Latest / Inside The Consulting Room - Understanding the Child Behind the Behaviour / Inside The Consulting Room, Episode 3. The Angry Child

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Inside The Consulting Room, Episode 3. The Angry Child · Inside The Consulting Room - Understanding the Child Behind the Behaviour

• 0:00
  SPEAKER_00: Hello, this is Kim Lee, child and adolescent psychotherapist, and this is episode three of the series entitled Inside the Consulting Room.
• 0:11
  SPEAKER_00: And as I've said before, the purpose of this series is to try and give listeners an insight into the very real work that happens with children who are struggling with a whole variety of difficulties.
• 0:26
  SPEAKER_00: In this next episode, I want to talk about Marcus.
• 0:30
  SPEAKER_00: And I'm calling this particular episode The Angry Child.
• 0:39
  SPEAKER_00: This boy slams his bag onto the floor as he enters the room.
• 0:45
  SPEAKER_00: A wooden block flies across the room and it hits the wall with a sharp crack.
• 0:51
  SPEAKER_00: He turns away, avoids eye contact, and mutters under his breath, I hate this place.
• 0:58
  SPEAKER_00: Anger in children is often the emotion that adults find the most difficult to tolerate.
• 1:04
  SPEAKER_00: It disrupts families, unsettles classrooms, creates tension and a sense that something's out of control.
• 1:12
  SPEAKER_00: And so the focus quickly becomes one of trying to stop the behavior, contain it, manage it.
• 1:21
  SPEAKER_00: And whilst there's nothing wrong with that, anger in children is rarely the beginning of the stories.
• 1:28
  SPEAKER_00: More often it's the final expression of something that's been building quietly beneath the surface, and often for a very long time.
• 1:38
  SPEAKER_00: Marcus was eight years old.
• 1:40
  SPEAKER_00: His teachers described him as explosive.
• 1:43
  SPEAKER_00: He shouted at classmates and they were frightened.
• 1:46
  SPEAKER_00: He would push children, throw objects around when he was frustrated, and behavior plans had been introduced, clear consequences, firm boundaries, all the usual things one might expect to see, but nothing seemed to change.
• 2:02
  SPEAKER_00: Now, at first consultation when I took a case history, the parents informed me of how all of these behaviors found expression and in which situations, and sadly, their response to Marcus's anger because they were struggling so badly themselves was anger itself.
• 2:25
  SPEAKER_00: From a clinical perspective, Marcus's presentation could be understood through the framework of what's called oppositional defiant disorder.
• 2:35
  SPEAKER_00: He displayed frequent emotional outbursts, defiance towards authority, low frustration tolerance, and prolonged and pronounced irritability.
• 2:46
  SPEAKER_00: But diagnosis doesn't explain meaning.
• 2:49
  SPEAKER_00: It describes the pattern, but it doesn't describe or explain the origins.
• 2:55
  SPEAKER_00: Now, if we look a little deeper, and in previous episodes I've talked about some of the neurological aspects that drive emotions and behavior.
• 3:05
  SPEAKER_00: So from a deeper psychological and neurobiological perspective, what we can understand is that his behavior suggested that his anger was a defensive response to underlying shame and emotional instability.
• 3:23
  SPEAKER_00: And so neurobiologically, the part of his brain called the amygdala, which is highly reactive to perceived threat, you know, the amygdala is the alarm bell, meaning that the prefrontal cortex of the brain, which is the brain's regulatory managing system and making sense of system, was easily overwhelmed.
• 3:48
  SPEAKER_00: So his nervous system moved rapidly into a kind of fight mode.
• 3:53
  SPEAKER_00: So things like his small triggers like a correction, a mistake, someone laughing were experienced as threats.
• 4:02
  SPEAKER_00: And his body responded instantly with anger.
• 4:07
  SPEAKER_00: Over the previous three years, I learned that Marcus had been living in a household under significant stress.
• 4:14
  SPEAKER_00: His father had lost his job and his grandfather had died.
• 4:18
  SPEAKER_00: The financial strain on the family had increased dramatically, and the risk of losing the family home was very real and frequently voiced.
• 4:30
  SPEAKER_00: Arguments between his parents became a daily experience.
• 4:35
  SPEAKER_00: Sometimes they were loud, sometimes prolonged, often unresolved, and Marcus had often been present, although not directly involved, but emotionally exposed.
• 4:47
  SPEAKER_00: And children don't need to be spoken too harshly to feel dysregulated.
• 4:52
  SPEAKER_00: They absorb emotional tone, tension, and unpredictability.
• 4:59
  SPEAKER_00: Over time, Marx's nervous system learned something essential: that emotional intensity could escalate quickly.
• 5:09
  SPEAKER_00: Emotional safety wasn't guaranteed.
• 5:12
  SPEAKER_00: And that in moments of emotional threat, the safest position wasn't one of vulnerability, but power.
• 5:21
  SPEAKER_00: Now, very often anger is underpinned by fear, but what we see is the angry behavior, not the fear that's driving it.
• 5:30
  SPEAKER_00: Because the child, and in fact, most people are unable to recognize that it is fear that they're experiencing.
• 5:39
  SPEAKER_00: So it becomes converted often in a nanosecond into angry behavior.
• 5:46
  SPEAKER_00: But that angry behavior is defensive.
• 5:49
  SPEAKER_00: Inside the consulting room, Marcus Raleigh entered the room calmly.
• 5:56
  SPEAKER_00: He carried tension, he moved quickly, and there was a sort of agitated style to his movement.
• 6:05
  SPEAKER_00: He would spontaneously touch objects and open drawers, and it was as though his nervous system was already activated before anything had happened.
• 6:16
  SPEAKER_00: One afternoon I remember he came in and went to the toy cupboard and took out some bricks and he began to build a tower.
• 6:27
  SPEAKER_00: And it was really careful and deliberate, and I was aware of the fact that here was a child who was being very controlled, very deliberate, something I hadn't seen very much of.
• 6:41
  SPEAKER_00: And it block by block this this this construction began to develop.
• 6:50
  SPEAKER_00: And the room was very quiet, very focused.
• 6:54
  SPEAKER_00: And then suddenly he just knocked the tower down, and the blocks went all over the floor.
• 7:02
  SPEAKER_00: And I felt a little bit disappointed.
• 7:05
  SPEAKER_00: I mean, only in as much as when I can cope with children knocking towers over, but I was really hoping that there was this, that what was building was us was something that was calm.
• 7:17
  SPEAKER_00: But he couldn't tolerate it.
• 7:21
  SPEAKER_00: And I didn't I didn't uh reprimand him or anything of that kind.
• 7:27
  SPEAKER_00: I just said, well, that came down quickly.
• 7:31
  SPEAKER_00: And Marcus just shrugged and said, well, it was stupid anyway.
• 7:36
  SPEAKER_00: And so I waited and I said, Look, sometimes it it when when things feel like they're not going to stay still or they're not going to be okay, it it can just feel safer to knock them down.
• 7:53
  SPEAKER_00: He looked at the the the blocks on the floor, and something seemed to soften in his posture.
• 8:03
  SPEAKER_00: And I said, Shall we try that again?
• 8:07
  SPEAKER_00: Thinking that my therapeutic brilliance would come to the fore, and he said, No.
• 8:14
  SPEAKER_00: So, okay.
• 8:15
  SPEAKER_00: But over a time, a pattern emerged.
• 8:19
  SPEAKER_00: There were moments of when he was feeling vulnerable that quickly transformed into anger, but gradually he began to say things he hadn't said before.
• 8:30
  SPEAKER_00: And I was very struck by the fact that it was really important for me to not react to his angry expression, but instead to observe it and to acknowledge it calmly.
• 8:47
  SPEAKER_00: And in this one session, he said, I hate it when people laugh at me.
• 8:52
  SPEAKER_00: Now I hadn't laughed at him, but it came from nowhere.
• 8:57
  SPEAKER_00: And it was like the anger was beginning to give way to something underneath because he had made a connection between what he was feeling and what he was experiencing, and and then what happened.
• 9:13
  SPEAKER_00: So that what that was the beginning of insight.
• 9:16
  SPEAKER_00: And I remember saying, Yes, I know, I know.
• 9:19
  SPEAKER_00: I think there are lots of things that that you find incredibly hard, even though other people aren't trying to make you feel bad, somehow you do, and then you get angry.
• 9:32
  SPEAKER_00: And he he he just he he nodded, but there were no more words.
• 9:38
  SPEAKER_00: Now, very often in my work, doing the one-to-one, which is you know 50 minutes a week, whilst it can uh in in its own right be enough for children, often more is needed.
• 9:57
  SPEAKER_00: And this comes from what's called the systemic approach.
• 10:01
  SPEAKER_00: I think about the family system, what's happening in the home, not from a judgmental point of view, but from a what's what's the family context?
• 10:12
  SPEAKER_00: What is happening inside this family, which the child's behavior is in some way an expression of.
• 10:19
  SPEAKER_00: So I began to work with his parents and meet with them every few weeks to try and better understand what was happening, but also to try and get an insight into what they were experiencing and how there was a there was something happening between all of the family members that created and maintained this terrible situation for the child, and indeed for the parents.
• 10:46
  SPEAKER_00: Because the child's difficulty does not develop and exist in isolation, it develops within an emotional system within the family.
• 10:57
  SPEAKER_00: Now the parents talked about feeling overwhelmed and stressed, but also they felt ashamed.
• 11:04
  SPEAKER_00: And they felt ashamed that their son was not only struggling in the way he was, but also because they didn't know what to do, and because they felt they had caused the problem.
• 11:21
  SPEAKER_00: Now, paradoxically, when parents say to me, It's my fault, as much as I try and help them to see that this isn't about fault, it's actually about them just trying to do the very best they could under difficult circumstances.
• 11:40
  SPEAKER_00: Another part of me thinks it is it is good that you make this connection.
• 11:48
  SPEAKER_00: Not not the connection of fault, but the connection of yes, there is a relationship between what's happened inside the family and how difficult it has been for the grown-ups and then what the child is expressing.
• 12:05
  SPEAKER_00: They reactive with each other and arguing with each other was common.
• 12:12
  SPEAKER_00: It happened in the consulting room.
• 12:14
  SPEAKER_00: They began to criticize each other, and it was very clear that their own emotional states were really quite high and that they couldn't regulate.
• 12:27
  SPEAKER_00: So I would very often just say, let's stop a second, let's just stop, and let's let's let's think about this differently, just trying to lower the emotional uh tension.
• 12:39
  SPEAKER_00: And bit by bit the focus started to shift from the behavior that they were exhibiting to being able to contain what they were feeling, stop, think, speak.
• 12:55
  SPEAKER_00: We call that affect regulation.
• 12:58
  SPEAKER_00: The parents were introduced to a simple but very powerful idea, and that it was simply this: that children don't learn emotional regulation through instruction.
• 13:11
  SPEAKER_00: They learn it through experience and through repeated exposure to adults who are able to tolerate strong feelings, remain emotionally contained, and can recover from distress without escalation, it that the child internalizes this, and people will know by now I talk a lot about internalizing.
• 13:34
  SPEAKER_00: I remember saying, look, when emotions rise so quickly, uh Marcus has a reaction which is is in a way mirrors that emotional tension and that emotional on occasion explosiveness.
• 13:54
  SPEAKER_00: In a sense, what his behavior shows us is that he is he's mirroring something that he has experienced and which then finds expression.
• 14:06
  SPEAKER_00: And therefore, when adults are able to slow things down, children begin to internalize that capacity.
• 14:16
  SPEAKER_00: And the focus wasn't on blame, it was about this this is about psychoeducation, it's about helping people understand.
• 14:25
  SPEAKER_00: Now, at first these conversations were difficult, and both of his parents were kind of alert to, or they sort of anticipated that I would be, I would be critical of them, that somehow I would confirm their worst fears and that they were awful people, and that very probably this would result in Marcus being taken away.
• 14:48
  SPEAKER_00: In truth, nothing of the kind was it was going to happen.
• 14:54
  SPEAKER_00: That was not my starting point.
• 14:55
  SPEAKER_00: And they began to learn, a bit like Marcus, that actually when you're in the presence of someone who isn't judging you, who is understanding, and who is and that by understanding I don't mean a kind of I understand.
• 15:10
  SPEAKER_00: That's not it.
• 15:11
  SPEAKER_00: It's not the words, it's the capacity to show that you understand through your behavior, the fact that you don't react.
• 15:21
  SPEAKER_00: So they began to learn that their emotional responses, their tones of voice, and their reactions on the stress were and had shaped the emotional environment Marcus was living in.
• 15:35
  SPEAKER_00: And it wasn't intentional, but it was powerful.
• 15:38
  SPEAKER_00: One of the parents said, eventually, I think he feels everything we feel, but he doesn't know what to do with it.
• 15:46
  SPEAKER_00: And that was a perfect description of what had happened.
• 15:53
  SPEAKER_00: When I work with parents, I'm very often trying to help them slow down their reactions during conflict and help them to think about responses.
• 16:08
  SPEAKER_00: I try and help them recognize the early signs of emotional escalation, pausing and then responding, repairing interactions, repairing problems, uh, and the relationship after arguments.
• 16:25
  SPEAKER_00: That's the rupture and repair principle.
• 16:28
  SPEAKER_00: Not perfection, but increased awareness.
• 16:30
  SPEAKER_00: And something gradually normally begins to shift.
• 16:34
  SPEAKER_00: The emotional intensity within the household is reduced, and moments of escalation become less frequent.
• 16:45
  SPEAKER_00: What's really interesting is some parents have said, when I started doing the thing that you suggested, which is normally to do with their own internal regulation, then I see that my child is different.
• 16:59
  SPEAKER_00: And over time, Marcus became different.
• 17:02
  SPEAKER_00: He began to change, not dramatically, but noticeably.
• 17:06
  SPEAKER_00: He still became angry, but the intensity reduced.
• 17:11
  SPEAKER_00: The recovery became quicker, and the the gaps between episodes became longer.
• 17:18
  SPEAKER_00: Inside therapy, he began using descriptive terms more frequently.
• 17:24
  SPEAKER_00: I don't like that.
• 17:25
  SPEAKER_00: That wasn't fair.
• 17:27
  SPEAKER_00: But he was saying the words rather than demonstrating what it felt like through anger.
• 17:35
  SPEAKER_00: Because that means that the anger is no longer required to carry the emotional burden because the environment had changed.
• 17:44
  SPEAKER_00: This work illustrates something fundamental, and that is that children's emotional regulation develops in relationship, not in isolation.
• 17:54
  SPEAKER_00: So when the emotional environment becomes more stable, the child's nervous system begins to reorganize itself.
• 18:02
  SPEAKER_00: From the outside, Marcus had appeared defiant, but in reality, he had been adapting to an environment that felt unpredictable, to emotions that escalated quickly, to a world where vulnerability didn't feel safe, his anger had been his solution, and it wasn't his failure.
• 18:25
  SPEAKER_00: Inside the consulting room, change rarely happens in one place alone.
• 18:30
  SPEAKER_00: And when a child begins to feel understood and the emotional world around them becomes more stable, something remarkable can happen.
• 18:39
  SPEAKER_00: The child who once needed to fight to feel safe no longer has to fight quite so hard.
• 19:09
  SPEAKER_00: That's really the purpose of these podcasts, and I do hope they help.
• 19:14
  SPEAKER_00: Thank you for listening.
• 19:15
  SPEAKER_00: I will be back with the next episode entitled The Invisible Child very soon.