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Session 17: Brain Change Review

Hope4Families August 26, 2022
Participants should go to Appendix A to locate the appropriate review.


Rage is an odd thing. Not many people, even those who have committed acts of domestic violence, ever
experience a true rage. But for those who do they know that rage can be life-threatening. Quite possibly
rage attacks account for more domestic homicides than any other single cause.

Rage can be defined as “an experience of excessive anger accompanied by partial or complete loss of:
a) conscious awareness; b) a normal sense of self; and/or c) behavioral control.”

       a) Loss of conscious awareness means that some rages are so intense that the rager cannot recall
some or all of what he/she did during the rage (Note: This is different than an alcoholic blackout.
Also, when someone says they blacked out during a rage episode don not treat their statement
as an excuse. Instead, get more information about exactly what they can and cannot remember.
       b) Ragers often feel like “That wasn’t me doing that stuff.” They act as if the rage took over – as if
someone else was in control of their body during the incident.
       c) Ragers also report doing things they would normally never do no matter how angry they were. Again, it’s like they were taken over by terrible, uncontrollable impulses.

We suggest that rages occur when someone is threatened by a devastating threat. There are five such
threats: to one’s body – survival rage; to one’s sense of control – impotent rage; to one’s sense of self –
shame-based rage; to one’s relationship security – abandonment rage; to one’s most cherished values
– moral rage. The questionnaire on the next pages should be used to help clients identify these patterns.
We suggest you go through the items one at a time.

Although most rage incidents happen suddenly, some build more slowly. The questionnaire on the
following pages helps clients identify the presence of these two types of rages, “sudden” and “seething.”
The goal of this group is to help clients identify rage as a problem different than anger. However, you
will want to help clients who rage learn ways to deal with them. Here are ways people can get help for
each type of rage. Unfortunately, you probably will not have time to go through them all during the
group. Instead, select the ones that appear most relevant to the group.

Rage questionnaire. Any “yes” item is of interest and should be discussed. If a participant has 3 or more
“yes” responses in any area he/she should be directed to the ways to heal in that area. If someone has
3 or more “yes” items in two or more areas it is likely that he/she has significant rage issues that might
call for individual therapy or medication management.

Note: Please read Ron. Potter-Efron’s book entitled Rage for a better understanding of this serious