Help for Oppositional Defiant Disorder

“I hate you, you’re such a bitch, I am too going to wear my red dress! You promised me yesterday, and if I can’t wear it today, I’m not getting ready for school!” Molly had been arguing about the dress for the past forty-five minutes. It was 8:05, mom was running late, and the dress was filthy. That overwhelming exhausted feeling enveloped mom and, once again, she caved. “Go ahead and wear it,” she screamed.

If your youngster has been diagnosed with oppositional defiant disorder (ODD), this scenario may sound much too familiar. According to the Diagnostics and Statistical Manual of Mental Disorders, fourth Ed., oppositional defiant disorder can cause clinical impairment in social, academic, or occupational functioning, and is characterized by a recurrent pattern of negativistic, defiant, disobedient and hostile behavior toward authority figures which persists for a period of at least six months.

Since kids pass through many developmental stages as they mature, it is important to understand the differences between normal childhood attempts to defy authority and symptoms of full-blown oppositional defiant disorder. Nine year-old Molly appears driven to defeat adults, is relentless in her pursuit of proving adults to be wrong, stupid, or both, and her thoughts revolve around defeating anyone’s attempt to exercise authority over her. She typically turns every interaction with adults into win/lose situations and is vigorously intent on winning.

Oppositional defiant kids share many of the following characteristics:
  • The ODD youngster is socially exploitive and very quick to notice how others respond. He then uses these responses to his advantage in family or social environments, or both.
  • These kids tolerate a great deal of negativity – in fact they seem to thrive on large amounts of conflict, anger and negativity from others, and are frequently the winners in escalating battles of negativity.
  • They possess a strong need for control, and will do just about anything to gain power.
  • They typically deny responsibility for their misbehavior and have little insight into how they impact others.

Besides oppositional defiant disorder, kids like Molly may also have another psychiatric disorder. ODD is frequently a co-morbid condition with attention-deficit/hyperactivity disorder. It can also be diagnosed along with Tourette Syndrome, obsessive-compulsive disorder, anxiety and mood disorders, Asperger’s, language-processing impairments, sensory integration deficits, or even nonverbal learning disabilities. What causes this troubling behavior? Some researchers believe that many of the symptoms of these disorders may share common neurobiological mechanisms. If your youngster is affected by one of these disorders, it is critical to keep in mind that ODD can create additional problems for you and your youngster.

Many authorities on parenting have indicated that oppositional behavior is more prevalent when structure in the home is out of balance – when there is either too much structure or not enough. In an overly structured environment the parenting is rigid and inflexible. These moms and dads “micromanage” and come down hard on their kids, controlling every aspect of their lives. This particular style of parenting only serves to create more opposition and defiance. On the other hand, structure that is too loose can also cause difficulties. Kids can exhibit oppositional defiant behavior when moms and dads do not provide enough structure by setting appropriate boundaries, or establishing and following through with consequences for misbehavior. These moms and dads usually give in to all of their youngster’s demands, either out of fear of the youngster, or in an effort to keep themselves in the youngster’s good graces. In order to prevent or reduce oppositional defiant behavior parents should aim towards a firm and loving parenting style in which the structure is balanced. Moms and dads must take charge, and place themselves at the top of the family hierarchy. They must use their authority as parents and, at the same time, make the youngster feel protected, loved and soothed.

How well the parents get along, whether married or divorced, is another factor to consider in preventing oppositional behavior. When couples are unhappy or oppositional in themselves, they frequently disagree on parenting issues, significantly limiting their success in changing the behavior of their youngster. Molly is an expert at dividing her parent’s authority, and will most certainly take advantage of exploiting rifts between her parents. Couples counseling may be in order to decrease the hostility and conflict between parents and set the stage for united, successful parenting.

Another factor to consider is how the family is affected by ODD. This can be one of the most stressful conditions a family faces and, when it is secondary to another neuropsychiatric disorder, that stress is compounded. Family counseling may be helpful to resolve family difficulties. The family therapist can provide a controlled environment which offers support and skills training to weary moms and dads.

Once marital and family issues are addressed, moms and dads can begin to train both themselves and their youngster. If Molly’s mother continues to respond to her quarrelsome behavior as she always has, Molly will continue to tune her out, escalate the arguments, and push mom’s buttons. Most adults engage in an argument with concern for the outcome. The adult’s goal in an argument is to come to a resolution. In other words, what transpires as a result of the conflict is most important. As a parent, from your perspective, if you have determined the outcome of the argument, you are the one in control. For the oppositional youngster the process of creating an argument is more meaningful to her than the outcome of the conflict. These arguments over insignificant issues may seem pointless however, with such a strong need for control, it is your oppositional youngster’s goal is to escalate the conflict until you are no longer the one in control. What is important to her is not the issue being argued over, as much as what is going to happen during the argument.

In order to control the process of the argument the oppositional defiant youngster attempts to determine the topic and direction of the conflict, and seems to instinctively know when you are feeling most vulnerable and your energy is low. She will bring up conflict-laden issues during these times, aiming towards pushing your buttons and diverting you from issues in which you are likely to be attempting to exert your authority over her. When your ODD youngster finally pushes your buttons, in her mind, she has gained control of you and your emotions. At this point she has now successfully taken over your position of authority. Furthermore, when you lose control of your emotions, your youngster’s anxiety level rises along with her defensiveness. When her defenses increase she becomes more oppositional which is her main defense mechanism. As she becomes more oppositional, the situation escalates and we are caught in an endless cycle of conflict.

Strategies for avoiding conflict are essential to de-escalate the situation. It is wise to change the subject if your energy is low, or you suspect that the topic of discussion will result in an argument. Walking away from the conflict is another strategy to consider. If you cannot change the subject, or walk away it is important to keep in mind that the ODD youngster’s goal is to push your buttons. Think about your endurance, how long can you endure really oppositional button pushing? When you get to the end of your rope, what are your options? It is critical not to take what your youngster says personally. As soon as you defend yourself, your youngster, by the rules governing arguments, has the right to defend himself against your attack. In turn, you get to defend yourself, and he has now pushed your buttons and gained power. You do not have to defend yourself or try to convince him you are right. Do not lower yourself to the level of your oppositional youngster.

There are two options available for preventing him from drawing you in. Tell him, in an unruffled rational manner, that he has two choices. If he wants to stay around, he can change the subject and stop complaining; or he can go somewhere else in the house to complain if he chooses. Should your youngster choose to escalate, it is time to use two powerful words which can cut through any argument. These words are “regardless” and “nevertheless”. For example, “nevertheless, this is how it is going to be…” Using these words repetitively (like a broken record), in a calm unemotional manner will serve to de-escalate the situation without allowing your youngster to draw you into the power struggle.

Utilizing effective consequences for the oppositional youngster can be difficult since this presents one more opportunity for conflict in which you are likely to lose power. Discussing consequences while you are in the midst of their negative behavior will most likely result in more frustration for you. Therefore, it is critical to focus on consequences that do not require cooperation of the youngster. Rules and consequences must be clear, and in writing to provide clarity for both youngster and parent before the conflict occurs. Begin by removing reinforcers and allowing your youngster to earn the items back as a reward for acceptable behavior. Reinforcers include items such as television, stereos, CD’s computers, video games, telephones, bicycles, skateboards, visiting friends, access to favorite clothing, favorite foods, etc.

Once you have successfully avoided having your buttons pushed and gained some control over your youngster’s behavior, it is time to go on the offensive to soothe her, and help her get back to an even place. Oppositional kids do not like being soothed by their caretakers. This places them back into the role of being a youngster, and puts you back into the role as the parent. One of the driving forces behind ODD is that, for whatever reasons, a youngster is trying to grow up too quickly, and considers herself to be equal to her parents. The ODD youngster may feel less loved due to the amount of conflict going on, and it is difficult to simultaneously feel loved as a youngster and try to operate on an adult level. Your youngster may know intellectually that she is loved, but not feel loved. Moms and dads must be able to show love, and soothe and nurture their youngster. This is not always easy to accomplish, especially when previous negative behavior patterns have become ingrained.

Kids look to their moms and dads for a sense of security, belonging and identity. As our society becomes more complex, the need for our kids to develop a clear set of values is critical. Current research also has indicated that boys with ADHD and increased oppositional behavior are at greater risk for later antisocial behavior. With this in mind, the need for structure becomes particularly relevant in today’s world. It is apparent that kids affected by a variety of neuropsychiatric disorders are at greater risk for oppositional behavior. Since this behavior will create additional difficulties for them as they pass through the various developmental stages, it becomes even more important to use the authority vested in us as moms and dads to establish consistent limits and consequences, and to distinguish boundaries within the family. This will form a family unit characterized by established guidelines, affording kids a secure backdrop in which they can grow and thrive.

==> Effective Disciplinary Techniques for Defiant Teens and Preteens

Teenage daughter runs away from consequences...

Hi Mark,

We bought my out of control teen for our problem teen, H___ aged 16 (with undiagnosed emotional problems) and have found the tools very helpful, however we are at a loss to know how to deal with her runaway episodes which she does when she receives a consequence.

She ran away late one night in bare feet and walked all the way to her dad's house 7& 1/2 kms away, (he was convicted with 18 charges of violence against me) she hadn't seen him for 10 years...and it turned out to be a bad experience...then went and stayed at a friend’s. As she told us she wasn't coming home but was planning to move out which she can legally do at the age of 16, which she is now. I just told her how her choice to move out would affect her...we wouldn't support her financially...she would have to arrange all that herself and stayed in constant contact with her.

We have contacted the police and they have said unless she is considered at risk (ie mental health issues which she does have) they do not have the power to go and bring her home.

I managed to persuade her through much carefully thinking and talking to come home and return to school which she wanted to drop out of. She did work experience during the holidays that I took her to and now school has started she became very wound up and yelled at and gave me mouth for half an hour when she was reminded of a job she was required to do.

She went to school Monday and never came home...I believe she has gone to a friends...and I don't know what to do....I replied to her text on someone else’s phone but have not heard back from her.

By running away when she is given a consequence (this has gone on for 2 & 1/2 years) she avoids all responsibility and accountability and I renders useless any discipline program.

What can I do about this as our Australian laws as we have signed the convention on the rights of the child have taken away parental rights?

How can I approach this problem for her benefit?

very distressed mum,

J.


Click here for my response...

Should I tell my stepson that I am not his biological father?

Hello Mr. Hutten,

I have a question for you. I have a 14 year old step son who does not know that I am not his biological father. His mother and I have been separated for 9 years. I get him and his brother, who is my biological son, three times a week. I have had this visitation arrangement with their mother for the entire 9 years.

I met the boy when he was 8 months old, and he really has no idea I am not his biological father.

That said, the boy treats me with no respect, gets into trouble and generally makes the time I have with him and his brother a nightmare. I could go on, but I am sure you can imagine what I have been going through.

My question-- Should I tell him that I am not his biological father? I really want to tell him because I do not think he appreciates exactly how good I have been to him. I spend a lot of time being angry at him and I think if he knew the real situation he might have a little more gratitude.

Please let me know what your professional opinion is.

Thank you so much for your help and your program.

Sincerely,

B.

Click here for my response...

It's been a year since our last argument...

Hi Mark,

Just wanted to thank you for this web site, it pretty much saved my relationship with my 16 year old son. We went from arguing, fighting and a final physical confrontation to him giving me a hug and telling me he loves me every morning before he leaves for school. It's been a year since our last argument. You're my hero!

Lee Michaelis, DDS

Online Parent Support

Your program is spot-on!

Mark,

I just wanted to follow up to let you know that your program is spot-on! I am just starting Session 3 in your materials and using the suggestions in my household with my 14 year old twins. They are blown away with my lack of engagement with their verbal attacks, behaviors and disrespect. I'm following your advice and using my words and actions carefully, as well as being consistent, and they are totally confused as to what happened to me. I simply refuse to let them get me angry or engage in their misbehavior; then I talk to them about consequences of continued behavior. It took several days of me calmly repeating myself with these new rules, one of them is getting it right away while the other is a bit more resistant but is coming to realize that she can't push my buttons anymore.

Thank you so much for making this program so affordable and supportive for the parent!!! I think we will make it through the next four years in a much calmer household.

D.B.

Online Parent Support

Daughter won't stop smoking pot...

Our 17 yr old daughter won't stop smoking pot – which she does daily to get through school. We have taken away privileges. Do we just ignore and ask her to leave once she's 18?

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This is a tricky subject and different for every family, but I truly believe that every teenager who wants to get marijuana, can.

Therefore, I always tell moms & dads, it is extremely difficult to try to shield a teenager today from being exposed to marijuana because it is so prominent. I believe parents, and what I do with many of my clients, need to spend their efforts trying to equip teenagers to make the right choices, so when they are exposed to it, they will choose not to get high.

No matter how strict a curfew you have, how often you drug test your teenagers, or whether they are an athlete, a scholar or a jock, your teenager will always find a way to use marijuana if they want to. They key is making sure they do not want to.

1. Ask Questions—Before you dive into trying to equip them with the power to ‘say no,’ try to gauge their level of involvement. Ask the tough questions. I am not saying to grill them before they go out, but showing them you are paying attention and are very involved is important and you can get an idea of how much or how little you know about their social life.

2. Build their Esteem—If you cannot prevent them from encountering marijuana, you can empower them to make the right choices. I do believe there is peer pressure to use pot. It is hard to say no when it feels like everyone is doing it and you know that if you get high, you have the chance to be friends with that jock, who would never talk to you otherwise. So encourage them to do esteem building activities, like running for student council, working out, or doing a hobby and help them be proud of who they are by engaging in their unique qualities.

3. Don’t Lecture—If you think we are doing marijuana, dabbling in marijuana, seeing it at parties or just want to talk to us about it, please talk, don’t lecture. I promise, we have heard all of the negative sides to smoking weed in health class. As soon as you start lecturing us, we stop listening. So, instead of approaching it like a health teacher, ask questions and let us come to our own conclusion, usually we know what is right or wrong, and if we feel like you are talking to us about it, not at us, at least we will come to you if we have questions or problems down the road.

4. Find Out Why—This is tricky, it is important to understand that, today, marijuana is not only for ‘the stoner’ teenagers. All different kinds of teenagers are doing it and it has become a sort of social unifier. A drama teenager and a jock might not hang out at a party, but if they get to the party and share a joint, they are friends. It is really important to understand this new social aspect and that it permeates all kinds of peer groups.

5. Listen to the Answers—Most times, when I hear moms & dads talk to their teenagers, parents do ask questions, but then answer the questions themselves. A question, and then silence will get you a long way. For some reason, even after we have already given a one-word answer, if we feel you are still waiting for more, we either get nervous (a sign we are hiding something) or splurge and let our mouths go. Also look at your teenager’s immediate facial response as soon as you ask a question. We are not as good at hiding our emotions and you might be able to gauge a lot by watching our reaction.

6. Look at Their Friends—I constantly hear the “well, it’s not my teenager because…” response when I do speaking engagements on this topic. If you feel your child is either an angel or unreadable, look at their friends behavior. Have they gotten in trouble? Are they the ones who make the decisions where to go on the weekends? Friend’s behavior means everything in the world of marijuana.

7. Offer Other Activities—When you talk to your parent friends, make sure everyone is on the same page with curfews and activities. If there is a semi-formal or prom coming up, offer to host a substance-free after party, host bbqs and movie nights. I think many teenagers get high simply because there is nothing better to do.

8. Offer Other Options—As horrible as it sounds, if your teenager wants to get high, they will find a way. Make sure that they know never to drive high. If you think they are smoking and you cannot do anything about it (sometimes it happens), then at least tell them to call you if they are ever in a situation and they will not get in trouble. Many, many, teenagers drive high or drunk and this worries me more than anything. If you do not think they would call you, then encourage an aunt, uncle, priest, rabbi, teacher, friend to be their secondary support system if they ever need to be bailed out or get a ride home.

9. Talk to Your Friends and Other Parents—Get informed about the marijuana culture in general and in your specific community. I post frequently on this topic and what teenagers are doing right now, so you can stay a step ahead. I highly recommend getting together with parent friends and talking about what your teenagers are doing and sharing notes about what they think is going on.

10. Give Other Reasons Not to Use Pot—I constantly talk to teens about smoking and always give them non-health class reasons not to use pot which, I believe, appeal more to their interests. I always stress to girls the aging effects of smoking. I spoke to a group of 16 year-olds about ‘anti-partying’ and gave them my reasons not to use pot (they were shocked, because they were so a-typical):
  • At a prestigious internship interview, a friend got offered the job and when they asked for a drug test, he knew couldn’t pass it and they took back the offer.
  • Gives you lip wrinkles.
  • Lowers your sperm count.
  • Make allergies worse.
  • Makes you taste bad when you kiss.
  • The pot makes your teeth yellow.
  • You never know who is going to take an incriminating picture and post it somewhere, or use it against you later.

11. Give Them Excuses—Ok, so maybe they have the self-esteem to say no, and maybe they agree with the reasons above to say no, but sometimes people will not let up with the “just take one hit!, Just try it!” So, think of excuses for them to use. Here are some that I have given and tell teens to use:
  • I am on a diet, it gives me uncontrollable munchies and I am not giving up my summer goal for one hit.
  • I hate the taste.
  • I have dance class/practice/a run tomorrow and I can never perform as well.
  • It makes me really sleepy, and I am no fun when all I want to do is sleep.
  • It makes me sneeze.
  • My parents are waiting for me when I get home, and they will smell it/notice it.
  • My parents/job/school/coach drug test me.
  • Offer to be the reason! My parents told me to clearly tell people that they were watching me like hawks and that I would get in big trouble if I used pot. This almost always works, because everyone understands strict parents. So tell them to use you as the reason…after all there is some truth to it!

==> My Out-of-Control Teen: Help for Parents

Your column "ask the parent coach" was like reading about my family's life story the last 9 months...

My name is L___ and I just want to thank you for your website that I stumbled upon while doing research on Reactive Attachment Disorder. Your column "ask the parent coach" was like reading about my family's life story the last 9 months. I have found a lot of websites on this disorder but yours really hit home for me.

We have a child that has been with us for 9 months that we were getting ready to adopt but have since decided that we do not have the capacity or time commitment to care for him. He was diagnosed with RAD by a school counselor recently and shows every sign of RAD except cruelty to animals. The more research I have done, the more I understand this disorder and the severity this boy has (he is 7). With 3 other young children, we have come to the conclusion that we can't commit to years of therapy without the rest of the family suffering in some way.

We know his family and he was taken away at the hospital and put into foster care for 3 months because his mother was a drug addict and he was tested positive for drugs in his system too. He has lived with his grandmother ever since but we feel, after reading all the websites that she too, has RAD. Her dysfunctional livestyle is all Austin has even known. We thought we could help him with "tough love" and discipline but now we see that is not the case and all our efforts these last 9 months have made little to no impact.

She also misdiagnosed him with ADD and heavily medicated him to keep him in control. She then tried to take her own life because she couldn't deal with him anymore and that is where we stepped in. We wanted to help out a needy child and the opportunity presented itself. Our hope is that he does not get back into the hands of her or his mother again. We hope it is with someone who can dedicate the time to get him the care he needs and deserves. We will have to advise the court of our findings and hopefully they can help us find placement for Austin. Again, I would just like to thank you for opening our family's eyes on this disorder. I didn't take it seriously before but I do now.

Sincerely,

L___

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