CHAPTER 3 THE THERAPY PROCESS

Introduction At this stage, the researcher attempted to apply the TA Therapy with Empty-Chair exercise to see whether the therapy can be appropriately used for anger management among the young couples with conflicts in their families. For the application of the therapy, the researcher selected ten couples with severe clinical anger by using a Clinical Anger Scale (CAS). The selected subjects are given the therapy and the verbatim reports are given in this chapter. However, in order to verify the effectiveness of the therapy, the researcher met the couples again after three months and gave the CAS afresh to see the difference. The reliability of the result is ensured by a control group consisted of ten couples with severe clinical anger who were not given therapy. The result is given in the concluding chapter to see whether TA Therapy can be proposed for anger management. 3.1 Selection of Subjects for Therapy The selection of subjects for therapy is done by using the Clinical Anger Scale (CAS) developed by William E. Snell, Jr. of South East Missouri State University.1 A copy of the CAS is given in the appendix.2

W.E.Snell Jr., S.Gum, R.L.Shuck, J.A.Mosley, & T.L.Hite, (1995). The Clinical Anger Scale: Preliminary reliability and validity. Journal of Clinical Psychology, 51, 215-226. Several specific analyses were conducted to examine the psychometric properties of the Clinical Anger Scale (CAS). Factor analysis was conducted to examine the factorial validity of the instrument, and reliability coefficients were computed to examine the internal consistency and stability of the CAS. Factor analysis of the Clinical Anger Scale confirmed reliability and demonstrated adequate internal consistency and test-retest coefficients or stability for the CAS.

As required, a written permission is attained by the researcher from Dr. William E. Snell Jr. The permission is attached here:
Dear Rev. Cherian Mathew, You are more than welcome to use any of my instruments in your work, including the CAS. You can find all of the information that you need at the following websites (see below), where I have summarized that information in an "electronic book" (the first website below) and where copies of my psychological instruments can be found as well as the scoring procedures for these instruments (the second website below). If I can be of any future assistance, please do not hesitate to contact me.

There are twenty one clusters of statements in the Clinical Anger Scale and in each cluster, there are four statements from which the subject chooses one statement as his/her type of feeling. The following symptoms of anger were measured by the CAS items: anger now, anger about the future, anger about failure, anger about things, angry-hostile feelings, annoying others, angry about self, angry misery, wanting to hurt others, shouting at people, irritated now, social interference, decision interference, alienating others, work interference, sleep interference, fatigue, appetite interference, health interference, thinking interference, and sexual interference. The four statements in each cluster varied in symptom intensity from A to D, with more intense clinical anger being associated with statement "D." Each cluster of statements was scored on a 4-point Likert scale, with A = 0, B = 1, C = 2, and D = 3. Subjects' responses on the CAS were summed so that higher scores corresponded to greater clinical anger (21 items; range 0 - 63). The scoring procedure is as follows: 0 to 13 - minimal clinical anger; 14 to19 - mild clinical anger; 20 to 28 - moderate clinical anger and 29 to 63 - severe clinical anger. As the first step, the researcher distributed the CAS forms to hundred couples with the help of friends, relatives, pastors and other religious leaders who have an understanding of couples with conflicts. In order to ensure the return of filled CAS, the researcher approached each couple to explain about the confidential nature of the CAS, and the need and importance of their sincere effort in filling it. The second step was the selection of those couples with severe clinical anger. From the filled CAS, the families of either husband or wife with severe clinical anger are selected by using the above scoring procedure. The researcher found that there were twenty three couples in which either husband or wife had the problem of severe clinical anger. The third step was the selection of couples for therapy. The consent of the families with severe clinical anger was necessary for applying therapy because counseling and therapy cannot be forced on any one without their willingness and only when they are willing to receive therapy, it will be effective for them. The researcher could attain consent of thirteen families for counseling. In the next step, the researcher met each couple at their convenience for therapy. After initial conversation for developing rapport with the couple, the therapist went for a structural analysis and finally the empty-chair exercise was given. As each case is different from one another, the verbatim reports of ten cases are given below to show how a structural analysis was done for each case and how the therapy was given for each person. 3.2 The Control Group In order to attain more reliability, a control group consists of ten families with severe clinical anger who have not undergone counseling and therapy is also used by the researcher. It can be argued that by passage of time everybody may be changed and therefore the researcher intended to compare the subjects who have undergone therapy with those who have not undergone therapy so that the reliability of the result can be ensured. The CAS will be given again after three months not only to those who have undergone therapy but to the control group also so that the changes could be compared and see whether significant changes are seen in those who have undergone therapy or not.

Good luck with your project.

3.3 Verbatim Reports A word-to-word report of counseling and therapy is given in this section to give a clear understanding to the reader about how a structural analysis is done by using the psychology of Transactional Analysis. Further, the reader is also helped to understand the process of the empty-chair exercise and how a structural change is taken place in the subject. Though the researcher gave therapy to all who gave consent, only ten verbatim reports are given in this section. In order to maintain confidentiality of the cases, the names used in the verbatim reports are fictitious. 3.3.1 Case One Pastor Denny is married for 13 years. He is unable to control his anger when he finds that he becomes late to leave for a place. He shouts at his wife and children and creates a very bad scene very often. His score as per the CAS is 32. Counselor: Yes, you can share your concern. Denny: I am unable to control myself when I find that I may fail to reach a place on time as planned earlier. Counselor: You mean, you become angry? Denny Yes. I am a pastor and I have to keep time. Very often I am unable to start on time. When I find that I am becoming late, I shout at my wife and children. I know that this is not an appropriate behavior. Counselor: You become angry and shout at your wife and children when you fail to start on time. And you said that this is not an appropriate behavior. Denny: I am a pastor and therefore I must be patiently responding to adverse situations. Counselor: How do your wife and children respond to your anger? Denny: They want to help me and I know that they are sad to witness my furious behavior. Counselor: How do you want to be? Denny: I should not become furious and shout at my wife and children. Counselor: But you may still become late. Denny: Even though, I want to be patiently facing the situation. Counselor: Why do you think so? Denny: It is good to be patiently responding. Counselor: Why? Denny: If I am patiently looking at the things, my relationship with my family will be more smooth. And I also can feel free and happy. Counselor: This seems to be a mature thinking. But now you are unable to control yourself. Denny: Yes. But I want to change myself. Counselor: Good. Pastor Denny - an adult, a matured person of 36 years - say that it is good to be patiently responding even in adverse situations. But Pastor Denny who is sitting just in front of me is unable to control himself. What is the difference between Pastor Denny who is sitting in front of me and Pastor Denny about whom I said earlier? Denny: It seems to be a question of maturity. Counselor: Good insight. Do you want to continue like this? Denny: Of course, not. I want to be a matured person. Counselor: Can you do this psychological exercise that I suggest? Denny: Yes, I can. (the counselor provides an empty chair in front of the counselee)

Now you are sitting on the Adults chair. Imagine that the little Denny is seated on the empty chair. You may tell the little Denny: I am a matured person of 36 years. As a matured person I can respond very patiently to any situation even when things are not favorable. (the counselee tells the same in his own words) Counselor: Now you may please sit on the little Dennys seat and talk to the Adult Denny: I am not a matured person and therefore I am unable to control myself. I behave furiously to my wife and children. (the counselee tells the same to the Adult Denny) Counselor: Please come back to the Adults chair. Tell the same again with boldness. (the counselee raises his voice and tells with boldness) Counselor: Go to the little Dennys chair and repeat the same. (the counselee does it). Counselor: Come back to the Adults chair and tell the same with much boldness and courage. (the counselee does it) Counselor: On which chair do you seem more comfortable? Denny: Here. (he holds the Adults chair) (the counselor removes the empty chair and sits in front of him) Counselor: What is your decision? Denny: I am a matured person and I will be patiently responding to all adverse situations. Counselor: Are you sure that it is your own decision? Denny: Yes. It is my own decision. Counselor: Good. All the best. Counselor: 3.3.2 Case Two Mr. John, 35 years, is married for 10 years. He becomes furious and beats his wife and destroys property when he finds that his wife is not obeying him and respecting him. His score as per CAS is 38. Counselor: I am glad that you wanted to meet me again. Tell me, what do you want to share with me? John: I am married for ten years. But we could stay together continuously only for ten to fifteen months. I use to fight with my wife very often and sometimes I beat her. Whenever I find that she is not obeying me and respecting me, I become furious and I cannot bear my anger. I become violent and destroy things and create a very bad scene. Then my wife leaves me for a while and comes back again. I fight with her again and she leaves me for a while again. Life is so miserable. Counselor: I think you feel sad about what is happening between you and your wife. When you find that she is disobeying you and not respecting you, you become furious and create a bad scene by beating your wife and destroying things. John: I am her husband and she has to respect me and obey me. Counselor: It seems that you expect an absolute obedience and when your expectation is not fulfilled, you become very angry. John: I know that it is not fair to beat her. But her behavior makes me angry. Counselor: Do you think that you can change her as you expect so that you can avoid all havoc? John: I was trying to change her. Counselor: But I think your efforts failed. John: She must obey me and respect me.

Counselor:

Your desire seems to be good. I can also speak to her to change her attitude towards you. But can we expect that she will be changed as you think? John: I dont think that she will change. Counselor: It is important to note that she may continue her behavior. As long as she continues the behavior, do you want to continue destroying things and beating her? John: (after a pause) I must stop doing like that. Counselor: Why do you think so? John: It seems not good to be furious, destroying things and creating a bad scene. Counselor: Your problem of anger is only with your wife? John: I had a number of fights with many people. Counselor: Whenever you find that things are not according to your expectations, you become angry. Do you think that you can change all others and be patient? John: No. I think I need to change. Counselor: Very good insight. All others, including your wife may continue their behavior. You may not be able to change them. The present need seems to be a change within you. John: How can I change myself? Counselor: How do you want to be? John: It is good to be patiently responding. Counselor: You want to be patiently responding even when others misbehave with you? John: Yes. But I am unable to be like that. Counselor: Your desire to be patiently responding seems to be a very matured thinking. John: But I am unable to control myself when I am angry. Counselor: Mr. John, a matured adult of 35 years, say that it is good to be patiently responding even when others misbehave with him. But Mr. John who is sitting in front of me is unable to behave patiently when things are not favorable. What is the difference between Mr. John who is sitting in front of me and the first John I mentioned earlier? John: The first John is a matured person who is very patient. The second John ... an immature person who is always fighting with others. Counselor: Do you want to continue like this? John: No. I want to be a matured person. Counselor: Are you willing to do a psychological exercise? John: Yes, I am. (An empty chair is put in front of John) Counselor: Just imagine that you, Mr. John of 35 years, a matured adult, is seated on the present chair and the John who is not mature is seated on the empty chair. Now tell the immature John: I am a John of 35 years. I am a matured person and therefore I can be very patiently responding to my wife and others even when they are not behaving according to my expectations. (John tells the same to the other John) Counselor: Now you come to the other chair and tell the matured John: I am not mature enough and therefore I become furious and destroy things and beat my wife. (John does the same) Counselor: Please come back to the other chair. Now tell the immature John strongly that you are a mature person and therefore can control yourself and can be very patiently responding to any adverse situation. (The exercise is repeated until John feels comfortable on the Adult chair)

Counselor: John: Counselor: John: Counselor: John: Counselor:

What is your decision? I will be patiently responding to all even when others are misbehaving with me. Very good. Are you sure that it is your own decision? Yes. It is my decision. Do you think that you can fulfill your decision? Yes. Because I am a matured person of 35 years. All the best. God bless you.

3.3.3 Case Three Mrs. Linda, 33years, is married for eight years. She becomes very furious when her mother-in-law accuses her before her husband. Once she took a knife to attack them and once she called the police to complain against them. Her score is 38. Counselor: Welcome Mrs. Linda. You can share your concerns. Linda: I have serious disputes with my husband and in-laws. My mother-in-law is always accusing me falsely and quarrels with me. She accuses me before my husband. My husband also is not understanding me. He believes what his mother says and fights with me. Very often I loose my control and use abusive words against my husband and mother-in-law. Life becomes terrible. One day I took a knife to attack them. Another day I called the police to complain against them. Now my husband says that he will divorce me. But I do not want a divorce. Counselor: When your mother-in-law and husband accuse you falsely, you become angry and use abusive words against them. Some times you become so furious and tend to attack or call police. Now I think that you are sad as your husband wants to divorce you. You want to live with him. Did your husband beat you or harm you physically? Linda: No. He just shout at me only. Counselor: Thank God. There is no physical assault against you. Linda: I think I am more furious than my husband and mother-in-law. Counselor: Did you have the problem of anger before marriage? Linda: Yes. I use to get angry with my mother and brother and some times with my friends. Counselor: I think you are conscious of the consequences of continuing the present behavior. Linda: My mother-in-law is creating more problems now. My husband believes what she says. Counselor: Do you think that you can change the behavior of your mother-in-law? Or do you think that you can change your husband? Linda: Why do they accuse me so badly? Counselor: She is an old lady. She may have her own pattern of behavior. She may not change her attitude. Your husband perhaps thinks that he may fail to gain his mothers love. Thus they may continue their behavior. Can you afford to be violent if you want to continue your family life? Linda: But I am unable to control myself. Counselor: What will be the better option? Linda: I had the problem of anger before marriage. I think it is better to control myself for a peaceful life. Counselor: That seems to be a good approach to maintain good relationship in the family. Perhaps your change may bring changes in the attitudes of your husband and mother-in-law. Linda: My attitude has been creating a lot of problems in my life. I think I need to change.

Counselor:

What kind of change? Your husband and mother-in-law may continue their pattern of behavior. Linda: I must be patiently responding even when they accuse me falsely. Counselor: Why? Linda: This seems to be a good approach. Counselor: Good. It is a very mature thinking. Mrs. Linda, a matured adult lady of 33 years say that it is good to be patiently responding even when her husband and mother-in-law continue their accusations. But Mrs. Linda who is just in front of me unable to control herself. What is the difference between these two persons? Linda: One is a matured Linda and the other is not. Counselor: Good insight. Do you want to continue like this? Linda: No. I need to behave as a matured person. But I am unable to control myself. Counselor: I would suggest a psychological exercise. Can you do it? Linda: Yes. (An empty chair is provided in front of Mrs. Linda) Counselor: Imagine that you are seated on the Adults chair. Now tell the immature Linda seated on the other chair: I am a matured person. I am an adult. I am 33 years old. As a matured person I will be responding patiently even when my mother-in-law accuses me or my husband misbehaves with me. (Mrs. Linda does the exercise) Counselor: Now come to the other chair and tell the matured Linda: I am not a matured person. I cannot bear when my mother-in-law and husband make accusations against me. I become furious and I cannot control myself. (Mrs. Linda does the exercise) Counselor: Now come back to the Adults chair. Repeat what you said earlier with more boldness and courage. (The exercise is repeated a number of times till the counselee becomes comfortable on the Adults chair) Counselor: What is your decision? Linda: I will be behaving as a matured person. Counselor: Very good. God bless you. Linda: Linda: Thank you very much. 3.3.4 Case Four Mr. Jose, 38 years, is married for 14 years. He beats his wife frequently as he becomes angry when he finds that his wife beats their son. His score as per CAS is 35. Counselor: I would like to appreciate you for seeking a counseling help. Jose: Thank you. Counselor: Tell me, what do you want to share with me? Jose: There are frequent fights between myself and my wife. We have two children. One daughter and one son. For simple reasons my wife beats the son. When I see that she beats him, I become very angry and I beat her. I cannot control myself. I told her not to beat him. But she does not obey me. He may be doing some mischief. But she could have told me. Instead of telling me, she becomes angry and beats him. When I see that I also become angry and shout at her. She will also shout at me. And finally I beat her. This happens very frequently. Sometimes she leaves for her home after the incident. This becomes a very difficult problem.

Counselor: Jose:

I think both of you are unable to control your anger and fight each other. I beat my wife because she beats the son. I told her many times not to do that. But she does not care. Counselor: Even after giving a number of warnings your wife beats your son and when you find that she is not obeying you, you become very angry and beat her. Jose: I am provoked by her and otherwise I do not do anything. Counselor: Can you expect that she will not beat the son? She may be doing that as part of disciplining him, with good intention. Jose: It may be right. But I cannot control myself. Counselor: If you fight each other and beat your wife, what would be the consequences? Will it not affect the future of your children? Jose: It will affect, sure. But she should stop beating the son. Counselor: You said, she may be right as disciplining the son. If she is right, why dont you give her permission to discipline him? Jose: But I cannot see that she beats him. Counselor: I think I can talk to her about it. But even if I talk and still she does not change, do you want to continue beating her and fighting with her? Jose: I know that this fighting is not good. Counselor: Why do you think so? Jose: That will destroy the peace and harmony in the family. Counselor: You want to see that peace and harmony is maintained at home. Jose: Yes. We should stop fighting. Counselor: If she continues her present behavior, do you think that you have to stop fighting? Jose: She may not change. But I must change. Counselor: That seems to be a more appropriate and a mature approach. Jose: But I do not know whether it is possible by me. Counselor: I think I can help you. It is good to be patient even when your wife is not patient, isnt it? Jose: Yes. Counselor: That seems to be a mature thinking. But now you are unable to be like that. Jose: I want to be patiently looking at such situations. Counselor: Mr. Jose, a matured adult of 38 years, says that it is good to be patiently managing even when his wife beats the son. But Mr. Jose who sits in front of me is unable to manage patiently. What is the difference between the first Jose and the second Jose? Jose: The first Jose is 38 years old, matured adult and the second Jose is not a matured person. Counselor: Good insight. Can you afford to be like that? Jose: I want to be a matured person. Counselor: I can help you. Will you be able to do this psychological exercise? Jose: Yes, I can. (An empty chair is provided in front of the counselee.) Counselor: Imagine that you are sitting on an Adult chair. Now tell the little Jose: I am a matured adult of 38 years. I will he functioning as a matured person, patiently responding even when my wife is not behaving as I expected of her (The counselee does it.) Counselor: Now come to the little Joses chair and tell the Adult: I am not a matured person and therefore I become very angry and beat my wife. I am unable to control myself because of my immaturity.

(The same exercise is repeated until the counselee feels comfortable on the Adult chair. Then the counselor ensures that the counselee takes a mature decision.) 3.3.5 Case Five Mr. Joseph, 37 years, is married for 15 years. He has regular fights with his wife and children when he finds that the expected cleanliness is not maintained at home. His score as per CAS is 34. Counselor: Joseph: Welcome Joseph. You can share your concerns. I am unable to maintain good relationship with my wife and children. I give more importance to neatness, cleanliness and orderliness. But when I see that things at home are not in good order, I cannot bear it. I become angry and shout at my wife and children. Sometimes I beat my wife. You become angry and shout at your wife and children and sometimes you beat your wife when you see that proper cleanliness is not maintained by them. I always tell them to keep everything at its place and maintain the house and premises neat and clean, but they are lazy. They dont care my words. Things are worse in my wifes house. Let them do whatever they want to do there. But in my house, I want to see that everything is in proper order. If she takes care of this matter, things will be alright. But she doesnt care. There will be frequent fights between me and my wife on this. Children are also careless. I have to go for work. I cannot be at home always. When I come home, by seeing all things in disorder I am very much disturbed and cannot control myself. Even after repeated advices your wife and children do not take care of the cleanliness of your house. You are provoked by their laziness and become very angry. How long have you been like this? Since my marriage I have this problem. She will agree to do it, but she fails. It seems that your efforts fails so far. So you are becoming very angry. How does it affect your family life? There is always fight at home. There is not a peaceful atmosphere at home. Your anger expressions seem to be your effort to change your wife and children. But your efforts have no positive results and only negative results are seen. Is it good to continue your behavior? I think there is no meaning in continuing this behavior, fighting with wife and children. But when I see things in disorder I become very angry and I cannot stop it. How do you want to be? I want peace at home. What is more important? Peace at home or cleanliness? Both are important. But I want more peace at home. That means even if things are not in proper order, you want to maintain peaceful situation at home. Yes, but I dont think I will be able to do that. I think I can help you. It seems good to be patiently responding even when things at home are not in order, in order to maintain peaceful situation. I think it is good to be patient. But how can I be? Mr. Joseph, a matured person of 37 years says that it is good to be patient even when things at home are not in proper order, in order to maintain peace. But Mr. Joseph who is

Counselor: Joseph:

Counselor:

Joseph: Counselor: Joseph: Counselor:

Joseph: Counselor: Joseph: Counselor: Joseph: Counselor: Joseph: Counselor: Joseph: Counselor:

sitting just in front of me is unable to be patient. What would be the difference between these two Josephs? Joseph: One is a matured Joseph and the other is not matured. Counselor: Can you this psychological exercise? Joseph: Yes. (An empty chair is provided and Joseph does the exercise until he finds himself comfortable at the Adults chair and he comes to a genuine decision that he will function as an adult.) 3. 3. 6 Case Six Mr. Aji of 39 years is married for 14 years. He has regular fights with his wife. He becomes very angry when his wife accuses him of illegal relation with other women. His score as per CAS is 32. Counselor: Aji: Good evening Aji. What do you want to share with me? I have serious conflicts with my wife. She is seriously suspicious of me. I dont have any unfair relationship with anyone. But my wife says that I have illegal relationship with my cousins wife. When she says about it and quarrels with me, I become angry and sometimes I cannot control me and I use to beat her. She wants me to cut off my relationship with that family. But I cannot think of cutting off relationship because I have a good relationship with my cousin. Now a days she denies sex also alleging that I have illegal relationship with her. This makes me more angry and our family life has become very pathetic. You become very angry and sometimes beat your wife because she quarrels with you and denies sex alleging that you have illegal relationship with your cousins wife. Your wife wants you to cut off relationship with that family, but you cannot do that as you have a good relationship with them. Do you know why your wife suspects you? My cousins wife's character was not good even before their marriage. My wife also knows about it. I have no restrictions. I use to talk to all in public including my cousins wife. This might be the reason why she suspects me. recently I had to go to my cousins house for taking a tool for my work. He was not there when I went there. I asked where John is. She said he is not here. I asked for the tool and she gave me the tool and without entering the house I left the place. When my wife saw the tool with me she began to question me and quarrel with me. I said repeatedly that I dont have any relationship with her and I left the place without entering the house. But she was not ready to believe it. She began to curse me and accuse me and I lost my control and I began to beat her. Even though you tried your level best to convince her of your innocence, she is not ready to believe you. In order to solve this problem, I thought of changing our residence. We have shifted to my wifes house and began to stay there. But still she is suspicious of me. One day I became very angry and my mother in law began to shout at me and asked, Are you going to kill my daughter? It was really a horrific situation. You have shifted your residence to your wifes house in order to make her understand that you love her and you have no illegal relation to the other lady. But still she suspects you and when she speaks about it you become angry and you are unable to control yourself. Well, if possible and if both of you are willing, we will have a counseling session together so that I can talk to your wife also. However, I would like to ask you

Counselor:

Aji:

Counselor: Aji:

Counselor:

whether you want to continue beating your wife and fighting with her even if she continues with her suspicion. Aji: I dont know whether she will believe me or not. But I think I have to control myself. Now my children are also suffering. They see we are fighting. That will affect their future. Counselor: In view of the future of your children, you think that it is better to be patient and control your anger. Aji: I always think that I must control myself but I am unable to do it. Counselor: It seems to be a very mature thinking. Mr. Aji of 39 years, an adult, a mature person, says that it is good to be patiently responding even when his wife is suspicious of him. But Mr. Aji who is sitting in front of me is unable to control himself and becomes furious. What is the difference between this Aji who is sitting in front of me and the other Aji about whom I said earlier? Aji: This Aji is unable to control himself. Counselor: The matured Aji of 39 years say that it is better to be controlling. But this Aji is unable to control himself. What is the difference between these two? Aji: This Aji is not a matured Aji. Counselor: Do you want to continue like this? Aji: No. Counselor: I would like to suggest a psychological exercise. Can you do this exercise? Aji: Yes. (The empty chair exercise is given and the counselee takes a genuine decision to function as an adult).) 3.3.7 Case Seven Mrs. Sara, 30 years old, is married for 10 years. She becomes very angry when others put her down. Her score as per CAS is 30. Counselor: Sara: Good morning Sara. You may please share your concern. Sir, whenever I see that others are putting me down, I become very angry and shout at them. I cannot bear when someone teases me. I dont tease anyone. Last week Shalomi mocked me in front of many others. Her comment in front of others that am so proud hurt me very much and I became very angry and shouted at her in front of others. Later I felt shame about it. I should have controlled myself. There were a number of similar incidence in my life where I became a mockery of myself because of my anger. Your anger expressions lead you to shameful situations because you think that you should have controlled yourself when others put you down. Shalomis comments hurt you and you were provoked to shout at her. You had so many similar situations. Can you expect that nobody will hurt you or say nothing against you? Why do they all target me when they are joking? They all means? I mean my church members. This kind of teasing takes place when I go for ladies meeting in the church. I hate many of them. They talk evil against others. When they see me they start laughing. I know they were talking about me. sometimes I used to think not to go for ladies meeting. But there are some sisters who love me. therefore I donot want to miss the meeting. But when I think of fighting with them, I am ashamed of it. Can you expect that others may say only good things about you?

Counselor:

Sara: Counselor: Sara:

Counselor:

Sara: Counselor: Sara: Counselor: Sara: Counselor: Sara: Counselor: Sara: Counselor: Sara: Counselor: Sara: Counselor: Sara: Counselor:

Sara: Counselor: Sara: Counselor: Sara: Counselor: Sara: (An empty

No. But when they tease me I cannot keep quiet. You have this problem only in the church? No. At many places I face the similar situation. What about home atmosphere. Sometimes my husband and daughter jopin together and tease me. I fight with them also. Do you think that it is good to continue this behavior? No. it is not good to continue like this. But it is possible that others may continue their behavior. Why dont they stop teasing me? Do you have any means by which you can stop it? I dont have. That means they may continue their behavior and you also will continue your behavior? I think, it is better, I change. Very good insight. That means, even when they tease you and out you down you want to patiently responding. Yes. But I cannot control myself. A matured, adult, Mrs Sara of 30 years say that it is good to be patiently responding even ehrn others tease her but Mrs. Sara whoi is sitting in front of me cannot be patient like that. What is the difference between these two? I think I am only 12 years old. Can you afford continuing like this? No. I should not continue like this. How do you want to be? I want to function as 30 years old. Can you do an exercise suggested by me? Yes. I can. chair is provided and the counsellee does the exercise and takes a genuine decision to function as an adult).

CAS
FEELINGS INVENTORY INSTRUCTIONS: The group of items below inquire about the types of feelings you have. Each of the 21 groups of items has four options. For example, ITEM 99 ....... A. I feel fine. B. I don't feel all that well. C. I feel somewhat miserable. D.I

feel

completely

miserable.

For each cluster of items, read and identify the statement that best reflects how you feel. For example, you might choose A in the above example. If so, then you would darken in the letter (A) on the answer sheet next to the item number associated with that group of statements. In this example, that item number would have been "99." FEELINGS INVENTORY The group of items below inquire about the types of feelings you have. Each of the 21 groups of items has four options. For each cluster of items, read and identify the statement that best reflects how you feel. Now go ahead and answer the questions on the answer sheet. Be sure to answer every question, even if you're not sure. PLEASE BE HONEST IN RESPONDING TO THE STATEMENTS. 1. ..... A. I do not feel angry. B. I feel angry. C. I am angry most of the time now. D. I am so angry and hostile all the time that I can't stand it. 2. ..... A. I am not particularly angry about my future. B. When I think about my future, I feel angry. C. I feel angry about what I have to look forward to. D. I feel intensely angry about my future, since it cannot be improved. 3. ..... A. It makes me angry that I feel like such a failure. B. It makes me angry that I have failed more than the average person. C. As I look back on my life, I feel angry about my failures. D. It makes me angry to feel like a complete failure as a person. 4. ..... A. I am not all that angry about things. B. I am becoming more hostile about things than I used to be. C. I am pretty angry about things these days. D. I am angry and hostile about everything. 5. ..... A. I don't feel particularly hostile at others. B. I feel hostile a good deal of the time. C. I feel quite hostile most of the time. D. I feel hostile all of the time. 6. ..... A. I don't feel that others are trying to annoy me. B. At times I think people are trying to annoy me.

C. More people than usual are beginning to make me feel angry. D. I feel that others are constantly and intentionally making me angry. 7. ..... A. I don't feel angry when I think about myself. B. I feel more angry about myself these days than I used to. C. I feel angry about myself a good deal of the time. D. When I think about myself, I feel intense anger. 8. ..... A. I don't have angry feelings about others having screwed up my life. B. It's beginning to make me angry that others are screwing up my life. C. I feel angry that others prevent me from having a good life. D. I am constantly angry because others have made my life totally miserable. 9. ..... A. I don't feel angry enough to hurt someone. B. Sometimes I am so angry that I feel like hurting others, but I would not really do it. C. My anger is so intense that I sometimes feel like hurting others. D. I'm so angry that I would like to hurt someone. 10. .....A. I don't shout at people any more than usual. B. I shout at others more now than I used to. C. I shout at people all the time now. D. I shout at others so often that sometimes I just can't stop. 11. .....A. Things are not more irritating to me now than usual. B. I feel slightly more irritated now than usual. C. I feel irritated a good deal of the time. D. I'm irritated all the time now. 12. .....A. My anger does not interfere with my interest in other people. B. My anger sometimes interferes with my interest in others. C. I am becoming so angry that I don't want to be around others. D. I'm so angry that I can't stand being around people. 13. .....A. I don't have any persistent angry feelings that influence my ability to make decisions. B. My feelings of anger occasionally undermine my ability to make decisions. C. I am angry to the extent that it interferes with my making good decisions. D. I'm so angry that I can't make good decisions anymore. 14. .....A. I'm not so angry and hostile that others dislike me. B. People sometimes dislike being around me since I become angry. C. More often than not, people stay away from me because I'm so hostile and angry. D. People don't like me anymore because I'm constantly angry all the time. 15. .....A. My feelings of anger do not interfere with my work. B. From time to time my feelings of anger interfere with my work. C. I feel so angry that it interferes with my capacity to work. D. My feelings of anger prevent me from doing any work at all. 16. .....A. My anger does not interfere with my sleep. B. Sometimes I don't sleep very well because I'm feeling angry. C. My anger is so great that I stay awake 12 hours later than usual. D. I am so intensely angry that I can't get much sleep during the night. 17. .....A. My anger does not make me feel anymore tired than usual. B. My feelings of anger are beginning to tire me out. C. My anger is intense enough that it makes me feel very tired. D. My feelings of anger leave me too tired to do anything. 18. .....A. My appetite does not suffer because of my feelings of anger. B. My feelings of anger are beginning to affect my appetite. C. My feelings of anger leave me without much of an appetite. D. My anger is so intense that it has taken away my appetite. 19. .....A. My feelings of anger don't interfere with my health. B. My feelings of anger are beginning to interfere with my health. C. My anger prevents me from devoting much time and attention to my health. D. I'm so angry at everything these days that I pay no attention to my health and well-being. 20. .....A. My ability to think clearly is unaffected by my feelings of anger. B. Sometimes my feelings of anger prevent me from thinking in a clear-headed way.

C. My anger makes it hard for me to think of anything else. D. I'm so intensely angry and hostile that it completely interferes with my thinking. 21. .....A. I don't feel so angry that it interferes with my interest in sex. B. My feelings of anger leave me less interested in sex than I used to be. C. My current feelings of anger undermine my interest in sex. D. I'm so angry about my life that I've completely lost interest in sex.

Copyright - 1995

Scoring Instructions for the Clinical Anger Scale (CAS):

The Clinical Anger Scale: Construct, Measurement, Reliability, and Validity. William E. Snell, Jr., Scott Gum, Roger L. Shuck, Jo A. Mosley, and Tamara L. Hite Southeast Missouri State University 0

Abstract
The purpose of the present investigation was to develop and validate an objective self-report instrument, the Clinical Anger Scale (CAS), designed to measure the syndrome of clinical anger. Several specific analyses were conducted to examine the psychometric properties of the Clinical Anger Scale (CAS). Factor analysis was conducted to examine the factorial validity of the instrument, and reliability coefficients were computed to examine the internal consistency and stability of the CAS. Also, in addition to providing evidence for the convergent and divergent validity of the CAS, an ancillary purpose of the present study was to provide preliminary evidence for its validity by examining some personality, psychopathological symptomology, behavioral, and family environmental correlates of clinical anger. Factor analysis of the Clinical Anger Scale confirmed essentially a unidimensional item structure; reliability analyses also demonstrated adequate alphas (i.e., internal consistency) and testretest coefficients (i.e., stability) for the CAS; and other results indicated that the CAS was unrelated to social desirability influences. Additional findings indicated that clinical anger was positively associated with several anger-related concepts (e.g., trait anger, state anger, anger-in, anger-out, anger-control). Other results showed that the Clinical Anger Scale was related in predictable ways to men's and women's psychological symptoms, personality traits, and early family environments. These results are discussed in terms of the need to distinguish and to investigate the concept of clinical anger and its therapeutic treatment.

Method
An objective self-report instrument--the Clinical Anger Scale (CAS)--was designed to measure the psychological symptoms presumed to have relevance in the understanding and treatment of clinical anger. Twenty-one sets of statements were prepared for this purpose. In writing these groups of items, the format from one of Beck's early instruments was used to design the Clinical Anger Scale (Beck et al., 1961; Beck, 1963, 1967). The following symptoms of anger were measured by the CAS items: anger now, anger about the future, anger about failure, anger about things, angry-hostile feelings, annoying others, angry about self, angry misery, wanting to hurt others, shouting at people, irritated now, social interference, decision interference, alienating others, work interference, sleep interference, fatigue, appetite interference, health interference, thinking interference, and sexual interference. Subjects were asked to read each of the 21 groups of statements (4 statements per group) and to select the single statement that best described how they felt (e.g., item 1: A = I do not feel angry, B = I feel angry, C = I am angry most of the time now, and D = I am so angry all the time that I can't stand it). The four statements in each cluster varied in symptom intensity, with more intense clinical anger being associated with statement "D." Each cluster of statements was scored on a 4-point Likert scale, with A = 0, B = 1, C = 2, and D = 3. Subjects' responses on the CAS were summed so that higher scores corresponded to greater clinical anger (21 items; range 0 - 63). A scoring procedure similar to Beck's (Beck et al., 1996). is used with the Clinical Anger Scale (CAS)--where a clinical anger score in a particular range is labeled in a manner similar to Beck's procedure. That is, clinical interpretation of the CAS scores is accomplished through the following

interpretive ranges: 0-13 - minimal clinical anger; 14-19 - mild clinical anger; 20-28 - moderate clinical anger; and 29-63 - severe clinical anger.

Results
These results are presented in several major sections. The first section presents the psychometric analyses of the Clinical Anger Scale. Included in this section are the factor analysis results, the reliability results, and other scale validity results. Section two then presents the gender norms and the ANOVA analyses conducted to examine the effect of gender on the CAS. The third section reports the research evidence for the convergent validity of both the CAS. This section presents the correlations between the CAS and Speilberger's anger-related instruments. Section fourth includes the results of the analyses conducted to examine the relationship between the CAS and the measures of psychological symptoms, personality traits, and unhealthy behaviors (i.e., acting out and neuroticism indexes). The fifth and final section describes the relationship between the CAS and the measure of early family atmosphere, the Family Environment Scale.

Factor Analysis Results

To examine the psychometric properties of the Clinical Anger Scale, a series of factor analyses (principal axis with varimax rotation) were conducted for males and females separately and in combination (using Sample IV). The results are shown in Table 1. An inspection of Table 1 indicates that for the combined group of both males and females, all of the CAS statements (except for item 3) loaded above |.30| on a single factor solution (the eigenvalue for Solution I was 9.53 with 45.4% of the variance being explained). No other factor solution had an eigenvalue greater than 1 (see Table 1). The CAS items were then analyzed for males and females separately. The resulting factor loadings are also shown in Table 1. Again, for both the male and the female analyses, only one factor solution with an eigenvalue greater than 1 was found (for males, the eigenvalue for Solution I was 11.33 and it accounted for 54% of the variance; for females, the eigenvalue for Solution I was 8.71 and it accounted for 41.5% of the variance). Although neither the male nor the female analyses produced more than one factor solution with an eigenvalue greater than 1, it is apparent from Table 1 that some of the secondary solutions were associated with the attitudinal, physiological, and performance manifestations of clinical anger.

Reliability
The internal consistency of the 21 items on the Clinical Anger Scale was analyzed by means of Cronbach alpha, and yielded reliability coefficients of .94 (males and females together), .95 (males only), and .92 (females only). The item-total correlations for these alphas are presented in Table 1. All the item-total correlations exceeded |.30|, except for item 3 (anger about failure) which had item-total coefficients of .13, .19, and .11, respectively, for the total sample, males only, and females only. [Although the item-total coefficient for item 3 was low, it was decided nonetheless to retain this item in the computation of the total CAS score, pending the results of additional investigations on other older samples.] In addition to conducting internal reliability analyses, test-retest analyses were also performed (see Table 2). The correlations between the two administrations of the CAS were .85 (males), .77 (females), and .78 (both males and females).

Social Desirability
Finally, to determine whether people's scores on the Clinical Anger Scale were contaminated by some type of response bias, the CAS was correlated with a measure of social desirability and with the EPI Lie Scale. The results, shown in Table 2, indicate that the CAS was independent of the tendency to respond in a socially desirable fashion and was largely independent of the EPI Lie scores (the only exception was the Lie scale for females, but this correlation only accounted for 4% of the overall variability in the scores). In brief, this information indicates that the CAS was largely unifactorial in nature, highly reliable, and essentially uncontaminated by social desirable and lying tendencies.

Gender Effects and Norms for the CAS

According to social stereotypes about gender, anger is an affect that characterizes men more than women. A series of ANOVAs for Samples I, II, III, IV, and V was thus conducted on the CAS to examine whether men and women would report different degrees of clinical anger. In these analyses, gender was treated as the independent variable and the CAS was regarded as dependent variable. The results are presented in Table 2, and reveal no evidence that males and females differ in terms of the syndrome of clinical anger (all ps > .05). This table also presents normative data (i.e., means and standard deviations) for males and females in each of the major samples (Samples I-V).

Convergent Validity Findings for the CAS

Preliminary evidence for the validity of the Clinical Anger Scale was determined by examining the correlations between the CAS and the scores on Spielberger's anger-related instruments. These correlations are shown in the bottom half of Table 2. As expected, the scores on the Clinical Anger Scale were positively and strongly correlated with the two subscales on the State-Trait Anger Scale. Moreover, the Clinical Anger Scale was positively correlated with the subscales on the Anger Expression Scale, although the relationships were not always as strong nor as significant as for the State-Trait Anger Scale. These findings thus provide support for the convergent validity of the Clinical Anger Scale. Additional Validity Findings for the CAS This section presents the results of analyses conducted to examine the relationship between the CAS and the measures of psychological symptoms, personality traits, and other unhealthy behaviors (i.e., acting out and neuroticism indexes). The results are shown in Table 3.

Psychological Symptoms and the CAS.

As an inspection of Table 3 indicates, the Clinical Anger Scale was positively correlated with the full range of psychological symptoms measured by the SCL-90-R. Also, as one might expect, males and females who reported greater clinical anger reported an elevated number of psychological symptoms associated with hostility. In brief, clinical anger was positively associated with a broad array of psychopathological symptoms.

Personality Traits and the CAS.

The Clinical Anger Scale was also correlated with two personality instruments, the Eysenck Personality Inventory and the Goldberg Big-5 Scale. As can be seen in Table 3 (for the combined sample of males and females), clinical anger was positively correlated with Eysenck's neuroticism scale and negatively correlated with Eysenck's extraversion scale, and negatively correlated with the Big-5 measure of extraversion, pleasantness-agreeableness, and emotional stability. Thus, feelings of clinical anger were associated in a predictable pattern with measures of dispositional personality attributes.

Unhealthy Behaviors and the CAS.

Table 3 (Snell et al., 1995) also shows the correlations between the Clinical Anger Scale and the measures of acting-out behaviors, neurotic behaviors, and interpersonal defensiveness. As expected, among the combined sample of males and females, clinical anger was positively associated with all three measures of psychologically unhealthy behaviors (although the pattern of results did vary somewhat among males and females). Thus, people who were characterized by more intense clinical angry reported engaging in a greater number of misdirected and inappropriate behaviors (e.g., lying, fighting, thefts, drug use); as being more uncertain and dissatisfied with their social and personal life; and as acting in a more suspicious and defensive manner about the intentions of others.

Family Environments and the CAS.

The relationship between the Clinical Anger Scale and a measure of early family environment, as assessed by the Family Environment Scale, was also examined. These correlations were computed for both males and females separately, but only the results for the combined sample will be interpreted (see Table 3). An inspection of this table reveals that clinical anger was negatively associated with a family history of cohesion, expressiveness, and shared recreational activities, but was positively related to an earlier history of family conflict and exaggerated family control (but see the gender specific correlations). No other correlations were statistically significant.

Discussion
The need for a reliable and valid instrument capable of assessing the symptoms of clinical anger led to the present research on the construction and preliminary validation of the Clinical Anger Scale. The Clinical Anger Scale was specifically designed to measure the array of psychological, physiological, affective, cognitive, motoric, and behavioral symptoms constituting clinical anger. Preliminary evidence for the validity of the CAS was demonstrated in a series of analyses showing that clinical anger was related in a systematic and interpretable manner with measures of state anger, trait anger, anger control, and anger expressed inwardly and outwardly. Moreover, other findings revealed that men's and women's feelings of clinical anger were predictably associated with a number of distinct personality characteristics, psychopathological symptoms, and inappropriate as well as problematic interpersonal behaviors. Snell, W. E., Jr., Gum, S., Shuck, R. L., Mosley, The Clinical Anger Scale: Preliminary reliability and Psychology, 51, 215-226. Beck, A. T., Brown, G., & Steer, R. Inventory II manual. San Antonio, TX: The Psychological Corporation. J. A., & Hite, T. L. validity. Journal of A. (1996). Beck (1995). Clinical Depression

Explicit written permission is need from Dr. William E. Snell, Jr., in order for individuals to use the Clinical Anger Scale (CAS). Address internet e-mail to: wesnell@semo.edu.
[ RETURN to Dr. Snell's Homepage ] This site was last Department of Psychology, SE Send comments and inquires to wesnell@semo.edu Copyright @ 1997 to Dr. William E. updated Missouri on State . University

Subject: Clinical Anger Scale (CAS) From: "Dr. William E. Snell, Jr." <wesnell@semo.edu> Wed, 30 Jan '13 6:43p To: You and others View blocked images Dear Rev. Cherian Mathew,

You are more than welcome to use any of my instruments in your work, including the CAS. You can find all of the information that you need at the following websites (see below), where I have summarized that information in an "electronic book" (the first website below) and where copies of my psychological instruments can be found as well as the scoring procedures for these instruments (the second website below). If Good I can be of any luck future assistance, with please do not hesitate your to contact me. project.

http://cstl-cla.semo.edu/snell/books/ http://www4.semo.edu/snell/TESTING.HTM

Take Bill Snell Dr. William (Bill) E. Snell, Jr. Department of Psychology-MS5700 One University Plaza SE Missouri State University Cape Girardeau, MO 63755 wesnell@semo.edu 573.651.2447

care,

From: thecherians@rediffmail.com Sent: Wednesday, January 30, To: Subject: Permission for using the Clinical Anger Scale (CAS)

[mailto:thecherians@rediffmail.com] 2013 1:42 AM wesnell@semo.edu

Dear Dr. William E. Snell, Jr., / Department of Psychology, SE Missouri State University, I am a Doctor of Ministry (D.Min.) student of Serampore University in India. I would like to use your CAS for my research among young couples who have problems in anger management. Would you please permit me to use the Scale? You are requested to kindly send your consent either by e-mail or by post as immediately as possible. Thanks. Sincerely Rev. e-mail: Address: Faith Theological Seminary, Manakala, Adoor, Kerala, India - 691551 Cherian yours, Mathew thecherians@rediffmail.com

Questionnaire for a Research

Dear Brother/Sister, This questionnaire is intended for a research study by which I want to help couples with anger management problems. Kindly answer the following questions sincerely and faithfully. The

informations provided will be confidentially used and it will never be misused or disclosed to any one else. I want to select some couples with severe anger expressions and if needed they shall be given a therapy for anger management. Thanks for your co-operation. Serial No.............. Section 1 Personal Informations Filled by: husband/wife Age:........ Religion........................... Profession.................... Educational Qualification ........................ Marital Status: married for 0 to 5 years/ 5 to 10 years/ 10 to 15 years/ more than 15 years. Present Family Status: Staying together/ Staying seperately SECTION 2 FEELINGS INVENTORY : CLINICAL ANGER SCALE
The group of items below inquire about the types of feelings you have. Each of the 21 groups of items has four options. For each cluster of items, read and identify the statement that best reflects how you feel. Now go ahead and answer the questions on the answer sheet. Be sure to answer every question, even if you're not sure. PLEASE BE HONEST IN RESPONDING TO THE STATEMENTS. 1. ..... A. I do not feel angry. B. I feel angry. C. I am angry most of the time now. D. I am so angry and hostile all the time that I can't stand it. 2. ..... A. I am not particularly angry about my future. B. When I think about my future, I feel angry. C. I feel angry about what I have to look forward to. D. I feel intensely angry about my future, since it cannot be improved. 3. ..... A. It makes me angry that I feel like such a failure. B. It makes me angry that I have failed more than the average person. C. As I look back on my life, I feel angry about my failures. D. It makes me angry to feel like a complete failure as a person. 4. ..... A. I am not all that angry about things. B. I am becoming more hostile about things than I used to be. C. I am pretty angry about things these days. D. I am angry and hostile about everything. 5. ..... A. I don't feel particularly hostile at others. B. I feel hostile a good deal of the time. C. I feel quite hostile most of the time. D. I feel hostile all of the time. 6. ..... A. I don't feel that others are trying to annoy me. B. At times I think people are trying to annoy me. C. More people than usual are beginning to make me feel angry. D. I feel that others are constantly and intentionally making me angry. 7. ..... A. I don't feel angry when I think about myself. B. I feel more angry about myself these days than I used to. C. I feel angry about myself a good deal of the time. D. When I think about myself, I feel intense anger. 8. ..... A. I don't have angry feelings about others having screwed up my life.

B. It's beginning to make me angry that others are screwing up my life. C. I feel angry that others prevent me from having a good life. D. I am constantly angry because others have made my life totally miserable. 9. ..... A. I don't feel angry enough to hurt someone. B. Sometimes I am so angry that I feel like hurting others, but I would not really do it. C. My anger is so intense that I sometimes feel like hurting others. D. I'm so angry that I would like to hurt someone. 10. ..... A. I don't shout at people any more than usual. B. I shout at others more now than I used to. C. I shout at people all the time now. D. I shout at others so often that sometimes I just can't stop. 11. ..... A. Things are not more irritating to me now than usual. B. I feel slightly more irritated now than usual. C. I feel irritated a good deal of the time. D. I'm irritated all the time now. 12. ..... A. My anger does not interfere with my interest in other people. B. My anger sometimes interferes with my interest in others. C. I am becoming so angry that I don't want to be around others. D. I'm so angry that I can't stand being around people. 13. ..... A. I don't have any persistent angry feelings that influence my ability to make decisions. B. My feelings of anger occasionally undermine my ability to make decisions. C. I am angry to the extent that it interferes with my making good decisions. D. I'm so angry that I can't make good decisions anymore. 14. ..... A. I'm not so angry and hostile that others dislike me. B. People sometimes dislike being around me since I become angry. C. More often than not, people stay away from me because I'm so hostile and angry. D. People don't like me anymore because I'm constantly angry all the time. 15. ..... A. My feelings of anger do not interfere with my work. B. From time to time my feelings of anger interfere with my work. C. I feel so angry that it interferes with my capacity to work. D. My feelings of anger prevent me from doing any work at all. 16. ..... A. My anger does not interfere with my sleep. B. Sometimes I don't sleep very well because I'm feeling angry. C. My anger is so great that I stay awake 12 hours later than usual. D. I am so intensely angry that I can't get much sleep during the night. 17. ..... A. My anger does not make me feel anymore tired than usual. B. My feelings of anger are beginning to tire me out. C. My anger is intense enough that it makes me feel very tired. D. My feelings of anger leave me too tired to do anything. 18. ..... A. My appetite does not suffer because of my feelings of anger. B. My feelings of anger are beginning to affect my appetite. C. My feelings of anger leave me without much of an appetite. D. My anger is so intense that it has taken away my appetite. 19. ..... A. My feelings of anger don't interfere with my health. B. My feelings of anger are beginning to interfere with my health. C. My anger prevents me from devoting much time and attention to my health. D. I'm so angry at everything these days that I pay no attention to my health and well-being. 20. .......A. My ability to think clearly is unaffected by my feelings of anger. B. Sometimes my feelings of anger prevent me from thinking in a clear-headed way. C. My anger makes it hard for me to think of anything else. D. I'm so intensely angry and hostile that it completely interferes with my thinking. 21. .... .A. I don't feel so angry that it interferes with my interest in sex. B. My feelings of anger leave me less interested in sex than I used to be. C. My current feelings of anger undermine my interest in sex. D. I'm so angry about my life that I've completely lost interest in sex.