Socially Outgoing Yet Explosive and Aggressive at Home

Reader’s Question

To the outside world, my son is friendly, outgoing, polite, kind, and considerate. He can be this way at home, too, unless something doesn’t go his way or he feels he is being treated unfairly. If this happens, he has angry and frightening verbal outbursts that seem out of his control. When he recovers, he is remorseful, but that doesn’t seem to prevent future outbusts. He is not rational when he loses control. We have seen counselors since he was four years old (he is now almost ten). Can you give any insight into how we can help him control these outbursts?

Our Consulting Clinical Psychologist’s Reply

There are several conditions that might produce the situation you describe. The most common would be ADHD, a condition that would have surfaced under the age of four years. ADHD children exhibit what I call “neurochemical excitability”. When upset, frustrated, angry, or irritated, we also experience a form of neurochemical excitement — that red-faced, fist-clenching, and stiff-back sensation that prepares us for a fight or argument. ADHD children are already “fired up” from a neurotransmitter standpoint so when they become upset, their normal level of hyperactivity is amplified by the release of fight-or-flight chemicals. The result — a sudden, very physical and very verbal outburst that may last twenty minutes. If we watch them with a videorecorder, we’ll see a tremendous amount of expended energy and physical movement. I’ve discussed this situation at length on my website (www.drjoecarver.com) in an article I’ve written on ADHD — Causes, Symptoms and Treatment. This is the most likely cause.

The second most likely is an anxiety/stress situation. Children under stress, and adults as well, often feel like a pressure cooker — building up emotional pressure until something very simple trips the release valve — then they explode. I’ve worked with stressed adults who have thrown their television set through a window, shot their automobile, or cut off all their hair when they couldn’t get their hair to look “just right”.

This level of agitation and outbursts tells me that an assessment is needed — probably by a psychiatrist or psychologist. The amount of energy and aggressiveness suggests some neurochemical issues. These are best evaluated by a psychiatrist or a clinical psychologist. Once the evaluation is completed, you will probably be presented with treatment options.

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