CBT for Anger: How Cognitive Behavioral Therapy Works on Anger

Cognitive behavioral therapy (CBT) is a practical, skills-based approach. It rests on one idea: your thoughts, feelings, body and actions all affect each other. Change one, and the others shift.

Applied to anger, CBT says:

• It's not only what happens that makes you angry. It's also what you tell yourself about it.
• Anger shows up in your body first, and you can learn to calm it.
• What you do when angry is a habit, and habits can be changed with practice.

CBT is short-term and goal-focused. It looks mostly at the present: what's happening now and what you can do about it. You learn skills in sessions and then practice them in real life between sessions. That practice is a big part of why it works.

Several research reviews have found that CBT-based anger programs help most people who complete them feel and act less angry. It's not magic, and not everyone benefits the same. But it's the approach with the most evidence behind it.

Most CBT anger programs, whether in therapy, a group or a course, cover these five parts:

Part 4 is the "cognitive" heart of CBT. It's also the part most people have never tried, so it gets the most space below.

The A-B-C model is the core of CBT for anger:

• A = Activating event. What actually happened. Just the facts.
• B = Belief. What you told yourself about it.
• C = Consequence. How you felt and what you did.

The key idea: B drives C more than A does. The same event can lead to very different feelings, depending on the thought in the middle. D is how you change B.

How to do it

Use it when you're back under a 6. At an 8, breathe or take a time-out first. The thinking brain needs to be online.

1. Write A, the facts. Like a camera would see it. "My coworker walked past my desk and didn't say hi."
2. Write B, the hot thought. The first thing your mind said. "He's mad at me. He thinks he's better than me."
3. Write C. How angry were you (1–10), and what did you do or want to do? "6. I gave him the cold shoulder all day."
4. Name the trap. Is B one of the five common thinking traps? (See the table below.)
5. D: Dispute it. Ask one or two questions:

• What's the evidence for this thought? Against it?
• What else could explain what happened?
• What would I tell a friend who thought this?
• Will this matter in a week?
• Is this thought helping me, or making things worse?

1. Write a cool thought. One you actually believe: "He looked stressed. Maybe he had a deadline. I'll say hi at lunch."
2. Rate C again. Even one point lower counts.

A good cool thought is believable (not "everything is great"), fair (doesn't blame only them, or only you), specific (no "always" or "never") and useful (points to a next step). Cool thoughts don't mean you have to like what happened. "This is wrong, and I'll handle it the right way" is a cool thought too.

Five thinking traps that fuel anger

Practice daily: once a day, write one irritating moment as A-B-C, name the trap, ask one D question, and write one cool thought. Five minutes. Over weeks, many people start doing it in their heads. Print the free Hot Thought, Cool Thought worksheet to get started, or keep it in your anger journal.

In the course: Lesson 4, Hot Thoughts, Cool Thoughts (8-hour class and up).

There's no single CBT anger program, but they share a shape. A public example is SAMHSA's anger management manual, a free, widely used CBT guide for group programs. It describes a 12-week group, with one session a week. Here's roughly how such a program runs:

1. Early sessions: understanding anger, the anger meter, triggers and warning signs, and a first plan for time-outs.
2. Middle sessions: relaxation and breathing, the A-B-C-D thought tool, and practice on real situations from the past week.
3. Later sessions: assertive communication, conflict resolution, anger and family, and putting it all into a written anger control plan.
4. Between sessions: homework, usually logging angry moments and practicing one skill. This is where most of the change happens.

In one-on-one CBT therapy, the same tools are tailored to you. A therapist can also look at what's feeding your anger, like stress, trauma, depression, or alcohol or drug use.

All three use the same core tools. They differ in depth, support and what they're for.

Good to know:

• A class is not therapy. If you're dealing with more than everyday anger, a class can be a good start, but it doesn't replace care.
• If a court has ordered a specific program, such as a Batterer Intervention Program, neither self-help nor a general class replaces it. Check exactly what was ordered.
• Self-help works best as practice, not as a substitute for help you need.

How to find a CBT therapist: ask your doctor for a referral, check your health insurance directory for "cognitive behavioral therapy," or ask a local community mental health center. Questions worth asking: "Do you use CBT for anger?" "How many sessions do you usually recommend?" "What will I practice between sessions?" If cost is a concern, ask about sliding-scale fees. Our guide to free anger management classes lists low-cost options too.

For a quick list of the skills CBT teaches, see our anger management techniques. Not sure if your anger is a problem? Read signs of anger issues.