Road rage: a disease, or just really bad manners?

There you are, taking a leisurely mid-summer drive through Ocean City (let’s say, trying to make a left turn’anywhere), when suddenly’Road Rage! More than just another media catch phrase, road rage now describes the most recent ‘disease’ to be foisted upon us by some psychologists and psychiatrists. They have named their latest affliction ‘Intermittent Explosive Disorder’ (IED for short).

According to the National Institutes of Mental Health, IED might affect nearly 8 percent of the entire U.S. population. And though road rage isn’t the only form IED takes, it is the most easily identified. We’ve all experienced it—either within ourselves or in others. You’ve seen people hammer repeatedly on their horn, display the proverbial ‘finger,’ or shout insults at other drivers. Or (and this is the important part), you might have FELT like doing these things, but you had enough respect for yourself to not act on those feelings. It takes more than just getting really mad to be considered IED. According to the standard psychiatric diagnostic manual, an individual must have had three (count ’em, three) episodes of impulsive aggressiveness ‘grossly out of proportion to any precipitating psychosocial stressor,’ at any time in their life. The person must have ‘all of a sudden lost control and broke or smashed something worth more than a few dollars’hit or tried to hurt someone’or threatened to hit or hurt someone.’ Three times. Interesting.

Though some health professionals (and, I am sure, more than a few crafty lawyers) want to see uncontrolled anger as a symptom of a physical disease, could it possibly be something else? Like maybe a lack of self-control? For years now, we have heard about the need for ‘anger management,’ implying that people should take responsibility for managing their own anger. They might need help, of course, including, at times, professional help. But in the end, an overly irate person has to take responsibility for curbing his own anger, just as the alcoholic works to control his alcohol abuse or the compulsive gambler has to stay away from the casinos.Dr. Emil Coccaro, chairman of psychiatry at the University of Chicago’s medical school, begs to differ. “People think [IED is] bad behavior and that you just need an attitude adjustment, but what they don’t know … is that there’s a biology and cognitive science to this.” He cites a two-year National Institutes of Mental Health study that suggested that anywhere from 5 to 7 percent of Americans fit the diagnostic criteria of IED.

OK. So a lot of Americans are angry—really angry. But does this survey prove that it’s heredity, hormones or biology? Medical science and the field of psychology cannot answer that question. For people who struggle with anger, the solution is—like it or not—attitude adjustment. Using psychotherapy, or maybe just plain old common sense, people who struggle with anger have to learn to say to themselves: ‘I have a choice here. I can explode into rage. Or I can take a deep breath and try to think about it.’ The difference between an IED person and a normal person is that the IED person has to work harder at improving his attitude. It might not be fair, but the IED person really doesn’t have any other choice. There is no pill to make all the anger go away.

On the road, it’s normal and natural to feel a lack of control. Columnist Eric Peters, writing for America Online, suggests that human beings are not psychologically or biologically ‘wired’ for sitting in traffic. ‘We were not bred for this sort of abuse. We have not had time to evolve new mechanisms (such as an internal morphine release gland, let’s say) to cope with an environment our hunter-gatherer systems are completely ill-equipped to deal with.’

It’s an interesting theory. And, as it stands, probably true. But the question remains: How are we supposed to deal with feelings of rage—feelings that stem from a sense of being out of control—at least in the immediate moment?

People who cope reasonably well with traffic, for example, tell me things like: ‘I put on my favorite music, or a book on tape’ Or, ‘I give myself extra time.’ Or, ‘I simply accept what I can’t control.’ Sometimes they will plan necessary activities at less busy times, or even consider relocating. The implicit premise here is that there ARE solutions. We simply have to look for them. The fact that we cannot control situation X (traffic, for example) does not automatically mean that we still don’t have control over our reactions, our attitudes and our lives.

So, accepting what you cannot control, and getting to work on what you can control, marks the foundation of successful attitude adjustment. Those who cope better with anger and rage (evidently the majority, according to NIMH) have either successfully adjusted their attitudes and behaviors, or started out with better attitudes.

Labeling every distasteful trait and destructive pattern as a ‘disease’ opens up a Pandora’s box of needless medications, ridiculous legal defense strategies, and phony excuses for all sorts of behavior. We can avoid all this by ‘curing’ ourselves, using the power of independent thought, and accepting responsibility for our own actions.