Tuesday, March 12, 2019

9 yr old has sporadic explosions

My 9 year old son is sweet, kind and calm most of the time.  However he has very explosive anger, which mostly we see at home. He will go months without any issues at school, and then have multiple episodes of anger in a row at school. For example this year, he was fine at school from August thru the second to last week of Feb. Now for the last few weeks he is having anger episodes  multiple times a week.
He had the same issue at his previous school, and we had to home school him on and off throughout the second half of the school year.  The last month of school, they threatened to suspend him due to an episode of rage.  At this point, it seems he is going to get kicked out of his new school as well, or they want some sort discipline plan?

We have no idea what to do...  The anger is sporadic, unpredictable and explosive.  How do we even find the right psychologist or resources in our area? Should we home school him or put him in private school? 

Any insights would be helpful.

Hi, Private schools generally do not have the mental health resources to help children with emotional problems, unless it is a special education type school specifically set up for children with emotional issues. Home schooling is a temporary option but I would not recommend it long term because your child would miss out on developing social skills with peers, and because home schooling puts a lot of pressure on the parents to be both teacher and parent.

What I would recommend is first making a chart of when your son loses control at home and at school.  What is going on right before he loses it?  Look over time for themes for some of the triggers.  Then think are there ways to work around the triggers, i.e. avoid them.  Or could you or the teacher forewarn your son that a potentially difficult situation will be occurring and help him think about it differently.  In my manuals I encourage parents to develop mantras, or sayings, that help the child to look at situations differently and to stay calm.  For example, if losing a game is a trigger, the mantra could be "everyone loses sometimes" or "even (the name of a person he admires) loses sometimes." 

Also if you can catch the anger before the overload phase, which is hard to do, you can use emotional distraction, which I explain in earlier posts and in my manuals.  Some children do better with a verbal label for their feelings rather than emotional distraction or mantras.  For example, if you catch it early, suggest to him "that's frustrating."  In other words, you would empathize and give him a word that is socially appropriate to use when we are angry.

See what works for your child.  If the outbursts don't slow down at all, ask your doctor for mental health professionals in your area that work with children and families.

Best, Dr. Dave Gottlieb

Tuesday, February 19, 2019

14 year old's anger in school

Hello
After reading your information blog on anger overload I feel compelled to email you in the hope you can offer some advice.
I have a 13 ( 14 in a few weeks)son who seems to be having anger issues. He is a kind caring person but his temper can be short at home at times. Though the occasions are pretty rare.

However at school his temper seems to be out of control. He seems to struggle with the constant need to pay attention. He feels one particular teacher goads him to get angry though I'm pretty sure this is my son reading the situation wrong. He loses his temper, lashes out or just walks the corridors in a bid to get away ( from his anger maybe??) He had more recently punch a window in anger and hit another boy who verbally attacked him. He is now classed at school as out of control. 

I have sat him down and he tells me he feels the anger in the pit of his stomach and it rises and he can't control it. I've told him to try breath through it ( he thought this was funny as he says he can't) . I've expressed walking away when he feels the anger brewing ( but again he can't if in school).

In general he is a lively boy, with a comical sense of humor, who can be quite bouncy and heavy footed all at the same time. He can be caring and loving and intelligent but the anger is paving the way for all off the good qualities to be ruined by this. Is this anger overload? ADHD? I feel I talk to him and he hears me but just can't implement what I tell him. How do I help him to learn to control his anger or what treatment do I seek out for him .

Thank you.


Hi, You made some good suggestions about taking deep breaths or walking away.  Also your son noticing a feeling in the pit of his stomach could be helpful.  Is this before he loses control, and could he learn a strategy to implement right at that time before he reaches overload?  Some schools will convene a 504 meeting that allows for modifications in the school routine.  You can ask for such a meeting.  In your son's case, it would be great if the school could work out a "go to" place for your son when he starts to feel angry.  In some schools this is the social worker's or nurse's office.  In other schools it is the hallway or bathroom.  In any case, your son would be encouraged to signal the teacher when he feels the need to leave and then return as soon as he calms down (usually 10 to 20 minutes).  

I outline strategies in my parent's manual and in the the anger overload workbook, both are  available from online book sellers.  I explain how it is important to consider the triggers.  In your son's case it seems interaction with one of his teachers is a trigger.  Your son should be on the lookout for his anger in that class, and work on ways to look at the situation differently.  For example, he could learn to say to himself that this teacher is strict or hard on everyone at times (or use whatever, adjective helps him to look at the situation in a new way).  He could be encouraged to think to himself that she may " bark" but she won't "bite", or some other memorable phrase.  In my manuals and workbook, I outline other useful strategies.  Ideally you would talk them over with your son and he would try one or two that he preferred.

ADHD is a different problem but can co-exist with anger overload.  With ADHD, children have a hard time staying focused in class; they are easily distracted.  In addition there may be some impulsive and hyperactive behaviors.  Usually there are signs of problems with concentration in school  from a young age.

Best, Dr. Dave Gottlieb

Monday, January 28, 2019

11 yr old with anger overload, ADD, and anxiety

Hi Dr. Dave,

I have just read your blog and article at Great Schools. I write to you because I feel identified with the stories you share. My son has been diagnosed to have ADD. He is also is diagnosed by IEP and by his pediatrician to have OCD, anxiety and mild depression.

My kid is having a hard time to at least find one close friend to come over for a play date that makes him feel very lonely, even when I am trying my best to have him busy. I find this situation challenging for me as a mother with not family close by. I have also a 14 year old, and he has good friends, and my 11 years old is always jealous and defiant with him because he cannot get friends like him. I am teaching  my older son to help his bother and be kind and tolerant because of the current issues with him. 

I see your description of overload anger and it pictures my child suffering from that more than anything else. I am a divorced mother. His father used to have this overload anger too very often, throwing things to the floor when you did not do things in his way or was in disagreement. Yelling or getting angry very fast for any minor issue. Sometimes yelling or even slapped one of my boys for minor things. I see my child react the same sometimes by throwing things to the floor or yelling.  

I found your techniques very interesting. I would like you yo please give me the title of all your books to help me out to help my son. He is 11. I wonder if you still work in Chicago. I am willing to maybe set up an appointment with you via phone conference if you are still in practice. 

Unfortunately, the father of my kid doesn’t want to accept that my kid has an ongoing neurological problem. I asked his father to come along to therapists, and he always discusses and affirms to them that my kid doesn’t have any problem at his place and he is well behaved at his home. I always believe he may have had this problems as a kid and he doesn’t admit it or want doctors  know it. However, he doesn’t understand that denying this problem and not accepting participation and leaving my son with no  therapy will leave him growing up unhappy and increase his anxiety and possibly a constant depressive mood. 

Please I would like to know your thoughts! 
Thanks for support with articles to parent like me!!


Hi, 

My books are available at online sites like Amazon and Barnes and Noble.  My books include Anger Overload:  A Parent's Manual, 
Anger Overload:  Additional Strategies for Teachers and Parents,  
The Anger Overload Workbook for Children and Teens,  
Your Child is Defiant:  Why is Nothing Working?
Why is My Child's ADHD Not Better Yet?   

It would help if all the adults worked together on the strategies I outline in my manuals.  Maybe don't disagree with the Dad about what happens at his house, but still let him know what you are working on at your house.  Maybe then he will consider the strategies too, even though he says that he does not need them.  Also, you could ask his father to let your son know that he supports your plans and wants your son to use the strategies at your house. 

Read the parent's manual first.  Next, the workbook for children and teens is for children 8 and over, and you could read that book with your son and devise strategies together. One of the books is especially written for teachers.  The other books help give advice for ADHD and for defiance.  

Regarding making friends, ask his teacher if there is anyone he spends time with at lunch or recess.  Also, try to find a children's club or group activity that meets regularly in your area.  Sometimes, a friend emerges from these activities.  Also, the school might have a social skills group that meets weekly during school hours. 

I don't do phone consultations, as state licensing laws do no yet permit that in most states.  Keep working with a mental health professional in your area and with the school.  See if you can implement some of the strategies in my books.  Over time, your son can develop better self control.

Best, Dr. Dave Gottlieb

Thursday, January 3, 2019

Grandma worried about 8 year old

Dear Dr. Dave,

I was just reading your blog and so many of them describe my grandson.  I am so worried about him.  He is an 8 year old boy who for the past 3 years has shown outbursts of anger.  It has gotten worse over the past year.  My daughter is taking him to a psychologist for the past few months.  She has suggested several different ideas to help him work out his anger.  Glitter jar to shake, or go to his bedroom, or make a fort to go to into when he is angry, but he does not do these things. When he gets angry he sometimes gets physical.  I notice that sometimes before it starts, he makes a growling noise.  He cannot tell us why he is getting angry.  There have been problems in the home at times.  His parents argue in front of the kids.  It is breaking my heart to see him going through this.  He tells them sometimes in this rage that he wishes they were dead.  

Does this sound like anger overload?  Need help to understand and help him!!!!


Hi, What I would recommend is writing on some paper what is going on each time before he explodes.  Has there been a disagreement among his parents?  Is he disappointed that something did not go his way?  If you can keep track of what happens first, then you might notice a theme or pattern.  You might be able to see what kind of issues precipitate his anger.

Then, you can try to head off an outburst by using one of the techniques I describe in my parent's manual.  You can use "emotional distraction," or lower your grandson's expectations before he gets upset, or use a calming technique with him. I describe these strategies in my manual and in other blog posts.

One thought I have is to use his growling noise as a sign that he is close to getting into the overload phase.  See if you can use emotional distraction or a calming strategy  at that point, before he explodes.

The reason why the strategies you describe above (like going inside a fort) do not work well is that once a child gets to the overload phase, he is not thinking rationally.  So the child will not usually follow advice at that point.  Then you have to wait it out and walk away (unless he is doing something dangerous).  I know that this is a difficult time for parents, and it's hard to walk away, but if you pay too much attention or try to reason with him during an outburst, he is likely to get more angry.

If there are family issues, then having the parents work on those issues with the psychologist will pay dividends for the whole family.  Also, you will need the parents' help to keep track of what goes on before an outburst, so having them involved in the therapy is important.

Best, Dr. Dave Gottlieb







Thursday, August 9, 2018

What to do about anger overload in children


I discovered your blogsite searching anger overload. My daughter is 7 years old.  She has been diagnosed with ADHD and anxiety.  She has outbursts in school and at home.  Her outbursts can range from screaming and defiance to physical aggression.  After she “blows up” she feels better and can always tell me how she should have handled herself.  She is usually remorseful after she has hurt someone and apologetic.  She has told me that she can’t control her anger.  She is a bright young girl and such a sweet child until she gets angry.  We have been to several therapists, a psychiatrist, and a pediatrician.  Nobody can seem to help.  They just want to keep pushing meds.  Is Anger Overload a real thing?  Is there anything that can help her?  She has so much potential.  This cannot be her life.  There has to be something out there to help this child.  Any information would be helpful.


Hi, I coined the term "anger overload" to describe the intense outbursts that some children have to frustration.  The diagnostic manual that mental health professionals use does not have a diagnosis for frequent angry outbursts, but I have been seeing children and teens for 30 years, and this can be a problem independent of other issues.  

I have written manuals for parents and children about how to reduce the frequency of these outbursts.  Other blog posts also describe some of the approaches:  monitoring when the outbursts happen and looking for themes, altering the routine that precipitates an outburst when possible, lowering a child's expectations to lessen disappointment, using emotional distraction because anger diminishes if you can get a child to giggle or smile, using labels and mantras to help a child anticipate frustration and head off an outburst.  These are some of the techniques I discuss in my manuals for parents and children.  The children's manual is best if a child is 8 or older.  My manuals are available from Amazon and other online book sellers.  

Best, Dr. Dave Gottlieb

Thursday, July 12, 2018

Follow-up about therapy and the use of consequences

Can I ask a couple more questions? 
Regarding seeing a clinician - If anger overload is something you coined, what language might they use? Should we see his pediatrician for a referral?
Regarding incentives - Would you stop consequences altogether? Do we seek a balance?

Again - thank you so much for responding and giving us some direction.


Hi, I would ask about whether the clinicians work with children and families on "anger issues," or an alternative question would be whether they work with children who have "repeated outbursts."  Pediatricians are a good source for referrals in your area.  Sometimes the school social worker or school psychologist know who to recommend, and lastly other parents might have suggestions.

I would recommend a balance of incentives and consequences, as each can increase a child's motivation.  But remember that they only help if the child is thinking rationally, and that is not likely at the moment of overload.  However, sometimes incentives and consequences help if the child thinks about them before he gets into the overload phase.

Best, Dr. Dave Gottlieb

Thursday, June 28, 2018

Questions about therapy, consequences and long term outlook

Hey Dr. Dave,
So many things running through my head, so I'll try to narrow them down. Our son is soon to be seven and exhibits behavior consistent with anger overload, though we've never seen a professional and thus no diagnosis. Frankly, I'm hesitant to have him diagnosed/labeled. Instead, we've done our own research, read your book and blog posts, and are convinced this is what we're dealing with. We've taken your advice to heart, even changing our own behavior to model appropriate anger, and have seen improvement in the few months since we started. Are we wrong in that approach? Are we depriving him (and us?) of help? Can you share your thoughts on this?

Our main challenge, lately, has been consequences. For the most part, we do well to recognize his triggers, attempt to distract, use coping words and techniques (e.g. 3 slow breaths), ignore him while he rages, give him a place to cool down, etc. But when it comes time to enforce the consequence for his inappropriate behavior, it seems so insignificant compared to the fit he threw. Additionally, he doesn't seem to care. He accepts the consequence as a matter of fact (disobedience = consequence), but it doesn't seem to serve as a warning the next time he gets angry. We need help determining what kinds of consequences are appropriate and will help teach the lesson. Should the consequence be proportional to the anger? Time out seems inconsequential when he's destroyed a bedroom or living room. We've taken away toys, had him sit out during pool time or other fun activities his siblings do, but none of it seems to stave off the next outburst. In fact, some of the consequences have triggered a new outburst.

Finally, is there information regarding how kids with anger overload turn out as adults? Are they more prone to mental health issues? Or to be verbally or physically abusive in relationships? Do they have trouble transitioning into adulthood from adolescence? I guess we're looking for reassurance that he can grow out of this.

Thanks for your work - it's been helpful!


Hi, you are effectively using a number of strategies outlined in my parent's manual, and you ask some good questions about where to go from here.  Let me start with your first question.  If you reach a point where the frequency and intensity of outbursts does not diminish over a month's time, then getting a professional consult might be helpful.  In that case, you would want a mental health professional who works with children and families on anger issues.  "Anger overload" is a term I coined to describe these outbursts; your clinician may not use that term, but what is important is that he/she works with anger issues.  The other thing a clinician can help with is to determine if there is another psychological issue that is contributing to anger overload.

In answer to your second question:  Consequences only help if the child has enough self control such that he is motivated to control his anger in order to avoid the consequence.  The problem is that most children in the overload phase are not thinking rationally and are on "automatic pilot" so to speak.  This is why consequences are not particularly helpful for anger overload.  Sometimes if you catch the anger before overload, the child can hold on in order to achieve an incentive or avoid a consequence.  I would recommend if you continue to try consequences that you also try incentives.  Some children respond better to incentives.  The incentive should be something short term and something the child really wants to do.  But incentives, like consequences, only work if the child is thinking rationally at the time of anger.

There are no longitudinal studies of anger overload that I am aware of.  However, from my experience and from articles written by other clinicians, I think most children improve significantly in self control as they get older, and these strategies help the process along.  Repeated use of emotional distraction, using calming techniques, developing self observation skills, and learning mantras all help with development of self control.  There is likely biological underpinnings of these changes.  We think there is better coordination with practice between emotional centers of the brain, like the amygdala, and the control centers in the prefrontal cortex.  

Best, Dr. Dave Gottlieb