Tuesday, May 27, 2014

8 yr old's frequent tantrums affecting marriage

Hi Dr. Dave,

I am a stay at home mom of a 3 year old boy and 8 year old daughter. I am at the end of my rope and losing hope.  My son for the most part is a very a calm, mellow, obedient child who can entertain himself and this bothers her. She is a beautiful loving child and mostly only acts out at home. My daughter has had anger issues since she was about 2. I have tried everything, behavioral therapist, psychologist, I've done Total Transformation, and brought her to a Pediatric Neurologist. She was tested for ADHD and does not have it. We go to church on Sunday and have always been on top of discipline with our kids. I am trying a new Behavioral Therapist next week. Nothing has helped and it seems to be getting worse. It has put a huge strain on my marriage which is crumbling and disrupts my day, everyday when she is home. I have bad anxiety, cry when they finally go to bed and can't eat most of the days.  My husband works long hours so basically I am alone Monday-Friday except for the mornings.

My daughter's anger is so out of control she yells, has tantrums, throws things, kicks and screams. Homework is absolute torture with tantrums and timeouts, and takes almost 2 hours everyday. She picks on her brother and fights with him constantly. She says things like: hate, die, dead which is so upsetting. Whenever she acts out she is put in her room for a time out but has to be dragged there, refusing and yelling the entire way. When she doesn't stay in her room I close and lock the door, which the lock is on the outside to keep her in,  when I eventually get her off the door knob. I open the door when time out is over and she comes out but not for long. Bedtime is a huge issue: she doe not like to go to bed or sleep alone so now she has told her brother if he sleeps alone he will have nightmares and bad dreams so he now cries and is afraid at bedtime. She undermines me and goes in his room and tells him to come sleep with her. She also cries a lot at bedtime and says she's sorry for her behavior and i feel bad because I know she can't control it, or doesn't want to.  We have a set schedule for everyday and she battles with me everyday to brush her teeth get dressed, get out the door for school, do homework, eat dinner..... She does not want to participate in any activities and says they are boring, I had her try soccer, girl scouts and summer camp. I can't take on the battle again of getting her ready and out the door for activities. Currently she is in dance but that's a battle every Friday. My kids want for nothing and maybe that's part of the problem but when she's home she says she is bored and walks around aimlessly and eventually starts an issue.  I am embarrassed to go out to eat with them or even have people over because they eventually end up fighting, misbehaving and creating a scene.  I could go on and on.........

I am very close with my Mom and just wanted that with my daughter but I feel like we have missed out on so much because she spends a great deal of time in her room because of her behavior and I have become a prisoner in my own house. This is not fair to my son. I love her dearly and just want my little girl.

Any advice is welcome, anything.....

Hi, It does sound exhausting to deal with.  I would try to strategize for one problem situation at a time, a) homework, b) bedtime, and c) going to activities.  For homework, I wonder what the difference is for her to do the work at home compared to school.  You mention that she does not cause problems at school.  I would talk with her teacher to see how she works with your daughter and then try to do similarly at home.  You may even meet with your daughter and the teacher together to talk about homework, and have the teacher reinforce her for completing homework in a timely way (you would fill out a brief check sheet for the teacher each night to let her know the basics of how it went).

For bedtime, I would consider having her sleep in the same room with her brother since it seems she is scared to sleep alone or she dislikes being alone at night.  Rather than get into a struggle each night, try to re-arrange the situation (if possible) to avoid conflict.  Unless you feel it is not a good idea for them to sleep in the same room, I would try it and see whether that makes a difference.  In my parent's manual, I write that sometimes you can avoid a tantrum by re-arranging situations to avoid some of the triggers.  

Regarding after school activities, I would talk about the importance of picking one activity, and let her pick the activity she wants.  By giving her some control, it may help avoid a struggle.  Also, be sure to do something fun after the activity if she gets ready on time; for example, maybe stop for ice cream some nights, or go to a favorite park to play after the activity.  If something fun comes afterwards on the days she gets ready on time, it may help her learn to cooperate.

Remember that during a tantrum, say nothing, or as little as possible.  Any attention during a tantrum tends inadvertently to reinforce it.  In my parent's manual, I describe other strategies, and see if your new behavior therapist can help you implement these at home.  On the positive side, you said she does not show these behaviors in school.  That tells me she can control herself better if you can figure out some of the triggers at home.  

My guess is one other issue might be that it is hard for her to do things at home by herself; she doesn't sound like she likes solitary time.  The basic idea then will be to try to give her some time with you or someone else when she cooperates (can she join you in the kitchen or in some way help you?) but not when she tantrums. And think about whether there is a hobby (artistic or musical maybe) that you can start out working on together and that she can then do sometimes alone (and show you later in the day what she accomplished).  Be sure to check out other blog posts or my parent's manual for other strategies.

 All the best, Dr. Dave Gottlieb  


Tuesday, May 20, 2014

8 yr old hits parents

Help!  A friend of mine sent me one of your articles and I felt like you were in my family room watching my daughter have one of her tantrums.  It’s getting so hard that I don’t know what to do.  She becomes incredibly violent and yells, kicks, punches, hits and then hits some more until she is at a point when she is ready to calm down.  She only will do it for me (her mother) or sometimes her father.  It never happens at school, camp or a friend’s house – just when me or my husband are around.  If she doesn’t get exactly what she wants when she wants it, if she gets frustrated or even if we look at her in a way she doesn’t like…she goes from 0 to 80 in half a second and there’s no stopping her.  We’ve tried everything…remaining calm, yelling back, ignoring her, hitting her back, locking her in her room, locking us in our room, hugging her and holding her tight, making her laugh…I mean everything and nothing works until she’s ready.  These can last anywhere from 20 minutes to an hour and a half.  It is completely destroying our family!  Imagine walking on egg shells whenever she’s around so she won’t get started.  We’ve been to 3 therapists and nothing seems to work.  We’ve done the rewards and punishments…that works a little, but not enough.  

Recently she created a list of 10 things she can do to calm down and I would give her a point for each one she does.  When she gets to 10 points she gets a reward.  Sounds great, right?  When she’s in the throes of her tantrum, she wants nothing to do with the list and would rather just keep hitting me.  I cry because it’s the most horrible thing to just sit there and take the abuse.  It’s also very difficult because after she’s done hitting me, I have to be the one to calm her and snuggle her and love her – talk about having to turn your emotions around and sometimes I just don’t want to.  And then I’m so incredibly hurt, on the inside and out, that I don’t want to be around her and don’t talk to her.  When she’s good, she is the best child a parent could ask for.  When she’s in one of her tantrums, you just want to run away.  This has been going on for several years and has seriously taken a toll on our family dynamic.  My poor son (11 years-old) loses out because we can’t go places because of her or she will go after him and start hitting him for no reason.  It hurts him very much to see the way that she treats me.  Again, at school she is the perfect angel and her teachers don’t believe me when I tell them what happens at home.  Any suggestions???!!!

Thanks for letting me tell my story.

Hi, It sounds so hard on everyone in your family right now.  As you noticed, when children rev up, rewards and consequences do not work well.  Children with anger overload are not thinking rationally during the overload phase.  During this time, when your daughter is striking out against family members, I would recommend restraining her, rather than letting her hit you.  I know this will be difficult and may take two of you.  But I would bear hug her and lie on the floor, or one of you grab her arms and the other parent grab her legs.  I know she will hate this and fight you, but you are then making it clear to her you will not allow anyone to be hurt.  Do not talk to her while you are restraining her, and let her go once she has calmed down.  You may have to hold her again if she revs up immediately after you let her go.  

If you let her hit you and then hug her when she calms down, you have in a sense rewarded the negative behavior.  I know this is not your intention, but too much love after a tantrum may inadvertently send the wrong message.  I would recommend instead talking about something totally unrelated to the tantrum after it is over.  Sometimes it helps to talk later in the day about what happened when she got mad and explain how important it is to work on anger together.  The second half of my manual describes ways to talk with children about their anger.
Since she tantrums mostly with you and sometimes other family members, I would consider hiring someone outside the family (if you can) or have a relative come by if you and your husband can't be there together.  That way you have someone to help if she tantrums, and furthermore it may discourage her if another adult is present.  I would only do this temporarily to try to break the cycle.

Another idea is to make a list of what preceded each tantrum, and then try to think of a way around some of those situations.  Granted you will not be able to predict many of the tantrums, but if you can avoid some of them, it will help you keep your sanity!   Look for patterns: are there times of day when she mostly tantrums, or during certain activities (or when stopping a favorite activity)?  In my parent's manual, I talk about "re-arranging the sequence" to avoid some triggers.  If you can't avoid a trigger, then sometimes predicting out loud that some chore  or activity is coming up that she will not like and then saying that "you  don't think she will be able to do it without a tantrum so you are getting ready to restrain her"--this may cause her to show you she can do it without a tantrum.  Just try this last idea once or twice; it may or may not work.  For children who are extremely oppositional, it sometimes helps to predict a tantrum because that can motivate them to show their parents that they can control themselves.

Once you reduce the frequency of tantrums, then the other strategies in my manual will be helpful.  But first she has to see that tantrums "do not pay."  And it will be a struggle for a few weeks, so wait until you and your husband are ready to try to break the cycle.  Even after a few weeks, there will sometimes be tantrums, but if you cannot reduce the frequency, get a psychiatric consult to rule out pediatric bipolar disorder. and/or check with a psychologist who works with parents on how to deal with angry children. Also, keep in mind that biological factors often play a role in extreme anger, and that as your daughter grows, the brain structures that deal with anger should also grow.  So hang in there.  I can tell you are trying really hard.  

All the best, Dr. Dave Gottlieb

Thursday, May 15, 2014

6 yr old tantrums in school

Dear Dr. Dave,

My 6 year old daughter seems to fit your profile for anger overload. I plan to buy your book. She just began talk therapy and may also begin occupational therapy soon for possible sensory integration problems but her angry outbursts at school are my main concern right now. She is basically holding the teachers at school "hostage" because they don't know how to control her screaming, until the school social worker is finally able to work with her. (interestingly, she never behaves this way for her stern AM teacher; PM teacher is young and easier to manipulate). She gets bent out of shape by negative peer interactions, a mean comment, if she doesn't do what the teacher asks, if the teacher yells at her, if she doesn't like her snack or lunch, etc. Would a child of her age benefit from anger management, either privately or as a group session? Could my use of Prozac during her pregnancy have caused this?

Thank you.

Hi,  On the blog and in my manual I have described a number of strategies to use with young children.  The strategies in the first half of my book are the best place to start with young children.  These strategies are directed by the parent and do not require the child to be aware of her triggers or early warning signs.  Most young children are not yet reflective about their anger, so I recommend parents and teachers a) observe some of the triggers and then b) try to change the sequence of events leading up to the outbursts (when possible), or c) try to change a child's perceptions about what is causing her frustration, or d) use "emotional distraction," or e) develop a relaxation station.  

In your child's case, I would talk with the teachers and determine what exactly the am teacher is doing that avoids an outburst.  Then I would see if the pm teacher could use some of the same strategies.  You mention that the am teacher is stern.  Talk with her (or have someone observe) how her demeanor is translated into actions in the classroom.  What exactly does she do when there are mean comments, or when a child does not listen to the teacher--you mention these are some triggers for your child.  My guess is that she catches the problems early and does not let things build up.  Also, with stern teachers, children know not to misbehave (or they will be seriously punished) so children often exhibit fewer provocative behaviors, and thus there are fewer conflicts.

If the pm teacher has trouble implementing the same approach, show her the other strategies in my manual and see if she can successfully implement one, or more, of them in her class.  One of the strategies that I use with older children, but might work for your child, is teaching a catch phrase that might help her think about a problem in a different way.  The catch phrase would be something you come up with together, and then make pictures with the phrase, and talk about it each day before school.  One example would be a phrase that might help her look at "mean" comments in a different way (so that she doesn't take it personally so often).  Help her see that mean comments are a sign that someone is having a bad day, and that the comments are not true.  Also, phrases that have some humor can help interrupt the build up of anger.  So one phrase I can think of now is "Meany needs go sleepy."  What you want her to consider is that the other person is tired, or out of sorts, or she wouldn't be so mean.  It's best to develop a phrase together that your child finds amusing.  It is important to explain that this is a special phrase for her to think of when someone is mean, but not to share with anyone--it is private between you and her, and you will ask her after school if someone was a meany today.  If your child does not like this strategy, or if she has trouble with the idea that this is a special phrase for her to think about when someone is mean, that is okay, then stick to the approaches I describe in the first half of my manual until she is older.

Regarding anger management groups, some schools arrange for small groups of children to meet with a social worker or psychologist to practice dealing with anger provoking situations.  In essence, my manual outlines strategies to help develop self control, or in other words, anger management. The more practice a child has, the more likely she is to remember the strategy at times of anger. So groups can help, but not every young child is ready to participate in groups.  It helps if the child is a) fairly verbal, b) can reflect afterward about her behavior, and c) wishes she could handle it differently.  If a child is not ready for such a group yet, then the teacher could still implement the strategies that do not require a child's direct participation, such as the strategies that I mention in the first half of my manual.

As for your question about prozac during pregnancy, I am not an expert on possible side effects of antidepressants.  I know that some of my female patients over the years have used SSRI medication like prozac during pregnancy.  Their medical doctors felt the benefits outweighed any possible risk.  If you want to know more, check with a medical specialist, like a neonatologist.

All the best, Dr. Dave Gottlieb

Tuesday, May 13, 2014

8 yr old erupts when teased

I was wondering if you could give me some advice.  My beautiful, creative, and intelligent boy has major fits of anger.  He has ruined many beautiful days by being hyper sensitive.  He has no tolerance when it comes to being teased, and will often become verbally and physically abusive towards other children.  His whole body becomes rigid and his face contorted.  He is impossible to distract when he is in the middle of his rages, and usually turns his anger on anyone who tries to help him.  His verbal abuse is getting worse as he gets older.  I am at my wits end.  I feel helpless and I am beginning to go out less, for fear of another outburst.  I have had all sorts of reward or incentive charts in place to no avail.  I can see him going to his angry space, but I can not seem to divert him from going there.  I feel like I want to give up and send him to live with his father, who has anger issues himself. This I know would be detrimental, but I feel he is ruining my life.  He is so rude and abusive, and I feel as though I have totally failed as a parent.  I have started smacking him, which is having little or not effect. I threaten to send him to his father's, which he begs me not to do.  I can't give up on him, but I feel so helpless. 

Do you have any advice that could help? I would be incredibly grateful.  Thanks.

Hi, Usually rewards and consequences do not work well for anger overload.  As you have observed, the anger erupts quickly, and a child is not thinking at that time about rewards.  He is not really rational at the moment of anger overload; his emotional brain is fired up and "running the show."   If you cannot distract him, or if there are no early signs of frustration, then during the overload phase you would try to not say or do much of anything, except to make sure that everyone is safe.  

As far as interventions, you would try to prevent some outbursts by working around some of his triggers.  You wrote that one trigger is when he is teased.  Try to make a list of the times he has been teased lately. Does it happen mostly in school?  If so, in what class or activity?  Can the teachers either a) work around that activity, or b) work with your son to view the activity differently?   "Working around the activity" could mean offering an alternative activity or sitting nearby to catch any "teasing" as it happens.  The first part of my parent's manual explains how to re-arrange a sequence of events to avoid a trigger.  The second half of the manual goes over techniques that you would work on with your son while he is calm, and one of these is helping him "view the activity differently." 
For teasing, I would suggest explaining that other children may be jealous of him, or want his attention, or want to get the focus off themselves. I ask the child to think about the "teaser" and what his motivation could be.  I also empathize with the child that no one likes being teased a lot. For minor teasing, I teach kids to ignore it (give a cold shoulder instead of giving attention to the "teaser"), and for more significant teasing, I teach kids to alert an adult or to sit near friends (preferably a big or popular kid) who might help intimidate the "teaser."  I would also encourage the child to invite other friends to join him at recess or lunch (where most teasing occurs in school), and I would ask the teacher to arrange to have friends (or at least "kind" peers) sit near the child more often in class.  For serious teasing, I explain to the child that the "teaser" has major problems, and it takes many people (the teacher and other students) working together to get through to a child who has major problems.

It would also be important to help your child see how he is likely viewed by others when he loses control of his anger.  Sometimes a child does not feel badly about losing control.  In that case, I recommend talking with the child when he is calm and explain that other children might get a kick out of seeing him explode, and then I would say that he does not want them to get a laugh at his expense.  Also, I would talk about how hard it can be to control anger, but that you are willing to work on it together. It will not be easy and it will take a while, but you both can work on it so that when he gets angry he can do things to head off an explosion. Explain also that he does not like it when his Dad loses his temper, so it would be important to learn how to act differently, or else his friends will someday want to avoid him.  In other words, it is important to help a child see that angry explosions have a cost and motivate the child to work on it with you.  

If a child is motivated to develop better self control, then the strategies that I mention above, like changing a child's perception of a trigger, will be more effective.  In the manual and in other posts I write about how to teach a child to look at things differently and how to come up with catch phrases to help a child remember to deal with his anger differently.  Whenever a child tries one of the strategies you work on together, be sure to praise him, regardless of whether the strategy worked to prevent an explosion.  You want your son to feel that you and he are a team, that you do not expect immediate results, and that you will be excited whenever he tries something you have discussed together.  If he continues to make an effort, eventually you and he will see progress. 

All the best, Dr. Dave Gottlieb

Wednesday, May 7, 2014

4 yr with anger overload, not ADHD

Dear Dr. Dave,

I have a four year old daughter that I have been having a problem with since she was 2 years old. She gets very angry, throws things, kicks, hits, destroys property, tells me she hates me, scratches, etc. She will even go as far as trying to hurt our family dogs. I have had her in behavioral therapy on and off for the past 2 years. We moved her to a psychotherapist who put her on quillivant, but that only made the angry outbursts worse. I took her off the medicine immediately. I just don’t know what to do anymore.

Hi, Quillivant is used for ADHD, but your daughter probably does not have ADHD.  Symptoms of ADHD include hyperactive behaviors, impulsivity, and distractability.  A child can have all or just some of these symptoms.  The difficulty with making an accurate diagnosis is that children prone to anger outbursts do have some characteristics of impulsiviity, at least when they get angry.  Thus, doctors may sometimes think a child is exhibiting ADHD when they have angry outbursts.  However, most of these children are not impulsive all the time, just when they get angry.  Thus, anger overload is a better fit than ADHD for many of these children.

The other diagnosis to rule out is pediatric bipolar disorder.   These children are prone to frequent changes in mood, including angry outbursts.  But with bipolar disorder there are other signs of manic behaviors, such as a) always being on the go, b) impulsivity, c) disregarding other people's feelings, and d) grandiose thinking.  It is difficult to diagnose with 4 year olds, because many children at that age are self-centered, somewhat grandiose, and sometimes moody.  So it is hard to determine, unless you are a clinician who has seen a lot of these children, whether a young child truly has pediatric bipolar disorder.  

More common than bipolar disorder in young children is anger overload.  In my parent's manual I explain that there can be delays in the development of the prefrontal cortex, which is the part of the brain that modulates angry emotions that emanate from the limbic system of the brain.  So when these children get angry, it can be extreme.  My manual goes over strategies that parents can use to lessen the frequency of outbursts.  The first half of the manual is appropriate for four year olds.  

When a child is in the overload phase, the best thing is to say or do little, unless someone is in danger physically, or unless something of value is about to be destroyed.  Then some form of physical restraint is called for.  Generally, children in overload need time to settle down, and the more parents engage them at that time, the longer the outburst usually goes on.

The manual explains how to intervene earlier in the cycle before the overload phase occurs.  This is not always easy because children with anger issues can escalate so quickly.  So it is important to observe some of the patterns (not that every outburst will follow a pattern) and either 1) change the sequence, 2) lower a child's expectations in order to lessen disappointments, 3) use "emotional distraction" or 4) develop a calming station in the house.   In the manual I explain each of these steps in more detail.  It takes several months or more sometimes to determine the best set of strategies and to learn when to use which approach for each child.  I would suggest using the manual, and if you have difficulty implementing the strategies, bring the book to a therapist who works with parents and who knows about cognitive behavioral strategies for anger, and work together on fine tuning the approaches for your child.

All the best, Dr. Dave Gottlieb

Sunday, May 4, 2014

Intense 10 yr old has rages

Hello, I just read and article by you on Anger Overload in children and it brought tears to my eyes. You described my son so accurately it was alarming (and relieving because we were beginning to worry it was Bipolar).

He is as perfect as you could ask a ten year old boy to be 80% of the time.  The other 20% are horrific, humiliating, embarrassing and a terrible example to my other three children (he is an oldest but also a twin). He does not seem to rage at school although when he was younger he had "melt downs" on multiple occasions. They usually happened when he or someone else got in trouble for something they didn't really do, another child in the class had very bad behavior and he found it very upsetting, or he had a run in kickball called an out when he believed it wasn't (or something along those lines). He has always been and still is a perfectionist (to the point of lying to cover up something he believes makes him look imperfect to others), he has always been intense and he a has always been a worrier (even about things that are for the adult to be concerned with such as running out of gas or getting somewhere on time).

The majority of his bad and really concerning behaviors are at home or with us. He also seems to have a fresh and disobedient strain that comes out (more and more as he gets older) such as trying curse words when he thinks we aren't listening, watching a forbidden TV program or testing out discussing an adult topic in an inappropriate setting (when company is over etc.).  It seems to be getting worse, and it is taking a huge toll on me as I am a stay at home mother dealing with this more than anyone else, and it is having a bad influence on his siblings etc.  I want to be sure you know that I understand kids push limits and try things they aren't allowed to do. This is more in the category of defiance.

The article talks about strategies involving charts etc but at ten, he is a little beyond that.  I am at a loss.  I try stating clearly that if he continues he will have to go to his room, go back home, loose a privilege etc but he (when in or entering a rage) repeats himself to the point of seeming mentally insane. For example, if, for whatever reason, we tell him to give us his iTouch he will respond in an extremely loud voice "BUT I WANT IT, WHEN CAN I HAVE IT BACK, I WANT THE I TOUCH. HOW LONG DID I LOOSE IT FOR, BUT I WANT IT BACK, I WANT MY ITOUCH" this can go on for 10, 20, 30 minutes sometimes.  Sticker charts and redirection are not working on him.  He is too old, too smart, and way, way, way too intense.

Do you have any other advise or resources you could point me towards?

     Hi, Last year I published a parent's manual for anger overload; the first half of the manual explains strategies you can use without discussing what you are doing with your child.  Then the second half of the manual involves working with your child when he realizes he has a problem and wants to develop better self control.  The goal of the first half of the manual is to lower the frequency of outbursts, and the goal of the second half of the manual is to teach your child how to control himself better on his own.

     Taking away things when a child is getting upset usually does not lessen the outburst.  When children are in anger overload they are not thinking rationally, and thus incentives and consequences at that time are usually not very effective.  During the overload phase, it is best to say or do as little as possible.  The more you say, the more upset a child is likely to get.  Once your child is calm, then you can review what happened and sometimes a brief consequence can reinforce your message (though sometimes the consequence may re-ignite a child's anger).  When you talk with your child, you would explain how his anger was really over the top, and that together you want to work on helping him to say what he wants without losing it.  You could tell him you sometimes lose it too, and it is not easy to control anger, but you think it is important to try.  Ask him what he thinks, and if he seems motivated, then the second half of my manual describes a number of techniques you can work on together.

     If your child is not ready to work on anger with you, or feels it is someone else's fault that he gets angry, then you would use the strategies in the first half of the manual (that do not require his direct participation).  Some of these strategies are 1) to change the sequence to try to avoid one of his triggers, 2) "emotional distraction" in order to change a child's mood or emotional state, 3) developing a "fun" calming zone in the house.  These strategies work best if you can catch your child's frustration in the early stages.  I realize this is not always possible, because many situations can provoke anger overload, and you will not know all your child's triggers.  But try to keep a list for a few weeks of the kinds of situations that trigger his rage.  Then you can look for the early signs and try to head off an explosion.

     Regarding the issue of perfectionism, I'd refer you to some of the other posts (for example see April 24, 2014) where you will find recommendations for helping with children who are perfectionistic and get upset when making mistakes.   

     All the best, Dr. Dave Gottlieb

Friday, May 2, 2014

9 yr. old poked a child with a pencil

Dear Dr. Dave, 

I have just come across your blog regarding the "anger overload" issue. Wow I am excited to see that my child is not the only one that reacts like this! My son is 9 almost 10 and has always shown a sense of being overwhelmed by his emotions. He is a very smart, caring and thoughtful child but once he gets his mind made up that things are not going his way, his anger can get the best of him. He can be disrespectful to me and his friends. While he doesn't get physical with me or his friends he will punch or throw things out of anger.
Our home life is very normal, me and my husband both work but I am just part time so I am able to be with our son outside of school. He has been  involved in Tea Kwon Do for the past 3 years and is in line for his black belt. So if he wanted, he would actually do harm. I am scared that one day he may use this skill out of anger and not defense. I received a phone call last night from a parent of a friend he has goes to school with. She said that my son poked her son in the knee with a pencil and there were marks. When I asked my son about this he said that he was frustrated with another child and basically took it out on her son.   (Her son was also kicking him and would not stop when asked.) I feel this was out of anger and could have been much worse. My son was very remorseful that he had actually hurt his friend, so I know he wasn't trying to be mean. I just don't know what to think about this.
One thing that I know is not helping the situation is that he likes to play the video games. I have restricted him from playing during the week after his attitude and being disrespectful started showing. I am aware that these games are not very good for developing minds but he does enjoy them like any other 9 year old boy. 
I guess I am just venting thoughts and would like your opinion on any ways I may be able as a mother to change this behavior. Thank you for listening and appreciate any thoughts you may have. 

Sincerely, Concerned 

     Hi, Yes, many children have trouble controlling their anger, and the first step is for you to identify some of the situations that trigger your son's rage.  You mention that it happens at home when things are not going his way. If there are certain times that he is more likely to get disappointed about things not going his way, then you would try to anticipate these trouble spots, and  re-arrange those situations (if possible), For example, if he gets upset when he has to stop one activity in order to get ready to do homework, you would try to re-arrange the order so that what he wants to do (play a game) comes after what you want him to do (the homework).  Or, you could warn him in advance that something is about to happen that may disappoint him.  Sometimes if children know ahead of time what is coming, they do not respond so angrily.  You will not be able to anticipate every outburst, but if you see some patterns, then you can try to head off some problems before they reach the overload phase.  I write in my parent's manual how parents can either change the sequence, or lower a child's expectations, in order to head off angry outbursts. 

     Other techniques I write about in the first half of my parent's manual are "emotional distraction" (that changes a child's emotion from anger to laughter or to some other emotional state) and developing a calming zone in your house.  All these techniques you can employ without having to explain to your son that your goal is to prevent or lessen his outbursts..  The second half of the manual discusses other strategies that do require your son's participation, and they are useful once your son realizes he has a problem with anger and desires to develop better self-control.

     When he poked the child at school, what was he frustrated about?  Who was kicking whom?   If the provocation was serious (like being kicked), first empathize with your son's anger, and then think with him what else he could do if that happens again so that he would not get in trouble.  If the provocation was not serious, you would say that you see how your son interpreted what happened, but you would add that there are other ways to look at it.  You would then try to help your son understand the situation from the other child's point of view. In my manual, there is a section about teaching children about other points of view. Some children do not realize when another child's behavior (like bumping into someone) is accidental, and misinterpret an accidental bump as an intentional act.  If a child can see things from another person's point of view, he would be less likely to get angry.  So teaching your child (when he is calm) about other points of view may be helpful.  

     This can take months to really help at the time of emotional upset, though.  Because anger overload happens so fast, children often do not stop to think about what was going on and just react.  But it is worth the time and effort to go through examples where people think differently about something.  You can also use yourself as a role model, and talk about a time when you got upset, but realized later that the other person was not meaning to hurt you.  Another technique that can help is to practice repeating a phrase with your son at least once a day for the next few months that will help him remember to think first.    In my manual I write about how these "catch phrases" can help a child remember to think about things before reacting.

     All the best, Dr. Dave Gottlieb