Explain intermittent explosive disorder and safety plan — CASC communication station

Open and agenda-set. Name time; acknowledge frustration at the label; ask what he has already been told. [1]

Explain diagnosis. “Intermittent explosive disorder describes repeated sudden anger attacks that are much bigger than the trigger — shouting, throwing or breaking things, sometimes hitting — that are not carefully planned to get money or control. Afterward people often feel guilty. It is a clinical diagnosis of impulse-control problems, not a moral insult and not the same as calling someone a psychopath.” [1]

Explain treatment. Skills-based psychological therapy (CBT for anger/aggression) helps people spot triggers early, calm the body, challenge ‘they meant to disrespect me’ thoughts, and choose safer responses — there is research support for this approach in IED. Medicines do not ‘cure personality,’ but an SSRI such as fluoxetine has trial evidence for reducing aggressive outbursts in IED; we would start low (for example 20 mg daily by mouth), review side-effects and response, and adjust carefully. We also need to tackle alcohol if it is pouring fuel on the fire. There is no single magic pill. [2][3]

Partner and confidentiality. Usual privacy applies, but if we believe someone is in serious danger we may need to share limited information to keep them safe — we will be as open as safety allows. We can help with a safety plan and support options for your partner. [1]

Close. Agree goals (attack diary, CBT referral, consider fluoxetine, alcohol plan, early review), teach-back, written information, hope without false promises. [2][3]