Last week, we explored the guilt phase of grief as part of The Psych Writer series. Thanks for sticking with me thus far, as we’re almost finished with grief, and it’s a difficult topic to face. But after this, there are only two more left in the series, so hang in with me.

So after guilt, the anger phase often follows. Keep in mind the codicil that you can pretty much repeat with me now: these phases are organized for the benefit of the clinician. They are not set in stone and the patient will likely not feel these things in order, or one at a time. They might, but they might not. Grief is individualized.

Now back to anger. The person who is experiencing the anger phase may lash out in a variety of ways. That will depend on the person, the source of loss, and their current circumstances. They get angry with a person for dying, they get angry with the doctors or medical team for “not doing enough” or making a mistake (whether there was a mistake or not doesn’t matter), or they get angry with people for tangential reasons.

While the anger is a natural reaction and completely expected, it is vital that the person doesn’t get stuck in this phase, and it’s probably one of the most addictive phases to get into. You may already know this, but emotions are handled by the amygdala in the brain, and judgment is handled by the prefrontal cortex, and the left prefrontal cortex can shut down emotions. (This is basic information for the sake of brevity: if you want to read more, about anger, check out this article.) When a person is angry, there are a number of hormones released, including adrenaline and noradrenaline. Because those are “pump you up” hormones to get the body ready for a fight, anger can be addictive. It’s like runner’s high without all the knee blowout from running.

Anger from the Patient’s POV
The patient is pissed off royally. How dare X happen? How could grandma do that to you? How dare she die at a time like this?! How dare Phyllis divorce you?! Who does she think she is? Those fucking doctors don’t know anything! They couldn’t save Uncle Phillip and they’re all just money-grubbing bastards. What were they thinking?

There is a touch of the indignant to this type of anger. Remember, the focus of the anger can be anywhere, even at themselves. Grief is necessarily selfish, so the anger is most likely due to the fact that this person has been left alone, holding the bag as they say. There are underlying feelings that are feeding this phase.

Anger from the Therapist’s POV
As the therapist, it is your job to dig with the patient and find out which feelings are feeding the beast. Sometimes it’s fear. Fear of being alone. Fear of loss. Fear of mortality. Sometimes it’s feelings of helplessness. They were abandoned. They lost their sense of control. Or all of the above, plus ones you can’t fathom at the moment.

All of these feelings, and more, are normal and expected. When someone dies, and the patient is angry, it’s important to let them explore those feelings in a safe environment.

Here, you monitor for homicidal ideation even more (although you always monitor for suicidal as well, homicidal should not be forgotten) than before, because people who are angry may not be able to switch on the prefrontal cortex’s ability to stop them from doing something that could ruin even more lives.

Other things you have to watch for is increased substance abuse and self-harm.

What this Means for You, the Writer
This is the perfect opportunity to get your character set up for starting their revenge against whomever caused their loss. It can also be a good opportunity to write about their anger turned inward, and how they fell into a pit of depression, struggled with addiction, or committed acts of self-harm.

If you’re writing an unethical therapist, keeping the patient in this phase can help them orchestrate a murder, create chaos, or other unsavory ends via unsavory means.

Remember, it’s not the grief itself that’s interesting, it’s how the character faces it, doesn’t face it, or makes matters worse that is interesting to the reader.

If you came here looking for psychological assistance, please contact your local crisis line. Dial 2-1-1 in the US for the United Way, or contact the Samaritans in the UK. For a list of international crisis lines, click here.

Good luck, and get writing.

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Just two more to go and then we’ll move on to other mental health topics. You’re almost at the end of the grief series, can you believe it? If you’re in need of some lighthearted diversions, check out my Facebook and Twitter. Or for some entertaining fiction that touches on grief and loss, grab a copy of Exit 1042.