Maggie McKay (Host): Welcome to Conversations Like No Other, presented by Valley Health System in Paramus, New Jersey. Our podcast goes beyond broad, everyday health topics to discuss very real and very specific subjects impacting men, women, and children. We think you'll enjoy our fresh take. Thanks for listening. I'm your host, Maggie McKay.

Today, we have with us licensed marriage and family therapist, Megan Coral, to discuss how to parent an angry child. Megan, it's so great to have you here.

Megan Coral: Maggie, it's so great to be back.

Host: So, let's just dive right into it. Why does it seem that today's children are angry all the time?

Megan Coral: So, there are so many things going on with our kids. there's social, academic, environmental pressures. We think about the way their brain functions, any mental health conditions like lack of sleep, lack of adequate food intake, stress, media influences, like watching other people's behavior, not feeling well, and a lack of resources to manage their emotions are all reasons why kids can display anger. Any one of these things can make children angry. And frequently, our kids have so many more things to deal with. They have so much more access to information and they're constantly being bombarded with news and updates, which also can be really overwhelming. And anger is a really common way for people to express other emotions and can mask anxiety, fear, sadness, being overwhelmed.

One reminder I often give grownups is that children are people whose brains aren't fully developed. So, we think about is the behavior that the child is displaying something a grownup would do, a grownup does do, or they have seen adults whose brains are fully developed do. Does our child have the skills to manage their emotions? Does our family model and practice coping skills together? It's all helpful to think about the ways that the child's behavior, is a reflective of their environment and the things that they're experiencing, and we can think about easy interventions to reduce the behavior so we can go over some of those later.

Host: Good point. As a parent, when should we be concerned that our child's anger is excessive?

Megan Coral: So, grownups should think about if your child's anger and outbursts are harmful to the child and others, if their anger is really negatively impacting their life, if the anger outbursts are occurring in all areas of the child's life or one very specific area, all of that is important information.

Children are going to be angry, because they can't regulate their emotions and have outbursts of anger, which is typical for childhood. It's when the anger occurs consistently in more than a few weeks and is the most common emotional response that our child has, especially coupled with violence to themselves, to others, then parents might want to consider meeting with a therapist. It's really common for kids to behave well in school and with other relatives or with other people, and only demonstrate that anger at home with their parents. Showing anger at home lets the child feel safe to express it, and it helps the child know that the parent is a safe person for them. So, we want to think about those things.

Host: So, are there any tips or tactics that a parent can use to diffuse a situation?

Megan Coral: Oh, so many. So, I tell parents a lot to think of themselves as two things. When kids are younger, think about yourself as a container. Kids struggle to manage their emotions because they don't have executive functioning capabilities that help them regulate their emotions and their behavior. So, they need their grownups to help contain them. They need their grownups to stay regulated, to tolerate the difficult feelings, and to help them with those feelings.

When kids get older and have some skills to manage their feelings, they need their grownups to be a lighthouse. Their child is this ship, navigating the storm of their emotions. And regardless of the sizes of the storm, the lighthouse always continues to beam that light constantly. So, parents are the emotional regulators, guiding them, giving them that safety and that consistency to help the child regulate themselves. We want to think about parents need to be able to demonstrate that regulation so that their children will be able to do it, manage their emotions.

Children aren't able to start regulating themselves until they're developmentally age five. So, we talk about specific ages to help parents put things into perspective where your child might not be capable yet of managing those emotions on their own, especially if they haven't seen it.

So, before a child has an angry outburst, we want to think about teaching our kids emotional vocabulary. We want to help normalize experiencing their emotions and talking about emotions. We want to help their grownups share little things that upset them and talk about what they did to model managing emotions. We want to practice coping skills as a family. We want to help the child know that they're not the only one who needs help with their emotions. And we want to help them learn the skills to manage their emotions, to get themselves calm when we're not around.

So, we can model coping skills like box breathing. We can model skills like 5, 4, 3, 2, 1; walking away, stretching, listening to music; engaging their senses through smell, touch, sight, and sounds. We want to talk about what to do when an outburst occurs. And we try to stay calm and keep them company as their grownups. We want to help them be aware of when outbursts are most likely to occur and see if we can help prevent them or reduce them.

So in the moment, some things that we can do with our kids are try to be calm during the storm and take your own breaths, right? You're that lighthouse. Say very little, set clear boundaries, and validate the feeling. So, it will look like "I can see you're really angry. It's okay to be angry. I'm going to help keep you and me safe until that anger passes." We want to think about if the outburst is a result of trying to escape or avoid a situation. We're not giving into the demand. That will just reinforce a child to engage in outbursts when they want to avoid a situation again.

And then, after the outburst, we talk to our child about it. But we don't push. We want to talk about what happened or what might set up them off when they're ready to talk. And if they don't know, we're not going to push to figure out why the outburst happened. But we talk about what we could do in the future. And again, if they're not ready, encourage them to come back to you, and we might revisit it in a day or two to just check in and see if this is something that they want to talk about. All this helps them develop skills to self-regulate independently in the future.

Host: I love the lighthouse analogy. That's so great. So Megan, should a parent be concerned if their child seems angry and defiant all the time, or is this just part of growing up?

Megan Coral: So, a lot of times when parents tell me their child is angry all the time, I ask them to track it because it often doesn't occur as much as they think it does. So, that would be the first thing. Like, let's see how often this is actually happening, and how long it's lasting. And then, we talk about what is developmentally appropriate. How long are these outbursts truly lasting? How frequently are they occurring? and are there some clear triggers? Because a lot of times I'll get into the, like, "Here we go again. This is what always happens."

And if you think about any relationship with anybody, we often think about it occurring in patterns. So, we want to see what is realistic as far as their age, as far as their ability, and are we practicing skills? Does the child have the skills to manage their emotions? Because let's see if we can teach them those skills and do the outbursts reduce? So if we are implementing some of the skills and the strategies that I already talked about, and you're not seeing a reduction, then it might be time to think about getting some external help.

Host: And if a child is expressing anger that seems beyond "normal", what sort of treatments are available?

Megan Coral: We think about normals relative to the child, and anger can also be a way that many emotions are expressed. There's a lot of options for help. Cognitive behavioral therapy, play therapy, anger management training, parent training. In some cases, medication can help. So, these are just some of the options.

Host: Does this mean they're depressed or that they have a mental illness?

Megan Coral: Not necessarily. Sometimes having angry outbursts means that a child's trying to figure something out. It could be a mask for other emotions that the child might be feeling. If the behavior is atypical for your child and it came out of nowhere and it's been lasting for more than a few weeks, then it's probably time to think about meeting with a therapist and see what might be underneath it.

Host: And what about siblings and learning from the angry child's behavior or being scared?

Megan Coral: So in family systems, we learn from each other. Children are always watching and learning from the behavior they see from others. Some children might be afraid, others might replicate the behavior, and some of the reactions can be influenced by their temperament and by the environment. I like to have families as a whole practicing these coping skills for this reason, because everybody needs to be able to manage their feelings without hurting others. So, we want everybody to get the message that we can be angry, and this is how we express it in this family.

Host: So does an angry child outgrow the behavior?

Megan Coral: So as our brains develop and we have those executive functioning capabilities and we learn skills, we're able to manage more of our angry responses. So, the behavior can certainly change, but we can't just rely on growing up and aging out of it to eliminate the behaviors, especially as they impact the child's functioning in home, in school and peers. So, we don't want to delay intervening and teaching necessary skills.

Host: Megan, what if a parent feels like they're just failing at being a parent? What can they do to keep their cool?

Megan Coral: So many parents feel this way. So many parents feel like they're supposed to be a hundred percent on the ball, totally emotionally regulated all the time. And we're people and that's just not what happens. Life gets in the way.

For children to develop the ability to attach to their parents and others, they need to be emotionally attuned to their parents 30% of the time. So, that's from Ed Tronick's study with Still Faces. So if 30% of the time you feel like you're doing a good job and you are in tune with your child, that's important, right? And when we make mistakes, we need to repair. And what that looks like is taking accountability for our actions. So when we lose our cool, and we might yell at our kids, or we might do things that we're not proud of, we, we take responsibility and we apologize. "I'm sorry I behaved that way. I shouldn't have yelled. I shouldn't have done whatever it is I did, but I'm going to do better." And actively trying to do better.

So, we want to think about parenting is hard. Raising humans is hard, and no one is a better parent for your child than you. No one can you love your child like you can. Nobody keeps their cool all the time. If you want to think about changing your behavior, think about one thing you want to be different and what you're going to do instead. So if you want to stop yelling and decide you're going to take a breath instead of yelling, count how often you're successful. Start small and slowly and you can make bigger behavior changes. There's a lot of resources that focus on connection. Cool, Calm and Connected by Dr. Martha Straus; How to Stop Yelling by Dr. Laura Markham. Podcasts like Big Little Feelings and Good Inside with Dr. Becky are also some resources to help parents try to keep their cool. But we all lose it sometimes. It's the repair that's most important.

Host: Good to remember. How do boys versus girls handle anger differently?

Megan Coral: So typically, boys tend to be more physical with their anger, girls can be more verbal. But anger is an expression that's child and family-specific. Boys tend to have shorter experiences of anger acting out and moving forward faster than girls do. The way girls express anger can be tricky. Girls might cry or withdraw when angry, and that gives the appearance of sadness. They might lash out when they're anxious, and it can look like anger instead. Girls tend to experience anger longer and might not be as quick to express it or release it, so it builds. And managing anger is best done through slow movements and exercises, even though that can feel counterintuitive to what we want to do.

Host: You touched on this a little bit, when you said, you know, we don't all keep our cool all the time, but how can a parent's own anger affect their children?

Megan Coral: Our kids are always watching us and learning from us. So if parents express their anger through hitting, yelling, or breaking things, children may think this behavior is okay and is how anger is managed and replicated. When children don't understand why something is happening, they tend to blame themselves for actions and events that are scary. It's more emotionally acceptable for them to blame themselves rather than their parents for their parents' behavior when a caregiver's unpredictable.

Parents get mad, we all do. And if you've done things you aren't proud of, talk to your child about it. If you feel sorry, apologize, like explain to your child that you acted in anger and that it is your responsibility, your accountability. But our kids learn from watching us. So, we can model things in both the positive and the negative. We can model those coping skills. We can model managing our frustration. We can model some of the negative behaviors, so this screaming and yelling. But we can also model the positive and take ownership of ourselves. And also, that teaches our children to apologize. It teaches our children to take accountability for their own reactions. For parents who have children who act out and then all of a sudden deny or blame or lie about the things that they did, we as parents can practice taking responsibility and taking ownership to show our kids, like, this is okay, and this is what we do. This is how we behave in relationships with other people.

Host: I always remember this parenting class I took when my son was a baby. And the teacher said, just pretend you have a permanent recording device on your shoulder and it is always recording everything you do, that's your child. And I thought, "Oh my--"

Megan Coral: That's so much pressure.

Host: God, I know. That's what I thought. I'm like, "Good Lord." But I took it with a grain of salt, but I did kind of have it in the back of my mind. Like yeah, they're watching you and they're noticing and they might end up acting the same way you do. So, you better act good. Is there any research on the effectiveness of one parenting style over another that handles anger better?

Megan Coral: So, there's a variety, but it boils down to parents who are common, consistent, and set clear boundaries tend to have the best success helping their children. It used to be labeled as an authoritative parenting style, but there's a lot of positive parenting courses out there. Like Triple P that we offer at Valley, parent management training, parent-child interaction therapy are all types of therapies to help parents learn how to understand behavior, recognize their role in their child's behavior, help them learn and help them manage behavior in a way that teaches children to behave better.

Host: Megan, is there anything else in closing that you'd like to add that we didn't cover?

Megan Coral: We went over a lot. Parenting is hard. We do the best that we can and we can always learn. But as much as we might not be proud of the behaviors that we engage in as parents, we can always change that. We can always model things that are better. We can always help our kids, and we're not striving to be perfect parents. We're striving to be good enough.

Host: It's good to remember. Give yourself some grace, right? Thank you so much for sharing your expertise. We always love talking to you.

Megan Coral: Great talking to you too, Maggie.

Host: Again, that's Megan Coral. For more information about Developmental Pediatrics at Valley, please visit valleyhealth.com/developmentalpediatrics. Thanks for listening to Conversations Like No Other, presented by Valley Health System in Paramus, New Jersey. For more information on today's topic, or to be connected with today's guest, please call 201-291-6090 or email valleypodcast@valleyhealth.com.