By Patrick J. McGrath, OC, PhD, FRSC
Question:
What can I do about my eight-year-old son? He gets frustrated and then gets angry. He swears and slaps himself in the face or hits his head against the wall. In other ways, he is a kind, sweet person. He has these "fits" about once a week. He used to have them at school but now only has them at home and with his friends. I have tried punishing him, talking to him, ignoring him but nothing seems to work. What can I do?
Dr. Pat responds:
You may have already had your son checked out by his family doctor or pediatrician. If not, you should do this. There are some brain conditions that might lead to this type of behaviour. It is always better to have his doctor do a good history and physical to rule out these possibilities. If there are any indications of a brain problem, your son's doctor will order tests or refer him to a specialist. Most likely your son does not have a brain disorder but a problem with handling frustration.
Do not change how you deal with them for at least a couple of weeks. Start to gather information about what these outbursts are about. Do this until you have information on at least four outbursts. Be open with your son that you are collecting this information. Maybe you can record outbursts on a tape recorder or video.
Keep a careful diary of these outbursts. In the diary, you should include information about the outburst:
- the time and date
- what happened to him before
- what he did during the outburst
- how long it lasted
- how aware he was of what was going on
- what was done by others after
- what he did after
- what was going on in the home, at school, or in his social life
After each outburst is all over, you could also ask your son what he thought was going on before, during, and after the outburst.
After keeping this diary for three or four outbursts, try to analyze what is going on. It is best if you include your son in doing the analysis.
First of all, look for clues in the period before the outburst. Is there any pattern?
Do they often happen just before a meal or are they occurring late in the day?
Is there a particular trigger (person, place, or situation)? Is there a certain type of frustration that is occurring? Take time to think about it.
Second, you can examine what happens during the outburst. Are there any clues to the cause or how to control the outbursts? Did some outbursts stop short? Do you or others raise the level of emotion? Does he get a lot of attention for the outburst?
Third, analyze what happens after the outburst. Is there any positive outcome? Does he get what he wants? Is punishment consistent? Is there a pattern in the consequences? What is the consequence of him dealing with frustration?
With your son, design your plan around this analysis. Try it out for a month. If things are improved, even if not perfect, celebrate success and keep going. Tweak the plan if you can see how to make it better. It will take several months to solve the problem.
If this doesn't work, ask your son's doctor to help you find some professional help.
Patrick J. McGrath OC, PhD, FRSC is a clinical psychologist and a researcher. He is Professor of Psychology, Pediatrics, and Psychiatry at Dalhousie University and Vice President - Research at IWK Health Centre in Halifax. He is also the CEO of the Strongest Families Institute, which provides mental health care to families across Canada.
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