msbelle- I am glad to hear things are improving. I don't want to make this all about me, but in some ways I really relate to Mac and how having all these feelings that he doesn't know what to do with sometimes causes actions that he might feel bad about later.
I don't know if this helps at all because I don't think my mother ever solved this problem with me, I just seemed to outgrow it but... I was a horrible child to my mother. I never misbehaved when out of the house, but in the house I could be an irrational screaming kicking crying mess. I hit, kicked, bit, yelled and said really really mean things and called my mother horrible names. And I was so so angry and had so much feeling in me (this would have been from age 7 - 10 or thereabouts, so it wasn't the teenager stuff)-- why, I do not know. And the thing is, the punishment/reward thing did not work for me at all, because I knew that I was stronger mentally and physically than my mother-- that ultimately she couldn't force me to do anything. For some reason, it was very important to me that I had the power and that I was in control. There was a part of me that fet triumphant when I won and my mother gave up. Again, forgive me if this is ground that is well-trodden, but it seems to me that somehow getting Mac to feel that he won't lose you even if he lets you be in power is the important thing. One of the things that helped me was reading Jane Eyre in 4th grade. When I saw Jane in the red room, angry and having a tantrum, I understood that I wasn't the only child who was angry and unhappy and not really well-liked. Probably Jane isn't the appropriate role model for Mac, but maybe there is something he can relate too...