Laura Petracek, author of
The Anger Workbook for Women.

New Harbinger Publications: Why is there a need for an anger workbook specifically for women? What are some of their unique issues with anger?

Laura Petracek: Most anger workbooks for men approach dealing with anger on an intellectual level. This is because the common causes of men’s anger are issues related to power and control. But women are much more relational than men, and their anger triggers have more to do with relationships than with power and control. The common roots of women's anger are powerlessness, injustice, and the irresponsibility of other people. Socialization and culture play key roles in shaping the ways women's anger is negotiated. The anger experience for women and girls is complex, both internally and in a broader social context.

This workbook is unique in that it focuses on anger from a woman’s perspective. Rather than following a traditional, psychopathology-based model, the book concentrates on the adaptive and functional aspects of women's anger. Recognizing the relational nature of women’s anger, it includes clinical illustrations from actual clients and comments by women talking about their own perspectives on anger. It also looks at how anger is intertwined with the development of self.

NHP: What are a few myths about women and anger and how does the data controvert them?

LP: (The numbers in parentheses refer to the reference list that appears after this interview. If you’d like to learn more about anything Dr. Petracek mentions, we encourage you to explore the books and articles to which she refers—NHP)

Many people assume that fathers hit more than mothers, but the opposite is actually true, largely because mothers spend more time at home. Assaults by fathers are more often fatal, but mothers cause the greater number of deaths through neglect. (17)

It’s commonly thought that the rate of physical assault by men against women is greater than physical assault of women against men. In fact, the overall rate of physical assaults by men against their female partners is 11 to 12 per 100 couples; the rate is 12 to 13 per 100 couples for women against their male partners. (17)

Among young adults, the rate of partner assault violence is highest in female-to-male violence rather than the other way around. (1, 13)

Another myth is that men use weapons more than women do in domestic assaults. Men are far more likely than women to beat up their partner, but women more often hit with objects. Men and women are equally as likely to use a weapon during an assault. Women are the victims in 50 to 72 percent of fatalities. (1)

Here’s a big myth: Most partner violence is men upon women. In fact, most partner violence is mutual. Men initiate violence 40 to 45 percent of the time; women initiate 50 to 55 percent of the time. (12, 17) Between 10 and 21 percent of women, and 15 to 27 percent of men, claim self-defense after an assault. (3, 15)

People tend to assume that men more often under report abusive behavior. Both sexes, though, tend to under-report their own abusive behavior, and men are somewhat more likely to under-report than women. Men, however, more often under-report assaults against them. (2)

Finally, consider the notion that heterosexual women experience more partner violence than lesbian women do. The fact is that lesbian women report twice as much of this abuse by their female partners than do heterosexual women by their male partners. Overall, lesbians report 70 percent more abuse upon them than do gay men. (19)

NHP: You talk about the "anger-in" and "anger-out" styles of anger expression that you see in women. Can you tell us a little about these two ways of coping with anger?

LP: Loosely speaking, this distinction boils down to something like the venters (anger-out) those who don't hesitate to let the world know when they're displeased and the martyrs (anger-in), those who say "I'm fine, really" while they fume silently inside.

In psychologist-speak, most women fit an anger-in profile. We have an assessment, Spileberger’s multiple-choice test, which is designed to deliver anger-in and anger-out scores. Your score on this test places you along a continuum between, as you'd expect, those who display their anger and those who suppress it. A final group of questions identifies the physical manifestations of an anger behavior that isn't working.

Most women will buck at the characterization, but statistics bear it out. Women are more likely to deny their rage than men are. And really, this should come as little surprise. There are words for an angry woman—bitch, shrew, nag. Acting the part of anger-in is in keeping with traditional notions of femininity.

Women's anger does not conform to the feminine ideal of the selfless, ever-nurturing, perfect mother. Many women described feeling embarrassed and debilitated by their anger.

I once asked women in my group, “What do you look like when you're angry?”

“Ugly," the women replied.

Most women ignore their anger like bad advice. Women usually keep everything locked inside because otherwise when they explode (anger-out), and they say things that they later regret.

NHP: Let's talk a little about your background. When did you first start specializing in women and anger? What strategies or programs have you developed for treating it, and how do you know they work ?

LP: During my first year of my doctoral internship at Harborview Hospital in Seattle, Washington, I worked exclusively with men in the Anger Management and Domestic Violence Treatment Program.

During the beginning of my second year, my supervisor Dr. Roland Maiuro, stated that the program was receiving a lot of calls from women. He asked if I would consider conducting my doctoral research and dissertation on women with anger control problems as opposed to men. I thought it was a great idea, and I immediately agreed.

The methods and interventions you’ll find in the workbook were developed from my clinical experience conducting anger groups, my empirical research on women over the past ten years, and my observations of women’s experiences of their anger.

Teaching cognitive-behavioral skills is the primary method of intervention in traditional anger workbooks for men. This approach challenges men to stop abusing power and to learn to share it equally with their partners. For women, though, interactive techniques, like the kind you’ll find in my workbook, tend to be more effective—especially if they can be worked through in a group therapy setting. These techniques challenge women to address the negative cultural view of the direct communication of their anger. Above all, this kind of strategy recognizes women’s anger as visible and legitimate.

NHP: You devote a section of your book to the particular issues that lesbians face when it comes to anger. How are these different from the issues that confront heterosexual women?

LP: Lesbians face the double of oppression of sexism and homophobia. What is homophobia? It is the fear, dread, or hatred of homosexuality. It is the result of a carefully designed system of stereotypes, myths, and half-truths that enforce traditional sex-roles, which, in turn, perpetuate male dominance.

Internalized homophobia keeps lesbians feeling ashamed and experiencing low self-esteem. It makes them choose to be invisible and closeted, which leaves them unable to know themselves. Homophobia can lead to lesbians acting out their anger on themselves and others.

LP: Over the last few decades, the rate of female delinquency has increased relative to the rate of male delinquency. Between 1993 and 1997 the arrest rate for teenage females grew by 26 percent, as opposed to only 9 percent for males (Siegel and Senna, 247). Girls in mixed-sex groups have been found to be more delinquent than girls in same sex groups, and females are more likely to report a member of the opposite sex as instigating their delinquency (Mears, 264).

And what of that small but increasing percentage of girls who are delinquent? Whereas most male gang members come from working class homes, most female gang members usually come from impoverished and abusive families, and most serious female offenders come from more troubled homes than their male counterparts (Bottcher, 898).

This makes sense when one considers that a serious female delinquent must violate not only the law but, more importantly, our society’s gender schema. Women’s socialization makes them less likely to become deviant, and society discourages it so much that it takes a lot of pressure to drive them to a delinquent lifestyle. The result is that the few who are delinquent come from worse conditions than most male delinquents.

Society’s idea of how women should behave is so strong that when women are punished for delinquency, their punishment exceeds that of males. Once a female is inside the justice system, she will usually be punished more severely. A much higher proportion of delinquent girls than delinquent boys are referred to the juvenile courts (Mann, 147). Girls and boys have a 4 to 1 ratio of arrest but a 3 to 1 ratio of incarceration. Girls are more often detained while awaiting a hearing, and are detained for less serious crimes (Mann, 148).

NHP: You mention that the lower your self-esteem, the more likely you are to get easily angered. Do you think the link between low self-esteem and anger is stronger in women than in men?

LP: Yes, I think the link is stronger in women than in men. This is primarily because of the unfortunate fact that women in general are more apt to suffer from low self-esteem than men. Because high stress, low self-esteem, and anger tend to occur together, it is important for women to understand each concept and to learn how to identify them.

NHP: Chapter six of The Anger Workbook for Women addresses the effects of a mother's anger on her children and the ways in which the stresses of being a mom can trigger anger. Can you talk a little about this?

LP: Women with young children experience high levels of stress, whether they’re homemakers or employed outside the home. Mothers who don’t have supportive partners and who have children under five years of age are more apt to become clinically depressed than any other group of adults. Stressful situations can make women more vulnerable and can trigger anger quickly.

Women still retain primary responsibility for child care, with mothers spending, on average, twenty-eight hours per week versus father’s nine hours. Mother can experience “role overload,” especially when hey work outside the home. This daily stress can easily trigger a woman’s anger. Women are also twice as likely as men to experience daily conflict with children because they are in more contact with their children, which again can easily trigger anger.

NHP: What are some of the health risks women with unhealthy anger management styles face?

LP: Women who deny their anger or experience frequent anger risk cardiovascular illness, headaches, and stomachaches. They also experience higher rates of asthma, arthritis, elevated blood pressure, insomnia, ulcers, back pain, and obesity. Women usually have one particular part of their body that bears the brunt of their anger. Rates of breast cancer were found to be higher in women who openly and/or frequently express anger than in women with more moderate anger responses. Anger is sometimes changed into a physical symptom, in what has been called a “socially accepted pathology.” The physical symptom is given attention while the anger itself remains unacknowledged and therefore is not addressed.

NHP: You say that when the women you work with comment, "I didn't get angry at all this week," you remind them that not getting angry is not the goal of treatment. What does this tell us about how women generally view anger and about what you think needs to change in their general conception of it?

LP: Unfortunately, many women are unable to articulate anything positive about anger. Some women had never think about anger as a useful response before coming to an anger group. Many women receive messages from society that it is not okay to get angry, that expressing anger is unladylike. During the group process, many women are able to recognize that they have made important life decisions as a result of their anger.