Did you know…
That your child’s behavior can be understood, addressed, and corrected?
Are you frustrated, burnt-out, and resentful about your child’s behavioral problems?
The good news is that with some education and hard work you can turn things around. In fact, studies have shown that parent education and guidance can make a big difference in children’s behavior.
Think about that for a second.
Can you fix your child’s ear infection with parenting techniques? Of course not.
The fact that parent guidance and education has been shown to significantly improve child mental health is incredibly empowering for those parents who are willing to put in the time and effort to become the very source of their children’s healing.
In my opinion, excellent parenting is more important than any medication or psychotherapy out there.
You’re with you child 24/7, and if you learn how to understand and help your child with his or her struggles, that will go a long way.
If you want to understand your child’s behavior so you can help correct it, you’re in the right place.
In this article I’ll share with you my approach to problematic behaviors. These are some of the attitudes and techniques that I teach parents, as I simultaneously work with children and their parents to position kids for success and help parents break the cycle of frustration and helplessness.
But first let me tell you a little bit about myself and how I see things.
My name is Jason Dean, MD, and I am an adult and child psychiatrist.
I received my adult psychiatry training at Harvard and my child psychiatry training at Yale.
In my work with patients, I combine medication, psychotherapy, and parent guidance to help angry kids, frustrated parents, and strained families.
I also treat adults, providing medication, individual psychotherapy, couples therapy, and family psychotherapy.
I approach things differently than many psychiatrists.
Most psychiatrists today only prescribe medication, but they do not practice psychotherapy (talk therapy).
I try to combine medication and psychotherapy as often as possible because psychiatric problems run deep. I have found that in order to really get to the bottom of things and create profound and lasting change, psychotherapy is crucial.
Psychotherapy is not just about treatment, psychotherapy actually uncovers the deeper reality of what is going on beneath the surface. When you have that deeper understanding and the proper diagnosis, the treatment is much more likely to be effective.
Let’s jump into my five step process for addressing childhood behavioral problems, and you’ll start to see why I view psychotherapy as essential.
Step 1: Recognize the humanness of mental disorders
Isn’t it true that mental disorders are caused by chemical imbalances in the brain? Well…yes and no.
Yes, chemical imbalances have been found in many psychotherapy conditions, but that’s only part of the story, especially when a serious mental illness is not present.
Disorders like oppositional defiant disorder (ODD) are often related to very understandable human psychological issues. In fact, oppositional defiant disorder basically just means “angry disobedient child disorder,” but it doesn’t tell you WHY the child feels and acts that way.
The way I see it, a child’s struggles such as anger, sadness, and worries, are rooted in who he or she is as a person – i.e. his or her personality – and in the family structure.
Symptoms that seem irrational can usually be understood psychologically, but their severity is usually due to the underlying biological issue. Biological issues prevent people from processing and tolerating psychological pain, which makes it unbearable.
Let me give you an example, if you’re addicted to coffee, like so many of us, and you haven’t had your morning fix yet, you might not be at your best. Or let’s say you come home after a long day where you skipped lunch, and you’re hangry.
Then something small upsets you and you snap at your spouse or kids. We usually explain the event away, saying that it was just because we were tired, hungry, stressed, hadn’t had our coffee yet, etc.
The same thing happens with kids who are overtired. Ah, the dreaded “overtired.”
Kids go insane when they’re too tired, and we are used to shrugging our shoulders and saying they were just tired.
And all of that is true.
But the reason you were upset at your spouse has psychological meaning.
Maybe you were feeling hurt, unloved, or anxious. It’s just that because you weren’t mentally at your best you weren’t able to process the issue and control yourself as well as normal.
Your tired kid has a psychological reason for being upset, but because he or she is exhausted, it leads to a meltdown.
In psychiatric disorders, biological problems or chemical imbalances are like being tired. They explain why the person gets overwhelmed with the feelings and why they’re so debilitating, but they don’t explain the underlying reason why he or she feels that way.
The type of psychotherapy that I provide is called psychodynamic psychotherapy. It is a type of talk therapy, or play therapy for younger children, that strives to uncover the underlying root of the problem.
All too often, the symptoms of anxiety, anger, aggression, and defiance are just the tip of the iceberg.
Psychodynamic psychotherapy is like plunging your head under the freezing water and taking a look at the giant iceberg beneath the surface.
We do it more gradually, carefully, and thoughtfully than that, of course, so that it’s not overwhelming, but you get the idea.
With adolescents and adults, the exploration occurs mostly through talk therapy, similar to that in adults. With younger children, therapy takes place with symbolic play with dolls, toy cars, etc., as well as drawings and other symbolic forms. Children are usually not able to express their feelings with words, so we explore and address the underlying issues in symbolic form in play. From the way children play, we catch a glimpse into their inner world, and we can actually intervene and help children work out psychological issues all while playing. Children don’t even need to realize we’re talking about them when we talk about the angry or sad doll, etc.
One of the most important parts of the therapy is the ability to express these deepest feelings in some way, to be heard, and to be supported in the process.
The goal is to understand symptoms in the broader context of who the child is as a person, as well as the family structure. We often come to understand the problem in incredible depth, where the treatment plan is a comprehensive and intensive intervention for the child, the parents, and the family as a whole.
Medication, while often essential, is just one part of that plan.
It certainly is not for everyone, but for those families that are willing to make the investment – the investment of time, energy, and money – to dig deeper and get to the bottom of things, this type of treatment can create profound change.
Making that investment now, rather than a simpler approach such as just using medications or a more superficial form of psychotherapy, may be harder at first.
After all, who wants to plunge their head into the ice water and see that giant iceberg?
Taking a look at the underlying problems is not always for the faint of heart, but for those with the courage and foresight to make that investment, it will pay dividends for years to come.
My advice: Put in the hard work up-front so you can reap the benefits in the future.
Step 2: Be curious – learn how to speak child
Many parents do not realize that there is a reason why their children behave the way they do. The first step toward helping your child improve his or her behavior is to understand it. Here’s the thing, children do not speak your language. We as adults are used to discussing our feelings, needs, and complaints. As least most of us!
Children….just don’t do that.
The language of children is action.
As in…massive tantrums, screaming on the floor.
Kids don’t tell you how they feel. They show you.
Why is that, you might ask? It would definitely be a lot easier if a child just told you how he or she was feeling. But the reason that children cannot do that is that they have not developed the ability to convert their raw feelings into language.
That’s actually a very long and complicated process that happens over many years, and many adults never even get there. That process actually occurs when adults, particularly parents, help children understand their feelings and translate them into words. For the most part, children don’t actually know how they feel, or at least they’re not able to understand or express it in words.
A child who hits his or her sibling often has no idea that he or she is angry unless an adult says, “Oh, you must be really angry.”
So the first step in the process is to be curious and have an open mind. Some parents think their kids are just trying to get at them, or they don’t care about what their children might be feeling – they just want them to obey.
If that is your attitude, this approach might not be for you. However, even if that is your attitude, it’s probably worthwhile considering a change. After all, how well has that approach worked up until now?
Learning how to speak child means learning how to understand the underlying issues and motivations that lead a child to act a certain way. It’s like being a detective of sorts, learning what behaviors mean and what they’re meant to communicate.
This is one of the most important points: Behaviors have meaning, and they are communications. If you learn to understand the communication, you gain a highway into the inner world of your child, after which helping him or her is that much easier.
This leads us to the next step.
Step 3: Your kid is not a bad kid, your kid is a sad, mad, or scared kid
There is a reason your child acts this way, and it’s probably a good reason.
Let me give you an example. A six year old girl, let’s call her Lilly, refuses to follow her parents’ rules and directions, and she often hits her sister. She seems to blow up at the littlest things, like being told that she can’t have candy or to clean her room. To her parents, her outbursts seem totally irrational – crazy. The reactions are totally out of proportion to what’s actually going on.
The trick is not to take the bait and miss the underlying message.
In fact, when the reaction is out of proportion to the situation, an alarm should go off in your head. That usually means it’s a reaction to something INTERNAL.
If EXTERNAL reality can’t explain what’s going on, we need to consider the internal world of a child.
It’s not about the candy, it’s about the underlying reasons she’s so angry she can barely handle it, so that the littlest provocation sends her over the edge.
I often ask parents to consider: What is she so angry about?
The reality might be that Lilly has a tremendous amount of anxiety and anger. When she refuses to follow directions or trashes her room, here’s what she really means to say:
“Mom and Dad, I feel really worried about my position in the family. Ever since my younger sister was born, I just feel worried all the time about whether or not there’s enough love to go around. I feel like I was dethroned, and it seems like you love my sister more than me.
I am furious with you for having another child and for withholding from me all the love that I need.
Of course, it doesn’t feel great to be furious with my parents, whom I love so much, and that makes me really anxious too.
I’m sure you understand, Mom and Dad, that since I’m only six it’s really hard for me to talk about these things, but I really appreciate your patience and understanding while I work out these issues.”
If little Lilly sat down and said that, the result would probably be pretty different, but what actually happens?
What actually happens is that Lilly drives everybody in the family crazy, refuses to follow any kind of rules or authority, and makes the entire family focused on dealing with her and her behavioral outbursts.
For many families, what ensues is a power struggle, where the parents attempt to squash the negative behavior and force the child to comply, which just makes Lilly even more anxious and angry.
If you think about it, Lilly has actually communicated a lot with her actions.
The trick is learning to speak child so that you actually get the message.
Once we understand what’s going on beneath the surface, the response to bad behavior could actually be to spend more quality time together, give more praise, and make little Lilly feel more loved. It’s a bitter irony that the intuitive response that most parents take, which is to discipline the child and try to force compliance, is actually the direct opposite of what would help.
And so the dance continues, like the blind leading the blind. Children speaking child…adults speaking adult…nobody actually understanding anything.
If you know how to speak child, and you can decipher your child’s communication, you can speak child back. Then, and this is crucial, you can teach your child to speak adult.
Step 4: Ignore the bad and focus on the good
What parents sometimes don’t realize is that bad behavior can be deliciously reinforcing for children. Little Lilly who throws herself on the floor with a supernova tantrum may actually find the attention pretty appealing, even though its’s negative attention.
Think about how parents often respond to the meltdown – screaming, threats, discipline.
The truth is that this kind of attention for bad behavior actually reinforces it and makes kids behave that way more, which is the direct opposite of what parents want.
The best way to deal with negative behavior is to ignore it.
Ignoring negative behavior takes away the attention that children crave so much, which helps them find more positive ways to get your attention. Of course, dangerous behavior cannot be ignored. We’re talking more about whining, tantrums, name-calling, etc. A lot of parents put their foot down over somewhat trivial, annoying behavior and accidentally make the problem worse.
Here’s the truth, punishments don’t really work very well, at least not in the long run.
By punishments, I mean adding something negative that the child does not like, like putting soap in a child’s mouth for swearing, screaming, threatening, or spanking a child for bad behavior.
In general, punishments that produce pain or discomfort do not work. Removing a reward or something positive, when coupled with praise for positive behavior, does work.
Let me explain. Punishment obviously works in the short-term, otherwise nobody would do it.
Yelling at a child or threatening him or her might make a negative behavior stop for now.
However, punishments, and particularly physical punishments like spanking, make your children afraid of you and angry at you.
Remember Lilly from earlier in the article? If her parents threaten her or spank her, she’s just going to feel even more unloved, more furious, and more anxious. Then later that day or later that week she’s going to act out even more.
It’s a vicious cycle. The unfortunate reality is that these types of toxic interactions are actually very intense, and many kids learn to depend on bad behavior to force these intense connections with their parents.
It might sound counter-intuitive, but Lilly might continue to disobey her parents because she knows that fighting with them guarantees her the attention she craves.
She’s too scared to try any other way because for a six-year-old it is much, much, much worse to be ignored indefinitely than to be screamed at.
The best strategy, then, is to ignore negative behavior to avoid reinforcing it and to avoid making your child even more angry and anxious. Of course, you need to be smart about it.
It’s not good for a child to be overwhelmed with negative emotions for long periods of time. If ignoring a tantrum is going to cause your child to be totally out of control for a long period of time, it’s probably a better idea to help them calm down.
As you stop reinforcing negative behavior, you want to pour tons of time and effort into reinforcing positive behavior.
I have seen this point trip up a lot of parents. If most of a child’s behavior is negative, a lot of parents wonder how you can ignore the negative and reinforce the positive.
The reality, though, is that you need to “catch your child being good.”
Let’s say that Lilly plays quietly in the other room for thirty minutes. Most parents ignore her or don’t even realize that she’s being good. The second she starts up with her sister, her parents swoop in with discipline and criticism. That strategy actually reinforces the negative behavior and loses a crucial opportunity to reinforce the good behavior.
You need to train yourself to see the good in your child and notice the positive behavior.
The more you ignore the negative behavior and provide praise or rewards for the positive behavior, you’ll see a shift toward better behavior, since it will be more gratifying for your child. Sticker charts or point charts where your child receives points for good behavior and then cashes them in for prizes can be really effective.
Step 5: Get an evaluation
All of these tips and attitudes assume that something more serious is not going on.
There are several more serious conditions that may require special evaluation and treatment.
Some of these conditions include attention deficit hyperactivity disorder (ADHD), intellectual disability (low IQ), a specific learning disability (such as dyslexia or trouble with math), autism spectrum disorder, or a mood disorder like major depressive disorder or bipolar disorder.
Seeing a child psychiatrist for an evaluation is often a wise choice because many of these conditions respond well to medication or other specific interventions.
Often, children who have intellectual disability, developmental delays, learning disabilities, or ADHD struggle so much at home and in school that they develop self-esteem issues, which leads them to act out. These self-esteem issues can also contribute to anxiety and depression.
Diagnosing and treating these issues often leads to an improvement in behavior, since so much of the negative behavior was driven by the fact that the child simply found every day a grind.
Children with ADHD who are all over the place often have really negative interactions with their parents and teachers.
Children who are essentially being criticized and yelled at most of the time end up internalizing those interactions into a negative sense of self and poor self-esteem, which can lead to anger and anxiety, and it creates a vicious cycle.
Children with major depressive disorder or bipolar disorder may need medication to address their mood issues before psychotherapy can make much of a difference.
So while I cautioned you earlier about assuming that everything is biological, now I’ll caution you not to assume the opposite and to make sure any more serious conditions are diagnosed and treated medically if necessary.