Book Review: Parenting a Child or Teen Who Has Intense Emotions

Parenting a Child Who Has Intense Emotions: Dialectical Behavior Therapy Skills to Help Your Child Regulate Emotional Outbursts & Aggressive Behaviors

by Pat Harvey, LCSW-C and Jeanine A. Penzo, LICSW

New Harbinger Publications, 2009, ISBN-13: 978-1572246492, 207 pages, $19.95

Parenting a Teen Who Has Intense Emotions: DBT Skills to Help Your Teen Navigate Emotional & Behavioral Challenges

by Pat Harvey, ACSW, LCSW-C and Britt H. Rathbone, MSSW, LCSW-C

New Harbinger Publications, 2015, ISBN-13: 978-1626251885, 224 pages, $17.95

My two favorite books of the summer were about Dialectical Behavior Therapy (DBT was developed by Marsha Linehan) and its application to parenting. Dialectical refers to the idea of holding two opposing concepts at once. For example, my child is experiencing deep and painful emotions AND he can behave better.

The following are some reflections on these. I think even very experienced parents can learn a lot by reading these books.

Key components include understanding that:

1. Your child has deep and painful feelings which are driving her behavior — and it is your job to learn how to label these feelings for your child (if she can’t do it for herself) so you understand and accept them rather than dismiss them. This does not mean that you agree with or accept the behavior.

2. Every way you respond to behavior is either reinforcing or discouraging it so you need to think carefully about what your goals are for your child and the pros and cons of your own reactions. This part can be fun once you get into it. For more entertaining reading on this same topic, you can read this article: What Shamu Taught Me About A Happy Marriage:

3. Only your child can change his own internal state and must work hard to do so. You can help him by talking when he is calm about ways in which he can soothe himself and then rewarding him when he successfully practices this. You might consider buying these workbooks to help your children with some of the DBT concepts: “Don’t Let Your Emotions Run Your Life for Kids” by Jennifer J. Solin, PsyD, and Christina L. Kress, MSW, and “Don’t let your emotions run your life for teens” by Sheri Van Dijk, MSW. You are responsible for managing your own internal state and will probably also have to work very hard to do so! Things will not change in your family until you learn to do this.

The concepts sound very simple but are complicated to put into action. You must respond to your child in a way that they feel understood AND hold them accountable for their behavior (and yourself for your own behavior). The books have excellent guidance for doing so and are great at validating how you might feel parenting a child who is easily and often dysregulated. And they cover how to manage upsetting behavior such as violence and self-harm in a matter of fact way.

There are also many tidbits of DBT philosophy (a philosophy that is very closely aligned in many respects with the work of Dan Hughes, Arleta James and others at the forefront of interventions for children who have experienced adverse childhood experiences) shared in these books. For example, one concept is “acceptance” and it is applied to parenting in noting that your child may always struggle more than others in managing emotions and this might influence her ability to achieve certain milestones on the same timeline as her peers or limit her achievements. You might need to work on accepting this fact just like you would need to work on accepting that a child who has spinal cord damage will not walk. However, you can still pair acceptance with hope.

One caveat: the theory behind the need for DBT maintains that some humans are genetically pre-dispositioned for emotional dysregulation but also that invalidating environments (parents who deny their emotions) are responsible for creating humans whose emotions get in the way of their functioning. In emotionally-healthy families, I lean more toward the genetic predisposition, however if a child has experienced adverse childhood experiences before they came to you, this will certainly impact their ability to regulate their emotions as well as be impacted by what can sometimes seem like mysterious triggers. Not your fault, in other words! — Sarah Gerstenzang, LCSW, and parent

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