Type A Behavior and Anger

imagesType A people are described as competitive, goal-oriented, productive, ambitious, leaders in the making who are in a hurry. They are competent and determined to be successful—and frequently are. The problem is that they are also likely to be hostile and angry.

The specific aspects of a Type A individual that continue to be related to heart disease are explosive reactions, competitiveness, impatience, irritability and hostility. Lumped together these traits equal anger.

It is the tendency to be angry and hostile that results in the Type A paradox: the anger that drove you to triumph over all obstacles to reach professional heights is the same behavior that puts you at risk for serious illness and death. Closer examination suggests that the crux of the matter is motivation. Type As seek excellence to prove their worth. Type B people, on the other hand, can also achieve personal success but do so because the process is enjoyable to them. Type Bs feel secure inside and do not need hostility or competition to succeed.

While discussions about adrenaline and noradrenaline—two of the stress hormones associated with the sympathetic nervous system (SNS); its opposite, the parasympathetic nervous system (PNS) is less frequently discussed. This is unfortunate since the parasympathetic nervous system is vital for survival. When activated the parasympathetic nervous system released a compound called acetylcholine to any tissues served. Once inside of a cell acetylcholine has the ability to neutralize adrenaline. Most organs involved in the fight or flight response receive input from both the sympathetic and parasympathetic nervous systems. The PNS can put the brakes on the fight or flight physiological changes. It cools us down and calms us. It puts the brakes on anger.

In a series of studies carried out in Japan it was discovered that Type A men, especially those with high hostility levels, have weaker parasympathetic nervous systems than men with low hostility levels. An effective PNS can help counter the effects of the SNS which results in the heart working less hard and lowering the risk for developing heart disease.

There is also research that indicates that the immune system may be weaker in hostile people. The immune system is thought to play an important role in helping keep us cancer free, especially in the action of “natural killer cells” which can kill tumor cells that form in the body. A study involving low and high hostility scoring med students indicated a reduction in the natural killer cells in the blood of high hostility students during high-stress exam periods.

In summary, hostile Type A people are wired differently. Their SNS is activated at the slightest provocation while nonhostile people’s SNS show relatively small responses to even strong stimuli. The end result is that hostile people spend more time under the influence of an aroused nervous system which can set the stage for the development of heart disease because of repeated exposure to elevated cardiac demands, increased mobilization of cholesterol into the blood, and increased clumping of platelets while the immune system functions are decreased. This difference in exposure may account for the increased death rates seen in aggressive Type A individuals.

Heart disease

If your immediate impulse when faced with having to wait in traffic or in a long line at the grocery checkout, or dealing with a recalcitrant computer is to start blaming people, and getting angry you are slowly killing yourself. Your anger has turned into hostility and you are at increased risk from death from many causes.

Research indicates that high hostility levels in older men are strongly related to the development of heart disease. Hostility appears to be a greater risk factor than high cholesterol levels, smoking, and being overweight. Furthermore the older men in this study with the highest levels of hostility were at the greatest risk of developing heart disease. This increase in risk appeared to be independent of insulin levels, body mass index, waist-to-hip ratio, triglyceride levels and blood pressure. In other words, being highly hostile appeared to be more closely related to the development of heart disease than the more commonly thought of risk factors and the higher the hostility level the greater the likelihood of developing heart disease.

Constant chronic feelings of anger, hostility and aggression raise the risk of developing arteriosclerosis and coronary heart disease as much as five times the normal rate. Suppressing anger is not a major contributor to heart disease; over-experiencing and over-expressing anger is the villain.


Research has indicated that anger causes high blood pressure in hostile people in much the way salt increases blood pressure in people who already have high blood pressure.

Anger is a poison for hostile people. In a research study that examined the effect of harassment on men trying to perform a mental test, ONLY highly hostile men showed increases in blood pressure and blood flow to the muscles. Men who scored low on the hostility scale did not demonstrate these physiological changes. The high hostility group also reported much higher levels of anger and irritation afterward than the less hostile men. In a second study the high hostility men were shown to also have a larger increase in stress hormones than the less hostile men. This closer connection between anger and physiological hyperactivity can be one of the explanations why hostile people have more health problems. Hostile people need to control their anger if they want to avoid increasing their risk for health problems.

Social costs of anger

It is no fun being around someone who is constantly angry. Hostile, angry people are not happy. Not only do hostilely angry people hurt their spouses but they also hurt their children. While they may not resort to physical violence, verbal abuse is common and extremely detrimental to the children. If nothing else anger can reduce the intimacy in personal relationships as your partner and other family members become more guarded in their interactions with you.

Hostile individuals also report more stress in the interpersonal aspects of work. They are less satisfied with their jobs and have a negative view of work relationships. In addition, an aggressive interpersonal style sabotages the goodwill of subordinates and lowers the probability of work goals being met. Colleagues begin to avoid the hostile employee resulting in the chronically angry individual feeling isolated.

Many hostile people blame everyone else for their social problems. This is unfortunate because lack of a social support system is one of the paths a hostile person can take to serious disease. Angry people frequently have cynical attitudes toward others and are unable to recognize or utilize support when it is available; especially if the offers for help are judged inferior because of their overly demanding expectations. When genuine attempts to help are shunned or ridiculed it only worsens the situation, pushing others further and further away.

Finally, angry people tend to drink, smoke and eat more than their less angry counterparts. Without a social network of people to dampen these tendencies the probability of serious health consequences seems inevitable.


Anger Can Be Poison

angerAnger is an emotion that is experienced by all people everywhere. Anger usually results from an emotional hurt. It is typically experienced as an unpleasant feeling that occurs when we feel injured, mistreated, or are opposed in long held views, or are faced with obstacles to attaining personal goals. Anger varies in its frequency, intensity, and duration. People also vary in how easily they get angry, their anger threshold, as well as with their comfort level with the emotion. Some people are always getting angry while others don’t even recognize that they feel angry. While some experts say that the average adult gets angry about once a day and annoyed or peeved around three times a day, those who work with people with anger management issues suggest that getting angry 15 times a day is average. In any case, anger is a common human emotional which we probably experience more often than we would like to admit.

It should be noted that anger can be constructive or destructive. When well managed, anger or annoyance has few detrimental health or interpersonal consequences; when mismanaged anger can be deadly. There is a difference in feeling angry and expressing your anger. To feel anger is to be human. The feeling contains information that can be of value. Expressing your anger inappropriately or prolonging the experience of anger can be dangerous. Not only can out of control anger damage personal relationships, it can lose you your job, land you in jail, damage your health or even kill you. For example, recent research suggests that men who have poor anger management skills are more likely to suffer a heart attack before age 55 than their more mild-mannered peers. A separate study involving 774 older white men (average age 60) indicated that high hostility levels were more predictive of developing coronary heart disease than risk factors like high cholesterol, alcohol intake, cigarette smoking. Older men with the highest levels of hostility were at the greatest risk for developing coronary heart disease independent of the effects of BMI (body mass index), waist-to-hip ratio, fasting blood-sugar levels, triglcyride levels, and blood pressure.

Anger can alienate friends, co-workers and family members. Your expressed anger elicits anger in others as a defense. Hostile, aggressive anger not only increases the risk for an early death but also the risk for social isolation, which is in itself a major risk factor for serious illness and death.

Anger is composed of the thoughts that trigger the emotion, the bodily arousal a person experiences, and whatever behaviors are exhibited, which are often culturally determined. The goal of anger is to protect or further our self-interests, or those of our loved ones, or uphold principles and causes we hold sacred. Instinctively anger often results in the desire to defend ourselves and strike back at its cause, often aggressively. Behind all anger is some form of pain, physical or emotional. It can start with not feeling well or feeling rejected, feeling threatened, or enduring a sense of loss. The type of pain does not matter; the point is that it is unpleasant and it makes you want to end the suffering. It is when these unpleasant feelings are associated with trigger thoughts that anger erupts. Trigger thoughts are assumptions, evaluations or your interpretation of situations that make you feel like you are being victimized or someone is deliberately trying to hurt you.

Many of our trigger thoughts have their roots in childhood. Often a person will overreact to a current situation because they learned earlier in life to be very angry when they experienced hurt, neglect or abuse. As an adult the person will have difficulty with situations and conflicts that threaten them with feeling unworthy, unloved or unsafe. Any time a situation “triggers” these old feelings of betrayal, the anger expressed will not only be about the current irritant but also about remnants of the pain felt before. When one of these old triggers is unleashed the degree of anger expressed is often excessive for the immediate aggravation. In addition if parental role models use anger to manipulate and control family members the children may learn destructive ways to manage anger. The children learn not only to be extremely angry because of the mistreatment they receive, but also how to express their anger in an inappropriately aggressive manner.