12 yr old explodes at home and school

My son is 12 in 5 weeks time and suffers from what I believe to be Anger Overload.

I believe what I call not normal behavior begin as a toddler.  Almost OCD like, he would flip out if for example, If he said he was going to turn the light off and I did it instead.  He would have to turn it back on and then off again.  All the while screaming and crying about it.  While the OCD type behaviour died a natural death his anger/rage bursts have escalated.

He is of above average intelligence, and does not struggle academically in school. Although he does suffer some anxiety, and requires details/explanations of the task at hand to be repeated to him at times.  He will say it's too hard or I don’t know what to do, when the task at hand is quite within him.  The same happens with homework.  He is very good at sports and participates In many activities.

His outbursts are over the slightest thing, or if he feels he has been wronged.  His rage is intense both verbally and physically. He yells, screams, crys, punches, hits, pushes etc.  There is no calming him once he gets to that danger zone.  Trying to restrain or talk to him in this moment is fruitless.  He will sometimes say he wants to kill someone (mum,.dad,younger sister) or kill himself while raging. As he has gotten older this school outbursts have lessened but near the end of each year (like now) problems arise at school again.  We have had 3 occurrences in as many weeks.  He goes to a small school of only 230 kids and so only a small group of his age to play with.  There are 2 kids especially who push his buttons.

The other worrying sign is that he appears to have what I can only describe as rage blackout.  He will recollect a school incident at home; it is rarely his fault, but when I speak to teacher more information comes out.  Then when you ask him about this he says it never happened that way, I honestly believe him too.  He has no recollection of this extra information, usually the most damning. He is always remorseful and upset after such episodes but tells us he just can't stop.

His sister is nearly 6 years younger than him, and most of his rage at home is about her.  He has next to no tolerance of her.  Don’t get me wrong,  they can play nicely together, but when it goes wrong it really goes wrong.  His outbursts at home would be 4-5 per week. We have seen psychologists since he was about 8, at first he was very uncooperative with this, but over time this situation has improved.  I just don’t know if I am wasting my time and money on something that is not helping.

He saw a pediatrician at age 8-9 who did nothing more than a GP and deduced it was a behavioral and he needs to learn to control himself. He has also had saliva hormone tests done in the past and was found to have no melatonin in his body and cortisol levels also out of whack. I am also concerned with his growth and development.  While he is of average height / weight (50 percentile). In saying this though he is the shortest in his class.

His motor skills ?? are not progressing.  He has done athletics since he was 8-9 years old and still sprinting, jumping same times and distances as he is now nearly a 12 year old.

I don’t know much about this but I would assume that between ages 4-14 we all get faster, jump higher/longer etc even if we have no sporting ability.

The entire situation is tearing our family apart., and I just don’t know what to do anymore.  I  read the above and it doesn’t sound that bad, but believe me I don’t know how much more we can take.  I am falling apart, my husband is at his wits end, and I fear for our daughter, how this is affecting her seeing this behaviour constantly.  I fear for him as he gets older and what will become of him if he continues down this path.

Hi, It sounds like you have been through a lot and have not seen much improvement.  There are a number of strategies I recommend in my Parent's Manual for Anger Overload in Children, and in the recently published Anger Overload in Children, volume two.  In volume two, I make some additional suggestions for helping sensitive children deal with anger, and I also explain how to apply the strategies in school.  One important idea is trying to catch a child's frustration early, before it escalates into a tantrum. Admittedly this is not always possible because children can escalate so quickly.  

What you want to do first is chart each time your son loses it over the next few weeks, and then look for patterns or themes.  Then you would develop a strategy to deal with each theme.  For example, if he is frustrated when he feels the homework is too hard (though he can do it, you explained) you could prompt him before starting the homework in one of these ways to encourage him to hang in there:  "Homework can be hard, and it's okay to make mistakes."  Or "everyone makes mistakes."  Or "just do what you can, no one is perfect."  The idea is to normalize mistakes and thereby lessen his feelings of frustration.  Other possible strategies, such as emotional distraction, relaxation, and changing the sequence are explained in other blog posts and in my two books on anger overload.

If he has trouble with certain kids in school, try to find out what happens before he gets angry, and see if you or the teacher can use a mantra (or short saying) each day to remind him how to handle it.  The more you can anticipate and help him "normalize" certain frustrations, or help him learn how to deal with frustrations, you might be able to prevent some upsets.  You are right that it is hard to intervene once a child is in the overload phase.

Your son sounds a little rigid: you mention the earlier OCD.  Make sure the psychologist you see has ruled out Asperger's, which is a high functioning level of autism.  This is not likely, but you want to rule it out.  The fact that he does not remember all the details of the problems in school is not that unusual.  I find many children either minimize or forget what they did in school that contributed to the problems.  What might help is for the school counselor to meet with your son regularly to go over some of the incidents while they are still fresh in his mind, and gently help him see the connection between what he said or did, and what the other student said or did.  Then the counselor might be able to suggest a strategy for your son to deal with the  other student, or suggest a strategy the teacher could use to intervene before an outburst might occur again.  

If you feel your son is not developing motor skills or coordination, you could get a consult from a developmental pediatrician or a pediatric occupational therapist (OT).  OT's look at sensory integration and motor skills.  

Hope you see gradual improvement in the coming months, Dr. Dave Gottlieb

Manual Update Now Available

The supplement to the anger overload manual is now available ( at the publisher's site:  https://www.createspace.com/5326409 ). You can also find the parent's manual and update on sites like Amazon. The update is entitled "Anger Overload in Children:  Additional Strategies for Teachers and Parents."  The paragraph below is a description of what is covered in this new supplement to my manual. 
 
This update is a helpful companion text for parents and teachers who are using Dr. Gottlieb's manual: "Anger Overload in Children." Since Dr. Gottlieb's manual was published in 2012, he has received several hundred stories and questions from parents and teachers. In this supplement to his manual, Dr. Gottlieb provides detailed answers to many of the questions he has received. He introduces additional strategies for the home and shows how many of the strategies can be adapted for school. Some of the topics that are covered: a) how to help sensitive children keep perspective, b) what teachers can do for blow-ups at school, c) when to use incentives and consequences, d) how to intervene before a child reaches the overload phase, e) how to handle some common triggers, f) how to motivate a child to work on cognitive strategies, and g) how to find professional help. If your child has frequent angry outbursts, this series by Dr. Gottlieb will teach you how to help your child develop better self-control.

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.




Hi,


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

Taking explosive 7 yr old on vacation

Doctor,

My grandson has always had temper tantrums as a toddler.  This includes hitting people.  When he was 5, he punched me in the face.  Now he is in first grade and he is hitting, and kicking at recess; if he doesn't get his way he strikes.  His parents have never spanked him.  They carry him to his room until he calms down.  He is seeing a psychologist, but only 5 visits so far.  Last week he kicked a boy, today he punched another in the face.  Taking away tv and video games as punishment has not been effective.  Next week we are to travel to the Bahamas to celebrate my birthday.  All his Aunts and Uncles will be there.  My son is considering not going and keeping the 7 year old at home.  My daughter-in-law and other grandson would come.  Would this be an effective punishment?  This trip has been planned for months and having it disrupted by the 7 year old just doesn't seem fair.  What would you recommend?

Hi, I can see why you are troubled by what is happening with your grandson.  There is the short term issue of what to do about the celebration and the long term issue of how to help your grandson develop better self-control.  As for the issue about the celebration, keeping your grandson home may bot be seen as a punishment by the child, especially if he gets a  lot of one to one attention from his dad.  On the other hand, the parents may worry he will act out in front of all the relatives and that may cause significant stress for them.  I would recommend letting the parents and therapist make the final call.. You don't want to be too insistent with the parents, because then it could cause problems between you and your son.  You could express your point of view, and then go along with whatever decision they make.  Enjoy your celebration even if everyone doesn't come.  

In general, if parents spend a lot of time with a child during outbursts, the child may inadvertently get "rewarded" by their attention for his negative behavior.  It is unclear from what you write whether the parents stay with the child in his room until he calms down.  It would be important for the parents to interact as little as possible with their child while he is in the midst of a tantrum.  Only if the child is physically harming someone would they need to hold onto him (to prevent someone from being injured). 

In my parent's manual, I outline steps that parents can take to head off explosive behavior and to build a child's self control.  It takes time but is well worth the effort.  The therapist may be working toward this goal, but it can take months to see significant change sometimes.  I hope you have a good celebration and that your grandson learns how to control his anger.  Next month, I am going to publish a supplement to my parent's manual, and one section will address how schools can deal with angry outbursts.  My current manual focuses on what to do in the home. 

Take care, Dr. Dave Gottlieb 

What to Do If Tantrum Disrupts Dinner

My wife and I are presently reading and working through your workbook entitled "Anger Overload in children".

We have a 7 year old boy who will have a tantrum, let's say at the dining room table or while someone is playing piano as examples.  We will ask him to leave the room and go to his bedroom until he has calmed down.  Our challenge is what to do when he will not comply with the request, as his tantrum then severely disrupts the rest of the family's experience with whatever they are involved (we do not live in a very large house).  You suggest in your book that we should ignore the tantrum, however in order to get him to his room, we must continue to give him attention.

  

Do you have a suggestion for this issue?

Thanks so much in advance!

Hi, you ask a very good question that I get in my clinical practice as well.  There are several possibilities.  One is to have a "back up" consequence that applies if he does not go up to his room when he is told.  You would talk about the back up consequence at some other time when he is calm.  You want the back up consequence to be something short term that he will miss, such as a favorite toy or game.   It has to be something he really cares about.  Then the next he next erupts, you would ignore him, and later when everyone is calm put the back up consequence into effect.  The downside of this approach is that he may escalate again when you impose the consequence, and also you still have to put up with the noise when he does not go to his room.  Furthermore, if he is in a huge tantrum, he will not care about the back up consequence, as he is not thinking rationally then. Your goal with the back up consequence is to have him consider it in his mind when he is only a little angry, that is when he is still rational.  Then if the back up consequence is something he cares about, he will eventually cooperate more often.  So you would need to ask him to go to his room before he gets too emotional, and this is not always possible! 

Another possibility is to set up his room as a relaxing place to go play when he is not angry.  Then you would cue him before someone starts at the piano, before he gets mad.  The downside here is that you cannot always predict which situations will cause a tantrum. 

.   

A third possibility is just to ignore the tantrum and try to talk or play the piano as best you can.  Over time, his screaming will subside if it was being "fed" by your attention.  Remember that nothing you say at that point will help.  The problem with this approach is that if your child is so angry that he is not thinking rationally, it may take him a while to soothe himself even if he is not getting your attention.

Finally, see if you can identify a theme for what is causing some of his tantrums.  Is he jealous that others are getting attention at dinner or at the piano?  Then you may be able to head off a tantrum by a reassuring comment or a distracting activity (like a hand held game or drawing materials).  Let's say the theme is that his sibling is getting your attention at dinner.  Then before you start talking with his sibling, you could say to your 7 year old something like "now it is your brother's turn to talk, but I will give you a turn in a few minutes."  Then compliment him while he is waiting and remind him it will soon be his turn.  Try not to wait too long the first few times you try this. The question therefore to ask yourself is why does he have tantrums at the dining table or while the piano is being played, and see if you can come up with a reassuring statement or a distracting activity for him that will head off a tantrum.  It is harder to deal with of course once the tantrum occurs.  

Best, Dr. Dave Gottlieb 

6 yr old withdraws when angry

I am concerned with one of my granddaughters. She is 6 years old; she has some anger issues that really worry me. It kind of sounds like anger overload, except she does the opposite of yelling and screaming.  She will go sit on the couch, floor, corner, etc...and not talk, she likes to seclude herself, and if we try to talk to her she gets more upset, and also says troubling comments.  Like "I shouldn't be in this family", "I wish I was dead". I'm really concerned. Her mom and dad are divorced since she was about 2; they argued in front of her until recently. She is a wonderful, sweet little girl when not upset. I'm considering buying your book.  My son works out of town. Between her other grandmother and me we help watch her while her mom works.  Please any advise would be greatly appreciated. Thank you.


Hi, Usually children with anger overload are explosive rather than withdrawn when angry, but still your granddaughter sounds like something is really bothering her.  Think about what some of the triggers have been: What is going on when she withdraws silently?  Make a list of a few situations when she gets upset and then think about what are the themes:  Has someone said something to her that she does not like or that she misinterprets?  Is she disappointed about something?  Does she feel badly about something she has done?  If you are unsure, keep track of the situations in the next two weeks when she gets angry.  

One approach then would be to address the underlying "hurt."  Maybe offer a reassuring word, or else a distracting comment, but do not talk a lot while she is withdrawn.  Talking with her while she is angry seems to bring out more anger and her negative comments about wishing she were dead.  Usually when children make these comments only when they are angry, it is a reflection of their anger and not their wish to hurt themselves or die. But if she makes these comments even when she is not upset, or if they are frequent, you should consider a consult with a mental health professional in your area to determine if your granddaughter has an underlying depression.

When she is calmer, try to engage her in a conversation about what bothered her.  Even if you think she is misunderstanding or exaggerating something, show empathy for what she feels.  Then gently help her see that there might be another way of looking at things (if she is not seeing something).  But if she feels hurt by this, then stop and let her know you love her and understand that her feelings were hurt.  Empathy can go a long way toward helping a child feel better.  

You mention that her parents used to argue in front of her.  That is likely to be one cause of her distress. Hopefully her parents will cooperate about child raising issues.  Your granddaughter wants to love both her parents no doubt, and does not want to hear arguments, nor would she want to hear negative comments by one parent about the other.  If the parents' tension recurs, it would be ideal if they sought help from a family therapist.  Even though they are not married, they still are parents together and it will be best if they can cooperate when it comes to the children.  It is great that you and the other grandparents can help out when the parents are working or out of town,  I can tell you care a great deal about your granddaughter, and if things don't improve, consider asking the school social worker if she can talk with your granddaughter, or ask the child's doctor for a recommendation for a therapist in your area.

Best, Dr. Dave Gottlieb    

7 yr old sensitive and explodes in school

I have a 7 year old son who fits your description to a tee. It started out mostly at school where something triggers him and he will become enraged. It was never physical with another person, only objects. He screams for 20 minutes straight, covers his ears, is disrespectful to adults, kicks things, throws things, rips things off the wall.  The triggers are usually very minor. He will get upset if he is not called on, or if someone gets a turn and he doesn't.  He does not know how to cope. 

He is beginning to become really aware that others know he is different. When he talks and the other children look at him, he will yell "don't look at me." This is very wearing on the teachers and I feel he has now been labeled at his new school after 2 months. He hit another child, which rarely happens but said the other boy hit him first. No one saw the other boy hit my son, so my son was punished. 

He has developed really low self esteem saying you don't love me, no one believes me, and often calls himself dumb. He has even questioned what is wrong with me? He was diagnosed with ADHD, but his current doctor doesn't offer therapy and wants to keep him on the lowest dose. It is helping a lot with the frequency of outbursts, but i need to do something now. I'm having a hard time finding a good therapist for my son who won't let him run the show in sessions. Could you help us find a good therapist?


Hi, I would recommend you ask the school psychologist or social workers whom other parents have gone to in the area, and ask your child's primary care doctor as well.  Another resource is that most states have a psychological association, and that association has names of masters and doctoral level therapists who work with children.  When you get a few names, you want to find out how often they work with children and whether they have helped children who have intense angry outbursts.  You might even refer them to my blog or parent's manual to see if they have experience in some of these strategies.  Also, a therapist could help rule out other possible causes for your child's outbursts. 

It sounds like your son is very sensitive to feeling left out when he is not called on.  It might help for the teacher to cue him first thing each morning that she will give him a turn once in a while when he raises his hand, but that she needs to call on other children to give them a chance too.  He could earn points for staying calm when other children are called on.  

You would want to identify other triggers as well, and work on ways to help him think through ahead of time (on a daily basis) another way of looking at these triggers.  These cues would be brief reminders to help him keep perspective.  He could also draw pictures to illustrate the situations and together you could come up with a short phrase to say to himself when these situations occur. Then you could remind him of the saying in the morning before he goes to school, and check in with him after school if he used the saying that day.  The basic idea is to get him thinking of a new way of looking at the situations that trigger him before he explodes.  

Once he is having an outburst, it is best to say as little as possible.  If he can be moved to a quiet area until he calms down, that would be ideal.  But not every school has a space nearby for children to calm down.  Check with the social worker or psychologist in your child's school to see what space might be available for calming down; also the school social worker could work with your child's teacher on putting these strategies into practice.

All the best, Dr. Dave Gottlieb