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Anger

What is anger?
Anger is a normal human emotion; however, it is also one letter away from danger. Recognizing when your child has crossed the line from anger to a dangerous rage is important.  Children communicate their unmet needs through anger at times, but when children continue to have regular emotional outbursts, it can be a symptom of internal distress.  They may sometimes lash out if they're frustrated or be defiant if asked to do something they don't want to do. But when kids do these things repeatedly, or can't control their tempers a lot of the time, it may be more than typical behavior. Here are some signs that outbursts should concern you:
  • If your child's tantrums and outbursts are occurring past the age in which they're developmentally expected (up to about 7 or 8 years old)
  • If his behavior is dangerous to himself or others
  • If her behavior is causing her serious trouble at school, with teachers reporting that she is out of control
  • If his behavior is interfering with his ability to get along with other kids, so he's excluded from play dates and birthday parties
  • If her tantrums and defiance are causing a lot of conflict at home and disrupting family life
  • If he's upset because he feels he can't control his anger, and that makes him feels bad about himself

What causes the dangerous anger?
The first step is understanding what is triggering your child's behavior.  There are many possible underlying causes, including: 
  • ADHD:  Many children with ADHD have trouble controlling their behavior.  They may find it hard to comply with instructions or switch from one activity to another, and that makes them appear defiant and angry.  "More than 50 percent of kids with ADHD also exhibit defiance and emotional outbursts," says Dr. Vasco Lopes, a clinical psychologist at the Child Mind Institute. Their inability to focus and complete tasks can also lead to tantrums, arguing, and power struggles. That doesn't necessarily mean they've been diagnosed with ADHD—in fact, ADHD is sometimes overlooked in kids who have a history of severe aggression because there are so many bigger issues.
  • Anxiety: Children who seem angry and defiant often have severe, and unrecognized, anxiety. If your child has anxiety, especially if she's hiding it, she may have a hard time coping with situations that cause him distress, and she may lash out when the demands at school, for instance, put pressure on her that she can't handle. In an anxiety-inducing situation, your child's "fight or flight" instinct may take hold—she may have a tantrum or refuse to do something to avoid the source of acute fear.
  • Trauma or neglect: A lot of acting out in school is the result of trauma, neglect, or chaos at home. "Kids who are struggling, not feeling safe at home can act like terrorists at school, with fairly intimidating kinds of behavior," says Dr. Nancy Rappaport, a Harvard Medical School professor who specializes in mental health care in a school setting. Most at risk, she says, are kids with ADHD who've also experienced trauma.
  • Learning Problems: When your child acts out repeatedly in school or during homework time, it's possible that he has an undiagnosed learning disorder. Say he has a lot of trouble with math, and math problems make him very frustrated and irritable. Rather than ask for help, he may rip up an assignment or start something with another child to create a diversion from his real issues.
  • Sensory processing issues: Some children have trouble processing the sensory information they are getting from the world around them. If your child is oversensitive, or undersensitive, to stimulation, things like "scratchy" clothes and too much light or noise can make her uncomfortable, anxious, distracted, or overwhelmed. That can lead to meltdowns for no reason that's apparent to you or other caregivers.
  • Autism: Children on the autism spectrum are also often prone to dramatic meltdowns. If your child is on the spectrum, he may tend to be rigid—needing consistent routine to feel safe—and any unexpected change can set him off. He may have sensory issues that cause him to be overwhelmed by stimulation, and short-circuit into a meltdown that continues until he exhausts himself. And he may lack the language and communication skills to express what he wants or needs.
What is the typcial treatment approach for a child with anger?

With a thorough assessment, we seek to understand the experiences your child had beginning intrauterine and throughout childhood.  This helps us understand how the brain developed and pathways we can work on in therapy to help re-build relationships and teach the child to regulate big emotions. Our focus is on creating a therapeutic environment of trust and openness to change.  Dealing with behavioral disorders is challenging and requires a great deal of openness into history of family functioning and childhood development.  The assessment includes:

  • Review of current symptoms, concerns, duration and intensity
  • A thorough review of child development and past medical history
  • Review of family systems
  • Additional important family background information including history of mental health issues
Learning coping skills to control anger, and developing mindful awareness of the mind-body connection are skills that can be learned in therapy. We often use dialectical behavior therapy and relaxation skills in conjunction with traditional talk therapy to treat children and teens with anger issues. Many parents also require some support with techniques to help manage their child's big feelings. When angry outbursts persist and interfere with relationships with family or friends, it is time to consider more serious possible causes: ongoing threats to a child’s safety, deeper tensions in the family, a developmental delay in language that leads to frustration, or a delay in social skills that brings on aggression.

When you bring your child to us for an intake assessment, we use evidence-based methods to gain perspective on the nature and intensity of your child's symptoms.