Wednesday, January 30, 2013

Why does 8 year old forget his outbursts?

I have found your blog and articles so helpful. We have a son who is almost 8. He became upset last night and said things like, "I don't want to live. I want to be killed" and "I want out of this family/" This was in response to his not getting his way to play some Wii with a new babysitter. We greatly limit the Wii time, but thought it would be a good icebreaker with a new sitter. When his older brother (who is almost 9 w/ADHD/anxiety) and he began to argue over which game to play, we told them that they were not going to be playing Wii.  Our younger son flew into a complete rage. I took him in another room, held him and he was crying very hard and saying all of these awful, awful things.

But yet, when I asked him today about it, he said he doesn't remember saying any of that. Is that possible? The whole meltdown lasted for about 25 minutes. After he calmed down a bit, my husband and I were able to get out to dinner nearby and we kept in close touch with the sitter. We were told that he calmed down after we left. We had a great day today--went to a science museum and went for a hike as a family. And he was happy. He also said he liked the sitter.

Is the fact that he's not remembering his rages a sign of being bipolar? He is an excellent student, but is very behind socially and is having a great deal of trouble making friends.
Thanks so much for listening.

Hi, Many children do not remember the details of their tantrums after they are over.  Usually they remember they got upset, but because their brain was on emotional overload, the details of what happened may not get into long term memory.  Not remembering does not mean your son has bipolar disorder.  With bipolar disorder there are frequent changes in mood, not just angry episodes.  Also, with bipolar disorder, children often exhibit impulsive, risk-taking behavior.  

If your child only says he does not want to live during an outburst, it is unlikely he has plans to harm himself.  During overload, children often say extreme things, in part because they are lashing out at their parents, and in part because they so overloaded that it is hard for them to put there feelings into more nuanced language. If your child does actually harm himself during outbursts, or if your child talks about self-harm while he is calm, then it is more worrisome, and it would be advisable to have a mental health professional evaluate what is going on.

Since he has trouble making friends, you might want to talk with the school social worker to see if there is a social skills group at school, or ask if the social worker knows of one in your community.  Also, if your son has a friend in school, maybe he can invite the friend over some day.  The more one-on-one practice with peers, the better to develop skills.  Group settings can be harder for children to manage unless they are structured by an adult.  In unstructured groups, there are so many social interactions going on that it is generally more difficult for children to keep track of the conversations and know how best to respond.

All the best, Dr. Dave Gottlieb

Monday, January 28, 2013

3 year old and "all hell breaks loose"

I recently started looking into Anger Overload. I have a very lovable 3-year-old but when she gets upset, all hell breaks loose. I’ve had friends and family tell me it is just her age, but once they’ve seen the tantrums they admit that it’s bad. When these melt downs happen they generally last an hour or more and she is impossible to console, she doesn’t want me to touch her but gets more upset if I turn or walk away from her. One of the common triggers is when I’m making her leave somewhere she doesn’t want to leave, so often times we are sitting in the car and I can’t get her into her car seat to deal with it at home. I’ve read some new ways to deal with it on your blog and other resources, but I noticed a lot of the information is focused on older children who are more developed. Do you have some tips on dealing with a younger child in these situations? I’ve thought about calling her pediatrician, but I have a feeling I’m just going to be told that they can’t tell at such an early age. Should I call?Thank you!

Hi, Three year olds can have some severe tantrums when they are frustrated; they often have difficulty containing anger and have difficulty delaying gratification.  What I would recommend is that you try to help your daughter deal with leaving somewhere she likes by changing her expectations in advance.  Let her know where you will be going and that it is for a short time only.  She may not understand what "short" really means, so you should also have something fun to distract her in the car (that she only gets to use once in the car seat), or tell her in advance about an activity she will look forward to doing once you get home (and remind her about it on the way to the car).   In essence you re-arrange the sequence of events so that the visit is one in a series of fun activities. 

Another strategy (if she is not in a full blown tantrum yet) is to distract her, maybe by singing a fun song she likes, or by talking about a favorite cartoon character, or by talking to one of her favorite stuffed animals and asking the animal what she would like to do next.  Maybe you can speak in a make believe voice for the stuffed animal.

If your daughter is already screaming and can't be consoled, I would recommend waiting there (unless you are in a hurry) and maybe sit in the front seat and get busy with something, maybe check your cell phone for messages.  Try not to talk with her while she is screaming but once she has calmed down then talk about a topic she will find interesting (rather than talk about the tantrum).  You use distraction, as any mention of the tantrum is likely to prolong it. 

In the first half of my book I describe these strategies in more detail.  Your daughter will likely develop more self control as she gets older.  The frontal cortex of the brain will grow in the years to come, but in the meantime, try some strategies and see what helps with your daughter.  You may not have success all the time, but if you can reduce the frequency or severity of her outbursts sometimes, it will help you get through the day!  If there is no improvement in the next month, then check with your pediatrician for someone who works with young children who have angry outbursts.  All the best, Dr. David Gottlieb

Friday, January 18, 2013

When your child has a tantrum in public

Hi, I have written a brief article for the neighborhood parents network in Chicago.  The article will appear on their website on Tuesday, January 22nd.   The topic is how to handle your child's tantrums in public places.  The website is:

If you have questions on this topic after you read the article, feel free to send them to my e-mail address: and I will answer your questions on my blog, or you can comment on the neighborhood parents network website.  Take care, Dr. Dave Gottlieb

Friday, January 11, 2013

What to do for 11 year old with 20 minute tantrums

We need help.  We have an 11 year old son that has rage.  Most of the day he is a great kid.  He gets good grades and has nice friends at school.  He is active in sports and school, but there are triggers that will set him off.  When he has an tantrum it usually will last about 15-20 minutes but sometimes longer than an hour.  We try and follow a lot of the things that are discussed, including, let our son calm down, we try not to talk with him while he is upset and do it when he is calm, we give consequences for the behavior that caused it and not the tantrum, but all this doesn't seem to be working.  It is like a switch in his head flips on and no matter what we do or say he doesn't listen while he is upset.  Then the switch will go off and he will listen and we can talk about it.  Whenever we ask him, "what set you off" or "why did you act that way" the answer is "I don't know".  It is like his brain shuts down and and he can't control it and has no idea why.  Any ideas?

Hi, What I would do first is chart what is going on before the tantrums start, so that you develop ideas about what triggers his rage.  Then begin sharing your chart with your son while he is calm.  Show him what you have come up with.  When he tantrums again, wait till he is calmer and then fill out the chart together.  Do this repeatedly after tantrums have ended. I have an example of a chart in my book and I include blank charts for parents to use.  The  purpose is to make your child more aware of his triggers.  

Once he is beginning to see some patterns, then you and your son can develop strategies to catch his frustration in earlier stages before a tantrum is extreme.  In my book, I explain how to use benign (nonjudgmental) labels, like colors, to point out when anger is beginning.  The label is like a signal for your child to think about what is happening while he is still rational, and then to try to use a calming strategy.  If he can't, or won't, use a calming strategy, then you try to distract or re-direct him.  I also explain how to teach your child to look at other people's perspectives.  Often children have misperceptions about other people's intentions, and many children have egocentric perceptions about what people should be doing for them.  For example, one child felt parents didn't care about him if they said no to a sleepover.  Teaching a child to look at other points of view is a key part of developing self-control.

Lastly, I explain in my book how to teach a child to compromise.  Basically, you pose the dilemma to him and ask how he thinks you all should solve it:  "I feel....and you feel..., what are we going to do?"  You have this discussion before a tantrum, or if the tantrum has already occurred, you discuss possible compromises later when he is calmer.  Then in the future you try to problem solve together before he erupts.  This approach works for issues where you are okay with compromise.  Some rules are non-negotiable in families, like he must attend school and he cannot physically hurt other people, so you wouldn't use this strategy then.

All the best, Dr. Dave Gottlieb