Dear SorrowMom:
 
I'm so sorry that you've had such a hard time with your son, and his life has been so rocky so far. And I'm not surprised that the medications haven't worked to help at all. I am not a medical doctor, but if the medications are not working, it makes some sense to me to drop them.
 
Several parents who have been to psychiatrists, counselors, occupational therapists, and other experts have tried our less conventional approach and found that it worked well with children whose behavior was also extremely challenging.
 
I will try to explain in a very short post: there is much more information in our booklets and in the free articles on our website, which I will reference below.
 
The idea is that, early in a child's life, often prenatally or at birth or shortly thereafter, difficult things happen that frighten a child deeply. The child experiences a threat to his or her existence. A difficult birth, a prenatal difficulty in development or trauma to the mother, a stay in neonatal intensive care, an early illness, or any kind of medical treatment or other trauma can be the precipitating cause of behavior like your son's. For instance, they have shown that mothers who were close to the 9/11 disaster in NYC, and pregnant at the time, had children who were much more disposed to have symptoms of post-traumatic stress disorder, a sign that they experienced, and remembered, the fear that their mothers felt during this crisis.
 
So you can safely assume that your son is terrified, deep down inside, and that these feelings of terror, from something that must have happened to him long ago, are driving him into these behaviors. And you, frightened and beside yourself with all kinds of responding feelings, have communicated more upset to him, so there's been a fear-inducing feedback system set up between you and him--he gets scared, acts out, and you feel scared/mad/resentful/helpless, and communicate that something is indeed very wrong, which scares him further, and digs him deeper into his emotional state.
 
The way out is what we call Staylistening. This intervention works best with children who are not on any drugs. The next time your son does something even slightly off track, you move in, put your arms around him, offer warmth and eye contact, say, "No, I can't let you do that," and stay close to him. He will fight, scream, try to get away, hate you, and be a wild child. Your job is to communicate that you care, that you will stay with him until he feels better, and his job is to offload all those feelings. He has tried to do this in the past, but it doesn't work for him to cry and rage and destroy things, without a partner in the interaction who is transmitting caring, and confidence that he's OK, he will come out of this, he is a good boy, and worthy of your support while he feels awful.
 
The things to say to a child in the midst of offloading feelings of fear are something like, "I'm right here, watching over you. I won't let you be hurt." "I don't want to leave you while you are feeling so badly." "I know this feels awful. I'm sorry it's hard." "You are going to have a good day. This won't last forever." "I want your life to be good. But I need to stay with you while you're trying to hit or hurt." You need to use a confident and caring tone. Don't coo or speak softly--he needs someone to communicate that all is well in no uncertain terms while he feels as terrified as a human being can get.
 
Signs that it's going well are perspiration, trembling, deep fright and panic, and what looks like crying, but with few or no tears. Thrashing and writhing and arching and kicking all go with this process of shedding deep and nameless fear. So does blaming everything on your parent.
 
This Staylistening is very challenging to do, but if you can do it and stay with him, preferably holding him (and protecting yourself from his attacks by gently holding his wrists so he can't hit or hurt you) for the duration of an emotional episode, which I would guess would last for an hour or perhaps more, he will emerge feeling better, much better. He will feel at peace. He is likely to be affectionate, and free of challenging behaviors for a while. The deeper the fear he has stored up inside, the shorter this period of rest and cleared behavior. He will need to go many times to this panicked, "I feel like I am going to die so I'm going to kill someone first!" place in order to clear out all the upset that has built up over time.
 
There are other important things to do as well: Special Time and Playlistening are two, but there's not room to describe these here. Big picture, you want to build his sense of safety, which has somehow taken a big hit, and to try to connect with him during his emotional outbursts, and to persist until he can accept the connection and feel your support. Feeling support soothes the mind, and lets children act reasonably and creatively. Our booklet set, Listening to Children, describes "Listening Tools," and gives you an understanding of what's going on with him emotionally.
 
This approach has changed the lives and personalities of many children. You will need courage and emotional support to do this. Please visit our website for more about the approach, how it works, and how to access support if you decide to give this a try. I'm citing an article below that gives you an anecdote about helping a child with aggressive behavior that illustrates Staylistening, and the goodness of children trapped in aggressive behavior.
 
Yours, with respect and an offering of hope that things can get better,
 
Patty Wipfler

My daughter is PDD-NOS basically on the autism spectrum and ADHD.  We had trouble with her when she was very young being aggressive tword others and her self and at the same time very very loving all in the same day.  I had her to a specialist who put her on ritalin the generic stuff and very low dose and that did a small bit of help but then she suggested adding a anti-psychotic to her pills also VERY small dose less then 1mg and she is almost 100% normal makes friends very social and loving.  Didn't know if just maybe the Anti-psychotic was something you haven't tried?  It maybe worth a shot it helps with bi-polar and autism spectrum disorders. Risperdone is one that my daughter is on.  Hope that helps.