Exposure therapy for low frustration tolerance

Discussion in 'General Parenting' started by Jules71, Nov 30, 2011.

  1. Jules71

    Jules71 Warrior Mom since 2007

    So, third visit with difficult child and the therapist - he asked to talk to me first. Told me difficult child is pretty hard on himself, appears impatient, wants to be in control, and has some problems with empathy but they don't appear autism-like.

    We talked about difficult child's low frustration tolerance (LFT) and he asked how we responded to his frustration. I was honest and told him that as a baby I would give in a lot to stop him from melting down or having a tantrum. For ex. if he was screaming his head off because he wanted something - I chose not to fight the battle a lot and just let him have it. I also said a lot of times we tip toe around difficult child so the bomb doesn't go off. I told him I know that is not the right thing to do but we have so much chaos that we need some peace too. I told him last year when we put our foot down more with things he would have 2 hour rages where we would have to restrain him.

    So now, I am feeling like I am to blame for the reason my child has LFT and is oppositional. So I ask - what came first 'the strong willed demanding child' or the 'passive mom'? I am not like that with my other child. He doesn't have the negative persistence difficult child has.

    So whatever - he wants to do "exposure therapy". Basically putting difficult child in frustrating situations - just on the edge of what would make him explode and then helping to teach him how to respond better to the frustration emotionally. Does this seem like the right path? My child has serious self esteem issues and thinks he is no good and we all hate him. He mentions suicide and I worry about his safety - and the therapist thinks we should purposely frustrate him?!! I don't know what to think.

    Anyone been through this type of therapy or have any thoughts about this? When I google low frustration tolerance I get a lot of Oppositional Defiant stuff. I know what most of the ppl on this board feel about ODD. I am just not sure if this is the right starting point for difficult child and the therapist.
  2. shellyd67

    shellyd67 Active Member

    Jules, IMVHO, the strong willed child came first.

    I have often asked myself that very question.

    You use the term negative persistance. My goodness have I have used that term a million times to describe my difficult child.

    I have not had any experience with the therapy you listed above but would be curious to learn more about it.

    As always, it is nice cyber chatting with you. Shelly
  3. KTMom91

    KTMom91 Well-Known Member

    I agree with shelly that the strong willed child came first. From day 1, at my house.
  4. Jules71

    Jules71 Warrior Mom since 2007

    Thanks Shelly and Mary! I guess I am just feeling a little defeated or something. So we work on what has become but not on what brought us here. difficult child's initial problems and our lack of being able to deal with them have contributed to all of these current problems. It feels like we are becoming more dysfunctional by the day. Maybe the correct approach is for me to go to therapy and learn how to deal with it all because I really really doubt anything with difficult child is going to change. Isn't that the case with so many ppl on this board? You try everything under the sun and at the end of the day - what is, still is. I think we have to change how we deal with it, how we think about it, how feel about it. Unless and until that happens - no peace. At least it feels that way.
  5. buddy

    buddy New Member

    Interesting. I would think it would be great for someone who can think through things before and after. To see that you can experience frustration and handle it and the world won't end. But if someone suggested it for my son??? I would probably worry about how stuck he gets. Once it is an issue, even if it was for practice, he is just feeling what he is feeling... I dont know. DId you google it to see if there is any research? Keep us posted because it does sound logical, just not sure unless it is very individualized. Maybe they start with very tiny frustrations to show how the process works???
  6. DaisyFace

    DaisyFace Love me...Love me not


    It sounds wacky to me...

    If the child is "exploding" because he has no coping skills - the time to teach those skills is when the child is calm....NOT when the child is on the verge of another explosion...

    UNLESS - the child is working with someone that they trust completely, and who can reach them in that "pre-explosion" moment, and who will be able to effectively communicate in such a way that the child will cooperate in order to avoid the meltdown. Do you have such a person...?
  7. Malika

    Malika Well-Known Member

    Jules (like everyone here), I really understand what you are saying - and the frustration, doubt and confusion about all this. My own sense of it, for what it's worth, is that however you had handled your boy when he was young, he would have been the same... I just feel the negative persistance, meltdowns in the face of thwarted desire or frustration and inability to "go with the flow" are too powerful to be altered from the outside. With the ODD-type personality, being "strong" against the defiance only makes it worse. So, who knows, odds are your "passivity" made him better than he would have been :) All this said from my own daily experience, of course...
    As for the frustration therapy... I don't know. Give it a try? If your boy trusted the doctor, trusted his kindly intentions in doing this, it could maybe work to some degree?
  8. HaoZi

    HaoZi Guest

    My gut is that exposure therapy is for PCs. Isn't one of the first rules of the Explosive Child to avoid those situations which cause frustration and work with them when they're calm instead?

    I'd say if doctor wants to try it, doctor can sign a document that they will be responsible for all physical damage, property damage, mental trauma, and loss of limbs for anyone affected by the aftermath of said experiment ("aftermath" to be defined as a specific period of not less than 48 hours and not greater than one month).

    ETA: Does difficult child know doctor suggested this, and is difficult child willing to at least attempt it? If difficult child is willing to attempt it and shows honest effort, it might be worth a go to see if it works or if it might be something better tried later (or never).
  9. AnnieO

    AnnieO Shooting from the Hip


    I get frustrated fairly easily. However, I do have coping skills.

    And when I am slightly frustrated? It takes toothpicks to push me over the edge into full-blown frustration. And that's WITH those coping skills.

    I agree with HaoZi about a certification of responsibility... because if you put ME there, we're talking WWIII.
  10. aeroeng

    aeroeng Mom of Three

    First your giving in to avoid the battle and then walking on egg shells to avoid the two hour battle did not in any way make your son the low frustration tolerance, difficult child kid he is. You only prevented more battles. We have tried both ways. Strict consistent rules, behavior contract charts, and on and on. Some kids just get frustrated and do not know how to manage it and explode. I believe this is a result of him not developing the proper mental skills required to manage the frustration, not your parenting skills. (this is like blaming a child's poor math skills on the type of paper you gave him. Just does not matter). Most kids (even the difficult child) would chose to behave if they knew how, they just did not learn it as easily as the average kid. When we were more strict it was just constant battle after battle.

    What finally helped us was the book by Dr. Green , the Explosive Child. He stated that rewards and punishments only become something else to fight about. Rather he focuses on teaching the child how to manage the frustrations. When we learned how to reflect what our son was experiencing and learned how to articulate what his issues were for him he calmed down. He did not know how to manage his own frustrations. Things like he did not want his brother to touch his computer, but yet the wanted his brother to fix it. Both can't happen and until he learned to articulate what was bothering him he could not logically identify the issue, and could not resolve what he really wanted. Then he would just get frustrated and explode on something totally unrelated.

    I do not believe his difficulties in managing his frustration came from your parenting style. (It is not that easy, you could always change your parenting. - You can't change him)

    He does need to develop the skills to understand and then manage his skills. but I an not sure about the idea of "exposure therapy". Sounds like it could be equivalent to teaching someone to swim by dropping him into the deep end of a pool. And just as likely going to increase the problem by traumatizing him. I think there are enough frustrating situations in an average day you would not need to create artificial ones. We had a therapist who taught us how to guide him through the frustration episodes through a technique call "reflection".
  11. InsaneCdn

    InsaneCdn Well-Known Member

    To continue with the "swimming" parallel...
    To me, this "exposure" therapy is a but like how they handle kids who are absolutely terrified of water...
    First, they take water out of the pool, and let them play with it, pour it on their feet, etc.
    Then, they get to where they can sit beside the pool, then maybe dip a toe or finger in...
    And on it goes...

    I understand the theory..
    However... if it were therapist doing the exposure and training, I'd say its probably good.
    Wanting YOU to do it, at least initially... I'd be a bit leery.
    If therapist can break the ice and get a process going, and THEN involve you in additional work... maybe.
  12. AnnieO

    AnnieO Shooting from the Hip

    Sounds to me more like they're taking someone terrified of water, who cannot swim, and throwing them in the deep end.
  13. Josie

    Josie Active Member

    My daughter did exposure therapy for Obsessive Compulsive Disorder (OCD). For that, it was clear what triggered her. The therapist put her in that situation and had her feel the anxiety and see that it would go away on its own. No one can maintain that intense level of anxiety for too long, according to the theory. They started small and worked up, but it was important to feel that anxiety every time.

    She worked with a therapist and was supposed to do more at home. It was too intense for her to do at home, so I had her see the therapist more.

    She has had a low frustration tolerance in the past, too. For her, I am not sure how we would have set up the exposures. It seemed like everything could set her off. If there is one thing that consistently frustrates him, I could see it being helpful. My daughter has been able to use that method for other anxieties that have come up and they never got out of hand.

    I think it is important that he know what you are doing, knows when it is going to happen, and is given some coping strategies. If the therapist is just talking about being more firm with him, I am skeptical.
  14. Jules71

    Jules71 Warrior Mom since 2007

    Thanks for all the feedback. To answer some questions...

    No, I don't think difficult child knows about it. I think the therapist is just going to do it.
    No, we don't fully trust this person yet. difficult child has only met with him 3 times. I met with him alone the first time. I have probably only talked to this man for 90 minutes total. That is not enough time for him to know the situation fully in my opinion.

    I have read the Ross Greene books (Explosive Child and Lost at School) an my theory is the same as his - identify the lagging skills, identify the unsolved problems, then teach the skills. I did mention to the therapist that they try to teach him certain skills at school and he said - well they are approaching it cognitively - and that is not working. So the alternative to teaching it cognitively is what? Emotionally? I really don't know and should have asked him to explain it.

    I read some info on the internet about exposure therapy. It seems to mostly be used for anxiety. I think the first step is to identify a list of things that cause you anxiety (or in this case frustration). I don't know - should I meet with the therapist and ask for more information about this? How does my 9 year old son figure out what causes him frustration? Basically it is anytime things don't go his way, he is told no, he thinks something is unfair, something is too hard, etc. You know - classic gfgness.
  15. Jules71

    Jules71 Warrior Mom since 2007

    Well he did tell me he thinks I should take the TV away from him. He asked about our morning routine and I said difficult child gets up when I wake him (no problems), goes to the couch, I give him his pills and a bowl of cereal while we watches TV and wakes up. Then when it is time to get ready for school he isn't very cooperative. He said take the TV away (disconnect the cable) and tell him you will be happy to let him watch TV after he gets ready. This is what I would do with a easy child. It sets off the bomb with a difficult child. Basically he is saying take the TV away - frustrate him - don't give in to him. How does this help him cope? We all know he doesn't 'learn' to cope by doing this. I could do this and we would have a HUGE BLOWUP every single day. He would not eventually adapt. He doesn't adapt. It's what makes him a difficult child.
  16. HaoZi

    HaoZi Guest

    I'd bet there is more to his frustration than listed. The little things that pile up during the day... the sun glare off so and so's desk is too bright, so and so is wearing a shirt in a color I hate and sitting right in my line of sight, lunch didn't taste great so I didn't eat all of it and now I'm hungry, I'm thirsty, too hot/too cold, my clothes are itchy, the seam isn't sitting right, my left shoe is tighter than my right shoe... you get the idea.

    Getting "minor" annoyances down in overall level helps him to be able to think instead of just react when bigger annoyances hit. Has he been checked for any kind of sensory disorders that could be causing higher overall levels of frustration (or do you already know/suspect he has them)? It can sound petty to someone with no experience, but seriously I will re-tie my shoes several times during the workday (which is to say about once an hour) just because one has become slightly looser than the other. Then that one is tighter and I have to retie the other one to match. If that alone, which wouldn't bother most people, continues, I will become even more irritable and snappish than usual (and I'm naturally short on patience to begin with).
  17. Malika

    Malika Well-Known Member

    I agree, Jules - there is no or little ability to adapt and accept thwarted desires. On the other hand... and this may well just be an age thing (ie it works with my son because he is nearly 5 and not with yours because he is 9), my son does forget and move into new habits. TV is a case in point. We used to have a TV and J would watch it... however, he wouldn't watch it a bit, moderately, but wanted to watch it all the time, to the detriment of having a child's life. So... while we were away in Morocco, the TV "broke" (he was bright enough to ask how I knew it had :)), and was removed when we got home. He had a minor protest but basically accepted it - because I had spent days building up to it, reminding him daily that there would be no TV when we got home, etc. We now have a new TV, which I watch sometimes and he knows that - but he doesn't ask about it or pester to watch (or only occasionally and half-heartedly). He has acquired a new habit. And, believe me, he is as difficult child as they come in terms of digging his heels in and insisting on what he wants... So I'm just wondering if you are certain that, after the initial protest and meltdown, you boy might not accept a new habit, such as no TV in the morning?
  18. Jules71

    Jules71 Warrior Mom since 2007

    HaoZi - yes everything seems to irritate him and frustrate him. He does have some sensory issues but not about how clothes feel or shoes etc. He doesn't like when his little brother eats peanut butter around him, he doesn't like the weird stuff a classmate eats at lunch next to him, he doesn't like cooking smells, he doesn't like the sun shining, he doesn't like being too cold or too warm, he doesn't like how the car makes him feel sometimes, he doesn't like when the weather report is wrong, he doesn't like when he has to try hard to do anything - he wants to get it automatically, he hates being bored - it goes on and on and on. It would be easier to think of what he does like - and I can't think of anything right now. Lol.

    Habits... you are right. He probably would eventually get over it, but he would replace it with another habit and that habit would interfere with him getting ready. He used to not be able to go to sleep without the tv on. I put an end to that and now we read. But now he won't go to sleep unless I read - and I have to read until he is asleep. So the tv habit was replaced with a reading habit. If for some reason I decide not to read - total MELTDOWN.
  19. aeroeng

    aeroeng Mom of Three

    Then you say, "You are angry because you did not get the bla bla bla that you wanted. This makes you frustrated, and you don't believe it is fair."

    Child will say: "No. I wanted to bla bla bla and you made me miss it! I hate you!"

    You calmly say, "You wanted to bla bla bla and you believe I made you miss it. This makes you very mad at me."

    This goes back and forth, until you really state what is bugging him. It won't make it go away, but it will help him understand two things. 1) you are lessening to him and are understanding what his position is. 2) You will help him articulate what his frustration is. You will never get it correct the first time, but where he probably could not tell you what was bothering him, he will be very good at identifying that you were wrong. You will probably not agree with him very much. You want to state how he is feeling, or what his perspective is. Often this perspective is very one sided, and you will not agree with him. Use terms like, "you feel", "you believe", "you think".

    Once you articulate his position you can try to present yours:

    "I understand your frustration, but your father and I feel that school work is important...".

    Reflect his answer to you:

    "You disagree and think you should get some TV time first."

    This type of approach is hardwork and difficult to learn but is what seemed to work the best for my difficult child.

    MY difficult child would tend to explode whenever things happened differently from what he expected. We found that heading off perceived unfair things helped. "When we get home this evening, your favorite show will not be on because of the presidents speech." Letting him know about it in advanced helped. He also would get mad if he thought something was not fair, and frequently his perception would be totally lopsided. "You let easy child have a cookie and you did not let me have one." When difficult child ate all of what was left of the pie. He could not connect that where he had 800 calories of desert, that easy child only had 200 calories. He would only see that easy child got the cookie and he did not. Again if we could catch him before the desert and explain it out he would develop the expectation that they both get something different. If we did not imagine it would be an issue reflecting after would help some. Other times walking a way from the explosion was required.

    And at all times keep the voice calm. Which sometimes is completely impossible.
    Last edited: Dec 1, 2011