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anger management

Tykes with a temper

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DISTRESS CALL: If ignored, anger issues in small children can lead to problematic behaviour later

Rehaan Malik is three and a half and he sees a therapist for two hours, thrice a week. His parents say he is prone to bouts of yelling, uncontrolled crying, breaking things and even hitting people. Rehaan is too small to understand what's going on but his behaviour forced his parents to push the panic button. "He would throw and break things, and then look at us for a reaction. At his play school he would bite or hit other kids. His teachers threatened to keep him in isolation at school, " says Ketan, Rehaan's father who is a lawyer based in Bangalore. On their family doctor's advice, Ketan and his wife enrolled their son for anger management.

Surprising as it may sound but toddlers, aged between two and four, are being referred to mental health experts for anger issues. While tantrums are a part and parcel of growing up and considered quite normal in young children, it is when things go out of hand that alarm bells need to go off.

Experts caution that if a child's temper tantrums carry on for more than 15 minutes or occur three or more times a day at ages younger than one or older than four, then they need attention. "There's been a progressive increase in manifestation of such behaviours in children living in urban centres. Such behaviours include head banging, refusing food, squatting on the floor and crying, holding their breath, poking with a pencil or hitting with toys, stealing things and even setting fires, " says Dr Jitendra Nagpal, consultant psychiatrist with Moolchand Medicity in Delhi. Many parents may laugh such things off or find them cute but these could be signals that your baby is seething with rage.

Four-year-old Rahul Singhal was referred to Dr Pulkit Sharma, consultant psychologist and psychoanalytical therapist at VIMHANS Delhi, for violent, aggressive and defiant behaviour. "When I first met Rahul he came across as sharp, extrovert and really cute. He did not show any peculiar reaction when his mother left the room and got busy exploring the surroundings. " But soon, says the doctor, he started throwing all the toys around him while making grunting sounds. "To attract his attention, I started flying a toy plane and we started playing. But whenever I would stop, he would start yelling to force me to continue. After the session ended, he was reluctant to leave. He cried and hit his mother when forcibly picked up. "

In a subsequent session, Rahul was seen fiercely flogging a cushion. When asked why he was doing so he replied that "this is a person who drives a car and goes to school leaving me, therefore, I'm beating her". This act, according to the doctor, was a reference to his working mother. "Rahul lacked the skill to express his emotions in words. So he acted out his impulses rather than thinking about them or communicating them. " Rahul had a very low threshold for tolerating frustration, says Sharma. In another session, Rahul bit Sharma's knee when he took a short break while playing with him.

In cases like these, the underlying source of anger can be found in the child's immediate environment - be it school or home. Inattentive parents, intimidating peers or teachers, dysfunctional families are usually linked with expression of extreme opposition and rebellion in children. In some cases, it can just be too much television. In Rehaan's case, the doctor told the parents that too much television-viewing was the culprit. "He loves Bodyguard and has seen it many times. When he fights he fights like Salman does in this movie. Even in his sleep he sometimes asks his mother to put this film on for him, " says Ketan.

But Dr Murali Raj, head of psychiatry at Manipal Hospital Bangalore, says we tend to exaggerate the role of television in exposing the child to violence. "Violent and abusive parents are more harmful and leave a lasting impression on the child's mind. "

There are cases where anger is an outcome of an existing health condition. Mumbai-based psychiatrist Dr Harish Shetty cites the example of a fouryear-old girl who was bought to him for her anger issues. "She used to bite her classmates and was very activity-driven. It turned out that she was anaemic and sleep deprived. " Both these conditions led to retaliatory behaviour. So the only intervention that worked for her was increasing her hours of sleep, addressing anaemia and giving her a break from school for a while. Other mental health conditions, like ADHD and depression, also show up as anger in children.

Shetty is worried that parental approval of aggression may be encouraging children to adopt a 'might-is-right' philosophy.
At a basic level, though, anger is an effective attention-seeking tool for children. In the absence of large families and parents who are mostly working, children could resort to tantrums, banging their heads, yelling or breaking things to get attention. Children want someone to play and communicate with them all the time, to tell them that they are good, they are loved. They need to be held, hugged. "But this does not mean that parents have to sacrifice their profession in order bring up a healthy child. The realities of modern life often demand that both parents be working, " says Sharma.

There can be a middle ground. One of the parents, be it the mother or the father, needs to compromise and spend more time with the child. "Or, they should get good caregivers, like grandparents, " says Raj. Just as important for the parents is to moderate their response to the child's anger. Most parents either get scared and give in to the child's demand or take punitive action. The right way to respond is to first give the child a patient hearing and find out why it so angry. Next, take an honest call whether the child can be gratified at the moment or not. If not, then the parent needs to explain to the child, creatively and with love, why the demand cannot be fulfilled. Boundaries need to be set but the parents need to guide them into discipline with patience and dialogue.

Names of parents and children have been changed

Reader's opinion (3)

Gomati KuttyFeb 10th, 2012 at 06:45 AM

Parenting, indeed is an art combined with loads of responsibilites. Also, patience,thy name is mother/father as the case may be. Shouting at your child to make him /her listen to you does not work; it is like trying to steer your car with the horn; rather handle the kid with lots of love and care.

Kamal TripathiFeb 7th, 2012 at 13:44 PM

Parenting itself encompasses all virtues enlisted in Bhagwadgita in the name of Karmayoga. It cant be explained in mere words. It should be in the habit of the individual. Every moment must be considered in the learning mode for parents and rest of the things should be left to the almighty.

Afrin ZahoorFeb 6th, 2012 at 16:10 PM

Parenting,is itself an art and every parent should know the way they can control them patiently.If they get angry over any issue the must be handled with love and utmost care.

 
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