Fire and Gun Fire:A Naturopathic and Academic Approach

to Anger in Young Men

Dr. Steve Rissman, Metro State University of Denver

Collaborative Family Healthcare Association 15th Annual ConferenceOctober 10-12, 2013 Broomfield, Colorado U.S.A.

Session #_____ Friday, October 11, 2013 or Saturday, October 12, 2013Session #A5b

Saturday, October 12, 2013

Fire and Gunfire:

A Naturopathic and Academic Approach to

Anger in Young Men, Briefly

Dr. Steve Rissman

• Naturopathic Doctor- Private Practice Specializing in Men/Boys Anger and Anxiety issues (NaturalHealthMen.com)

• Associate Professor- MSU Denver, Health Professions

Goal of Presentation

• Present social theories of young men’s anger in attempt to prevent troubled lives.

• Provide a naturopathic approach to working with anger in young men.

Angry Young Men

• Dzhokhar• Klebold, Harris• Lanza, McVeigh,

Loughner• James Eagan Holmes,

Seung-Hui Cho• Tip of the iceberg?

“How much more grievous are the consequences of anger than the causes of it.” - Marcus Aurelius

Why Are Young Men So Angry?

- STUDENT IN MY “ANGER IN MEN” CLASS

“No Anger? Know Anger!”

“MEN’S LIVES ARE VIOLENT BECAUSE THEIR SOULS HAVE BEEN VIOLATED”

James Hollis

“Under Saturn’s Shadow”

Imagine how you might feel if:

• You witnessed massive changes in the world and were extremely unclear about your role

• You were ridiculed for asking for help• You were told to act like a boy but lived isolated from

your father and other men• You could never measure up to what society tells you a

man is• You were desperately trying to hold tight to your honor

or some righteous belief• You were punished for expressing your perspective,

especially if you were angry

The End of Men?

• Hanna Rosins, Atlantic Monthly article, subsequent book.

• What if the modern, postindustrial economy is simply more congenial to women than to men?

• The postindustrial economy is indifferent to men’s size and strength. The attributes that are most valuable today—social intelligence, open communication, the ability to sit still and focus—are, at a minimum, not predominantly male.

• As thinking and communicating have come to eclipse physical strength and stamina as the keys to economic success, those societies that take advantage of the talents of all their adults, not just half of them, have pulled away from the rest.

“Guns and the Decline of the Young Man”By Christy Wampole

• From the civil rights and feminist movements of the 1960s and onward, young men – and young white men in particular – have increasingly been asked to yield what they’d believed was securely theirs. This underlying fact, compounded by the backdrop of violent entertainment and easy access to weapons, creates the conditions for thousands of young men to consider their future prospects and decide they would rather destroy than create.

• Can you imagine being in the shoes of the one who feels his power slipping away? Who can find nothing stable to believe in? Who feels himself becoming unnecessary? That powerlessness and fear ties a dark knot in his stomach. As this knot thickens, a centripetal hatred moves inward toward the self as a centrifugal hatred is cast outward at others: his parents, his girlfriend, his boss, his classmates, society, life.

Why Don’t Men Ask for Directions?

• Socialized message that men must conceal their vulnerabilities.

• “Young men and boys receive many contradictory messages about health while growing up. A health professional might encourage a young man to seek help when he needs it; yet research repeatedly shows that parents, other adults, and peers all discourage boys from seeking help-and ridicule and punish them when they do.”

– Courtenay WH. Constructions of masculinity and their influence on men's well-being: A theory of gender and health. Presented in partial fulfillment of the doctoral degree, University of California; June 26, 1996; Berkeley, CA.

• In 1998, William Pollack, prof of Harvard Medical School, wrote Real Boys, based on 20 years of work with boys. This book was one of the first to discuss some of the issues facing boys.– Boys are confused about what is expected of them;

they say they are fine, but are suffering silently; they are lonely

– Boys aren’t performing well in school, have fragile self-esteem, and many of them are depressed.

Real Boys: Rescuing our sons from the myths of boyhood

• Fathers have nearly tripled their time with children from 2.5 hours in 1965 to 7.3 hours per week in 2011, they're still more likely to feel they don't spend as much time as they want with the kids, compared to moms (46% vs. 23% for moms).

Fathering time

• The more time boys spend with other boys, the more stereotypical their behavior.

• Encouraged to control feelings

• Discouraged from controlling behavior

Social Dosage Effect

Can you relate?

EDWARD ABBEY

“In the modern technoindustrial culture, it is possible to proceed from infancy into senility without ever knowing manhood.”

Manhood: Hard Won , Easily lost

• Manhood is elusive, must be earned.

• Manhood status is tenuous and impermanent.

• Manhood is confirmed by others, requiring public demonstrations

• Hard won and easily lost: A review and synthesis of theory and research on precarious manhood. Vandello, Joseph A.; Bosson, Jennifer K. Psychology of Men & Masculinity, Vol 14(2), Apr 2013, 101-113.

Pema Chödron, Buddhist Nun

• Anger is an emotional response to a threat that creates an overwhelming feeling that

compels one to resolution.• If we examine the split second between the stimulating

event and the anger, there is usually a feeling that is too painful to experience, so one can’t stay there. Need to create a response of anger instead.– The reaction of anger causes further damage to the situation.– Her teaching on “learning to stay” teaches tolerance of pain

long enough to investigate. • It creates dilemma, often resulting in defensive posture

of righteousness. Being right strengthens our position and “justifies” our anger.

Waller Newell,“The Righteous Anger of Young Men”, The Globe and Mail, May 20, 2013

• “What if terrorism had little, if anything, to do with economic deprivation or lack of individual opportunity? What if it were rooted in the capacity of young men for righteous anger, harnessed in the service of what they fervently believe to be a divine mission to bring justice to the world?”

“Any thinking… that involves the word should is violence provoking.”

Marshall Rosenberg, The Surprising Purpose of Anger

• “Anger is the price we pay for being attached to a narrow view of being right, while the collective pain we cause others and ourselves bleeds our souls.”– Jon Kabat-Zinn

How Might Young Men Feel?

Anger is …

• Fiery/hot• Intense• Inflammatory

– Productive– Destructive

• Like all disease, a great teacher

How Angry is Your City?!

• http://www.menshealth.com/men/health/metrogrades/how-angry-is-your-city/article/9ca8a9f3340dc010VgnVCM10000013281eac

• Number 1- Orlando, Florida• Number 26/100- Denver, Colorado

– 95. Burlington, VT– 96. Portland, OR– 97. Corpus Christi, TX– 98. Fargo, ND– 99. Bangor, ME– 100. Manchester, NH

What to do?

• Homeopathic approach- “like to cure like”• Feel what young men might feel

• Find men who are willing to confront their own issues and create opportunities for young men to talk with and listen to other men.

See Me

• http://www.youtube.com/watch?v=z9CmEZEPYbI

Chinese Medicine, Liver and Anger

• According to Chinese medicine, the liver is responsible for the flow of qi. The classic diagnosis of an angry liver is “liver qi stagnation”; anger is a sign that the qi is not flowing smoothly.– Characterized by anger, moodiness, depression,

hard/bitterness, stiffness– Treated with: Acupuncture to specific points to move

the liver qi, herbs such as bupleurum which move the liver.

Bupleurum for Liver Qi Stagnation

• Title: Effects of Chai Hu (Radix Burpleuri) containing formulation on plasma β-endorphin, epinephrine and dopamine in patients.Chen JiaXu, Ji Bo, Lu ZhaoLin, Hu LiShengAmerican Journal of Chinese Medicine

• Chai Hu (Radix Burpleuri), a major ingredient in many traditional Chinese medicine formulas, such as Xiao Yan Wan, is used in the treatment of liver stagnation The objectives of this study were to examine the effects of Xiao Yao Wan containing Chai Hu on the changes of plasma indices in patients with LSSDS.

• This is the first evidence showing that the effect of Xiao Yao Wan on the treatment of patients with LSSDS may be through decreasing epinephrine and dopamine release, regulating nervous and endocrine systems and contributing to the improvement of the clinical status of patients with liver qi stagnation.

• A prospective study of 1055 men followed up for 32 to 48 years to examine the risk of premature and total cardiovascular disease (CVD) associated with anger responses to stress during early adult life.

• Highest level of anger was defined as a self-report of all 3 possible anger reactions to stress (expressed or concealed anger, gripe sessions, and irritability) on a checklist questionnaire administered in medical school. Premature disease was defined as events before age 55 years.

• High level of anger in response to stress in young men is associated with an increased risk of subsequent premature CVD, particularly myocardial infarction.

• Chang PP, Ford DE, Meoni LA, Wang N, Klag MJ. Anger in Young Men and Subsequent Premature Cardiovascular Disease: The Precursors Study. Arch Intern Med. 2002;162(8):901-906

Substance Role Further Info

Acetylcholine Cholinergic/excitatory mechan.

Muscaric receptors

Norepinephrine Variable results Subtypes mediate different effects

Dopamine Facilitates aggression D2 receptors in the ant. med. hypothal

Serotonin Suppresses rage Difference in 5HT 1A and 2 receptors

Opioids Mostly suppress Various subtypes

The Role of Neurochemicals in Impulsive Anger

Neurochemicals and Anger (cont.)

Substance Role Further Info

Substance P Facilitate aggression

Acts on neurokinin (NK) receptors

Cholecystokinin CCK-B receptors potentiate rage

Found in PAG, few studies

Glutamate Excitatory NMDA receptor

GABA Inhibitory Mediates hypothal

Alcohol Excites Defensive Rage

Inhibits Predatory

Herbs that affect GABA Awad, R., Levac, D., Cybulska, P.,

Merali, Z., Trudeau, V., & Arnason, J. (2007). Effects of traditionally used anxiolytic botanicals on enzymes of the γ-aminobutyric acid (GABA) system. Canadian Journal of Physiology & Pharmacology, 85(9), 933-942

Botanical Increases GAD Decreases GABA-T

Centella Yes- asiaticoside, low doses; high decreases

Melissa Yes- strongly

Valerian Yes- low doses

Piper meth Yes Yes

Scutellaria Yes

Hypericum Yes

Passiflora Yes

Matricaria No- inhibits

Humulus No- inhibits (beer?)

Nervines

• Herbs that act to soothe the nervous system, thereby decreasing anxiety and stress– Oatstraw– Lemon balm- 2009 study of luteolin not anxiolytic d/t

any effect on GABA receptors, may affect NMDA receptors; “Investigation of the Anxiolytic Effects of Luteolin, a Lemon Balm Flavonoid in the Male Sprague-Dawley Ra”,Rain, T, et.al, AANA Journal • February 2009 • Vol. 77, No. 1

– Lavender- some studies on the monoterpenoid linalool, showing anticonvulsant properties in glutamate-related seizure models and effects on NMDA receptor binding. K. Yamada, Y. Mimaki and Y. Sashida, Anticonvulsive effects of inhaling lavender oil vapour, Biol Pharm Bull 17 (2) (1994), pp. 359–360; E. Elisabetsky, L.F. Brum and D.O. Souza, Anticonvulsant properties of linalool in glutamate-related seizure models, Phytomedicine 6 (2) (1999), pp. 107–113

Nootropic Herbs

• Nootropics- first coined by Romanian Dr. Corneliu Giurgea, meaning “to bend the mind”

• Pharmacokinetics-– Increase supply of neurochemicals– Improve brain’s oxygen supply– Stimulate nerve growth in the brain

• Ginkgo, grape seed extract. • In a 2005 article in Phytomedicine by Russo and Borelli, the nootropic

effects of Bacopa were discussed. Likely increases 5HT in hippocampus and hypothalamus. Increases GABA. Anxiolytic. Cardiotonic

• Ashwaganda,Tulsi,Rhodiola (Japanese study shows neuroprotective effects of rhodiola extracts; also known to decrease the breakdown of serotonin); Vinpocetine

In Summary:How to Help an Angry Young Man

Manage the fire: 1. Know when to fuel it- allow the feelings, identify the frustration, and intensify by

talking with other young men2. Know when to cool it-say nothing, meditation to encourage parasympathetic

pathway; teach the practice of being uncomfortableCardio Protection:

Cool the liver:1. Herbs2. acupuncture

Get out of Orlando, move to Portland?

Look at neurochemistry:1. Herbs2. Supplements