Psychiatrist Christine Adams on Tantrums & Meltdowns

An Interview with Psychiatrist Christine Adams

Christine Adams, M.D. is a child and adolescent psychiatrist who is double board-certified. She is an award-winning, best-selling author regarding how emotional conditioning effects relationships.

Nikayla Jeffrey:  Thank you for joining us today. I'm Nikayla Jeffrey, research intern at Seattle Anxiety Specialists. I'd like to welcome with us child and adult psychiatrist, Christine B. L. Adams, MD. She is co-author of the bestselling, award-winning, Living on Automatic: How Emotional Conditioning Shapes Our Lives and Relationships. A double board certified psychiatrist, some of her work deals with topics such as tantrums and meltdowns in adults, and that's what we'll be discussing today. Before we get started, Dr. Adams, can you please let us know a little bit about yourself and some about the work and writing you've done?

Christine Adams:  Sure. Thank you for inviting me. I've been a child and adolescent psychiatrist and also worked with adults for 42 years, and I've worked primarily in private practice doing psychotherapy rather than medications with people to help them understand the roots of their problems. I also was a professor at a medical school and worked in community mental health centers. I also, for 25 years, was a forensic child psychiatrist who gave expert testimony in child abuse cases, mainly sexual abuse, and also divorce and custody and parental alienation cases. I worked for a while with the Social Security Administration doing disability appeals on children, and I worked with the Department of Defense for a while. So that's kind of my work background.

My writing background is pretty varied. I have a blog at PsychologyToday.com where we look at all sorts of issues having to do with relationships, how people manage emotions, custody disputes, whether sole custody or shared custody is best for children and under what circumstances, and also parental alienation. My book, Living on Automatic, is a study done by two psychiatrists, me and my mentor, Homer Martin, and it covers 40 years of work for him and 40 years of work for me, and we looked at the development of people's personalities and how parents shape them early in their lives. By age three, we found the personality is rather set. So that has been the bulk of my writing interest over the last 10 years.

Nikayla Jeffrey:  Wonderful. What do you think made you first become interested in this field? What sparked your interest in these topics?

Christine Adams:  Well, when I was in training, I began to observe things, and I didn't understand, and so I began asking my supervisors. And Dr. Martin was one of my mentors. And the things that I began to observe were things like why are siblings so different when they're raised in the same family? And why are people that I would see in psychotherapy from different families so similar to one another? And that perplexed me, and I started asking questions, and he encouraged me to keep observing and to research more on this. But that's kind of what got me started, questions that I couldn't really answer, and that most of my supervisors couldn't answer.

Now, what got me into psychiatry was that I was kind of overloaded with psychiatry as a child. My father was a child psychiatrist. My mother's grandfather was a psychiatrist at the turn of the century, the early 20th century, and my mother worked for a psychoanalyst in New York City. So I had all these books available. I heard all this talk all the time about psychiatry. I thought people were fascinating, because I didn't understand them as a child, and that's what got me into the field. And then as I got older, I realized children need a voice. They often get lost in their families and they need a voice. They need somebody to help them articulate what they're thinking and feeling, and to learn how to tell their families, because it will cut down on their emotional suffering.

Nikayla Jeffrey:  In one of your pieces, you write about tantrums and meltdowns specifically in adults, rather than in children. Can you touch on what the differences are between these two things and perhaps how one can maybe turn into the other?

Christine Adams:  Sure. I think this is from a blog that I have on Psychology Today that you read. A tantrum is an emotional blowup when somebody is thwarted from getting something that they want. When they don't get it, they pitch a fit. That's what a tantrum is. A meltdown is an emotional blowup or an emotional shutdown when a person is unable to cope with a situation, so it's a coping problem. They're totally overwhelmed. Now, it may be something extraordinary that is overwhelming, like a divorce or a custody battle or the death of somebody that you're close to. Or it may be, depending on your personality, something rather trivial that you can't cope with. And the example I often use is a person who can't get to work on time gets reprimanded by their boss for being late, and they have a meltdown because they just can't cope with the idea that they need to get to work on time every day. So we can discuss later, some personalities suffer tantrums and some personalities are more prone to meltdowns.

Nikayla Jeffrey:  So it has to do a lot with your specific personality type, whether or not you'll be prone to tantrums or meltdowns as an adult?

Christine Adams:  Yes. And the circumstances will be very different for the two personalities is what we discovered.

Nikayla Jeffrey:  So with talking about types of personalities, you mention in that same piece something about divergent personalities. I was wondering if you could define that?

Christine Adams:  Well, this gets into our research that's in our book, Living on Automatic. What we discovered is that there's two main roles or personalities that people form. These are formed by the way parents shape you emotionally, unbeknownst to you and unbeknownst to parents, early in your life, so that by age three, your personality is pretty much set, which is kind of scary, because that happens before you're largely verbal. But you learn all these emotional cues from your family about how you're to see yourself and how you're to see other people.

And it turns out that they're pretty much opposites. We call them one type, the omnipotent personality, and the other type is the impotent personality. And the omnipotent personality is very, very strong. They're very high in self-control. They give unlimited care to other people. They give very poor care to themselves. As a child, parents expect a great deal of them. So when they grow up later on, they expect a great deal out of themselves. And you can see how as I describe these two types of personalities that emotional problems set in with each type of a different variety and in a different way. But the way parents condition people makes them prone to emotional illnesses or suffering and relationship conflict down the road.

Now, the impotent personality is just that, impotent. Feels very helpless about themselves. Feels they can't conquer things. They expect others to care for them. They expect others to meet their needs. They expect others to take responsibility for them and troubleshoot for them, and they have very poor self-control. Parents overindulge them and expect very little from them in the way of accomplishments and in the way of giving care to other people that they care about. So you can see how these are divergent. These are very opposite and different. And, of course, we go into tremendous detail from infancy through people in their 90s in the book, Living on Automatic. So you can read more about it in the book if you're curious.

Nikayla Jeffrey:  And this stronger omnipotent personality, they expect more from themselves, that you mentioned is connected to experiencing meltdowns, correct?

Christine Adams:  Yes. What happens with an omnipotent, is omnipotents rarely have tantrums, because they're not good at promoting things they want. So they will easily acquiesce to other people, so they will rarely have tantrums where they pitch a fit for something they desire. But if they're totally overwhelmed by somebody asking or wanting something from them that they want to deliver but they can't because it's impossible, then they will have a meltdown. Tears, lots of guilt over failing the other person's request. They can have rage at themselves. Their suicide risk can go up at these points. So that's what their meltdowns look like.

Now, an impotent can have a meltdown, the example I gave before, being reprimanded for being late at work, they can say, "This is awful. This is unfair." And be full of tears and rage and anger. But the anger is not at themselves. The anger is at the person who's reprimanding them. So they project the anger that should be their responsibility onto the person who's complaining about them. So the meltdowns are for different reasons in the two personalities, and only the impotents have tantrums. Omnipotents don't have tantrums when they need to have a tantrum or should have a tantrum.

Nikayla Jeffrey:  In discussing tantrums, you said that it's important to decide whether a tantrum is a reasonable response for that situation for these people. They've said whether a tantrum is called for, almost. And I would ask, is a tantrum ever a reasonable response?

Christine Adams:  Yes. What I often advise omnipotent patients is you need to have a... I call it designated tantrum with the person who's asking too much of you. You need to pitch a fit or do something to get their attention so that they know they're being unreasonable with you. Because an omnipotent personality tends to acquiesce and say, "Okay, you're being unreasonable, but I'll try and do what you want." So it's reasonable for an omnipotent to occasionally throw tantrums with people when they're overstepping their boundaries with them. But for impotent personalities, they so often easily resort to tantrums that there's really no need to promote that behavior. There's the opposite need to promote not having a tantrum and to letting them assume responsibility for what they have done.

Nikayla Jeffrey:  And when it comes to these emotional blowups that happen, you also mentioned that a reality check is needed. Can you give an example of what a reality check might be? And then talk about whether one personality type may be more resistant to a reality check than another.

Christine Adams:  Yeah. When I talk about a reality check, it's evaluating how reasonable your thinking and your behavior is for the situation you find yourself in. So it's sort of saying to yourself, well, let me take a time out with myself and let me look at the situation not with my emotions, but with my brain, and think about what am I doing here, what am I feeling, what am I saying, how am I behaving, and is this reasonable for the situation?

So an omnipotent might say, "My boss has asked me to work all weekend on a project. I was going to go on a short trip and now I have to cancel the trip and turn in this project first thing Monday morning. And I'm going to cancel my plans and work on this all weekend." So they might say to themselves, "Is this reasonable behavior on my part in thinking that I believe I can do this and should do this?" Now, an impotent will be late to school repeatedly and need to say to themselves, the reality check, "Am I being reasonable here being late to school every day? Everybody else gets there on time. I'm missing classwork. I'm disturbing the classroom when I come in."

So it's a way of evaluating for the situation whether you're being reasonable or not. And it's difficult for both personality types to do reality checks. And we talk in the book, Living on Automatic, how you do this with yourself, regardless of your personality, because both personality roles or types need to do this. So we talk about how you do this, because each role must work diligently through their lifetime to undo some of this emotional conditioning and bring themselves sort of from afar back to the middle where they can be more reasonable with themselves and other people.

Nikayla Jeffrey:  So both personality types need reality checks, but it looks different for each type of personality?

Christine Adams:  Yes, absolutely. You got it.

Nikayla Jeffrey:  Okay. Perfect. Those are all my specific questions, but I know you wanted to talk a little bit about the research that you're doing, correct? The new research about your book.

Christine Adams:  Well, I also wanted to say, if you encounter a situation with yourself or with a family member or coworker who's having emotional blowups, you might be able to help yourself or them by looking at two different issues. The first is what kind of person am I dealing with? Am I dealing with an omnipotent who rarely blows up at anybody or am I dealing with an impotent person who blows up a lot and has tantrums a lot? And then you can help them do a reality check. Ask yourself or them, okay, what circumstances provoke the episode you're having? What does the person talk about or focus on? Are they upset with themselves or are they upset with another person? Who do they lash out at, themself or another person? If it's a tantrum, is anything really reasonable wanted? Or is it in the realm of it's just something you want and it's not very reasonable? If it's a meltdown, is it an overwhelming event or is it a trifle situation? And I would ask them or ask yourself what can you say or do differently next time to see if there's any learning involved in how to better manage the situation? And this sometimes makes people pause and think about what they're doing, and it's a way to help others and it's a way to help yourself.

I am doing a lot of book marketing for Living on Automatic. I have podcasts, media interviews, articles, Psychology Today blogs, all on my website, DoctorChristineAdams.com. I'm going to be teaching a webinar that will be posted on my website about emotional conditioning and these two personality types. And I'm also on LinkedIn, Facebook, and Twitter. And if you want to write me, ask questions, you can do that through the website. I have a newsletter that you can join. And I'll just hold up the book one more time, so you can see it. It's got a picture of two people with cogs in their head, one's a man and one's a woman, and the cogs are turning around.

Nikayla Jeffrey:  Perfect, thank you.

Christine Adams:  Yeah. Thank you very much. Do you have any other questions?

Nikayla Jeffrey:  I don't think so unless you have any last parting words of advice on how to work with the different personalities in your life. Or any parting words. But besides that, no more questions.

Christine Adams:  Well, I just think it's most of the time we go through life and we think other people are like us, and they're not. People are very different. But we found that they do kind of fit into two opposite, divergent roles or personalities. So if you can learn to identify the different types of people then you know better how to deal with them.

Nikayla Jeffrey:  Thank you very much.

Christine Adams:  Thank you.

Please note: The views expressed by the interviewee are for educational and informational purposes only, are not meant to diagnose or treat any condition, and do not necessarily reflect the views of Seattle Anxiety Specialists, PLLC.


Editor: Jennifer (Ghahari) Smith, Ph.D.