Although I've never received any sort of counseling or treatment, I've had to deal with it myself. I have made adjustments in how I do things and I act in ways that are not what my impulses tell me to do. (Does that make sense?) When I want to kill someone, I have to walk away and take my mind elsewhere. When I have the dreams, i tell my wife about them. she listens and calms me.
Overall, these techniques have kept me out of trouble most of the time but not always. In the instances that my reaction to some minor aggravation has gotten me into trouble, I've tried to learn from the incident and to avoid repeating it. I can't have the window shade above the toilet open (even though we live in the woods and no one can see in) because of the sniper that exists in my mind waiting to take the shot when I'm framed by the window. It's a hell of a way to live.