April 21, 2000 -- He was a college freshman, a hothead who drove a pickup, very often on someone's bumper. He sometimes forced drivers off the side of the road. In his back seat was a baseball bat -- to defend himself, and to threaten those who angered him.
One night, a young girl did just that. She cut him off, trying to pass him on a mountain road.
"I jumped out of truck, had the baseball bat in my hand ? and then I realized how stupid it was," he later told his therapy group. "This woman was scared to death. She was shaking like a leaf. I threw the baseball bat back into the truck, then went back and talked to her."
"He changed from public menace to public helper," says the young man's therapist, Jerry Deffenbacher, PhD, a professor of psychology at Colorado State University. "He was still mad at the young woman for not passing safely and bumping his truck, but he calmed himself down. He told us, 'I realized I didn't have to behave this way.'"
So-called "high-anger drivers" like this young man are twice as likely to engage in risky behavior, like drinking and driving and driving without seatbelts, Deffenbacher says. They are also 1.4 times more likely to have accidents or speeding violations. But his research shows that relaxation therapy can help these drivers feel less angry and change their dangerous ways.
Deffenbacher's paper on hostile drivers appears in this month's issue of the Journal of Consulting Psychology. He has spent nearly two decades studying anger and road rage.
Road rage takes many forms, and not all are aggressive, Deffenbacher says. Sometimes, it can simply make life miserable.
One typical scenario involved a woman with a 45-minute commute in Denver. "She would get so mad on her way to work, it impacted her work environment for about an hour. She got angry on the way home and withdrew from her husband and kids, because she would be so tired and mad," Deffenbacher tells WebMD.
The result: "She had stomachaches, she had headaches. Her doctor said she needed to manage her anger better, that it was impacting her health. She said, 'I've got to get a handle on this, because it's impacting my health, and my family doesn't like me any more, either,'" he says.
Although one of the studies described in Deffenbacher's article explored the emotional, behavioral, and accident-risk characteristics of high-anger drivers, a second looked at treatments for the problem.
The studies included 57 college freshmen and sophomore students (23 men, 34 women) enrolled in introductory psychology classes at Colorado State. Each scored high on a driving-anger scale, Deffenbacher tells WebMD. "They had to personally identify their own driving anger as a personal problem they wanted counseling for."
The students were assigned to attend eight therapy sessions -- either relaxation or cognitive relaxation therapy, both common methods for treating anxiety, stress, and anger.
Relaxation therapy "works on the notion you can be really angry and really calm at the same time," says Deffenbacher. "A great number of people get all hot-headed, physically angry and charged up. But if they could calm down, they would think [the situation] through more calmly."
Each student was taught basic techniques of relaxation: tensing and releasing the muscles, and deep breathing. This was followed by sessions in which they visualized "road rage" situations while a therapist prompted them to control their reactions.
The cognitive-relaxation group got the same type of relaxation interventions along with work on anger-provoking thought processes.
"For example, let's say you cut me off in traffic," Deffenbacher says. "I'm thinking, 'Crazy [woman], she shouldn't be allowed on the road. This is awful, I'm going to run over her.' That's a very angering way to think about it. Instead, I could think, ''Wow, she almost hit me. Back off, Jerry; let her have her accident somewhere else. Just chill out and let her go down the road.'
"Those are two very different thought patterns, even though your behavior is identical in those examples," he tells WebMD. "We help people identify the thought patterns that take a bad situation and make it worse."
The study showed that the two types of interventions were nearly equally effective. "They don't make people absolutely anger-free but they do reduce the frequency and intensity of anger," Deffenbacher says.
People must want to change, or none of it will work, Deffenbacher says. He advises anyone who wants to change angry behaviors -- whether or not they are related to driving -- to check the yellow pages for therapists who deal with stress and anxiety issues. "In the mental health profession, anger has not been identified as a diagnosable condition," he says.
Deffenbacher, whose work is funded by the CDC and the National Institute on Drug Abuse, is now studying the effects of treatment on students who drink and drive angry.
The paper is very interesting but preliminary, says Richard Wetzel, PhD, professor of medical psychiatry and psychology at Washington University School of Medicine in St. Louis. He tells WebMD that in some respects, the studies are unrealistic. "These are not real patients; these are students from a psychology class ? people who are bright, they're willing to admit that have a problem, they have insight into it. ? They haven't been referred by the courts for treatment, which is very different."
"These [relaxation] therapies are helpful in that they make people feel like someone is dealing with them," Mitchell H. Messer, MA, LPC, who established the Anger Clinic in Chicago three decades ago, tells WebMD. However, Messer adds that "these are people whose anger issues have not been dealt with for 19 years."
"My bias is that they are not addressing the deeper underlying issues like they should," Messer says. "It's typical of anger management thinking in this country. ? It seems to be based on the premise that people get angry after they get in the car. Our finding is that they've been angry for [many] years. And that driving in the car reactivates and ignites angers of long standing that have not been identified or relieved."
Getting people to question their belief systems is critical to treating road rage, says William H. Mueller, PhD, professor of behavioral sciences at the School of Public Health at the University of Texas in Houston. He says relaxation training may not have this effect.
"You need to raise people's awareness about their thinking," he says. "What are the real consequences of a person grabbing my parking place? You need to get people thinking about the greater scheme of things."
- Drivers who are hostile are more likely to engage in risky behaviors, get into accidents, and have speeding violations.
- People who experience road rage can express it in many forms, from attacking other drivers to allowing anger to ruin their personal lives.
- Two types of anger management programs shown to be effective in reducing the intensity and frequency of anger while driving are relaxation therapy and cognitive relaxation therapy.