Tuesday, February 3, 2015

10 yr old's outbursts affect whole family

Dr. Gottlieb,
My daughter is 10 years old and has had explosive rages since she just turned 6 years old. When she was 5 1/2 years our family moved.  Initially, I faulted the stress of the transition to her fits of rage. Moving and a baby brother maybe proved too much. Then, I faulted myself for taking her from an environment where she was doing well and not being able to help her cope. Four years later, and I have taken her to four different doctors here  (none of whom had worked with children with her symptoms, but our only options here) and I have spent hours and hours reading articles and books about defiant children. I feel like I have tried every suggestion. Your article about anger overload fits my daughter more so that anything else I have read. One counselor here considered Opposition Defiance Disorder which fit most indicators but not all.

The conflict she creates is taking a toll on our family. My husband and I argue about how best to handle her outbursts. I would tell you that he is too inconsistent and undermines me in front of our daughter, and he would tell you that I am too rigid with the rules. Our youngest son is beginning to mimic her hateful words, and our middle child is losing attention. I try to set days aside for her alone and then our oldest screams how unfair I am. She lashes out then at our middle child and calls her "perfect" in a hateful way. And screams that she hates her which makes our middle, tender-hearted girl burst into tears.

We need some help to put this family back to a loving, supportive place. Do you have any suggestions? Thank you for your time.


First, it would be important for you and your husband to talk together when the children are not around about how you will handle the rules.  If you are not both on the same page about a certain issue, either meet in the middle, or don't make a new rule, but enforce the ones you have agreed on.

I would not recommend talking or disciplining your child while she is in anger overload.  In my manual, I explain that any conversation usually causes a child's anger to escalate, plus she is receiving your attention during a blow-up, and that can lead to an increase in blow-ups.

Try to observe what some of your child's triggers are.  What is going on before she is angry?  Who is she talking with and what is the issue about?  You imply that one trigger may be jealousy of her sibling.  You want to try to intervene before she gets extremely angry, and in order to do that you need to identify a few of her triggers.  As an example, if jealousy is an issue, you could cue her before you start doing something with the middle child that you are going to be doing an activity with her sibling for a little while, but when you are done, you will do something with her.  Talk about options for her to do while you are busy.   Praise her if she waits without screaming (even if she interrupts you, even if she is not perfect about waiting).  You want to gradually shape her behavior so that over time you might expect more patience.  I talk about this in my anger overload parent's manual and in my soon to be published update.

For other triggers that you can identify, plan an early intervention.  One idea is to help your child realize that she has different levels of anger by labeling the different levels with neutral words.  Cue her at the early stage with the neutral word, and help her think of what she can do when she is at a lower level of anger (when she is still thinking rationally).  Another possibility is to use "emotional distraction."  That is, come up with a funny or interesting saying that will divert her attention from whatever is bothering her.  I explain more about this in the manual.  

Certainly you will not identify all triggers, and even if you do, you may not always be able to head off a tantrum.  But if you can reduce the frequency, everyone in the household will benefit.   Best, Dr. Dave Gottlieb

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