How can a therapist help a client safely externalize pent-up anger?
I think that might be the wrong question. “Letting it all out” doesn’t work and can be dangerous.
Doctor A explores Magnus’ deep-seated angers and encourages him to “let it all out, let it go, scream and beat that pillow until you’re worn out” or some quieter office-friendly equivalent. Because anger is a primitive, adaptive response that can save our lives by helping us fight danger at extreme levels, yelling and pounding and surviving can feel good for a short time. Until the next episode. And the next.
Doctor A also refers clients to “Destruction Therapy,” where clients are given baseball bats and objects to destroy.
Doctor B teaches rapid calming techniques in response to specific triggers, involving deep selective muscle relaxation, strategic breathing, and even practical self-hypnosis, until it’s thoroughly learned. At the very first hint of unwanted endocrine-mediated autonomic hyperarousal (anger), the client almost automatically engages the steps that will engage parasympathetic calming, soothing, and comfortable equilibrium.
Doctor A believes that escalation and “release” of status anger are good because Magnus briefly feels better and “not angry anymore.” (Until it builds again).