Hello Dr. Dave,
My 9-year-old daughter suffers from anger overload and her episodes have gotten more frequent and pretty scary. My husband and I are wondering if we should follow the course you recommend in your book on our own, or seek professional help. Some background…
We can trace E’s angry outbursts back to when she was a newborn and would get so mad when we would put her in her carseat that she would hold her breath and turn purple. As a toddler, she was more volatile than my older daughter, but we figured her behavior was in the range of normal for her age. Between the ages of 5 and 7, she had several over-the-top reactions to seemingly small disappointments or when she would not get her way. The summer after she turned 7, things got worse. Practically every day, something would set her off and she would scream at the top of her lungs, cry, say nasty things to her parents and sister, and throw stuff around. Once she pulled out a clump of hair and once she banged her head on the floor, before realizing it wasn’t a great idea. In desperation, I searched the Internet and came across your book, “Anger Overload in Children: A Parents’ Manual”. I ordered it and quickly read through the introduction. Your description of anger overload fit E to a tee. Before i could get farther into the book, the summer ended, school started, and the horrible episodes disappeared. I filed the book away, hopeful that we didn’t need it after all.
During the winter of 2nd grade, E had a struggle with anxiety, and we ended up seeing a LCPC, who helped us identify the problem, label it, and taught E some basic skills to deal with it. E has not had to deal with anxiety interfering with her life since then.
E continued to have infrequent anger episodes, though few stand out in my mind, as I reflect back on that time. Fast forward to February 2017. E is now 9-1/2. Without warning, she began to have more frequent and more intense episodes. The triggers are different - once she was struggling with homework, another time she received a piece of modestly disappointing news. The reactions are often fierce. She screams, cries, throws hurtful words at her family, and is modestly destructive. Of most concern, she has hurt herself by pulling out her hair and hitting herself in the head. She says that she wants to kill herself or wishes we would kill her. After the episode passes, E acknowledges that she does not want to hurt herself and is generally a sweet, happy kid.
We went back to the therapist she had seen for anxiety, but I realized that the therapist was not equipped for this type of problem and it was no longer a good fit. I also met with a psychologist, who E is supposed to see for the first time later this week. However, the psychologist didn’t seem to have any experience with behavior like this and I am a little concerned that she will take the wrong path. E does not want to see anyone.
In the midst of all this, I remembered your book and once again read through the introduction. I am certain that anger overload is descriptive of E’s condition. I am unsure, though, if we should handle this on our own, following the recommendations of the book, or if we should be working with a professional, given the threats of self harm.
Hi, Yes, given the self harm behaviors, I would recommend you consult with a mental health professional who works with children and their parents. Many of the strategies in my parent's manual may be helpful and woven into the course of therapy. Continue to record what some of your daughter's triggers are. That will help you and the therapist anticipate some of her outbursts and devise the best strategies to help.
In reading your e-mail, I wonder if your daughter expects too much of herself. You wrote that she experiences anger overload when she struggles with homework or gets modestly disappointing news. I would recommend cuing her before she starts homework that some of it will be hard, and that it's good she does not know some answers. If homework were too easy, she would not be learning anything new. You could shorten this into a catchy mantra that your daughter helps to create. An example would be "mistakes are good. It means I'm learning new stuff." Or "everyone makes mistakes." This would be practiced daily, until it gets internalized (i.e. until your daughter can deal better with disappointments, like homework difficulties).
Beyond the mantra, the parent's manual has other strategies to help her with self control. In addition, therapy can help identify further the source of her upsets, and help your daughter feel better about herself. Therapy helps with underlying issues as well as helps a child develop self control strategies.
Best, Dr. Dave Gottlieb
Tuesday, March 21, 2017
Tuesday, March 7, 2017
5 yr old trashes the classroom
Dear Dr Dave
I came across your article on anger overload after desperately in tears reviewing the internet. It is the first time I have actually read something that sounds like what my just turned 5 year old has!
We are waiting for proper Assessments to be carried out at the moment but first discussion with Pediatrics & we were asked to complete Conners 3 & the social communication checklist. Neither myself or or the teachers at my sons school think he has ADHD or Autism. He is a very intelligent little boy & is extremely loving especially to animals & younger children & his no problem with attention. They have witnessed his sweetness & had great conversations with him over lunch.
From an early age he has what we call a flip switch, where he just loses his temper. It's usually linked to frustration, what he thinks is unfairness or just not getting his own way.
Sometimes we can distract him out of it, normally with something that requires thinking & sometimes we can't. Outbursts at home are limited probably as we have learned to control them or just tackle major stuff but at nursery (where the changes began in preschool room lashing out at adults) & now school it is has been a real problem.
First two weeks at school he struggled to settle (separating from me) but then after this, he had great first term & even got certificates & awards for his good work. The teachers have said he is ahead with his work. It all changed in 3rd week in December last year. None of us know why.
He has taken to lashing out at the teachers & walls mainly, shouting, hitting, kicking in an anger episode. He also sometimes runs off when he gets cross down the corridor. The outbursts are short in time & never normally over 30 minutes.
He was taken in from the playground one day in January due to fighting with two other boys & he wouldn't calm down. He deemed this to be unfair & he then trashed the classroom. Throwing things off pegs, pen pots, books etc, kicking teachers & hurting them. The teachers called me to collect my son. This happened again later that week & the whole classroom was trashed. I was devastated & he was then excluded & then put on a reduced timetable since the end of January. This is when we reached out to our GP.
Outbursts have reduced in intensity & he has not wrecked classroom since (he didn't like mummy crying & being upset) but ED psychologist linked to school has suggested a few things like 1:1 supervision & to give him choices out of two options & they now use now & next cards to prepare him. This strategy has seemed to back fire. This last week he has started to refuse more & more direction at school & the anger outbursts (hitting staff) have returned almost daily. One day he was great until he was asked to use soap to wash his hands & he got angry & lashed out. I asked him later, & he said they don't usually have soap available in the toilets to use & so he has to usually use just water.
He is not allowed playtime with the other children as the staff are worried that another child may get hurt in his outbursts. It is difficult for us to understand as we have play dates, go to parties etc & if he ever gets cross we are able to manage it but this is rarely. We suppose we are in a fun setting, we are there & can intervene & he knows this.
We have tried reinforcing how he should behave at school, no hitting, kicking & reading books together on how he should act & rule following. Even sticker charts don't seem to be working.
Have you ever come across anger overload happening more often in a controlled setting? And refusal of direction? Do you have any advice as how I can help the school?
We are not sure if there is anything underlying linked to school that is increasing the anger episodes there.
After reading your parent guide I am planning to start recording occasions at home. I was going to ask school to do this too?
Any advice you can give I would really appreciate it.
Hi, You have done a good job of trying different techniques and worked well with the school. It must be so frustrating that your son's outbursts at school increased in December. Do you have any idea whether something changed in your son's life at home or school at that time?
I try to get clues about the triggers from what is happening when a child gets angry. As I read through your email, I was making notes of some of your son's triggers: separation when you drop him off, when there was a dispute on the playground with two other boys, and when he was asked to use soap to wash his hands (when he was used to only washing with water). Transition times seem to be a trigger sometimes, and unexpected changes seem to be another trigger. Keep trying to make a list of triggers and then see if you and the teachers can anticipate a stressful situation for your child and intervene before the overload phase. It will be difficult to anticipate all things that will trigger his anger, but if you can anticipate some, and work out a strategy ahead of time with the school, it may reduce the frequency of outbursts. I outline how to use emotional distraction and relaxation strategies in my parents' manuals. The second manual has a section specifically on applying the strategies to anger in school. Also in the second manual, I explain how to develop jingles or mantras that you would practice with your child ahead of time.
I like the ideas of the school psychologist: offering a choice of two options sometimes helps head strong children. But if a strategy stops working, then the school may need to try something else. I find that mantras, early emotional distraction, and relaxation "stations" (a place separate from the other children with relaxing objects) are often helpful. In answer to your question, structure usually helps, but not always with children who are head strong.
If you try again to use positive reinforcement, keep the chart brief--one or two items--and have a daily, exciting reward. Sometimes it helps to teach your child how to "go with the flow." The teacher could use a hand signal when she wants your son to "go with the flow." Then if he does that once or twice a day, he earns a fun activity at home or school. Keep in mind that it is sometimes trial and error to find what rewards motivate a child.
I would continue with the evaluation by your child's doctor to see what else may be contributing to the outbursts. The frequency and intensity suggest that psychotherapy is a good idea.
Best to you, Dr. Dave Gottlieb
I came across your article on anger overload after desperately in tears reviewing the internet. It is the first time I have actually read something that sounds like what my just turned 5 year old has!
We are waiting for proper Assessments to be carried out at the moment but first discussion with Pediatrics & we were asked to complete Conners 3 & the social communication checklist. Neither myself or or the teachers at my sons school think he has ADHD or Autism. He is a very intelligent little boy & is extremely loving especially to animals & younger children & his no problem with attention. They have witnessed his sweetness & had great conversations with him over lunch.
From an early age he has what we call a flip switch, where he just loses his temper. It's usually linked to frustration, what he thinks is unfairness or just not getting his own way.
Sometimes we can distract him out of it, normally with something that requires thinking & sometimes we can't. Outbursts at home are limited probably as we have learned to control them or just tackle major stuff but at nursery (where the changes began in preschool room lashing out at adults) & now school it is has been a real problem.
First two weeks at school he struggled to settle (separating from me) but then after this, he had great first term & even got certificates & awards for his good work. The teachers have said he is ahead with his work. It all changed in 3rd week in December last year. None of us know why.
He has taken to lashing out at the teachers & walls mainly, shouting, hitting, kicking in an anger episode. He also sometimes runs off when he gets cross down the corridor. The outbursts are short in time & never normally over 30 minutes.
He was taken in from the playground one day in January due to fighting with two other boys & he wouldn't calm down. He deemed this to be unfair & he then trashed the classroom. Throwing things off pegs, pen pots, books etc, kicking teachers & hurting them. The teachers called me to collect my son. This happened again later that week & the whole classroom was trashed. I was devastated & he was then excluded & then put on a reduced timetable since the end of January. This is when we reached out to our GP.
Outbursts have reduced in intensity & he has not wrecked classroom since (he didn't like mummy crying & being upset) but ED psychologist linked to school has suggested a few things like 1:1 supervision & to give him choices out of two options & they now use now & next cards to prepare him. This strategy has seemed to back fire. This last week he has started to refuse more & more direction at school & the anger outbursts (hitting staff) have returned almost daily. One day he was great until he was asked to use soap to wash his hands & he got angry & lashed out. I asked him later, & he said they don't usually have soap available in the toilets to use & so he has to usually use just water.
He is not allowed playtime with the other children as the staff are worried that another child may get hurt in his outbursts. It is difficult for us to understand as we have play dates, go to parties etc & if he ever gets cross we are able to manage it but this is rarely. We suppose we are in a fun setting, we are there & can intervene & he knows this.
We have tried reinforcing how he should behave at school, no hitting, kicking & reading books together on how he should act & rule following. Even sticker charts don't seem to be working.
Have you ever come across anger overload happening more often in a controlled setting? And refusal of direction? Do you have any advice as how I can help the school?
We are not sure if there is anything underlying linked to school that is increasing the anger episodes there.
After reading your parent guide I am planning to start recording occasions at home. I was going to ask school to do this too?
Any advice you can give I would really appreciate it.
Hi, You have done a good job of trying different techniques and worked well with the school. It must be so frustrating that your son's outbursts at school increased in December. Do you have any idea whether something changed in your son's life at home or school at that time?
I try to get clues about the triggers from what is happening when a child gets angry. As I read through your email, I was making notes of some of your son's triggers: separation when you drop him off, when there was a dispute on the playground with two other boys, and when he was asked to use soap to wash his hands (when he was used to only washing with water). Transition times seem to be a trigger sometimes, and unexpected changes seem to be another trigger. Keep trying to make a list of triggers and then see if you and the teachers can anticipate a stressful situation for your child and intervene before the overload phase. It will be difficult to anticipate all things that will trigger his anger, but if you can anticipate some, and work out a strategy ahead of time with the school, it may reduce the frequency of outbursts. I outline how to use emotional distraction and relaxation strategies in my parents' manuals. The second manual has a section specifically on applying the strategies to anger in school. Also in the second manual, I explain how to develop jingles or mantras that you would practice with your child ahead of time.
I like the ideas of the school psychologist: offering a choice of two options sometimes helps head strong children. But if a strategy stops working, then the school may need to try something else. I find that mantras, early emotional distraction, and relaxation "stations" (a place separate from the other children with relaxing objects) are often helpful. In answer to your question, structure usually helps, but not always with children who are head strong.
If you try again to use positive reinforcement, keep the chart brief--one or two items--and have a daily, exciting reward. Sometimes it helps to teach your child how to "go with the flow." The teacher could use a hand signal when she wants your son to "go with the flow." Then if he does that once or twice a day, he earns a fun activity at home or school. Keep in mind that it is sometimes trial and error to find what rewards motivate a child.
I would continue with the evaluation by your child's doctor to see what else may be contributing to the outbursts. The frequency and intensity suggest that psychotherapy is a good idea.
Best to you, Dr. Dave Gottlieb
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