Suppressed Anger and Chronic Pain

In the previous piece I described how FEAR and PANIC/GRIEF are two of the more common generators of persistent pain. This piece covers a third protective system that is often more difficult for people to see in themselves, often because many of us have been trained from a young age to channel this system indirectly, often through suppression.

Panksepp called it RAGE.

I’ll say more about what he meant in a moment. But it’s worth naming, at the outset, that the word carries a great deal of cultural weight. For many people, the word “rage” calls up images of someone out of control — a parent who scared them, a stranger on the road, a public figure they find contemptible. It is easy to hear the word and think “That’s not me.”

Even Panksepp described how rage is a distinctly unpleasant experience. It is often so unpleasant that we learn ways to avoid the feeling — intellectualization, distraction, displacement — all forms of suppression.

But with RAGE Panksepp was pointing to a fundamental protective system in the mammalian brain that responds when a creature is blocked, thwarted, cornered, or forced to accept something that isn’t acceptable. In its healthy form, it produces resistance. It says “no.” It stops an intrusion. It sets a boundary. It fights for what matters.

This system is not a moral failing. It is protection.

Why we don’t often see it in ourselves

Many people arrive in adulthood having suppressed this system so thoroughly that they no longer have felt access to it. They may know they were angry once — as children, perhaps, or as teenagers — but the anger doesn’t seem to be there anymore. What is there instead is a quality of accommodation. Working hard to keep the peace. Being agreeable. Finding the reasonable interpretation of someone else’s behaviour. Blaming themselves before others.

There are many reasons the RAGE system gets suppressed. A parent who reacted to anger with anger of their own, or with withdrawal. A family that treated the expression of anger as a failure of character. A culture that valued harmony and treated resistance as ingratitude. A period in childhood when expressing anger was actually dangerous. A message, absorbed early, that good children don’t get angry, and that being good is the way to remain loved.

For a child, this suppression was intelligent. If expressing anger would have cost the child something they needed, like a parent’s presence, a family’s stability or physical safety, then learning not to express it was a reasonable adaptation. The problem is that the RAGE system doesn’t stop firing just because it stops being expressed. Suppression means it just goes underground.

What suppressed RAGE looks like

After going underground, RAGE can become embodied in felt sensations and actions rather than directly felt as anger.

In the body: jaw tension, gritting teeth, clenching. Muscular bracing. Headaches that arrive around certain people or situations. Digestive symptoms. A subtle constant readiness in the body that never quite settles. Chronic pain conditions that don’t respond to the usual reassurances of safety.

In action: finding it very hard to say no. Accommodating people whose behaviour warrants a different response. Realizing, sometimes hours or days later, that you were angry about something but didn’t recognize it in the moment. Saying “I’m fine, it doesn’t matter” when it wasn’t fine and it did matter. A pattern of collapsing or going quiet in situations that would call for someone else to push back. A tendency to turn anger inward and blame yourself for something someone else did to you, or for something you had no control over.

In felt experience: a low-grade tension that doesn’t have a name. Sometimes a sense of being small or invisible around certain people. Sometimes an unaccountable exhaustion after seeing certain people or leaving certain contexts. Sometimes a quality of numbness that is puzzling to yourself.

For many clients I work with, the RAGE system has been running quietly, in the background, for decades — producing somatic symptoms and behavioural patterns without ever surfacing as recognizable anger. When the pattern is finally seen, the recognition is often accompanied by a mixture of relief and grief. Relief that there is a name for what has been happening. Grief for how long it has been going on.

An account of finding it in myself

Some years ago, I used the Pennebaker method in relation to someone from my past. I had never really let my feelings toward this person fully express. There had been reasons, at the time, for keeping quiet. There always are.

When I sat down to write, I could feel a specific sensation in my stomach — a prickly, bubbly quality that I had come to associate with centres of chronic pain I had lived with for twenty-five years. I started writing about the situation. My mind moved through a variety of things: the people I had cared for, what had been done, what I had felt at the time. As I kept writing, following Pennebaker’s suggestion to free-associate without bringing in an editor to make the writing “clean,” I began to access an intensity of anger I had not felt before.

What surprised me was that I was able to give it room. The images that came were violent in a way I had not expected of myself. I had always self-identified as someone who was more passive than physically expressive. As a child I had learned to suppress anger toward others, and to channel what came up into sports or to turn it back toward myself. I discovered that when the anger was allowed to go to the extreme — placed safely on the page, in imagination, without harming anyone in the world — something shifted.

The shift, when it came, was not what I would have predicted. As the anger completed itself moving through the person I was angry at, my attention turned toward my younger self. Not with judgment. With something like tenderness. He had been growing into a man. He had been facing things that were beyond his capacity. What he had needed, at the time, was a friend who truly cared — someone he could sit with and feel that there was a love present far greater than the suffering he was feeling. Images of my own childhood surfaced. Fond remembrance of people who had been helpful along the way. And a conclusion I had not been trying to reach emerged: it may sound strange, but I no longer needed to feel obligation, either to hate the person who had been harmful or to feel compassion toward him. The rage had passed through him completely and there was nothing left to process. The anger had completed.

I only did two of Pennebaker’s four writing sessions. I may return to the practice, but at the time I had gotten what I needed: closure on something that had been present in the pre-conscious emotional networks for a very long time.

The pain I had been living with did not disappear immediately. But over the following months, working with pain reprocessing therapy, I noticed a loosening of tension in the common places where I had been holding things. When I tried, on occasion, to turn the anger back up — to see whether it was still there — there was nothing to find. It had completed.

The effect on my everyday life was harder to name at first. What I noticed, over time, was more space in my nervous system to handle ordinary things. More patience with my own family. More capacity to be present with two small children in the middle of a demanding period of life. It felt as though something that had been quietly consuming a portion of my nervous system’s bandwidth had stopped consuming it.

What the practice does

Pennebaker’s method is not the only way to work with suppressed RAGE. It is one method, and it is not right for every person or every situation. But it illustrates something true about how the system works.

Suppressed RAGE does need to be expressed in a way that feels contained and safe: where there is a built-in reassurance that the expression will not harm anyone. The act of writing — placing feelings on a page — acts as just such a container. And importantly, the free-association of Pennebaker’s method helps unlock the RAGE circuitry that functions at a primary processing level of awareness — at a pre-conscious level. The method helps unlock this emotional material and give it the freedom to release in a safe way.

For some people, a full release happens in writing. For some, it happens through targeting processes in therapy where RAGE is given a chance to express fully. The specific method matters less than that the RAGE has somewhere to go, to complete without harming anyone.

What does not work is more suppression, like generalized venting where anger is expressed diffusely with hesitation, repeatedly, and thus suppressed. Effective work with suppressed RAGE is targeted, contained, and allowed to reach its own conclusion.

Where this leaves us

If you have recognized yourself in this piece — if you have noticed the somatic and behavioural signs of a RAGE system that has been running quietly underneath — that recognition is an opening.

The work of recovery, when RAGE is part of the picture, is to give the system a way to complete what has been left unfinished. When that happens, the RAGE system stops running. It allows the nervous system to shift out of protection mode and cultivates ground for the body to settle. The fire that has been quietly consuming the nervous system for a long time can burn cleanly and open fresh pathways of connection to the important activities and relationships in life.