A User’s Guide To Anger

crispydoc Uncategorized 9 Comments

For generations, anger was believed by social science to be a vestigial remnant of our ancestral evolution, the emotional equivalent of your appendix. It served no function other than to inconveniently cause embarrassment and negative social consequences. A recent article by Pulitzer prize winner Charles Duhigg in The Atlantic examined the purpose of anger in the context of our current political era, with some startling conclusions.

Anger, as it turns out, is a dense and meaningful form of interpersonal communication. Expressing anger at an individual level leads to positive outcomes more often than negative outcomes, some of which surprised me:

  • increasing willingness to listen
  • more honest expression
  • accommodation of other’s needs
  • more often resulted in short, restrained episodes than major blowouts
  • increased insights into personal shortcomings
  • strengthened relationships more than it undermined them
  • increased respect for the angry person more often than not
  • increased reports of happiness in those expressing anger

The article went on to describe a normal cycle of expression of anger, leading to reconciliation, catharsis (a purging or relief of bottled up emotions), and compromise.

Does recognition of the positive value of anger provide the license you’ve been waiting for to manifest your secret inner SOB? Not exactly – becoming that SOB might make you a target for commercial and political manipulation.

On a potentially sinister note, the article profiled a business professor’s academic investigations into how companies were learning to profit from the selective use of anger. You may not be surprised to learn that debt collection agencies pioneered the (ab)use of anger in raising their rates of collection.

The debt collection template ran something like this:

  1. Expression of hostility by debt collector, “I want my money now!”
  2. Debtor, provoked into anger, screams back.
  3. Debt collector allows debtor to vent anger. At opportune moment, debt collector expresses remorse for provocation, becomes accommodating and speaks in soothing voice, “Let’s resolve this thing.”
  4. Debt collector capitalizes on debtor’s feelings of catharsis and desire for reconciliation to collect on debt.

Impressive use of psychology for commercial gain! I imagine there are brilliant potential sociologists who ended up behind bars because their understanding and aptitude for manipulation of human emotion tempted them to exploit it illicitly. (Those who exploit anger illegally are criminals. Those who exploit anger within the confines of the law we call politicians and lawyers.)

The article also highlighted how anger can be roused more effectively in those with little perceived power by framing it as moral indignation. The case presented was of Cesar Chavez organizing farm workers in California’s Central Valley in the 1960s.

Prior organizers had attempted to unionize workers with promises of personal gain (improved work conditions and higher wages) to little effect. Those living hand to mouth could barely afford to strike one day. What alternate tactic rallied these same workers strike for weeks on end? Their struggle was portrayed in historical terms as part of a moral wrong they could right. The union was no longer about getting the boss to install toilets and pay a higher hourly wage. It was a vehicle for moral agents on a crusade to end the exploitation of disenfranchised poor migrant workers.

Physicians are not disenfranchised farm workers, but they recognize and respond to moral indignation. The exorbitant costs of Maintenance Of Certification (MOC) programs that consume time and money with no apparent benefit to patient care sparked a grassroots physician revolution manifest in the birth of the National Board of Physicians and Surgeons – an alternate certifying body for physicians devised to eliminate the high costs associated with MOC. Even Physician on FIRE (the Cool Hand Luke of physician finance bloggers) has vented his righteous anger on the subject in a memorable post.

What happens when moral outrage is manipulated by powerful commercial interests? They profit and society loses. The uptick in opinion programming and outrage present in cable news outlets across the political spectrum resulted in more time spent on op-ed programming and less time spent on news coverage.

Rage sells – it keeps your eyes on the screen and the cable company in the green (Nominate me for Johnny Cochrane Rhyming Poet Laureate in 2019!).

Although the profitable merchandising of anger makes economic sense from a media perspective, it undermines the social benefits by leading to a revenge impulse.

Anger no longer leads to reconciliation, catharsis and eventual compromise. Instead, it generates ” a cycle of recrimination, rumination and ever-expanding fury.” The goal is no longer to feel heard, extract a concession or be accommodated. Instead, it is to hurt the other party and teach them a lesson.

This perversion is further compounded when an undesired outcome results from a process perceived to be unfair. A downsized worker will be angry if they lose a job, but they won’t feel vengeful if they feel performance evaluations and seniority were considered in deciding their fate. If nepotism or favoritism are perceived to protect certain workers from the chopping block, the quality of anger changes significantly.

Where does that leave us? A provocative study from a bitterly divided political scene provides some insights on how to soften seemingly intractable divides. Israeli researchers found that when a demographically conservative religious suburb that seemed uniform in its condemnation of liberal politics was subjected to an ad campaign advocating more extremist right-wing stances, the polls showed a softening of political sentiment.

It seems that presenting someone with the extremist version of their own beliefs can be a wake-up call to adopt more of a middle-ground stance. Put differently, when you hold the right mirror up to someone, it might shock them into dissociation from the fringe nut jobs who might otherwise hijack that anger to reach positions of power.

Anger, expressed and channeled effectively, can produce positive outcomes that resolve differences. These feelings can unfortunately also be exploited for commercial and political gain by forces that don’t always have our best interests at heart. I strongly encourage you to read the original article and share the insights you take from it.

Comments 9

  1. That is a great point of using psychology and anger to manipulate social interactions in your favor (the debt collector is the perfect example you mentioned).

    As physicians I think we are starting to get to levels of outrage after years of complacency. The recent run of lawsuits against the medical boards is a good example of getting to the point of such anger that legal course of action is undertaken. The MOC has become a rallying point for sure.

    1. Post


      The debt collector frightened me – I could easily myself getting suckered, especially being a people-pleaser by nature. I’ll be curious to see if MOC is the ultimate undoing of ABMS, although I’m leery of the new boards that allow docs to claim the ability to practice my specialty based on a test instead of training. Jury’s still out.

  2. Interesting. When I get a patient that makes me irritated or frustrated, I’m going to think of an extremist version of them in order to achieve a more middle-ground opinion of them.

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      “They could be worse” is a powerful tool.
      Another favorite is a revised law of the House of God “They can always hurt you more, but they can’t stop the clock.”
      Appreciate your stopping by, Look For Zebras!



  3. “anger” in a tribe is used to determine social status. primarily male social status. The tribe need not be human or even primate. THIS means the biology exists at sub cortical levels, is very biologically ancient and in fact extends to crustacea (which don’t have brains but merely ganglia for nervous systems) and is controlled by serotonin based receptors. In male interaction men know precisely how far to push it BEFORE an altercation happens, so the threat of attack is also a form of emotional communication. This is not really part of the female biology in the same primordial way. In females the power lays in reproduction and seduction, dopamine based emotions. You can be as egalitarian as you want and that doesn’t change the biochemistry. To deny the biochemistry is to invite delusion and living in delusion eventually leads to social destruction, most recent case in point Venezuela. Anger has been usurped now by “virtual anger”. In the normal biology the governor is social ostracization even to the point of imprisonment or death, and the real threat of actual individual physical violence i.e. getting your butt kicked. Virtual anger has no feed back loop. It just seething rage against essentially nothing. THAT process of raging against nothing is ripe for emotional manipulation. Simply read twitter or watch CNN.

    There was a survey of psych types who were treating people despondent over Trump’s election and the first bit of advice was turn off the TV and social media. Imagine that! Turn off the sources of manipulative virtual anger, things will get better and normal human discourse will resume. We think ourselves rational but we are far from it.

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      A corollary to the biology you lay out is the stress associated with one’s role in the hierarchy. A favorite professor with a mesmerizing lecturing presence, Robert Sapolsky, spent every summer in the Masai Mara surveying constantly shifting hierarchies of male baboon troops and periodically obtaining cortisol samples (using blow dart sedation to draw specimens). Turns out being in a particularly insecure position in the order leads to high stress, not surprising since everyone dumps on subordinates and it all flows downhill. The apex male baboon (the alpha male) suffered high stress due to the constant vying by others to replace him in times where younger, strong males challenged his authority. The implication run from comic scenarios in The Office to more sobering in our medical groups.

      Makes me wonder if the solution of going part-time, where you no longer grasp for the shiny brass ring of the alpha position and simultaneously remove yourself from being in a position to receive fang marks from lower ranking baboons.

  4. The loss of reconciliation and eventual compromise as compared to media and cable news is well put. It’s obscene, but does keep them in the green. Do you know what I mean? ; )

    Thinking through this, I should probably add a sliver of anger to my management philosophy. I am relatively easy going and do well on employee engagement surveys, but it could help foster quicker results and evidently an increased respect. Have a good weekend.

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      If only I’d known of your skills as a wordsmith, I’d have extended a personal invitation to contribute some FI-IKU.

      I don’t know that I’d change a thing if you can through life without experiencing the adverse effects of anger. Your employee engagement surveys suggest you command sufficient respect – enjoy your superpower of having enough!



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