What Do People with Intermittent Explosive Disorder Work on in Therapy?

Intermittent Explosive Disorder

Ever get angry? Who doesn’t? We all experience feelings of anger on occasion. For some people, however, irritability can escalate into rage or even violence. And it can happen in an instant. Anger that quickly gets out of control may be a sign of intermittent explosive disorder (IED), a mental health disorder. Talk about an ironic acronym, IED also stands for “improvised explosive device,” which is something that can detonate without warning and cause great harm. It’s similar to the way a person can explode in anger and cause lasting emotional (or physical) damage to anyone in their vicinity. IED can destroy relationships and kill careers.

If you can’t control your aggressive impulses, you may want to consider seeking professional help. Psychotherapy can be an important aspect of an IED treatment plan. Before you can work on gaining control of anger and aggression, you need to address any underlying issues that may be causing it.


Researchers have spent decades looking into potential causes of and contributors to IED. Understanding what might be contributing to your anger issues and treating them is one of the keys to healing. Some of the most common treatable issues related to IED are emotional trauma, head injuries, other mental health conditions, and issues with brain chemistry.

Emotional trauma

One of the main findings from years of research into the causes of IED is that experiencing trauma is a common denominator among people with the condition. For example, a 2012 study in Psychiatric Research that looked at data on 5,575 individuals found that IED is associated with increased exposure to trauma, especially childhood trauma. Adverse childhood experiences that can contribute to IED include emotional or physical neglect, sexual or physical abuse, living with someone with an addiction or mental illness, and more.

Healing strategies: A non-invasive therapy that can aid in overcoming emotional trauma is called EMDR, which stands for eye movement desensitization and reprocessing. This can be an important piece of the puzzle in understanding and coping with anger issues.

Head injuries

At Amen Clinics, which has built the world’s largest database of functional brain scans related to behavior, it has become clear that head injuries increase the risk of anger issues and IED. In a 2018 study in The Journal of Neuropsychiatry and Clinical Neurosciences, researchers looked at the relationship between mild traumatic brain injuries (mTBI) and IED. Among 1,634 individuals involved in the analysis, those with IED were more likely to have experienced a mTBI compared with healthy controls and those with other psychiatric disorders. On SPECT scans at Amen Clinics, damage to the temporal lobes (located on either side of the temples behind the eyes) is often associated with anger, aggression, and violence.

Healing strategies: If your brain is injured, it makes it difficult to follow through on anger management techniques. To enhance brain function, put the brain in a healing environment with hyperbaric oxygen therapy (HBOT), eating a healthy diet, eliminating environmental toxins, and avoiding alcohol and drugs.

History of mental health disorders

People with ADD/ADHD, borderline personality disorder, antisocial personality disorder, and other psychiatric conditions are at increased risk of IED.

Healing strategies: Seeking treatment for these mental health problems can help make it easier to follow anger management strategies.

Brain chemistry issues

Some research suggests that abnormal levels of neurochemicals may play a role in IED. Specifically, low levels of the neurotransmitter serotonin have been cited as a possible contributor to the condition.

Healing strategies: To boost serotonin naturally, eat a diet that is lower in protein and higher in complex carbohydrates. Natural supplements such as saffron and 5-HTP also increase the feel-good neurotransmitter.


In addition to addressing any underlying causes of IED, a comprehensive treatment plan for IED will usually include psychotherapy and anger management. A number of techniques may be helpful, such as:

  • Cognitive restructuring: Learning to change the way you think about frustrating and stressful situations that typically trigger aggression can be beneficial.
  • Relaxation strategies: Engaging in a relaxation practice that includes deep breathing exercises, yoga, self-hypnosis, or guided imagery can help keep you calm when your blood starts to boil.
  • Coping skills: Therapists can help you develop a toolkit of coping strategies to help you deal more effectively with situations that typically set you off.
  • Group therapy: In a 2018 study, researchers concluded that “structured cognitive behavioral group therapy, with a focus on anger management and cognitive coping, may be a promising approach to the treatment of IED.”

Intermittent explosive disorder, head injuries, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.


  1. Infections can also be a trigger. PANS/PANDAS/ Lyme/Bartonella. These have to be studied and ruled out or addressed as a part of true holisitc treatment.

    Comment by Dianna M — October 18, 2021 @ 7:06 AM

  2. I feel lost in a web of diagnosis’ and being misunderstood by family and friends my whole life. But this IED really resonates with me finally ! Maybe this is the answer for my “BiPolar” anger issues with DID,PTSD,cPTSD,&high anxiety issues also…whew!!!

    Comment by Charlotte Collie — October 18, 2021 @ 9:23 AM

  3. Sure seems common among Children of Divorce after they are grown up. And then they get years and years of mis-diagnoses as the psych community refuses to help them. It seems that the guys end up in jail because they break things in public, so this becomes a real problem. Their mothers feel protected by their violent and loyal feelings of protectiveness. And these kids rarely get through college.

    Comment by B. — October 18, 2021 @ 9:44 AM

  4. I hesitate to articulate, but Rick Warren a Pastor of Saddleback Church has stated
    Revealing how you are feeling is the beginning of healing.
    So here goes.
    This article describes the entire life of my 2 sons who Outwardly appeared normal, gravely Disturbing to say the least for them with these debilitating issues.
    I carry guilt/ blame for my DNA. After all I chose their fathers.
    I suffered from a totally heartbreaking response of family, friends, schools, church, society, legally. Unbelievably sad as I witnessed the crescendos and descents during which time No expert answers gave us any true relief. Only more intense and costly ramifications from their actions.
    Presently maintaining a status quo, our stability undermined as they evolved into further poor mental health and I bear scars that seem to develop into ptsd Reviewing it all here, weeping as it opens old wounds.
    Is it too late to help their brains or mine? Yet they wouldn’t want it, and I’m unable to afford. My recommendation if you sense the need seek out and follow and retain the vast amount of direction, ideas, information on Dr. Amen’s site because he offers the best support today, and your life doesn’t have to be a tragedy.

    Comment by Linda Swartz — October 20, 2021 @ 5:13 AM

  5. My grandson has dealt with this disorder as well as bipolar and high anxiety, glad to know there may be some help on the horizon for him, it has been a tough road.

    Comment by Julia Senkbeil — October 20, 2021 @ 1:06 PM

  6. My 15yr old grandson is in dire straights. My daughter has been an addict for 16 years. She used heavily while pregnant and eventually lost custody of all 4 of her kids. Eli has always been a “problem” child he was shuffled from foster home to foster home, group residential homes and completely separated from his brothers. He was adopted at age 10 and as of yesterday they adoptive mom relinquished custody back to the courts. This child has no chance if someone doesn’t care enough to help him. I had a conversation with the adoptive mom asking to have a SPECT scan but she wasn’t willing. The damage was done in utero to start with then the life of having a mother who is an addict just sealed his fate. Please can you help us !

    Comment by Pam Jonas — October 22, 2021 @ 10:51 AM

  7. Hello Pam, thank you for reaching out. We’d be happy to contact you directly to give you more information and resources. We look forward to connecting.

    Comment by Amen Clinics — October 28, 2021 @ 10:22 AM

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