The Angry Child
By Dr M C (Ian) Opperman
10 signs of when your child needs help coping with anger:
- The child can’t control their aggressive impulses and hits people (other than siblings), past the age of five.
- Frequent explosive outbursts, indicating that the child is carrying a “full tank” of anger and other upsets, that’s always ready to erupt.
- Constantly reflexively oppositional behaviour.
- Does not acknowledge their role in creating the situation, instead feeling constantly victimized and “picked on”.
- Frequently loses friends, alienates adults, or is otherwise embroiled in interpersonal conflict.
- Appears preoccupied with revenge.
- Threatens to hurts him-/her-self physically (or actually does).
- Regularly damages property.
- Repeatedly expresses hatred toward him-/her-self or someone else.
- Hurts smaller children or animals.
- Introduction
In this article I am going to discuss the different disorders that can be diagnosed around aggression, including Oppositional Defiant Disorder, Conduct Disorder, and Intermittent Explosive Disorder. Further we will look at what the child can do to regulate themselves emotionally and in the process gain control over their aggressive impulses, by understanding the more threatening emotions under the anger and how to solve problems constructively without the need to become aggressive. Lastly, the parents role in assisting their child with controlling their aggression is discussed, including modelling the correct behaviour, deescalating the situation that could cause aggression, reassuring the child that feelings are natural, providing he child with alternatives to managing their angry impulses, helping your child to be aware of the warning signs of aggression, setting limits on aggressive behaviour, and the development of emotional intelligence amongst others.
- Aggression Disorders
We will shortly discuss the diagnoses under which anger can make its appearance, namely, for approximately primary school ages, the child will be diagnosed with oppositional defiant disorder, and if this is not successfully controlled, it might become conduct disorder in the child’s high school years. Further the child might be diagnosed with intermittent explosive disorder.
- Oppositional Defiant Disorder
Children with Oppositional Defiant Disorder display a pattern of angry/irritable mood, argumentative/defiant behaviour, or vindictiveness. They display the following symptoms from any of the three categories and exhibit this behaviour with at least one individual who is not a sibling:
- Angry/Irritable Mood
- Argumentative/Defiant Behaviour
- Vindictiveness
- Conduct Disorder
A repetitive and persistent pattern of behaviour which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by some of the following criteria:
- Aggression to people and animals
- Destruction of property
- Deceitfulness or theft
- Serious violations of rules
The disturbance in this behaviour causes clinically significant impairment in social, academic, or occupational functioning, and the child meets some of the criteria above, the child may be considered to have conduct disorder.
- Intermittent Explosive Disorder
Recurrent behavioural outbursts representing a failure to control aggressive impulses as manifested by either of the following, indicate possible Intermittent Explosive Disorder:
- Verbal aggression or physical aggression
- Behavioural outbursts involving damage or destruction of property and/or physical assault involving physical injury against animals or other individuals.
The magnitude of aggressiveness expressed during recurrent outbursts is grossly out of proportion to the provocation or to any precipitating psychosocial stressor. The recurrent aggressive outbursts are not premeditated and are not committed to achieve some tangible objective. These outbursts cause either marked distress in the individual or impairment in occupational or interpersonal functioning, or are associated with financial or legal consequences. The chronological age of this disorder is approximately six years.
- Affect Regulation
Affect regulation is the ability of the child to regulate themselves emotionally and understand the difference between the stimulus (the thing that makes them angry) and the response (their reaction to the thing that makes them angry). One regulates your emotions and behaviour, by coming to the conclusion that “I have control over my response”. As children’s brains develop, they gain the capacity to manage their anger constructively; they develop self regulation abilities.
- Controlling aggressive impulses: As we accept our child’s anger and remain calm, the child lays down the neural pathways and learns the emotional skills to calm herself down without hurting people or property. By the time they’re in kindergarten, children should be able to tolerate the flush of adrenaline and other “fight” chemicals in the body without acting on them by clobbering a playmate. (Note: It’s not unusual for kindergartners to still hit siblings).
- Acknowledging the more threatening feelings under the anger: When parents accept and empathize with the child’s emotions, the child learns that emotions aren’t dangerous and can be felt but not necessarily acted on. By contrast, if we don’t help kids feel safe enough to feel those underlying emotions, they will just keep losing their tempers, because they don’t have any other way to cope with the upsets inside them. These kids often seem to have “a chip on their shoulder” because they walk around ready to get angry.
- Constructive Problem-Solving: Eventually, the goal is for your child to use the anger as an impulsion to change things as necessary so the situation won’t be repeated. With your help, your child will learn to calm him-/her-self when the child is angry so that the child can express his/her needs and wants without attacking the other person, either physically or verbally. The child will learn to see the other person’s side of the issue and to look for win/win solutions to the problem, rather than just assuming that the child is right and the other person is wrong.
Obviously, it takes years of parental guidance for kids to learn these skills. If parents are able to help kids feel safe enough to express their anger and explore the feelings underneath, kids are able to increasingly move past their anger into constructive problem-solving during the grade-school years.
- Parents’ role
The parent has a huge responsibility to help the child to regulate their emotions successfully and one of the core strategies to achieve this goal is to master one’s own emotions and anger. Following please find some tips that you as a parent can do with your child to help them cope with their anger more successfully:
- Start with yourself
Know that you are modelling behaviour that your child will certainly copy. If you give in to your temptation of aggressive behaviour (physical or verbal) you can’t expect your child to learn self-control. Your child learns from watching how you deal with disagreements and conflict. Your calm presence helps your child feel safe, which helps him develop a neural pathway in the brain to shut off the “fight or flight” response and allow the frontal cortex, the “reasoning brain”, to take over. That is how children learn to soothe themselves. They learn from self-regulation that anger and other upsetting feelings are not as scary as they seem.
- De-Escalate
It is difficult to stay calm when things get turbulent, but yelling at an angry child reinforces what the child already feels, which is that the child is in danger. Your anger will only make the storm worse. Your job is to restore calm, because your child can only learn and understand how to “do better” when they themselves are calm.
- Remember that all feelings are allowed
Only actions need to be limited, because when children suppress their emotions, those feelings are no longer under conscious control, and arise unregulated. If the emotions are allowed, the child can accept them, instead of trying to repress them. That gives the child the ability to enjoy cognitive control over the feelings so that the child can start putting them into words instead of acting out aggressively.
- Give your child ways to manage his angry impulses in the moment
Your child needs to know how upset they are and why; it is helpful for your child to be able to show you how upset the child is, so that the child may feel understood. When the child is calm, make a list with him/her of constructive ways to handle emotions, and post it somewhere where they will see it often. Let your child do the writing and add pictures, etc. so that the child may feel ownership of the list.
- Help your child be aware of “warning signs”
Once children are in the full flush of adrenaline and “fight or flight” neurotransmitters, they think it’s an emergency, and they are fighting for their lives. At that point, managing the angry impulses is almost impossible, and all we can offer children a safe haven while the storm sweeps through them. But if you can help your child notice when the child is getting annoyed and learn to calm him-/her-self, the child will have fewer tantrums.
- Set limits on aggression
Allowing feelings does not mean that we allow destructive actions. Children should never be allowed to hit others, including their parents. When they do, they are always asking for us to set limits and help them contain their anger. Some children really need to struggle against something when they are angry. It is fine to let them struggle against your hands, or even holding your arms, if that’s what they want, but don’t let yourself get hurt. Similarly, don’t let children break things in their fury. That just adds to their guilt and sense that they’re a bad person. Your job is to serve as a safe “container” and “witness” while you listen to your child’s upsets.
- Don’t send your child away to “calm down” by themselves
Your goal when your child is angry or upset is to restore a sense of safety, which requires your calm presence. Remember that kids need your love most when they “deserve it least.” Instead of a “time out”, which gives kids the message that they’re all alone with these big, scary feelings, try a “time in”, during which you stay with your child and help them move through their feelings. You’ll be amazed at how your child begins to show more self control when you adopt this practice, because the child feels less helpless and alone.
- Restore connection
Your child needs to know that you understand and are there to help. Learn to give explicit permission.
- Do preventative maintenance to help your child work through the emotions that come up daily
There are a few practices that help your child feel safe and connected, and that help him/her work through the emotional challenges that all children encounter in daily life. Those practices are:
- Respond to everything the child expresses with empathy and respect, even when you set limits (You won’t be able to be empathic 24/7. Just work on increasing your ratio.)
- Spend a minimum of 15 minutes one-on-one with each child daily, just connecting and enjoying the child.
- Use routines so your child knows what to expect, which helps children feel safer.
- Accept all the emotions your child expresses, and make it safe for them to cry when they need to.
- Give your child control of their choices when possible.
- Make sure that each child gets a daily chance to belly-laugh for at least 10 minutes, preferably by being physically active with them.
- Help your child develop emotional intelligence
Children who are comfortable with their feelings manage their anger constructively. Some children, unfortunately, don’t feel safe expressing their uncomfortable feelings. Sometimes they have parents who discount or even ridicule their fears or disappointments. Sometimes they’ve been sent to their rooms to “calm down” and never received the help they needed to handle their upsets. Sometimes the pain or grief just feels too overwhelming. They try hard to repress their fears, jealousies, and anxieties, but repressed feelings have a way of popping out unmodulated, as when an otherwise loving preschooler suddenly hits the baby. These children live in fear of their feelings. To fend off this reservoir of fear, grief, or other pain, these children get angry and they stay angry. When this happens, a child may benefit from professional help.
DSM-V