Conceptualization and treatment of rage in self psychology

This article presents a self-psychological understanding and treatment of anger. Angry reactions are based on various types of injury to self-esteem, and on disappointments in those one holds in special esteem-such as early caretakers and later important others. When these injuries and disappointments are massive--traumatic--the ensuing angry reaction is especially intense and often destructive. Treatment addresses the patient's vulnerability, the soil on which all these forms of anger arise, through an empathic entry into the subjective inner world of the angry or enraged individual rather than through direct confrontations. Empathic entry leads the therapist to the sources of anger, often precipitated by inadvertent, unempathic responses in the therapeutic encounter. Accepting nonjudgmentally, understanding uncritically, and explaining patiently the meaning and origin of the anger may lead to the amelioration of the vulnerability that gives rise to the anger.