A Mother at Wit's End About Son's Tirades

Q.Sometimes my son has fits of intense anger, which can include physical violence, but usually he just slams doors, stomps around and throws and breaks his siblings' things.

At other times, however, he says, "I want to burn down the house" or "I want to kill you," and this worries me a lot. Although he's never acted on these ideas, I'm afraid of what he'll do when he's a teenager. I don't want to end up as a headline in the news.

My husband and I tell him repeatedly that he is in charge of his own anger, but he blames it on others instead and says things like, "You're making me mad."

Although he usually reacts in anger, I feel a huge sense of relief when he doesn't, and I always praise him for it. I also try to ignore the bad behavior and reinforce the good and to deal with him in a calm manner, but it's hard to quench my own anger when he gets so mad at me.

We have also used the "1-2-3 Magic" discipline system as well as a money jar -- I add money when he's had a good day and take it out when he's had an angry fit -- and I've given him timeouts in his room, too. These techniques usually work for a short time, but then he gets totally out of control again, and I can't even talk to him about it. This makes me wonder if his problem could have a physiological basis, as well as an emotional one.

Should I take him to a therapist to find out why he acts this way and how to manage his anger better? And if so, what kind of therapist would be best?

A.Your son should get help as soon as possible, but make sure that it is the right sort of help.

If his explosions had just started, you might suspect abuse or some unknown trauma and then you'd let your son talk it out with a psychologist or a clinical social worker. Or if his siblings had angry outbursts, too, you'd put everyone into family therapy, go to parenting classes with your husband and maybe get some marriage counseling as well, since children often misbehave when their parents are unhappy.

However, you son's angry episodes have apparently gone on for a long time and your other children seem to behave pretty well, so maybe he does have a physiological problem. In that case, he needs to see a physician. Try to find one who is both a psychiatrist and a neurologist, if you can, and young enough to have learned the latest theories in med school, seasoned enough to know that textbooks don't have all the answers, curious enough to consider new possibilities, humble enough to listen to your ideas and empathetic enough to relate to your child.

This therapist will counsel your son, of course, but he will probably make him get a full medical work-up -- including a test for hypoglycemia -- as well as allergy tests, and he may put him on the Feingold diet, a gluten-free diet or some other regimen for a few weeks to see if his behavior improves.

If it doesn't, he may order an MRI to make sure that your son didn't have a head injury long ago, which could be affecting his behavior today, and he also may order special blood and urine tests to look for other causes, including an inability to absorb a particular vitamin or mineral or the amino acids and essential fatty acids he needs. A preliminary study, published in 1997 by Psychology and Behavior, tested 135 assaultive males between 3 and 20 and found that most if not all of them had a shortage of zinc in their blood, which made their copper get too high. If that turns out to be your son's problem, the doctor might have him take zinc supplements and other nutrients since this treatment lowered the copper and made the violence of angry children disappear in four subsequent studies.

You'll find an abbreviated account of the first study, and other published studies, in Crime Times, a fine, free newsletter that reports on the physiological problems that can cause abnormal behavior in adults and children. To read more of these fascinating reports, go to its archived material at http://www.crimetimes.org.

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