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Anxiety Disorders and Emotions: Anger, Guilt and Shame

The Role of Emotions in the Development of Anxiety Disorders and Depression

Anxiety Disorders and Anger, Guilt and Shame


"Holding onto anger is like drinking poison and expecting the other person to die."



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Most people who seek therapy do so because of feelings and emotions. Even if the main problem is one of incessant negative thinking, it's usually what we feel about the thoughts and our inability to control them that hurts.

How we feel about having anxiety disorders and depression, or any illness for that matter, can make things worse – feelings and emotions are paramount.


Dictionaries define emotions as strong feelings but they are more than this, they are a combination of feelings, thoughts and behaviours. Anger may involve feelings of tension in the chest, rapid heartbeat and increased blood pressure. We may think we want to kill someone and waive our arms around or stomp our feet. Conversely, in joy, we may feel warm inside, think how much we love someone and smile or laugh.

Emotions may consist of other emotions: passion can involve enthusiasm, optimism and hopefulness; jealousy may comprise hatred, anger and revenge. We all experience a great range and mixture of feelings and emotions all of the time, however, there are some feelings and emotions that seem particularly relevant to anxiety disorders and depression, namely: anger, guilt and shame.


We need anger to survive. It is the precursor to aggression and all of us may have to fight to protect our self or loved ones at some stage in our lives. Like anxiety, it is an energizer that readies us for action.

Anger can mask anxiety, for example: the first reaction of a mother on finding a child that has gone missing, is often to scold him or her; getting angry with them masks the fear of what might have happened. Similarly anxiety can mask anger. It is natural to get angry in conflict, to want to take some action and do something about it.

As children, we often see our parents getting angry in dealing with various situations and when they act angrily towards us we want to complain, get angry back and stop the conflict. But this isn't possible; we cannot fight a more powerful adult and anger towards a loved one is not acceptable because we love them and need them, so we suppress our anger.

'Angry' situations also make us scared and anger is associated with being afraid so we suppress it further. From small children to teenagers, severe parent-child conflict often ends in tears (for the child) as the suppressed anger comes out in the form of crying.

In households of family conflict or over-strictness, some parents are angry virtually all of the time. How many people with anxiety-related problems have had a childhood dominated by the angry man or woman?

Angry people get angry all the time. They know how to be angry so very well given the right situation (and isn't it strange just how often the right situation occurs for them?) Their voice, stance and what they say, demonstrate their anger impeccably.

Angry people usually want to tell others what to do and then criticise them for their shortcomings; their lack of inner peace is obvious. The anger shows on their faces and in their whole demeanour; family and friends tread carefully as not to upset them.

Regarding anger in families and particularly a parent's anger towards their children, we need to realise that although it may often be directed at us they are really angry with themselves and their lives. Regarding our own, suppressed anger, it shows in various things, such as: temper tantrums, petulance, sulking, boredom and verbal abuse as children, and sarcasm, gossip, violent behaviour and illness as adults.

Suppressed anger runs throughout many, if not all, anxiety and depression-related problems. People with OCD often express high levels of aggression towards family members or significant others, the release of bottled up emotions in PTSD frequently results in anger and in depression we often feel that even getting angry is hopeless. Indeed, getting angry can be a good defence against depression; angry people don't get depressed for they are always taking action (getting angry) to some degree.

It is not anger per se that's the problem; it is when it's not expressed or resolved that is. In (family) conflicts where the anger is not expressed or not resolved through conciliation, when there is no making up with apologies, hugs, acceptance and compromise – anger festers inside us.


Guilt is fear, about punishment and rejection. It involves feeling responsible for our actions and that our actions have broken the rules; rules generally laid down by our parents, grandparents, teachers, society, religion and so on. It is the regulator of the family and of society and without it many rules wouldn't be obeyed and society would break down.

Guilt involves anxiety, the apprehension about being found out and punished, and anxiety promotes guilt –"why am I anxious, what have I done?". Conflict in families often leads to children feeling that they are to blame and that if they were better in some way, perhaps the conflict would stop. Here, guilt seems to be a by-product of the situation, although it can still affect us throughout our lives and make us feel guilty for almost everything.

Some guilt, however, is thrust directly upon us. Parents often make their children feel guilty as a means of control. Phrases such as: "after all the sacrifices I've made for you" and "you have it so easy compared to my childhood" are frequently employed and can make children feel guilty for just existing.

At the extreme, in families where conflict goes hand in hand with high religious beliefs, it is not uncommon for children to be threatened with the wrath of God. Imagine being constantly under the threat of punishment from God! No wonder many children reared in such environments, feeling bad and fearing punishment from above, go on to develop compulsive rituals as the only means of allaying their anxiety.

It is relatively easy to assuage guilt; we can admit our wrong doing, ask forgiveness and make amends. The problem is that many of us carry guilt around without actually doing anything wrong ... it was just the way we were made to feel. Whereas anger can stay inside us because we are afraid to express it, some guilt stays with us because there is nothing to make amends for.

The effects of guilt can mirror those of anger and unresolved guilt cuts a stream through many anxiety disorders: the obsessive-compulsive feels guilty about often-normal thoughts, the bulimic feels guilty about food, and guilt, like anger, can be a defence against depression. In depression we feel helpless but at least with guilt we feel we have done something that has had some effect.


Whereas guilt is concerned with doing something wrong, shame is about feeling wrong as a person. With shame we feel bad about something about ourselves, it strikes at our very core and it can be nothing to do with our true qualities. The child from a poor background who dresses poorly is often ashamed of it and the overweight child is frequently ashamed of it, no matter how good a person they may actually be.

Shame is so powerful it can transcend death. In the fourth century B.C. in Greece and centuries later in Marseilles, suicide rates were so high that, in an effort to reduce the numbers, laws were passed decreeing that anyone who committed suicide would be dragged through the streets naked. Suicides rates dropped dramatically. It seems that people could not face the public humiliation and shame (even though they wouldn't be around to experience it).

Destructive criticism creates shame, as does being severely chastised and humiliated in public.

Shame is related to a perceived 'self-weakness' and if it is felt often enough and long enough it can set the foundation for the 'self-dislike' that underpins many anxiety and depression problems. And these problems, themselves, are often seen as a personal weakness and we are ashamed of having them.

Shame goes hand-in-hand with humiliation, two things that destroy people – humiliation and shame can be the greatest form of pain. Unlike guilt, where we can atone for our deeds, shame is not so easily healed. It cannot be expressed as such, only understood and changed.




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