Amy: A child’s temper tantrums can be a mysterious, sometimes troubling problem. It’s painful, how these young creatures can reduce parents–mature grownups–to a state of helpless confusion. We’ve all been there. Of course, occasional temper tantrums for little children are normal. A temper tantrum is often the way a small child, who hasn’t yet acquired enough language, to register their feelings about how things are going. It’s only when temper tantrums, or behavioral problems, become persistent that we need to begin to look for clues in what the child is trying to tell us. As a family therapist, I have had many families come to see me, feeling both worried and defeated by their young child’s behavior.
Here is a vignette from the office:
I had seen Judy and Jim over a year ago for problems in their marriage. They returned to therapy recently for a “reboot”, having slipped back into some distressing patterns. They were earnest about improving their relationship and family life, and within a couple of sessions they were feeling better about themselves and each other.
But they were still concerned about four-year old daughter Lucy’s temper tantrums. The couple described her as “impossible”, she “doesn’t listen” and her behavior was, according to them “out of control” especially when she they asked her to do something she didn’t want to do, like go to bed. These problems mostly showed up at home. Her teachers had no complaints; apparently they loved this little child.
Judy commented that Lucy had a significant speech delay and she thought this might be contributing to her daughter’s outbursts. Judy hoped to bring Lucy in alone, but I know that in order to understand a kid’s behavior, it’s best to have the other siblings there. They can be very helpful. We ended the session with my suggestion: “Bring the little cherubs in!”
As the quartet walked through my door, my first impression of Lucy was that she looked like a Wild Child. Her hair was unkempt, her clothes, though they were cute and pink, looked disheveled. Brother Darien, by contrast, was the picture of a well-kept kid, neatly put together with his spiffy glasses and dapper clothes.
The kids eyed my dollhouse, games and Lego sets, and I gave the green light that they could start to play. I watched as they made a beeline for their preferred toys. I sat back, and the parents and I began to talk about the kids. Lucy and Darien knew they came to my office for a “Family Checkup.”
As I listened to Judy and Jim, it sounded like six year old Darien could do no wrong. He was their Little Prince. And there was an perhaps an underlying reason: Darien had been diagnosed with Crohn’s disease at age four. Since then, this little child had been through the medical mill with an onslaught of doctors and treatments, all of which had taken an emotional toll on everyone. His health was good now, but the parents had acquired a state of ongoing vigilance in relation to this child.
When I gave the kids my magic wand and asked what they would change about the family if they could, they both mentioned Daddy’s “not going to the gym so much” and Mommy “screaming less.” Despite these little worries, the kids didn’t seem overly anxious about their folks; The kids played easily with Dad who was sitting on the floor, and went back and forth between the parents as they played with the toys. Meanwhile, I was paying attention to the interaction.
I was struck by a couple of things: Lucy did indeed have a significant speech delay, so much so that it was often difficult to understand her. And though she had a really sweet quality, she had trouble getting any juice from the folks. They didn’t seem to enjoy her much and reserved most of their interest, attention and praise for Darien. Even when Darien boldly snatched Lucy’s sticker from her wrist, the parents didn’t admonish their son.
I decided to praise little Lucy. I asked Mom to give her a couple of instructions–I just wanted to test the question of compliance, since the parents complained that she “didn’t listen.” The Mom asked her to do a couple of things–put this toy away, don’t touch the picture, etc.–and the little girl responded without a problem. Clearly little Lucy wanted to be good. She seemed eager to please.
As I began to point out all of the great things about Lucy–“See what a good mommy she is with the doll” and “Lucy is such a caring little sister” the family seemed to become somewhat uncomfortable. This was unfamiliar territory. This went against the unconscious family patterns. They were not used to hearing loving and caring words about Lucy, said out loud. Lucy lit up, wanting to show us all the good things she was doing with her baby doll. She became good-er than good. Darien began to whine and demand more attention.
Mom was sitting on my couch, and I asked her to call Lucy over for a cuddle. “Lucy is a special girl”, I said. Lucy plopped on the couch next to Mom and they both looked a bit awkward, though they appeared to enjoy this apparently unfamiliar closeness. And Darien didn’t like it one bit. He acted like he’d been robbed! He continued whining to his Dad, accusing him of “not helping” him with the Lego house. Darien didn’t cry, but continued to pout, despite his Dad’s assurances of help.
Darien said he had to go to the bathroom, and as he left the room, Lucy jumped up to follow him. The parents were in the middle of crying “No!” to Lucy, as she darted out of the room. Dad looked at me as if to say, “See?” I told him to go get her. “She’s easy”, I said.
Dad brought her back, no problem. She returned to the serious business of taking care of her baby doll. I said, “She’s easy to turn around.” And she was. I watched as she responded to commands and requests, and she showed that she was malleable. They had painted her as a two-ton giant, and I wanted to leave them with a different diagnosis, one that offered them a different, more dynamic view.
By now, our conversation had taken on a strong theme, one that subtly connected Lucy’s temper tantrums with the ongoing, inadvertent parental neglect. Of course I didn’t talk about it this directly: I said that Darien has been “special” for a long time, and Lucy needs to be “special” too. The parents clearly saw how Lucy flourished during the session, in response to her “special” treatment.
We talked about some things they might do, like develop some special bedtime rituals with Lucy. Mom also said she was going to plan some “Mother-Daughter” time, something she rarely did. We agreed to meet in a month or so. I called the pediatrician, a colleague of mine, who recommended that the couple bring the kids to see me. I shared my observation with him that Lucy was suffering from Lack-of-Specialness compared to her brother. He thanked me for my input. He said he’d only seen the mother and children for a couple of brief visits and gave what he called his “generic temper tantrum advice.” He didn’t have the luxury, or expertise, to observe the family as a whole, for an entire hour. He now would reinforce the “Special Lucy” prescription as a way of helping the family realign their relationships and calm the daughter.
Judy and Jim ended up not coming back as a family, though I did see the couple from time to time. Things were much better at home with Lucy. The parents clearly absorbed the message of our meeting and responded with intelligence and thoughtfulness. As I reflected on the session with the family, I realized I didn’t anticipate that outcome. From Judy and Jim’s description I expected to see a “disobedient” four-year old who was being triggered by parental tensions and was busy pushing buttons. Instead, by seeing this child in her natural habitat–her family–I was able to observe patterns that are otherwise unknowable. And it’s understanding these patterns which help us uncover the sources of distress, and point the way toward health.