Everyone gets angry. I've written previously about the psychology of grudges, aggression in kids, and other topics related to anger. Anger plays a large role in daily life, and sometimes it's uncontrollable. Before we delve into how to control anger, let's briefly talk about the origins of anger. 

Before anger, there was sadness

In my clinical experience, anger is almost always a secondary emotion. The primary emotion is the feeling of sadness or hurt. For some this may seem counter intuitive or flat-out wrong, but consider depression, especially in men. One of the criteria for a diagnosis of depression can be irritability. For kids, depression can be masked by acting out in an hostile or angry manner. The image of a depressed person is usually someone sitting alone and crying. However, depression can present in an aggressive manner, such as yelling or fighting. 

In my post, The Psychology of an Extremist, I lay out the idea that before we see the rage, there is a pattern of sadness (e.g., rejection, isolation, alienation, worthlessness). The same applies to moments of uncontrollable anger. 

How to understand your anger

Get to the real source of your anger. You might be wondering why I'm talking about sadness in a post about anger. There is a reason. In order to control your anger, you first have to figure out why you are angry. If your friend is late for dinner, are you angry that your friend is late or are you hurt that your friend doesn't value your time and that is what makes you angry?

Listen to your body. I wrote a general piece about how your body is constantly sending your mind feedback about your emotional state. For anger, reflect and be thoughtful about what is happening with your body when you are feeling angry. Are you shaking, sweating? Is your heart pounding, hands balled in a fist, jaw clenched?

Get in your head. Be aware of what you are thinking. Are you having thoughts of hurting someone, yourself? Are you fantasizing about yelling or other aggressive acts? When experiencing uncontrollable anger, you are probably experiencing thoughts that are out of your character. Along the lines of depression, it's common for angry feelings to turn into self-deprecating thoughts of inadequacy and worthlessness.

How to control your anger

In the next post, I'm going to write more about strategies to utilize to manage and control your anger. Some techniques will work for you while others will not. Like anything, you have to try something to determine if it is right for you.


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With my previous post about parenting teens, I certainly didn't want to give the notion that teenagers are a population that you have to approach with caution or tiptoe around. Whether it's kids, teens, adults, or parents, each of these groups have qualities and hallmarks unique to their group. With that in mind, I thought it would be helpful to give teens some tips on how to talk to their parents. 

Before the tips, let's consider where parents are developmentally. For the first 12 or so years, parents are used to being the confidant, chauffeur, bank, best friend, rule-maker, and many other things for their kids. As I mentioned in the previous post, the teenage years result in a significant shift not only for the teen, but also for the parents. Both parent and teen identities are changing. Part of the process of a new identity is confusion, uncertainty, and anxiety. This is a recipe for conflict. Here are some tips that might be helpful:

1. Trust your parents. If your parents have been loving and trusting thus far, keep trusting. This doesn't mean you have to agree with them, just listen to their perspective.
   
   
2. Manage your anxiety. Your life is rapidly changing. Puberty, peer pressure, social demands, etc. That's a lot of pressure, and sometimes stress can affect your relationships. Figure out if your feelings are truly about your parents or something else.
   
   
3. Ask your parents ahead of time. I know, sometimes things are spontaneous. Parents don't expect you to know Tuesday what your plans are for the weekend. However, be proactive, and give your parents enough time to make a decision.
   
   
4. Keep promises. If you promise to be home at a certain time or to take the trash out, then do it. When your parents see you following through on a promise, they'll give you more independence.
   
   
5. Humor your parents by talking to them. If you talk to your parents, even about superficial stuff, parents will ask less questions. If you are secretive, don't be surprised when you are interrogated.
   
   
6. Introduce your friends. The introduction doesn't have to be hours, even a short 5-10 minute conversation can work. Then when you say you are hanging out with so and so, your parents will feel better because they have actually met the person.
   
   Quick thought: If you don't want to introduce your friends, what does that mean about your friends?
   
   
7. Want more independence, act responsibly. No one expects you to be perfect, but be responsible. If you make a mistake, own it. If your parents trust you, then maintain that trust by doing the right thing.
   
   
8. Timing is everything. If you have a request, wait for the right time to ask. If you and your parents aren't on the best of terms in the moment, it's probably not the best time to ask for something.
   
   
9. Be honest. Parents always tell me what hurts the most is when their teens lie to them. Teens will counter with they have to lie because their parents will be mad. Sometimes parents should be mad, but when lying enters the game, trust leaves.
   
   
10. Ask for space. Life is hard, being a teen is harder. If you need space, ask for it. Let your parents know that you don't want to talk right now, but give them a specific time when you will talk to them.
    
    

Keep in mind these are general tips. Many teens and parents are probably reading this and thinking these tips aren't realistic. This is true in some cases, and that's why the next post is going to focus on when there is already conflict in the parent-teen dynamic.


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This post isn’t going to focus on the health, economic, and social risks of smoking cigarettes. It’s not going to focus on interventions like nicotine gum, the patch, or going "cold turkey". I want to talk about the psychology of smoking within the framework of Sigmund Freud’s developmental stages.

I won’t write in depth regarding Freud, mainly for the sake of brevity and because his theories are widely considered to be inefficient and inaccurate. However, there is merit to the oral phase of his developmental theory in relation to cigarette smoking.

Freud's oral phase occurs in the first year of life where the baby’s existence is largely centered on instant gratification. Babies are oral, whether it’s nursing, eating, tasting a new toy, biting, crying, babbling, etc. Freud posited that if you didn’t mature and develop healthily, you would be stuck in certain developmental stages and riddled with anxiety (read more about anxiety here).

So the oral phase of Freud’s developmental theory emphasizes the need for oral gratification at any cost. An underlying aspect of the oral phase is the inability to tolerate frustration or cope with stress. A baby in the oral phase doesn’t have the capacity to cope with frustration, anxiety, and emotions. All they know is get comfort orally (e.g., mother’s breast, pacifier, biting, eating).

For a baby, nursing on the mother’s breast is the greatest comfort. Healthy development is the progression of receiving comfort from the mother (e.g., nursing), to self-comfort (e.g., pacifier, thumb-sucking), and to more advance mechanisms (e.g., crying and soothing self, verbally expressing feelings, etc.). As you progress, you become more independent and psychologically strong.

With that in mind, it doesn’t take much imagination to understand the gratification received from smoking a cigarette. A smoker literally takes a puff and receives gratification. However, the gratification received is short-lived and, more importantly, unhealthy. I'm not comparing smokers to babies, but smoking is infantile within the context of Freud's theory.

Think about it, the vast majority of smokers use cigarettes when increased stress levels are combined with an inability to cope in a healthy manner. In these moments, gratification is a decrease in stress/anxiety/emotionality. For some, a cigarette provides that instantly. The same logic can be applied to overeaters, alcoholics, or any other population struggling with addiction.   

So if you want to stop smoking, it’s not about avoiding cigarettes. It’s about delaying instant gratification, recognizing the frustration of delayed gratification, finding effective coping strategies to manage frustration and anxiety, and then being consistent. When effective coping strategies are in place, you will get gratification in a healthy way.

If that sounds impossible, trying sucking your thumb instead of smoking that cigarette the next time you feel the urge. Just might work :)

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I don't know if there is a right way to die, but Jo went out in a great way. In this past year, I have met with a number of Knoxvillians who work with the child/adolescent population. Jo was as vibrant and energetic as any. That's quite the feat considering she was living with two, rare autoimmune disorders that impacted her physical health and daily life.

News of her death last month was a shock. I had just met with her weeks earlier and she was as energetic as ever. As details became known, it became very clear that Jo had a sense all along. She developed plans for her "work" kids to help them cope with her death. These preparations were made months in advance and were incredibly thoughtful. Imagine writing letters to those you care about, knowing the end is near, and still being as dedicated to living as ever. Incredible courage and vitality.

I thought, "Wow, Jo was making new friendships as she was dying." This certainly isn't a rare phenomenon, but it is phenomenal. It's an incredible life lesson: Live life for you, stay in the moment. That's exactly what Jo did, she faced death and kept going. She easily could have retired or isolated herself. She continued living life, for herself and those she cared about. She valued herself.

Jo was the poster child for living in the moment. She blocked out outside and internal distractions, and was able to enjoy the moment for what it was. She could have had a tasty dinner and wondered if this would be her last great meal. Instead she chose to enjoy the meal for what it was, a great meal.

To be honest, I was confused and upset as to why Jo didn't confide in me, I am a psychologist after all. In a way it was shameful and egotistical, but it's how I felt at the time. Then it hit me: it wasn't about me, it wasn't about her, it was about living. Jo didn't let death take control, she lived on her terms. Talking about life expectancies, cell counts, immune systems, would have taken away from her essence of living. She was a genuinely open person, she accepted her fate.

I'm not doing Jo justice, she was more remarkable than words can capture. However, I hope you gained a sense of her spirit and love for life and others. I hope when adversity presents itself and you are feeling hopeless, defeated, and overwhelmed that you find your way and thrive. Regardless of the situation, you can have some sense of control. You have options, just like Jo.

You will certainly be missed. Rest in peace, Jo.


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One billion dollars is spent every year on dieting. Billion. Think of what you could do with that type of money. Ok, I just lied. It’s not one billion, it’s 60 billion. Sixty billion dollars on dieting, books, dieting drugs, and surgeries.

Weight gain is a numbers game. If you consume more calories than you burn, you will gain weight. Weight gain is your body saying, “I have no idea what to do with these extra calories so I’m going to store it in this love handle.” Remember that previous post about your body constantly talking to you (read it here if you missed it)? The same concept applies to eating.

Diets give you a framework for how to lose and maintain weight. In the end, it doesn’t matter what diet fad you adhere to, what matters is you. What are you doing fundamentally to change the way you view your relationship with food? Why are the diets not working?

Be realistic. Have realistic goals. Don't set yourself up for failure. Instead of cutting out all unhealthy foods, start by removing one food from your diet. If you eat out for lunch 5 times a week, set a goal to eat out 4 times a week.

Slow down. Take your time when eating. The faster you eat, the more you eat. Your body hardly has time to send you the “I’m satisfied” signal before another bite. Remember when you were young and everyone said chew your food 20 times? Well, chew your food 20 times.

Be mindful. Don’t just eat. Notice the flavor, texture, and other features of what you are eating. Being mindful changes your eating experience and helps you determine when you are satisfied before you are stuffed.

Recognize if you are actually hungry. Many people eat because they are bored, stressed, upset, it’s the typical eating time, or the opportunity simply presents itself. Ask yourself, “Am I hungry or am I just eating to eat?”

It’s okay to make a mistake. No one is perfect. If you gain weight or “cheat” on your diet, it’s okay. Reflect on what happened and learn from it.

Drink water. Your body is 60% water. It needs water. Water flushes toxins, transports nutrients, and can speed up metabolism. Most professionals recommend 12 glasses of water for men and 9 for women (8oz glass).

Water is also an appetite suppressant. For babies, the more food they eat, the less milk they drink. The more milk a baby drinks, the less food they eat. So, the more water you drink (which you need anyway), the less food (and calories) you will consume.

Avoid temptations. Alcoholics are taught to stay away from places where alcohol is readily available. Stay away from snacks and foods that are your weakness. Don’t peruse the snack aisle at the grocery store, and keep certain foods out of your home.

Adhere to your guidelines and be patient. Give your dietary change a chance. Your body needs time to adjust. If you don’t see instant results, stay positive.

Support. Changing your food lifestyle is hard. If you need support, get it. Whether that means a support group, dieting partner, therapy, or whatever is helpful for you.

The statistics are there: 95% of folks regain the lost weight within 5 years. Over 100 million Americans are dieting. Diets are short-term and superficial. Instead, change how you think about food and eating at the core (no pun intended), and you can change your life.

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In a previous post titled "Letting Go",  I briefly commented on grudges within the process of moving on from relationships. You can read that post here. In this post, I want to say more about the idea of a grudge and how it may speak more about your coping and communication style than anything someone has done or said to you.

What is a grudge? A grudge is the resentment of another for a past harm. Psychologically, a grudge is what remains when an emotional injury hasn't healed properly or completely; essentially, an emotional wound or scar.

A few weeks ago, I wrote about how your body sends your mind signals when you are feeling specific emotions (to review that article, click here.). A grudge is your mind sending the following signal to your consciousness:

I continue to have thoughts about that person because of what happened, and because I still have unresolved feelings about the person and experience.

If you find yourself preoccupied with resentful feelings toward another person, you are holding a grudge. You have three options: continue to hold the grudge, address your feelings with the appropriate person, or decide to actively move on with your life. You could also do some sort of combination of the three.

Option #1: Hold on to the grudge. The benefit of this is you get to focus all your anger and resentment at this person inside of your head. The downside is chronic angry and resentful feelings puts your mental and physical health at risk. The other downside is you learn (or continue) to suppress your feelings, which will feed the cycle of being hurt and not advocating for yourself.

Option #2: Address your feelings. The purpose of sharing your feelings with the appropriate person (the perpertrator) is not to get that apology or for the person to grovel for forgiveness (though that would be nice), the purpose is to find your voice, to advocate for yourself. This value is sometimes lost in the process. Advocating for yourself is taking ownership of your life, it's saying that I can't control what other people do but I have power over my actions and how the actions of others affect me.

Option #3: Move on with your life. Many choose this option, but be careful. At face value, moving on and even learning from your experience sounds like a healthy, well-adjusted way to live. This option may very well work, but be aware that for some, continuing to be the "bigger person" may result in emotional and relationship issues later in life.

Why do some experiences result in grudges while others are resolved and released? That's a great question to reflect on. Is it simply because you have fully expressed your feelings and have complete understanding of the situation or are there other factors?

Many hold grudges because of the fear of what may happen if their true feelings of anger, sadness, and resentment are expressed. Expressing your feelings in a healthy way usually won't result in the catastrophic damage you imagine. It will result in a personal sense of accomplishment and mastery of one's environment.

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You might be confused by the title, especially if you are familiar with the terms “narcissist” or “narcissistic personality disorder”. These terms tend to carry a negative connotation and most imagine a narcissistic individual as self-centered, conceited, and even delusional in their own self-worth. Other characteristics of a narcissist can include lack of empathy, relational exploitation, and entitlement. With all this said, narcissism can be a good thing…as long as it is in moderation.

What is narcissism in moderation? Basically, taking the good narcissistic tendencies and rejecting the bad. Many psychologists refer to two types of narcissism: healthy and unhealthy. The fundamental difference between these two types is the person's sense of self. Unhealthy narcissists lack a stable, healthy self-esteem. To compensate for feelings of inadequacy, the unhealthy narcissist exaggerates self-worth and importance.

The healthy narcissist has a stable and sound self-esteem, so there is little need for grandiosity and power-grabbing. The healthy narcissist is still confident and ambitious, but these feelings are grounded in a realistic view of personal strengths and talents.

How do you cultivate healthy narcissism?

It comes back to moderation and hopefully it starts from an early age. You certainly want your children to be confident, ambitious, and successful. At the same time, kids should be kind, considerate, and thoughtful. Instead of teaching kids to “win at all costs”, the focus should be on giving a great effort. This doesn’t mean kids shouldn’t want to win, it means their self-esteem should include both the outcome and their effort. The same goes for academics. If your child tries their best, be happy with the effort regardless of the outcome.

As for adolescence into adulthood and beyond, reflect on your successes. Did you reach milestones on your own merit or through exploitation and deceit? Did you consider the feelings of others or only focus on what was important to you? There is no easy answer, but most people have a sense of whether their successes are their own, someone else's or a combination.  

What are everyday signs of unhealthy narcissism?

Unfortunately there are unhealthy narcissists everywhere. Here are a few signs that someone might be a narcissist:

Showing compassion for a friend, but taking pleasure at their failures/difficulties.

Someone who can't see their faults or take any responsibility for a mistake.

The inability to apologize; it's always the other person's fault.

Someone who only talks about themselves or takes your successes and makes them their own.

Taking someone's concern as criticism, and responding defensively and critically.

The inability to empathize; lacking the ability to see the world from a perspective different from their own.

These are just a few of the many types of interactions with unhealthy narcissists. For me, when I find myself wanting to roll my eyes during a conversation, that's a signal that someone might be a narcissist, the unhealthy type.

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Hey Salmaan, I wanted your opinion regarding conversion therapy considering you are in the field. Particularly because you are a Muslim, what's your opinion about conversion therapy and what role do your religious beliefs play in working with someone who is gay.

-- Anonymous, August 2013

I openly admit I do not have first-hand experience with conversion therapy, I have only heard stories from those who were willing and unwilling participants. The stories I have heard have been negative; however, I know there are positive stories out there.  I am not sure if a “conversion” to heterosexuality makes the therapy a success, or if the goal of conversion therapy is to manage homosexual desires in a heterosexual manner. It's certainly controversial, and therapy in general is usually a failure if the participant has been coerced into therapy.

In my professional work, when someone who is confused or struggling with their sexuality enters my office, I focus on the struggle and confusion. I never have and never will push someone to one orientation or another. That's me speaking as a psychologist and a Muslim. Maybe I'm doing my faith a disservice, but I don't think so. In my life and work, I believe it’s not my place to judge; my role is to increase understanding and awareness in your life.

Part of therapy with me is having a conversation about what would it be like to be straight and what it would be like to be gay. This allows for a genuine analysis of how the person feels and may bring clarity regarding their sexual orientation. If someone wants to talk about the role of their faith, that conversation is certainly explored. Many do struggle with balancing their religious beliefs and their orientation.

In my experience, people know their sexual orientation upon entering therapy. Therapy is usually more confirmation and supportive than analytical. A major part of the therapy is how to manage current relationships, especially family relationships. For many, the major stress is how to tell family, especially if the family is opposed to the lifestyle. The fear of being ostracized and disowned from their family is very real for many.

For those who have been adamant that homosexuality is a choice, I always say your political/religious affiliation is a choice, so spend the next 5 years genuinely being of a different political mindset or different religion. That might provide perspective into what it is like to pretend to be something that you are not. That’s my personal belief.

As usual, feel free to share this post via facebook, twitter, etc. Comments are welcomed!

Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN. If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville on facebook here or can follow me on Twitter here. Thanks for your support! 

In case you missed it, there was an entertaining dialogue between Tina Fey and David Letterman on his show the other night. You can watch the clip here.

To paraphrase, Fey pondered aloud whether her 2 year-old might be a sociopath because of a few incidents, including an end-of-bath-time choking episode. All of this was in a humorous way but it's an interesting observation.

Most are familiar with the term "sociopath", but for clarity I will highlight some characteristics of a sociopath. Sociopaths tend to lack remorse, shape their sense of morality for personal benefit, manipulate and exploit relationships, are intelligent, have violent tendencies (especially against the defenseless or weak), and can seemingly respond unemotionally to an emotionally-charged situation. 

I imagine your child has exhibited these traits at some time in their short lives. I hope so, because it is largely normal and part of the developmental process. Think about it, your toddler disturbs your sleep and functions on their schedule, your child might lie to get something or hurt someone's feelings without showing care/concern, and your teen may have behaved in a self-centered, selfish manner. These are all sociopathic behaviors, not traits, just behaviors.

So what can Tina Fey and other parents do to nurture these sociopaths into emotionally well-adjusted adults? 

Teach your child about emotions and relationships. When they act, help them understand why their friend (or you) felt happy, sad, or any emotion. There is a big difference between saying "Don't do that!" and explaining why something should (not) be done.

Explain to them why sometimes it's appropriate to say, "I'm sorry". Learning to apologize will help your child gain empathy and insight into other's thoughts and feelings. Apologizing is uncomfortable for some, so it's good to normalize the process.

Role play. With kids, simple is best. Any lecture on empathy, respect, or trust will probably be too overwhelming. If your child calls someone a name (e.g., stupid), you can ask your child how it would feel to be called stupid. The message can really sink in by acting out each role so your child can see what they are like and what it feels like to be the other.

Model appropriate behaviors and emotional expressions. A child's main reference for learning is their caregiver(s). Show your child how to express emotions appropriately and how to engage in healthy conversations. No one is perfect, so when you make a mistake or say something you shouldn't say, own it. This will teach your child that it's perfectly okay and normal to make mistakes.

If you are having trouble managing your emotions and relationships, find someone to help. It doesn't have to be a professional. It can be a family member, friend, or anyone who would be a positive, healthy person in your child's life.

It's important to always remember that kids make mistakes. With your guidance, your child will develop a sense of empathy and respect for others. It will take time and is a long-term project. I encourage you to work on empathy as early as reasonably possible, but know that their behavior won't consistently change until early to middle childhood (5-10 years of age).

As usual, feel free to share via facebook, twitter, etc. Comments are welcomed. If you are interested in being notified of future blog posts, you can “like” The Family Center of Knoxville page by clicking here.

Suicide is a mostly avoided topic, but there is a good chance you will be impacted by a suicide in your lifetime. More than likely, you will personally know someone or know of someone who has taken their life. Here are some sobering statistics (courtesy of the National Center of Health Statistics, 2010):

Suicide represents 1.6% of all deaths in America.

Suicide is the 2nd leading cause of death among teens.

Suicide ranks 10th in causes of death in America. Homicide is 16th.

Men are 4 times more likely to carry out a successful attempt than women.

Women attempt suicide 3 times as much as men.

There are approximately 1 million suicide attempts/year.

So what do you do if feeling suicidal? It’s important to know that as lonely and hopeless as you feel, many people from all walks of life have suicidal thoughts. Feeling suicidal is scary, but it’s not uncommon. Suicidal thoughts are the result of being overwhelmed with feelings of sadness and pain. You feel like you can’t cope and there is no other option. What’s important to know is with time and healthy choices, suicidal feelings can pass and you can regain control of your life. Here are some things that help if feeling suicidal:

Talk to someone.  Don’t keep suicidal feelings to yourself. Talk to someone. Feeling understood will decrease the loneliness and hopelessness.

Avoid drugs and alcohol.  Some feel that drugs and alcohol numb the pain; however, drugs and alcohol can actually exacerbate suicidal thoughts and feelings.

Make your home safe. If you have thoughts or a specific plan of how to hurt yourself, remove household items, weapons, and/or medications from your home. If you can’t, then go to a safe place or have someone remove the items for you.

Exercise and get outside.  Try to exercise for 30 minutes. Go for a walk outside. Even 10 minutes of activity can result in an improvement in mood.

Keep yourself busy.  Staying busy keeps you from thinking about suicide and keeps you productive. It also gives you time to gain perspective on your situation.

Focus on what keeps you from attempting suicide.  You are alive and that is for a reason. Focus on what keeps you alive (faith, family, friend, hobby, anything that helps).

You may be thinking that everyone will be better off, or even happier, if you aren't around. That is never the case. A suicide leaves a path of pain and sadness behind for those left to deal with the aftermath.

If you are feeling suicidal, there is always someone to talk to. In the U.S., you can call:

The National Suicide Prevention Lifeline at 1-800-273-TALK (8255)

The National Hopeline Network at 1-800-SUICIDE (1-800-784-2433)

Outside the U.S., you can search for a resource in your country by visiting the website below:

http://www.befrienders.org/directory

If you know of someone who is suicidal, you can call 911 or take the person to the nearest emergency room.


As usual, feel free to share this post via facebook, twitter, etc. Comments are welcomed!

Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN. If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville on facebook here or can follow me on Twitter here. Thanks for your support!