A new Approach for Understanding and Parenting Easily Frustrated

Therapist: George, I understand you got pretty 
frustrated at soccer the other day. 
George: Yep. 
Therapist: What happened? 
George: The coach took me out of the game, and I 
didn’t want to come out. 
Therapist: I understand you told him you were very 
mad. 
George: Yep. 
Therapist: I think it’s probably good that you told him. 
What did you do next? 
George: He wouldn’t put me back in, so I kicked him. 
Therapist: You kicked the coach? 
George: Yep. 
Therapist: What happened next? 
George: He kicked me off the team. 
Therapist: I’m sorry to hear that. 
George: I didn’t even kick him that hard. 
Therapist: I guess it wasn’t important how hard you 
kicked him. I’m just wondering if you can think of 
something else you could have done when you 
were mad besides kick the coach. 
George: Well, I didn’t think of anything else then. 

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Pathways and Triggers 
35 
Therapist: Can you think of anything else now? 
George: I could have asked him when he was going 
to put me back in. 
Therapist: That probably would have been better 
than kicking him, yes? 
George: Yes. 
Therapist: How come you couldn’t think of anything 
besides kicking him when you were at the 
soccer game? 
George: I don’t know. 
Can children be taught to use a basic feeling vocabu-
lary? To articulate their needs and frustrations more ef-
fectively? To access the more adaptive solutions that are 
stored in their brains more readily? Of course. But not 
with a reward and punishment program. 
EMOTION REGULATION SKILLS 
Most children (like the rest of us) are a little irritable, ag-
itated, grumpy, cranky, grouchy, and fatigued some of the 
time. At these times, children (like the rest of us) tend to 
be less flexible and more easily frustrated. If they’re 
lucky, the irritable mood is relatively short-lived and they 
return fairly quickly to their relatively happy baseline. 
But there are some children who are in an irritable, agi-

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36 
The Explosive Child 
tated, cranky, fatigued mood a whole lot more often than 
others, and they experience these feelings a whole lot 
more intensely. These kids’ capacities for frustration tol-
erance and flexibility are compromised much more 
often, and as a result, they may fail to acquire develop-
mentally appropriate skills for handling demands for 
flexibility and frustration tolerance. 
Are these children depressed? Some mental health 
professionals reserve the term depression for children 
who are routinely blue, morose, sad, and hopeless, which 
actually tends not to be the case for many irritable ex-
plosive children. Do these children have bipolar disor-
der? Over the past five years or so, there has developed a 
troubling tendency for some mental health professionals 
to equate “explosive” and “bipolar,” to interpret irritabil-
ity as a purely biological entity, and to believe that a poor 
response to stimulant medication or antidepressants cer-
tifies a child as bipolar. This probably helps explain both 
the increased rates at which bipolar disorder is being diag-
nosed in children and the popularity of mood-stabilizing 
and atypical antipsychotic medications. 
As you now know, there are many factors that could 
set the stage for a child to be explosive; irritability is only 
one. And there are many factors that could set the stage 
for a child to be irritable; brain chemistry is only one. 
Some children are irritable because of chronic problems— 
school failure, poor peer relations, being bullied—that 
have never been solved. Medicine doesn’t fix school fail-

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Pathways and Triggers 
37 
ure, poor peer relations, or being bullied. There are many 
“bipolar” children whose explosiveness is far better ex-
plained by lagging cognitive skills and whose difficulties 
are therefore not well addressed by the multiple mood-
stabilizing medications they have been prescribed. If the 
only time a child looks as if he has bipolar disorder is 
when he’s frustrated, that’s not bipolar disorder; that’s a 
learning disability in the domains of flexibility and frus-
tration tolerance. 
What’s crystal clear is that the explosiveness of many 
children is being fueled by a fairly chronic state of irri-
tability and agitation that makes it hard for them to re-
spond to life’s routine frustrations in an adaptive, rational 
manner.