The Terrible Twos... And Threes...In Perpetuity

But if you try some time, you just might find, you get what you need

John Rosemond, the least favorite parenting authority of the ADHD/Pediatric Bipolar apologist crowd, wrote a wickedly excellent newspaper column that appeared in my local paper on May 3 of this year.  I hope he does not mind if I quote from it liberally.

Somebody wrote to him inquiring about a four year old who continued to throw temper tantrums when he could not have or do something he wanted.  The writer thought that four years old seemed a bit old for this type of behavior, which is referred to in the vernacular as the “terrible two’s.”  As in: two years olds.

John Rosemond

Dr. Rosemond noted that until recently, such temper tantrums were rare after a toddler’s third birthday.  Only during the last two generations has that changed.  He defines the “terrible two’s syndrome” quite clearly and concisely: tantrums, belligerent defiance, persistent impulsivity, and separation anxiety.

Sounds a lot like the new bulls**t diagnosis for children that was proposed for the upcoming edition of the psychiatric profession’s diagnostic manual, the DSM-5, called temper dysregulation disorder.  (I think the proposal has been dropped, but it may have just been renamed.  We’ll see).

Rosemond blames the recent prolongation of toddlerhood on parents who keep their kids at the center of their attention “in perpetuity,” and on the parents' enabling behavior.  He defines the latter as “doing for children what they are capable of doing for themselves, however imperfectly.” As a further result of these changes in parenting philosophy, American society is now saddled with “large numbers of perpetually dependent children” who “don’t cope well with the realities of life."

Central to these realities is neglect of what Dr. Rosemond cleverly refers to as the “Mick Jagger Principle:” You can’t always get what you want.

Another very important point that he makes in his column is that the enabling parents are actually victims themselves.  He states that there is tremendous peer pressure on parents to “enter into co-dependent relationships with their kids, and be constantly stressed, anxious, and guilt-ridden as a consequence.” I wrote extensively about the explosion of parental guilt and the peer pressure that reinforces it in my book, How Dysfunctional Families Spur Mental Disorder. But I have also experienced the peer pressure first hand.

When one of my children was in college, she decided to take advantage of a “study abroad” program offered by the college, and spent a semester in Australia. In those days, internet connections were not up to what they are now, and overseas telephone calls were still relatively expensive.  


There was something around called a “phone card.”  This pre-paid card allowed the person who bought it a certain limited number of minutes to spend talking on the phone.  We gave our daughter one card for each month she was to be in Australia.

Of course, she used up the first card in less than two weeks, and was then upset that she could not call us.  She was, no surprise, experiencing a bit of loneliness. 

Well, when we mentioned this turn of events to a couple of our friends, they pounced on us with surprising ferocity.  What was the matter with us?  Why did we not just give her another card?  We could afford it.  Our daughter was lonely, and how could we just let her suffer like that.  We were just terrible!  Neglecting our parental duties! 


Listening to them, you would have thought we had just hired Ivan the Terrible to travel to Australia and impale her.

Gee, loneliness.  How awful!  How unendurable!  A bit shell shocked, we nonetheless stood our ground.  The ability to delay gratification is a very useful skill to develop, and we wanted our daughter to be able to learn to do just that.

I remember when I first went off to college.  There were some days when I was very lonely – even somewhat depressed.

I was barely 17, away from my family for the first time, and 400 miles away from my high school sweetheart as well.  I was also in a very strange and unsettling (but fascinating) new world:  Berkeley, 1966-1967, at the height of the Haight-Ashbury hippie days, before the hippies had been discovered by the media.  


Furthermore, almost all of the college girls I had contact with were older than me. (In those days, not only were cougars unheard of, but most girls would not date a guy so much as one day younger than them.) And girls were outnumbered almost two to one by the boys.  

And in those days, we didn’t call home at all, because long distance calls were expensive.  We actually wrote letters.  Snail mail.  Getting replies took days or longer.

Well, I somehow survived.  And I wouldn’t trade that year for anything.  Watching the Grateful Dead for free in Golden Gate Park before they had recorded their first record.  Watching Jim Morrison invent diving into the crowd from the stage at a Doors concert.  Dancing to the Jefferson Airplane, live, at the Fillmore Auditorium.  And we had to hitchhike across the Bay Bridge to get there because none of us had a car.  My parents would never have let me do that back at home.  Priceless.

Recipe for producing frequent tantrums in children

Joseph Biederman is the Harvard Psychiatrist who has been pushing the diagnosis of "pediatric bipolar disorder." He also advocates the use of potentially toxic brand-named antipsychotic and mood stabilizing drugs for children who display symptoms of this alleged condition, because Lithium tends to not work in this population. That could be because these children are not bipolar to begin with. According to the New York Times, drug companies paid Dr. Biederman at least $1.6 million in consulting fees from 2000 to 2007, but for years he did not report much of this income to university officials, according to information given Congressional investigators.

Biederman argues against the use of any duration criteria for manic or depressive episodes in these so-called bipolar children. In the current DSM, hypomania - a mild form of mania - must be present constantly for at least four days, and a full-blown manic episode has to last seven. Although these time lengths are obviously arbitrary, they were put in the DSM so psychiatrists would not label normal mood reactivity as being due to bipolar disorder.

Biederman argues that mood swings in bipolar children can last just a few minutes and rapidly alternate. He further argues that pediatric bipolar disorder is unlike adult mania and is manifested by the key symptoms of temper tantrums and “explosive irritability.” There is no credible scientific evidence that such behavior is related to bipolar disorder. He just MADE THIS UP.

The folks writing the DSM-V are somewhat concerned about the widespread adoption of this ridiculous idea by doctors who only dispense drugs and do no psychotherapy, so they decided they might come up with a whole new mental disorder, discussed in an earlier post, called "temper dysregulation disorder."

Actually, children do not have to have any biogenetic disorder in order to display frequent temper tantrums. We used to call such behavior acting out.

There is a well-known recipe that parents can use to produce this behavior in nearly any child. Just follow the following steps:

1. Start with one parent who constantly tells a child to do or not to do something, but always caves in so the child always disobeys and always does whatever he or she wants to do.

2. Add in the other parent yelling and screaming at the child about this, but still allowing the child to do whatever he or she wants to do.

3. Stir up the mix by having the parents criticize one another’s parenting in front of the child and blame one another for the child’s behavior.

To make a child with borderline personality disorder, follow these additional steps:

1. Add parents who start blaming the child in addition to each other for all of the family problems, but still let the child always get his or her way.

2. Have the whole family invalidate what the child says and does as much as possible.

3. Have parents vascillate between hostile overinvolvement and hostile underinvolvement.

Optional: If a severe case is desired: add in neglect and/or physical and/or sexual abuse of the child.

One has to keep in mind that if parents who usually act this way somehow listen to advice and stop it, the child’s behavior will get worse before it gets better. Furthermore, if the parents occasionally lapse back in to old habits, the child’s misbehavior will continue on even longer before it stops.

This is due to something behaviorists call a variable intermittent reinforcement schedule. The child will keep testing the parents to see if they will revert to prior practices.

Temper dysregulation disorder with dysphoria

The DSM-V Committee has decided to float a trial balloon about this new "diagnosis." Supposedly their hope is that doctors will quit labeling kids as bipolar, since there is no evidence that the behavior of a typical temperamental kid is in any way caused by or linked to true bipolar disorder. I think the new term will just provide another, even more outrageous label that will provide justification for drug dealing docs to use sedating, brand named, potentially toxic atypical antipsychotic medication on kids

My comments to the DSM-V Committee about this new proposed diagnosis:

Temper Dysregulation Disorder with Dysphoria

This diagnostic category is crazy, and would only help those parents who want to avoid looking at their own behavior and its effect on their children and to avoid taking responsibility for it. There is not one shred of respectable scientific evidence that having frequent temper tantrums is a psychiatric disorder (let alone having three per week), and a world of evidence that shows that in a neurologically intact child with a normal IQ it is triggered by parental inconsistency in discipline. If any psychiatrist is so sheltered he has never personally witnessed a family behave this way, he can watch a very accurate portrayal of it on the TV show "Supernanny." You can also read about it in John Rosemond's nationally syndicated parenting advice newspaper column.

The idea that this "diagnosis" will help doctors avoid labeling acting-out children as bipolar is not a good reason for such deception. The people pushing the idea of manic children do not believe that a manic episode requires ANY duration. A few minutes for them is enough. The children and the families in their studies are never observed in their homes during troublesome interactions. The "experts" make diagnoses using symptom checklists that do not take in to account the context, pervasiveness, and exact time course of the symptoms. They recruit subjects from a website called bpkids.org that has a message boards in which parents advise each other on what to say and what not to say to doctors to get their kids diagnosed as bipolar. Some have been paid large sums by pharmaceutical companies which were not disclosed to their university.