Deborah Cox comes from a small, conservative town in the South. Growing up, she sensed that many women of her parents' generation were "infinitely furious," stockpiling their grievances like canned vegetables. It was, she felt, a simmering frustration born of and sustained by the women's lack of influence in their community. As long as the women remained silent about the cause of their anger, they failed to take action on their own behalf.
Later, Cox fled the South and the local women's normative tradition of silent suffering. (Hers is not the personality of someone mired in hidden rage.) But she continues to be an ardent observer of human behavior and social mores.
Now a psychologist at Southwest Missouri State University, Cox recently conducted a study of 203 women in an effort to get to the bottom of that enduring mystery of her youth: Are women who suppress their anger more likely to feel ineffective, powerless -- less "instrumental," in her words -- than those who don't?
The results surprised her, and they also pointed to a puzzling discrepancy between women's health and happiness: Many women who withhold anger nevertheless described themselves as effective, successful and assertive.
At a recent Congress on Women's Health in San Francisco, Cox and six other women gathered to present their findings from recent studies on women and anger. The presentations began with the results of another, broader study on anger, led by psychologist Sandra Thomas of the University of Tennessee. A few years ago, Thomas polled 535 women in an effort to determine what those of the gentle sex do when they're mad. And, like the women from Cox's hometown, it turns out that most of us hold it in.
Said one 21-year-old female in the Thomas study: "I don't think that a lot of us feel worthy of being angry. We want peace more than we want to actually express our anger and have somebody have to deal with it. It's a lot easier just to suppress it and not make anybody unhappy."
In psychologist-speak, this means that most women fit an "Anger/In" profile. Many studies on anger (including Cox's and Thomas', although both also used focus group discussions) draw heavily from a multiple-choice test designed to deliver "Anger/In, Anger/Out" scores. Responses to these questions place subjects along a continuum between, as you'd expect, those who display their anger and those who suppress it. Loosely speaking, this boils down to something like the venters and the martyrs, those who don't hesitate to let the world know when they're displeased and those who say "I'm fine, really" while they fume silently inside. A final group of questions identifies the physical manifestations of an anger behavior that isn't working.
Most women will buck at the characterization, but statistics bear it out. Women are more likely to deny their rage than men are. And really, this should come as little surprise. There are words for an angry woman -- bitch, shrew, nag -- and acting the part of Anger/In is in keeping with traditional notions of femininity. As Thomas points out, "Women's anger does not conform to the feminine ideal of the selfless, ever-nurturing, perfect mother."
In Cox's and Thomas' surveys, many female subjects described feeling embarrassed and debilitated by their fury. In one conversation Cox quotes in "Women's Anger," a book she co-wrote, a researcher asks a group of girls: "What do you look like when you're angry?" "Ugly," the girls reply. Another subject ignores her anger like bad advice: "I keep everything to myself because I know that when I explode, I say things I regret later. I just keep everything to myself."
But if women have been socialized to suppress anger, is doing so keeping them from getting what they want?
It's here that Cox steps in, sealed envelope with her results in hand, and awaits her cue. If all women fit the mold of those Southern women of her youth, Cox would expect to find a correlation between Anger/In women and those who felt ineffective, unlikely to succeed.
Cox's results tell a different story. Though most women fit the Anger/In profile, many of them also described a strong sense of instrumentality. Here she found a clear distinction along gender lines. Men who fit the Anger/In profile typically felt ineffective; they lacked assertion. Among men, anger fueled action. In contrast, the Anger/In women often anticipated success in their lives. Given the limited scope and size of the study, Cox's results must be considered tentative. Still, it appears that the Anger/In women felt that their voices were heard just as often as the Anger/Out women.
One shortcoming of Anger/In, Anger/Out questionnaires is that they don't give respondents much of an opportunity to explain what, exactly, they do with their anger. For example, a woman who both "takes it out on others" and "talks to a friend or relative" would be described as an Anger/Out/Discussion personality, even though she may never direct her anger to its source. As a result, speculation about how women deal with their anger is just that. In Cox's educated guess, "Maybe they tell someone else besides the target of their anger, maybe they just chomp down on it, keep quiet and find an indirect way to make some kind of change."
But is giving your husband the silent treatment -- even if it works -- really a healthy way to effect change in a marriage? Earlier research shows that keeping it all inside can put women at a health risk.
From a scientific perspective, anger is just one way that people experience stress. In order to test the physiological strains of stress, researchers subjected participants to (among other things) a series of timed math problems. Bombarded by 7s and 13s, the subjects unconsciously readied themselves for escape, releasing a dose of adrenaline, which in turn caused blood vessels to constrict as their heart rate and blood pressure increased.
Now this may be just the jolt that saved ancient man from the woolly mammoth attack, but over time, that kind of repeated physiological call to action takes its toll. In 1998, a 10-year study led by Dr. Karen Matthews at the University of Pittsburgh School of Medicine found that women who scored high on Anger/In tests were more likely to exhibit early signs of heart disease.
One can't help wondering whether these are the same kinds of women we met in Cox's study, the women who -- despite their tendency to suppress anger -- felt they were doing pretty well in the world. Considered jointly, the two studies leave us with incongruous notions of mental and physical health: What works for one can be disastrous for the other. So what's a woman to do?
For vast numbers of women, the answer lies not within scientific discourse, but in the abundance of therapist-written self-help books that address the subject of women and anger. After all, the selling premise of self-help books is that they provide answers, not questions. And for the women who continue to struggle with their anger, this is surely a comfort.
It may also be a comfort that self-help advice on the subject of anger is not exactly revolutionary. Harriet Lerner, author of one of the most popular of these books, "The Dance of Anger," cautions women to temper their anger with reason, to "strike while the iron is not hot" and to "get creative in problem-solving." Like most common wisdom, there's truth in it.
In fact, this is just the kind of advice that you'll hear from researchers, once they turn their attention away from statistical analysis and multiple-choice questions. Despite the contradiction in their findings, both Cox and Matthews conclude (to quote Matthews): "It may be best to express negative feelings in a constructive fashion [rather] than to hold them in." Women will find solace and physical health neither in Anger/In nor in Anger/Out but through direct, honest communication with the target of their frustration.
When statistics leave us scratching our heads, common sense provides the answer. Reflecting back upon her findings, Cox's words take on a tone that's more therapeutic than scientific.
"We hear women so often talking about not wanting to make a decision when they're angry. And I have some serious doubts about anger diminishing our ability to think, if being really angry doesn't help us get very clear about what we need. The more angry we are, I think sometimes, the more we see."