It’s no secret that many jail and prison inmates have problems with impulsive anger. To put it simply, they “snap” easily. They do not think about the consequences of their actions–they simply react quickly and violently to any situation in which they perceive even a slight threat to their egos or physical safety. Prisoners both with and without mental health histories have this problem.

While it’s true that the mentally ill often experience a reduction in anger problems when they are treated with psychiatric medications, Western society in general relies too much on medication to change behavior. One frequently overlooked but potentially helpful tool in reducing impulsive anger is exercise.

The New York Times recently published an article discussing whether exercise can moderate anger. The author discusses a recent study that was presented at the American College of Sports Medicine annual meeting. In the study, the investigators flashed a series of slides, many of which were disturbing and designed to incite angry feelings, in front of the participants. Electrical brain activity and numerical scores were used to measure their anger levels.

On alternate days, as the slides were again shown, some participants rode a stationary bike while others sat quietly. Those who exercised still became upset during the disturbing slides but by the end of the session their moods had returned to baseline. The moods of the non-exercisers, on the other hand, were still angry.

While there are hypotheses that anger is reduced by exercise via increases in brain serotonin, the exact mechanism(s) is not known.

I am not surprised at all by these results. Although usually we hear about the physical health benefits of exercise as well about it being used as an adjunctive treatment for depression, we usually do not hear about it being used to reduce anger.

However, I’m guessing that many of us have found through our personal experiences that we feel less stressed and frustrated during and after exercising. I’ve also seen numerous instances of angry inmates who have learned to cope better with significant frustration by working out regularly.

Imagine spending 6 solid months in a house with several close friends and relatives. Nobody would be allowed to leave. Even though you like each other, you’d probably get tired of each other’s annoying little habits. Everyone would likely become more irritable. By the end of the time, there likely would have been numerous arguments and frustrations. If you already had problems controlling your temper you might have “snapped” a few times. But this scenario isn’t as stressful as prison.

Now pick a large group of people you don’t know. All of them have criminal backgrounds. Some are 18 going on 14 and think life is a joke. Many of them have anger problems and will snap if provoked. You may be from different races, cultures, and socioeconomic backgrounds. You have nothing in common with some of them. Imagine living with them in close quarters for anywhere from 6 months to the rest of your life. That’s roughly what prison is like.

Now imagine that in the latter scenario you have the ability to exercise regularly. I’m not talking about doing push-ups in your cell; I’m talking about being able to run, participate in sports activities, and maybe lift weights. You have the opportunity to “burn off” a lot of your anger and improve your overall frustration tolerance.

What I’ve wondered is why correctional facilities everywhere do not promote exercise among inmates. If cost and security are truly major issues of concern in the industry, then why not focus more on prevention among inmates?

Promoting regular exercise might improve institutional security by reducing anger problems. It might promote a healthy competitiveness among inmates (sports instead of fighting). Problems such as obesity, hypertension, lipid abnormalities, heart disease, etc., could be reduced. Health care costs could therefore be reduced–fewer people would require medical care, and many people could be taken off medications.

What am I missing here? What are your thoughts about this?

Photo by OldOnliner

I’m a firm believer that both nature and nurture strongly influence a person’s character. Our genes may determine our character to some degree, but for most of us, our personality and values are further shaped as we are growing up by our life experiences and role models.

Photo by femaletrumpet02

Kids often idolize professional athletes. Being talented, physically fit, rich, and famous is appealing to many, but especially to impressionable young people.

Unfortunately, many professional athletes, especially given that they are so well-compensated and that children look up to them, behave in very disappointing ways. Temper tantrums and other acts of poor sportsmanship, domestic violence, and cheating are some of their behaviors that we see  far too often.

I worry about the message that such behaviors by such high-profile role models send to kids: Getting pissed, breaking things, hitting people, and using steroids are all okay.

Recently a Major League pitcher showed a great deal of class, integrity, good sportsmanship, and even forgiveness in a situation that many of us probably wouldn’t have handled so gracefully.

Armando Galarraga of the Detroit Tigers had nearly pitched a perfect game against the Cleveland Indians on June 3rd. (A perfect game is when a pitcher pitches an entire 9 innings and does not allow anyone on base–that is, no hits, walks, or hit batters.) It has only been achieved 20 times in the history of Major League Baseball.

On what should have been the last out of the game, the batter for the Indians hit the ball, the ball was thrown to first, and the umpire called the batter safe. The only problem was that that batter had clearly been out. It was fairly obvious to everyone else watching that he had been out, and the replay clearly showed the umpire had made a bad call.

The most significant part of this story is the pitcher’s reaction to the erroneous call. Galarraga did not get angry. He simply smiled in disappointment. He and his team celebrated what would have been a perfect game anyway. The umpire personally apologized to Galarraga. Galarraga forgave him and noted that everyone makes mistakes.

I’m sure there are some who negatively judge Galarraga for not getting angry. After all, righteous indignation on his part would be “justified,” right? But that’s the problem with anger–it’s an emotional cancer that poisons things for everyone, including the one who harbors such feelings.

I believe Galarraga deserves a special award for being the best role model for good sportsmanship among professional athletes for 2010. He epitomizes the type of role model that such athletes should be for kids. In fact, GM awarded him a 2010 Corvette convertible for his performance both on and off the field.

Watch for yourself:

What do you think?

How many times do we condemn or agree before hearing the other side of a story? How many times do we stand accused of not listening carefully? How many times do we misinterpret or misunderstand a gesture, a word, an intention? Why do we assume that we know so much about other people’s lives even though we clearly do not? And, even if we did, why do we think we know what’s best when it comes to how others should live their lives?

Through our cumulative experiences in life, the figurative spectacles through which we see the world become tainted. We, unlike small children, lose the ability to see all things as they are. Instead, we see things through our tainted lenses and think we know best.

I recently wrote about how I feel judged by others in my role as a correctional psychiatrist. Maybe I just think that being judged is a negative when in fact it’s a positive. It’s a constant reminder to me of how I do not like to be stereotyped or judged. Consequently I am less likely to judge others.

Like most other mortals, I slide back to being judgmental at times. I really don’t intend to do so. In fact, I really want to be completely nonjudgmental. It’s frustrating to keep trying to be a better person yet inevitably falling down.

That’s one interesting twist about practicing medicine in prisons. I have the opportunity to work with people who have behaved very badly. Some of my patients have committed the worst possible crimes against their fellow humans.

What I’m not proud of is that when I see the news stories just after these criminals are caught, I sometimes have the same visceral reactions about them that many other people do. I’m outraged, indignant, angry. How dare these bastards do such things to other people! In the moment, I really want them to pay for what they did!

Some would say that it is healthy or “realistic” to have such a reaction. While I agree that it would be unhealthy to be indifferent to violent crimes, there is a definite difference between, on the one hand, disapproving of the actions of criminals and wanting to see them brought to justice, and, on the other hand, allowing the fact that others have committed crimes to result in one exuding hatred toward others. Fighting hatred with hatred never works. As Gandhi said, “An eye for an eye makes the whole world blind.”

A selfish benefit of the work I do is that I am presented with endless opportunities to judge others. If I gave in to this temptation, I would not be able to provide good psychiatric care. I am therefore nearly forced to be nonjudgmental. I like being in this situation. It is like having a personal growth program built in to my weekly schedule!

I have worked hard at this, though, and once I am meeting one-on-one with a patient, (nearly) all judgment is gone. I focus on what I am there to do, and I see the patient as another human being in need of assistance. I am far from doing it perfectly, but regardless of the person’s past, I treat him respectfully and try to see him as he is in the present moment.

Ironically, by writing this post on being nonjudgmental, others will judge me. Without knowing me, they will jump to conclusions. I will let them. My ultimate goal is not to be better than anyone else but to be better than I used to be. I have a long way to go, but I don’t plan to give up. Judging another says nothing about the person being judged. It simply says that the one doing the judging has a need to judge others.

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