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. 

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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

Manual helps, but young child won't talk about anger

Just a line to thank you so much for your excellent helpful Manual on Anger Overload. My 5 year old son has always from 2 until 3 and a half ish had intense and prolonged aggressive tantrums in reaction to being told no. However as he started school we experienced a set of much heightened responses, mainly directed at me his mother. He shouted nonstop, hit, kicked spat, words, used very violent words, and indeed tried to hurt himself. Hurting himself and being so distressed was truly awful. The rage lasted up to an hour and NOTHING could distract from this locked in response. It almost had to wear out from him. 

Thanks to your Manual we have felt an immediate ability to calmly attempt the emotional change at a trigger moment and start to help him and us cope with strategy that works. It is very hard at times to know what to do for the best. But we feel that your expertise diffused via the book and website has rescued what for us was almost becoming a crisis situation. So I feel immensely grateful to have found your knowledge which is so readily shared and accessible. And most importantly works. We know it will be a long haul but with this blueprint we have a model to work with.
 
My son finds it difficult to want to talk about his overloads - he doesn't want to address his responses so would you have any advice please about how we get him to be reflective. He has a wide vocabulary and seems to respect his father more than me. Should he start more of the discussion?

Many thanks indeed for your help.


Hi, For five year olds, many of the strategies in the second half of the manual will not work yet. Young children are often not ready to look at and discuss their behavior.  The first half of the manual is key for young children, and it sounds like you are applying those strategies. These are directed by the parent, and do not require the child's direct participation.  

What you could try is making up a story with dolls or puppets, and use any that your child already likes.  They could be stuffed animals or superhero figures he has at home or watches on television.  Think carefully about what themes you want the story to contain. Use themes that are consistent with your child's triggers, and write stories and resolutions that are dramatic, but metaphors for how your child could someday handle anger.  In other words, use fantasy in the story; your child's triggers would be disguised.  You want the story to be appealing and send a message, but it needs to be indirect for your child to be interested and listen. So the character in the story may for example throw giant boulders (when angry) and the boulders may almost land on a house.  But then a wise superhero says "you are destroying their house.  Why don't you build a fort with the boulders instead." Eventually after a few weeks, the ending may be about making peace with whomever the character was angry with.  "Talking works when you don't scream,": the wise sage could explain.

Another idea would be to make up a funny song with lyrics about anger that has a helpful resolution, or make pictures together about anger, or read a story together. (There is one by Mercer Mayer, for example, called "I was so mad.")   The basic idea is to begin a "discussion" about anger indirectly with your young child.  

Also, be sure to use yourselves as an example.  Talk out loud sometimes about what got you angry one day, and how you handled it.  All these techniques give the message to your child that everyone gets angry and that it is okay to talk about it.  It may be a year or more before your child is ready to talk more directly about his anger.  At that point, you might start by using a labeling system for levels of anger, which is one of the strategies I write about in the second half of  my manual.  The idea behind that strategy is to develop greater awareness about levels of anger.  It is easier to control anger if one takes an action at lower levels of anger.  But first a child needs to observe that anger comes in different forms.
All the best, Dr. Dave Gottlieb

How to get an 8 yr old to work on her anger

I have an 8 year old daughter who has always had substantial anger issues. She does not have ADD or ADHD, is not bipolar, I'm sure, although I've never tested her for anything honestly. I am an American ex-pat living in Europe with my husband and we moved here about a year after our daughter was born. These kinds of diagnosis and definitely medication for mental health are just not as common and practiced here as they are in America, and I never thought she was bad enough to warrant the diagnosis anyway. However, she does happen to have a very strong personality, wants to be the leader at all times, is very bossy, and many times has emotional outbursts with us, other family and her friends and teachers at school. 

She very easily cries in general and many times if she feels that another child intentionally tried to wrong her, even though many times her behavior leading up to the episode is usually be a big cause of that. Sadly, she is an easy target for teasing at times, because other children realize how sensitive she is and her reactions are always very impulsive and even if she is right in being angry about something, her reaction is so intense that it overshadows her valid feelings. 

She also tends to say things in a very rude way and acts disrespectful but doesn't seem to realize when she is doing it, and why others may not want to be around her,  no matter how many times we've discussed good manners and treating others with kindness. I will always make a point to praise her when she has done something nice or thoughtful, which she is also many times capable of. 

The interesting thing is that when she becomes extremely angry with other children at school and has a dramatic outburst, it doesn't last long.  She seems to realize quickly that she went too far and then wants to move on, many times joking about things and completely changing the subject like nothing happened. she also says things like "i'm so messed up, i don't know how to act." followed by behavior i can only explain as degrading of herself. As I'm sure you can imagine, it's heartbreaking as a parent to watch this dysfunctional pattern repeat itself over and over. 

She is very smart, no problems academically and loves music and art and has great talent. She is very sweet, funny and loving and craves attention. It's easy enough to get her to do things like homework, practicing piano and some chores...bedtime is tough, but probably nothing over the norm resistance wise. However regarding her anger, I feel like I don't know what to do anymore and my biggest fear is that we will lose our bond as she grows older and continues in these patterns because she can feel that I am always disappointed when these episodes occur..which these days is daily. Even though I try my best to be patient and as understanding as possible, talking to the teachers, keeping communication open, I know she probably hears too much criticizing from my husband and I when we try to explain things to her and why it's bad to behave that way. .

I know we are not perfect. I wish I knew of a better way to approach everything, but what do you do when you walk into the building to pick up your child from school and can hear them yelling at another child at the top of their lungs down the hall because they are so angry about something? I am so weary of the school pick up and hearing about what she did that day. Last year she really started to show improvement and the teacher was really proud of her. She had a group of friends she enjoyed and seemed to be turning a corner, but it seems like its always one step forward, 2 steps back. We did have to change schools because her other school was private and it became too expensive, so I am aware this could have a huge deal to do with her current state..but it's really always been an issue more or less.....

I am sorry if my email seems like an excessive complaint of my child - I am just trying to point out all of the details so that you can understand the challenges and perhaps offer guidance to the best approach..because simply speaking, I am at a loss trying to figure out the best approach and need some help. I happened upon your blog and thought I would try to get in touch. I feel like a failed parent, but I love my daughter so much..it breaks my heart that she has to make things so hard on herself. Any insight or advice is very, very much appreciated. Thank you and all the best to you.

Hi,  The positive signs in your e-mail are that she realizes after an outburst that she has gone too far, and it is also a good sign that the outbursts are short in duration.  She regains control and feels sorry about her behavior.  This indicates that she will be motivated to work on her behavior in the coming months.  It does not mean she will be able to consistently stop from having outbursts in the short term because she feels "injured" emotionally fairly easily and because her anger is easily stimulated.  So how do you get started helping her?  

First, I would talk with her about how some people have quicker angry reactions than others, but that everyone gets angry sometimes.  Tell her you would like to work together on how to express anger, and give an example when you exploded and what you thought you could have said (or not said) when you calmed down.  You want to show her she is not alone, and that you empathize with how hard it can be to control anger sometimes.  

In my manual, I offer worksheets to keep track of anger.  Basically, you want to work together each day on what triggered her anger that day and how she reacted.  Talk about whether there are any early signs that she is getting angry.  Help her to see any early signs as a cue to take an alternative path.  We can all control anger better the earlier we realize we are getting angry.

When you review different situations, write down what she said and what the other person said.  You would do this repeatedly for the next month or two, and you want to keep the records together; it is important that this be done patiently and non-critically in order to sustain your child's participation.  Praise her for her efforts keeping the records together.  

The idea is that over time, she will begin to see some patterns of what provokes her.

I also suggest you establish labels for different levels of anger.  In my manual I write about using colors for low, medium and explosive anger:  blue, yellow and red.  The idea is to help your child see that there are different levels of anger, and for her to see that she has better control at the lower levels.  

In the manual I write about how to tie her observations of early signs of anger with calming strategies.  You want to share with her how you calm yourself and have her choose some ways that feel good for her.  Then you practice together.  If she is willing, you could role play an anger provoking situation and practice one of the calming strategies she prefers.  

It is a gradual process of recognition of triggers and of developing calming techniques.  In addition, over time your daughter may realize that there are other ways to look at "provocations" (a different perspective) that might help her not feel so angry.  Finally, you want to reassure her that she is not "messed up," and that everyone has things that come easy and things that take time to work on.  Give her examples from your life, and point out what comes easy to her too.  

All the best, Dr. Dave Gottlieb

Shy child hates to leave home, has outbursts

My son is 11. He has had anger overload issues since he was about 5. When he gets angry it does not last long. Most of the time it's because he lost in a game or he can't do something on his own. Otherwise he is very funny and sweet.

Now when he is at school he does not talk...does not get angry...instead he puts his head down on his desk.  I asked him why he only gets angry at home and he said because that would be too embarrassing. So he is aware of it. He tells me he has anger issues. He also is very shy.

The school thinks he has many emotional issues. Me, as his Mom, I think it's this anger overload...and he is very sensitive.  Is there any type of testing to get done to see what he really has? He is not on any medication.  He goes to school...which is a fight everyday...other than that he hates to leave the house.

Hi, it is possible to have anger overload and to be sensitive or shy as well.  It sounds like your son has some anxiety about leaving home, but you can get him to go to school, which is good.  Mild anxiety can best be overcome by going through with whatever triggers the anxiety.  In this way, the person sees that he can do it, and over time, anxiety usually lessens. 

It is good that your son recognizes he has an issue with anger since he will be more willing to work on it then.  It is also good that he does not explode at school.  This shows that he has some self control.  I would suggest you work on the strategies in my manual to help with the situations you describe:  when he loses a game or when he can't do something on his own.  Consider using emotional distraction (from the first half of the manual) and using a "mantra" that lowers his expectations about winning (from the second half of the manual). 

There is no test specifically for  anger overload.  Anger overload is defined as having frequent, intense rage reactions to disappointments or frustrations.  Children with anger overload can have other issues as well.  You mention the school thinks he has emotional issues.  Ask them to be more specific.  And if you are unsure what the underlying issues are, it might be wise to get an evaluation from the school psychologist and/or a local mental health professional who works with children and families.  By interviewing you and talking with your son, a mental health professional could advise you what issues seem most important and how best to work on them.

All the best, Dr. Dave Gottlieb

What can teachers do for outbursts in school?

Thank you for posting your article on Anger Overload. I have only just found it and have already ordered your book.  I am so relieved to finally find an accurate description of my son's behavior after 8 months of going to multiple therapists and experts -- all of whom tell me "he's unusually complicated" with multiple issues at play.  They all agree he has anxiety related to his learning disabilities.  But, the intensity and sporadic nature of his anger (despite two very patient, even-keeled parents) hasn't been explained...until now.

My son is a loving, cuddly, creative kid who makes friends easily.  As a competitive gymnast, he will practice back flips and dangerous stunts anywhere he goes (not just during his 9+ hrs/wk at the gym).  He has been diagnosed with reading, processing and anxiety disorders.  While he has shown signs since preschool of extreme anger when triggered, he can go for months without an episode.  Summers, vacations and sports practices tend to be anger-free -- school is the main location of his rage-episodes.  It appears to increase in frequency and intensity as the academic expectations increase.  He can be triggered by all the things you mentioned in your article (being told no, minor criticism, noticing other kids finish their test while he is still working, etc.).  I can't tell you how eager I am to read your book.

In the meantime, I have a question:  Do you have a recommendation for the teachers on what they should do when he gets into a rage-state?  He can't hear anything while he is in that state (hitting himself, kicking the desk, being verbally disrespectful to the teacher, literally covering his ears, etc.), but they can't just wait it out while the other children's learning is being impacted.  He does go to a private school with a Learning Specialist and Social Worker on site, but they are not always available.

Any guidance you can give would be greatly appreciated.

Hi, Yes, while at home a parent can ignore an angry outburst, in school this is usually not an option if a child is disrupting the class.  So one key is early recognition and developing an assortment of tools your child can use.  First, I would recommend the teachers record what is going on when the outbursts occur in the next couple of weeks.  You mention some triggers in your e-mail, such as minor criticisms and finishing his test while others are still working.  Once some of the triggers are identified, the teachers would develop possible interventions for each trigger.  For example, before mentioning a minor criticism, the teacher could point out something your son has done well, so that he is less likely to feel "injured." Your son can't keep critical comments in perspective yet, and that is not unusual for children with learning issues.  They get frustrated easily and sometimes feel inadequate compared to their peers. So the teachers could help him keep their remarks in perspective by pairing a critical remark with a positive one.

For testing, it sometimes helps a child with learning issues to take tests in a separate room so that they are not distracted or concerned with their peers.  Like my previous suggestion, this would be a way to prevent an outburst from  occurring.  

But what happens when your son is getting frustrated and the staff did not see it coming--and this will happen sometimes no matter how much planning the teachers do.  First, early intervention is important.  Are there warning signs before your son erupts?  Could the teachers have a "go to place" or a distracting activity that would help him calm down?  I would recommend the teachers talk with your son privately while he is calm, and explain they want to help him with his frustrations, and mention that they will give him a signal (it could be verbal or a nonverbal signal) when they want him to stop working and go somewhere (in or out of the class).  They would explain this is not a punishment but a way to help him "chill".  He could get points, or a positive note home, for following directions about using the chill place.  They would empathize with him that sometimes the work will be hard.  They could also say we all have trouble working when we get frustrated, so that's why it is good to take a short break then.

Once a child totally erupts it will be hard to distract him.  At that point, the teacher could either tell the class that your son is having a hard time and ask them to please try to let him calm down on his own, or he would need to be escorted out of the room.  The staff would explain to your son in advance where this place would be, and then without much discussion take him there as needed.  Depending on the age and size of your child, they may need help from a strong adult to bring him to that place.  It would preferably be different place than the "chill" zone.  The "chill zone" is often within the class, whereas when a child erupts, it is usually best to leave the class.

In the second half of my parent's manual, I explain also how to teach a child to use a catch phrase to help him with frustration.  This doesn't work during the anger overload phase, but can help if the anger can be caught at an earlier stage.  For your son, the catch phrase could be something like:  "School can be a pain sometimes" or "Yes, somethings are hard but other things are easy for me."  It would be important to practice saying the catch phrase to himself several times a day so that eventually it becomes automatic.  You would discuss with him some possibilities and pick one that he likes.  Another possibility is to help him think of a funny scene when Mom or Dad had trouble with something.  He could try to think about this when he is frustrated in school to help him realize everyone has trouble sometimes.  These latter strategies work better with children who acknowledge they can get very angry sometimes, and want to try to learn to control it on their own.

All the best, Dr. Dave Gottlieb