CHAPTER ONE: THE WAFFLE EPISODE

Jennifer, age eleven, wakes up, makes her bed, looks around her room to make sure everything is in its place, and heads into the kitchen to make herself breakfast. She peers into the freezer, removes the container of frozen waffles, and counts six waffles. Thinking to herself, "I'll have three waffles this morning and three tomorrow morning," Jennifer toasts her three waffles and sits down to eat.

Moments later, her mother and five-year old brother, Adam, enter the kitchen, and the mother asks Adam what he'd like to eat for breakfast. Adam responds, "Waffles," and the mother reaches into the freezer for the waffles. Jennifer, who has been listening intently, explodes.

"He can't have the frozen waffles!" Jennifer screams, her face suddenly reddening.

"Why not?" asks the mother, her voice and pulse rising, at a loss for an explanation of Jennifer's behavior.

"I was going to have those waffles tomorrow morning!" Jennifer screams, jumping out of her chair.

"I'm not telling your brother he can't have waffles!" the mother yells back.

"He can't have them!" screams Jennifer, now face-to-face with her mother.

The mother, wary of the physical and verbal aggression of which her daughter is capable during these moments, desperately asks Adam if there's something else he would consider eating.

"I want waffles," whimpers Adam, cowering behind his mother.

Jennifer, her frustration and agitation at a peak, pushes her mother out of the way, seizes the container of frozen waffles, then slams the freezer door shut, pushes over a kitchen chair, grabs her plate of toasted waffles, and stalks to her room. Her brother and mother begin to cry.

Jennifer’s family members have endured literally thousands of such episodes. In many instances, the episodes are more prolonged and intense, and involve more physical or verbal aggression than the one described above (when Jennifer was eight, she kicked out the front windshield of the family car). Mental health professionals have told Jennifer’s parents she has something called oppositional-defiant disorder. For the parents, however, a simple label doesn’t begin to explain the upheaval, turmoil, and trauma that Jennifer’s outbursts cause. Her siblings and mother are scared of her. Her extreme volatility and inflexibility require constant vigilance and enormous energy from her mother and father, thereby lessening the attention the parents wish they could devote to Jennifer’s brother and sister. Her parents frequently argue over the best way to handle her behavior, but agree about the severe strains Jennifer places on their marriage. Although she is above average in intelligence, Jennifer has no close friends; children who initially befriend her eventually find her rigid personality difficult to tolerate.

Over the years, Jennifer’s parents have sought help from countless mental health professionals, most of whom advised them to set firmer limits and be more consistent in managing Jennifer’s behavior, and instructed them on how to implement formal behavior management strategies. When such strategies failed to work, Jennifer was medicated with innumerable combinations of drugs, without dramatic effect. After eight years of medicine, advice, sticker charts, time-outs, and reward programs, Jennifer has changed little since her parents first noticed there was something "different" about her when she was a toddler.

"Most people can’t imagine how humiliating it is to be scared of your own daughter," Jennifer’s mother once said. "People who don’t have a child like Jennifer don’t have a clue about what it’s like to live like this. Believe me, this is not what I envisioned when I dreamed of having children. This is a nightmare."

"You can’t imagine the embarrassment of having Jennifer ‘lose it’ around people who don’t know her," her mother continued. "I feel like telling them, ‘I have two kids at home who don’t act like this -- I really am a good parent!’"

"I know people are thinking, ‘What wimpy parents she must have...what that kid really needs is a good thrashing.’ Believe me, we’ve tried everything with her. But nobody’s been able to tell us how to help her...no one’s really been able to tell us what’s the matter with her!"

"I hate what I’ve become. I used to think of myself as a kind, patient, sympathetic person. But Jennifer has caused me to act in ways I never thought I was capable of. I’m emotionally spent. I can’t keep living like this."

"I know a lot of other parents who have pretty difficult children...you know, kids who are hyperactive or having trouble paying attention. I would give my left arm for a kid who was just hyperactive or having trouble paying attention! Jennifer is in a completely different league! It makes me feel very alone."

The truth is, Jennifer’s mother is not alone; there are a lot of Jennifers out there. Their parents quickly discover that strategies that are usually effective for shaping the behavior of other children -- such as explaining, reasoning, reassuring, nurturing, redirecting, ignoring, rewarding, and punishing -- don’t have the same success with their Jennifers. Even formal behavior management programs -- sticker charts, contingent rewarding and punishing, and time-outs -- and commonly prescribed medications have not led to satisfactory improvement. If you started reading this book because you have a Jennifer of your own, you’re probably familiar with how frustrated, confused, angry, bitter, guilty, overwhelmed, worn out, and hopeless Jennifer’s parents feel.

Besides oppositional-defiant disorder, children like Jennifer may be diagnosed with any of a variety of psychiatric disorders and learning inefficiencies, including attention-deficit/hyperactivity disorder (ADHD), mood disorders (bipolar disorder and depression), Tourette’s disorder, anxiety disorders (including obsessive-compulsive disorder), language- processing impairments, sensory integration dysfunction, nonverbal learning disabilities, reactive attachment disorder, and even Asperger’s disorder. Such children may also be described as having difficult temperaments. Whatever the label, children like Jennifer are distinguished by a few characteristics -- namely, striking inflexibility and low frustration tolerance -- that make life significantly more difficult and challenging for them and for the people who interact with them. These children often seem unable to shift gears and think clearly in the midst of frustration and respond to even simple changes and requests with extreme inflexibility and often verbal or physical aggression. For reasons that will become clear, I’ve come to refer to such children as inflexible-explosive -- not because I’m interested in inventing yet another syndrome (there are plenty already) -- but because I think it’s more accurate and descriptive and therefore gives us a better idea about what they need help with.

How are inflexible-explosive children different from other kids? Let’s take a look at how different children may respond to a fairly common family scenario. Imagine that Child 1 -- Hubert -- is watching television and his mother asks him to set the table for dinner. Hubert has a pretty easy time shifting from his agenda -- watching television -- to his mother’s agenda -- setting the table for dinner. Thus, in response to, "Hubert, I’d like you to turn off the television and come set the table for dinner," he would likely reply, "OK, mom, I’m coming" and would set the table shortly thereafter.

Child 2 --Jermaine--is somewhat tougher. He has a harder time shifting from his agenda to his mother’s agenda but is able to manage his frustration and shift gears (often with a threat hanging over his head). Thus, in response to, "Jermaine, I’d like you to turn off the television and come set the table for dinner," Jermaine might initially shout, "No way, I don’t want to right now!" or complain, "You always ask me to do things right when I’m in the middle of something I like!" However, with some extra help (Mother: "Jermaine, if you don’t turn off the television and come set the dinner table right now, you’re going to have to take a time-out"), these "somewhat tougher" children do shift gears.

And then there is Jennifer, Child 3, the inflexible-explosive child, for whom shifting gears -- from her agenda to her mother’s agenda -- often induces an unimaginable, intense, debilitating level of frustration. In response to, "Jennifer, I’d like you to turn off the television and come set the table for dinner," these children get stuck and often simply explode, at which point all bets are off on what they may say or do.

Inflexible-explosive children come in all shapes and sizes. Some blow up literally dozens of times every day; others only a few times a week. Many "lose it" only at home, others only at school, some both at home and school. Some scream when they become frustrated but do not swear or become physically or verbally aggressive. One such child, Richard, a spunky, charismatic fourteen year old who was diagnosed with ADHD, began to cry in our first session when I asked if he thought it might be a good idea for us to help him start managing his frustration so he could begin getting along better with his family members. Others scream and swear but do not lash out physically (including Jack, an engaging, smart, moody ten year old, diagnosed with ADHD and Tourette’s disorder, who had a very reliable pattern of becoming inflexible and irrational over the most trivial matters and whose inflexibility and irrationality tended to elicit similar behaviors from his parents). Still others combine the whole package, such as Marvin, a bright, active, impulsive, edgy, easily agitated eight year old with Tourette’s disorder, depression, and ADHD, who reacted to unexpected changes with unimaginable screaming, swearing, and physical violence (on one occasion, Marvin’s father innocently turned off an unnecessary light in the room in which Marvin was playing a video game, prompting a massive one-hour blowup).

What should become quite clear as you read this book is that these children have wonderful qualities and tremendous potential. In most ways, their general cognitive skills have developed at a normal pace. Yet their inflexibility and low tolerance for frustration often obscure their more positive traits and cause them and those around them enormous pain. I can think of no other group of children who are so misunderstood. Their parents are typically caring, well-intentioned people who often feel guilty that they are no longer able to feel great love for their children.

"You know," Jennifer’s mother would say, "each time I start to get my hopes up...each time I have a pleasant interaction with Jennifer...I let myself become a little optimistic and start to like her again...and then it all comes crashing down with her next explosion. I’m ashamed to say it, but a lot of the time I really don’t like her and I definitely don’t like what she’s doing to our family. We are in a perpetual state of crisis."

Clearly, there’s something different about the Jennifers of the world. This is a critical, often painful, realization for parents to come to. But there is hope, as long as their parents, teachers, relatives, and therapists are able to come to grips with a second realization: Inflexible-explosive children often require different disciplinary practices than do other children. Unfortunately, there is no bible on how to deal with these children, particularly if medication and standard behavior management strategies fail to resolve their difficulties. Thus, the parents, teachers, relatives, and therapists of such children often aren’t sure what to do or where to turn.

What I’ve found is that dealing more effectively with inflexible and explosive behavior requires, first and foremost, a new understanding of what these children are about. Once parents have a better sense about why these children behave as they do, strategies for helping things improve become clearer. In some instances, helping parents achieve a more accurate understanding of their child’s difficulties can, by itself, lead to improvements in parent-child interactions, even before formal strategies are tried. The first chapters of this book are devoted to helping you think about why these children adapt so poorly to changes and requests, are so easily frustrated, and explode so quickly and so often. At the same time, you’ll read about why popular strategies for dealing with difficult children may be less effective than expected. In later chapters, you’ll read about alternative strategies that have been helpful to many of the children and families with whom I’ve worked over the years.

If you are the parent of an inflexible-explosive child, this book may restore some sanity and optimism to your family and help you feel that you can actually handle your child’s difficulties confidently and competently. If you are a relative, friend, teacher, or therapist, this book should, at the least, help you understand. There is no panacea. But there is hope.

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