If survivors always bottle up feelings of anger or turn it in on themselves, it can have negative physical and emotional effects.

Physical effects can include digestive problems, high blood pressure, heart and circulation problems, being more sensitive to pain and lowered immune system.

Emotional effects may include depression, sleep problems, addiction to substances to blot out or cope with feelings, being unkind to or bullying others, compulsions such as overeating or overworking, or other out-of-control behaviour.

When people feel and react like this it can damage relationships with other people. This can lead to increased isolation and can affect self-esteem.

There are things you can do to express and manage anger in ways which do not harm you or other people around you.

Survivors have found the following helpful for expressing and managing anger:

• People have different ways of expressing anger, and their patterns form in childhood. It can help to know your own patterns. Do you hold your anger inside you? Or do you find that anger takes control of you when you least expect it? Be aware of your own pattern as this can help you manage it.
• Work out a plan for when you are overcome with anger, or when it is getting too much.
• Some people find that releasing anger can be helpful. Some suggestions for releasing anger safely so that you do not hurt yourself or anyone else are:
• Express the anger by hitting a pillow with a tennis racquet or tearing up a thick catalogue/phone book
• Go somewhere where you won’t frighten anyone and shout or make a noise
• Talk about it. When your thoughts stay in your head, they can overwhelm you. Having the opportunity to say them aloud to someone who believes you and supports you can be a relief. It can make them clearer and help you work out what you want.
• Write it down. Put down on paper what’s going through your head. Don’t worry about spelling or grammar. You could buy yourself a diary or notebook with a lock. Write a letter to the person who abused you. You don’t have to send it.
• Draw a picture or paint it. When you can’t put emotions into words, drawing colours and lines can help. You don’t have to show it to anyone.
• Exercise to let off steam. This can be walking, gardening, swimming, going to the gym, aerobics, or whatever you enjoy.
• Learn to recognise when you are feeling angry and say so in words rather than actions.
• Notice the thoughts and feelings you have when you feel angry.
• Learn assertiveness techniques to help you express yourself in ways which respect others.
• Use relaxation techniques such as yoga or listening to music.
• Eat well - not eating well can make you feel irritable
• Cut down on alcohol as it can affect your ability to cope with and control anger. It can also interfere with your mood, and the quality of your sleep.

Try to manage your anger by practising the STOPP steps below:

• Stop – take a step back, do not react immediately or automatically
• Take a breath – notice your breathing, try to keep it regular
• Observe – what are you thinking and feeling, are these thoughts helpful, are they accurate?
• Pull back – put in some perspective, try to view the situation as an outsider would, what meaning are you giving the event and is it proportional?
• Practise what works – what will the consequences of your actions be, what is most helpful for you in this situation?

You can also:

• Walk away from the situation. If you are angry at someone, go away and calm down.
• Ask yourself why you are angry. Is it because of something now or something from the past? Is your anger justified? Is it in proportion?
• You may need to talk this over with another person to get a clearer sense of what is going on.
• If your anger is about now and is justified, think about how you will express it. This will vary depending on whether you are angry at a friend or a professional or an institution. But for all situations, practise what you want to say. Say it at a time that is convenient. Be clear about what you say and what you want. And listen to the other person’s point of view.
• Be prepared. If you know you are going to be in a situation that can trigger your anger, try to plan for this. Think about the kind of response you would like to make using the above steps. Take something with you that you find calming or reassuring. Think about something you can do afterwards to reward yourself if you think it has gone well.