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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10567
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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I have a nephew who has extreme anger issues. I am afraid he

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I have a nephew who has extreme anger issues. I am afraid he will hurt someone. Especially his older brother. He has always had an extreme temper and we have always had to watch him closely but it seems to be getting worse. He has cause his parents to split up and now is making their new relationships horrible also. I don't know what to do to help him or my sister (his mom) but she's at the end of her rope. If something doesn't happen for them soon I am afraid someone will be hurt.

DoctorZ :

Hello I believe I may be able to help you with your concern regarding your nephew's extreme anger issues

DoctorZ :

Now you mention that at school he does exhibit this type of anger, but at home he does. Is that correct?

Customer:

Yes at school he is helpful to a very special needs child in his class but once he is out of school he is horrible.

DoctorZ :

Okay and how long has this behavior been going on for? And in your opinion do you believe it has been escalating (getting worse)?

Customer:

He has always been extreme but my sister believed he was just stubborn and wanted his way. Now that he is older we are noticing the behavior has not gotten any better. His outburst are getting worse or more intense. As a child he would push over a shelf of book or toys but not he will hit and kick his brother and just yell at anyone. It does not bother him to behave this way no matter if we are in private or out in public.

DoctorZ :

And what kind of activities does he enjoy? Sports, video games, movies, etc...?

Customer:

It's very hard to say. We have tried Karate and he liked it for a little while but then HATED it. Just like soccer. He will play video games but if he is not winning or doesn't get to chose the game another battle is started.

DoctorZ :

So it sounds like he gets easily frustrated and is not patient

Customer:

I am not sure but he seems to show his worst behavior when his Mom is around.

Customer:

Not at home or with the family. At school the teacher said she has never noticed any of the behaviors we have mentioned.

DoctorZ :

And is there any history of abuse towards your nephew that you know of?

Customer:

My sister does get very frustrated with him. I have talked with her before about spanking him because it seemed when he was little to go to far. I haven't noticed anything like that in the past few years. On the other hand they do yell back and forth.

DoctorZ :

Well i can understand your sister's frustration, it is one many parents feel in this type of situation

DoctorZ :

What I believe your nephew has is called Oppositional Defiant Disorder (ODD)

Customer:

I agree. I feel like she just needs some help and does not know what to do to help him.

Customer:

I will look into this. Is it treatable?

DoctorZ :

It is a disorder where children will increasingly act out against authority figures, especially parents. The reason your nephew does not do it with teachers or at school is because he knows that his parents will always love him no matter what, while teachers do not have that unconditional love

DoctorZ :

Yes this is treatable, but it will take some time. The good news is that he is still young and you caught it early before it escalates to more severe psychopathology like antisocial personality disorder

Customer:

Where do we go from this point? Should he be on some type of medication or is it just counseling.

DoctorZ :

The first key is to see a child psychologist for your nephew to help change his behavior, this can include family therapy to bridge communication and understanding to help your nephew understand why his behavior is wrong.

DoctorZ :

Sometimes medication is necessary to lessen the severity of symptoms and to allow him to be more focused on therapy, but usually the medication will not have to be long term as he become more open to the therapeutic techniques.

DoctorZ :

The best form of treatment for his behavior is called Cognitive Behavioral Therapy, because it focuses on changing his thinking to be more positive and not negative. The theory of this modality is if you change the thought pattern then the behavior will change as well.

Customer:

I appreciate all of your help. As I am reading it does seem to be his issues. What can I do to help with his anger towards his brother? He is very aggressive physically towards him.

DoctorZ :

He has to be set firm limits and to disconnect him with his brother before escalation occurs. Do not really try to reason with him at the heat of the moment, disconnect him from his brother and walk away. Then maybe when he calms down, you can talk to him and help him understand why his behavior is wrong. You do not have to prove the facts to him, just acknowledge his feelings and tell him what his brother's perspective of the situation is.

DoctorZ :

While your sister's parenting style is not at fault for your nephews behavior, but she will have to adapt her behavior to better manage your nephew's disorder. Here are couple books that I personally like for this situation. They will give more detail on how to manage and lessen the severity of your nephew's symptoms and behavior

Customer:

I have noticed that my sister is worn out by this. Is there anything you can suggest for her.

Customer:

Thank you!! You answered before I even got it out.

DoctorZ :

And I completely feel for her being worn out from this. Stronger medication may be able to help give your sister a break to catch her breath as he starts to get used to therapy

DoctorZ :

A child psychiatrist would know which type of medication would be wise to use, since I know you have already tried medication for his behaviors

Customer:

I can not thank you enough. I will give her all of this information and try my best to find him someone who can help. I am worried if he doesn't get help soon he could really hurt someone.

DoctorZ :

You are most welcome, I am always happy to help. I think getting him treatment at his age has a good chance for successful management in the future of his behaviors, so it is good that you caught this early

DoctorZ :

I wish you and your sister luck with your nephew. And if you have any other questions or concerns, please feel free to contact me anytime

DoctorZ :

I hope I provided you with excellent service today

Customer:

Yes you have! Thank you so much!

DoctorZ :

Anytime, good luck with everything.

Customer:

I am not sure if you are still there but I did want to ask one more thing. Today my sister was in the car and touched her ankle. When she did he flipped out. He started screaming at her to not touch her foot. Why would he react this way?

DoctorZ :

Most likely he was just being openly defiant at the most minor of issues. His disorder can cause him to have an anger outburst that is disproportionate to the event, like you just described. Also children can be very intuitive and he might realize that he is approaching your sister's breaking point and he is trying to achieve this.

Customer:

You are brilliant! Thank you!

DoctorZ :

I am just happy to help you and your family, but thank you for the compliment

Customer:

I am so thankful for your help.

DoctorZ :

I am happy to help, if you need anything else please feel free to ask me at anytime

DoctorZ :

Now before you sign off, could you please rate me positively so I can get credit for this question. I would greatly appreciate it.

Customer:

Sure

DoctorZ :

Thank you so much :)

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