ChildrenWhen parents come to me presenting a picture of one of their children being seriously out of control at home, I usually hear three key complaints: We’ve tried everything and nothing works, we think his behavior is manipulative, and it’s causing significant conflict between the parents. Family life is spinning out of control because this child has become the center of the family universe. It’s as if someone is expecting the sun to revolve around the earth. The parents’ role as the “sun” has been lost; the core stability they provide to the family has also been lost.
Typically, the child’s behavior is impacting every aspect of family life. Morning crises have everyone starting the day in a foul mood. There is significant trepidation when the child returns from school. Family outings are either avoided or disastrous. Going out, if it works at all, seems to require allowing the troubled child to be in charge. Dinner, after-dinner, and bedtime are like walking on eggshells, trying to avoid something that will trigger an explosion. Often it happens anyway. Siblings are usually feeling ignored and angry. It seems as if their good behavior serves no purpose because their brother is getting all the attention and appears to get away with all the things they’re not allowed to do.
Another common characteristic is that the mother is being blamed for the problem. She is usually seen as having lost control of the situation, accused of giving into the child too much, frequently is being verbally and/or physically abused by the child, and she has accepted responsibility for being “the problem” while resenting the accusation at the same time.
For the sake of clarity, I’m referring to children who have serious, and frequent (at least 2-3 times/week) tantrums in which the child has “lost it” for 30 minutes or longer, often flailing about on the floor, sometimes destroying objects, screaming almost non-stop, sometimes running out the door, and, in general, incommunicado once the loss of control has begun.
The parents are angry, desperate, guilty, embarrassed, drained, and scared. At times they are afraid for their child’s safety and/or the safety of other family members. They have an image of a child who is going to grow up into some type of terrible person who will never make it in the “real world.” They will admit to disliking this child who is making a mess of their life and often have lost sight of any of his virtues. They are seeking a quick, magical solution while they simultaneously believe nothing will work. They feel defeated – therefore, they are, at least for the moment.
A careful history is needed to understand what role temperament (has he been difficult from birth), medical conditions (illness, allergies, disabilities), learning disabilities, social problems, coordination problems, and psychological problems (anxiety, depression, extreme mood shifts) might play in the etiology of the problem. Identifying probable causes is important not only to help develop strategies but to enable parents to see that they are not the cause of the problem. Parents may be maintaining or exacerbating the problem, but they are not the original cause. This is the critical first lesson that must be learned. By eliminating the blaming process that has evolved, it sets the stage for constructing problem solving.
The focus of this article is on the child who is functioning okay outside the home. There are no school problems or social problems fueling the struggle. School may play a role in struggles over homework and social issues arise in conflicts about limits on play activities. At the core we have a child who appears unable to accept parental controls. The word “No.” is a frequent trigger for the start of a conflict as are phrases such as “It’s time to stop.” or “You can’t do that now.”
The primary issue here, as described in Ross Greene’s book, “The Explosive Child”, is the inability of a child to be flexible. The mental and emotional requirements for adjusting to sudden changes or disappointments are lacking, somehow not fully developed. As we will discuss later, the main strategy is to help develop this delayed skills along with re-establishing the parents’ role as disciplinarians.
The explosive behavior appears manipulative to the parents because the child often gets his way and because it only occurs at home. This is a complex question. It is manipulative in a very limited sense because the child does learn that tantrums often get him something he wants, or, at the very least, gives him greater control over his environment. But it is not really manipulative. By that I mean the child does not really want to “lose it.” Tantrums are a loss of control that is usually a frightening experience for the child. Furthermore, the exaggerated influence that comes from the tantrums is not really desired by the child on a deeper level. Children want – need – their parents to be in control of the situation because children are very aware of their need to be cared for and protected. Thus, even though the child is trying to get his way, the loss of control is not really what he wants to do.
Strategies:
The process of turning things around involves helping parents to stop blaming each other and themselves, to create a more predictable environment for the child which includes re-establishing their role as authoritative parents, learn what accommodations are needed to reflect the child’s weaknesses, what actions will promote the child’s growth in flexibility, and to address the frustrations of the other children. Yes, this does sound like a lot of work, which it is. But there are a few core principles here that help to tie it all together.
Typically the parents have intuitively tried some very appropriate strategies but have given up too quickly because they didn’t see change right away. The first point, aside from helping parents to stop blaming themselves/each other, is to establish a belief that this problem can be solved but it will take persistence on their part. Often my two biggest roles are to keep parents focused on the game plan long enough for it to take effect and to be able to help them refocus on the child’s strengths.
The global strategy is to create an environment that is more structured, makes fewer demands on the child (which means prioritizing what is really important to be asking of the child), establishing consequences to reinforce desired behavior and not reinforce undesirable behavior, and help the child to improve his skills at becoming more flexible.
The issue of prioritizing is particularly critical. Too often there are struggles about cleaning rooms, finishing meals, practicing piano or completing homework that are simply not worth the consequences. Some of those issues can be addressed when things are improved. Also, if some situations are just too difficult to manage right now, e.g., taking the child on a family activity, then arrange a sitter or a drop off at a friend’s and avoid ruining everyone’s experience. Explain to the child that you are working with him to fix the problem and eventually he’ll be able to come along. Again, this is about setting priorities and either targeting behaviors that can result in initial success or behaviors where safety/health is a concern.
One aspect of this process is referred to as behavior management. It means a more organized approach to targeting certain behaviors to be recorded and reinforced in order to increase/decrease their frequency. Please refer to my two earlier articles on charting and rewarding behaviors in children for more details on how best to do this. A key issue is that most parents cannot maintain complex charts or do formal reinforcement programs for extended periods of time. So this aspect of the approach needs to be short-term and used primarily to get a key behavior or two changed in order for the child and the parents to experience some early success. Thus, it could be earning five minutes of video game time for each time the child is cooperative (always a good idea to identify and reward cooperativeness because there is usually more of it happening than is realized) or earning a story/game with a parent in the evening for being ready for bed on time.
But it is the broader approach that is the key here. Let’s try some examples. After dinner talk to the child about his plans. Is there a TV show he wants to watch? Will he be doing homework? Review expectations about bedtime and map out a schedule that may help to manage those expectations. But something is still likely to go awry.
Parent: Jon, it’s time to turn off the video game and get ready for
bed.
Jon: But Mom, I can’t stop now. I have to finish this.
Here is a potential trigger for a conflict and blow-up. So try to be flexible without giving away your role as parent.
Mom: How much time do you need?
Jon: I don’t know. I’m having my best game ever!
Mom: Jon, I know you can save it if you have to but what I am going to do is
give you 15 more minutes. Here, I’m setting the timer so you know how
much time is left. If you are able to stop then and be cooperative, you can
use the video game tomorrow. But if you are not able to stop when I return,
it will be put away for 24 hours.
The mother is doing a few things here that are helpful. She’s not being rigid, yet she is setting parameters that creates structure that may help the child plan for this transition. These children need training in how to make these transitions and this approach helps. Yet the mother is also being clear that there will be a negative consequence if the child is unable to be cooperative. My conversations with these children underscores their strong belief that parents will not follow through on consequences. It is critical for parents to be persistent and consistent about this. That helps these children to experience the sense that their parents are really in charge and it provides some of the assistance they need in focusing on getting better at being able to adjust to expectations.
It works best if the consequences are directly related to the specific situation and are short-term. One major reason for failure to follow through is threatening consequences that are too severe or too long. Another aspect of consequences is for a mistreated parent to still provide services to the child that should be earned rather than treated as inalienable rights.
Mom: Jon, it’s time to come in. You have to get ready for your soccer
game.
Jon: I hate you. You’re always spoiling my fun. You’re the worst
mom in the world. (This turns into a 15-minute struggle with increasingly nasty
language on Jon’s part.)
Mom: I have told you that if you are angry you have to find an acceptable way
to express it. This was not acceptable. Being so mean to me means I’m
not going to do something nice for you anyway, so forgot about being driven
to your soccer game. I’ll call your coach and tell him you won’t
be there.
Jon may now throw a tantrum about not being able to go to his game, but if Mom and Dad are consistent about these kinds of consequences for parental abuse Jon will gradually decide it is not worth it.
Helping Jon to learn about transitions requires preparation and training. A piece of that was in the earlier example of setting a timer and being clear on consequences. Another example would be an approach to the previous situation.
Jon: Can I go out and play until my soccer game?
Mom: I would like to say yes but sometimes you get angry when it is time to
stop playing. Is there anything that would help you to not do that?
Jon: Not sure. Maybe if you give me a couple of warnings, you know, like 10
minutes left, 5 minutes left.
Mom: Okay, let’s try that.
The old reverse psychology piece actually can be helpful, i.e., to predict that Jon is likely to have a blow-up. Partly it takes a way some of his sense that he is doing the unexpected. More importantly, repeatedly engaging in this type of discussion helps Jon to strengthen his ability to adjust to transitions.
When parents begin to reassert their roles as being in charge and working with the child to improve his ability to be more flexible, the child will likely respond initially by getting worse. Even though he doesn’t really want the old system to remain in place, it is his natural instinct to try to hold on to what he knows rather that commit to uncharted waters. Parents must believe in what they are doing and remain persistent, which is hard after having developed a sense of failure about trying to manage this problem. But, if you can, it will pay off with positive results.
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