Redford Williams, M.D. is interviewed by Stephen Josephs, Ed.D., author of Dragons at Work.
This is the second half of an interview with Dr. Redford Williams, who has spent the better part of his career researching how the cardiovascular system is affected by emotions. His programs give people who are prone to anger and stress reactions practical, research-based advice about how to mitigate the effects of anger.
(For the first part of the interview click here. It explains what anger does to our bodies.)
SJ: What advice would you give to people who are under stress and react angrily?
RW: In our work with hostile personalities we have found a simple, effective system that really works. To illustrate, let’s go back to Dan in the driveway. When he saw the truck driver getting ready to pull out, he immediately thought: This guy is incompetent. This guy is not going to take my couch like he’s supposed to.
Dan’s getting angry, frustrated, and his system is producing all the flight or fight reactions I described in the first part of the interview. Instead of storming to the driver’s side and barking at the guy, it might be a good idea for him to decide whether this is a situation where he needs to do something or to chill out. Because when you’re feeling stress, when you get angry, sometimes your anger is a signal that you need to do something about a situation, because you or people you care about are being harmed. Rosa Parks would still be riding in the back of the bus if she had not done something about her anger.
On the other hand, a lot of times your anger is about something that you really can’t do anything about, or maybe it’s inappropriate anger; and so when you’re getting angry you need a way to decide: Is this Rosa Parks in the back of the bus time or is this a time when I need to chill out?
And the Williams LifeSkills program has a tool that people like Dan can use to decide whether the thoughts and feelings they’re having should lead to action or chill time.
People like Dan need to have a way of evaluating their thoughts and feelings in the light of the objective facts of the situation. And in the LifeSkills program we have people ask themselves four questions:
- Is this situation Important to me? Lots of times the things we’re getting upset over are trivial, like the little old lady who can’t find her credit card, and don’t merit our taking it any further. On the other hand, in Dan’s case, this probably is important. He wanted to get rid of that love seat. It’s taking up space and he had gone to a lot of trouble to get it out there, and so forth.
- Are the thoughts and feelings I’m having Appropriate to the objective facts of the situation? Would any reasonable person in this same situation be thinking and feeling what I’m feeling? If you get a no to this question, it’s time to chill out. But if you get a yes, you go to the next question.
- Is the situation Modifiable? If you’re not certain, ask yourself if it ought to be modifiable? Ought I be able to get this truck driver to take my love seat? And if so, when I consider myself, the driver and any others involved, I ask the next question…
- Is it WORTH IT to undertake the actions necessary to change the situation?
A “no” to any one of these questions means it’s time to chill out. You can chill out by just telling yourself Hey, this is not that important or Hey, it’s not appropriate because this guy has a perfectly good reason for not wanting to take the love seat. If I can’t stop him from leaving, it’s not modifiable. And if it’s not modifiable it isn’t worth it for me to get myself all riled up.
On the other hand, it is Important. It is Appropriate. Dan believed it was Modifiable, but when he got evidence to the contrary he should have chilled. A no to any of the four questions means it’s chill out time.
Four yes’s, and it’s time for Rosa Parks to move to the front of the bus. You need to do something. But four yes’s is not 007 with License to Kill time (which is the way Dan is reacting here). If he’d asked those questions and gotten the four yes’s, he would need to take effective action. And in this case, it would be assertion, which I’ll explain in a moment.
Now how do you remember these four questions when you’ve got enough adrenaline in your bloodstream to kill at least two rabbits, if you injected it into the rabbits? Important starts with the letter I; Appropriate, A; Modifiable, M; and we add “worth it”. I AM WORTH IT! You are worth taking the trouble to figure out whether this is a time to do something or a time to chill out. And the phrase I AM WORTH IT! reminds you to ask the four questions.
SJ: Wow, what a great system! I like how it interrupts emotional patterns, like Dan’s anger. Just asking those questions is a form of chilling all by itself.
RW: The I AM WORTH IT! tool is a really neat way of telling yourself Hey, wait a second. I am worth it. And it also recognizes that sometimes your anger is valid and that you do need to do something. This is where Assertion, not 007 aggression, comes in. Assertion has three steps: 1) describe the behavior that’s bothering you, 2) describe the feelings you’re having, and 3) ask for a specific change in behavior in the other person.
In addition to assertion, we also train people in relationship skills that prevent them from getting into these situations in the first place. While we don’t have time to describe that program here, people can find more information on our website.
We now have several randomized clinical trials that have evaluated effects of the Williams LifeSkills training program, published in peer-reviewed medical journals. The results of these trials have been very gratifying.
In one trial involving men who had coronary bypass surgery, the LifeSkills training brought their anger levels down. Also their depression levels went down. Their social support levels went up and their satisfaction with their life in general went up. In addition to that, their resting blood pressure and heart rate went down.
Before training, when participants were asked to recall a situation that made them angry, their blood pressure went up about 25 mm of mercury, which is a pretty hefty increase in systolic blood pressure. After the end of the LifeSkills training, those patients’ blood pressure only went up about 12 mm, and three months later, with no further training, it only went up around seven or eight mm.
SJ: Now, that is brilliant. Those are great results.
RW: In contrast, depression and anger levels increased among men in the control group, and their blood pressure still went up 24 mm at the end of the six-week training period and three months later it went up 28 mm.
This is cognitive behavioral training that has been shown to work using the gold standard test — the randomized clinical trial. We don’t know whether the heart patients in the study are going to have a lower mortality rate, because it wasn’t sufficiently large to be able to answer that question. And as I’m sitting here talking with you, we are planning a larger study that will include 2,000 to 3,000 patients to see if in addition to these physiological and psychological benefits, there is also a medical benefit – reduced risk of another heart attack or dying.
SJ: Dr. Williams, we’re at the end of our interview. It’s been a great pleasure talking with you. I’m glad your work is bringing so much benefit to people and that its effectiveness not only lasts post-training, but actually increases over time. And because the instruction is video-based, you can reach a lot of people.
RW: Thanks, Stephen, for the opportunity to share with your readers what I’ve learned from this research over the past 40 years.
Click here for information on the Williams LifeSkills Program.
And here to sign up for your chapters of Dragons at Work.
For the part one of the interview, click here.