Aggressive, oppositional behavior problem
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Peter B. xpeteb...@carolina.rr.com
My nine year old nephew lives with my wife and I. About a year ago he developed tics. We took him to a pediatric neurologist who thought that it might be Tourettes. He prescribed 10 mg of Paxil, which was later upped to 20 mg once a day.
The tics virtually went away within six weeks. It looked like success to us. His grades were always good and his behavior in school was excellent.
At home his behavior was pretty good, but he would occasionally be hard to handle, especially for my wife. In the last six weeks his behavior has degraded badly at home. He has turned into a hateful, belligerent kid who goes around looking for a reason to throw a fit.
He can't seem to tell the truth these days and he blames everything that happens to him on someone else. Today he flew into a rage because his shoes were not were he normally keeps them. He refused to wear any other shoes and was a vicious monster for the next five hours.
At school his only behavior issues are that he is impulsive and likes to either talk in cl*** or get out of his seat during cl***. His grades are very good. His handwriting is a bit sloppy, but he is working on that.
He has a difficult time sitting still. He squirms a lot and he is easily distracted if the subject matter is not interesting. If he is doing something that he likes, he is so intent that he will ignore you unless you make a loud nose or touch him.
When everything is going his way, he is the most pleasant and loving kid on this planet. When something pisses him off, he is vicious lunatic who threatens us and damages our property. He make the Taliban look like boy scouts in comparison.
If we cannot find some relief from this behavior, he is going to end up being institutionalized. I love the boy, but his behavior is disrupting and stressing our lives to the point where we may be forced to make a very sad decision.
What I find to be interesting is that he is able to control his behavior when he is away from the family. His teachers, friends, and our neighbors all think that he is the sweetest kid on earth.
This weekend he flipped out and we decided to take him to the hospital. The entire trip to the hospital was filled with his threats against my wife and I. He spit all over the car, threatened to go to the bathroom in the back seat and generally screamed the whole way there.
Upon letting him an my wife out at the emergency room entrance he stepped from the car with a smile on his face and walked into the hospital as if he were a guest in a hotel.
He was polite to everyone as long as he was around other people. As soon as the nurse closed the door on the examining room, he started telling us how much he hated us again.
How is he able to control his behavior for ten hours a day at school (he is in after school too)? Just being in public does not inhibit his tantrums. He will gladly put on a show in a restaurant or the mall.
But if he knows the people who are there or of he perceives them to be in a position of authority, he will behave himself. Go figure!
Does the medication for hyperactivity help with the bad behavior. My niece is on Ritalin and it really calmed her down. He grades went from D's to A's, but she never was a hateful kid.
What medications or other treatments have you found work best to resolve the oppositional and hateful behavior?
Thanks - Pete Xpeteb...@carolina.rr.com Remove the "X" to send e-mail.
"Jodi" hellofromj...@charter.net
Paxil is an anti depressant, i don't think it had anything to do with the tics going away. Has the behavior gotten worse since the Paxil?
Maybe that should be explored. I don't have any experience with OD behavior, but i am sure others here can help you.
Best Wishes, Jodi
"All Star Gal" allstar...@earthlink.net
Please read about the aggressiveness and violence PAXIL activates in people, and consider the fact that the boy's drug might be activating his problem http://www.insteadof.com/articles/p8.htm Its my understanding, most people with TS are generally very defensive, not aggressive.
oppositional, yes, but in a dig in their heels, defensive way.
"Joanne Cohen" joco...@attbi.com
A re-visit to the doctor is in order. The Paxil might be winding him up.
Also PLEASE consider a good therapist who specializes in kids with behavior problems. He's at the age where that might be occurring. Good therapy can make a world of difference. Also, please go out and buy the book "The Explosive Child" by Ross Greene and READ IT carefully! It can help you know how to react and how your reactions/actions when he acts out can help him.
Don't give up on him yet.
Also, consider getting some support for you and your wife. This must be Very trying on you and stressful.
Good luck. I hope other regulars here will chip in because they have a wealth of knowledge.
Jo (clinical social worker) ...
"J&S Bouchard" joanne...@hotmail.com
It would also help to read "The Explosive Child" by Ross Greene. It really changed my relationship with my son.
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Joanne Mom to Mat the brat!
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Peter B. xpeteb...@carolina.rr.com
His neurologist believes that the tics are in some form or fashion related to obsessive compulsive behaviors. Therefore he prescribed Paxil because he thought that it might stop the tics. He was right about that, they stopped.
For the first nine months on Paxil we noticed no changes in behavior.
Then there were a few episodes where he seemed to get a little more angry or the event lasted longer than you would expect.
In recent weeks the behavior has become outrageous. We took him off Paxil and are hoping that will help with his behavior. The neurologist said that increasing his dose of Paxil could make him aggressive.
We have an appointment with the neurologist on Thursday.
Pete Xpeteb...@carolina.rr.com Remove the "X" to send e-mail.
"Joanne Cohen" joco...@attbi.com
Peter, is there anything that might have triggered this behavior? Any chance something happened in school?
When you ask him AFTER an episode, does he say things like "I don't know what happened" or does he show any remorse?
Kids with Oppositional Defiant disorder react differently afterwards than kids with other conditions.
Does he get moody, aside from the tantrums and hate-spewing?
PLEASE get Ross Greene's book "The Explosive Child" ASAP.
Please let us know what the neurologist says. You might want to schedule an appointment with a behavioral psychologist also.
Good luck.
Jo
Peter B. xpeteb...@carolina.rr.com
Over the years that he has been with us he generally was generally pretty well behaved. If he did get mad, he would apologized later admitting that he should not have done whatever he did. Usually it was getting a little angry because he did not get his way. These events were short and not at all violent or destructive.
Now he just tries to act like it never happened. This weekend was two days from hell. In addition to several fits, he broke my wife's sungl***es, threw a cheesecake from the basement refrigerator into the trash and poured out my eye drops.
When confronted with these events he either said that he didn't do it or that he had no memory of doing it (the Nixon defense).
Today he was a real sweetheart, other than getting really wired about two hours before bedtime. He was not at all defiant, moody or hateful.
He has a very low level of frustration though. While on the web looking for some collector cards he became a bit angry when he could not find what he wanted, but he was quick to let me know that he was not mad at me or my wife.
That was a short term improvement, but at this stage of the game any improvement, no matter how short in duration is welcomed.
Pete Xpeteb...@carolina.rr.com Remove the "X" to send e-mail.
Peter B. xpeteb...@carolina.rr.com
My wife has the book and I am going to read it this week. (If th child will leave me alone long enough to hold a thought in my head).
He has a good psychologist and a neurologist. We are adding a psychiatrist to the mix next month. I think that if we can just get him to slow down a bit that a lot of his problems will be much easier to manage.
The neurologist wanted to put him on Ritalin months ago, but I objected. I was wrong. I head that there is a new drug for hyperactivity that is safter than Ritalin without the amphetamine punch that Ritalin carries. We may give it a try. At the moment he is off Paxil and only takes medication for his allergies.
The stress on my wife and me has been horrific. The last two weeks have been horrible. We both have demanding schedules and the child's behavior has left us drained and demoralized.
I can deal with the runny noses, homework, school and afterschool activities with ease, but living with his abusive and destructive behavior is becoming more than we can handle.
Last week he spent four days with his mother and grandmother. I felt as if a great weight had been lifted from my shoulders as did my wife.
(We are his uncle and aunt). I don't know if I ever reconginzed what a burden his behavior was until I was free of it for almost a week.
By the end of the week I was dreading having to pick him up. I realize that he is just a little kid and that he has some serious problems, but it is hard to see the light at the end of the tunnel.
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gnlw ...@aol.com (gnlwood)
I find it interesting that he can behave around other people and I think that is a very good sign. My 14 yr. old boy with TS is also sometimes very explosive and it can be quite hard. He, too, will act fine around others which has led people to tell me that he obviously is directing it at me because he can get away with it. I really don't know the answer but it sounds like maybe the Paxil is playing some kind of a role in it. I think, though, that some people with TS and OCD just can have extra anger, be it from the condition or the stress of living with it I don't know. Maybe they are comfortable venting it at us because we love them. Who Knows but I know how tough it can be. I look at him sometimes and can't believe how he can get. Hopefully, the late teen years will show an improvement. Hang in! Good Luck Lisa
"J&S Bouchard" joanne...@hotmail.com
At school and around others that are not so close to us, Mat is considered "an angel". At home, I refer to him as my monster. He truly can become vicious, calculating ( so it seems ), manipulative, unforgiving, angry, hateful, frustrated and so on... He truly becomes a monster the minute he walks through the door from a full day at school. But in the end, I know it's not directed towards me, it was suppressed all day at school and finally at home he can ( and rightfully so ) let it all out. I know it's hard and you need to be a "special kind" of parent to be this child's punching bag. Regardless if it is due to the medicine or not, I really believe a new "discipline" approach is needed. I am certain the child does not want to hurt you... he can't stop it. I commend you on taking care of this child. You are indeed that "special kind" of parent to take on this load. It is hard but you can beat it, I'm sure. Please read that book: "The Explosive Child". My husband didn't read it in the beginning and now that he is totally exhausted, he has decided to read the book. It's a real eye opener, not only does it show you a different way to handle your child, but it also shows you that your child is not "the only one". You are not the only parent suffering through this... and it gets better. Good luck and God bless your heart.
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Joanne Mom to Mat the brat!
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Peter B. xpeteb...@carolina.rr.com
On Tue, 18 Mar 2003 14:16:06 -0500, "J&S Bouchard" My nephew is fine, even at home, if he can get his way. Yesterday he had no problems and he was an angel.
Tonight he demanded that we order him a pizza for dinner. My wife had made him one of his favorites, taco salad, but he refused to eat it.
After a minor blow-up he suddenly came down the stairs asking for taco salad.
Tyler has virtually no perceptible tics. You really have to watch him when he is tired to see some eye blinking that might or might not be a tic. When this condition first presented itself he was clearing his throat, and making a lot of facial grimaces. He does not have to suppressed his tics.
I get the feeling that he is not saving up his rage for me and my wife, nor for his grandmother and mother by suppressing it around others.. It appears that he will go after anyone in the family that he sees regularly. That is really irritates me. I truly believe that he can control this full time, but that he makes a conscious decision to attack us.
To be honest, I have a very low tolerance for hateful people. To date, I have not found one person with a mental illness who was as nice as Tyler is hateful. What is it about these conditions that brings out the animal in people?
We will do the best that we can for this child, yet I can't see myself surviving his hatred and destructiveness for the next ten or fifteen years. Nor do I believe that someone with his temperament could ever hold down a job or take care of themselves.
I can deal with tics, school issues, and the other basic kid stuff, but living with a nine-year old version of Charles Manson is a living hell.
Xpeteb...@carolina.rr.com Remove the "X" to send e-mail.
gnlw ...@aol.com (gnlwood)
Dear Pete, I hear and feel your frustration but please try to be a bit more tolerant.
Your saying that you don't think he will be able to hold down a job, while I can understand where it comes from, you are not going to do the child any good feeling so negative about him. As hard as it is, he needs someone to believe in him otherwise the way you're viewing him will become a "self-fufilling prophecy" and he will learn to hate himself more. A child like him, as difficult as he is, needs someone to make him feel better about himself. My husband does the same thing with my son at times gets so angry he lashes out.
Why not get some counseling yourself to help you deal with him.
Lisa
"All Star Gal" allstar...@earthlink.net
If your feelings toward that child are so hateful that you are calling him the next Charles Manson, it would be best for that child to get as far away from a person who has such hateful feelings towards him.
Your hateful feelings go a long way towards explaining why he thrives away from you.
"J&S Bouchard" joanne...@hotmail.com
Oh boy... I'm sorry you feel that way, but no, this child does not target you or the people living around him. He CAN'T control it. He is not HATEFUL he is FRUSTRATED... please be open minded about this.. read that book. These comments and feelings are doing you and this child no good. He senses what you feel... he knows you hate him now and his feelings are not his fault...
And yes, no matter what, he may still be suppressing certain tics at school, they may be mental tics or even vocal tics. Tics come and go... just because he doesn't do strong tics in front of you doesn't mean they aren't there ready to come out.. you have no idea what this little person is living through... you have no idea.
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Joanne Mom to Mat the brat!
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"Joanne Cohen" joco...@attbi.com
This is just a wild guess perhaps, but might he secretly want to be re-united with his mom?
Have you found a behavioral specialist yet? He needs to be ***essed. Do you give him a time out or send him directly to his room when he loses it? How do you and your wife *respond* when he needs to have his own way? Are you two able to remain calm and firm?
Do you yell back at him? Have you tried consequences for his behavior, and if so, has that worked?
Jo ...
Peter B. xpeteb...@carolina.rr.com
My feelings toward the child are not "hateful," nor did I call him the next Charles Manson. I simply used the Charles Manson comparison to try to convey his horrific behavior.
This child has a problem. At times it is a very severe problem.
Attempting to spin his behavior into something other that what it is would be dishonest.
This kid has physically attacked members of the family and has made threats that are so horrific and detailed that it did sound like the words of a very dangerous and disturbed human being.
My behavior toward Tyler is tolerant and loving, though firm. Out of the entire family, he is much better behaved around me than anyone else. His grandmother, who dotes on him and lets him do what he wants is often the target of his worst behavior.
It is because of me and the tens of thousands of dollars that we spent in court to get him away from his parents (my wife's sister and her husband) that the child even has a roof over his head today.
Without my intervention he would undoubtedly be languishing in foster care or worse.
Don't confuse my discussions of the reality of this matter with how I relate to or care for this child. You simply do not have the information to make such a judgement in this particular situation.
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Peter B. xpeteb...@carolina.rr.com
It is difficult for me to approach life in a practical and logical fashion and see anything positive in this child's behavior. To be honest, I don't think that he hates himself. Most people that I have know who are hateful to others are very self-absorbed, some to the point of being narcissistic.
On day when he is a monster, what can one do to make him feel better about himself? He seems to derive a lot of enjoyment antagonizing and har***ing the family.
A positive note is that now that he has been off Paxil for six days, his behavior has been a bit more tempered. He still gets mad, but he gets over it in a matter of minutes, instead of hours or days. He is not as vicious either.
Tonight we took him for an MRI and tomorrow we have appointments with his psychologist and his neurologist. The neurologist wants to put him on Ritalin. Unless Tyler has another severely episode of toxic behavior, I'm going to keep him free of all drugs for several weeks to see what he is like without any pharmaceutical influences.
If there are any problems, at least we can have him evaluated in his "natural" state.
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"Joanne Cohen" joco...@attbi.com
Peter, Tyler needs a complete psychological/neurobehavioral ***essment. I hope you can line that up soon.
I don't blame you for the way you feel or describe his behavior. It sounds honest and accurate, and must be extremely trying on you and your family.
Your statement that he is better around you (the firmer one) and worst around grandma (the most lenient one) is good news. That means he responds to limit setting. I think the whole family needs to learn more about behavior disorders, etc. HAVE YOU GOTTEN THE EXLOSIVE CHILD yet? Please do read it. It'll take you less than 2 hours to read the book and I promise you it will make a HUGE difference.
Also, you haven't told us what you use for consequences or whether or not you time him out. What DOES work?
Jo ...
Peter B. xpeteb...@carolina.rr.com
On Wed, 19 Mar 2003 11:36:51 -0500, "J&S Bouchard" I DON'T HATE HIM! If you could talk to him he would tell you exactly that. Tonight he went to the hospital for an MRI. When it was time to go in for the exam, he grabbed my hand so that I could be there with him.
I spend most of my evening with him. We read, do his homework, work on the computer or any number of other things. We play basketball, hike, walk, ride bicycles, etc.
While he might be frustrated, he expresses it in a very hateful fashion. His behavior has been truly outrageous, violent, and threatening.
For the last nine months he has not presented any tics that are noticeable to anyone. At times there is a slight change in eye-blinking that might or might not be a tic.
I don't have any idea what he is living through. You are right about that. But I do know exactly what the family is living through and it is hell.
His behavior is not all that different from people who are suffering from depression or a host of other mental illnesses. Many of people with these conditions attack their families and a lot of them can control their behavior when they want to do so.
Overall, he is one happy kid. When his psychologist talks to him, Tyler tells him that everything is just fine. He expresses the same perceptions to our friends, his teachers, and just about anyone else who comes in contact with him.
Up till the last two months or so, his behavior never was bad enough to cause any change in our lifestyle. He went everywhere with us and I do mean everywhere.
Year before last he was upset that he could not go to the Speedway Childrens' Charity Ball. It was then that my wife and I realized that this would only the second time since Tyler came to live with us that we were going someplace without him.
If you watched the fly over at the last Winston Cup race of the season, the B-52 that dipped its wings and opened its bombay doors was piloted by one of our friends who promised Tyler the previous day that he would wave goodbye to him with his bomber. A general in our suite went thorough the roof when he saw the bombay doors open on that plane. Tyler just smiled. He counts Mary Jo Andretti as one of girlfriends. At a recent charity walk for the Victory Junction Gang, Tyler spent the entire walk talking to Kyle Petty and was photographed as a candidate for a Cheerios box. (The fact that he is not disabled will reduce his chances of achieving a fleeting moment of breakfast table fame).
Tyler has such a rich life and has had so many good experiences that for anyone to say that I "hate" the kid surely does not know me, my family or Tyler.
But none of that precludes the fact that his recent behavior has been so outrageous and so persistent that it has nearly brought this family to its knees.
We all pray that the Paxil was the culprit or that this physicians can find a viable remedy.
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Peter B. xpeteb...@carolina.rr.com
Jo, it is no secret. He is upset that he does not see his mother very often and that the quality of those meetings is poor. His mother behaves a lot like Tyler. She is one of the most vicious people that you could ever hope not to meet. She has had a drug problem since she was twelve. She steals, lies and cheats and does not understand that it is wrong.
She has been involved in prostitution, burglary, auto insurance scam, shop-lifting, and a plethora of other antisocial and illegal activities. When we filed a private petition to protect Tyler, she was leaving him in her car with strangers while she turned tricks in a crack-house.
He has a psychologist, neurologist, and he will soon have a psychiatrist. His first ***essment was about a year ago. The neurologist decided to treat his minor tics with Paxil and he wanted to give him Ritalin though he did not diagnose Tyler as being hyperactive.
I overruled the Ritalin suggestion because Tyler's grades were excellent and he was having no discipline problems in school. I don't like doping up a kid when it is not absolutely necessary.
While on Paxil he became more fidgety, but it did not cause any other issues until the last two months. It was only in the last two weeks that he decided to defy me. Though he had been giving my wife and grandmother grief for months, though none of it was threatening or abusive.
When he gets angry, I tell him that he is having another event and that it would be best if he went to his room a while. He often fights that suggestion because it must not be any fun for him to be so mad without someone to take it out on.
I stay calm and I don't fight with him. There have been times when he has refused to go to his room and I have to convince him that he will be paddled if he does not comply. That usually does the trick. He will stomp to his room and yell at everyone through the door.
Yelling would not have a beneficial impact on his behavior. He wants a confrontation and yelling would just play into his perception of the world.
I don't let him stew by himself. Every ten minutes or so I stop by to see how he is doing and to be called an "***-hole" or whatever other colorful language comes to his young mind.
Then he will emerge from his bedroom with a smile on his face as if nothing has happened.
Some of his behaviors are hard to understand. When he is threatening to beat us up or kill us, he verbalizes how he will do us in. Never has he ever discussed shooting us. At first I thought that was strange because Tyler is a crack shot with both a rifle and a target pistol.
He can cut the center out of a target at fifty feet with a .22 target pistol. (No guys, he does not have access to firearms - they are all locked up).
When I asked why he never spoke of shooting us when he had though up everything else from bombs to poisonous spiders, he replied, "That's a dumb thing to say Uncle Pete, you know that you never point a gun at another person." He has had a lot of firearms safety training and it somehow stuck.
He has not been able to apply that to the more abstract principle that you don't hurt other people, period!
Now it's late and I'm rambling.
Pete Xpeteb...@carolina.rr.com Remove the "X" to send e-mail.
Peter B. xpeteb...@carolina.rr.com
My wife has the book and I intend to start reading it this week.
While he might respond to setting limits, I am also the only one that he can't physically intimidate.
I can send him to his room or to another time out. He tells my wife and his grandmother that he does not have to go there and that there is nothing that they can do about it. He is a tough kid when he is mad.
In many cases, nothing works. When he resorts to a tantrum where he throws himself on the floor, it is best just to leave him alone unless you want to physically drag him to his room. He is so violent that the risk of moving him is not worth the effort.
During our last meeting with his psychologist, I presented a number of situation where the doctor had no viable suggestion to control the boy's behavior. It is a sad situation.
When we took him to the hospital last Friday, I literally had to us an arm hold on him to get him into the SUV. He was a maniac.
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sesgard ...@aol.com (Sesgardner)
Pete, I can tell you love your son, just by the fact that you are continuing this conversation with us. I would challenge you, however, to not compare his behavior to his mother's or vice versa. And not to try to read his mind by the way he is behaving.
Something is going on with him right now, and while it may not seem to you that he is suffering, please believe that he is. My son went through a period of time like this (it started with a wrong medication choice) and it was hell for everyone. You AND son NEED counseling and so does the whole family. I can't imagine trying to get through this without professional therapeutic help for everyone involved.
While medication can and does work wonders in many cases, therapy and counseling is the other part of the picture.
As for the Explosive Child book, please get a copy for yourself. You and your son's mom will each need your own copy to refer to as needed. It truly is extremely helpful.
His threatening to beat you up or kill you is a symptom of a problem, not a character flaw. If it's left untreated, or mistreated, it could very well turn into a character flaw as he grows up.
Good luck from someone who's been there.
Sara
mariett ...@aol.com (Coffee)
Good advice Sara.
M
"All Star Gal" allstar...@earthlink.net
I have given it some more thought.
And what I have to say is just that...food for thought...because you are correct that without being there I cannot possibly know what the situation is.
Its just what I think, ok?
I think I might know what you may be feeling that causes you to say what you said. .
I know from my experiences raising a son with Tourettes that the behaviors engaged in are most often inane, but sometimes those behaviors can seem very disconcerting to those who do not understand. Disconcerting enough to cause someone who doesnt' understand TS, that is around the TS child a lot.to feel very uneasy about the disconcerting behaviors. Unease which causes anxiety and even great fear if one allows one's imagination to run wild like yours has.
You are bridge croosising, cause you have had to cross an awful lot of brideges in your imagination to imagine the behaviors your step son displays makes him a 9 year old charles manson.
The problem with your fearing what you do is that your fears can make that a self fulfilling prophecy.
If you read Charles Manson's biography, Charles Manson was not born that way, his environment MADE him that way.
Your step son hasn't been diagnosed with psychopathy, or NPD, or APD or any other mental illness that the kinds of people you are comparing to have.
Your step son has been diagnosed with a NEUROLOGICAL disorder, not psychiatric, which causes him to manifest tics, and behaviors that are inane and at times disconcerting, and perhaps in your step sons case very disconcerting..
Sometimes when someone engages in behaviors that disconcert us, we react by insisting they cease.
In a TS child, the inane and disconcerting behavior is the result of a wayward impulse creating an irresitable urge to manifest the behavior.
Some adults might get into a contest of wills.with a TS child, when the TS childs behavior they find so disconcerting is not a product of his "will" but the exact opposite, the product of a wayward impulse therefore any adult who gets into a contest of wills about such behaviors will LOSE the contest of wills with a TS child. .
All any adults accomplish by getting into a contest of wills with a TS child is escalate the situation.
wind up getting frustrated.then..expressing ill will toward the TS child...
which the TS child who is echopraxic will MIMIC without any actual malice and so on and so forth...
Is there any possibility some of this may be going on?
Just food for thought...FWIW...
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