Coming to this late, and may be repeating a bit what I have said on other threads, but here goes:
To summarise:
"What is the deal with the toy box and the million other situations that example represents?"
Being able to identify a box isn't the issue here. it is more than that. I wonder if he is getting overwhelmed with the decision? Is it possible that he isn't able to follow the steps of a command? DD could identify the box, could identify the stethescope, and would know that she wants to play with it, but couldn't necessarily follow the multiple steps that involve getting the right box, then choosing the stethescope and NOT getting all the other stuff.
"What about the emotional insecurity? If something is bad he will insist it is good. He gags a lot and has learned the word gag and now goes on and on about how lovely gagging is - all because he is scared shitless of it. This scares me as some things are supposed to be bad. And I feel this makes him vulnerable."
It sounds like he is trying to comfort himself by telling himself that it is OK. DD is phobic about "soreness" and she will say "all better, not sore!" when she has hurt herself and we put cream on her. It clearly is sore, but she is trying to calm herself.
"How the hell can I get him to stop being whiny all the time? And stop being so loud? And sit still for 5 minutes? And not whack me in the face with a toy hammer every day?"
When you find out, let me know....
"How do I stop him melting down every time things dont go his way? I understand I have to reduce his triggers but at the moment his triggers involve anything and everything so I cant reduce all that."
Once you have identified the triggers, I think it is more about getting there first. So the triggers will still be there, but you try and intervene before they get pulled. Exhausting.
Has anyone suggested a "special box?" It is a box of items that are kept away from general toys, out of his reach. It should have things that would be a treat for him. For DD that means anything that has real sensory properties. She has things like a windmill she can blow, a squidgy ball, a rubix cube, a tub of 'goo', a wriggly caterpillar, a scratchy mitten, a massage roller, and a crinkly tube. All really cheap and cheerful from places like Hawkins Bizzarre. It comes out when I can forsee a meltdown or if she is completely wired, for example, and she can play with it. As soon as she loses interest, it goes away again.
The idea is that it gives a constructive outlet for her energies, and a focus.
"How do we get him sleeping in a remotely sane way? 2 am? waking up for the rest of the day? No I really cant carry on this way!"
Not sure about this one. For us, we have tried hard to identify the triggers for DD. She has a strict 'order' of things that must be in place at bedtime, and sometimes going through this order (covers on, bear in arms, cat behind head on the right hand side, fan on, star on) reassures her that it is OK to go to sleep. Sometimes chatting about anything other than sleep, and then gradually moving on to chatting about who we think is asleep helps. Boring but "Daddy is asleep, DD2 is asleep, doggy is asleep...do you think Grandad is asleep? Is X (family friend) asleep?....mummy needs to go to sleep now too. Time for sleep now". Other times none of this helps. DD is now prescribed Melatonin, which works magnificently in bedtime settling, but more variable results are had for the middle of the night wakings. Even if she has been up for several hours in the night, she is likely to wake for the day at around 05.30. We just warn preschool if she has been up for a particularly long time the night before.
"How do I discipline him, without hurting him. Remember I am a softie and I love him more than myself or anything else ever. And he is extremely over sensitive and I refuse to really upset him. I just want him to learn some boundaries."
This is a toughie. Discipline does hurt. When DD was first assessed at preschool, she was 2.10. The inclusion co-ordinator told us to stop the 'naughty step' because she just didn't understand the naughty concept. We went with that, but I posted in desperation a couple of weeks ago, and Time Out was suggested.
I warn DD, and if she doesn't respond, then she gets taken to her bedroom (there is a stairgate across her door) and told she has to stay there for 3 minutes (she is now 3.3). She HATES it. I HATE it. She cries, she screams, she says "I lost mummy, Mummy gone", it is awful. When I go back after strictly 3 minutes, I sit her on her bed, remind her why, very factually, she was put there, and that she needs to say "sorry Mummy". She does, and we have a get better hug. We haven't seen massive changes in her general behaviour, but the more extreme things, like biting, kicking or hitting are reducing, because as soon as I see her start to raise her hand, I say "DD, stop! If you hit/kick/bite me/x you will have timeout." She hates it so much that she will stop.
I do think it will lose its effect if I do it for too many behaviours, because the effectiveness of it is there because it is such a huge thing. So I reserve it for times when she is going to hurt herself, or others.
"Please help and just give me your general opinion on what is going on. I am so sorry to always be on here whinging but really things are very difficult with him at the moment. "
Not qualified to say. But, things that I observe with DD is that it is very easy to think I know what level she is at, and I have usually expected way too much, even now. And she is so variable, that sometimes I pitch it right, and the next moment I get it completely wrong. And she is exhausting. You need to get support, for your own sake, because these wonderful children are really very hard work!