when they reach the level of pounding and panting, but most people don’t
register smaller changes unless they’re actually counting. The usual rule I
use with my clients is: If you’re aware of your heart and breathing, keep your
mouth shut.
Chronic anger is hard on the circulatory system. It can manifest itself
as high blood pressure and other cardiovascular disorders, whether the
person has a Type A personality or not.
RESTLESSNESS. Often, the first noticeable sign that anger is brewing is
the inability to sit still. Angry people sometimes find themselves up, pacing
around, looking for something to do even before they realize that they’re
feeling keyed up and on edge.
INCREASED MUSCLE TENSION. Blood and adrenaline flowing to the mus-
cles makes them expand and tighten. People who are getting angry usu-
ally feel tense. Sometimes the tension is generalized, but often it shows up
as clenching and unclenching various muscle groups as if warming up for
a fight. Actually, there’s no as ifabout it. The muscles that are most often
involved are in the arms, shoulders, and the jaw. Frequent sources of refer-
rals for anger treatment are dentists, because they recognize worn-down
teeth as a sign of chronic sympathetic arousal.
FLUSHING, SWEATING, TREMBLING, AND TINGLING. Remember how
it felt when I had you experiment with hyperventilating, back in the chap-
ter on fear disorders? Rapid breathing without corresponding strenuous
activity causes all sorts of weird sensations that arise from changes in the
chemical composition of the blood. A fairly typical pattern is for angry
people to experience hot faces and chills down their spines, accompanied
by clammy, tingling hands.
QUEASINESS. Remember that to get ready for action, the digestive sys-
tem shuts down and tries to dump whatever it’s carrying. Sometimes the
first sign of anger are feelings of stomach upset.
Everyone gets angry in his or her own way. The important thing is
getting an angry person to notice before it’s too late to stop. In addition
to the internal, physiological changes, there are several external signs of
220 ❧Explosions into Anger