A touchy preteen needs a full physical before she gets therapy

August 14, 2012

Q. I have three daughters, 14, 12 and 7, but it’s the middle one that I’m worried about. She has really struggled in middle school because she is so quick to take offense and so slow to forgive.

This child had temper tantrums when she was young, but they stopped around first grade, and I thought she had outgrown them. Not so. She now gets extremely angry over minor things and then she yells, shrieks and causes a scene. If someone bumps into her, she says he did it on purpose. If she can’t find her homework, a sister must have moved it, just to be mean. And if she oversleeps, the radio station was playing the wrong songs or I gave her the wrong kind of clock.

Her teachers liked her last year and she got along reasonably well with her three coaches, but her classmates didn’t like her at all and her teammates avoided her. At first, I thought a clique of mean girls was picking on the new kid, but she had a meltdown during a game and I could hear her shrieking across the field. The ref had made a call against her team — not even against her — and she wouldn’t stop yelling and stomping around. Finally, the coach made her sit on the bench for the rest of the game. Her take on this experience: The referee was being stupid; the coach wouldn’t stick up for himself and everyone picked on her because they were liars and cheats and they hated her. My take: I was shocked and angry, and for better or worse, I let her see that I was disappointed in her behavior and that I had no sympathy for her.

My daughter might not be known as “that weird girl” next year, because she is changing schools in September, but what if she acts like she did last year? My husband thinks that this behavior will blow over, but I’m not so sure. This daughter has always been prickly, and I’m afraid that the hormones of puberty will push her over the edge. I hate to think that my angry teen might turn into a bitter, vindictive adult one day.

How can we help our child the most? Should she see a physician? Or a therapist? 


(Hadley Hooper/ FOR THE WASHINGTON POST)

A. It sounds like she needs to see both, but take her to the pediatrician first and ask him to give her a full workup to find out whether a physical problem could be causing this extreme behavior. If it is, all the talk therapy in the world can’t cure it, any more than it can cure a broken leg.

Even if the pediatrician doesn’t find a physical problem, you should take your daughter to an allergist before seeing a psychotherapist. As more and more studies are proving, people often get angry — or hyperactive, depressed or exhausted — if the mast cells in their central nervous systems have been sensitized to a particular food or an inhalant.

Choose this allergist with care. Even a good one can miss a sensitivity if he gives 20 to 40 tests at once, because the more tests he gives, the weaker the allergens must be. This wizard should also know that the dyes and preservatives in processed foods, as well as the salicylates that are in some fruits and vegetables, can make a child fall apart; that gluten — the protein that’s in wheat and other grains — can upset behavior if she can’t process it and so can the casein that’s in milk, cheese and other dairy products.

If your daughter has one of these common problems, you can probably stabilize her behavior by changing her diet or getting rid of the dust that lives in your house (and mine). This can seem like a daunting job at first, but it’s a whole lot easier to prevent the behavior than to deal with the turmoil and the distress that your daughter is causing now.

Whatever the findings of the pediatrician and the allergist, your daughter will probably need some talk therapy to deal with the messes she’s made and to correct the problems that come with middle school — that time when preteens and young teens are expected to adjust to more physical, mental and emotional changes than they’ve ever faced before and to do it with grace and aplomb.

You can help your daughter deal with these issues better if you wrap her in your arms several times a day — especially when she’s falling apart — and if you say “I love you” to her over and over again. As one wise lady once said, “The unlovable child is the one most in need of love.”

Send questions about parenting to advice@margueritekelly.com.

Read a transcript of a recent live Q&A hosted by Kelly at washingtonpost.com/advice , where you can also find past Family Almanac columns. Her next chat is scheduled for Aug. 23.

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