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Based on the clinical
literature and my clinical experience, it is clear
to me that 'rage attacks' or problems with anger
and aggression are one of the most socially
disabling aspects for many individuals. While some
adults have learned to cope with the problem, their
ongoing struggle sends a clear message to those who
will listen: do not assume that the problems you
see in the child will miraculously remit or just go
away. We need to take the time and make the effort
to help the child or teen learn to manage this
problem via proactive and constructive means,
including cognitive skills and social skills
training, if indicated. And although I always
recommend to parents who email me about their
children that they find a qualified psychologist or
therapist in their area who understands these
disorders and how they contribute to rage
outbursts, I know that in many places, parents and
schools do not have local mental health
professionals with expertise in these disorders. If
you have a student who is having rage attacks in
school, you will need to work closely with the
parents, other members of your school team, and any
prescribing physician to figure out how to help the
student learn to self-manage. It may be difficult,
but consider this:
If the parent can't or
doesn't stop destructive rages that hurt others or
others' property, and if the school can't or
doesn't stop it, then it will be stopped in the
courts. But it will be stopped, because no matter
what the reason, assaulting others or their
property is unacceptable in most societies.
That said, there is a
difference between holding the child responsible
for their behavior and saying that the child
voluntarily chose to exhibit the behavior. So....
is a child responsible
for such behavior? In my opinion: unless the
"behavior" is known to be an involuntary tic that
the child has no warning is coming, then yes, I do
think the child is 'responsible' for their
behavior. And we do not do children a favor when we
don't help them understand that they are
responsible for their behavior or if we teach them
to excuse everything because they have a
"diagnosis." Even if a child or teen is not
"responsible for" their tics, they still have a
responsibility as members of society and
communities to do what they can do to insure that
their symptoms or problems don't create problems
for other people. Even if their "storms" or "rage
attacks" are neurochemical events, they have some
responsibility for attempting to learn what they
need to do to avoid triggers or to avoid taking
their outbursts out on others. Are they entitled to
understanding, support, and reasonable
accommodations? Absolutely, in my opinion. But that
doesn't mean that having a diagnosis is license to
destroy or harm or threaten others. And it doesn't
mean that we should necessarily suspend or expel a
student who has a 'rage attack' in school, even if
we could.
What do we do, then, if a
'rage attack' destroys property? What do we do if
our student is threatening others or shouting
obscenities at them? While we work with the student
to help them avoid such unhappy or unfortunate
situations, and while we educate the peers to help
them understand the student's problems, we had
better instill in the student a sense that they
need to make restitution or reparations. If they
punch a hole in the wall, then they should either
repair it themselves or help the building
maintenance team repair it. If they create a major
disturbance in class, do they just pretend that
nothing happened or do they acknowledge the impact
of their symptoms/behavior on their classmates and
teacher and offer some apology? If a student has
rage attacks and does not say anything or do
anything to restore and repair their relationships
with their peers, they will suffer socially. If a
student has rage attacks, they can protect their
relationships with their peers by taking steps to
protect their peers from their loss of control, by
letting their peers know that they are trying to
take steps to deal with the problem, and by making
reparations afterwards if they do lose control.
We may not be able to prevent
all symptoms at all times, but we can teach
children what it means to be members of a
community.
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