Wednesday, May 23, 2012

Interview with Dr. Gottlieb in the Chicago Tribune newspaper

Here is the interview in today's newspaper about dealing with anger overload:

Managing Your Child’s Meltdowns: 
It’s Best Not To Intervene in the midst of anger overload

By Bonnie Miller Rubin, Chicago Tribune reporter
May 23, 2012
Kids are kids, which means they get angry — and don't always choose the right time or place to lose it. So, how best to maneuver around a meltdown? We turned to David Gottlieb, a Harvard-trained clinical psychologist, who has worked with children and families in the Chicago area since 1985. He is the author of the just-published "Anger Overload in Children: A Parent's Manual," a follow-up to last year's "Your Child is Defiant: Why is Nothing Working?"
He also has a parenting blog,, and as a father of three, plenty of on-the-job training.

Q. What is "anger overload," and how do parents know when it's a problem in their child?
A. "Anger overload" is an intense rage reaction to some frustration, and the level of anger is out of proportion. Usually this is because the child misperceives or exaggerates the significance of a disappointment. For example, if a parent says their child cannot play video games today or have a friend over to play, any child might be disappointed, but the child with anger overload goes into a rage that can last minutes or hours. ... The child does not keep the disappointment in perspective. This child might feel if he can't have the friend over today, then the friend will stop liking him.

Q. Can you describe it?
A. Anger overload is a problem when a child "loses it" and screams hateful things or throws things. ... We all can get quite angry once in a while, but this child has outbursts frequently that can last for minutes or even hours. If the child does not learn to contain his rage, this problem can get in the way later in life.

Q. What's the appropriate reaction when your child is going to have a meltdown?
A. Parents can intervene in the early stages or after the fury has subsided. During the overload phase, it is best to say or do nothing, unless someone is getting physically hurt. ... Your child is not thinking rationally. If you recognize a pattern for when your child is more likely to lose it, you can intervene early by lowering your child's expectations. ... So, if your child loses it when it's time to turn off video games on school nights, one possible solution is to not play video games after dinner.
You can't always predict the triggers, but if you see your child starting to show signs of anger overload, try an "emotional distraction"... saying or doing something that he'll find engrossing. ... If you know your child loves a certain game or activity, you can start the game ... or try a calming activity. For some, it's music on their iPod, for others, a bike ride or yoga.

Q. It seems that more children are defiant these days. Is this accurate?
A. Honestly, I haven't noticed a change in the last 30 years of practice. When I work with defiant children and get a family history, it's not unusual to hear a story about a parent, grandparent or relative who gave his parents a hard time ... or left home in anger.

Q. Is this learned behavior or an organic issue?
A. Some children are more prone to angry outbursts, and there is increasing evidence of underlying biological factors. The prefrontal cortex is believed to be the main "control center" of the brain, while the amygdala is generally thought of as where angry feelings originate. One prominent theory: The prefrontal cortex is immature in some children and is not able to regulate the emotions in the amygdala. Recent studies in adults suggest that low levels of certain neurotransmitters — chemicals in the brain — are associated with people who exhibit extremely angry or violent behavior. Research is ongoing, and we do not have a medicine that is an anger "antidote." However, with repeated practice, most children can develop better coping skills. ... With practice, the brain changes.

Q. Should parents use consequences if a child swears or strikes out during anger overload?
A. The issue of consequences is an interesting one. During an outburst, it's not wise to talk about consequences because it will cause most children to escalate. However, it is sometimes helpful to talk about a brief consequence after everyone has calmed down — especially if certain family rules are broken. So you are not punishing the outburst per se, just a behavior, such as swearing or throwing things. Some children learn from consequences ... however, many children will continue to say the meanest things they can think of to "strike out." If a child says, "I hate you. You are the worst parent ever," I tell them that children do not mean what they say at that time. Don't pay attention to the words. If you can ignore your child, that is in itself a consequence. When he calms down, then you start listening and talking with him.

Q. Can certain foods, allergies or diet trigger angry behavior?
A. There are not large-scale studies that I am aware of showing that allergies or diet trigger tantrums. Some parents notice that their children have more outbursts during allergy season, and this makes sense, because if children are struggling with allergies, they are often more irritable.

Q. What has proven to be the most effective technique in dealing with anger overload? Is it the same if kids have some kind of disability?
A. I give parents an "arsenal" to work with ... different strategies for different stages of anger and different ages. For children with a disability — say, like fetal alcohol spectrum disorders — timeouts or any suggestion — even well-meaning — usually exacerbates the rage during the overload phase. These children have structural brain damage, so suggestions before and after outbursts will have more modest effects.

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