Difficult children (part 3)

Written by: Ms Elise NOIROT, Ms Sophie COURBION, neuropsychologists
Supervised by Dr Marcelline RENAUD-YANG, child psychiatrist, Day Therapy Activities Centre (CATTP)/Learning Difficulties Assessment Centre (CDTA), Centre Plati, Monaco.

Understanding emotional dysregulation:

An event which provokes an intense emotion can lead to a feeling that persists throughout the day. This “undigested” emotion forces the child to make an effort to contain themselves (particularly in a highly regulated environment, such as school). When the child arrives home, we see something which can be described as a “pressure cooker” effect (a state of emotional overflow), associated with a feeling of greater freedom to express themselves.

All emotions, even those deemed positive, can cause a degree of internal destabilisation.

A tantrum is a physiological reaction which lasts around 20 minutes, on average, as described in our previous article. There are three phases to a tantrum:

• The build-up (the perfect time to put strategies in place). This is the point at which physiological changes occur. Discussion may be difficult but is still possible (put what is happening into words).
• The tantrum itself: during this phase, the child is no longer at all receptive to discussion. This phase is often violent and includes provocation. The latter is seeking a parental response, which often ends in the opposite of what the parent wants/expects, i.e. a prolongation of the tantrum (spiralling). If the parent has built a support network, the ideal solution is to call on a member of that network at this point and remove themselves from the situation.
• The post-tantrum phase: a variable phase including physical breakdown (exhaustion, falling asleep, etc.), which often concludes with a feeling of shame and guilt on the child’s part.

How can you teach a child to manage their anger?

The idea is to look for solutions with the child, so that he or she can vent their anger in a different way, and to suggest ways that he or she can respond (set things right) if there has been material damage.

The child needs to feel strong feelings inside to help them calm down (e.g. listening to very loud music, pushing with their hands as if trying to move a wall, etc.). Initially, the child needs to be supported in this type of activity.

Managing tantrums with the help of neuroscience:

• The first part, which corresponds to the reptilian brain;
• The emotional part (managed by the limbic system);
• And the neocortex.

Schematically, the brain comprises three parts:

If we compare it to the cockpit of an aircraft, the part which deals with primary functions (such as heart rate, body temperature, etc.) is the flight engineer (who you never hear). “It gets on with the job” in a sense.

Then, there is the co-pilot (he’s the emotional one, the “daredevil” of the outfit) who always needs to be monitored when he takes control of the aircraft.

Finally, there’s the captain (= the one with the experience), our wise neocortex.

In young children, the captain has only just been promoted. He doesn’t yet have a lot of experience, or maturity. When the child gets angry (cries, etc.), it is the co-pilot (limbic system) who is at the helm. The wise neocortex struggles to take back control. If you ask a child who is having a tantrum an open question (“What did I say to you?”), you are asking them to think with the aim of getting the captain (who is lost) to react. We can’t yet rely on the wisdom of the neocortex, so we attempt to manage the co-pilot (“Mr Emotional”) as best we can. The co-pilot cannot multitask – he cannot be angry and feel joy at the same time. To move him from one state to another (from anger to calm) requires as much energy as the state of anger itself. It is possible to use the switch method (for example, overplaying astonishment or surprise, pointing out to the child something they love. In other words, shift the focus to their interests).

In conclusion, we can see that a child who is angry finds it difficult to calm down because their neocortex is still very young and immature. There are two options:

• Assist the child by asking open questions to help them calm down. This forces them to think and to make use of the neural circuits in their neocortex.
• Since the emotional brain can only focus on one thing, use the switch technique to move the child from their feeling of anger to a different emotion (such as surprise). Non-verbal aspects are very important here (facial expressions and gestures, tone of voice, etc.).

Thus it is clear that it is vital to understand the different stages of a tantrum (in general terms) and to think about ways of defusing it, so that neither the parents, nor external observers nor the child is left to suffer.

You can check out (or go back to) the first article in this series here.

You can check out (or go back to) the second article in this series here.