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Topic : 02/02 Rage Caught on Tape: The Follow Up

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Created on : Thursday, January 29, 2009, 07:32:07 pm
Author : DrPhilBoard1
Dr. Phil continues his look at rage. When Isabella first appeared on the show, cameras installed in her home captured outrageous behavior . Has she changed? Find out how she reacts when she hears what DrPhil.com message board writers posted about her. Isabella's mom, Mary, joins the show and gives insight into Isabella's childhood. Why does she feel her daughter's anger is like a cancer that could destroy her? Then, find out why Isabella says she feels like she could actually hurt someone. Dr. Frank Lawlis, Chairman of the Dr. Phil Advisory Board and author of The Stress Answer, reveals the results of Isabella's evaluation, which he conducted at his PNP Center. Will the findings shed light on why Isabella loses control? And, Stuart says his rage is like a train on a collision course, and he's fearful for what might happen. He unleashes on everyone from his family members to strangers. How will he react when he sees what it's like to be on the receiving end of his out-of-control anger? What's at the root of Stuart's behavior? Plus, if you feel a fit of rage coming on, don't miss the exciting feature on DrPhil.com that will help mellow your mood! Join the discussion.

Find out what happened on the show.

As of January, 2009, this message board will become "Read Only" and will be closed to further posting. Please join the NEW Dr. Phil Community to continue your discussions, personalize your message board experience, start a blog and meet new friends.

February 2, 2009, 8:43 pm CST

INTERMITTENT EXPLOSIVE DISORDER

Quote From: savala88

Has dr. phil explored INTERMITTENT EXPLOSIVE DISORDER???


besides her lack of empathy she seems to match this disorder to the T

I found some interesting info on this disorder, which many may already know.  Yep! Describes Isabella to a T.

 

Definition

Intermittent explosive disorder (IED) is a mental disturbance that is characterized by specific episodes of violent and aggressive behavior that may involve harm to others or destruction of property. IED is discussed in the Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) under the heading of "Impulse-Control Disorders Not Elsewhere Classified." As such, it is grouped together with kleptomania, pyromania, and pathological gambling.

A person must meet certain specific criteria to be diagnosed with IED:

  • There must be several separate episodes of failure to restrain aggressive impulses that result in serious assaults against others or property destruction.

  • The degree of aggression expressed must be out of proportion to any provocation or other stressor prior to the incidents.

  • The behavior cannot be accounted for by another mental disorder, substance abuse, medication side effects, or such general medical conditions as epilepsy or head injuries.

The reader should note that DSM-IV's classification of IED is not universally accepted. Many psychiatrists do not place intermittent explosive disorder into a separate clinical category but consider it a symptom of other psychiatric and mental disorders. In many cases individuals diagnosed with IED do in fact have a dual psychiatric diagnosis. IED is frequently associated with mood and anxiety disorders, substance abuse and eating disorders, and narcissistic, paranoid, and antisocial personality disorders.

Description

People diagnosed with IED sometimes describe strong impulses to act aggressively prior to the specific incidents reported to the doctor and/or the police. They may experience racing thoughts or a heightened energy level during the aggressive episode, with fatigue and depression developing shortly afterward. Some report various physical sensations, including tightness in the chest, tingling sensations, tremor, hearing echoes, or a feeling of pressure inside the head.

Many people diagnosed with IED appear to have general problems with anger or other impulsive behaviors between explosive episodes. Some are able to control aggressive impulses without acting on them while others act out in less destructive ways, such as screaming at someone rather than attacking them physically.

Although the editors of DSM-IV stated in 2000 that IED "is apparently rare," a group of researchers in Chicago reported in 2004 that it is more common than previously thought. They estimate that 1.4 million persons in the United States currently meet the criteria for IED, with a total of 10 million meeting the lifetime criteria for the disorder.

With regard to sex and age group, 80% of individuals diagnosed with IED in the United States are adolescent and adult males. Women do experience IED, however, and have reported it as part of premenstrual syndrome (PMS).

Causes and symptoms

Causes

As with other impulse-control disorders, the cause of IED has not been determined. As of 2004, researchers disagree as to whether it is learned behavior, the result of biochemical or neurological abnormalities, or a combination of factors. Some scientists have reported abnormally low levels of serotonin, a neurotransmitter that affects mood, in the cerebrospinal fluid of some anger-prone persons, but the relationship of this finding to IED is not clear. Similarly, some individuals diagnosed with IED have a medical history that includes migraine headaches, seizures, attention-deficit hyperactivity disorder, or developmental problems of various types, but it is not clear that these cause IED, as most persons with migraines, learning problems, or other neurological disorders do not develop IED.

Some psychiatrists who take a cognitive approach to mental disorders believe that IED results from rigid beliefs and a tendency to misinterpret other people's behavior in accordance with these beliefs. According to Dr. Aaron Beck, a pioneer in the application of cognitive therapy to violence-prone individuals, most people diagnosed with IED believe that other people are basically hostile and untrustworthy, that physical force is the only way to obtain respect from others, and that life in general is a battlefield. Beck also identifies certain characteristic errors in thinking that go along with these beliefs:

  • Personalizing. The person interprets others' behavior as directed specifically against him.

  • Selective perception. The person notices only those features of situations or interactions that fit his negative view of the world rather than taking in all available information.

  • Misinterpreting the motives of others. The person tends to see neutral or even friendly behavior as either malicious or manipulative.

  • Denial. The person blames others for provoking his violence while denying or minimizing his own role in the fight or other outburst.

Symptoms

The symptoms of IED are described by the DSM-IV criteria for diagnosing the disorder.

Diagnosis

The diagnosis of IED is basically a diagnosis of exclusion, which means that the doctor will eliminate such other possibilities as neurological disorders, mood or substance abuse disorders, anxiety syndromes, and personality disorders before deciding that the patient meets the DSM-IV criteria for IED. In addition to taking a history and performing a physical examination to rule out general medical conditions, the doctor may administer one or more psychiatric inventories or screeners to determine whether the person meets the criteria for other mental disorders.

In some cases the doctor may order imaging studies or refer the person to a neurologist to rule out brain tumors, traumatic injuries of the nervous system, epilepsy, or similar physical conditions.

Treatment

Emergency room treatment

A person brought to a hospital emergency room by family members, police, or other emergency personnel after an explosive episode will be evaluated by a psychiatrist to see whether he can safely be released after any necessary medical treatment. If the patient appears to be a danger to himself or others, he may be committed against his will for further treatment. In terms of legal issues, a doctor is required by law to notify the specific individuals as well as the police if the patient threatens to harm particular persons. In most states, the doctor is also required by law to report suspected abuse of children, the elderly, or other vulnerable family members.

The doctor will perform a thorough medical examination to determine whether the explosive outburst was related to substance abuse, withdrawal from drugs, head trauma, delirium, or other physical conditions. If the patient becomes assaultive inside the hospital, he may be placed in restraints or given a tranquilizer (usually either lorazepam [Ativan] or diazepam [Valium]), most often by injection. In addition to the physical examination, the doctor will obtain as detailed a history as possible from the family members or others who accompanied the patient.

Medications

Medications that have been shown to be beneficial in treating IED in nonemergency situations include lithium, carbamazepine (Tegretol), propranolol (Inderal), and such selective serotonin reuptake inhibitors as fluoxetine (Prozac) and sertraline (Zoloft). Adolescents diagnosed with IED have been reported to respond well to clozapine (Clozaril), a drug normally used to treat schizophrenia and other psychotic disorders.

Psychotherapy

Some persons with IED benefit from cognitive therapy in addition to medications, particularly if they are concerned about the impact of their disorder on their education, employment, or interpersonal relationships. Psychoanalytic approaches are not useful in treating IED.

Prognosis

The prognosis of IED depends on several factors that include the individual's socioeconomic status, the stability of his or her family, the values of the surrounding neighborhood, and his or her motivation to change. One reason why the Chicago researchers think that IED is more common than previously thought is that most people who meet the criteria for the disorder do not seek help for the problems in their lives that result from it. The researchers found that although 88% of the 253 individuals with IED that they studied were upset by the results of their explosive outbursts, only 13% had ever asked for treatment in dealing with it.

Prevention

Since the cause(s) of IED are not fully understood as of the early 2000s, preventive strategies should focus on treatment of young children (particularly boys) who may be at risk for IED before they enter adolescence.

Key Terms

Cognitive therapy A form of short-term psychotherapy that focuses on changing people's patterns of emotional reaction by correcting distorted patterns of thinking and perception.

Delirium An acute but temporary disturbance of consciousness marked by confusion, difficulty paying attention, delusions, hallucinations, or restlessness. Delirium may be caused by drug intoxication, high fever related to infection, head trauma, brain tumors, kidney or liver failure, or various metabolic disturbances.

Kleptomania A mental disorder characterized by impulsive stealing.

Neurotransmitter Any of a group of chemicals that transmit nerve impulses across the gap (synapse) between two nerve cells.

Pyromania A mental disorder characterized by setting fires.

Serotonin A neurotransmitter or brain chemical that is responsible for transporting nerve impulses.

 

 

 
February 2, 2009, 10:53 pm CST

Rage button???

My husband has suffered from bipolar disorder and, in the past, had explosive bouts with rage.  Fortunately, the correct combination of medications and adjustment to the home environment has made all the difference in the world and he hasn't experienced this rage in years.  We clicked on the rage button on your website to see what suggestions were made and, given his experience, he didn't feel that someone in a rage would be able to stop and control the rage enough to think that he needs to go to the website and click that button and wait, while the music plays, to get instructions from Dr. Lawless.  By that point that person is already beyond control.  A suggestion might be to listen to the information while not in a state of rage, so that you might know what to do beforehand.  With the experience smy husband has had, his response would have been to slam the laptop down while the music was playing.
 
February 3, 2009, 6:46 am CST

I can relate

 While watching the show I sat there thinking to myself, my god she is a female version of me. Is this really what I show to others and how can I talk to this woman and tell her "I am you, you are me". She understands what I go through, and I her. But do I really want others to see me this way?
 
February 3, 2009, 7:05 am CST

someone who knows

I want to take a minute to comment about the show after seeing it and reading the latest messages.

First of all please don't judge people without knowing them,it's easy for peolpe on the outside looking in to say something negative about a person wihtout walking a day in their shoes.I feel for both guests...yes Isabelle deserved a second chance on the show because she was still in denial of how serious her problem is and the people in her life that it does effect.I had a relationship with a person that anger issues and it destroyed my life,I ended up having CPS involved in my life and this person needs help.They won't get the help because they have been made to believe their whole life that they are not wrong.Dr.Phil said something on the show that touched home...anger is the safest emotion...very true now hearing that I see where that plays a big part in this person's anger.As a society men are to be brave and not cry and people with emotions are weak,their are people out there who respond with anger because thats all they know.Anger is not a bad emotion,it's only bad if it's harmful.I have lived with an Isabella and this person out of anger would say harmful and toxic things,it becomes a problem when you hurt the ones that love you.please remember that so you can get the help you need.And as a mother you do not want to be involved in the most crooked system called child protective servives,believe me I'm there and my life is pure hell.I may never see my children again because of anger issues that were in my home.And for the man on the show(didn't catch the name) that was a step to getting you help,you have to be open and willing to see the underlying problems.It takes a big person to admit when they are wrong and that they need help.i wish the best to all and again for your family and the ones that love you get the help that has been offered.

 
February 3, 2009, 2:01 pm CST

02/02 Rage Caught on Tape: The Follow Up

Quote From: mcm224

I want to take a minute to comment about the show after seeing it and reading the latest messages.

First of all please don't judge people without knowing them,it's easy for peolpe on the outside looking in to say something negative about a person wihtout walking a day in their shoes.I feel for both guests...yes Isabelle deserved a second chance on the show because she was still in denial of how serious her problem is and the people in her life that it does effect.I had a relationship with a person that anger issues and it destroyed my life,I ended up having CPS involved in my life and this person needs help.They won't get the help because they have been made to believe their whole life that they are not wrong.Dr.Phil said something on the show that touched home...anger is the safest emotion...very true now hearing that I see where that plays a big part in this person's anger.As a society men are to be brave and not cry and people with emotions are weak,their are people out there who respond with anger because thats all they know.Anger is not a bad emotion,it's only bad if it's harmful.I have lived with an Isabella and this person out of anger would say harmful and toxic things,it becomes a problem when you hurt the ones that love you.please remember that so you can get the help you need.And as a mother you do not want to be involved in the most crooked system called child protective servives,believe me I'm there and my life is pure hell.I may never see my children again because of anger issues that were in my home.And for the man on the show(didn't catch the name) that was a step to getting you help,you have to be open and willing to see the underlying problems.It takes a big person to admit when they are wrong and that they need help.i wish the best to all and again for your family and the ones that love you get the help that has been offered.

Maybe it's just me, but I have a VERY hard time having much sympathy for her outbursts.  I found her, as others stated, egotistical, arrogant, harsh, and incredibly abrasive.....she's like a tsunami....comes ashore....destroys everything in it's path, then retreats, and feels better, and feels like she's had "her release" meanwhile, destruction and devastation lie all around her.  And ANYONE who thinks that she "keeps her rage" from her son, is fooling theselves.  She is teaching him HOW to relate to others, and what a horrible thing to teach him!  I find her heartless and she gets not an OUNCE of understanding from me.  She's an adult!!!!  And she claimed "no one ever held her responsible."  Frankly, neither did Dr Phil, by giving her a convenient "out."  How disappointing!!!!
 
February 3, 2009, 4:10 pm CST

Isabella

Quote From: vmcdevitt1

Why is she wasting all this time???  She is obviously proud of being a b***h.  She needs to get over herself , get a life and GROW UP!!  She is also very self-centered and egotistical.  I don't want to waste my time watching  spoiled brats on Dr. Phil.   There are people out there with real problems who need real help!

I totally agree with you.  This girl is proud of the way she behaves.  She is obviously hurting because I can't see a normal person acting this way.  One thing is for sure, she has not ran up on the right person.  She is going to mess around and snap on someone, and that will be the last time she snaps on anyone!

 
February 3, 2009, 11:30 pm CST

has to be hormones

I was truly upset listening to Isabella ranting and raging... that used to be ME!!  I started taking the pill at around 19 years old.  I had a boyfriend on and off for many years...God Bless him.. he was the receiver of half the rages I had and I would get soooo upset at customer service reps that could not help me..etc etc... it wasn't until I stopped taking the pill for a couple months, in my late twenties, where I felt a HUGE weight on my shoulders lifting off... I suddenly felt good, no, I felt GREAT!! I was nice to people I had to call for internet, credit cards, etc.. I got back on the pill and the ANGER came back... my sister told me to try a lower dose hormone birth control, but it was the same exact thing... rage rage rage.. I would look at someone and just want to hit or slap them for no reason..!!  I finally realized at 30 years old, the cause of my rage.  I truly believe it is possible for someone to be very sensitive to receiving hormones they are not used to and everyone is made differently... one does of hormone could be good for one woman, but not her sister..etc.. I decided to stay off the pill and be anger free.  Nothing gets me going like hormones did..I too felt that the world owed ME!!... perhaps Isabella has an imbalance, and needs to try hormones made specifically for her..good luck Isabella and God Bless.  and to all women out there, we need to take control of our bodies and not let our doctors pump us with bad medicine...only you know your body...
 
February 4, 2009, 1:39 am CST

Isabella

i watched the 1s show and the follow up with Isabella and i totally get it.

she is pissed off at the world for being so stupid. i also have no tolerance for

incompetency and stupidity and have often LOST IT to retaliers and service providers etc

 

I give her credit for standing up and giving people what they deserve.

 

I am angry too.. YOU GO GIRL !!  there is nothing wrong with you

 

 

 
February 5, 2009, 6:19 am CST

a child ptsd,and huband ptsd

my daughter has been in state care 16 months has not slept in her bed for 1 yr 3rd of this month,she has done nothing wrong nor have i,help my child return to me,dcyf lies,and judge is bios,my daughter has been threw 24 dealths at age 13,14 now 16.how do i stop he abuse on my daughter and myself,both disabled,husban is in jail now 4 days but dwells on abuse while he was abused,talks daily about it wondering why he cant get over it,the stress me not haveing my child,i raised 4,all were wanting to die,but im a warrior and will not quit till i get my daughter and my husban can afford his medication and help he needs,i have reported abuse to gov.seneter,justice center,and treated terribly.god as my witness,i will not quit and someone needs to investigate this town and police and judge,police quit alot here.plz help save my child and husban,i also was arrested falsly twice,which my lawyer is a judge and never seen this before,guilty with no evidence,im tired of being a victim and my daughter wants home,im all she has
 
February 18, 2009, 6:29 pm CST

30 minutes of fame?

Quote From: chelle222

I totally agree with you.  This girl is proud of the way she behaves.  She is obviously hurting because I can't see a normal person acting this way.  One thing is for sure, she has not ran up on the right person.  She is going to mess around and snap on someone, and that will be the last time she snaps on anyone!

I agree what a waste of valuable tv time. If you watch her "hidden" camera videos, it seems she is always in perfect view of the camera, so she can put on her best "act" for a hopeful reality tv show in the future. She got her now 30 minutes of fame Dr. Phil let her go back to her miserable life out of the camera's view!
 
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