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The question: I have a close friend I've known for 20 years who still can't control her temper. Once or twice a year she completely loses it – yelling, screaming at me, an adult version of what you expect from a four-year-old's tantrum. Later she's ashamed and mortified. What can she do? What can I do?

The answer: No matter how hard we wish, we simply do not have the ability to change other people. The only person we have control over is ourselves, and that alone can be difficult to do even in the best of times. So, there are only two things you can do: Monitor – and, more importantly, modify – your responses to your friend's tantrums, and offer to support her if she wants to make changes.

One of two things usually explains the presence of longstanding, ingrained behaviours that have lasted decades; the most likely situation is that your friend's intermittent outbursts are working for her. Ostensibly, they allow her to communicate her distress to those around her. Likely, her outbursts have the actual effect of modifying the behaviours of those in her environment. But unfortunately, the negative consequences (feeling shame, feeling mortified) haven't been sufficient in motivating her to make changes to her behaviour.

Another less likely, but certainly tenable, possibility is that she truly has wanted to change, but hasn't found the tools she needs to do it. By tools, I mean alternate strategies to manage and cope with trigger factors, and effective ways to communicate how she is feeling to others.

Tantrum-like behaviour, for children and adults alike, is really just communication behaviour. Psychological or substance-use factors can certainly contribute (a personality disorder, or alcohol or drug use), but essentially she is making a decision to act or react in a particular way.

Ask yourself: How do you respond to her behaviour? It sounds as though, at some level, you have tolerated her actions. What factors trigger her to react this way to you? What do you do (or not do) after she reacts this way? And, have you given her feedback about the impact on you?

What contribution do you make to the situation, if any? I do not ask this in a blaming way, but I want to ensure that you are not engaging in similarly inappropriate behaviour toward her.

Assuming that you do not play any significant role in her behaviour, you need to have a very blunt conversation with your friend. Let her know in no uncertain terms that the way she acts is unacceptable, and although you have tolerated it, you will not continue to do so. Let her know that you value her friendship and are prepared to help her develop skills that can better control her anger. Offer to help her understand what her triggers are, and seek professional help from a mental-health professional with expertise in anger-management skills.

The Anger Management Sourcebook, by Glenn Schiraldi and Melissa Kerr, offers cognitive-behavioural strategies that teach people to identify personal triggers of anger – and better cope with those feelings.

Dr. Joti Samra, R.Psych., is a clinical psychologist and organizational & media consultant. She is the host of OWN: Oprah Winfrey Network's Million Dollar Neighbourhood and is the psychological consultant to CITY-TV's The Bachelor Canada. Her website is www.drjotisamra.com and she can be followed @drjotisamra .

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