I treat a lot of children in my practice and a common complaint parents want treated is the temper tantrums that afflict their children. As often the case, there are many reasons for such behaviors. Listening to the child and hearing their story allows one to step into their world and try to bring together the threads that help to formulate an image for their needed remedy. Here is a case I hope illustrates how the child’s feelings reflect the challenges she faces at home dealing with a younger sister, attachment insecurities with her mother and the parallel universe that is shown in her dreams.
This is an edited video case for this article to illustrate how the case was understood. I have also included commentary to give the reader an understanding of my thoughts as the case unfolded.
Girl aged 8 years. First seen: 8/10/2013
Presenting Complaint: Her mother brings her daughter for treatment because of her temper tantrums. She has had them pretty much all her life. They can go on for 2 – 3 hours, usually 2 – 3 times a week. They are not responsive. She also had separation anxiety from about 18months of age.
K.A.: So tell me about these then?
Pt.: Mummy tells, not me.
(I am thinking that her response is to deflect to her mother, i.e. her mother can speak for her – suggesting, “I am dependant on you.”)
Her mother says that the tantrums are getting more violent even to self-harming.
I interview the child separately to try and understand her state further. As she talks, what is noticeable is that her speech has a childish quality to it.
(Her tantrums have occurred since she was an infant. It is not something new, so in a sense, we can say that her state has not changed since then. Her behaviour is still as though she was an infant).
K.A.: What’s the feeling that you get?
Pt.: Really sad and angry.
(So we have two types of feelings: Sadness and Anger)
K.A.: So tell me more about that sad and angry feeling?
Pt.: I’m really sad because I don’t get what I want. (Row 3: needs not being met). I don’t get to watch the TV because Kirra (her younger sister) doesn’t let me, she sits in the wrong spot; we have to do the dishwasher and sometimes Kirra doesn’t do it and I have to do it… at night time. Kirra says it’s her turn to choose the book to read, but it is really my turn.
(Again, issues about choice: Row 3. So she is telling me that her needs are not being met – these are issues that relate to the mineral kingdom. It is not an issue of sensitivity relating to the plant kingdom or feeling of being a victim as in the animal kingdom).
K.A.: When was the last time you were angry?
Pt.: I think it was last week when daddy was at work and it was on a Monday because I wanted a cuddle from mummy but she didn’t let me and I kept going on and on.
(Again, she wants a cuddle and does not get it. This is then what upsets her – Row 3 issues of care)
K.A.: And what is that feeling like?
Pt.: I’m sad again.
(The other feeling is Sadness)
K.A.: So if mummy is not really there with you, that makes you a bit angry?
Pt.: Nods. Sad because when she goes out for dinner and doesn’t come back until midnight and that makes me very sad.
K.A.: You like to have mummy around you?
Pt.: Nods. At night-time.
K.A.: Do you pick things up and want to throw them or break things?
Pt.: I don’t want to break things but I do want to throw things. I don’t want to break anything because I know I will get into big, big trouble. Sometimes I break stuff and it is a very special and I want to play with it and it is gone, broken.
K.A.: Do you want to hit or strike out?
Pt.: Hit people but I only want to do it at home. It’s normally my sister teasing me and me getting in trouble instead of Kirra. That happens a lot.
(So the people “I am dependant on disappoint me, it makes me sad and angry”)
K.A.: What’s that feeling like?
Pt.: Makes me very angry.
K.A.: Do you punch or hit?
Pt.: I get really angry and then I tell mummy. She normally believes me than Kirra because Kirra tells lies, goes back to mummy and gets me in trouble. That’s what I don’t like, getting into trouble.
(She needs her mother for help, love and support – Row 3 issues)
K.A.: Describe that feeling to me then?
Pt.: I don’t like getting into trouble because I get screamed at. It makes me feel even angrier.
K.A.: What do you feel when you start to get screamed at?
Pt.: Very sad.
(This is the other side: when she is getting reproached she becomes sad)
K.A.: Tell me what dreams can you remember?
Pt.: Mummy getting taken away.
K.A.: Tell me about that dream then?
Pt.: I have lots of different dreams, but that was one of them a long time ago. Mummy got taken away for a week by a monster. Then the police caught the monster and brought mummy back home. She was taken away at night and in the morning we looked and looked then we learnt that mummy was gone.
(We see the person who she is dependent on and who is supposed to care for her is taken away – a similar experience at home with her mother not giving her enough love)
K.A.: How did the monster come and manage to take your mummy away?
Pt.: He sneaked in through the door or window I can’t remember which one. And without anybody knowing crept around the bed and got her out of the bed and put a dummy and painted it like mummy, but daddy pulled down the covers, then we saw mummy was taken away. He tried to trick us. Then we looked everywhere and we realised that mummy was gone.
(So mummy is taken away by the monster (Kira) who has tricked us)
K.A.: So there was no one there to help her?
Pt.: No we were all asleep. But it never happened.
K.A.: How do you think your mummy felt in the dream when she was taken by the monster and there was no one to help her?
Pt.: Very scared.
(Even though she is talking about someone else in the dream, feelings that occur would be a reflection of her own state – especially as they share a similarity to her issues of separation. Therefore asking her to describe what those feelings might be allows her to indirectly describe her own state.)
K.A.: Tell me about that feeling?
Pt.: She was really scared that she was going to get eaten up by the monster (I’m alone and I’m violently attacked). She tried to get out of the monsters arms, but she was so scared that the monster was opening his mouth pretending to eat mummy but was just tricking mummy. Then the police found her a week after holding mummy and mummy told them where she lived and she came back home.
K.A.: Do you get sad at other times without being angry?
Pt.: Sometimes. But not often.
K.A.: What happens at those times?
Pt.: Sad because mummy has gone out. And she hasn’t said good night to me before she left.
(Like the dream with the monster taking mummy away without her knowing)
I interview the mother now to see if there are any other details she may be able to offer:
K.A.: So when she gets angry, how angry does she get?
M.: Very angry. She kicks and throws things at me and it’s been getting worse. It’s alright when they are 3, but at 8 it’s the same. Everyone kept telling me she will grow out of it; no, she is growing into it. She will attack me, she will hit me, throws stuff. Attacks her sister if her sister comes anywhere near her.
K.A.: So is it just between you and her sister?
M.: It’s between me and Kirra…
K.A.: What else can you tell me about her nature? Is she a quiet sort of child, active or restless child?
M.: She would never talk to adults until she was 4 ½, she was very very shy…
K.A.: Does she want to be around people or be alone?
M.: Around me, she will follow me around constantly. And that has been always, no different between when she was 2 to now. She doesn’t self amuse. She may occasionally, do some colouring, but she generally likes me in the area. So if I am in the kitchen she will do some colouring there, will move wherever I move. If I am in the shower, she will sit on the floor and colour in.
K.A.: Can she be sad without being angry?
M.: Yes. With the angry, she writes me notes that she wants a hug. I do try and approach her and give her a hug, but if you make the slightest, not to her satisfaction, then she will just get even angrier.
K.A.: What does she say when she is like that then? That if it doesn’t go the way she wants it to go?
M.: When she gets angry, she will just scream at me, that I’m not doing it right, or I didn’t do it early enough.
(We see one side of her behaviour i.e. her demanding nature: “I’m not getting what I expect”, reflects the instability of the halogens on the RHS of the row)
I do the warnings, that if you continue to scream at me I will leave the room. Then she will continually scream at me until it stops and I will try and leave the room and she will hang on to me.
(Here we see the other side of her behaviour: the clinging, “I need you”, dependency seen on the LHS of the row)
K.A.: Anything else which makes her anxious or uptight?
M.: She has a definite view on how things should be…I’m too random, she’s logical. She sees things in a distinct pattern. It would be the blocks, if I didn’t put the blocks away in the certain pattern they were supposed to be, she would have these temper tantrums. If I am not doing something that she perceives the right way she will get frustrated and angry.
Lastly, her appetite is large, her mother saying that she constantly needs to eat; she has a number of food allergies, she is very restless, constantly needing to be amused doing something with her mother.
Rx: Natrum Iodatum 1M once per day for 4 days.
Follow-ups after remedy:
Her mother immediately noticed that her tantrums started to settle. She became calmer and was more accepting when her mother said “no”. Even when she would be expected to have a tantrum, they didn’t eventuate. When a tantrum did occur, they gradually became shorter and shorter in duration. She became less clingy and not needing to be around her mother as much.
The remedy was repeated periodically over a nine-month period. She was also given Nat iod 30 when she developed an acute tonsillitis and cough/cold that also helped her recover. The frequency of developing sore throats also diminished. The foods she was previously sensitive to are now not causing her any more problems.
Analysis of the case:
Her main concern is that her needs are not being met (Sankaran’s Row 3: care, love and nourishment). What she wants she does not get. Her response is to have a tantrum. She complains that her sister gets what she wants but she does not. Her reaction is not to behave as though she is in competition with her sister (so there is no animal-type of response), but to argue that she does not get to have her choices responded to (Row 3). This makes her sad (Natrum – Scholten) and her response is to have a tantrum, a very childish – column one (Natrum) type of behaviour.
Her dreams also reflect the sense of loss. We see her mother, the person who she is dependent on and who is supposed to care for her is taken away – this is a similar experience at home with her mother not giving her enough attention. It is like the monster (Kira) has played a trick and has taken mummy away. Sankaran points out that Natrum is dependent on someone else to take care, love and nurture him or her. This was apparent as this girl who is lost without her mother and compensates by needing to be around her all the time.
Her feelings of being let down and disappointment suggest issues related to the Halogen group. The intensity of her reactions, the violent nature of her anger, her restlessness and increased appetite lead to Iodum.
Iodum: they have to face new situations (Row 5) alone that feels dangerous whereby they can feel threatened, betrayed and cannot depend on anybody. They feel that the person who is supposed to show or guide them is either not there or has turned against them.
- Very logical
- Sees things in distinct patterns
Column One Themes:
- Clingy, dependant on mother
- Childish manner
- Tantrums – infancy to now i.e. she has not grown out of this pattern
Row Three Themes:
- I don’t get what I want
- I don’t get to choose
- I want a cuddle and don’t get – (Issues to be cared for)
- “Mummy tells, not me” (I am dependant on you to tell me who I am)
- Disappointment, let down by those they are dependent on
- Alone, isolated
- Violent, striking, angry
- Constant appetite
- Restless, always on the move
Materia Medica for Nat Iod
There are no proving details for this remedy.
The initial picture we have for this was from Scholten who suggests:
“That one is alone in your fight for your existence”.
This is interesting when we see the types of situations and reactions that occur for this child.