Tensions are high about many things right now in America, and health and safety concerns over the COVID-19 virus rank high among them, particularly in families. Many parents are fearful about in-person classes for their children; others are upset that classes will remain remote. Neighbors are irritated by those not abiding by the latest public health guidelines, and by those who are. Some workers can’t wait to return to their offices; others resent being forced to. No one wants to get sick or lose their job.

David H. Rosmarin has seen and heard it all. The assistant professor of psychology in Harvard Medical School’s Department of Psychiatry is a clinician at McLean Hospital. He runs the hospital’s Spirituality and Mental Health program and has observed rising levels of anger — and its expression in aggression and domestic abuse — in his practice. Rosmarin spoke with the Gazette about the pandemic-fueled ire afoot in America today and what counsel he would offer us all.

Q&A

David H. Rosmarin

GAZETTE: It doesn’t take heightened perception to see a lot of anger abroad in the country. There’s anger around masks; parents are angry; teachers are angry. There were protests against the shutdowns, then the George Floyd protests, and continued protests today. Let’s start with your observations. Do you agree that there seems to be more anger in the country and is it showing up in your practice?

ROSMARIN: There’s no question. Tension is heightened today, and anger is definitely part of that, maybe even an artifact of that. People are definitely exhibiting more anger. Incidents of domestic violence seem to be increasing, which is the most concerning. Personally, I was on a run the other day and somebody yelled at me for wearing a mask, in Boston. So, I looked into it, and they’re actually right. I’m running around a reservoir; I’m away from everybody. So the next day, I think, “Maybe I won’t wear my mask today.” Then I approached a lady, I’m 20 feet away, and I smiled at her and she angrily yelled, “Don’t smile at me. You’re not wearing a mask. You’re taking a chance with my life!” So you can’t win. That was the conclusion I came to.

GAZETTE: What are you seeing in your practice?

ROSMARIN: We’re definitely seeing tensions heightened in families: domestic violence, domestic abuse. There’s some indication of child mistreatment increasing. People are more on edge and one of the ways that they express that is through anger, which obviously is not healthy.

GAZETTE: I don’t know if being mad is officially a condition. Are there conditions that manifest as anger?

ROSMARIN: Anger actually does come up in the clinical literature. One is “intermittent explosive disorder”: repeated, sudden episodes of impulsive, angry, violent behavior. But that’s not a common diagnosis, and it’s not usually the kind of thing that people come in for. The other place you find it is in bipolar disorder. The most common presentation of bipolar is where people are hyper, high, excited, or elated. It’s not as common, but it does happen that the primary symptom of mania is being irate, angry — an out-of-control anger — starting fights with strangers, a level of anger that’s really disconnected from the reality of the situation.

GAZETTE: I read that both anxiety and depression can manifest as anger. Is that accurate?

ROSMARIN: Yes, very much so, and I don’t think that the clinical literature captures what’s going on here. One of the ways of thinking about anger — which I find helpful from a clinical standpoint — is to conceptualize it as a secondary emotion. Fear, anger, joy, and sadness are your four primary emotions, and secondary emotions occur as a reaction to our primary emotions, rather than to the situation. If I called you up and said, “Hey, I have a million-dollar check for you to come pick up,” you’ll have a joy reaction — and maybe some fear — but an automatic emotional reaction. But with anger, it is usually a secondary reaction. I feel sad or I feel anxious and I don’t like that feeling, so I get angry at the person.

Tensions are high about many things right now in America, and health and safety concerns over the COVID-19 virus rank high among them, particularly in families. Many parents are fearful about in-person classes for their children; others are upset that classes will remain remote. Neighbors are irritated by those not abiding by the latest public health guidelines, and by those who are. Some workers can’t wait to return to their offices; others resent being forced to. No one wants to get sick or lose their job.

David H. Rosmarin has seen and heard it all. The assistant professor of psychology in Harvard Medical School’s Department of Psychiatry is a clinician at McLean Hospital. He runs the hospital’s Spirituality and Mental Health program and has observed rising levels of anger — and its expression in aggression and domestic abuse — in his practice. Rosmarin spoke with the Gazette about the pandemic-fueled ire afoot in America today and what counsel he would offer us all.

Q&A

David H. Rosmarin

GAZETTE: It doesn’t take heightened perception to see a lot of anger abroad in the country. There’s anger around masks; parents are angry; teachers are angry. There were protests against the shutdowns, then the George Floyd protests, and continued protests today. Let’s start with your observations. Do you agree that there seems to be more anger in the country and is it showing up in your practice?

ROSMARIN: There’s no question. Tension is heightened today, and anger is definitely part of that, maybe even an artifact of that. People are definitely exhibiting more anger. Incidents of domestic violence seem to be increasing, which is the most concerning. Personally, I was on a run the other day and somebody yelled at me for wearing a mask, in Boston. So, I looked into it, and they’re actually right. I’m running around a reservoir; I’m away from everybody. So the next day, I think, “Maybe I won’t wear my mask today.” Then I approached a lady, I’m 20 feet away, and I smiled at her and she angrily yelled, “Don’t smile at me. You’re not wearing a mask. You’re taking a chance with my life!” So you can’t win. That was the conclusion I came to.

GAZETTE: What are you seeing in your practice?

ROSMARIN: We’re definitely seeing tensions heightened in families: domestic violence, domestic abuse. There’s some indication of child mistreatment increasing. People are more on edge and one of the ways that they express that is through anger, which obviously is not healthy.

GAZETTE: I don’t know if being mad is officially a condition. Are there conditions that manifest as anger?

ROSMARIN: Anger actually does come up in the clinical literature. One is “intermittent explosive disorder”: repeated, sudden episodes of impulsive, angry, violent behavior. But that’s not a common diagnosis, and it’s not usually the kind of thing that people come in for. The other place you find it is in bipolar disorder. The most common presentation of bipolar is where people are hyper, high, excited, or elated. It’s not as common, but it does happen that the primary symptom of mania is being irate, angry — an out-of-control anger — starting fights with strangers, a level of anger that’s really disconnected from the reality of the situation.

GAZETTE: I read that both anxiety and depression can manifest as anger. Is that accurate?

ROSMARIN: Yes, very much so, and I don’t think that the clinical literature captures what’s going on here. One of the ways of thinking about anger — which I find helpful from a clinical standpoint — is to conceptualize it as a secondary emotion. Fear, anger, joy, and sadness are your four primary emotions, and secondary emotions occur as a reaction to our primary emotions, rather than to the situation. If I called you up and said, “Hey, I have a million-dollar check for you to come pick up,” you’ll have a joy reaction — and maybe some fear — but an automatic emotional reaction. But with anger, it is usually a secondary reaction. I feel sad or I feel anxious and I don’t like that feeling, so I get angry at the person.