Episode 180 - Dr. Howard Lipke: HEArt for Veterans: Identifying the Hidden Emotion

Monday, November 23, 2015, 9:43:15 AM

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In this episode, Dr. Howard Lipke describes what he calls the Hidden Emotion Articulation (HEArt) Program, a contrast to traditional anger management programs. This approach, developed especially for the unique needs of veterans, helps clients identify the hidden emotion that lies beneath their feelings. Dr. Lipke contends that identifying the hidden emotion can help vets understand and prepare for sensitive situations in which they may be triggered into anger (and, for many vets, rage).

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Average Rating: 4.4 stars (9 listener reviews )

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Average Rating: 4stars  review of podcast #180, Monday, February 10, 2020

By April :

While working for the VA, Dr. Howard Lipke noticed that the treatments being used at that time to treat veterans with PTSD, had results that were mediocre at most. No treatment really stood out with great results. Out of his research, he developed a treatment program known as Hidden Emotion Articulation referred to as HEArt. This is a concept of adding to the conventional treatment of managing feelings like rage and anger as secondary feelings that are due to underlying emotions or as he refers to, hidden emotions. These could be fear, confusion, or a sense of weakness. Dr. Lipke noted that these untreated hidden emotions lead to the anger itself. The veteran is then offered a new path away from the anger that deals with the emotions behind it. The veteran is then given the choice to investigate those emotions. as part of the treatment and healing process.
I would like to see the follow up of this work since 2015 to see if it has been used and what the success rate has been.

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Average Rating: 4stars  getting past anger; the veterans choice., Wednesday, January 31, 2018

By Mike Shurmatz :

Dr. Howard Lipke’s exploration into anger and rage, beyond the traditional anger management model is fascinating. As a fellow combat Veteran, I am well aware of the power, both good and bad, of anger. While anger can be something that helps keep you alive in combat, it can also become extremely destructive in civilian life. Dr. Lipke’s Hidden Emotion Articulation (HEArt) Program does more for the Veteran than simply allowing them to talk about their anger; this happens and this is how it makes me feel. It allows the Veteran to more or less become an active participant in the treatment; he explains to the Veteran what the hidden emotion is, how feelings and emotions are unique from one another but impact one another, and that vulnerability is not a weakness. He helps the Veterans navigate their anger, a secondary emotion that masks underlying emotions such as fear, sadness, or grief, and move past it. When they see that anger essentially blocks them from experiencing the “hidden emotion”, they can begin the process of deciding whether they are ready and willing to process those root emotions that have been suppressed. A specific feature that I feel is what makes this program effective with Veterans is the decision aspect. Dr. Lipke tells his Veteran clients it is their decision if it is worth it to deny their anger and look past it to the hidden emotion, and than try to deal with them. This is extremely challenging for the Veteran because anger has become the norm, and working through these “new” emotions is going to take time, effort, and commitment. The Veteran needs to make that decision for him/herself, and I feel getting that buy in from the Veteran yields the commitment necessary for the work to produce positive results. As I continue toward a profession of working with combat Veterans I look forward to further studying Dr. Lipke’s unique approach and apply the fundamentals to my area of practice.

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Average Rating: 5stars  anger, Monday, February 06, 2017

By Isatou Ndow :

Dr. Lipke’s program, Heart, presents a very insightful and informative approach to veterans around anger/rage. I must admit, the concept that emotions and feelings were separate entities puzzled me but I think as the podcast went on, Dr.Lipke conveyed his point well. Nonetheless, this podcast has opened my eyes to the function that anger undertakes in relation to emotions that we may harbor, it pushes them aside. Dr. Lipke proclaims that anger is a defense mechanism for an underlying emotion, such as fear. Anger comes to the forefront in order to mask emotions. If anger is acknowledged as a secondary issue, the focus strays away from managing anger. The focus then shifts to identifying what the primary issue, the underlying emotion, is. I think this focus on anger prevention poses a contrast to the idea of managing anger. I am curious to see what this means for anger management for clients who are not veterans. Though this program is implemented, it would be interesting to see the results of this program upon participating clients.

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Average Rating: 4stars  emerging anger management practices, Monday, February 08, 2016

By Mariah :

Dr. Howard Lipke’s podcast on Hidden Emotion Articulation Therapy (HEArt) was eloquent in describing how understanding the hidden emotions behind feelings of anger is essential in healing from anger issues. Most enlightening was describing how anger is a feeling that hides a hidden painful emotion. One of the key components of understanding the effectiveness of HEArt, as opposed to other anger management programs, is that addressing the hidden emotion behind anger is a primary step. This is a distinctive component to this therapy as often times anger management focuses on controlling situations and physiological coping skills. Allowing patients to explore what triggers them to be in state of anger before they are experiencing the feeling will give them the control they need to heal.

One aspect of Dr. Lipke’s work that I admired was how he framed patients with the choice of recognizing their hidden emotions behind anger or not. He educates his patients about hidden emotions, but respects that addressing these emotions can be difficult and painful, and for some, might not be worth the pain of addressing them. I think this is a trauma informed way of addressing a patient’s emotions.

The HEArt model appears to be effective in supporting clients who are dealing with anger management issues. The model is specifically linguistic and would require a client to have the intellectual ability and language skills to understand the nuances of the conceptual definitions. I was curious as to how this model works when working with veterans who have experienced a traumatic brain injury, or have differing cultural associations.

Finally, Dr. Lipke describes how his success with the HEArt model has not been test outside of basic evaluative surveys that he utilizes in his own practice. It is important for the HEArt model to be tested in a controlled scientific setting.

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Average Rating: 5stars  a review of the heart program, Sunday, February 07, 2016

By Ryan W :

The Hidden Emotion Articulation (HEArt) program developed by Dr. Lipke is a clearly defined and essential program designed to reach out to veterans, their families, and their partners. The program is unique in that it is designed to help veterans identify the hidden emotions behind anger, which is a new and emerging way of helping people understand anger and how to prevent it. The HEArt program is able to help individuals’ reach, identify, and overcome their hidden emotions by focusing on anger prevention rather than just anger management. Focusing on anger prevention was recognized as a beneficial tool to help people understand what’s going on behind their anger. This is dually important for veterans (especially combat veterans) who may experience a range of emotions that may not have been fully self-recognized and accepted. Some of these emotions that were identified include pain, loss, fear, and powerlessness. Dr. Lipke identified that veterans have a unique experience in that their present situations can easily be a reflection of past events that have taken place in their lives. As a veteran myself, I find that I am able to relate to a lot of what Dr. Lipke has researched and implemented in reaching towards hidden emotions behind anger. After reviewing this article I found it to be very informative and interesting. What I found most helpful about this podcast is how it emphasizes the connection between hidden emotions and destructive anger which can manifest as destructive behavior. I look forward to seeing lots of other veterans receive and utilize the benefits the HEArt program has to offer.

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Average Rating: 5stars  review, Sunday, February 07, 2016

By Stacee Muolo :

Dr. Howard Lipke discusses his program, HEArt, in addressing anger and working with Veterans. Dr. Lipke delineates the difference between emotions and feelings and explains a causal relationship between the two. He illustrates how hidden emotions, such as sadness or fear, lead to feelings, such as anger. Dr. Lipke expresses the importance of Veteran’s understanding their emotions, learning how to effectively cope with these emotions, and how these emotions have lead them to feelings of anger. He implements this modality through the HEArt program in group and individual therapy. Dr. Lipke addresses the variance of typical anger management programs which focus on teaching recognition of problem situations, calming and relaxation techniques, coping with intellectual behaviors, and the emotion compared to the HEArt model which focuses on anger being a defense mechanism against the hidden emotion. Lipke notes if the person can work on the recognition of the hidden emotion they can then work through that emotion and not feel anger. Dr. Lipke discusses the absence of acknowledgement of the hidden emotions due to the functionality of anger in the person’s life. I’ve found this to be especially relevant to Veterans as they are typically trained to draw from anger to “get the job done”. Dr. Lipke further describes anger and/or numbness as critical to combat Veteran’s survival.
After listening to this podcast I was intrigued to further research Dr. Lipke’s HEArt program as I work with Veterans. My program has purchased his book, Don’t I have the Right to be Angry?, and we are further researching this approach in consideration of using in group therapy.

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Average Rating: 4stars  heart program: an interesting take on addressing anger , Wednesday, February 03, 2016

By Miranda Little-Moore :

Lipke provides an explanation for the common feeling of anger and rage that combat veterans experience and goes on to explain the differences between “emotions” and “feelings” as they relate to anger. The explanation itself was somewhat difficult for me to understand initially, however the interviewer assisted my understanding of Lipke’s explanation by drawing out a more detailed explanation of how these differences relate to his work within the HEArt program with veterans. According to Lipke, anger is a secondary feeling, which arises to protect the individual from discovering and identifying hidden emotions such as pain and sadness. Lipke’s program works to assist veterans in identifying the hidden emotion behind their anger so that the true emotions are able to be addressed rather than forced down.
Lipke’s discussion of the differences between the HEart program and anger management programs was interesting and helpful to put his program within a real context. From Lipke’s explanation regarding these differences it seems that anger management programs focus more attention to the anger itself and the ability to control and alleviate the feeling, rather than its potential hidden triggers or underlying emotional responses. I felt this explanation resonated with my experience both within my own life, thinking about times that I have felt extreme anger, as well as within my discussions with veterans.
While there is not much evidence based support thus far for the HEArt program, I am very interested to learn more about in its application to both combat veterans and trauma survivors in general. I think Lipke ends his discussion with a very valid point regarding the lack of evidence regarding a sufficient reduction in anger for client’s who have completed anger management classes and the clear need for more research and effort to discover new ways to assist individuals in these situations.

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Average Rating: 5stars  heart offers new approach for veterans coping with anger., Tuesday, February 02, 2016

By Alicia Kaufman :

Dr. Howard Lipke began working with veterans coping with PTSD and observed how destructive their feelings of rage could be. He developed HEArt (Hidden Emotion Articulation) to address those feelings of anger in a way that allowed veterans to acknowledge that there were other feelings beneath the rage.

Often times we use anger to cover emotions that open us up to being vulnerable, considered weak, or incapable. Dr. Lipke asked his clients to begin to call the feelings what they truly were by first defining different emotional states. This practice is drawn from concepts in trauma focused cognitive behavioral therapy, where feelings are first defined before acknowledging how they apply to the individual. Clients were asked to notice the mechanism of how anger occludes feelings of fear or sadness. Clients developed the ability to note differences between the situation and the feelings about that situation.

This approach helped veterans understand why they might avoid the hidden emotion and opt for rage. Dr. Lipke also asks that clients be responsible to define for themselves what constitutes ‘destructive’ anger. This intervention empowers the client to make decisions about their feelings and how the experiences of their past shape their future actions.

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Average Rating: 4stars  podcast summary, Sunday, December 06, 2015

By Daphne Booth :

Dr. Lipke’s HEArt Program aims to help Veterans in the prevention of becoming angry. HEArt is an acronym for Hidden Emotion ARTiculation. He compares his program to other anger management programs by saying that HEArt emphasizes uncovering the hidden emotions behind the anger. Lipke admits that his explanation of his program is convoluted - and it is. Fortunately, Dr. Smyth helps clarify points in the discussion. In the discussion, Lipke describes how military training teaches soldiers to view people, things, and situations as good or bad, safe or dangerous – with no middle ground. Military training also encourages the use of anger and numbness to carry out difficult missions. These skills are essential for the functioning and survival of soldiers and are reinforced by combat experience. However, these same skills that protected the soldier in combat, do not serve the same function in civilian life and most often cause reintegration problems for the Veteran. Lipke states that the purpose of anger is to push things away, such as fear, sadness, and powerlessness. In this way, anger is a defense that protects feelings because anger is often easier to feel than the fear, sadness, and powerlessness. Compared to many civilians, most combat Veterans have experienced a greater degree of fear, sadness, and powerlessness and require Veteran-specific ways to process this; according to Lipke. The anger, and often rage, that Veterans experience is triggered by memories of combat trauma. By working on the old trauma to reduce triggers, Lipke’s program seeks to identify the emotion hidden behind the anger. He asserts that by identifying the emotion behind the anger, the Veteran can prevent the anger.

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