Randolph was a 32-year-old Caucasian man who sought treatment for “rage episodes” at the request of concerned family members. At intake, Randolph described ongoing “episodes of uncontrollable rage” during which he reportedly damaged property (e.g., threw objects, punched walls, etc.) and berated those in his presence, the majority of whom were family members. These “episodes” occurred multiple times per week, most frequently upon waking, and lasted up to several minutes. He indicated that sleep disruption was an apparent trigger for his rage. He often had trouble sleeping due to his untreated sleep apnea and when his young children would awaken him he would go into rage. His explosive anger has frightened his children which he “feels awful” about. Additionally, his wife has lost patience with his behavior, giving him the ultimatum that he gets his anger in check or he “was looking at a divorce.” His anger is not solely limited to sleep related incidents. During a family dinner, he became angry and began berating his parents for their religious beliefs, claiming that their strict religious upbringing of him had ruined his life. He stated that …show more content…
In addition to his verbal expressions of anger, he estimated that he had physical acts of anger about every 2 months; for example, he threw his computer across the room when it wasn’t working properly, he kicked a hole in the wall when the dog made him angry, and he threw his cell phone out of his car window after his wife “pissed him off.” He denied physical fights but described almost coming to blows with the UPS delivery person because “they were rude.” This particularly concerned him because he would “never want to hurt someone.” Randolph sought therapy to gain insight regarding his outbursts of rage and to increase his ability to control his