Tuesday, November 13, 2012

7 year old who kicks and throws things

We have three children, all of whom were adopted. Our son always sweet as a baby is now our biggest source of stress and heart break. He was somewhat obsessive about skateboarding, even when he was 2 but not more than many boys were with trains. He had a language issue when he was a baby and was very frustrated, and was classified so he could have help negotiating himself in the nursery school classroom. He was always very much a "boy" but all his teachers said it was never a problem. Starting second grade he decided not to go to school . It was too hard, not enough breaks and too long of a day. He has always been insecure about his intelligence. He gets some reading support at school but is not behind the curve and is doing very well now. Over the summer, and spring, he developed a love for video games, especially Mind Craft, which he dreams about but reacts to it like crack. We've tried sticker charts, the explosive child strategies, therapy, punishment of all sorts and every thing  works a little for a little while. He is getting more angry when he doesn't get his way. He kicks doors, chairs, throws things, and is 7. I fear what may happen when he gets a little older. If you can help in anyway it would be greatly appreciated. 

Hi, some children have trouble regulating anger.  Once they get frustrated, their anger quickly escalates into explosive behavior.  The key is to try to intervene early in the sequence when possible.  Rewards don't always work because these children are not thinking ahead at those times, but reacting emotionally.  The first thing to do is to observe carefully what some of your son's triggers are, i.e. what situations lead to his tantrums.  Then think about whether you can re-arrange the situation to avoid the trigger.  Or if you cannot avoid the trigger, can you prepare him in advance to get ready for the situation.  Before he gets aroused, he may listen to suggestions or incentives. 

The other set of strategies is to teach him how to handle his frustrations.  The key here is to get your child to think with you about his explosions each time they happen (later in the day once he is much calmer).  You talk about what happened, what the trigger was, and help him think of alternative ways of thinking and alternative ways of reacting.  I explain the steps in my parent's manual.  If your son does not yet see his tantrums as a problem to work on with you, then you will focus on the strategies in the first half of the manual (strategies you can employ without your son's cooperation).  You would still talk a little after an explosion (but not during) to try to get him to see the costs of his behavior.  Once he recognizes the pain he is causing, he would be ready for teaching him alternative ways of thinking and alternative approaches to regulating anger.

You would also want to deal with any insecurities your son has, especially if they contribute to his anger.  Does his reading problem, though improved,  precede an outburst?  You mentioned mine craft:  does he have trouble getting off that game?  Are other transitions hard for him?  Did his therapist have any thoughts about problems that could be contributing to his explosions?  You would want to help your son deal better with any underlying insecurities.

All the best, Dr. Gottlieb

Wednesday, November 7, 2012

12 year old with increasing angry outbursts

Dear Dr. Gottlieb:
     I came across your blog and book while searching for ways to help our son.  We quickly ordered your book and your description of children with anger overload really does describe our son perfectly.  He directs his anger only towards me and his 4 year-old sister, whom I tried to shield.  He blames her for everything and thinks it's unfair that he has to do homework, while she has none.  He would literally go into a tirade unless I give her some "homework" to do.  I eventually printed out some letters and shapes for her to trace, which she was very willing to do.  That did not appease my son, and he soon found something else to complain about his sister.  He would push her or slap her every time he passed by her.  We had our daughter when my son turned 8.  At the beginning, he was excited, but soon became increasingly jealous and annoyed of her presence.  Whenever we could, either my husband or myself would take our son out to the movies or to lunch, just to have a one-on-one day.  He really enjoys those.  When he comes home from those trips, he is usually much nicer to his sister, but in a day or so, he will be extremely annoyed with her again. 

     The second trigger is homework, in particular, Math.  Math is his favorite subject, so when he moved up to Advance Math, he was super excited.  However, the bulk of his tantrums are during Adv Math homework time or studying for a Math test.  He would literally open up his text book and throw a fit.   I started keeping a "tantrum" chart to keep a record of his outbursts, and he seriously goes into one of his tirades every other day.  My husband and I have asked my son to step down to regular Math, so that he will be less stressful, but he refused and threw another tantrum.  So I told him that I will help him with his Math (I excelled in Math and used to be a Math tutor) and we will go through the homework together.  But that didn't help, because with or without me, he will do all his other homework first, and would procrastinate until the very last minute before he will tackle his Math homework.  Then he would throw a tantrum because by then, he's stressed AND tired.   So we suggested that we would tackle the Math homework and/or studying first.  That just threw him into another fit because he didn't want to....he wanted to tackle his Math last.  

    He also, a few weeks ago, started to hit me physically, point his finger at me, and curse incessantly at me (with the f-word and all).  He would literally scream at the top of his lungs.  I tried talking him down before a full-blown episode, but it just hastened the onslaught.  But he's only like that at home.  Everyone else thinks the world of him.  He's very respectful, humble, talkative, nice and easy-going at school.  Even his friends' parents like having him around.  The only person he disrespects constantly is me.

     I admit that there had been occasions where I had lost it as well, and there would be really horrible shouting matches.  Mentally I'm so exhausted, but I have to bear the brunt of it because my husband is short-fused.  He grew up with an extremely angry and volatile father.  I truly believe that there is something inherited here...something in the genes so to speak.

     We tried to seek professional help and looked into counseling.  The counselor only wanted to meet with our son.  At first we trusted her and hoped for the best.  But later, as things deteriorated, we inquired about his sessions, and the counselor refused to divulge any information. 

     So, what can we do if the trigger is a part of life?  How do I isolate our daughter from our son?  What can a parent do when homework is the trigger?  Any suggestions or insights would be greatly appreciated.  We have just started the 2-week observation period suggested by your book.  Thank you so much.

Hi,  It sounds like you have tried several things, like doing one-on-one activities with your son, offering to help with his math work, and trying to talk him down.  You identified two triggers: jealousy of your attention to his sister, and frustration with the math homework.  How best to respond to these triggers?

First, I would talk less when he gets angry about math, and I would not offer choices (since he refuses the options and escalates).  Decide if you want to help him with math or let him do whatever he can, and then he could ask the teacher or a tutor for help.  You pointed out he does not get angry outside the family, so he would probably work better with a tutor or the teacher.  If you are going to work with him, let him know when you are available (what time of day, preferably the same time each day) and tell him you will stop for the day if he yells at you or tries to hit you.  Then stick to your guns.  Only help at the time you say and stop if he yells.  Yes, he will likely tantrum worse then at first, but over the course of the next few weeks he will probably realize that you are going to continue to withdraw when he loses his temper.  Remember that talking at these times does not usually work.  Most children will escalate if you try talking with them while they are angry.

Also, I would have a serious consequence for any hitting or physical contact.  Tell him ahead of time what that consequence would be (usually 24-48 hours with no "screens"--television or computer, or something else that he would miss), and then let him know when he is calm (after a hitting episode) that the consequence is now in effect.

I like that you are spending some one on one time with your son, and in addition, I would set up some rewards for cooperative activities with his sister.  Explain that he is the leader, and he can choose the activity, but that any fun activity he does with her, you will then do an activity with him alone later that day or the next day.   Since he has kept her busy, you can say you were able to get your chores done, and in appreciation you will do something with him.

Basically, you are re-arranging the sequence, so that cooperation leads to time with you, and yelling or hitting does not.  You also eliminate the homework issue if you have a neutral party help him with math.  It is hard for some children to have their parents be tutor and parent.  These children have trouble accepting help (do not want to make mistakes) in front of their parents.

In my book, I also explain how to use cues and calming strategies, and how to teach children about other points of view.  I also have a section about how you and your husband can be role models by talking out loud about what you do to handle your anger.  You will get to these chapters after you finish the worksheets in the first half of the manual.   As for therapy, there are different approaches, but you might have a better experience with a psychologist or social worker who talks with the parents as well as the child, and who works with anger regulation issues.

All the best, David Gottlieb, Ph.D.