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Health

Do 'Rage Blackouts' Actually Exist?

Fury to the point of unconsciousness, after which your actions are no longer your 'own', is a controversial theory among mental health experts.

This article is part of That Feeling When—a partnership between VICE Australia and youth mental health initiative headspace.

"Anger is a normal emotion, and something that everyone experiences. But just because it’s normal, doesn’t make it easy to handle. For some, anger can become a problem and can affect a person’s daily life and relationships. Anger is commonly a problem when it spills over into aggression and impacts on others. It can also be a common sign of distress that may be masking sadness or depression.

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"It is important to remember that anger is manageable and there are steps that can be taken in order to help yourself, as well as seeking support from your GP or health services like headspace. Learning to be aware of anger and how to express it appropriately is an important part of good mental health. You can read more about anger on the headspace website, as well as find details for your nearest headspace centre."

Vikki Ryall
Head of Clinical Practice at headspace the National Youth Mental Health Foundation: www.headspace.org.au

Alicia* was seven when she first realised her anger wasn’t normal. “I was seeing a child psychiatrist for my rage,” she says, “and she gave me this worksheet.” On it were ten faces, the first placid and the last livid. One of them had flames. "The sheet was given to me as homework, and I was meant to fill it out and take it to my next psychologist appointment as an evaluation of my day. Instead," Alice says, "I ripped it up.”

She then “blacked out from rage,” regaining consciousness seconds later, or what felt like it. “I remember waking up and seeing my sister’s room absolutely trashed," she recalls. "I fucked with her desk and flipped her mattress. The angry faces from my therapy sheet were all over the floor. I felt like I’d lost track of reality.”

Some anger-management experts, like US-based psychotherapist and author Dr. Ron Potter-Efron, believe that the likes of Alicia are experiencing something called a “rage blackout”—defined by extreme, almost primitive anger, followed by unconsciousness. While the person experiencing rage is in the midst of this rage blackout, the theory goes, they are more or less a victim of their own disassociated state, just as those around them are subject to a visceral tirade of abuse, and sometimes physical violence too.

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According to Potter-Efron’s rage blackout rubric, these bouts of unconsciousness can last anywhere from seconds to hours, leaving the individual exhausted with no memory of their actions.

But while intermittent explosive disorder—characterised by “repeated, sudden episodes of impulsive, aggressive, violent behavior or angry verbal outbursts in which you react grossly out of proportion to the situation,” (the Mayo Clinic)—is generally accepted by experts, the concept of a “rage blackout” is by no means mainstream. Psychologist Grant Brecht, the Director of Insight Elite Performance Psychology and an anger management expert who specialises in young Australian male athletes, says that the very concept is risky and unfounded: “I think that the rage blackout is not a good term to use, psychologically,” he says. “It's a misnomer and does more danger than good—it makes people think they’re losing consciousness and blacking out, when they’re not.

“Some people get off on the fact that ‘I can’t help it, I’m a hothead,’ Brecht continues. “Ninety-nine percent of the time, however, that’s not the case. What they really ought to be saying is: ‘I’m not putting enough time and effort into controlling my emotions.’”

Like most mental health experts, Brecht believes that any spectrum of rage is primarily brought about by a lack of impulse control. “There’s a middle ground where we can acknowledge that we’ve got an anger problem and an impulse control problem, where we can shift some levers with our thinking, our behaviour, and our emotional reactions to things,” he says.

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If that angry person employs anger-management strategies—like slowing down their breathing, taking a time out, and so on; as well as altering how they view certain situations, for example through cognitive behavioural therapy (CBT)—they can re-engineer their reactions.

“It’s a lack of control of emotion,” says Brecht. “Unless we’ve got some real neurological brain damage, we can learn, if we want, to put in the time and effort to control that anger and that rage … Unfortunately, more and more people in our society are developing a victim mentality of blaming others, with too many people unwilling to take responsibility for their lack of socially acceptable behaviour.”

Potter-Efron begs to differ, however. He insists rage blackouts are real, and that understanding the syndrome will afford its sufferers more sympathy. “I think that there’s absolutely no reason why rage blackouts aren’t real,” he says. “We’ve studied this association. We know that traumatised people disassociate, and we know this is a form of disassociation under extreme threat.”

“[In a rage blackout], whatever comes out of their mouth is very primitive,” he adds. “There’s a lot of swear words and repeated statements, which are often at the top of their lungs. It’s to totally intimidate the other person, to destroy them, and the consciousness will return when the person is either exhausted or the threat to them is over.”

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Potter-Efron shares the story of one of his female clients. “She had a rage [blackout] that lasted half an hour. She couldn’t remember what she said or what she did. All she could remember about that rage was yelling, ‘Stay away from me!’” After she regained consciousness, he says, she slept for "a staggering 36 hours.”

“The most important thing initially, when you’re leading someone to describe this, is first of all to name it,” he says. “They need to understand that there’s a name for this condition, and that other people have it [too]. They need to make a strong commitment as they possibly can to deal with it, to lessen the disastrous consequences.”

Both Brecht and Potter-Efron do agree that if someone who suffers from severe anger management issues acknowledges they’re experiencing debilitating rage, to the point that they feel they can’t control it, simply being aware of the issue will help them spot the initial triggers. Despite differences in defining some of these experiences, they also agree that there several steps someone can take to better manage their anger. Interventions will include strategies to address the thoughts, feelings, and past experiences that underpin someone’s anger, as well as addressing behavioural responses to the experience of anger. People need to know that anger does not need to control them; that they can learn to control their anger. Seeking out more information and professional support, as well as developing a self care plan, are also important parts of the process.

Alicia agrees. She says that along with meditating every day, a savage workout routine, and "humanising the other person", she has finally managed to curb her rage blackouts at 24 years old. “I take a lot of deep breaths,” she says. “But more often than not I’ll leave a situation I’m in. If it’s making me mad I’ll just fuck off, because otherwise I’ll stay there and fester and I’ll get angrier and angrier. And that’s when I’ll say stuff I don’t want to say.”

To discuss how you're feeling in a confidential, open environment, or for info on any of the issues raised in this article, please get in touch with your local headspace office.