Dear Concerned Mom,

My name is Jody McVittie. I am part of the team that answers questions. First an apology. We are WAY late in responding to you. This is partly because your question challenges us. Some questions are just harder to answer by email. We tend to want to see and talk to people...and answering a written question one paragraph long can make us a little anxious that we are off the mark. The answer is also late because the person who was going to answer it had some medical problems that made it hard for her to follow through and your question got passed around. I am sorry for the delay.

Before I answer your question it may be helpful for you to know a little bit about me. I am a family physician (though currently not practicing) and the parent of three children (ages 16,14, 11). I teach parenting classes and classroom management classes based on Positive Discipline and the work of Alfred Adler. I have to be
honest with you. The internet medium is challenging me a little bit here too. In parenting class I get to know parents and their concerns and can answer their questions with a little more confidence.

I have a strong suspicion about what is going on....but you will have to read the answer ad see if it "fits" for you. I really hear two questions from you: 1.What do we do about this behavior? and 2. Is this NORMAL? I will try to answer both.
First: Is this NORMAL? My first guess is that yes, your son is normal. That is not to say that his behavior is average or common...but that it is his way of getting his needs met. Adler (and Rudolf Dreikurs who was one of the major people who brought Adler's work to the US) saw all behavior as "purposive." By that he meant that it had a purpose....not to "get you" as parents, but to move the person to a place where they felt better. You might ask how hitting or hurting oneself helps a kid feel better. It is impossible to know from here but you can figure this out by making some educated guesses. First, as humans we all need to feel belonging and  insignificance. We need to feel like we are part of "our group" (in this case the family) and within that group we need to feel important. Most behavior that looks like mischief or trouble is an attempt by the child to get that feeling of belonging and significance. The problem is that the child has mistaken ideas and beliefs
about how to get belonging. For example, a child may believe that "I belong only when I am the center of attention." With that belief, you can imagine that you get some pretty interesting behaviors at home and in the classroom. Other common beliefs are "I belong/am significant when I am in control," "I belong when I can hurt others back" and "I don't belong, I won't belong so why bother." Drekurs called these mistaken beliefs, "mistaken goals."

One of the best ways to get an idea of what is going on for your child is to notice your own feelings. What are you feeling when you notice your son's behavior? Do you feel annoyed/irritated/guilty, or do you feel challenged/provoked/threatened? or perhaps hurt? If you are feeling annoyed/irritated/guilty you might start by guessing that your son has the mistaken idea that he belongs best when he has your
attention. You could check this out by asking: "Could it be that sometimes you hit yourself because it works to keep me (us) busy with you or concerned about you?" From the tone of your letter, that would be my guess. However if you feel more challenged or provoked by his behavior you might ask "Could it be that sometimes you hit yourself because you like to be the boss or in control?" After you ask the question, you look for his body language to say yes or no. What he says in words is less important.

The other reasons I suspect it has to do with his belief that he belongs when he has your attention, is that he seems to prefer to do this when you are around. He also does not do this at school where he seems well adjusted. However, it could be that feels controlled and wants to prove you can't control him, or that he feels hurt by something and wants to hurt back. (Children often hurt themselves when trying to hurt others (seek revenge for their perceived hurts.)

What next? There are several strategies to support and encourage children who are telling you through their behavior that they need more belonging.
1. Address the real problem (lack of perceived belonging) directly.
- Make sure that you spend special time with him often. This would be a time where you can give him your undivided attention. It might be reading, playing a game, going to do a fun event, rough housing, playing in the park. The key is that his perception is that you are there for him and that you don't do other things at
the same time (like try to solve a work problem in your head, answer your cell phone etc). Lots of parents find this hard for an extended period of time. We are not used to keeping our attention divided. Start with a doable piece. 15-20 minutes regularly.
- Make sure he knows that he is an important part of the family. What important jobs does he have that help the family function better? Does he help cook dinner? Does he help fix machinery? In addition to "chores" around the house it is important that each family member knows that they contribute in a valuable way.
- Does the message of love come through? Reading your question, it seems very likely that it does. However it is an important question for each parent to ask. In parenting class we ask ourselves how WE knew that we were loved, what did the person DO that communicated the message of love. We brainstorm a list together...and each time the list is very similar. The people who communicated caring and love to us listened, took time, hugged us, had high expectations of us, had faith in us, knew things about us, shared personal stories with us etc. Think about how you know you are loved and make sure the message is getting through.
- You note that he seems to over react to frustration. It is really important to MODEL how to react when things don't go right. This means announcing your mistakes...and pondering out loud about how you will solve the problem. It means speaking out when you are frustrated...often...so he understands that adults
have these feelings to. I would avoid doing it about being frustrated with him...but for
example if dinner does not turn out right "Its so upsetting when I think things will be fine...and I am disappointed with the result...I think I'll do xxxx to help my self feel better" or When a driver cuts you off. "GRRRR it makes me angry when people drive unsafely. I'm worried someone will get hurt. I have to work hard to stay calm myself so I can drive safely when someone does that to me." You get the idea. It is
hard to do this at first. It breaks all the rules about being "nice and happy" all the time. But that is an illusion anyway. We all experience a wide variety of emotions. AND we learn how to get ourselves back on an even keel when things don't go our way.
2. Respond to the behavior. There are LOTS of choices how to do this. Here are a few. Again, I am going to treat it as if the mistaken belief were "I know I really belong when people are giving me special attention." The solutions for other beliefs are slightly different.
- Acknowledge that he might need some special attention. "Honey, when you do that it makes me wonder if you feel like you need some special attention right now." Then offer alternatives: I would be glad to sit and snuggle with you, I would be glad to listen to you, I would be glad to play a game with you... or I am in the middle of cooking right now but I could sit, snuggle, play with you right after dinner at xx o'clock, would that work? A lot of people will react to this suggestion by feeling that it is rewarding or re-enforcing his behavior and he will do it more. People who think that way believe (knowingly or unknowingly) in a "behavioristic" model of human behavior. We do things one way if rewarded, and stop behavior if punished. In contrast, Adler believed we behave to get belonging and significance. By verbalizing his need, you help him realize what is really going on and model other choices
for him. (One reason this can be complicated is that sometimes children are pampered get too much attention and then just demand more and feel they don't belong if they don't get what Adler called "undue attention." Some parents don't give children the opportunity to develop their "disappointment muscles", or
their "capability to solve their own problems". That is why it may be important to say, "I'm busy right now, and I'm looking forward to our "special time" at xx o'clock.)
- Offer choices: "Sometimes when you are upset you do need to hit something. In our house though, we don't hurt people or property...and that people includes you. We love you and you are important to us. If you need to hit something, let's find some nails and an old board that you can really wack at."
- Help him explore what is going on. Do you have any clue what happened that resulted in you feeling that way? Would you be willing to do a scientific study? Maybe you can start paying close attention to what happens at school or at home that seems to trigger that. I can get you a little notebook to keep your
notes. (This strategy changes the focus....it helps him think and notice about him...instead of focusing on your attention).
- Don't offer special service (like over reacting and rushing to him) and don't panic. Have faith that you (your family) can figure this out and let him know that. Having faith in your child is sometimes the hardest thing we can be asked to do. I believe it is one of the most valuable.

I suspect you have read Jane Nelsen's Positive Discipline. If you haven't, I recommend it. It is so encouraging. We need that as parents too.

You ask if this is different than the self mutilation we see in teenage girls. Yes it is. It is primarily different in the level of discouragement. Teens who cut themselves are either experimenting (because teens do that...they try lots of things on) or they are very discouraged. They often feel like they have no voice. Be careful with lots of the things you read about teen self mutilation. I think they are very guilt inducing for
parents. That does not always help solve the problem for parents of teens...and I don't believe it will help you here either.

You ask if you should rush of to a therapist. My recommendation would be to try a few of these things first. If the problem is not resolving over a month or so, it is appropriate to find someone in your area that works with families and children and ask for their opinion. Even though I think your son is most likely normal, you
must remember that all I know about him is the words you have written. A local therapist who can meet with you in person will have much more information and be able to make a more accurate assessment.

Your love for your son comes through loud and clear in your note. He's a lucky guy. Best wishes!

Jody McVittie, MD, Certified Positive Discipline Associate.

PS. I have one parent in this parenting class with a younger child who is hitting herself. I will see what she has tried and ask her to share with you if it might be helpful.