DMDD and Discipline
Updated: May 18
Written By Jennifer Perillo, who is the mom of a wonderful daughter who was diagnosed with DMDD. She lives in New Jersey with her family, dog, gerbils, fish, and parakeet.
My daughter’s bedroom was nearly empty; her bureau and bookshelves were bare. All her favorite stuffed animals were gone, piled up in garbage bags in my closet. For several weeks, her dad and I had been taking one item away every time she misbehaved, thinking that at some point she would simply have to stop. But she didn’t. She was still raging every day.
For a long time, my husband and I had struggled to find the right way to discipline our daughter. In her good moments, she was smart, funny, and polite; yet in an instant she could turn dark. She frequently hit or kicked other kids; I got used to exasperated calls from her teachers or complaints from other parents on the playground. At home, she’d melt down, scream, and physically attack us. We had no idea how to handle it. We tried sticker charts and time-outs and incentives and 1-2-3 Magic. By the time we reached the empty room stage, all we knew for sure was that nothing was working.
I’ve since learned that our struggles are typical for parents of children with DMDD and other disorders - children who often can’t behave in expected ways (calmly waiting their turn in line, turning off the electronics when it’s time to go to bed, accepting that they can’t play outside when it’s raining) - and who explode instead. The key word is can’t. Due to a quirk in their neurological wiring, kids like ours simply cannot control their impulses and reactions in the way we’d like, especially if they feel upset, overwhelmed, or anxious. Frustration tolerance, problem-solving, and flexibility are skills that must be developed - just like riding a bike. Some kids acquire these skills more quickly than others. You wouldn’t punish a child with a learning disability for not being able to read; you would try all sorts of creative teaching methods until you found one that worked. Parents of children with DMDD have to treat behavior in the same way.
The first step is to remember, in the words of Dr. Ross Greene (author of The Explosive Child), that kids do well if they can. “If your child had the skills to handle disagreements and changes in plans and adults setting limits and demands being placed on him without falling apart, he’d be handling these challenges adaptively,” Greene writes. “Because he doesn’t have those skills, he isn’t. But let there be no doubt: He’d prefer to be handling those challenges adaptively because doing well is preferable.”
Unfortunately, as Dr. Greene goes on to explain, most traditional parenting wisdom assumes that kids do well when they want to, and that any child who misbehaves must be deliberately choosing to for some ulterior motive. Thus, typical reward and punishment schemes attempt to make children want to behave better. But as my daughter’s empty shelf taught us, those methods won’t work with children who cannot manage their behaviors. Taking her toys away didn’t help her learn how to problem-solve or calm herself or monitor her own emotions. All it did, in fact, was alienate her from us - and make her feel more out of control.
So, then, how should parents react when a child acts out? Should we ignore it when our children scream at us, hurt their siblings, hurl a remote at the TV, or disrupt the class? Not at all. There are techniques that can help lessen your child’s outbursts (or at the very least, not make them worse). Disciplining a child with DMDD takes a lot of forethought, creativity, flexibility, and above all - patience.
Sarah Ockwell-Smith, author of Gentle Discipline, recommends being “focused upon teaching and learning, rather than punishing, and having expectations for children’s behavior that are realistic, given their level of brain development.” With that in mind, here are some suggestions that may work for you and your family.
Understand your child’s triggers. If you can, keep a log of incidents and see if any patterns emerge. Does your child struggle with transitioning (especially from a fun activity to a not-so-fun one)? Do they hate having to adapt to a change in plan? Do they get stressed out by sensory overload? Dr. Greene refers to these as “lagging skills.” The Explosive Child presents an entire method on how to uncover, discuss, and problem-solve these specific issues with your children collaboratively.
Show empathy for your child’s struggles. It’s almost impossible to understand our kids’ overwhelming rages over issues that seem unimportant - to us. It’s easy to dismiss or ridicule their choices and concerns instead of trying to understand them. Many years ago, we took a family trip to Disneyland, and our daughter preferred staying at the hotel pool all day to visiting the parks. My desperate attempts to practically force her on a ride led to several embarrassing outbursts in the middle of Magic Kingdom. I was so angry with her for “ruining” the trip instead of trying to understand her preference for the pool. (Now that I have more compassion for her sensory issues, I have no idea why we chose Disney in the first place.) The key here is to show real empathy when your child is struggling over some issue, no matter how seemingly small - and react with nonjudgmental curiosity to try and understand it.
Understand your own triggers. My parents were old-school disciplinarians. They would never understand (let alone allow) the disrespect I have endured from my daughter when she is in a rage. When she loses it, all my subconscious insecurities as a parent come to a boil, and that makes me more likely to yell, cry, and do all the things I tell her not to. Whatever she says or does in a rage, I have to remind myself: She can’t help it. Don’t take it personally.
(If you are co-parenting) understand your partner’s triggers. All of the above also goes for your partner, who may have their own subconscious parenting ideals and patterns that they are struggling to reconcile with reality. The stress, anger, and exhaustion of dealing with DMDD can make it almost impossible to maintain a solid co-parent relationship. My partner and I have learned to recognize the signs of burnout in each other; one of us takes over when the other is clearly about to lose it.
Plan C the small stuff (and even the not-so-small stuff). If your child is like mine, you have many behaviors you’d like to improve at any given time. At one point my husband and I were trying to get our daughter to do more chores, have better table manners, improve her social skills, and not get physical when she was frustrated. Our days were filled with conflict - and by trying to solve so many problems at once - that we didn’t move the needle on any of them. In The Explosive Child, Ross Greene refers to “Plan C” as setting aside certain issues (temporarily) while you work on your priorities. We focused on the aggression and let everything else go.
Don’t try to discipline during an episode. Many children cannot process information in the midst of a rage; don’t try to reason with them or lecture them. (And making disciplinary decisions or threats while you are heightened isn’t a good idea either.) Focus on keeping your child and everyone else safe; model self-regulation skills as best you can. Debrief afterward when your child is more receptive.
Offer logical consequences. Old-school discipline relies heavily on illogical consequences; that is, punishments that have no relation to the problem behavior. (Like taking away my daughter’s toys because she hit someone at school.) As Sarah Ockwell-Smith notes, illogical consequences can weaken the parent-child connection and, over time, make children numb to any disciplinary threat. By the time my daughter’s room was empty, we had no bargaining chips left, and my daughter had no motivation to improve. Logical consequences, on the other hand, follow naturally from the behavior and allow the child to learn. Ockwell-Smith offers this example: One day her teenage son went over his allotted screen time by an hour. Rather than imposing a random punishment, she asked him what he thought the consequence should be. He suggested losing his hour the following day, and she agreed. This approach is collaborative and flexible; it can be adapted for younger or older kids as needed.
Daniel J. Siegel and Tina Payne Bryson offer other examples in No-Drama Discipline:
“Making a toilet-paper mountain means helping clean up. Riding a bike without a helmet means…for two weeks there will be a required 'safety check' any time the bicycle comes out of the garage. Leaving a bat at baseball practice means having to borrow a teammate’s bat until the other one turns up. These are connected parental responses that are clearly linked to the behavior. They aren’t punitive or retaliatory in any way. They are focused on teaching kids lessons and helping them understand about making things right - which is why they can be so effective in terms of changing behavior.”
Watch your use of time-outs. According to No-Drama Discipline, time-outs are meant to be brief (3 to 5-minute) interludes during which parents can calm down during stressful interactions with their kids. When used correctly, research shows, time-outs help parents refrain from hurting their children. However, a time-out as most parents use it (certainly as I did) is more a tool of anger and punishment - often, during a time when your child most needs empathy and connection. It will not help change behavior. (Note that using a time-out as punishment is not the same as separating your child during a rage to keep everyone safe.)
Focus on connection rather than correction. “One of the most important things you can do as a parent is to nurture - and repair, when necessary - the bond you have with your child,” Ockwell-Smith writes. She recommends regular, ideally daily times of connection. Similarly, Dr. Kathryn Kozlowski, a clinical psychologist, refers to “Special Time” as “a protected, private, and universally positive period of time that you will spend with your child on a regular basis...time that they can speak with you alone, when they have your total attention, and they can’t be yelled at.” She recommends that parents do not try to teach, ask questions, or give commands during Special Time; let it be entirely child-led.
Reconnecting after an episode is particularly hard for me. How am I supposed to smile, hug, and be a loving parent again after being abused by my own child? I have to remind myself that perhaps the most important lesson I can teach her is forgiveness and the ability to start over.
None of this is easy; it’s all exhausting, and I have to admit I’m jealous of parents who don’t have to spend so much time in fear of their children’s behavior or trying to figure out ways to change it. The fact that you are visiting this website shows that you are trying your best to understand and help your child, and that’s a crucial first step.
Ablon, J. Stuart (2014). Rethinking Challenging Kids - Where There's a Skill There's a Way [TEDx Beacon Street Talk]. https://www.youtube.com/watch?v=zuoPZkFcLVs.
Delahooke, Mona (2019). Beyond Behaviors: Using Brain Science and Compassion to Understand and Solve Children’s Behavioral Challenges. PESI Publishing & Media.
Greene, Ross W. (2014). The Explosive Child: A New Approach for Understanding and Parenting Easily Frustrated, Chronically Inflexible Children. HarperCollins.
Hughes, D. and Hudson, J. PACE in Parenting.
Kozlowski, Kathryn. Strongsville Psychological Services. Special Time.
Ockwell-Smith, Sarah (2017). Gentle Discipline: Using Emotional Connection - Not Punishment - to Raise Confident, Capable Kids. TarcherPerigree.
Siegel, Daniel J. and Bryson, Tina Payne (2016). No-Drama Discipline: The Whole-Brain Way to Calm the Chaos and Nurture Your Child’s Developing Mind. Bantam.