Ask the Doctor - Answers to your Parenting Questions

Dear Karen,
I can see why you're worried about your son's hurting himself.   Your son is still very little. He doesn’t have the verbal capacity to express himself very well. He has big feelings and wants whatever he wants at that moment with great passion. It will take him years to learn to manage his emotions; right now they overwhelm him and he can’t help himself: he explodes with frustration, hitting and tantrumming. We all know what that feels like – in fact, most of us have had the experience of bursting out yelling even as adults!

I wonder what you mean when you say that you “try not to react to his tantrums". You certainly don’t want to give in to whatever caused the tantrum, or he will think that’s the way to get what he wants. But there is a myth that parents should ignore tantrums. Research has shown that strategy is misguided; it just causes the child to tantrum more frequently. If you think about it, this makes sense.  He's tantrumming because he has such big feelings and no other way to express them. If you ignore him, he is doubly frustrated because not only is he frustrated, now he has also lost his connection with you. If he felt that you understood what he was feeling, he might not need to act his feelings out so graphically.

Of course, he will sometimes need to resort to tantrums to blow off stress, and that is fine. Toddlers just need to cry sometimes. Tantrums are nature's way of letting off frustration. If you can stay close to him and reassure him, and comfort him afterwards, it will help him enormously. What he really needs at those times is your attention and love, which helps heal that hurting place inside him. (And no, it won’t make him tantrum more, as long as he is also getting plenty of your attention when he isn’t tantrumming. If a little one has to resort to tantrumming for attention, then he is clearly sending an SOS that he isn't getting enough attention.) You will be amazed at how much his behavior improves once he’s had a good cry with you as a compassionate witness.

So let’s get to your questions: what can you do to stop your son from hitting you, and to stop him from hurting himself when he tantrums?

Reducing or eliminating this behavior requires us to work on five fronts at once:
1. Give him more internal resources to handle frustration.
2. Reduce the amount of frustration he has to handle.
3. Help him develop EQ, or emotional intelligence, which is the ability to manage his emotions.
4. Give him alternate means of expressing his frustration.
5. Teach him how to relate lovingly to other people.

Let’s take each of these in turn.

1. Give him more internal resources to bear more frustration.

You’ve probably noticed that his behavior is worse when he’s tired or hungry. Feeding him before he’s starving, and putting him to bed before he’s tired, are the most effective ways to avoid tantrums. But kids have another basic need that we often overlook: connection. When they don’t feel connected enough to us, they get stressed and can’t tap into their own internal strength. So if you see him getting a little cranky, offer a hug, or some cozy time on the couch with a book, to re-fuel him.

2. Reduce the amount of frustration.

Toddlers find the world an exciting but frustrating place. Parents order them around. Towers fall down. Other kids take their toys. They can’t manage so many things they want to do themselves. As he becomes better able to express himself verbally he will be able to blow off steam by putting his feelings into words. But over the next six months or so, you can help him by reducing the things that frustrate him to a level he can manage more easily.

How? Give as many choices as you can, so he doesn't feel pushed around. Try to say yes rather than no whenever possible. When you do need to set limits, do it empathically so he has your help in dealing with his upset about the limit you’ve set. That doesn’t mean you have to agree with him, or that you stop setting limits. It means you acknowledge his feelings and offer empathy. “You wish you could have that candy. It’s almost dinner time, so no candy. I know that makes you sad. You can have some carrots if you’re hungry, and I can give you a hug to make you feel better. We can snuggle on the couch and read your book. I see you’re too sad and mad to read right now, you want that candy so much you’re crying. It’s hard to be so sad and mad. When you’re ready I’ll hold you and give you a big hug.

Remember also that anger is always a response to disappointment, hurt or fear. Your little guy gets frightened by many things in the course of a day. The more you can recognize those incidents and empathize, the less he will need to act them out with tough guy attacks on you later in the day. Your morning might be peppered by comments like “Oh, you couldn’t find me? I was in the bathroom. I’m so sorry I scared you. You don’t have to worry. Mommy always comes back. Or “Wow, that barking dog is scary! Don’t worry, I will always keep you safe. Remember also that TV is full of scenes that scare little ones. The American Academy of Pediatrics recommends that kids younger than two years not watch any TV at all, partly for this reason.

3. Help him develop EQ, or emotional intelligence, which is the ability to manage his emotions.

Parents lay the foundation of emotional intelligence by empathizing with their child’s feelings, as described above. Simply put his emotions into words so that he knows you understand. He may or may not be able to express himself in words yet, but he will certainly understand your words and tone. Not only does offering him empathy teach him a language that helps him learn to understand and manage his emotions, it also reduces his frustration: “You worked so hard on that tower, and then it fell down. That is so hard. Of course you're mad. Research has shown that many tantrums can be nipped in the bud by simply getting on the toddler’s level and saying emphatically “You are mad! You are showing me just how mad you are!

We can also hasten the development of EQ by giving our child words and explanations as we move through daily life: “Henry is mad because he wants the ball." ... "The baby is so sad. Do you think she wants someone to hold her?"

4. Give him alternate means of expressing his frustration. Many moms find that when they stop their little one hitting them, he instead begins to head bang or hit himself. What he needs is an alternate way to let those feelings out. You could say “People are not for hitting. You are so mad. Show me how mad you are on this pillow. Or, when he’s feeling good, say “Let’s make mad faces. Then you can show me when you’re mad. Or offer him a squeeze ball and tell him to fill it up with his mad feelings. Or teach him to take a “calming" breath when he’s frustrated (breathe in deeply through the nose, hold it a moment, and let it out very slowly through a small hole in your lips). Later, when he starts to lose it, you can hand him the squeeze ball or pillow, or say: “Wow, are you mad. Show me how mad you are with your mad face. The trick with all of these things is to teach him while he’s feeling good, then remind him when he's upset. You’ll be amazed when you see him try one of these techniques when he’s under stress.

5. Teach him how to relate lovingly and respectfully to other people.

Obviously, kids learn this lesson mostly from their interactions with us. If we are reliably loving and respectful with them, that becomes their mode of behavior. This is why hitting our kids when they hit backfires. It is also why timeouts, which rely on our greater size, won’t work with many kids, and stop working as soon the child is big enough to physically challenge us. As you can see, I am not a fan of time outs. They're infinitely better than hitting a child, but they set up power struggles.  They cause behavior like you are seeing with your son, where he gets angry and lashes out, hurting himself and others.

And if you have been doing them for two months and he is still hitting, it doesn't sound like the timeout strategy is very effective in eliminating your son's hitting behavior.  I strongly advise you to stop using timeouts and begin using positive discipline techniques instead. Click here for more info on why timeouts don’t work.

So should you just let your child hit you? Absolutely not. That doesn’t teach him about loving relationships. In fact, it undermines your closeness to him.

Your child does not want to attack you. When he hits you he is crying out for connection. The best way to stop his hitting is to reconnect, which is why the most common recommendation to eliminate hitting is to get down on your son’s level so you make eye contact, and hold his hands while you say calmly “No hitting. Hitting hurts. We keep our hands on our own bodies. The key to this is to be very serious and really make contact with your child. If he is angry, say “You are very mad, but we don’t hit. Here, show me how mad you are with this pillow.

However, often this approach doesn’t work -- as it sounds like it is not working with your son -- because logic can’t heal the disconnection that our child is feeling from us at that moment. Sometimes kids respond by laughing, or continue hitting, in which case he is testing you, pushing you to reconnect with him. But his aggression will melt away if you can move close and take him lovingly in your arms, saying warmly “Hitting hurts Mommy. You must be very upset to hit me. I know you feel bad right now. I will keep things safe. You need a hug from your mom who loves you."

He may well go limp in your arms at that point and cry.  If so, that is exactly what he needed.  Remember that anger is always a defense against hurt, sadness or fear.  If your son has been storing up those "yucky" feelings all day, the only safe way to express them is with the person he he feels safest with.  So he hits.  When you don't let him hit you but you also stay loving with him, the anger vanishes and the hurt, sadness and fear are released, which is what he needs.

What if he struggles? Hold him securely so he can’t hit you, and say "Mommy will keep everyone safe. It's ok to cry. Mommy's right here. Mommy loves you."  Let him move into an expression of all those feelings he's built up that led to his hitting you, which means he will begin to cry. Again, he may well melt into your arms and just sob at this point, and your job is just to let him sob as long as he needs to, offering him a compassionate safe haven.

If he keeps struggling, and is too big to hold without your getting hurt, put him down on the rug and stay with him, with a hand on him if at all possible. Don't let him hurt you, but keep him enveloped in your love, and keep talking while he tantrums: “You are so sad and mad. Right now you just need to cry. It’s okay, everybody needs to cry sometimes. I am right here. I love you very much and whenever you are ready I will hold you."

If he yells "Go away!" then take a step back and say "I am moving back, away.  But I am right here if you need me.  I won't leave you alone with all these upset feelings."

Don’t lecture or try to reason with him while he’s in the throes of emotion. Just let him cry and struggle, which will let off all the tension he’s feeling, especially with your loving presence to help him feel safer.

Most parents find this challenging at first. It is hard to just be a compassionate witness for someone else's pain, particularly our child's. How to stay calm yourself? Use the same loving, nurturing tone to remind yourself that everyone needs to cry sometimes and you are giving your child a priceless gift: the loving acceptance of the full range of his feelings, and an opportunity to heal all that yucky emotional stuff he's unloading.

When he’s done, he will want to be close to you and reassured of your love. But – full circle to where we began – by giving him this safe space to express himself you will find that his tantrums lessen in severity so that he doesn’t need to hurt you, or himself. And you’ll find that your relationship with him will deepen. In fact, as much as this attentive parenting is a gift to your son, it is even more of a gift to yourself, because your son will become much more cooperative, not just during the "terrible twos", but throughout his childhood.

Good luck, and enjoy your little guy. He'll be through this phase and in kindergarten before you know it!
Dr. Laura