The Explosive Child - Ross Greene, PhD

[mbdc45]

The Explosive Child: A New Approach for Understanding and Parenting Easily Frustrated, Chronically Inflexible Children Author: Ross Greene, PhD Publisher: Harper Paperbacks; 5 Rev Upd edition (May 20, 2014) Paperback: 304 pages ISBN-10: 0062270451 ISBN-13: 978-0062270450

I read that book, & his new one, treating explosive children, by Ross Greene & Dr. Stuart Ablon. I just attended a symposium with both of them as guest speakers.

The main gist of their book is the children cannot control their behaviors and they have a new approach to treatment, the collaborative problem solving. Collaborative problem solving is more evolved than the basket theory. Years ago I tried implementing Ross Greene's approaches and they did work.

My son is 18 & after six years of turmoil he has finally been diagnosed BPD.  Collaborative problem solving is geared more for the child/adolescent, really not for the 17+ age. My son is just starting Dr.Gundersen's BPD treatment program McLean hospital. Hopefully this will be the answer to my prayers.

I do definitely recommend trying these approaches with younger kids - setting limits seemed to be easier when they were younger, now it's not so pretty!

Great book.

Mary

[Randi Kreger]

Children who are inflexible-explosive don't choose non-compliance but are delayed in developing skill. The reason why has to do with multiple and complex interwoven factors, but primarily temperament, neurobiological and genetic factors and comorbid disorders (see p. 13, 37, 55) These children fail to develop flexibility and frustration tolerance which normally develop at about age three. The consequences are that even in benign circumstances they: 1)      Can't delay gratification; impulsive2)      Can't control emotions 3)      Can't shift gears 4)      Can't solve problems5)      :)o not have the skills to express their needs6)      :)o not have the skills to move from black and white thinking7)      :)o not have the skills to work out disagreements8)      Have sudden outbursts and prolonged tantrums9)      Are verbally and physically aggressive This leads to an adverse impact on relationships with parents, teachers, siblings, peers, parents. If you (parent) interpret these behaviors as willful (such as oppositional-defiant disorder which has many of the same signs) you may try to resolve the problem by teaching the child “who is boss” and attempt to command more authority.However, this backfires and fuels an adversarial pattern that often makes things worse. Ask yourself why a child, if they had a choice, would intentionally behave in a way that makes other people respond in a way that makes him miserable?  If you can gain a comprehensive, in-depth understanding of your child's explosive behavior, seeing it as unintentional and a result of developmental delays, you can get a clearer idea of how to be helpful and better intervene.   Common Characteristics of Inflexible-Explosive Children Note: Thinking affects emotions, and then emotions affect reasoning. Not linear but circular pattern. Primarily Cognitive Characteristics 1)      :)ifficulty remembering how to problem solve and compromise. 2)      May not be responsive to rational and very reasonable attempts to problem solve and is disorganized in their thinking. When asked why they are behaving as they are, they don't know. Frustration lessens the child's ability to think (brain "short-circuts" p. 21. Intense emotions makes rational thinking nearly impossible. 3)      Sees people and situations in black and white and has no memory of previous satisfaction with these people and situations. Primarily Emotional Characteristics  4)      :)ifficulty managing and controlling emotions; inability to stay calm made worse when there is already an underlying negative state such as a bad mood, tired or hungry, or irritable. 5)      Constantly irritable, agitated, cranky state of mind.6)      Frustration over trivial events out of the blue with an intensity unlike other children and tolerates them less adaptively. Can't shift gears. Certain issues seem to be high triggers.7)      Severe anxiety8)      Has little ability in her faith to handle frustration and so sees the world as one filled with insurmountable frustration beyond her control  Primarily Behavioral Characteristics 9)      Unskilled at social interactions, has trouble recognizing the effect of their behavior on others (Goldman calls this "social illiteracy"10)  Unpredictable behavior11)  Comes off as manipulative, demanding, self-centered, and lacking in empathy and social tact.12)  Behavior gets worse when parents try limit setting and punishment, even when it is of a high level. Poor impulse control and high volatility  :)r. Stanly Turecki (With Others) Temperament Theory Temperament (rather than “personality”) is a "natural, inborn style of behavior that is innate and not produced by the environment." (p. 26). May be present at infancy. In addition to qualities above, he finds they also: 1.      Have a high activity level (behavior)2.      Are easily distracted (thinking)3.      Poor reaction to new or unfamiliar things4.      Poor reactions to changes in routine5.      Negative persistence, e.g. strong-willed, whiny, rigid Temperament and inflexibility-explosiveness exacerbate each other. He says, "Inflexibility-explosiveness may best be viewed as the most toxic manifestation of a difficult temperament." (But combination not universal.) He says much of this overlaps with ADD (what are the differences?) Inflexibility and low frustration tolerance can look different in different children.   The World From The Child's Point of View  1.      They don't understand their behavior and are sure no one else does, either. (think)2.      They are angry at being misunderstood (feel)3.      They are incredibly frustrated at inability to think clearly and communicate. (feel)  Finding Treatment "Children may exhibit such behavior for any of a wide variety of reasons, so there is no right or wrong way to explain it and no one-size-fits-all approach to changing it: (p. 86)  Treatment Goals 1.      Help children manage their emotions and think clearly in the midst of frustration by providing "roadmaps that help him stay rational “ (p.49)2.      Stay calm enough to help child achieve goal number one. Search Method (p. 106)1.   Pick a child psychiatrist or neuropsychologist 2.   Have an assessment, bringing required info to doctor (very involved procedure) MedicationSee qualities needed in physician, p. 181. Addresses biological causes and paves the way for teaching child (below, see Basket B). Medication can address cognitive, emotional, and behavior problems.  Communication Intervention Strategies Usual Pattern is as Follows: 1. The child expresses inappropriate behavior caused by “brain lock”2. The parent responds by screaming, berating, trying to reason, insisting, rewarding, and punishment3. This leads to the child's further frustration and lapse into even more destructive, abusive behavior (meltdown).  :)uring and after this, parents put their energy into "reactive intervention" which is not productive ("after" also goes against shaping recommendations). This is unproductive because the child cannot learn or be receptive to learning in an incoherent stage. This pattern becomes "stuck." Alternative Pattern:1.   Reinterpret behavior, depersonalize, understanding that they have real biological differences that cause their behavior. This helps prevent the parent from becoming emotional and having unrealistic expectations. All adults child interacts with need to be on the same page, eg teachers. Help change thinking by changing words (p. 126) 2. Recognize situations that routinely lead to brain lock and if you can help avoid them. He calls this creating a more user-friendly environment. Keep a record of meltdowns to determine patterns and triggers. (p. 110)3.   If this is unworkable or unavoidable, intervene at stage 2 above by responding in a way that prevents further deterioration and (best case) facilitates communication, problem solving, and collaborative problem solution. This includes:a.   Empathyb.   Help child think though the situation c.   Redirect child into another activity (distract) eg humord.   Slowly “downshift” child (this is not well-explained) (p. 114)Se page 226 for many other suggestionsDont ignore. If child too emotional, go to basket technique, which has to do with setting priorities. Basket Method for Prioritizing Flexibility-Explosion GoalsThree goals:1.   Maintain adults as authority figures2.   Teach flexibility and frustration tolerance3.   Understand childs limitations BASKET A: Crucial behaviors worth risking a meltdown. Helps achieve goal 1.  Always includes safety. (p. 133). Child must be capable of performance and parent must be willing and enable to force the issue. This doesnt actually teach the child anything; its just a must situation.BASKET B:Important but not worth a meltdown. The basket that helps child learn 2. The roadmap basket. Area where you can help child think, communicate and problem solve. First: empathy. Then invite problemsolving together. See roadmap discussion below.BASKET C: Off radar for now; helps you understand 3. Helps with safety because you are not risking meltdowns. This is not “giving in.” Its just you deciding to put your time and energy in the teaching involved in basket B and avoid situations that create major problems yet have little return. Parents, not children, determine what is in each basket.Roadmaps A ROADMAP is “a mental script that can provide a child with a way to think more clearly and stay calm while in situations that might otherwise cause them to be irrational or explosive.” (p. 193)Part of the childs difficulties that make roadmaps hard to use are:1.   Cant tell or communicate about their emotional states. May be in the habit of saying nasty things to parents when generally upset about something else. This causes frustration and miscommunication. 2.   Distorted interpretation about what is happening. (Gets back to schemas). The point is for the child to see the parent as someone who doesnt take it personally but tries to problemsolve with them. You might say “I know you think/feel………but I think…….”a)   You check to see if whats really bothering them is x. b)   See if that is it. c)   Ask what they need from you (p 215)d)   Try to get kid to go right to what they need or want directly rather than say nasty things; no attacking, swearing, hitting, hurting the other persons feelings. Other family members: 236FAQ: 243Schools-chapter 12Residential, etc. chapter 13How parents feel, chapter 14

[Abigail]

Based on the outline of symptoms and descriptions, it very much sounds to me like ADHD along with a problem in the cingulate gyrus area of the brain (this causes someone to be inflexible, rigid, argumentative, oppositional, anxious, "stuck" on certain thoughts, esp. negative ones, whiny, etc.)  This is best described in two books by Dr. Daniel Amen--"Healing the Six Types of ADHD" and "Change Your Brain, Change Your Life".

  Some of the ADHD symptoms mentioned are impulsivity, low frustration level, not being able to shift gears, easily distracted, social illiteracy, emotional intensity, poor reaction to change in routine, don't know why they behave as they do, come across as demanding, self-centered and lacking in empathy and social tact.

  There is also the possibility of bipolar disorder.

  My daughter has ADD (no hyperactivity) and the cingulate gyrus problem (called Overfocused ADD in Dr. Amen's book).  She is 24 and does not have any symptoms of BPD (aside from overlapping symptoms caused by ADD).

  I highly reccommend the two books mentioned by Dr. Daniel Amen.  He has done a lot of research in using SPECT scans of the brain to determine underlying neurobiological problems in the brain.  The symptoms of temporal lobe problems that he mentions sound quite similar to BPD.  It is very interesting and informative reading.

  Abigail

[homemadecookie]

My daughter's behavior, and her father's bipolar diagnosis, took me to the Explosive Child. like the other poster on the thread, I come here from the mental illness direction. I never knew this was a DSM IV disorder.

My daughter was good as a child. Quiet, smart, not a rager. All A student in any school she is in.

Even her terrible two's were not bad. The Hyper sensitivity was hard to handle, (socks in shoess), an Aspergers trait.

She did have bipolar, and was medicated, but she cuts, so. And, now I am getting it.

She didn't get this flavor until recently. This is when I say, "euwww, she sounds like her father." So the Explosive does work for the Man/child adult Borderline. Reading the text about the baskets is so smart!

I think there is much around that doens't name this as "borderline". Just so you may see it as symptoms to a behavior that you need to manage or get away from.

Me, for one.

So the Explosive Child is good for tools for the bipolar kids. Hey, we had nothing until "the bipolar child."

[Southerngal]

This book seems like it might offer help with a young child, but not an older child or teen.  It also seems to be an extremely complicated method to attempt to follow.

While this book depicts many things that are common with BPD, there are many other issues that I discovered over the years that are not mentioned.  Maybe it would describe something like "BPD Lite".

Compared to my experiences with BPsd, this book does not address that quite often the BP knows full well what they are doing and enjoys it.  Countless times, BPsd could be seen or heard laughing or smiling just after creating total mayhem with one of her explosions.

Also, so much of BPsd's behavior was driven purely by a desperate need for attention.  It did not matter whether it was positive or negative attention ... .as long as she was the center of it.  As can easily be understood, there is a limit to how much positive attention one can earn, but there is no limit to how much negative attention one can get.  Therefore, it seemed to me that this had a lot to do with why she would resort to bad behavior so often ... .even when good behavior would actually have been easier.

As for "Ask yourself why a child, if they had a choice, would intentionally behave in a way that makes other people respond in a way that makes him miserable? ", sadly, I believe that in many cases a BP has suffered rejection so very much in their lives that they often are determined to force people to dislike them before they have the opportunity to do so on their own.  In doing so, the BP is in control of the situation.

From what I went through with BPsd, this book would not have offered much help.

SG

[ataloss]

I think it sounds great in theory but in practice... .it is difficult.  I believe all of the suggestions take practice until it becomes second nature.  I am new to living with a step child who has BPD. 

[prairieguy]

After reading through the overview, I need to get the book now. My 8 year old S is a stereotype for the description given. He is a classic Explosive Child. He has been that way since he was born. Most of the time he is exceptionally bright (his school advanced him a grade when he was 7) and a wonderful, charming boy. The academic testing he's had this year places him at a par with 13 year olds. But when the fuse blows, he becomes an ogre and often violent. He has hit xBPW and myself frequently, struck other kids, and punched his teachers. He can easily keep up a screaming, violent tantrum for 15 minutes. The school, xBPW, and I all have a room set up to take him to when these start. After a tantrum starts, there is no way to reason with S and we just have to wait until the emotions subside which can be anywhere from 30 seconds to 30 minutes.

We have taken him to see a number of doctors and psychologists. He does not fit any classification like bipolar, ADD, or ADHD. We have managed to get him classified as a special needs student due to his behavior and this allows us to keep him in school despite his occasional outbursts. Otherwise he would have been expelled from school already (at age eight!). Many of the suggestions in the outline match the school's efforts. It does seem to be working, but outbursts still occur from time to time.

Finding triggers has been challenging. Surprises are one. Another that I've noticed is that S is more susceptible to outbursts when he's hungry. And if I can manage to get him to eat a snack when I see him getting anxious, then he can usually stay calm. I've started trying to ply him with healthy snacks at critical times and have suggested this to xBPW and the school. (He's a slender, muscular kid so overeating is not a problem.) He makes this difficult because when his fuse does start to blow, he refuses to eat. Then a hunger-anger cycle starts which makes everything worse.

The school pointed xBPW and I to a T who seems to understand "Explosive Child" well and T helped us set up the special needs program at the school. Unfortunately, xBPW can not stand this T and since we have joint custody, xBPW has vetoed taking S back to T. Also T is outside of my insurance coverage which makes seeing him expensive.

I tried talking to S about his latest violent outburst at school a few days ago. He readily talked about what led up to it (he missed lunch!) but absolutely refused to discuss his actions during the outburst. This is the way he has always been. He never talks about the ogre, almost as if he doesn't know. Reminds me of the Incredible Hulk comics.

Prairie Guy

[luv2cook80]

Iam reading this book it is a very good book . I have a son with Aspergers and a daughter with BPD and they both respond like the book says  so we are learning how to react to them. Its a book to read over and over.