Anger Under Cover- Passive Aggression– Part One

Posted:  September 24, 2009

Anger Under Cover- Passive Aggression– Part One

Joe Pereira, LICSW, CAS

Passive aggression is also referred to as hidden anger. This behavior occurs when anger is not expressed directly. Sometimes the hostility is clear, as when one family member in conflict with another makes sarcastic remarks during dinner. Most often, only after a pattern of particular behavior does it occur to others that anger is the source. A coworker is late to work, procrastinates doing a project, blames a coworker for not getting the work done on time, and leaves meetings early which can be all a manifestation of a person’s hidden anger. Over the years, the mental health field has looked more closely at passive aggression and refined definitions and characteristics. Debate continues as to whether a passive-aggressive personality disorder exists, and if it should be included in the Diagnostic and Statistical Manual as a psychiatric diagnosis.


Tim Murphy and Loriann Hoff Oberlin, in their book Overcoming Passive-Aggression, describe passive aggression as anger that is invisible or subtle. The authors make it clear that anger itself is not the problem. “Anger is sometimes okay but should never be mean.” With passive aggression, fear causes people to act to avoid conflict. They imagine conflict to be frightening and very hurtful. These distorted thoughts cause alarm because of the perceived harm of unpleasant interactions and confrontations. A teen pretends to lose a report card to get out of talking with her parents about a bad grade at school. When a manager talks to an employee about his mistakes, the employee points out mistakes made by other workers or says that the directions for the project were not clear which serves as a distraction.

Their definition of hidden anger includes these traits:
• Indirect anger as a dysfunctional way to interact with others
• Secretive manipulative behavior
• Not engaging in interactions and avoiding obligations
• May be intentional or may be unconscious
• Motivation is to hurt and harm others
• Person denies responsibility and even acts as victim
• Destructive to individual relationships and group interactions, especially when it continues

Most of these traits are recognized in people with anger management problems in general. The difference is that with individuals who behave passive-aggressively, the anger goes underground. Subtle and sneaky reactions are more difficult to identify than direct expressions of anger. Passive aggression takes time to negatively affect people. The cycle of anger occurs, but in a less obvious way, with anger shifted to indirect and complex expressions. Similar anger management techniques can be used for hidden anger, with some adaptations. Passive Aggression Part II in the next Outlook Associates newsletter will discuss how to manage passive-aggressive behavior for yourself and with others.

Personality Characteristics

We have all been the recipient of these behaviors, and even may have acted this way ourselves! In fact, experts maintain that everyone is passive- aggressive sometimes, as a defense against feeling or showing anger directly. These authors also differentiate between the harm of passive-aggressive behavior and the avoidance of a difficult situation, which does not hurt others.

In his book, Martin Kantor believes that a passive-aggressive personality disorder exists. In his book he presents a definition that includes his conclusions about the source of passive aggression:
1) Centrality of anger
2) Indirect method of expressing anger (origin also in past family patterns)
3) Behavior is related to family dynamics and emotional and communication patterns, such as troubles and conflicts regarding dependency, control and status in family

He writes about reasons for passive-aggressive behavior: internal conflict between anger, anxiety, and guilt about feeling anger; fear of consequences of anger, such as loss of relationship (particularly true for people who are relationship-dependent); indirect anger as a way to get angry without guilt and protect against retaliation; an effective weapon to hurt others.

Passive-aggressive behavior is hard to spot, in our- selves and in other people. Once we see clearly, it is as if the puzzle falls into place, explaining the reason for days, weeks, or months of disruptive and deceitful actions. Fortunately, anger management skills for addressing hidden anger are available. The next newsletter addition will talk about these strategies.


Kantor, M. Passive-aggression: a guide for the therapist, the patient, and the victim. Westport CT: Praeger Pub- lishers, 2002.

Murphy, T. and Oberlin, L. Overcoming Passive- Aggression: How to Stop Hidden Anger from Spoil- ing Your Relationships, Career and Happiness. New York: Marlowe & Company, 2005.

(The article was done with the research/writing assistance of Alice Miele, LICSW)


Health Effects of Marital Conflict

Recent studies have shown that how often couples fight or what they fight about does not matter. Rather, it is the nuanced interactions between men and women, and how they react to and resolve conflict, that appear to make a noteworthy difference in the health of the marriage and the health of the couple.

A study of nearly 4,000 men and women from Framingham, MA asked whether they typically vented their feelings or kept quiet in arguments with their spouse. Notably, 32% of men and 23% of women said they typically bottled up their feelings during a marital spat.

In men, keeping quiet during a fight did not have ay measurable effect on health. But women who didn’t speak their minds in those fights were 4 times more likely to die during the 10-year study period compared to women who always told their husband how they felt. The tendency to suppress feelings during a fight is known as “self- silencing”. For men., it may be simply a calculated but harmless decision to keep the peace. But when women stay quiet, it takes a physical toll.

The emotional tone that men and women take during arguments with a spouse can also have a negative impact on their health. University of Utah researchers videotaped 150 couples to measure the effect that marital arguing style has on heart risk. The men and women were mostly in their 60s, had been married on average for more than 30 years and had no signs of heart disease. The couples were given stressful topics to discuss like finances and household chores.. The comments made during the ensuing argument were labeled as warm, hostile, controlling or submissive. The participants also underwent heart scans to measure heart disease risk.

The researchers found that the style of argument detected in the video sessions was a significant predictor for a man or woman’s risk for underlying heart disease. In fact, the way the couple interacted was as an important a risk factor as whether they smoked or had high cholesterol.

But arguing style affected men and women differently. For women, whether a husband’s arguing style was warm or hostile had the biggest effect on her heart health. In the study, a warm style of arguing by either spouse lowered the wife’s risk for heart disease.

For men, the level of warmth or hostility had no effect on a man’s heart health. For a man, heart risk increased if disagreements with his wife involved a battle for control. And it didn’t matter whether he or his wife was the one making the controlling arguments.

The study also asked men and women to fill out stand questionnaires about the quality of their relationships, but those answers were not a good predictor of cardiovascular risk. The difference in risk showed up only when the quality of the couple’s bickering style was assessed.

(New York Times, Health Section, October 3, 2007 (On-line edition))

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About the Author

Joe Pereira, LICSW, CAS
I am a licensed clinical social worker and addictions specialist who has been practicing for over 30 years. I have provided therapy services in a number of different settings including correctional institutions, inpatient hospital units, community mental health centers, and employee assistance programs. I was a co-founder of Outlook Associates of New England in 1997 which was a practice started to assist persons with anger control problems. I am currently in private practice in Arlington, MA, and Boston, MA offering individual and group therapy in addition to training and consultation with a focus on anger management to adults and adolescents. I have given numerous trainings locally as well as nationally and internationally on the treatment of anger management problems as well as workplace safety, substance use disorders and stress management. I am also currently an adjunct instructor at the Boston University School of Social Work since 2013.