Q. My son was recently diagnosed with intermittent explosive disorder. In talking with several other parents, it seems their children have also been given the same diagnosis. Could you tell me more about it?
A. According to “Psychology Today,” Intermittent Explosive Disorder (IED) is a serious impulse control disturbance characterized by “failure to resist aggressive impulses, resulting in serious assault or property destruction.” You may find that your son’s aggressive behaviors, like that of many children diagnosed with IED, are grossly out of proportion to the stressful situations he experiences.
Some IED sufferers describe their behavior as “attacks.” They report experiencing a tremendous build-up of tension resulting in a behavioral explosion that is beyond their control. After the explosion, they often feel remorseful or embarrassed.
According to the Mayo Clinic website, children with IED are more likely to become troubled adults. They are more likely to experience road rage, to engage in domestic abuse, and to cause bodily injury and property damage.
Psychological treatment is essential for a child to overcome IED. It is not a phase. Cognitive Behavior Therapy (CBT) helps children or adults to identify their behavioral triggers, to discover methods for managing their outbursts, and to learn effective coping skills. Children should begin psychotherapy as soon as they are diagnosed with IED.
Your son will likely be seen by a psychiatrist as well since a psychologist cannot prescribe medication. Do not be fearful of the psychotropic drugs, but do your homework. Ask about side effects. The purpose is to make your child more highly functional, not to make him tired or non-responsive.
There are many excellent resources online. I would suggest that you begin with the Mayo Clinic site and Harvard Health Publications. These resources will provide you with more information about IED as well as helping you to understand his treatment options.
Q. My teenage daughter has been cutting her arms and legs. I am extremely concerned and don’t know what to do. Why do teens cut themselves and what can I do to help?
A. Cutting and other forms of self-harm have become more widespread over the last few decades. According to parenting.org, one out of every eight people has engaged in some form of self-harming behavior. In young people diagnosed with depression or anxiety, that number rises to one in four.
There are many reasons that teens engage in cutting. Some of the more common ones are to distract from emotional pain, to bring about control in their seemingly out of control lives, and even to be accepted by their peers.
Your first step is to discuss the self-harming issue with your daughter. Is she experiencing extreme distress at home or at school? Many teens begin to cut as a response to a stressful or neglectful home environment. Others begin to cut because they are being bullied or pressured at school.
Many parents believe that cutting is a suicide attempt, and over-react in negative ways. Cutting is usually not a suicidal action. Hauling her to the emergency room may cause more harm than good. Your daughter should feel free to talk with you about her feelings without being chastised, dismissed or fearful of the consequences. Many parents offer well-meaning lectures when all the teens really want is someone to listen. Whatever you do, this is not a time for punishment or scolding; it is a time for understanding and concern.
Your daughter should meet with a mental health professional to discuss better ways to manage emotional distress. Even if she promises never to cut herself again, the behavior can become addictive, according to Dr. David Rosen, a professor of pediatrics at the University of Michigan. Therefore, some type of intervention should be taken.
There are several books on self-harming behavior that both of you should read. I suggest “Cutting: Understanding and Overcoming Self-Mutilation” by Steven Levenkron and “A Bright Red Scream: Self-Mutilation and the Language of Pain” by Marilee Strong.
Nancy Ryburn holds a doctorate degree in psychology from Yeshiva University in New York City. She teaches psychology at Southeast Arkansas College and maintains a private practice.