Handling Children’s Aggression Constructively: Toward Taming Human Destructiveness

by Henri Parens, MD. Jason Aronson, a division of Rowman & Littlefield Publishers, Inc, subsidiary of the Rowman & Littlefield Publishing Group, Inc, Lanham, MD, 2011, 295 pages, $65.00 (hardcover).

Violence is found in nearly every arena of life from the political landscape to the domestic setting, and yet the impulse for violence is not always understood. Certainly, in child psychiatry, one of the most common presenting complaints is a child’s aggression within the school or home. Within this context, then, Dr Henri Parens’ book is particularly timely and relevant. Dr Parens, a senior psychoanalyst and professor of psychiatry at Thomas Jefferson University Medical College, intended that his book serve as a guide for parents, mental health care providers, pediatricians, and other caregivers in managing and understanding children’s aggression.

Chapter 1 opens with a naturalistic, observational study of 10 mothers from Philadelphia with their newborn infants and young children. Dr Parens met with the mothers and their children twice weekly over a 7-year period. He provided parent guidance to the mothers and observed the behaviors of the children with each other and with their mothers. The families were interviewed again later at 19 years, 32 years, and 37 years. In addition, he analyzed the aggression profiles of these children using the Fitzgibbons Anger Inventory, a measure that indicates levels of anger, trust/mistrust, passive aggression, and violence potential, and found reduced aggression profiles in the study population compared to the general populations from which they had come.

Dr Parens’ assertions regarding aggression arise from his clinical work and from his study findings. He commences with the premise that aggression is associated with the level of attachment between a child and a caregiver. Where there is a secure, emotionally healthy, strong attachment between parent and child, the aggression profile of the child is improved.

According to Dr Parens, aggression can be divided into 3 main categories—nondestructive aggression, nonaffective destructiveness, and hostile aggression. Nondestructive aggression is evident when children engage in sports or in a child’s assertiveness on his own behalf. Nonaffective destructiveness refers to the aggression driven by hunger rather than by emotion, such as human consumption of plant and animal life. Hostile destructiveness includes feelings of anger, hostility, rage, and hate. Per Dr Parens, the experience of intense emotional pain is the most critical factor in the creation of hostile destructiveness.

The book continues with the theme of prejudice, stating that most people have some level of benign prejudice that arises from stranger anxiety and from a desire to identify with one’s own family or culture, but that this can evolve into malignant prejudice or racism if 2 factors are present—if the individual has hostile aggression that is displaced and projected onto others and if the individual receives a militant education that teaches him that another population is to be despised or hated. The origin of the individual’s hostility and hate would be trauma or neglect that he or she has experienced earlier in life.

Dr Parens elaborates that aggression in young children falls into 4 main categories: “unpleasure-related destructiveness” (that which arises from a painful experience), “nondestructive aggression” (an infant’s internal drive to explore his/her environment), “nonaffective destructiveness” (feeding behaviors), and “pleasure-related destructiveness” (teasing behavior) (p 36). The unpleasure-related destructiveness and nondestructive aggression fall under the larger umbrella of hostile aggression.

It is not until the fifth chapter that Dr Parens moves away from the description of theoretical models of aggression to practical advice and clinical examples. He focuses on how parents can mitigate their child’s experience of “unpleasure” and thus reduce the accumulation of hostile aggression. In subsequent chapters, he describes the distinction between compliance and obedience and explains how parents ought to inculcate an attitude of compliance rather than blind obedience in their children. He continues with guidance on limit-setting, management of temper tantrums, facilitation of expression of hostility, and helping children cope with painful emotions.

A criticism of the book is that significant portions of the first 4 chapters are rather redundant as the author repeatedly rehashes his descriptive model of aggression. In addition, in chapter 7, he seems to imply that harsh child rearing contributed to the development of Nazi Germany and other totalitarian regimes. He distinguishes obedience from compliance and asserts that obedience is linked to militant fundamentalism and that parenting styles that emphasize obedience, rather than compliance, create citizens who blindly follow authority. Some of these assertions can seem too simplistic and reductionist and can detract from the stated intention of the book to help parents and caregivers understand aggression. The assertion that parenting styles dictate what sort of an individual one’s child will become and what type of society will develop ignores the significant contribution of other factors such as temperament, genetics, social and economic forces, and psychopathology.

However, in general, this book was excellently written, as Dr Parens skillfully weaves in developmentally relevant psychodynamic concepts such as Erikson’s life stages, Piaget’s cognitive developmental theories, Bowlby’s attachment theory, and Mahler’s concepts of separation and individuation into his discussion of child development. He also discusses anxiety in detail with a developmental lens. He defines and describes separation anxiety, stranger anxiety, and other childhood-specific anxieties. He provides specific clinical vignettes and explains the child’s behavior with a clinical perspective. He also provides detailed, practical advice for parent guidance and for intervention in children.

Though the target audience includes parents, some of the developmental theories and psychodynamic concepts may be too complex for parents to understand. However, for mental health providers who treat children, this book provides a refreshing, comprehensive guide to understanding aggression in children from a developmental perspective.

Julie M. Sadhu, MD

julie.sadhu@gmail.com

Eugene V. Beresin, MD

Author affiliations: Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. Potential conflicts of interest: None reported.