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This is a great conversation – and a complex one. My understanding from taking a couple of Allan Abbas’ courses is that it is not the anger/rage that is causing the symptoms, rather the guilt and shame that we feel when anger/rage rise up that is causing the conflict of emotions which is causing the symptoms. So, anger arises when my brother tells a sexist joke, I begin to feel angry and hurt, I then feel guilty for feeling anger at my brother because I also love him dearly, so then I feel guilty and ashamed that I felt or expressed anger and then I get …..xyz symptom. I explain this to the patient and then guide/encourage them to feel the anger without the shame/guilt. I help them see that they should not be ashamed for having normal human emotions, or for standing up for themselves. I get them to connect with the hurt, sad part of themselves that is trying so hard and doesn’t deserve to be treated that way. I don’t encourage compassion for the other in the beginning because that is often just taken as more guilt and shame for having the original emotions of anger and shame, but now our therapist/doctor is telling us that our original emotion isn’t “right” or “good”. When the patient seems comfortable with the idea of the guilt suppressing the anger and the anger “just wanting to be seen, acknowledged and felt”, NOT acted out or RAGED OUT, then they are often ready for an ISTDP-type exercise of imagining a past situation when anger was arising and asking them to feel how it feels in their body, where is it? (…my arms are starting to shake, etc.). Then, what does it want to say? and what does it want to do? in the Allan Abbass style. Patients can destroy their abusers in their imagination and that is not dangerous. It can also come out in dreams. The anger wants to just move through the body and once it is out, it is out. I feel that moving to quickly to concepts of “forgiveness” or “compassion” towards the other, the perceived abuse, just works to further repress/suppress difficult to feel emotions like anger.