Adult Temper Tantrums

I have been more and more impressed recently how valuable it is to see people as a kind of sandwich with an adult layered on top of a very active child. It is surprising when one starts to think that way, to see how much of what we say and do comes from the child. Many if not most of the problems that are solvable through psychotherapy are best understood as the inner child making an appearance and crying out for solutions to issues from long ago. The key to helping these troubled inner children is a readiness to work with them as a compassionate and understanding adult. Let’s take a look at what that means.

When children are troubled by an unmet need, they know that the solution is to get the adult to understand and solve the problem. In adulthood, if the need still hasn’t been met and the shortfall isn’t fully accepted, that means the child has experienced the original caregivers as unwilling to take care of what should have been their responsibility. So the need is still there, and with it is anger, hurt, frustration, and some hope that someday, some grown-up may understand and finally take care of business.

This situation is a set-up for a roller coaster of hope and disappointment. The child within finds hope that somehow the need will at last be met, then it turns out that the grown-up who had been identified as the one to solve the problem is not going to solve it. Then anger starts to boil. Just as it was long ago the child realizes that the responsible adult is not accepting responsibility. The anger has no where to go, so it shows up as helpless rage. Maybe it gets directed at people who don’t really deserve it. Maybe it gets turned against the self, and maybe it gets covered up and buried. When the latter happens, the rage turns into destructiveness. As a therapist, when I see rage and/or destructiveness that is causing tremendous harm but can’t seem to be stopped, I think of an adult temper tantrum.

The best tip-offs that a temper tantrum might be taking place are anger that fails to dissipate and destructiveness that seems to keep going even when it is obviously dysfunctional. These hallmarks are no different from those of a two-year-old tantrum. In fact, I have come to believe that what is going on, outside of awareness, is exactly the same. So let’s start by examining the anatomy of a two-year-old temper tantrum.

Why Tantrums are Life-And-Death Struggles

The reason tantrums appear during the “terrible twos” is that before that point in development, toddlers are not cognitively equipped to see the danger in a power struggle with Mom. They see the world as revolving joyously around them. Mom’s will (or that of the primary caregiver) is perfectly aligned with the child’s will. When I want something, Mom wants it for me. When I don’t, she is on my side, too. The world is indeed the toddler’s oyster. Yes, of course there are times when Mom says, “No, you can’t have that,” but somehow it doesn’t break through the blissful harmony of the relationship. Mom says no, and the child somehow lets go, and no one is the worse for the wear.

Rather suddenly, around age two, this changes. Now, the two-year-old becomes intolerant of disagreement on Mom’s part. To my mind, the best explanation has to do with cognitive development. Before, the Mom who was smiling and agreeable was a different Mom, from the one who said no.  Furthermore, the self who was told no, was a different self, so there wasn’t any clash between the two self-other pairs. According to this theory, what happens developmentally is that cognitive advances lead to a realization that the two are actually the same. The mother who says yes and the one who says no are the same mother. At that point, disagreement with the mother who says no becomes a threat to the vital attachment to the one who says yes.

For this reason, from the child’s point of view, the only solution to a disagreement is that Mom has to change. The child experiences rage, then helpless rage, that Mom has to give in and why doesn’t she? Why is it that Mom is the one who must change? Giving in feels like a complete loss of self. It seems like a loss of everything that made the self cherished and lovable. So the child has no choice but to put up a life-and-death fight to get Mom to change her mind. The stakes are not simply the thing being fought over, but life itself. If the child loses the battle, then, like the gladiators of Rome, he or she will die.

How Tantrums are Resolved

The healthy resolution of a tantrum is this. Mom scoops up the child in her arms, preventing the child from doing any damage to self or to her. The child continues to flail for a while, screaming things like “I hate you, Mommy.” It is very fortunate that two-year-olds are small and not very strong, so preventing them from doing harm and staying physically close is pretty easy. After a while, the child stops thrashing and begins to cry. Soon the tears turn to clinging and the rage runs its course, allowing mutual feelings of love to return, expressed in the holding and maybe soothing words given by Mom and accepted by the child.

According to the theory, what has just happened, is an incremental fusion of the two internalized relationships, the loving mother and self and the angry mother and self. In other words, the child has begun to learn from experience, that you can lose a battle and still be lovable. That is huge. It is what allows us to survive our failures and mistakes and to allow ourselves to admit failure and accept being forgiven. More simply, repeated many times, we learn to lose battles gracefully. On the other hand, when these abilities are missing, we can imagine that the inevitable temper tantrums were handled differently.

Other resolutions to the tantrum are not so good. Children who are overindulged cannot learn to lose the battle because they always win. Lacking the ability to accept losses, they feel an absolute need to win every time, or, more likely, give themselves the illusion of having won. Children who are punished or rejected and isolated for their willfulness are no better off. Threatened with emotional death, they, too, resolve that they must win every battle. These are the conditions that appear to promote development of a Narcissistic Personality Disorder. This is why I don’t recommend placating a child or putting him or her in a room alone. Resolving a battle at this age should be a very physical, personal encounter with a successful ending.

What if Mom acts hurt and isolates herself? Then the child will be afraid to have a battle and won’t learn to hold his or her ground, for fear of injuring the one person who is most important in their life. One way of coping with this, according to the theory, is the “borderline” solution, to keep the good mother-good me relationship distinct and separate from the angry me-angry mother relationship, holding onto an earlier cognitive stage. People who keep the two separate are the ones who suddenly switch between an idealized relationship and one of arch enemies. Obviously these whipsaw switches take a toll on close relationships.

The Adult Tantrum and its Treatment

Adults can and do slip back into the mode of a child having a temper tantrum, but it is not as immediate or obvious. Unfortunately, adult temper tantrums can last for years. As indicated above, the signs are raging and destruction that are clearly harmful but don’t stop. What may not be visible is what is being fought over. I have seen this in Binge Eating, Agoraphobia, alcohol and drug abuse, and other destructive behaviors. Overt rage might be the kind that won’t be calmed or healed. The rage may also be buried or turned against the self.

I have sometimes described the therapy for adult temper tantrums as having a solid and unmoving rock on the shore upon which the raging sea must crash over and over till the storm runs its course and the sun comes out. This is easier for a therapist to do than a parent, spouse or friend. Therapists don’t have to be there every minute and are compensated for their endurance. Furthermore, it may be easier for them to have some perspective on what is happening. On the other hand, even for therapists this is a hard thing to do. Not infrequently, the rage is turned directly on the other person. Being criticized, insulted or even threatened is not so easy for anyone to handle including therapists. Some therapists do well in this role and others may don’t. Hopefully the therapist knows and doesn’t raise hopes that he or she can’t fulfill.

Nonetheless, the elements of a successful outcome are the same as for the child. The first is containment of the rage. Destructiveness must be contained or it will continue to escalate. In the case of direct threats to the therapist or other person, limits must be set so the recipient is not in any real danger. In the case of other kinds of damage, the destruction may have to run its course till the adult patient decides that enough harm has been done. Sometimes police or other authorities, or even family can intervene, putting a stop to the destruction, but the individual must become ready to stop. This is a kind of “hitting rock bottom” where the non-conscious destructive wish is relinquished, and health takes charge. In practice, getting through this phase can be extraordinarily challenging.

The second element is to reestablish empathy and connection. The person having the tantruPridigal Sonm must feel needy enough and safe enough to allow the self to be soothed. Accurate empathy is key, meaning that the therapist needs to have a real understanding and appreciation of the emotional issues  and why acceptance is so hard to achieve. This empathic connection may have to be reestablished multiple times to be internalized along with the belief that the self, even if imperfect, can be forgiven and can still be loved. Rembrandt’s painting of the Prodigal Son expresses this ending perfectly.

Is Every Adult Rage a Tantrum?

I think the answer is no. Normal rage, once it comes to the surface, can heal like other emotions. It heals by the process I call Catharsis, that is, being fully felt in a context of empathic connection (See the Post on Mechanisms of Healing). But there are many situations where the mind is afraid to connect the dots and acknowledge what the rage is about and to whom it is directed.

Let’s look at rages and/or destructiveness that seem resistant to healing, should every instance be called a tantrum? In many of those situations, there is some major threat associated with the rage becoming conscious. If the fear is loss of self, then we should think of it as a full blown temper tantrum. Other possibilities are that holding onto rage has some kind of payoff and that the reason for resistance to healing is some other fear. But it may be hard to discern such subtle distinctions. After all, this is going on in the non-conscious part of the mind and may only give off a vague sense of resonance to indicate what it might be about. I think the answer should depend on whether the concept is useful in unraveling what is going on, getting the destruction under control and healing the rage.

What I do with my patients is to clarify that there is some kind of “NO,” some kind of refusal to let go of the rage and/or destructiveness. Then we can begin to explore what it might be using free associations, theories about past experience, intuition, etc. Fears of one’s own rage other than death of the self might produce a similar picture on the surface. As we become aware of the emotional work that must be done in order to let go of the feeling and behaviors, then we can focus on that very challenging work.

I have to say that this area is one I am gradually learning more about, but I am sure that I have not yet explored the entire breadth and depth of the issue. So I would encourage readers to share their knowledge and experiences, especially about working with a relatively intractable rage or destructiveness.

Whatever the details, the valuable take-home is that the concept of the adult temper tantrum coming from the child within leads very naturally to the important therapeutic goals of 1) containment, and 2) understanding and feeling the emotion with an empathic witness.




    • Thanks, Linda. Since I wrote this post, I have been further impressed by how hard it is to switch from the tough-love therapist who lets the patient come up against the reality that their ardent wishes and demands cannot be fulfilled, then, when acceptance begins, is supposed to be there with compassion and empathy for the pain that results. One reader wrote to me about a situation that sounded like that, and I can identify with the therapist who seemed to be having trouble moving from tough love to empathy. It is not easy to experience the brunt of the patient’s rage then be ready instantly to empathize with the pain. I hope this helps everyone be more understanding.


    • That rage is absolutely nasty. It hurts the person you love and destroys yourself people thinks oh just stop it only if I could. Thought therepy it is getting painful but it is so painful it actually feels like you are going to die.

  • Hi Jeffery, Yes I can imagine that it’s not always easy for a therapist to move from tough love to empathy within a therapy session! Therapists are human too, and though they have a much broader perspective on people than non-therapists, switching between such different emotions must be challenging. So therapy clients should be mindful of this indeed…

  • THanks for the great post. I KNOW I have adult temper tantrums when it comes to therapy, and most of the anger ends up being directed towards myself. We are working hard on it though and I think I am starting to have some compassion for that little girl within, given that the pain is within certain parameters and that I know that my therapist is there should I need her.

    WHen I see my kids having tantrums, I can see the real pain and despair in their eyes. It is even worse when you are an adult I think- the pain having built up for so long. Yet we are so good at covering up the pain and despair in our eyes- I wonder when we learn to do that?

    I’d love to hear more of what you have to say about the inner child’s role in therapy- it is becoming more and more obvious in my therapy that it plays a huge role (whatever name you give it!)


  • Temper tantrums comes from a perceived state of helplessness. People get angry for a number of reasons. Many are so stressed that even a small incident can set them off. We can identify temper triggers and try and avoid them. But again, that isn’t a long term solution. Professional help can be a great option.

  • I believe that the seeds for adult ‘temper tantrums’ are sown during infancy with the occurrence of protracted and persistent failures for whatever reasons to meet sufficiently the basic visceral needs of the infant, and for which the infant has very limited ‘response’ ability. This is almost inevitably reinforced in early childhood and then ongoing. The reactions then show up as either raging/tantrums or as giving up/defeat/collapse. This latter is generally named as depression, an ‘treated’ with medication, which, of course does not get at the underlying process, dynamics, or history.
    Thank you for your light shedding writings…

  • Dr Smith I am a patient from some time ago. This article explains a lot to me and proves you were my best Dr.


  • I am so grateful for this website and in particular for this article. I’m trying to understand my own rage and tantrums, especially after my last appointment with my therapist. I’ve been working hard with her for the last three years to try and heal from a childhood full of a variety of abuse and trauma. Historically, I’ve tried to keep my rage hidden. I would throw my tantrum at home, cut myself, then bring the evidence to my therapist and tell her about it, with no emotional display at all, just sort of reciting the facts. She’s been working to get me to understand that self harm is not a solution. I’ve worked to find other ways to deal with my rage and haven’t hurt myself for quite some time.

    But recent changes in our scheduled meetings has resulted in less time with her and my rage has been surging. The last time I saw her, I went into a dissociative state and completely lost control. I hurt myself in front of her. I surprised and confused myself with my outburst and have been searching for insight. I was scanning through my journal and found an entry from last November where I was talking about my rage and how hard it is to let it go. I wrote, “My rage is all that makes me feel like I am worth something, worth saving, worth living. If I stop fighting I may as well die.” Also, “Being forced and unable to control makes me feel like I am nothing and I fight it…I fight against being nothing.” And, “My rage is how I know I have value. No one fought for me except me and no one cared to even know about it. If I stop fighting it means I don’t care and I’m the only one who ever did.”

    Then I read this article and the theory about the two mothers and it makes perfect sense to me. My mother was one who would be hurt by my fighting and would walk away saying, “I don’t care!” The “borderline” response describes how I adapted.

    What I find interesting is that my journal entry was talking about rage in reference to a moment of life threatening sexual abuse that happened to me at age 3. I had decided that the intensity and life defending feel of my rage was in response to my very real helplessness and powerlessness during that event. But, now, in light of this cognitive development theory, I have to think that it’s more complicated than that and the two mothers theory seems a more accurate description of what’s been going on in my subconscious.

    My rage has been increasingly focused at my therapist for things she does that I can’t stop her from doing (like taking vacations, or not clearing extra time for me in her schedule). The powerlessness that I feel for not being able to control her fuels my rage…which seems like a situation that corresponds perfectly with a two year old not being able to change her mother and the life threatening feel stems from the impossible dilemma of losing either myself or my perceived “life source”…because my only choices are either to accept her doing whatever she’s going to do even if I don’t like it, or to leave the relationship.

    The really frustrating thing about all of this for me, is that I work really hard at trying to get better. I have group support, I read and journal, reflect, and meditate, yet all the intellectual knowledge and understanding that I’ve accumulated seems to have very little impact on my patterned emotional reactions. I keep trying to brainwash myself into a new way of behaving, but it’s like the message just isn’t getting into my subconscious. My inner two year old rejects the concept of “acceptance”.

    I’m wondering if this is a natural progression (marked with occasional regression), or if I’m not working hard enough? If I’m totally honest, I think a deep part of me wanted to do that and is satisfied at having gotten it out…not just telling her about my rage, but showing it to her. I feel kind of bad…I really let her have it, like, personally, before I turned on myself. I guess it’s a good thing for her that she’s going on vacation now. I’m sure she needs the time to recuperate. Her response to me was fairly measured and calm, focusing more on ensuring physical safety and reminding me of the work I should be doing. Unfortunately for me, her going away on vacation means we didn’t get to reestablish empathy and communication. I only hope that opportunity will occur once she returns.

    Anyway, thank you so much for the article and all the great information on this site. It truly is helpful.


    • Dear PersistentOne, This is a great comment in that it takes us down to a level of detail that is so important when it comes to applying theory to real life. I have been finding in my practice as well that the old principles apply, but it is hard to appreciate just how and to what degree. In my post, I make it sound almost trivial, much too easy to face feelings instead of acting on them. In fact, “feeling” is much to mild a word. These are, to use one patient’s apt adjective, “primal” feelings. They are so basic, so tied to survival, and so deep that when we run into them, they have the power to drive any kind of unhealthy behavior.

      As I said in my post, it is far more natural to run from feelings by putting them into action. So how can we push ourselves to expose and face our primal feelings? I would welcome further comments and examples from readers. So far, since these often happen at night and not necessarily during sessions, I am recommending first to work on writing a paragraph or a page using the best words you can find to describe the most primal feelings and their original triggers. Then, when the feeling is lurking, as indicated by the temptation to act out, it is time to get out the paragraph, read it, picture it, and experience it.

      The amazing thing that will happen is that doing this will elicit compassion from yourself. But that is not the part of yourself that wanted to act out. It is the adult mother within you, understanding and empathizing with the small child. Each is present independently, the mother giving compassion and comfort to the chid, and the child feeling the intensity of the feeling. That is exactly the configuration that heals through what I like to call catharsis.

      On the other hand, this is hard to do. The temptation to escape is intense. One of the escape routes is for the adult to be critical and punitive, disgusted with such infantile feelings and reactions. If you can’t read your paragraph with compassion, then this procedure won’t work.

      The reason I am using the word “procedure” is also important. We are working on a compulsive and destructive behavior pattern that is well ingrained. In the “heat of battle,” like soldiers and firefighters, humans need to have well-practiced procedures readily at hand in order not to repeat instinctive, but unhelpful reactions at critical moments. With a practiced procedure, there is no need to think, only to implement. So, once again, the procedure I am thinking may be helpful, is to write down a description of the primal situation and emotions, and to have it ready to read at the moment of temptation to act out. I hope readers will help with personal experiences to see how well this works. Jeffery

      • Hi Jeffrey,

        I feel intensely self-destructive sometimes. This is often when I’m so frustrated trying to communicate and I feel, then, that I am not being “heard”. I realized a couple of weeks ago, that when I feel this way, I start to talk loudly and more rapidly. To others (for example, my husband), this looks “irritable and argumentative”. Really though it’s a valiant but ineffective attempt to get them to “see” what I’m trying to say. It never ends well for me to talk like that (loudly and rapidly repeating nearly the same thing). since I realized this, I have been able to stop myself from the “irritability argumentative” response a couple of times (and a couple of times, not been able to stop).

        I have to realize that the FEELING of “not being heard” is NOT an emergency. That I can leave the discussion and return to it. That I can try a new way of expressing my idea or thought or feeling or perception. I still don’t like, the way it feels. But I can tolerate the distress by using DBT skills for distress tolerance.

        The last time this happened and I felt so explosively destructive, and self-destructive: I took a deep breath and waited, didn’t act on the self-destructive impulse. I don’t know how I did it, really, except that I was aware I wanted to. It’s really difficult.

        • Dear Sylvia, The last paragraph resembles something I have been noticing and thinking about. People often slide into health, or just say to themselves, “What the hell,” before doing the thing their inner self thinks is madness, in your case, not acting on destructive impulses. I’m glad you did. JS

  • Hi Jeffery,

    I relate to what you say ‘One of the escape routes for the adult is to be critical and punitive, disgusted with such infantile feelings and reactions. Like PersistentOne, I also cut when theses feelings are overwhelming and I feel totally ashamed of them. Cutting releases the intensity, but of course it provides problems of its own – needing medical attention, having to lie about the cause etc. Also it’s not easy for people with Borderline Personality Disorder to find a therapist to take them on. I’ve been told I’m too hard/needy/unstable in the past, but luckily this year I’ve found a wonderful therapist. It’s just that I’m so scared to show her my level of need and attachment. If it disgusts/shames me, then how can it not repel her?

    • Dear Catgirl, I’m going to give a general answer to this question as a new post in the Q&A section of the blog. Jeffery

  • I wish my former therapist would read this. For me to let go of the rage I would have to accept that she will never be a part of my life again, this is akin to accepting that my mother is dead. Her terminating me is unacceptable since it recreated my original trauma of being abandoned by my mother. She should have known early that she didn’t want to or couldn’t work with me. She did incredible harm by encouraging bonding over forty-eight sessions, making promises she didn’t keep, and inability to manage her counter-transference. I didn’t even get a good-bye-she said she was the mirror image of my mom, she verbally attacked me in our last session, not the first time, but it was the last.

    • Anne, I’m in a similar situation. I can hear the pain in your words.

      A month ago, I made one comment about my therapist not having enough hours, and I felt a switch flip in our relationship. Suddenly (10 minutes after that comment and on), my until-then kind and loving therapist stopped believing my accounts of events and started telling my I was in denial about my experiences.

      It seemed like I was much more aware of the shift than she was. Even after three apologies from me, she continued to respond to my experiences with skepticism.

      I started to wonder if she was unable to see me. Finally, this week, she kept bringing up one specific situation that we disagreed about until I would “get out of denial about it.” I had to end the relationship.

      Even though it was my choice to end it, I feel incredibly abandoned. I never wanted the relationship to end, but her behavior was aggressive.

  • Hi, very informative article. I am new to the concept of “adult tantrums” but old at being at the receiving end of them! The question for me is “do I stay in this relationship of 52 years or move on?” I am not sure that the tantrum delivering female is willing to recognize the issue!

    • Dear Mature, Here is the short answer: You can help your partner without any discussion or overt explanation. What needs to happen is that you stay in emotional contact, but disengage and don’t get provoked into an argument. In short, you need to contain the rage, but not try to stop it. Then let the rage run its course. As your partner begins to experience that each “hissifit” will run its course and no damage will be done, then they will get less intense and shorter, and eventually, a subject of humor (at least afterwards). That’s probably too short an answer but it is the essence, and no different from how a toddler learns that anger is not the end of the world. JS

      • I have the same question as Mature. I’ve been in a relationship for 20 years with a man and his frequent temper tantrums will be the cause of our demise if I take the permanent step to leave. I’ve separated twice before from him for this very reason. He’s done anger management courses, he’s quit drinking (9 years sober) and attends AA. He also recently started on Lexapro. It made a significant difference for about the first month or two but as soon as stress rears it’s head or life gets a little unpleasant, the tantrums return. Basically, to sum every tantrum up, it starts with
        Absolutely having no patience for something, and then it escalates into a poor me, everyone’s out to get me, no one works as hard as I do, no one appreciates me, intermingled with negative self talk. It’s bizarre to me and I’ve never been able to handle it. I don’t say much for a while, hoping it will run its course. But of course I’m usually the main punching bag in the tantrum and he starts accusing or belittling me, so of course I get defensive and an argument ensues. When I try and help I’m the one “getting mad” or “nagging.” Oftentimes I just walk away from the situation. Sometimes before an argument ensues, other times in the heat of the moment. But we are usually in the middle of a job or project together that is timely, so it’s usually imperative that I come back to help him finish the job. I’ve often wondered if I just shove myself in front of him and give him a hug – like you would a toddler- if it would work to sooth the tantrum away. He is the youngest child by several years and I’m quite sure his mother doted on his every need when he was a child.

        • BBR, you might be right. The best way I know to deal with a tantrum is to prevent damage from being done, and to stay engaged emotionally without trying to change the raging person, but containing the rage and waiting for it to run its course. JS

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