Before I dig into this week’s material, I wanted to apologise because last week I shared my Google Doc without the right settings. If you feel like adding your thoughts to my investigation about early education, as I explained last week, please check out the document here.
A couple of months ago I wrote a newsletter questioning the idea of the terrible twos. We know that by the age of two children become more independent but they are still not entirely verbal, and there is a lot of potential for meltdowns. But I asked myself: is it useful to call this phase “the terrible twos” and justify every crisis just like that, or does the expression limit our understanding of what may be bothering them? I argued that parents’ flexibility plays a role in children’s emotional reactions and that we may be able to avoid meltdowns if we don’t expect them to be a regular feature of our children once they turn two.
Several people responded to my story, but one email caught my attention. Michael, a reader, sent me a message from north Idaho, where he is based.
“Along with not calling them terrible, how about not calling them ‘tantrums’”, he wrote. “How about describing them instead of using words that have negative meanings.”
His email caught me off guard. I am not a native speaker of English, and I thought I used tantrum as a descriptive word. But when I started exploring my use of the word tantrum, I realised that Michael had a point.
I looked back at previous newsletters – before the one that Michael caught – and I saw that I had used the word tantrum twice already. First in this sentence here: “I won’t lie to you: sometimes I wish Lorenzo was already 18 years old and away at university and that I could avoid his bedtime routine (as well as his tantrums).“ And then I used it again in a piece about Donald J Trump’s childhood, here: “Every time I see Trump in difficulty, he seems to revert to the primitive part of his brain and either end a conversation with abuse or a personal attack, effectively with a tantrum, or trying to draw attention to something he did well – just like a child.”
Did I attach a negative connotation to the word tantrum? I did. In the first case, wishing not to see any more of them in my son, and in the second one attributing them to the (grown-up) former president of the United States.
I got in touch with Andrea Diaz Stransky, a child and adolescent psychiatrist at Duke University School of Medicine, US, to understand more about tantrums and whether they are the right word to use. Her work looks at children’s health in connection to the parents’, and focuses on coming up with interventions that support the whole family.
During her time at Yale University, Diaz Stransky collaborated on the Tantrum Tool, an online programme that trained parents to manage their children’s irritability and outbursts. The programme used 12- to 26-second animated videos that showed key triggers which can lead to meltdowns. For example, one shows a child getting frustrated and having a meltdown in a supermarket, while another has a meltdown when asked to put down the smartphone. The animations prompt parents to widen their perspective rather than focus exclusively on the single episode. For example, if the meltdown happens at dinner time, were there too many expectations of the child? Had the child just arrived home after a long day, were they expected to hang their coat, wash their hands and sit down at the table in quick succession? Did they need a break, maybe, or a time to connect with parents?
The Yale study used the word tantrum because researchers found that it was the one word that was most universally understood to talk about meltdowns, but Diaz Stransky is clear that tantrum is not a clinical term. In fact, for the past couple of years, the American Academy of Child and Adult Adolescent Psychiatry has been exploring what the appropriate term could be. She adds that irritability and meltdowns are common symptoms of several disorders or signs of extreme anxiety or depression, but recommends caution regarding premature diagnoses.
“Children that are not experiencing clinically significant mental health disorders might also feel irritable. We all sometimes get irritable.”
As Michael, the reader of The First 1,000 Days, pointed out, the definitions of the word tantrum available on dictionaries may be misleading. For example, Merriam-Webster calls it “a fit of bad temper”. At the same time, Google links its own definition (an uncontrolled outburst of anger and frustration, typically in a young child) to the following example: He has temper tantrums if he can’t get his way.
“How exactly is it uncontrolled if the example is saying it happens because they can’t get their way?” asks Michael.
Diaz Stransky makes the same point, arguing the word tantrum takes an outsider perspective rather than the attitude of understanding what the child is experiencing.
“It limits our ability to help them”, says Diaz Stransky.
At the moment, the preferred term among the medical community is outbursts because the word lends a clearer, less-charged, image to a phenomenon that can happen at any stage of life, but is more common for toddlers.
Used in the context of childhood, the use of a more neutral word may help us make sense of what is a simple, yet important development stage. Around 18 months, children start to become more aware of themselves and gain independence, but they also become more aware of their vulnerability.
“Meltdowns are not necessarily a bad thing. Children experience ambivalence and they don’t have the language to articulate this very complex feeling that they’re experiencing. Meltdowns are developmentally appropriate within a certain frequency and intensity and at certain ages,” says Diaz Stransky.
At the same time, parents usually go through a parallel process. I surely experience this myself, shifting from moments of joy when I realise that Lorenzo can now go to sleep by himself, to sudden moments of nostalgia, where I want to hold him like a newborn again and rock him in my arms to sleep.
“This relationship shift creates a lot of strain in both directions, since both the child and the parents are experiencing a transformation. And that is part of what leads to, oftentimes, the meltdown. Is it typical? Yes, because children are now acquiring the ability to say no and to manifest that and set their own boundaries. And we do want children to be able to set their own boundaries,” says Diaz Stransky.
In children on the autism spectrum (Diaz Stransky’s initial research focused on their needs), meltdowns may become more frequent. This happens because children on the spectrum often have very heightened responses to noises or light and may have a more limited capacity to express themselves, all of which combined can produce irritability.
“We are not trained as a society to understand what they’re trying to tell us,” says Diaz Stransky. “Children on the spectrum are perceived as difficult and more prone to tantrums, and they are stigmatised as a result. Unfortunately, it is not a population that is well cared for and understood.”
How can we deal with meltdowns then?
First of all, says Diaz Stransky, parents only need to worry if the meltdowns are out of the norm for that child’s usual temper or their age, or if they start interfering with the child’s development and important social relationships. Overall she believes that it is necessary for parents to have enough support first in order to help their children.
“As parents, we like to jump in and fix things, do something. But with meltdowns it is better to take a step back first. Stand there and pay attention. Try to listen to the tantrum, what’s happening? Why is this happening all of a sudden? A child doesn’t have the capacity to do that. It is our job to help them put words to their feelings and understand what’s happening.”
Listening and watching closely can help adults make sense of the rhythm and detect a pattern behind the meltdowns – something that has been observed by different researchers, as NPR’s Shankar Vedantam explains in this report.
When anger emerges, it is best not to intervene and let it pass – not unlike the way meditation teaches us to deal with emotions. If felt through, anger eventually leads to sadness, and when a child softens into sadness, it becomes easier for adults to console her. While we adults mostly fall into the trap of reasoning with a child who is overwhelmed, that makes no sense from a cognitive perspective because children don’t have a developed prefrontal cortex – the part of the brain that controls impulses and inhibits strong reactions.
If we stop thinking of tantrums as whimsical episodes of spoiled children and think of meltdowns as expressions of a child’s needs instead, we can try to meet children’s needs better. But in order to succeed at this, we parents need a lot of awareness and we most likely need our energetic wells to be full first – and that is a whole other issue that I’ll keep coming back to.
Do you find it helpful to call these explosions meltdowns rather than tantrums? I find the idea and the imagery of melting quite helpful – and endearing, actually – to remind myself as an adult of how tough this moment must be for that child, which opens the door of compassion, from where everything else just flows more easily. I’d love to hear from you, as usual, below this article. And remember that if you have any follow-up questions, you can ask them directly to Andrea Diaz Stransky.
Before I go, a message to all of you readers. Last week I sent out a newsletter talking about what it means for me to be memberful – i.e. being aware of the members of my community and involving them in every step of my reporting process. (I also shared a Google Doc asking for your input on a story about early education, so feel free to have a look if you missed it!)
After reading the newsletter, Chris, a reader, unsubscribed saying he doesn’t know how to contribute. It occurred to me that some of you may feel pressure from my prompts, but please don’t! I want to leave you the chance to contribute if you feel like it, but it is by no means a requisite to be a member! If you’ve ever felt any pressure, feel free to reach out – I’d love to hear from you and adjust my wording if needed.
With love and care,
Irene
📣 Catarina Fernandes Martins, a member of this community, edited and improved this newsletter with lots of love, logging in from Castelo Branco, Portugal. Thanks, Cata! (If there are mistakes, they are my fault, not hers!)
Photo credits and alt-text: Niranjan _ Photographs on Unsplash, cat-shaped toy with an angry expression.
4 thoughts on “Why we should stop using the word “tantrum””
So, as a pediatrician seeing kids with behavior complaints, some of whom have previously been abused, I see s lot of kids who have pretty substantial fits of tears, screaming, rage, aggression and etc. What most frequently provokes these, from the parents’ views, are unwanted or unexpected change, and being denied something they desire (not getting their way, or hearing “no”). Learning to deal with discomfort and disappointment without dysregulating emotionally, is an important developmental task. It starts in infancy and continues, often, through adulthood. Having a secure attachment to a person who manages their emotions well, and helps you manage yours, is a great help. Trauma, household chaos, ADHD, Autistic Spectrum Disorders, insecure attachment, and parent role models with poor emotional regulation are the commonest reasons that things go awry, in my experience. Some of this, too, is cultural. Different cultures expect different behaviors, role model and reward different behaviors, and thus produce children with different behaviors.
I am not one to get caught up on linguistic purity, thus I don’t mind the word tantrum. If you have faced the sadness, frustration, rage, and powerlessness of a two year old screaming, rolling around on the floor and throwing things in the grocery store, you will have a negative association whether you call this a tantrum, meltdown, emotional dysregulation, or fit of pique. The point is to know when it is more than typical development predicts (we call the “terrible twos” “the age of normal negativism” and it has to do with individualization in Erikson’s model of psychological development, a good thing!). If it is a problem, I think it is important to divide tantrums in two (at least).
Some tantrums are learned strategies for the child to win a contest with a controlling figure (mostly mom). These children have learned that a certain amount of fuss gets them their desires. When mom pulls back, the child ups the ante, mom caves, and a greater degree of fuss is rewarded. The cycle can repeat until things are pretty out of hand. These children have a problem, you are not giving them what they want. They are successful social engineers, and have solved their problem, they use their behavior to prevail in a social contest, pretty amazing when you think of it! The answer is simple (in theory, not in practice), stop rewarding the tantrum when it occurs; teach another technique to resolve the social contest of wills that is acceptable to you and within reach for the child; reward amply, immediately, and frequently when the child uses the new skill; and practice, practice, practice. The first new tool you use may not be your end point, but rather a step in the right direction, to be followed by successive steps until everyone is happy.
Other children, however, have a different problem, they lack the skill to deal with strong emotions. These children are not solving their problems. These are the children for whom modifying the environment to remove frustration is most important. When frustrations are more manageable, they may be able to learn better coping strategies. The strategies these children need to learn, however, may be more psycho-emotional, and less practical (think breathing and meditation and repeating a calming mantra rather than “use your words.”) A therapist might be helpful here. I would recommend two books at this point, “The Whole Brain Child” and “What To Do When Your Temper Flares.” Sometimes, however, books are not enough, and you need a therapist. Sometimes, the person who really needs the therapist is the parent, or the family unit.
Just to make it more complicated, there are kids who have both things going on.
To be clear, kids in both camps are doing their best to solve their problems. The kids in group one are successfully solving a problem, it is just not the one you want them to solve. The kids in group two are failing to solve their problems due to some form of disability. Both kids deserve our sympathy, and our well directed efforts, not our rage and recrimination, whether you call it a tantrum, meltdown, emotional dysregulation, or fit of pique.
Hey Steve, what a great, insightful comment! Thank you so much for this.
I love how you highlight that “learning to deal with discomfort and disappointment without dysregulating emotionally is an important developmental task”. And I also love that you say that different cultures have different expectations and hence behaviours will most likely differ as a result.
I also really like your bottom line: kids need our sympathy and our help, not our rage of recrimination. So maybe the point is not about changing how we call a certain behaviour but rather what underlies that word or concept. Thanks for this, it’s pushing me to think further, and I will share with the wider community!
Some spontaneous thoughts on this subject and the interesting comments above:
I agree that is it not about the word, but mostly about changing our perspective. The big challenge is to see the child as an agent, a subject that is unique and acts, not as an object of observation, research, let alone critique. Children act and have a reason for it. Most of the times this reason is linked to environment’s stimuli’s and adults’ expectations. This is at least my experience as a developmental psychologist and mother of two pre-schoolers (including both categories: children of typical and non typical development). Yet now matter how we call it (tantrum, or meltdown, or even banana), it still remains a difficult and demanding situation to deal with. Not just because we -parents, therapists, educators- are lacking of skills and patience, which is of course on a daily basis often the case. But how about the total attitude / culture we bear as western capitalistic societies? As a psychologist being raised up in this antagonistic society and being educated to classify children/people in general, how difficult it is to deconstruct this way of thinking in my praxis in order to see the child’s agency in this world!
Agency is an interesting concept. Children are clearly agents (at least as much as we adults are), acting to solve problems. That was an underlying premise in my over long response above. BUT, agency sometimes invokes concepts of culpability. As I look at developments in the neuro-psychological nexus, I see us moving away from an unbridled concept of free will ( and sometimes entirely away from an unreservedly free will at all). So, while I don’t want to go there lock, stock, and barrel, I do want to say that neither children nor adults make fully conscious choices to engage in each behavior they manifest. Biology and past experience (via biology) constrains what behavior is available to them. As parents we want to shape that for success (happiness, safety, and wellness).