Wednesday, July 4, 2012

7 year old with tantrums that can last a half hour

My son, who is seven, experiences outbursts of anger that are completely disproportionate to the triggers. When calm, he is a very bright little boy, but he is prone to fits of rage if things don't happen the way that he wants them to. Losing a piece of lego will precipitate a tantrum that can last up to half an hour, during which he will scream 'it is all your fault' and accuse me of not loving him and not caring about him, which I find immensely upsetting. Interestingly, after these tantrums, he is often calm and thoughtful, almost as though he has released some pressure. He is often contrite, promising not to do it again, until the next time, which at its worst can be later that day or the next day. Does this sound like anger overload? I think that it does judging by the limited amount of research that I  have done, and which of your books would you recommend to try and help all of us in our attempts to modify our behaviour?

I am desperate to do something, and keen to see if we can help ourselves overcome this problem. His irrational behaviour has the ability to ruin family occasions and as he gets older, I am running out of excuses as to why he behaves like this.

There have been no problems at school and despite direct questioning, the teachers deny that there are any issues with his behaviour in school.

Hi, Yes it sounds like anger overload, and I'd recommend first you read "Anger Overload in Children:  A Parent's Manual."  It is a "how to" book and explains various strategies in concrete terms and provides charts to help you implement the strategies.  My other book on defiant behavior is useful if you want to determine whether there are other underlying problems contributing to the anger overload.  Sometimes there are social, academic, or emotional disorders that can bring on anger overload, but your description does not suggest that this is the case for your son.  I'd try the strategies for anger overload and if you reach an impasse, I would check with a mental health professional to help.  (My third book is about ADHD and how in more than half of children with this diagnosis there are co-occurring conditions that need to be considered for treatment to be successful.)

There are often biological underpinnings for anger overload.  Some children react more intensely to frustration and have longer outbursts, and we think this is because for some children the prefrontal cortex (outside layer of the brain) is not developed enough yet or because the inner limbic brain, particularly the amygdala, is flooding the prefrontal cortex when anger is stimulated.  With repeated practice of strategies to change the way a child thinks about and reacts to triggers, a child can learn to have better control of his anger.  Our brains develop when we repeatedly use new behaviors.

I know it is hard not to feel bad when your child, in the midst of an outburst, accuses you of not loving him.  However, keep in mind that when your child is that angry he is not thinking rationally and he will strike out with the most awful statements.  It is like "verbal diarrhea."  When your child is calmer, he would be able to acknowledge that you really do love him, and it is what he says when he is calm that is truly meaningful.

In the manual, I first go through the steps that you can use with or without your child's direct participation.    In other posts and in the manual, I review in detail how you, as "agents of change" can sometimes alter the situations that bring on your child's rage.  In the second half of the manual I explain strategies you can work on with your child.  These "cognitive behavioral" strategies take time and practice.  Change occurs over weeks and months, rather than in days.  It is not easy for your child because he is biologically prone to quick and intense anger.  But with practice, he will learn to develop better self control, and this is so critical for him to get along better in the family and in his future relationships.  All the best, Dr. Dave Gottlieb

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