When a child is having an "episode," brain chemistry takes over. The child's weak prefrontal cortex (logic and reasoning) is left in the dust as the limbic system (primitive survival) is on autopilot. Cortisol and adrenaline flood the system, creating a sense of panic and threat. Much like living under battlefield conditions while wearing magnifying lenses, the primitive instincts of survival take hold. The child is extremely sensitive to stimuli, and small incidents are blown out of proportion. In the child's world, limit setting would be distortedly perceived as a massive assault on their person: "All the kids are going, therefore I must go, and if I don't go I'll die." Once their brain chemistry is aggitated, parents find that only time, exhaustion, or medication might reduce the resulting behavior episodes.

The typical family has been treating the child as if he can totally control these rage outbursts, since the outbursts are usually followed by "good time." This situation can seem similar to seizures or diabetes. The child unwittingly reacts like any "normal" person would if confronted with the same distorted perceptions of reality.

The child may instigate conflict-driven episodes in which the child will unconsciously seek out conflict with others, generating an adrenaline reaction, which is a natural body stimulant (as Adderall and Ritalin are stimulant medications), a self-medicating strategy.

Once the nature of the child's behavior disorder is identified, the parents and the child are responsible for compliance with treatment to contain and treat the symptoms. Tolerance of the child's slower learning curve and implementation of consequences without shame are grounded in parent education and training.