anger in kids

(Part 1)

        10-20% of youths (15 million children in the US) meet diagnostic criteria for a mental health disorder. Among those, only 20-30% receive specialized mental health care. This statistic is even worse for those youths from low-income families in the juvenile justice and child welfare system, ethnic minorities, and those with substance abuse problems. Bradshaw (2010) found that poorly managed anger in adolescents was linked to: increase in verbal and physical aggression, peer rejection, school dropout, juvenile delinquency, and later adult criminal behavior. This post will discuss a child’s development and how to manage their behavior to ensure safety. Part 2 will begin discussing genetic and relational reasons for why the behavior began and lingered.

        There is a variety of reasons why anger and aggression can be prevalent for children. Trauma, developmental disorders, and environmental factors contribute to a lot of aggression seen in kids and adolescence. To show the impact of trauma on kids, one study found that children exposed to family violence show the same pattern of activity in their brains as soldiers exposed to combat. For the developmental reason, we need to understand that most children and adolescence go through an egocentric phase. We hope this is a phase and not an everlasting condition. This phase is very important, however, and needs to be gone through. Babies are the most egocentric species out there. Cry when they are hungry, they get food. Cry when they are tired, get put down for a nap. Their life begins by having having tantrums and these tantrums lead to getting their needs met. Gradually they begin to become more independent and responsible for meeting their own needs.

        A 9 year old male client, let’s call him Ron, showed severe aggression to his family members. He would attempt to punch his mother in the stomach when she was pregnant (other posts will talk more about the relational component to these types of behaviors), bully his younger sister, and break doors and windows frequently. This child had a developmental disorder and a painful past. Therapy needed to respond first to the safety issues. Uncovering the pain and healing Ron and the family can only happen when safety is present. Ron, like a lot of children his age, had a egocentric view of the world (the universe was either all about him or all against him). He wanted things immediately and a lot of difficulty waiting. He was sensitive towards any perception of unfairness and became easily frustrated when told no. We can view kids like Ron as acting out in a functional way, meaning their aggression is to get their needs met but the way they are trying is unacceptable.

        The first step towards helping Ron and the family regain safety in the home was to empathize with Ron’s emotional experience while giving calm but firm directives. Having a sense of empathy doesn’t mean you agree with the child’s view (this is true for being empathic to anyone!). It means that we realize and show compassion towards the experience of the child that feels trapped, hurt, enraged, needing to control out of fear of being hurt again, etc. Starting there will have the child feel seen, heard, and not judged. Then we needed limits and clear boundaries for Ron. Many parents can understandably get fed up with the child’s behaviors or feel disrespected that they begin to yell at the child or begin pleading with the child. This is why it is important to have both a calm and firm tone when giving directives. The calmness shows empathy and it doesn’t add any fuel to the fire. The firmness shows clarity about the expectations and lets the child know that it is something he needs to listen and adhere to. Within a month, the parents felt safe and felt they didn’t have to walk on eggshells so we were then able to begin the longer process of healing the child and family. 

        Often children don’t know how to control emotions like anger and frustration and don’t know how to use words to express their feelings but use tantrums instead. Another male client, a 16 year old boy who we will call Jeff, would become severely fixated on getting what he wanted and would become dysregulated to the point of pulling out knives and threatening others while breaking objects in the home. Similar to Ron, Jeff had a developmental disorder and a painful past. Along with being empathetic towards Jeff’s emotional experience and being clear/firm, we used distractions to help Jeff become unstuck from his fixations. This could be distractions that were completely random or they can be something we knew would interest him in the home. After he became un-fixated for about 5 minutes, we would give him 2-3 options of what he would like to do that were acceptable by the parents. The parents were then able to apply these strategies with the child to create the safe environment consistently. 

        To recap, children’s anger often comes from a misguided attempt to meet their needs. So a good first step is to empathize with their emotional experience (imagine being as scared of being hurt as Ron or imagine being as fixated on something as Jeff and how that trapped/desperate feeling may eat you up). Then we need to provide calm (not aggressive, tense, etc.) but firm (assertive) directives to the child for them to be clear about the expectations without adding extra tension/frustration to their emotional state. Adding distractions and 2-3 options can help to get the child “unstuck” and help them refocus on the 2-3 options rather than the flood of emotions/thoughts they may have. These strategies are not an end-all-be-all. They are not going to resolve the pain and relational factors. We will talk about those in other posts. These strategies, however, can help redirect the child, begin rebuilding a safe environment, and give more opportunities for the child to express their needs in an appropriate way.