Tuesday, March 29, 2016

12 yr old with anxiety and anger overload

Dear Dr. Gottlieb, 

I just finished reading your blog about angry children. I couldn't believe what I was reading. It was as if you'd been standing in my room watching and listening to my 12 year old son. He is currently diagnosed with anxiety and ADHD, but after having read this, I think it is more likely that he has anxiety and anger overload issues. 

My son has very little self confidence, thanks in large part to poorly educated teachers. He has had wonderful teachers up to this point in his education, and they worked very hard along side of us to build his confidence. This year, his Special Ed case manager, and his teachers have formed a wall that has prevented him from achieving his goals. In fact, they have added obstacles in front of him at every opportunity. 

He struggles with his anxiety to the point that he often has insomnia and can literally have breakdowns. When he gets to that point, his next reaction is almost always anger. He knows when it is coming on thanks to a lot of cognitive behavioral therapy that was started when he was just 7. I received training from his specialist at the time on the techniques to help him learn his triggers and recognize the signs of an impending meltdown or explosion. He has become an outstanding advocate for himself. 

This year, when he advocated for himself, he is told that he has to "prove that it will help" to have a request fulfilled. For example, he and I have made several requests to have him moved up in his classes. He is currently in the lowest level classes (intended for children who are significantly below grade level). He doesn't feel challenged in them at all. His standardized test come back with him being at grade level, and last year's teachers agreed that he should be placed with grade level peers. The teachers this year - without consulting us, moved him down. It was a blow to him. He has been trying to prove himself all year to meet the expectations that they set for him as proof of his ability, however these have never been clearly defined, nor discussed. We have been told multiple times that he will be moved in "a few days" or "a couple weeks" but then some "reason" happens and they do not follow through. 

To add to that, he has been dealing with a bully in his classes. She is in all of his classes, and they claim that due to her "special needs" they can't do much to stop her or help him. He is beyond frustrated and now shuts down in class to try to avoid being her target. This has compounded the problems with the teachers believing he is an able student. 

I plan to print this article to give a copy to his special edication case manager. Perhaps if she reads this, it will shed light on the difficulties he is having, and just maybe they will begin to see why he has struggled, and why I continue to advocate for him so strongly.

Thank you for your insight.

Hi, It sounds like you have worked hard to help your child, and I hope the school will help consider his strengths academically.  Sometimes when a child has anxiety or anger that at times affects his school behavior, schools overlook the child's strengths.  Hope they will look at your "whole" child, and determine which class is the best fit for him.

In my parent manuals and child workbook, the sections on mantras would be helpful.  It sounds like your son can already identify his triggers, and mantras are ways of looking at the triggers from a new perspective.    

Best, Dr. Dave Gottlieb

Friday, March 25, 2016

Just Published: The Anger Overload Workbook for Children and Teens

Hi.  We just published our new workbook for children and teens that builds on the Anger Overload Parents' Manuals.  The workbook is written for children and teens ages 8 to 18.  It provides step by step instructions and worksheets to help children and teens identify their triggers and to choose from a number of strategies.  Parents or counselors have a role as coaches, and we provide instructions for coaches at the beginning of the workbook.  The workbook is meant to accompany our popular parents' manuals, and is available from the publisher at https://www.createspace.com/6151028.  It is also available on Amazon and other online book sellers.

David Gottlieb, Ph.D.

Tuesday, March 22, 2016

6 yr old hates to lose and hates to make mistakes

I found an article you wrote on Anger Overload, and it describes my 6 year old son to the T! Since preschool his teachers have been concerned with his lack of emotional self control. Now he is in first grade, and it is really starting to become a major problem at school. According to his teacher, he frequently has anger outbursts if he makes a mistake, is embarrassed, loses a game, or feels rejected. His outburst often seem inappropriate to the situation, and it is difficult to get him to calm down. Lately, the outbursts have gotten worse. He is banging his head and fist on the desk, kicking the wall, and screaming at other children.

He has been attending a social skills group once a week at school, but so far I haven't seen any improvement. They also have a color chart at school which is their from of behavior modification. Again, I am not sure how effective this system is for my son. We were doing small rewards when he came home on good colors, but lately we have been having so many issues at school he hasn't been able to earn anything.

At home, we rarely have any issues with him. He is a sweet little boy, and very affectionate. He is also extremely smart. He tested above the 95 percentile in Math in the school standardized tests!

Everyday before school I remind him that he needs to have control, but at least once a week I am getting a phone call from the school. I don't know how to help my son, and it breaks my heart. I want him to have a positive school experience, but the past few months have been extremely difficult for him.

Do you have any recommendations for how to talk to his teacher/school about Anger Overload? Does my child need to be evaluated for this? How can I get a couple of our Manuals ?

Any advice would be greatly appreciated!

Hi, First, the manuals are available online at book sellers like Amazon.  Search for "anger overload" on Amazon, for example, and my original parent's manual will appear as well as volume two (that has additional strategies for parents and teachers).

The manuals will help the teachers focus specifically on anger overload, because a  more general behavior modification chart will be less effective..  One approach I would strongly recommend that you and the school try is to develop "mantras" (short memorable sayings) for his triggers.   You mention four triggers above: losing a game, feeling rejected, making a mistake and embarrassment.  For embarrassment and rejection, you would want to keep track of when specifically he feels embarrassed or rejected, before you develop a mantra for those issues. But for the other two triggers, you could develop mantras now.  Here's how: 

For losing a game, you would talk with your son about someone he looks up to and explain how that person loses games as well.  In fact everyone does sometimes.  You would then work on a mantra, or saying, to express that fact, and then practice the mantra each day before school and again at school.  He could even draw a picture of someone losing a game, and you could post it on the refrigerator to help him remember the mantra.  The mantra could be something like "everyone loses sometimes" or "everyone, even ____loses." Fill in the blank with someone he respects.  

Another related idea would be to tell him you are going to give him a hug if he comes home and tells you he lost a game, or he could earn points for a special dessert if he loses three times in a week.  The idea is to normalize losing.  You are helping him develop a new perspective on losing.  

You would do something similar for making mistakes.  The mantra could be something like "it is good to make mistakes because it means you are learning new things" or "everyone makes mistakes."  You would pick words that he finds easy to remember, and practice the mantras each day at home and school.  Use no more than two mantras (for two issues) at a time.  Once he masters one problem, you could switch to another issue and develop a third mantra.

This is one of many strategies I outline in other blog posts and in my parent's manuals. Hope this helps you get on the right track.  Best, Dr. Dave Gottlieb

Thursday, March 17, 2016

How to help a strong willed 7 yr old

Ahhh I found your blog and book and finally feel like I have some hope—that we are not alone!  We have a 7 year old boy who has always been more competitive, more active and more of a risk taker than other kids.  He is at the top of his class in first grade, and has not had any problem with behavior at school or with anyone other than my husband and I.  He is very, very confident in himself-sometimes I worry too much so, but then I see all of the little boys on his Y-Ball team we coached, and they were much alike-so who knows! He is also a very loving, affectionate child, who loves hugs and still likes to sit with mom and snuggle:)

   He has always been strong willed, but we could distract him or convince him to make the right decisions with different behavior charts and incentive programs we’ve used.  When we did send him to time out, we’d send him to his room and tell him he could come out when he was ready to “make good choices”.  At times (not always) he would throw something, kick the wall, but it was very short lived, and once he calmed himself, he would come out and say “I’m sorry” and our day would go on happily. Self soothing and letting him calm down always worked better than us trying to talk it out like it did with our daughter.   

Most of the time, he is a smart, very funny little boy. However, a couple years ago, he began having angry outbursts, when he didn’t get what he wanted or was being told what to do(bedtime, chores, etc…).   It always seems like fatigue plays a part ( later than normal bedtime, or end of the week) -but for heavens sake, he goes to bed around 7 each night and sleeps 10-11 hours so I am not sure?   It usually begins with him talking back or arguing with his sister, we can see it coming, he pushes us—with a lot of attitude ( and even laughing at times), and then eventually turns into an explosion.  When we try to initiate bedtime, get him to do something, or lay out consequences, he yells, talks back, throws things,  and even pushes us or kicks us when we are trying to calm him.  If we ignore him, he yells things out his door, if we stay and try to talk-he just says mean things and tries to provoke us.  So we aren’t sure what to do?   He is completely inconsolable and irrational.  I am not sure how my funny, smart little boy can get so angry, so fast?  

I feel like your explanation fits him to a T, because except for intermittent (once a week or twice a month) angry outbursts, he is what I would think of as a normal 1st grade boy.  But my husband, daughter and I ( and grandparents) have unfortunately seen him explode, and it is so frustrating!  I know this is a lot, but am hoping that it gives you some insight and you can advise us in some way to conquer or learn to work through his anger.  I found your book on Amazon and so it should be here in 2 days, but if you have any advice, can you please send it our way?  Thank you so much!   I have been feeling hopeless and concerned about our little guy, and I am hoping your book may have some answers. 

Hi,  You write that you can often see it coming, and on those days you have more options to intervene.  At lower levels of anger, you can often use emotional distraction, relaxation strategies, or mantras to help your child settle down before a complete melt down.  I explain how to use each of these strategies in earlier blog posts and in my manuals.  When my manual comes, note that you can either use interventions in the first half of my manual without planning ahead with your child, or you can try to involve your child in observing his anger triggers.  In either case, you want to keep track of his triggers yourselves (which is sounds like you have already begun to do), because then you will know when a possible explosion is coming and can try to head it off.  

If you involve your son in the plan, try to help him see what some of his triggers are.  Be sure to do this in a noncritical way, and maybe talk a little about your triggers, because that will help him see that everyone has triggers.  You want to encourage him to work with you on this.  Then you can develop a mantra or distraction strategy for when one of the triggers occurs.  

If you decide to use interventions without discussing your plan with your child (if you think he will be resistant to working on it with you) then you would think through possible emotional distractions with your husband and your parents.  An activity or a funny remark that captures your child's attention will help divert him if you can catch his anger before it reaches the explosive stage.

If he is exploding, then try to say as little as possible.  When he is irrational, talking will not work. You can try talking after he is calm.  In the future, you would want to try to re-arrange the sequence of events such that you try to avoid or change the timing of whatever was frustrating him.  You mention bedtime routine as one trigger.  Try to have him prepare earlier and then do something fun together in bed, so that he is more motivated to get into bed.  You could play a short card game or read together.  If he is arguing with his sister (another trigger you mention), then try to re-position your daughter or son to avoid whatever they typically start to argue about.  Another option is to set up a cooperation chart, so that each evening there are no squabbles, they earn points together to do something fun on the weekend.  

You mention that your son is strong willed, and this can be an asset in most situations in life. But sometimes it can lead to difficulty with compromise, and as he gets older (if not now) take a look at my chapter on compromise, and consider working on it with him.

Best, Dr. Dave Gottlieb

Monday, March 14, 2016

Will 10 yr old become a "functional adult"?

My 10 year old has been having "fits" since he was a baby. He would get angry and spend 45 minutes to an hour just screaming, crying and throwing things. Kindergarten - 3rd grade was awful. I would be called into his school 2 to 3 times a week. I worked with guidance counselors, behavioral therapist, psychologist, psychiatrist, and nothing seemed to work. He was labeled as ADHD but the medications didn't help at all. I never thought he was ADHD but trying everything else I figured, why not? 

He is very bright and has been tested for gifted but misses it by a fraction. Every year his teachers say that he is the smartest kid in the class and they do not understand why he reacts to situations the way he does. If something does not go his way, something or anything can set him off. He never want to hurt anyone but will beat his head on the floor or throw a chair, or just scream and cry and hide in the bathroom. Now in 4th grade his "fits" have been better but still he gets so upset. I am worried for his future. Can he function like this as a teenager or an adult? He can be so sweet but turn so quickly. I am just worried no matter what I do he is going to end up with severe issues later, due to his anger. What steps can I take to help him become functional adult?

Hi, read through my blog posts over the last three years, and you will see your son is not alone, and you will see some ways you can work with him.  My parents' manuals are available on Amazon.  Also, in the next six weeks, I will be publishing a child and adolescent workbook on anger overload.  It follows the basic structure of the parents' manuals, and gives many concrete worksheets you can do together with your child.

Most children learn how to control their anger through practice and experience.  It doesn't happen over night, but if your child recognizes anger overload is an issue for him, then you can work him him on various strategies.  Some of the strategies that I outline in the parents' manuals you can implement without your child's direct participation.  The more advanced strategies you work on together.  

There are several overriding principles.  One is building a good working alliance with your child to help him take charge of his anger.  The second principle is to try to catch your child's frustration early (if possible).  The third principle is to develop different strategies depending on the level of your child's anger.  Some strategies require calm thinking, and that can't happen in the midst of an outburst.  

As your child feels some success, he will be encouraged to work some more on other strategies.  Having a "toolbox" of strategies is ideal, so that a child can use a different strategy depending on the situation.  

Best, Dr. Dave Gottlieb