Is Frequent Rage a Personality Disorder?

This is Sean, a family man with a lot going for him.

[BABY CRYING]

Hey, hey, what's this?

He's got a good job, a loving partner, and a baby son, with another child on the way.

[LAUGHTER]

But Sean risks losing it all because of one particular aspect of his personality.

[LAUGHTER]

Sean has agreed to have a camera rigged in his car to capture his problem.

I can lose it very easy in certain situations. I can get very angry in a very short space of time.

Oh, [BLEEP] move yourself.

To the point of ultimately losing control.

[BLEEP] sake.

Aw, [BLEEP]. Yeah, your side of the road, dimwit.

Come on, move your [BLEEP]!

[BLEEP].

The blood's pumping round me, and I've got so much adrenaline and so much anger.

You [BLEEP].

My body takes over and the brain just takes a 10-second blank.

[BLEEP]. [BLEEP]. Don't indicate [BLEEP] light on, will you, you [BLEEP]?

I will shout, scream, holler, all of these things straight away. But then after that, I'll be angry for a couple of hours. And then after that, I'll be ashamed.

He knows that he does it. And afterwards, he hates himself for it, especially if he gets short-tempered with Sam.

Do you want your nana? Do you want some nana?

I want him-- when he's old enough to understand, I don't want him to think that Daddy shouts all the time. He just can't stop and think before he acts.

[LAUGHTER]

Come here.

[BABY TALKING]

What you doing?

I've got too much to lose. I could lose Ange. I could lose Samuel. I could lose all of those if I don't change.

Sean knows that to keep his family together, the rages have to stop. So he's going to try a new approach.

We're talking about how we express our emotions about being angry. And over here are the two extremes, the nice side, and over here--

The idea behind the therapy is ambitious. It will try to change the way Sean's mind works by altering the structure of his brain.

So what sort of-- what's your trigger? What do you actually do?

Shout, scream. Adrenaline pumps. For about five to ten seconds, my brain doesn't know what's going on.

Yeah. And what about-- do you ever hit things? Like kick a car, or hit a wall?

I headbutted the front door and put my head through the window.

In a sense, there's parts of your brain that are fighting with each other. The conscious, aware-- actually, I know how I want to feel and behave, and the habitual part of the brain that's just used to snap reactions.

It's all about giving Sean's frontal lobes a chance to overrule his raging amygdala.

Going on out there. One of the things that I talk about a lot is buying time. So sometimes when you don't have the words right at the right moment, get yourself out of the picture. I left something in my van. I'll be right back. Anything that gets you out of that immediate confrontation. But if you begin to work those in and practice those things, even when it doesn't matter, you'll be able to do them when it does.

Right.

A week has passed since his first anger management session. Sean has been battling to keep his impulses in check.

Monday and Tuesday, brilliant. Brilliant. Really, really good.

Thank you, sir. Bye-bye.

Wednesday was a little bit stressful with Samuel,l and I was still a little bit moody by the time I got to work.

One, two, three. Oh, you [BLEEP].

I had such a crap end of the week that it worried me.

Oh, [BLEEP], you [BLEEP]!

I was totally ashamed of my behavior.

What's the matter with you, you think [BLEEP]?

Totally ashamed. Totally ashamed.

Personally, I've seen no change in him whatsoever since the first session. When he came home Sunday, he was full of ideas, he was full of talking about what had happened in the sessions and how he could think about it and change. And I really think that he wanted to try. But now we've been through the week, I think he can go back for his second session and hopefully talk about what's happened, and we'll see some improvement next week, I think. Fingers crossed.

My head hurts. I feel my head, all the way across there. It's just like it wants to explode, and just everything come out.

A battle still rages in Sean's brain, and he's desperately trying to put what he's learned in therapy into practice.

Notice what you do, even if you can't control it. Give yourself ticks. Acknowledge yourself for doing something well. It just keeps reinforcing the confidence that you're actually an OK guy.

But Sean's journey is only just beginning.

[BABY CRYING]

Sean has completed his intensive course of anger management therapy, and we're going to find out if he's got what he wanted-- a balanced personality he's in control of.

OK, Sunday morning. I've got this stupid thing on here. Stupid heart rate monitor thing. What we're going to do is we're going to go out for a little drive, see what happens, and see if anything happens with my heart.

[MONITOR BEEPING STEADILY]

Sean's heart rate it is a good indication of the level of stress he's under.

73.

And how active the amygdala is being, the part of his brain involved in triggering anger.

[MONITOR BEEPING FASTER]

[INAUDIBLE] sign for this roundabout, big roundabout. [INAUDIBLE]. I don't know why. I've done it so many times, and now it's going up.

If his heart rate increases but he shows no outward signs of anger, the frontal lobes of his brain are in control, and the therapy has worked. The ultimate test is if he can avoid feeling angry on a route he hates taking.

To be honest, I don't feel any stress at all today. I don't feel stressed. I feel very relaxed. Fell very calm. Feel very happy.

[MONITOR BEEPING STEADILY]

So far, he's doing very well. But something's about to happen that just 10 weeks ago would have sent him into a rage.

[MONITOR BEEPING FASTER]

Being overtaken by Alan Partridge. I don't believe it. [LAUGHS] He's cutting me up. Alan-- I've been cut up by Alan Partridge. [LAUGHS]

Sean has passed the test. His brain really does seem to have changed. It's now a month since Sean's course of therapy finished. What effect has it had on his relationship with his family?

I think I've changed in quite a few ways to, be honest. More relaxed, more calm. You know, instead of just shouting and ranting and raving, I'm thinking more. And especially at home, as well, with Ange. If I'm seeing a problem arise, I'm trying to deal with Ange as well. So trying to be much more in control. And I feel I am much more in control.

He seems a lot more calmer about just life in general at the moment. A situation would happen, and he just tends to be much more chilled out about it all.

I think it'll be the beginning of a better relationship, I think. I mean, we've had a fairly good relationship the last four years, and we've done a lot of things. And a lot of things have changed in our life, with obviously Samuel and the other one, the next one coming along. But it is sort of a beginning for us. So yeah.

It's come at a good time for us as well, hasn't it?

Yeah. Yeah. I think we need to just carry on, keep trying together. So I think that should be-- that'll be the hard part, but I think we can do it.