Aliza cringed as she listened to the principal describe her five-year-old Ari’s latest blow-up at school. “Like a human tornado,” Rabbi Levy said. He went on to recount how Ari had pounced on the teacher, kicking and hitting. Like a ferocious miniature warrior, he vented his fury on anything in his way. He shoved children and hurled objects. Only after a box of arts and crafts supplies got hit by a stapler he threw and came crashing down on him did Ari’s meltdown taper off to tearful sobs.
Aliza’s throat was dry. “What set him off this time?”
“Something about wanting to play Achashveirosh in the Purim play. When he was chosen for a different part, he just exploded.” Rabbi Levy paused and cleared his throat. “Mrs. Lieberman, we can’t allow the class to be held hostage any longer to Ari’s tantrums. Enough is enough. We have him waiting in the office now. I’d appreciate it if you would please pick him up.”
Her heart plummeted. “But Rabbi Levy,” she pleaded, “won’t you give him one more chance? I think we’re really about to turn the corner with him – ”
“We’ve put up with Ari’s explosive behavior longer than we should have. As far as I’m concerned, your son needs some good, old-fashioned discipline. That’s been my position all along. Coddling him does nothing but encourage his tantrums. When you and your husband get him fully under control, we can talk about readmitting him.”
Tears blurred Aliza’s vision as she drove to her son’s yeshiva. Smarting from Rabbi Levy’s criticism, she really couldn’t blame the school for running out of patience with Ari. She knew how nerve-wracking his tantrums could be. At home they walked on eggshells around him but he still threw fits of rage over trivia. That this short and skinny five-year-old had the power to create such havoc was outrageous. What was wrong with him? Their two older children never behaved this way. No normal kid behaved this way.
Later, driving home, she stole a glance at Ari through the rear-view mirror as he huddled in the back seat. His little face, still tear-stained, reflected pure misery. He had watched her empty out his entire cubby. He knew that meant he was not returning. Did he realize that today’s massive blowup had sealed his fate? Would he learn anything from it?
What must it feel like to be him, she wondered, to be so often gripped by rage reactions to the point where you spiraled out of control? What must it feel like to face the accusing stares of other children and adults who resented the chaos you stirred up?
As If His World Came to an End
Aliza guessed that Ari’s tantrum in school that day was triggered by the same mindset that so often lit his fuse – his inability to adapt to a real-life situation that ran counter to his expectations. He reacted to any deviation from the way he anticipated things as if his world had come to an end. He’d been playacting King Achashveirosh for days, strutting about the house in a home-made crown and scepter. In his mind, he already had been chosen for the part – not a good sign, Aliza knew.
Her foreboding led her to consider calling his teacher and asking her to give Ari the part, but her husband vetoed the idea. “It’s bad enough that we dance around him at home,” he said. “He’s got to learn to handle disappointment.”
“Should I have followed my instincts and made that call anyway?” Aliza asked me at our first session. “It could have prevented Ari’s meltdown.”
Aliza’s question went straight to the heart of an ongoing debate among mental health experts about how to deal with chronically explosive children. Should traditional discipline, using rewards and consequences, be applied? Or is it best to relax the rules and ignore chutzpah and bad behavior in favor of preventing explosions?
Rages Over Changes
We are not referring here to the “terrible twos,” or to the occasional temper tantrums typical of childhood. All children at one time or another throw fits of rage, especially when they are hungry or tired. Our interest is in the older child (five and above) who is habitually inflexible and explosive, who, with little or no provocation, turns the family and classroom upside down with his violent outbursts.
Children with such a temperament are handicapped by a remarkably low threshold of frustration. Many have problems making transitions from one activity or environment to another. For example, when plans for a trip are cancelled, or if when on the way to dropping the child off at her friend’s house, you make a spur-of-the-moment stop at the grocery store, such changes in the child’s “roadmap” can trigger a full-blown tantrum.
In addition, these children appear incapable of negotiation and compromise. Their one and only response to frustration and disappointment is to throw a fit. In the midst of a meltdown, they are incoherent and irrational. They may shout, use bad language, break things, kick and punch. The turmoil and discord they generate reduce parents to feelings of helplessness, confusion and despair.
Biological or Controllable?
While opinions are split on how best to deal with explosive children, the trend today is to forego traditional methods of discipline, with its incentives, rewards and consequences. Instead, parents of explosive children are being advised by experts such as Dr. Ross Greene, author of the widely acclaimed The Explosive Child, to view their children’s problems as neurobiological, as the result of a developmental delay in social and communication skills and the ability to cope with stress.
Expecting children in whom these skills are delayed to behave rationally when upset, and to penalize them for not doing so, is unrealistic, Greene argues. These children do not choose to behave badly any more than a child would choose to have a reading disability. Thus, the overall priority is to lessen the frequency of explosions by inducing the child to stay calm, often at the price of tolerating bad language and open defiance.
During a meltdown, Greene advises parents and teachers to focus on restoring the child’s coherence through empathy and negotiation. Example: Parent to child, as child rages and fumes: “You’re pretty angry, aren’t you? You’re upset because I made you come inside before you were finished playing, right? We do need to come inside when it gets dark, but what about if I give you a delicious treat before bedtime?”
Or, teacher to child as child rails at teacher: “You’re furious, aren’t you? You’re disappointed that I didn’t call on you when you were raising your hand… You wanted me to call on you so badly, didn’t you? I’m going to try hard to notice you right away next time!”
Is Medication the Magic?
Even these strategies are often inadequate to stop explosions, says Greene. Controversially, he prescribes medication for the majority of the children he treats. “Just as children with diabetes may need medication as well as a special diet and strategies to reduce stress, explosive children, too, usually need both medication and counseling,” Greene explains.
Critics of Greene’s approach say his philosophy weakens parental authority in an already too-lax culture. Calling it “appeasement tactics” and “less a strategy than a means of surrender,” psychologist Dr. Lawrence Diller also notes its over-reliance on medication.
While medication has a place in extreme cases, Diller writes, Greene tends to “overpathologize” difficult children, defining their challenges in terms of personality and emotional disorders. In fact, many of the drugs like Ritalin and Depakote that Greene prescribes for the children in his clinic happen to be the standard treatment for ADHD and bipolar disorder.
Is the success he professes to have with explosive children largely attributable to the sedating power of the drugs they take? Or is it due to his philosophy that asks parents to do everything possible to avoid conflict – tolerating foul language, disrespect and flouting of rules all in name of preventing meltdowns?
Exposure Therapy
In a new book, What Your Explosive Child is Trying To Tell You, Dr. Doulglas Riley sharply disputes the notion that tiptoeing around explosive children to keep them from facing conflict is necessary, or even desirable. “By being overly protective of explosive children, you run the risk of turning them into emotional cripples,” he writes. “You virtually guarantee that your child will remain brittle, tense, controlling and explosive.”
Paradoxically, he says the most direct way to help these children is to have them frequently face the very situations that are making them explode! Riley advocates treating explosive children who have particular trouble handling transitions and unexpected changes in their routine with “exposure therapy.”
This is a strategy based on the belief that a person can overcome what frightens him or induces anxiety by gradual, repeated exposure to it. Also known as “desensitization,” the practice has been found to trigger certain responses in the brain that gradually result in the suppression of the intense, negative emotions normally evoked by a particular situation. While in the short run, exposure therapy seems to create more turmoil in already-stressed homes, ultimately it vastly reduces explosiveness, advocates say.
During exposure therapy, a child who has difficulty with transitions or “road-map changes” is at first guided through play-acting situations in which she practices appropriate responses in place of exploding. For example, her mother tells her the disappointing news that instead of going to her friend after school as previously arranged, she will be coming straight home.
What happens now? Normally, such a change in plans would spark a tantrum. In the simulated scenario, the child practices using appropriate language to express her dismay and frustration. She and her parent role-play the situation, demonstrating how some “little kids” scream and throw things when their plans are changed, but “big kids” realize it’s no big deal; they’re old enough to handle it.
Real-Time Challenges
In the next stage, the transitions and road-map changes are real, not imaginary, but the child has been forewarned and has time to emotionally prepare for them. In the third stage, the changes and transitions are unexpected.
“In this stage, use techniques such as wishing your son a good day at school and saying you plan to have hot dogs and French fries for supper. Serve spaghetti and meatballs instead,” suggests Dr. Riley. “Tell him you’re going to pick up strawberry ice cream when you go shopping and come home with peach ice cream, instead. Rearrange some furniture in your den or living room. Be inventive, presenting your child with transitions, situations and surprises he typically has difficulty with.”
(To be continued)
