Tourette Syndrome and anger management

Like other emotions, anger is a natural response to certain experiences and can be important in guiding our behaviour. However, there can be consequences of losing your temper and these may cause problems long after an outburst. As many young people with TS also struggle with attention and impulsivity, they may be more likely to lose control over their anger and act out.

If they have difficulty controlling their anger, a young person might lose control in situations that seem small or insignificant to other people. This can cause a lot of worry, upset, and frustration for the young person and their family. However, there are some very good strategies to help manage anger.

It is important to recognise signs that you are becoming angry. A useful step is to think about what happens to your body when you start to get angry. The sort of body changes that might happen include fist-clenching, going red in the face, sweating, teeth-clenching, butterflies in the stomach, more rapid breathing, headache, sweaty palms, or flared nostrils.

You may also experience angry thoughts. Thoughts are often very specific when you are starting to lose control. You could be thinking ‘this isn’t fair’ or ‘I want to get even’. Although these can be difficult to identify at first, it gets easier to notice these thoughts with practice.

Some people have described the body changes and thoughts associated with anger as being like a volcano, ready to erupt. We know that anger attacks happen very quickly in young people with TS, so they will sometimes need to put in extra effort to control it.

One useful strategy is to think about what you can do when you start to feel angry. The best sorts of approaches are those that take you out of the triggering situation and into a different space. Think about the places or people who seem to make you angry the most easily. Making a list might be helpful. For example, do you get angry when your parents ask you to do something before dinner, perhaps when you are hungry and just got home from school or college? It might be useful to plan relaxation or low-stress activities things for the first 20 minutes or so when you get in from school or college.

When you notice that you are starting to get angry, there are lots of things you can do:

• Leave the situation and go to a quiet space (your room)
• Listen to some calming music
• Play an instrument
• Do a hobby
• Splash your face with cold water
• Count to ten slowly

It’s often helpful to talk to someone about your anger. If you would rather not talk to your parents, you can always talk to a mentor at school, a counsellor, a friend, or a relative. Finding a good listener can help you to see a different side to the situation.

Think about the difference between being aggressive and confident. Imagine someone who is confident and think about how they look, talk, act, and stand.

Now think about someone who is angry and how they behave.

Which person would you like to be?

How can you practise being the confident person rather than the angry person?

Remember to practise being confident in lots of different situations, such as at school and with your friends, as well as at home with your family.

• Try to understand the situations that make you angry and avoid them
• Work out how your body changes when you start to ‘lose it’
• Notice the thoughts going through your head when you are getting angry
• Think about ways to calm yourself down
• Practise being a confident person rather than an aggressive one
• Talk to someone else to see if they have any other ideas
• Praise yourself when you succeed in not getting angry