Thursday, February 9, 2012

9 year old bites self and bangs head

I have come across your website with great interest and relief, as my 9-year old son is, I believe experiencing anger overload. Until this evening I had not managed to find any information about this age child having such a problem. Only younger children or teens with such anger and outbursts. My son has up to 3 or 4 episodes in a bad week, sometimes twice in a day, and gets so angry for no reason that he ends up turning his anger on himself and biting his arms/hands/legs, or banging his head on the wall or floor. It is very distressing and my husband and I do not know what to do for the best for him.

He is bright, normally a lovely calm and interesting boy, but when he feels angry or unfairly treated, he can react in this way, and he’s getting too strong for us to hold him and stop him from hurting himself.

Hi, While these seem to be instances of anger overload you are describing, you would also want to go to a mental health professional to rule out other possible co-existing problems, like a mood disorder or autistic spectrum disorder.  There are many books about these problems, and you can also read more about various co-existing disorders in my book on defiant behavior (see link in photo above).  Once you have ruled these out, then the exercises in my anger overload manual will be of help to you.  The final version of the manual should be ready in a couple of months.

A few ideas to get you started:  Chart the instances during the week when your son has anger overload.  You want to see if there are any patterns that would explain some of the situations when he has an outburst.  Then you can try to use this information to catch the overload early (if possible) and use distraction (see earlier blog entries about how to do this) or plan to avoid the triggering event in the future.  Develop a chill place in your house (see earlier blog items) which your son could use when he is getting agitated.

Once your son is in full overload, it will be hard to interrupt the outburst.  But you want to make sure he is safe, so if you can restrain him if he is hurting himself or someone else, then do so.  If the head banging is severe or biting is severe, can you safely bear hug him or restrain him on the floor?  You may need help depending on how much your child resists.  

You also can begin to make him aware of anger overload and how to work on it by using yourself as a model (see previous entries) and by labeling the level of anger (see earlier entries).  Once you are able to catch it earlier before total overload, there are other cognitive strategies that you can use, including developing a catch phrase to re-direct his thinking.  Catch phrases are short sayings used to remind the child that there are other points of view, other than his current view (which is leading to his extreme disappointment).  This will be fully explained in the manual.  

I hope this helps you get on track.  I will be leaving town for 10 days, but will try to respond afterward if you have more questions, David Gottlieb, Ph.D.


  1. My 9 year old has a diagnosis of ADHD. He has recently started biting himself on the arm. When I ask him why he does this, he says it's because he is stressed or be cause he is feeling bad about the things he has done and feels like he needs to be punished. He has seen a psychologist and has also been diagnosed with anxiety disorder. I'm really worried about him. What do I need to do to help him?

    1. What does the psychologist suggested so far? Without knowing too much about your son, I have these thoughts: 1) It is good that he can verbalize he is stressed or feels he needs to be punished. 2) The next step might be to encourage him to brainstorm about what are several options he can take when he feels stressed and also several options for when he feels like he needs to be punished. You can suggest some options if he cannot think of any, but ask him if he likes your suggestions. 3) Then create a list he can keep in his room, and practice some of the options with him before he gets real stressed. One of the options could be to talk more about what is bothering him. Another option might be some diversion activities he enjoys so that he does not obsess about what is bothering him. A third type of option could be some kind of relaxation exercise. 4)It might also help him if you could "normalize" whatever behavior he is feeling guilty about. Some children are too hard on themselves and need to know that it is okay to make mistakes: you could tell him "everyone makes mistakes."

      Children with ADHD and anxiety can get down on themselves sometimes because they tend to forget things or not pay attention (due to ADHD, and then get "consequences" in school or home for not paying attention. Anxious children tend to get upset with themselves for making these types of "mistakes." Their anxiety and guilt gets activated when adults point out they were not paying attention, for example. Help your child to see this pattern, and try to help him take the pressure off himself. All the best, Dr. Dave Gottlieb

  2. According to the psychological assessment the DSM-IV states:
    Axis 1-attention deficit/hyperactivity disorder, combined type
    Axis2- anxiety disorder NOS
    Axis 3-diagnosis deferred
    Axis 4-asthma, allergies
    Axis5- GAF=50

    I spoke with him extensively about what was going on and he told me that his best friend was bullying him when other kids are around-peer pressure. I told him that I just wanted him to talk to me when he feels stress or anxiety. He has not self abused since that day, but I continue to worry about his coping abilities. He over thinks and over reacts and everything is "the end of the world". He takes clonidine for the ADHD and I thought about talking to his doctor about anxiety meds. However he is nine years old and I do not want him taking any more medication. He no longer plays at recess with other kids. He walks or sits under a tree to avoid any contact with the other boys in his grade. He cried this past Friday because everyone makes fun of him and he has no friends. I understand peer pressure, lord knows we've all been through it, but like I stated earlier his coping techniques concern me. Academically he is an A student.

  3. Maybe you and the psychologist can help him with new, more positive self-statements to replace thoughts like "this is the end of the world." One possible new thought is "sometimes a kid will tease me, but a lot of people still will play with me."

    The problem with avoiding social interaction at recess is that your son will continue to think he would be ostracized if he did join in. If there is some way he can be encouraged to play with someone (maybe with adult nearby at first to watch), and if it goes better, then he will learn that children do not generally make fun of him.

    Also ask the teacher if there are other children who he might relate to, and then maybe see if you can get the family's phone number and arrange for the boys to play outside of school. Sometimes a child will feel more likable and secure then, and will play with his new friend at recess.

    Make sure staff is aware of the problem too and comes down hard on any child who is verbally abusive to him.