Sunday, July 3, 2022

Tantrum

Tantrum (pronounced tan-truhm)

(1) A violent demonstration of rage or frustration; a sudden burst of ill temper, most associated with children but widely applied to the childish outbursts of adults.

(2) To have a tantrum.

1714: One of English’s etymological mysteries, other than being derived from the earlier tanterum, the origin is so obscure there’s no evidence on which to base speculation and while the first known reference in writing is from 1714, it’s likely it had been in (presumably colloquial) oral use for some time.  There are conventions of use such as “temper tantrum” & the common intransitive “throw a tantrum”; synonymous words and phrases include angry outburst, flare-up, fit of rage, conniptions, dander, huff, hysterics, storm, wax, hissy fit & dummy spit.  Tantrum is a noun & verb, tantrumming & tantrumed are verbs and tantrumy is an adjective; the noun plural is tantrums.  The noun tantrummery (on the model of constructions like poltroonery) is non-standard but is sometimes used in political commentary.

Social media, SMS or email posts in ALL CAPS or with an extravagant use of question marks (?????) or exclamation marks (!!!!!) convey shouting and are the textual version of a tantrum although this understanding was learned behaviour; many early systems (Telix etc) available only with upper case characters so there was a greater dependency on (?????) & (!!!!!) to denote anger, the asterisk (*****) & hash (#####) symbols inserted to permit vulgarities (f**k, sh## et al) to be understood without being spelled out.  That was a work-around of some significance because the telecommunication legislation in many nations actually prohibited swearing (even on telephone voice calls) over what was then called a “carriage service”, typical wording in the acts being something like: It shall be unlawful for any person in the operation of any telephone installed within the city, to make use of any vulgar vituperation or profane language into and over such telephone.  (Profanity over telephone: (Code of ordinances, Colombus Georgia, USA, (§ 663 (1914)), Section 14-49).  Such laws probably still exist in many places but instances of enforcement doubtless;y are rare.

Disruptive Mood Dysregulation Disorder (DMDD)

Remarkably, as a definable condition, the temper tantrum wasn’t medicalized (as a distinct diagnosis) until 2013 when the fifth edition of the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published.  Named Disruptive Mood Dysregulation Disorder (DMDD), it was classified as a mood disorder noted as affecting children aged 6-18, an unusual concession by the industry that tantrums in very young children are a normal and healthy (if annoying) aspect of human development.

DMDD was thus a new diagnosis but it really was a shift in classification, reflecting the early twenty-first century view that both the autism spectrum and bipolar disorder (BD, the old manic-depression) were being over-diagnosed.  Also a condition that can cause extreme changes in mood, it was noted that misdiagnosing BD can result in unnecessary medications being prescribed, the long-term use of which were associated with side effects including weight gain, lipid & glucose abnormalities and  reduced brain volume (and a diminished number of neurons in the brain).  Thus it being undesirable that BD be over-diagnosed in the young, DMDD exists as an alternative and, although many of the mood-related symptoms overlap with BD, there are as yet no FDA (the US Food and Drug Administration) approved medications for children or adolescents with DMDD and in the recent history of the DSM, that’s unusual.  There have been instances of updates to the DSM removing diagnoses while the specified drug remains on the FDA schedule but it’s rare for one to appear without an approved medication, the symbiosis between the industries usually well-synchronized.  Advice to clinicians continue to include the note that stimulants, antidepressants, and atypical antipsychotics can be used to help relieve a child’s DMDD symptoms but that side effects would need to be monitored, individual and family therapy to address emotion-regulation skills a desirable alternative to be pursued where possible.  The behavioral distinction between DMDD and BD is that subjects don’t experience the episodic mania of a child with BD and they’re at no greater risk of later developing BD although there is a higher anxiety as an adult.  Because of the potentially stigmatizing effects (possibly for life) of a diagnosis of BD, that’s something which should be applied only with a strict application of the criteria.

The tabloid press like the word "tantrum" and uses it often of certain celebrities, politicians and such.

It’s further noted that DMDD is a diagnosis that should apply to a specific type of mood (the tantrum) distinguished by being extreme and/or frequent; it should thus (as parents have doubtless always regarded tantrums) be thought a spectrum condition.  The markers include (1) severe, chronic irritability, (2) severe verbal or behavioral tantrums, several times weekly for at least a year, (3) reactions out of proportion to the situation, (4) difficulty functioning because of outbursts and tantrums, (5) aggressive behavior & (6) a frequent transgression of rules.  Observationally, DMDD may be indicated by (7) trouble in socializing and forming friendships, (8) physically aggression towards peers and family and even (9) difficulties in the cooperative aspects of playing team sports (although not merely a preference for individual disciplines).  The diagnostic criteria for DMDD require a child to have experienced tantrums (which are severe and/or of long duration) at least three times weekly for at least a year’ especially if between episodes they’re also chronically irritable.  However, if the tantrums are geographically or situationally specific (ie happen only at school or only at church etc) then DMDD may not be the appropriate diagnosis and other disorders (childhood bipolar disorder (CBD), autism, oppositional defiant disorder (ODD) or attention deficit hyperactivity disorder (ADHD)) may need to be considered.  A particular difficulty in the diagnostic process is that not only is there a significant overlap of symptoms in these disorders but instances of conditions themselves can co-exist.  With children, it’s recommended that when possible, DMDD treatment begins with therapy (psychotherapy and parent training), medications prescribed only later in treatment or at least starting in conjunction with therapy, cognitive behavioral therapy (CBT) thought helpful.

Noted temper tantrums

3 Ketchup Bottles (2021) by Kristin Kossi (b 1984), Acrylic on Canvas, US$8000 at Singulart.

Details of President Trump’s (Donald Trump, b 1946, US president 2017-2021) tantrum which included his ketchup laden lunch ending up oozing down an Oval Office wall were recounted during the congressional hearings into matters relating to the attempted insurrection on 6 January 2021.  Although apparently not the first time plates were smashed in the Trump White House during episodic presidential petulance, such outbursts by heads of government are not rare.  Indeed, given the stress and public scrutiny to which such folk are subject, it’s surprising there aren’t more although it’s usually only years later, as memoirs emerge, that the tales are told.

Warren Harding (1865–1923; US president 1921-1923) was once observed strangling a government official with his bare hands although that might have been understandable, his administration notoriously riddled with corruption.  When Harding dropped dead during his term, it was probably a good career move.  Adolf Hitler’s (1889-1945; head of state (1934-1945) and government (1933-1945) in Nazi Germany) ranting meltdown in the Führerbunker on 21 April 1945 as the Red Army closed on Berlin became a tantrum of legend and was the great set piece of the film Downfall (2004) about the last days of the Third Reich, a scene which has since generated hundreds of memes.  Even before the Watergate scandal began to consume his presidency, Richard Nixon (1913-1994; US president 1969-1974) was known for his temper tantrums, often under the influence of alcohol.  His aides would later recount his expletive-laden tirades during which, apparently seriously, he would order bombings, missile launches and assassinations.  All such instructions Nixon issued during these drunken tantrums were ignored and if informed the next day that the relevant military action or murder had not been carried out, usually he would respond: "Good".  His predecessor’s, (Lyndon Johnson (LBJ, 1908–1973; US president 1963-1969)) moods were said to be just as volatile and during episodes he would sometimes wish for whole countries to be destroyed although he stopped short actually of ordering it.

Admiring glance: George Stephanopoulos looking at crooked Hillary Clinton.

Reports of Bill Clinton’s (b 1946; US president 1993-2001) tantrums tend to emphasize their frequency and intensity but note also how quickly they subsided.  In the memoir of George Stephanopoulos ((b 1961; White House Communications Director 1993 & presidential advisor 1993-1996)) focusing on his time as communications director, it’s recounted that Clinton regularly lost his temper and would yell at the staff, the in-house code for the outbursts being “purple fits”, so named because of how red Clinton’s face became during the SMOs “Standard Morning Outbursts”.  Secret Service staff later interviewed were kinder in their recollections of the president but seemed still traumatized when describing his wife’s volcanic temper and Bill Clinton’s outbursts do need to be viewed in the context of him being married to crooked Hillary Clinton (b 1947; US secretary of state 2009-2013).

Anthony Eden (1897–1977; UK prime-minister 1955-1957) was elegant, stylish and highly strung; one of his colleagues, in a reference to his parentage, described Eden as “half mad baronet, half beautiful woman” and his great misfortune was to become prime-minister, the role for which he’d so long been groomed.  Ill-suited to the role and in some ways unlucky, his tantrums became the stuff of Westminster and Whitehall folklore, reflected in the diary entry of Winston Churchill’s (1875-1965; UK prime-minister 1940-1965 & 1951-1955) physician (Lord Moran, 1885-1975) on 21 July 1956: “The political world is full of Eden's moods at No 10 (Downing Street, the PM’s London residence)”.  The tales of his ranting and raging appeared in much that was published after his fall from office but in the years since, research suggests there was both exaggeration and some outright invention, one contemporary acknowledging that while Eden certainly was highly strung, “he seldom became angry when really important matters were involved, but instead did so over irritating trivialities, usually in his own home, and very seldom did he lose his temper in public”.  Unfortunately, the best-known "tantrum" story of the 1956 Suez Crisis in which Eden is alleged to have thrown an full inkwell at someone with whom he disagreed (a rubbish bin said to have been jammed on his head in response), is almost certainly apocryphal.

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