a "fire of the soul," while psychoanalysis and Cognitive Behavioral Therapy (CBT) understand it as a multifaceted phenomenon, deeply rooted in the unconscious or in dysfunctional thought patterns. When associated with alcohol use, this emotion intensifies, amplifying its impacts and reinforcing destructive cycles that affect not only the individual but also their relationships.

But how is it possible to transform such a primitive and often devastating emotion into a constructive force? What can the mythology of Ares, the god of war, and the teachings of thinkers like Seneca teach us about managing anger in a contemporary world? And, above all, how can modern therapeutic approaches, such as psychoanalysis and CBT, help guide someone on the journey of self-knowledge and balance?

In this text, we will explore the paths to understanding and managing anger, drawing parallels between philosophical traditions and therapeutic strategies, and discovering how the integration of different approaches can transform what destroys into something that builds. After all, anger, when understood, can cease to be an enemy and become an ally in the process of personal and emotional growth.

Anger in Stoic philosophy

In his work "On Anger ," Seneca leads us through a profound reflection on anger, treating it as one of the most dangerous and destructive passions of the human soul. For the Stoic philosopher, anger is not only irrational, but a true "brief madness," capable of consuming reason, corroding relationships, and ruining both the one who feels it and those who suffer its consequences. He categorically rejects the idea that anger can be useful, arguing that any apparent benefit it brings is quickly eclipsed by the inevitable damage it causes. In his analysis, Seneca not only defines anger but also offers strategies for recognizing it, confronting it, and, above all, avoiding it.

Early in his work, Seneca describes anger as a disease of the soul, comparing it to a fire that, once started, spreads destruction indiscriminately. He states: "Anger, however much it disguises itself as strength, is a sign of weakness of the soul." For him, anger is incompatible with reason and virtue, the pillars of a balanced life. This lack of control, which may seem momentary, is actually a manifestation of deeper emotional imbalances that need to be treated with seriousness and vigilance. Seneca believes that anger should be intercepted the moment it arises, before it takes over our actions. "Anger should not be nurtured; the sooner it is contained, the easier it will be to extinguish it," he advises.

One of the most striking aspects of Seneca's thought is his insistence on avoiding impulsive reactions. He warns that acting under the sway of anger compromises our judgment and leads us to hasty and disastrous decisions. "Everything done in anger is done rashly, and the consequences of rashness are inevitable," he writes. To avoid this, Seneca suggests a practice that is still widely recognized as effective today: pausing before reacting. This brief pause allows reason to regain control and prevents emotion from transforming into irreversible actions.

Seneca illustrates the danger of uncontrolled anger with historical examples, such as the case of Alexander the Great. In a moment of fury, Alexander murdered Cleitus, his friend and general, only to deeply regret it afterward. "How many kings have regretted their angry words, and how many would have given their crowns to erase them," Seneca reflects. This episode is emblematic of what he considers the greatest risk of anger: its capacity to lead to irreparable consequences, even among the most powerful. For him, the true strength of a leader, or of any person, lies in their ability to control anger, not in succumbing to it.

However, the Stoic philosopher doesn't simply criticize anger. He offers practical ways to deal with it, beginning with the importance of reflection and serenity. "Nothing is more admirable in a man than his ability to remain serene in the face of adversity," he states. This serenity is not indifference to injustice, but a way of facing it with balance, without being dominated by passion. For Seneca, anger should not simply be repressed, but understood and redirected. He suggests that the virtue of patience is key to dealing with challenging situations, as it allows us to face problems with clarity and justice.

Another central point in On Anger is the recommendation to avoid people and situations that fuel anger. “The company of angry men is fuel for the fire of the soul,” Seneca warns. He acknowledges that, while it is not always possible to avoid conflict, it is essential to protect our minds from negative influences that can amplify anger. This advice is especially relevant in a world where we are often confronted with situations that test us emotionally.

Anger in psychoanalysis

In the psychoanalytic approach, anger is seen as a psychic movement that emerges from intrapsychic conflicts. Sigmund Freud postulated that intense emotions, such as anger, often have their roots in repressed desires, accumulated resentments, or frustrations that find expression through the body and speech. This view is largely grounded in works such as Beyond the Pleasure Principle (Freud, 1920), where he explores the impact of unconscious drives on emotional life. The complexity of anger becomes even more evident when we analyze its interaction with alcohol, a substance that often acts as a catalyst for unconscious impulses and an emotional disguise.

In the case of a patient who, upon ingesting alcohol, experienced outbursts of anger, the substance initially provided momentary relief from psychic tensions, functioning as a kind of emotional anesthetic. However, as highlighted by Khantzian (1997) in his studies on the self-medication model, alcohol does not resolve underlying conflicts but only masks them, accumulating emotional pressure that frequently erupts destructively. This pattern was evident in the patient, whose emotional outbursts were linked to repressed resentments and frustrations, aggravated by the use of the substance.

Freud understood alcohol as a facilitator of the id, the component of the psyche associated with primitive instincts and basic impulses. Under the influence of alcohol, the regulations of the ego and superego become more fragile, allowing unconscious desires to emerge without the usual control. In this context, repressed anger found uncontrolled expression as an attempt to relieve internal tensions. Freudian analysis points to a phenomenon where alcohol weakens the ability to mediate these conflicts, transforming internal frustrations into impulsive external actions.

Lacan would complement this view by suggesting that alcohol amplifies the gap between desire and reality, intensifying the frustration that sustains anger. As explored in his theories on the imaginary and the symbolic ( Écrits , 1966), alcohol can be interpreted as a substitute object that fails to fill the subject's existential lack, exacerbating psychic suffering. In the patient's case, the use of the substance not only served as an escape but also intensified the feeling of inadequacy, exacerbating intrapsychic conflicts.

In clinical practice, it was crucial to identify the role of alcohol as a catalyst and amplifier of the anger cycle. During therapy, the patient was invited to revisit memories and associations related to drinking and emotional outbursts, revealing that these episodes were frequently linked to events of devaluation or unexpressed frustrations. Psychoanalytic listening, as described by Racker (1968), allowed the patient to bring to consciousness the connections between alcohol use and childhood traumas, often related to a lack of emotional validation or dysfunctional family patterns.

Over time, techniques of free association and dream analysis helped the patient explore the repressed desires that fueled his anger. For example, recurring dreams revealed images that recalled the feeling of powerlessness experienced in his youth, which elucidated how alcohol functioned as a mechanism to numb this pain. Introspection exercises, combined with an understanding of his psychic history, allowed the patient to create new narratives for his experiences, as proposed by Winnicott (1971) in his studies on the importance of the transitional space in therapy.

Furthermore, self-care practices, such as developing healthy routines and seeking alternatives to cope with stress, were introduced into the treatment. These practices helped the patient replace alcohol use with strategies that promoted a greater sense of emotional control and well-being. Gradually, he learned to name his feelings and to see anger as an indicator of unmet emotional needs, rather than a destructive force. This transformation aligns with Kohut's (1977) ideas on the importance of self-strengthening for the reconstruction of emotional patterns.

Just as the wrath of Ares, described in mythology, symbolizes an untamed force, anger in the psychoanalytic context represents an intrapsychic conflict that cries out for understanding. When associated with alcohol, this emotion can become even more destructive, reinforcing escape patterns and intensifying psychic suffering. Psychoanalytic therapy does not seek to eliminate anger, but to integrate it, transforming it into a constructive force. Understanding the role of alcohol as an escape and trigger is essential in this process, allowing the patient to regain control over their emotional narrative. Thus, they can find healthier ways to cope with their pain, demonstrating that true power lies in transforming what threatens us into a path to balance and healing.

Anger in Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) understands anger as a result of distorted thought patterns that directly influence behavior. When associated with alcohol use, this dynamic intensifies, generating a cycle of emotional reactivity that can be highly destructive for the individual and those around them. In this context, CBT offers pragmatic tools to identify, reframe, and manage the thoughts and behaviors that fuel this emotion.

In the case of a patient who experienced anger outbursts after alcohol consumption, CBT proved effective in breaking this cycle. Under the influence of alcohol, which acts as a disinhibitor, cognitive barriers were reduced, allowing negative automatic thoughts to emerge with greater intensity. Episodes of irritability were exacerbated, transforming into angry outbursts with serious consequences for the patient's personal and professional life. The literature on the impact of alcohol on emotional control, as observed in the work of Marlatt and Gordon (1985), reinforces that the substance can act as an amplifier of negative emotions, further destabilizing the individual.

Under the influence of alcohol, the patient frequently experienced a reduction in his capacity for rational evaluation. Distorted automatic thoughts, such as "people don't respect me" or "I'm always being attacked ," became predominant, triggering intense and sometimes disproportionate emotional responses. Beck (1976) argues that these automatic thoughts, when unidentified, can reinforce negative core beliefs related to feelings of inadequacy and vulnerability. In the patient's case, these beliefs were associated with past experiences of rejection and criticism, being activated almost automatically by alcohol, transforming small everyday events into triggers for disproportionate anger.

CBT structured the patient's treatment into five main stages. Initially, he was instructed to record dysfunctional thoughts, identifying the distorted interpretation patterns that preceded his anger episodes. As suggested by Padesky and Greenberger (1995), this technique was crucial in bringing to light automatic thoughts, such as catastrophizing ( "This always goes wrong" ) and personalization ( "They're doing this just to annoy me" ), allowing the patient to understand the origin of his emotional reactivity.

In the second stage, the patient was introduced to cognitive restructuring, a process described by Beck et al. (1979) as central to questioning automatic thoughts and replacing them with more balanced interpretations. For example, when faced with the thought "nobody respects me ," he was encouraged to seek contrary evidence and to reframe his view to something like "people don't always act the way I expect, but that doesn't mean they don't respect me." This technique helped reduce the cognitive distortions that amplified his anger.

Another crucial step was identifying and managing triggers. The patient was instructed to map stressful situations, interpersonal conflicts, and everyday frustrations that increased their propensity to consume alcohol and react with anger. Studies such as that of Witkiewitz and Marlatt (2004) suggest that recognizing environmental and emotional triggers is essential to interrupting the cycle of impulsive behavior. In this case, techniques such as mindful pauses and changes in environment were effective in reducing impulsivity.

Given the physiological impact of anger, CBT also included training in relaxation techniques, such as deep breathing and progressive relaxation. These practices, described by Davis et al. (2000), reduced the intense physiological activation associated with anger episodes, allowing the patient to regain control before reacting impulsively.

Finally, the therapist introduced strategies for replacing maladaptive behaviors. Inspired by the proposals of Hayes et al. (2004) on coping skills , the patient was encouraged to replace the habit of drinking with healthier activities, such as physical exercise and walking. This practice helped to weaken the association between alcohol consumption and emotional release.

Throughout the process, the patient realized that alcohol, far from being an escape valve, amplified his problems by perpetuating emotional dependence and the cycle of anger. This insight aligns with the studies of Koob and Le Moal (2008), which point out how substance use can reinforce maladaptive patterns of emotional regulation. With greater awareness of his triggers and the practice of new skills, the patient learned to see anger as a sign of unmet emotional needs, rather than a destructive impulse.

Anger at the Mental Health Clinic

At the Rodriguez Costa Mental Health Clinic, we believe that each individual deserves a personalized and comprehensive approach to dealing with their emotional difficulties. The integration of psychoanalysis and Cognitive-Behavioral Therapy (CBT) is one of the pillars of our methodology, especially in cases where intense emotions, such as anger, are associated with aggravating factors, such as alcohol use. Our integrative approach combines the best of both therapeutic approaches, providing an intervention that unites the exploration of the unconscious with practical tools for emotional management in the present.

Psychoanalysis, with its in-depth look at unconscious conflicts, traumas, and repressed desires, allows us to help patients understand the roots of their anger. This investigation is essential for identifying repressed memories and emotional patterns that perpetuate the cycle of impulsivity and frustration. For example, in the case of patients whose anger outbursts are associated with alcohol consumption, we often find that the substance is used as an unconscious attempt to mask feelings of inadequacy or shame, often rooted in childhood experiences of rejection. From these insights, we work to bring these conflicts to consciousness, allowing the patient to begin a process of emotional reconstruction.

In parallel, CBT offers practical tools to interrupt dysfunctional patterns and create new emotional and behavioral responses. This approach helps the patient identify and question automatic thoughts that fuel their anger, such as "nobody respects me" or "I'm always being attacked," replacing these cognitive distortions with more balanced and functional interpretations. Furthermore, specific techniques, such as managing emotional triggers and practicing relaxation techniques, help reduce emotional intensity in high-risk situations, such as workplace arguments or moments of personal frustration.

Our integrative model also emphasizes the importance of self-care and building healthy habits. While psychoanalysis investigates the underlying reasons why a patient may neglect their own needs, CBT offers concrete strategies for establishing practices that promote emotional balance, such as introducing wellness routines, physical exercise, and moments of reflection. This combination strengthens the patient, helping them reduce their dependence on escape valves, such as alcohol, and develop a deeper sense of emotional control.

By combining the exploration of the past promoted by psychoanalysis with the practical strategies of CBT (Cognitive Behavioral Therapy), we are able to offer a broad and holistic approach that connects self-knowledge to the development of emotional skills for the present. In our clinic, we believe that anger, when understood and managed, can cease to be a destructive force and transform into an engine for personal growth and the achievement of a more balanced life. With this integrative approach, our patients not only overcome destructive cycles but also develop tools to rebuild healthy emotional and behavioral patterns, creating a safe path to healing and lasting well-being.

Conclusion

Anger, so often seen as a destructive feeling, can be transformed into a positive force when approached with care and understanding. The combination of psychoanalysis and Cognitive Behavioral Therapy (CBT) allows the patient to delve into the deepest layers of their emotions, while learning practical ways to cope with daily challenges. This integration enables the discovery of lighter and more balanced paths, where self-care and understanding of one's own emotions become pillars of a healthier life. At the Rodriguez Costa Mental Health Clinic, we believe that this journey, although challenging, is liberating, and we stand alongside each patient to help them transform anger into an opportunity for growth and emotional fulfillment.

Shall we delve deeper into this discussion?

Anger is a universal theme that everyone, at some point, experiences or faces in their relationships. This article delves into its complexity, drawing on perspectives from mythology, philosophy, and psychology to show that behind every emotional outburst lies an opportunity for self-knowledge and transformation.

Now we want to know: How do you deal with anger? Have you considered how it might reveal something about you or your relationships? Share your thoughts, experiences, or insights in the comments. After all, exchanging ideas can be the first step to better understanding this powerful emotion.

If this content sparked your curiosity or resonated with something you or someone close to you is experiencing, don't keep it to yourself! Share this article with friends, colleagues, or family. Let's take this conversation further and help more people see anger not as an enemy, but as an ally on the path to emotional balance.

Curious to learn more? Have something to add? Leave your comment and participate in this enriching exchange!

BIBLIOGRAPHIC REFERENCES

ARISTOTLE. Nicomachean Ethics . Translated by Mário da Gama Kury. Brasília: Editora da UnB, 1991.

BECK, Aaron T. Cognitive therapy and emotional disorders . Translated by Maria Teresa Kim Barbosa de Souza. Rio de Janeiro: Zahar, 1997.

FREUD, Sigmund. Beyond the Pleasure Principle . Translated by Paulo César de Souza. São Paulo: Companhia das Letras, 2010.

HAYES, Steven C.; FOLLETTE, Victoria M.; LINEHAN, Marsha. Acceptance and Commitment Therapy: Processes and Applications . Porto Alegre: Artmed, 2007.

KHANTZIAN, Edward J. The self-deception of drugs: A psychodynamic model for the treatment of chemical dependency . São Paulo: Casa do Psicólogo, 1997.

LACAN, Jacques. Writings . Translated by Vera Ribeiro. Rio de Janeiro: Zahar, 1998.

MARLATT, G. Alan; GORDON, Judith R. Relapse prevention: Maintenance strategies in the treatment of addictive behaviors . Translated by Mário César dos Santos. Porto Alegre: Artmed, 2004.

PADESKY, Christine A.; GREENBERGER, Dennis. Mind over mood: Change your mood by changing your mind . Translated by Maria Inês Corrêa Nascimento. Porto Alegre: Artmed, 1997.

Seneca. On Anger . Translated by Aldo Dinucci. São Paulo: Autêntica, 2021.

WINNICOTT, Donald W. Playing and Reality . Translated by Álvaro Cabral. Rio de Janeiro: Imago, 1975.