Walking on Eggshells : Oppositional Children and Mental Health

Jaw-clenching frustration. Hand-wringing impatience. Lump-in-your-throat anger, and nights spent tossing and turning. Despite the common joys of parenthood, every mother or father knows the downside that children can bring: there’s a certain lack of control that comes with raising a human being full of their own thoughts, desires, and ideas. But while a certain amount of oppositional behavior is normal in all children, there comes a point when it crosses into the realm of a mental disorder. The scary part? If left untreated, it can affect your child for the rest of his or her life.

According to the American Academy of Child and Adolescent Psychiatry, Oppositional Defiant Disorder (ODD) is characterized by an ongoing pattern of “uncooperative, defiant, and hostile behavior toward authority figures that seriously interferes with a youngster’s day-to-day functioning.” While such a definition may seem broad — and it is, according to many mental health professionals — a certain number of symptoms are normally present in children with ODD. Among these are:

—frequent temper tantrums

—excessive arguing with adults

—active defiance and refusal to comply with adult requests and rules

—deliberate attempts to annoy or upset people

—frequently blaming others for mistakes or misbehavior

—often being touchy or easily annoyed by others

—frequent anger and resentment

—mean and hateful talking when upset

—often seeking revenge

Sound like common behaviors for the average adolescent child or teenager? They are. The difference between children with ODD and their peers is that uncooperative and hostile behaviors are so frequent and consistent in ODD children that they stand out from children at the same developmental and/or age level. According to Dr. Eileen Kennedy-Moore, psychologist and author of The Unwritten Rules of Friendship: Simple Strategies to Help Your Child Make Friends, adolescents with ODD are noticeable for a number of reasons.

“Many children and teens show these behaviors occasionally, especially if they are tired or stressed,” says Dr. Kennedy-Moore. “Adolescents with ODD, however, show at least four of these behaviors for a period of six months or longer. It’s definitely noticeable — especially at home or in a school setting.”

While many parents attribute the constant conflict to standard adolescent behavior, experts warn that untreated ODD can lead to serious conduct disorders in late-adolescent and adult life. Unfortunately, children with ODD suffer most with their lack of relationship skills. It’s not only adults that ODD children struggle with; oftentimes it’s also their peers.

“Children with ODD tend to be stuck in a rut, where relationships are about power, and trying to control others through negative behavior is standard,” says Dr. Kennedy-Moore. “ODD behavior tends to elicit angry, resentful, and withdrawn responses from others — including a child’s peers at school.”

Unlike many mental health conditions, there is no specific cure for ODD. Professionals such as Dr. Kennedy-Moore, however, point to the fact that many children with ODD have related conditions which affect the strength of their oppositional behaviors. Examples include ADHD, learning disabilities, depression, and bipolar disorder. For that reason, treatment normally involves a multi-dimensional approach. The National Institutes of Health, for example, recommends individual psychotherapy, behavioral management training for parents, and medication if other conditions exist. Generally speaking, parents who suspect that their child might have ODD are encouraged to follow the guidelines listed below:

—Enlist your child in counseling sessions, preferably with a specialist in child psychology

—Attend training sessions with a professional who specializes in behavior management

—Avoid power struggles with your child, preferably by setting clear limits and rules — any amount of “gray area” will likely be exploited by a child with ODD

—Schedule time for non-demanding, peaceful family activities

—Communicate with your child’s teachers and the parents of your child’s friends — inform them of the strategies and goals you’re working on

Consistency is key in dealing with a child who has ODD, as is the control of emotions. Do not meet anger with anger as this only escalates negative reactions from a child. Most of all, it’s important for parents to take care of themselves — scheduling weekly outings with a friend or spouse, engaging in hobbies, or simply requesting periods of “alone time” away from other family members. With the correct approach and the right amount of help, life with an oppositional-defiant child can be manageable.