By Kristie Tse, LMHC-D (NY License #009672)
If you or someone you know is in immediate danger, call 911. If you’re experiencing domestic or intimate partner violence, the National Domestic Violence Hotline is available 24/7 at 1-800-799-7233, or text START to 88788.
Violent behavior affects individuals, families, and communities, and it takes many forms: physical aggression, verbal abuse, destructive outbursts. People who struggle with aggression may be dealing with emotional dysregulation, unresolved trauma, or external stressors that build until they come out sideways. This behavior has real consequences, for the person acting out and for everyone around them, and it can damage relationships, deepen isolation, and contribute to real mental health struggles.
This article covers the common forms aggression takes, what actually drives it, and evidence-based approaches that help, while being clear that not everything covered here belongs in the same category, or gets addressed the same way.
A Note on Domestic and Sexual Violence
Domestic violence and sexual violence are not the same problem as difficulty managing anger, and they don’t respond to the same interventions. Domestic violence is rooted in power and control, not just poor emotional regulation, and anger management alone is not an appropriate response, clinical research has found it can leave victims at greater risk by teaching the person using violence to appear calmer while the underlying pattern continues.
If this describes your relationship, either as someone experiencing it or someone concerned they’re causing it, the right first step is the National Domestic Violence Hotline (1-800-799-7233, text START to 88788), not a general anger management article. For abusive behavior in intimate relationships more broadly, and for healing from sexual trauma specifically, we’ve covered both in more depth elsewhere.
The rest of this article focuses on aggression and difficulty managing anger, a different, more common problem that responds well to therapy
Understanding Violent Behavior
Aggression covers a range of actions that cause emotional or physical harm, and can be intentional or unintentional, driven by psychological, environmental, or neurological factors. Common patterns include:
- Physical aggression: hitting, pushing, or engaging in physical fights
- Verbal aggression: yelling, insulting, or threatening others
- Property destruction: breaking objects or venting frustration through destructive acts
- Emotional or psychological aggression: manipulating, humiliating, or controlling others through criticism, threats, or isolation
These behaviors often stem from frustration, unresolved emotional pain, impulsivity, or a genuine lack of coping tools understanding what’s actually driving it is the first step toward changing it.
What Contributes to Aggression
There’s no single cause. Aggression develops from a combination of biological, psychological, and environmental factors:
1. Difficulty with emotional regulation. People who struggle to regulate intense emotions are more prone to impulsive, aggressive reactions, this is distinct from having depression, anxiety, or PTSD. Research from APA and NAMI is consistent on this point: most people managing depression, anxiety, or PTSD are not more violent than the general population. The stronger predictors are substance use and specific patterns like intermittent explosive disorder or impulse control difficulties, not a mental health diagnosis on its own. If depression or anxiety is part of your picture, a therapist for depression can help address both the underlying condition and any related emotional regulation difficulty.
2. Autism and communication-related frustration. Some individuals with autism spectrum disorder experience what clinicians increasingly call “challenging behavior” rather than violent behavior, outbursts driven by sensory overload, difficulty communicating needs, or disruption to routine, not by a trait of violence. This is a meaningfully different clinical picture from interpersonal aggression between adults, and it responds to different tools: communication support, sensory accommodation, and structured routines, ideally through providers who specialize in autism-specific care. If ADHD or related attention/regulation challenges are part of what you’re navigating, our ADHD specialists can help; for autism-specific behavioral support, we’d point you toward a specialist in that area.
3. Trauma and childhood experiences. Adverse childhood experiences, neglect, abuse, exposure to violence in the home, increase the likelihood of aggression in adulthood. People who witnessed aggression early in life sometimes adopt similar patterns as a way of coping with stress, not because they’ve chosen to, but because it’s the model they learned. Dysfunctional family dynamics in particular can shape these patterns over years.
4. Substance use. Substance use impairs judgment, increases impulsivity, and is one of the more consistently identified predictors of aggression across the research. Addressing substance use directly, through addiction therapy, is often a necessary part of addressing aggression that co-occurs with it.
5. Environmental stressors. High-stress environments, financial pressure, or ongoing relationship conflict can all act as triggers. Building real coping strategies through stress management support helps people manage those pressures without the pressure finding its way out sideways.
The Impact on Mental Health and Relationships
Aggression carries real mental health costs, for the person struggling with it and for the people around them.
Increased anxiety and depression. People who struggle with aggression often experience guilt, shame, and social isolation afterward, which deepens existing anxiety or depression rather than relieving it.
Emotional dysregulation and impulsivity. Difficulty controlling emotional reactivity is often at the center of the problem. Dialectical Behavioral Therapy (DBT) is a well-established, evidence-based treatment specifically for improving emotional regulation and building healthier responses to distress.
Deterioration of relationships. Aggression erodes trust and creates fear, whether in family relationships, friendships, or romantic partnerships. Relationship therapy can help repair what’s been damaged once the underlying pattern is being addressed — though as noted above, this is different from couples work in the context of active domestic violence, which requires a different, safety-first approach.
Strategies for Managing Violent Behavior
1. Professional therapy. Cognitive Behavioral Therapy (CBT) and Rational Emotive Behavioral Therapy (REBT) help identify and change the thought patterns that fuel aggressive reactions, building real coping tools in their place.
2. Anger management skills. Techniques like deep breathing and mindfulness can help interrupt an escalation before it becomes an outburst. Anger management therapy offers structured support for building these skills — appropriate here specifically because we’re talking about individual emotional regulation, not power-and-control dynamics in a relationship.
3. Communication skills. A lot of aggression stems from frustration and misunderstanding rather than malice. Learning assertive communication and real conflict-resolution tools reduces the friction that tends to escalate.
4. Identifying triggers. Understanding what sets off a reaction, whether it’s a specific type of conflict, a stressor, or a physical state like exhaustion, makes it possible to intervene earlier and build emotional stability over time.
5. Medication and psychiatric support. For some people, medication is a necessary part of managing symptoms that contribute to aggression. A psychiatric consultation can help determine whether that’s appropriate alongside therapy.
Getting Support
Aggression can have lasting effects on mental health, relationships, and day-to-day life, but it’s genuinely addressable through self-awareness, the right kind of therapy, and consistent coping strategies. If what you’re navigating is difficulty with anger, impulsivity, or emotional regulation, we can help.
If what you’re navigating is domestic violence, in either direction, please start with the National Domestic Violence Hotline (1-800-799-7233, text START to 88788) rather than general anger management support, it’s built specifically for this, and getting the right kind of help first matters.
Book an appointment today to start working toward more stability and healthier relationships.
About the Author
Kristie Tse, LMHC-D (NY License #009672) is the founder of Uncover Mental Health Counseling, a virtual private pay practice in New York State. She specializes in attachment, relationships, anxiety, and identity with high-achieving adults, and has a particular focus on Asian American adults, LGBTQ+ individuals, and first-generation Americans. Her work has been featured in HuffPost, Verywell Mind, Well+Good, and Bustle.
