Solutions
to Oppositional Defiant Disorder
by Marilyn
Adams, LMFT
“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 If
your child 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 children 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 children share many of the following characteristics: ·
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. ·
The ODD child 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 children
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. Besides oppositional defiant
disorder, children 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 child is affected by one of these disorders, it is critical to
keep in mind that ODD can create additional problems for you and your child. 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 parents “micromanage” and come down
hard on their children, 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. Children can exhibit oppositional defiant behavior when parents
do not provide enough structure by setting appropriate boundaries, or
establishing and following through with consequences for misbehavior. These parents usually give in to all of their
child’s demands, either out of fear of the child, or in an effort to keep
themselves in the child’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. Parents 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 child 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 child. 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 parents. Once
marital and family issues are addressed, parents can begin to train both
themselves and their child. 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 child 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 child’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 child 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 child’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 child’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 child, 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 child. 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 child 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 child to draw you into the power struggle. Utilizing effective consequences for the oppositional child 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 child. Rules and
consequences must be clear, and in writing to provide clarity for both child
and parent before the conflict occurs.
Begin by removing reinforcers and allowing
your child 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 child’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 child, and puts you back into
the role as the parent. One of the
driving forces behind ODD is that, for whatever reasons, a child is trying
to grow up too quickly, and considers herself to
be equal to her parents. The ODD child may feel less loved due to the
amount of conflict going on, and it is difficult to simultaneously feel loved
as a child and try to operate on an adult level. Your child may know intellectually that she
is loved, but not feel loved. Parents
must be able to show love, and soothe and nurture their child. This is not
always easy to accomplish, especially when previous negative behavior patterns
have become ingrained. Children
look to their parents for a sense of security, belonging and identity. As our society becomes more complex, the need
for our children 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 children 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 parents to establish consistent limits and
consequences, and to distinguish boundaries within the family. This will form a family unit characterized by
established guidelines, affording children a secure backdrop in which they can
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