Wednesday, September 11, 2013

6 yr old explodes when touched or if not in charge

My son is almost six, and simply cannot seem to control himself when he gets angry.  If he is pushed, or touched (even by accident) he explodes. His anger is often directed to those whom he perceives as threats in some way (his younger brother, a threat for his attention) or peers who have strong personalities (He likes to be in charge.).   He rarely will hurt or explode at someone younger than him, or girls (He actually usually plays very nicely with girls and passive boys.).

He gets easily frustrated with himself when he cannot accomplish something, and can also explode then. 

He has not had issues in school yet, and in fact his teachers have even told me that he is a rule follower, and a great listener. focus and attention do not seem to be issues either.  I have watched him in sports and activities and notice than when he is engaged, he is the paragon of good behavior, However, left to his own devices, he is not to be trusted, and I am concerned that one day he is going to really hurt someone in one of his fits of anger. 

He seems to fit many of the characteristics of children with anger overload.  He is very energetic, and loves to play on the playground and loves jumping, climbing, and physical activity. While he is often very outgoing and confident in many areas, other times he is shy, especially if he is late or does not know people.  There are many moments of kindness, and sweetness, and friendship.  However, there are also too many times where he gets angry and can't control it. 

I have tried everything. positive reinforcement seems to work best, but he will go through phases of good behavior and then revert back to a downward spiral of behavior rooted in anger. 

I just ordered your book on amazon, but was wondering if you might think other diagnoses would be appropriate rather than anger overload.  Also, I don't know if your book mentions when to seek professional help and/or medication rather than rely on do it yourself behavioral therapy.  I am willing to try one more thing, but am wondering when enough is enough.

From what you describe, it sounds like your son exhibits anger overload.  It sounds like he pays attention well in school (does not have ADHD) and is not unusually moody (not depressed or bipolar).  It does sound like he likes to be in control, which is true of many children.  In addition to the strategies I outline in my manual, you might want to talk with your son (when he is calm) about how to handle certain tough situations you have noticed.  For example, help him understand  how to respond to pushing or touching by peers.  You could recommend he look at the other child and think about whether it was an accidental touch or a more deliberate shove.  Explain how he could respond verbally to each type of situation.  Practice with him short, firm, verbal responses if he thinks he was deliberately pushed, like "Don't push me." or "stop it."  If it was an accident (and the other child wasn't looking at him but just walking by) suggest he say to himself "no harm no foul" or "he didn't do it on purpose."  Since your child responds to rewards, you and/or the teacher could set up a reward if he tells you about a situation when he held back.  

Your son may not be able to implement these ideas right away if his anger escalates quickly, because as I discuss in my book, some children are flooded so fast with emotion that it is hard for them to delay and think about what to do.  Adult observers become key then.  If an adult can intervene early and distract him, engage him, or help him soothe, he may be able to slow down without exploding some of the time.  The important point is to intervene early, if possible, before your child's anger reaches the overload phase.  Or, re-arrange situations in advance to avoid a trigger.  For example, if your child is jealous of his sibling getting your attention, cue your son when you are about to help your other child that it will be his turn (to talk with you or do something with you) in a few minutes.  You want to give him a heads up since that may help soothe him and prevent overload.  

My manual is designed so that parents can try the strategies themselves.  But it can also be used in conjunction with therapy.   Sometimes there are underlying insecurities that contribute to a child's anger overload, and a therapist can be helpful in addressing possible concerns or worries that a child might have.   In other posts to this blog, I have explained how to find professional help.   

In my experience working with children with anger overload, medication is not helpful.  Medications might help if a child is depressed, anxious, or distractable, but do not help with anger issues alone.  Anger overload does take time to work through with a child because there can be biological factors, such as immaturity of the frontal cortex of the brain.  However, the strategies I explain in the manual will help a child develop better self control.   If you do not see any changes over a few months, then I would recommend a professional consult to see what else may be affecting your child. 

All the best, Dr. Dave Gottlieb

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