Wednesday, October 1, 2008

Anger Management and the Adolescent Child

Synopsis;
This article is about Jack, a high school freshman who was adopted after years in the foster care system. At 15, he and his adopted family are concerned with his inability to control his temper. Using hypnotic intervention, I was able to assist Jack in understanding why he had problems with the control of his anger. We uncovered that rejection was the cause and that the inability to control anger is very common with the adopted child. I also discovered my frustration, with how many people failed to do what was right for Jack.

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Anger Management and the Adolescent Child

The phone call from Jack’s mother started the same as many others had. A mother, concerned about her adolescent son and his inability to handle anger. “My son has anger management issues”, Diane started the conversation with the anxiety, fear and helplessness many mothers of adolescent children have. After talking with her for ten or fifteen minutes, I felt that hypnotherapy could help. I told her that anger management goes with pre-teens as peanut butter goes with jelly. She laughed but after hearing the stories of his overreaction to minor social frustrations, I sensed that there may be more to Jack’s anger management issues than that of a typical High School freshman. We scheduled our first session on Monday, January 7, 2008 at 5:30.

When I meet a new client, our initial conversation is very important; it sets the parameters and gives me the information I need to design the specific hypnotic process that would be the most effective. This initial conversation gives me insight into the cause of the issues that the person has and allows the person to address any concerns they may have. These concerns can include if they can be hypnotized, if hypnosis can help, can I as the hypnotist have the skills necessary to help, etc. Although we spoke on the phone, I did not know any specific information about the problems Jack was having, except that it pertained to his inability to control his temper. I knew that I must find what was causing his excess anger, in order to minimize, eliminate or assist him in controlling it. I say “excess” anger, because as I would later discuss with Jack, there is nothing wrong with anger; it is a necessary part of our psychological makeup, which is actually necessary if we are to survive in this culture. Problems arise when the anger becomes excessive. When a child overreacts with uncontrollable anger, the results can be obviously devastating to those around him and to the child himself. This is where the use of hypnosis can be so beneficial.

“How does this anger manifest itself?” I asked, looking at Diane. She proceeded to tell me how Jack had a problem in school with some of his fellow students. I asked Jack, who was sitting patiently and quietly, to join our “adult” conversation. As our discussion got into more detail, I learned how he reacted to his perceptions of being rejected, which seemed to be a exceptionally sore spot for Jack. In my mind, I decided to explore why rejection was so painful for him.“Does Jack see a counselor, therapist or school psychologist?” I asked, curious if Diane had tried traditional therapeutic intervention. Her response made me even more comfortable with her decision to see if hypnosis could help. “The psychologists I have sent him to have not worked and he is getting worse, not even a little better. He seemed angrier with this therapist. That’s why I wanted to try you”. She continued to relay the results of Jack’s therapies; saying that talk therapy and drugs did not seem to help and only would make him tired and irritable. As we spoke, Jack was intent on our conversation, quietly listening, occasionally nodding with approval; he did not seem agitated at all.

Jack is a 15-year-old, 5’10”, high school freshman with dark blond hair and bright eyes, which were intently focused on me. I knew that I was being evaluated; was I going to be just another adult social worker, just like all the rest? On the other hand, will I be able to help. I decided to turn the conversation around to Jack and involve him in the discussion, but I did not get the chance.
“Those guys [the therapists] didn’t care about me, the more we talked the madder I got,” he said staring at his feet. “They kept telling me that I shouldn’t let the other kids bother me… That I shouldn’t act this way or that way and the pills they gave me just made me tired…” He continued explaining how the past therapeutic methods were useless. I realized that both mother and child agreed that there was a critical need for intervention but had not found the right one…yet.

I was impressed with the mature and rational way Jack was discussing thedifficulty he had controlling his anger. One question puzzeled me… As we spoke, it was obvious that Jack had two supportive and loving parents. I learned that there were issues with his father, but nothing that was abnormally intense. They were the typical altercations between a father and his adolescent son. I asked Diane when she had noticed that the anger issue had started. I wanted to determine if the problems causing his anger might have been formed in his youth, from a repressed traumatic experience that was manifesting now. Yet I also felt that he was too young to have such repressed memories. Diane answered my question as to when the anger issues started…

“He’s adopted… and when he…” She was speaking but I stopped hearing as soon as I heard the word “adopted” that word made many flags go up and I instantly knew the direction I needed to go with Jack. I asked Diane to wait as I began to write down notes to myself as to the questions I wanted to have answered. I asked Diane to start from the beginning… his birth.
Diane told me Jack’s history. His birth mother gave him up for adoption when he was three years old. Jack told me she walked him up to his first of many foster homes, rang the doorbell, turned and walked away. Jack never saw her again and the last memory he has of his birth mother, was of her back as she left him with complete strangers. He was in foster care for 4 years. Jack would relay to me that he was shuffled around for those 4 years (which we call his “formative years”, I would wonder what was forming…perhaps, anger?). He was sent to live with different “nice” families. He told me that he would come home to find his (foster) “sister” had left and he had a new (foster) “brother”. When he was almost 7 years old, having spent 4 years in foster care, he was about to be adopted! He was elated! A family was going to adopt him! However, his new mother after a few months, informed the adoption agency, that she couldn’t “bond” with this little boy and he was sent back to foster care.

Within a year, another couple, looking to adopt, was again considering him. Diane and Joe finally adopted Jack. At 7 years old, he was finally adopted by the loving family he is with now. Now, eight years later, I am sitting with Jack and his mom, trying to find out why he has anger management issues. I thought that I would be much more surprised if he did not have anger management issues.

In the past 5 years, I've had three other clients who had children with anger management issues and all three children had been adopted. Unfortunately, I found that trying to work with adopted children with anger management issues could be a bumpy and frustrating two-way street. Two of the three did not respond well to hypnosis, while one young man was adopted at birth and was younger that Jack. His anger management issues were not related to adoption and were merely coincidental (even though I do not believe in coincidence). The two other adopted children had almost the same backgrounds as Jack and I was apprehensive that we might have similarly negative results. In both previous cases, the young men who were adopted in their early teens were so used to trying to manipulate their life situations, that they could or would not allow themselves to be hypnotized.

They feigned being hypnotized, which I was easily able to observe and after a few sessions, I told their parents that although I would be more than happy to continue working with their sons, the boys were not willing to allow themselves to be hypnotized. Although the boys protested and claimed that, they were hypnotized, I explained to their parents that I felt that they had become so self-protective, that they could not give up their perceived control. I suggested that hypnosis could be an effective method for rapid change, but that they initially needed a professional, licensed therapist for long-term therapy.

Now I had in a very similar situation. An adopted boy with anger management issues, with a very disturbing childhood. The comparison between Jack and the two other boys was obvious and I was not very optimistic that the results would be different. I would learn that the expression “third time’s a charm” has a certain amount of truth to it. There were many similarities between these three children and a few huge differences. Jack really wanted to control his anger. He was not being forced to come to me because his parents wanted him to control himself; he wanted to control his anger. He was sincere, involved, concerned and very involved in the process. He did not use a façade to feign hypnosis while trying to manipulate his environment as the other boys did.

After we had discussed the issue that instigated his bouts of uncontrolled anger, I knew what the common factor was. In retrospect, it was so obvious, but it was only obvious to me. I was not a family member who was so very involved with Jack’s well being, I was an impartial, rational and totally objective hypnotherapist. The common factor that initiated all Jack’s bouts of uncontrollable anger was rejection.

The normal pressures on adolescents are intense. These pressures contribute to rage in even the most well balanced child that comes from a nurturing family life. Mix the pressures of adolescence with the life experiences that Jack has had and when he is rejected in any way, by anyone; whether the rejection is actual or only in his perception… Jack explodes. After Jack, Diane and I spoke a little longer, I felt that I had enough information and I wanted to try hypnosis. I was still concerned that Jack, as the two prior adopted boys, would not allow himself to be hypnotized. Jack was very interested and involved and my concerns began to diminish and very soon would be completely gone.

Jack said he would be more comfortable if his mother were not in the room. Diane and I agreed, but I did tell Jack that the door to the hypnosis room would have to be open. As he settled into the recliner, I knew I needed to begin with addressing the subject of rejection.
“I know that what I am about to say may hurt,” I began, “but realize that I am not saying it to hurt, I am saying it to bring it up so you are aware of the problem…” I looked at him and said, “So take a deep breath, I don’t want you to comment right away, I want you to first think about what I’m about to say and then I’d like you to tell me what you are feeling… OK?… ready?”… Jack nodded and I said,
“When it comes to rejection, there is no one that knows more about it than you.” He took a breath, not really knowing how to react. I described to him what I thought he was feeling. I described feelings ranging from anger to sadness to hopelessness, he agreed with my observations. We began a long discussion on what he felt was the shortcomings of his past therapies. We were beginning to be comfortable with each other and I felt he was willing to try hypnosis. He was now able to trust me, which was a huge leap of faith on his part, considering his past; I was surprised he could trust anyone. After the first attempt to go into hypnosis met with a small amount of resistance, which is normal with boys his age and to my elated surprise on the second attempt he went relatively deeply into hypnosis.

He became a great hypnotic subject, not only going into hypnosis easily and deeply, he was looking forward to our sessions. This is not usually a big deal, but in Jack’s experiences with therapies, which only made him angrier, the fact that he actually wanted to return for additional sessions, demonstrated to me that the direction I was heading was the correct one. While hypnotized, Jack began to open up and understand his feelings about rejection. He was now, remembering his rejection in a different way. In the past, his memories of his rejection were unemotional, detaching from emotions was the way he was able to cope with the excruciating pain of rejection. However, when he was rejected, the energy needed to keep is anger in check was not enough; the result was an explosion of anger. He was also now allowing the emotions associated with those memories to be accessed.

He was able to accept that he had every right in the world to be as angry as he wanted. He started down a new path, one in which he could accept himself for who he is. As I worked with Jack, he began to accept, along with a better understanding of the cause of his anger, that he had no responsibilities for his situation and the frequency and severity of his bouts of anger began to decrease noticeably. I am optimistic about his ability to control his anger. I had been concerned that he wouldn’t allow himself to go into hypnosis. Now he is an excellent hypnotic subject.

In the past my experiences with adoptive children were not successful, now with Jack, I relished his success. The other children in his situation were not willing to be hurt again and thus, would not allow themselves to trust anyone, stagnating their personal health, development and growth. Jack had learned a wonderful life’s lesson; that he can allow himself to trust again.

I noticed a surprising amount of anger in the room, but it wasn’t coming from Jack. I realized that I was very angry! My anger was a general anger not directed at any one in particular. I was incensed that this sensitive child had been dealt a very raw deal, which was wrong in so many ways that I could not even start to list. How many people failed to do what was right for Jack?

Was it, his birth parents?
Yes, of course, if they were a loving average couple, I would not be writing this; Jack would be just the average kid with the average kid-type problems, in the average school, blissfully unaware that his average life could have been much, much different.

Was it the foster care system?
Somewhat, an overburdened system being run by overworked, underpaid, hopefully good meaning bureaucrats. It would be hard to point a finger at people who are working under the difficult conditions that they are. I suppose we could point a finger at politicians, but that would be too easy and would be futile.

Was it the adoption agency?
Sure, an organization that is making a profit from the desire of couples who cannot have a child and want to adopt, along with a child who has no one and wants to simply to be in a family that loves, respects and wants him.

Or was it his first adoptive family?
Let us look at the preceding sentence, “His First adoptive family”. Was Jack a puppy that was too much trouble to bother to “housebreak”? What could they have possibly be thinking? How could a couple who want to adopt a child, make the colossal decision to adopt that child only to “change their mind” and send the child back to the agency? How could anyone be that cold as to raise the hope of a child and then send this young boy back to the shelter as if he had no feelings or any rights?

The strange thing is that although they were at perhaps the top of the list of whom to blame for Jack’s anger management issues, they may have done him the largest of favors. For if he had stayed with these people who were so insensitive that they would have sent him away, Jack would never have met Diane and Joe, the wonderfully loving parents that he fortunately has now.

I am thankful to have met Jack and his family and hopeful that the difficult childhood that Jack has had, will no longer negatively affect his future. It had been a few weeks since our last session and I was curious as to how Jack was doing. I called and spoke with Diane who said that Jack is doing much better; he had an incident, which had caused him to be angry, but he controlled it well. I mentioned that we all get angry, it is part of life, but it is the method we use to control that anger which is so critical. When Jack had that recent angry incident, Diane had asked him if he wanted to make an appointment to see me. He said that he felt confident that he could handle it himself.

His response reminded me of the old addage about the fisherman and the fish. “Give a man a fish you feed him for a day, teach him how to fish and you feed him for a lifetime”. After we spoke, I felt quite confident in Jack’s ability to handle his anger and I felt privileged to be the person to give Jack his “fishing pole”.