Tuesday, October 2, 2012

9 year old with angry outbursts at home

I was excited to find your article about anger overload.  My 9 year old son has issues controlling his anger at times.  I don't think that he fits the description of oppositional defiance disorder and the like, but I know that something is wrong.
He's normally a sweet boy and he is extremely smart.  He is in his school's gifted program.  He has never had an issue at school.  Most of his outbursts occur at home, although he has had a couple during soccer games when he felt he was wronged (which was very embarrassing). Usually, his outbursts involve his older brother.  Big brother knows which buttons to push and this is something that we have been working on, too.  Summer was a trying time, since the boys were together all day, every day.  Things have been better since school has started up again.

His outbursts usually involve a lot of yelling, slamming doors, throwing or kicking things.  During the incident, he has no concept of reason and has no remorse.  That changes once he has completely calmed down. We have asked him about his behavior when he is calm.  He tells us that he can't control himself when he is angry.  I have also asked him why this doesn't happen at school.  He said that no one bothers him at school.

Unfortunately, once when he got angry with his brother, he tried to throw a large toy at him.  Instead he accidentally hit his cousin in the head, resulting in stitches.  Yesterday during an argument over a game, he threw a large rock at his brother.  I told him to stop and during the short time while I was making my way to where the boys were, he picked up another large rock and threw it.  Luckily, no one was hurt.  I worry that he may hurt someone again or have an outburst when he is away from me (at a friend's or relative's house.)   

We try to prevent his anger outbursts by intervening when we see he is getting upset and making sure he gets enough sleep.  He is definately more prone to them when he is sleep deprived.  However, life is life and I can't control all of the circumstance.  He needs to be able to cope on his own.

My main concern is two fold.  First, how do I know when he needs professional help and second, what techniques should I be using to help him?  I am looking forward to getting your book and I appreciate any insight you can provide.
Hi, What you describe is consistent with anger overload.  These children feel an intense surge of anger that is difficult for them to control.  One step that you have taken already is to try to intervene early in the sequence when your child is beginning to get upset; what I would recommend you do next is to try to prevent a blow-up from even starting.  See if you can identify some of your son's triggers as early as possible and try to re-arrange situations to avoid these triggers, when possible.   You mention that he often gets angry with his older brother.  See if you can identify the themes for some of these situations:  does the anger erupt in competitive activities, or when he is teased?  If the latter, what activity is going on when he is teased?  If you can identify some of the types of situations that trigger your son's rage, you can prepare him (and your older son) in advance:  "When you guys play soccer (if this were the situation, for example), remember that you are older and stronger, so I don't want you to play against each other, but rather on the same team."  You try to avoid a blow-up by identifying your younger son's trigger and preparing him (and his brother) in advance.  You repeat your advice regularly before they go out to play.

You can also teach your son other strategies that I outline in my parent's manual.  For some of the strategies, it is important first that your son recognize that he has a problem with anger, and believe that it is important to work on it.  You lay the groundwork after each incident of anger overload.  When he is calm, you review the situation, and explain that you are going to work on this together so that he can learn to be the master of his anger.  I explain in the manual that it is important for parents to be empathize with how hard this is, but also parents should point out to their child that he can learn tools to have better control, and that you, the parents, are going to help him.
In the first part of the manual, I explain strategies that parents can use without having their child agree on a plan of action.  If your son is not ready to see his angry outbursts as a problem, there are still strategies you can employ to lessen the frequency and severity of his outbursts.  
A professional can help when you are not making headway at home.  Sometimes parents are "so close" to the situation that they overlook something, or they inadvertently do something that angers their child.  One common mistake is to talk to children when they are raging.  This usually prolongs an angry episode.  You want to take action if someone is about to be hurt, but otherwise you want to wait out your child's outburst.  Whether you have to take action or not, you do not want to talk much.  The more you say, the more your child will say back.  As you point out in your comments above, children are not thinking rationally during anger overload, so they will not listen to what parents have to say at that time.
Besides helping to implement the strategies, a professional can help if there is an area of vulnerability (maybe there is a self-esteem issue) that underlies the episodes when he gets angry.  Another reason it may be hard to make headway at home is that there could be a secondary diagnosis that a professional can help identify.  So if you do not make headway in the next month or two, consider reaching out to a mental health professional in your area.  All the best, Dr. Dave Gottlieb

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