Friday, June 29, 2012

4 year old with anger overload

I just came across your article after searching for what is wrong with my son.
He struggles with what I describe as Jekyll and Hyde anger fits. Anything can trigger them even when he's well rested and well fed. Besides that he's normally a bright sweet child.

There isn't a lot I could find on the Internet about this and was wondering who I should be taking him to to see if this is what he has and to help treat him?

Also wondering which of your books you recommend we start reading first.
Thank you so much for writing about this in the first place and helping us pick the right track to get started. The more I read and poke around about it the more it fits so well to his behavior.

Hi, My parent's manual for anger overload in children would be a good book for you to read first.  It is available at the publisher's site: or on Amazon.  My book on defiance in children would be useful if you want to explore other possible diagnoses that can occur when a child is exhibiting angry and disobedient behavior.   Sometimes there are other underlying conditions that need to be treated in addition to anger overload.  However, I would start with the most direct approach, which is to work on your son's blow-ups by trying some of the methods in the anger overload manual.

For 4 year old children, I would focus on the first half of the manual.  Here I give strategies that use the parents as the "agent of change."  In other words, you employ strategies that do not require your son's direct participation or consent.  The second half of the manual outlines cognitive behavioral strategies that parents work on with their child.  Most of these work better with school age children and teens.  The one strategy in this second section that I would recommend trying with your child is labeling out loud the levels of your child's anger.  I suggest child friendly terms to help make your son aware of when he is starting to get wound up.   The idea is to help him realize what is happening so that eventually he can participate with you in calming activities.  However, this labeling process takes time and is not where I would recommend you start.

The strategies that put you in charge of the change process are going to be key for a young child.  There are three main stages and I describe strategies for each stage.  First is prevention.  Here I show you how to lower your child's expectations and change the sequence to avoid anger overload.  Next I explain what to do in the early anger phase:  how to use emotional distraction and calming strategies.  Then I explain what to do, and what not to do, when your child is in the height of the anger overload phase.  Also, I explain how you and your husband can be role models by labeling your efforts out loud to control your own anger.  You can also use praise and consequences but these generally do not work well when a child is in the full anger overload phase. 

You can also read more about these strategies in the earlier entries in my blog. 

Regarding your question about who to take him to, I would recommend a psychologist or social worker who works with young children and their parents.  The strategies that are most effective for young children involve you, the parents, as the agent of change, so you want a therapist who coaches parents in addition to evaluating your child. 

All the best, Dr. Dave Gottlieb

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