Category: Teens

Family Therapy Works!

Posted on by Dana Goldman

There’s a lot that I’m not intimidated by. While I’m naturally a bit introverted, I’ve worked hard to talk in front of groups fairly comfortably. I’m not scared of Atlanta’s parking garages, elevators, or boats (unlike certain family members). I don’t enjoy shopping, but I can hit up an Ikea and come out alive and well. In my therapy practice, I can comfortably help clients tackle sticky issues like challenging relationships, infertility, abortion, depression, grief, and trauma. But what puts fear in my heart?

The idea of being in counseling with my parents.

And I’m not the only one. Quite often when I’m working with a kid or teen, I mention that a few family counseling sessions might help with improving communication or clarifying expectations or figuring out how to respectfully disagree with one another. And then I watch those teens as their faces go from open and interested and curious (because after all, teens are awesome if you’re not their parents) to shut-down, please-Dana-don’t-make-me-you-must-be-crazy-if-you-think-I’ll-do-that.

And I get it. Family therapy can be intimidating. Kids worry they’re going to get teamed up on or lectured. Often they hate their parents seeing them emotional and would really rather not cry in front of their parents. Teens already recognize there’s a lot they don’t control in their lives, and family counseling can appear—at first—to be another place where they won’t have control or a voice.

And yet. And yet. Family counseling can be powerful: healing, reinforcing and strengthening relationships, shifting communication patterns to be more healthy and constructive, and building trust and mutual respect. Kids and teens find they have a voice and relax as they see their parents listening to them; parents find that their kids can hear them differently through family therapy. Together, we make strides to strengthen the family. Because at the end of the day, none of us lives in a vacuum. We’re all connected. So let’s work on being connected in healthy, happy ways… even if it’s intimidating at first.

Let’s have more moments like these, okay?

Talking Drugs with your Teens: Good Luck!

Posted on by Dana Goldman

Every time I do a presentation for parents of teens, two questions just about always come up:

  1. Will my kid be a functional, productive adult, even if right now they’re (fill in the blank):
  • not doing enough homework?
  • not doing anything but homework?
  • not taking school seriously enough?
  • taking school too seriously?
  • going out too much?
  • not going out enough?

AND…

2. What is the “right” thing to say to teens about drugs and alcohol?

The first question has an easy-ish answer: Despite (or because of) your kid’s idiosyncrasies, they will most likely make it through adolescence relatively unscathed and learn enough adulting skills to have a pretty reasonable life, even if their life, values, and priorities are different from yours. Most of us get through adolescence. If you’re reading this, I’m guessing you did.

But the second question is trickier. What is the “right” thing to say to teens about drugs and alcohol?

For starters, I’m pretty sure there is no one right thing. Teens (and the rest of us) are getting insane mixed messages about drugs, especially marijuana, right now. Some parents buy marijuana for their kids; some pull out a frying pan and an egg to give a 1980s-esque demonstration showing this is your brain on drugs. Some places it’s legal; some it’s not. Some people swear marijuana helps with anxiety, depression, creativity, and sleep; some people argue it interferes with all of the above as well as with brain development, makes ADHD and motivation worse, decreases efforts to build alternative coping strategies, and lowers the effectiveness of anti-depressants.  It’s especially tricky when we consider how common marijuana use is among white people as well as people of color, and yet marijuana laws are so selectively enforced, with huge disparities in enforcement based on race. A black teen getting caught smoking marijuana may face drastically different legal consequences than a white teen doing the exact same thing. So how do you create rules or express family values when there are so many shifting cultural messages, and no coherent community principles or agreed-upon research to support, reinforce, or guide you? Not so easily.

But I think there’s an even more important question that’s even harder to answer. How do parents build a strong enough relationship with their teens to be able to talk about drugs and have the best chance of a positive impact? That’s the gazillion dollar question. And it has no simple answers… except maybe family counseling (which is of course my bias).

I loved this article and this follow up  for their thoughtful discussions of these topics. Pro tip? Print the article and send it to your kid and ask them what they think about it. Sometimes introducing a topic through an article is a way to open up a conversation without defensiveness.

What Information Should Families Have If Their College-Age Kid is Depressed?

Posted on by Dana Goldman

I read with sadness but not surprise this article about suicide on college campuses. A big question the article talks about is when and if parents should be informed if their age 18+ kid  is struggling.

I’ve written before about the rise in anxiety and depression in teens and the general public. The news on the subject continues to be disturbing, with a 33% rise in depression diagnoses between 2013-2016.

I’m so glad that depression is continuing to be identified more quickly, and that more and more people are willing to seek help. But these numbers – and the stories behind these numbers – speak to a pretty terrifying moment for young adults and those who love them.

Anytime I work with a new client, we talk openly and honestly about confidentiality. Lots of us have had the terrible experience of having someone betray our trust and confidence, and I’m committed to keeping therapy a private space. It’s impossible to get the most out of counseling if we’re worried about someone out of the psychotherapy office knowing what we’re talking about.

BUT – I tell everyone – if I start getting worried about a client in an immediate life-or-death kind of way – I will tell that client directly, not going behind their back, and we’ll talk about if my concerns are justified or not. If so – if a client agrees they’re in a scary moment – together we’ll figure out a way to pull in someone from their life who cares about them, and loves them, and desperately wants and needs them alive.

I love being a therapist, and I take the responsibility of it incredibly seriously – both in figuring out when and how to support someone to get more help, if needed, and when to uphold and protect confidentiality if more support isn’t needed.

 

Teens and the Anxiety Epidemic

Teens and the Anxiety Epidemic

Posted on by Dana Goldman

The New York Times Magazine cover story this past week was about teens and anxiety. Yay!

And it’s not that I’m a sicko who takes pleasure from other people’s suffering.

Rather, it’s nice to see attention focused on what’s been obvious in my office: that many teens — delightful, smart, precocious, thoughtful teens — are really struggling in profound ways. Self-harm is one way that this struggle shows up. A struggle to get to school is another big way this shows up. And it puts parents in a huge bind over what to do.

Here’s what I want you to know. Anxiety is terrible, and the impulse is to avoid anxiety by avoiding what makes us anxious. But as this article mentions, avoidance generally makes things worse. What helps? Looking at and re-writing thoughts, coping skills for calming the body and mind, and practice showing up for things that feel scary — like school.

 

A Way Out of Loneliness — And It’s Link to Depression, Anxiety and Other Ailments

A Way Out of Loneliness — And It’s Link to Depression, Anxiety and Other Ailments

Posted on by Dana Goldman

The research is out, and loneliness is a public health epidemic. I was struck by this story on NPR earlier this week about not just its connections to depression and anxiety, but also its link to stress and resulting physiological problems. Of particular note: about 40 percent of people experience loneliness. That means there’s a lot of people feeling lonely… meaning we’re simultaneously alone in it, and also not alone with the experience.

The story comes from reporting from — who knew? — the Harvard Business Review about the impact of loneliness on workers.

I see teen and adult clients every day who you wouldn’t expect to be lonely. Lots of people have busy lives that may look fulfilling from the outside. Lots of us have relationships with people that have substance and depth. And yet – it may be that when we’re alone with ourselves, loneliness creeps in. Or we’ll be at a party, or at work, or with our families, and feel separate, like we’re pretending to feel something we don’t actually feel or pretending to be someone we’re not. Sometimes when we feel isolated, we stop going out — and then, as a result, feel even more isolated. Or we get busier and busier to avoid the feeling altogether.

There is a way out of loneliness that doesn’t require becoming busy beyond belief. I work with people every day on loneliness in a few different ways. First, we work so that relationships can become more authentic – so you have to hide less of yourself. This can mean dropping the need to look perfect, to yourself and others, which isn’t an easy task for many of us. We work on figuring out what you want for your life, so that you spend less time on things that feel fake or meaningless to you. We also work on your relationship with yourself. How can you spend time with yourself in a way that’s comfortable, and grow to have a relationship with yourself that’s companionable? Loneliness loses its steam when we grow comfortable with ourselves, and with being ourselves.

Blog Hodgepodge: ACE Scores, Bias, Lived Experiences, and A Radio Interview

Blog Hodgepodge: ACE Scores, Bias, Lived Experiences, and A Radio Interview

Posted on by Dana Goldman

I got to talk on the radio recently about depression, suicide, and teenagers. I’m glad to continue to spread the message about adolescent mental health concerns, even though it’s always sobering to consider how mental and physical health issues can be created or exacerbated by so many preventable factors.

I’m a big fan of the Adverse Childhood Experiences (ACE) Scale as a quick way to look at what sorts of factors may have been present – or absent – in my clients’ lives that may impact them to this day. None of us exist in a bubble. There’s good research on how trauma, neglect, race, class, immigration status, gender and gender identity, and so much else plays into how others treat us, brain function, and how we end up feeling about ourselves. (Here’s a recent reminder of racial bias affecting views toward young black girls.)

In my work as a therapist, I continue to be committed to seeing my clients as individuals whose own stories and experiences are a part of a larger social and cultural framework.

Some helpful stats about the importance of ACEs.

 

Separating Suicide Facts from Myths

Posted on by Dana Goldman

My heart has been hurting these past few weeks as I’ve been following a terrible story unfolding in the news. A teen was suicidal; his girlfriend urged him, via text messages, to actually kill himself. He did. She’s now been found guilty of involuntary manslaughter.

Everything about this story is awful, and this tragedy likely could have been avoided. Many people experience thoughts of “I just want this to end” at some point in their lives, and we know that most people who survive suicide attempts and live to recover from depression end up incredibly glad that they are alive.

Based on my professional experience, I want to mention a few specific points that are important for us all to know:

  1. If you think a loved one may be depressed or suicidal, it’s always, always, always worth getting them evaluated by a therapist or at a hospital. Here’s a good resource on identifying warning signs. There is no reason to wait. 
  2. No matter our age, depression and anxiety almost always cloud our judgment. For teens, add in a still-evolving sense of self, lack of control (here’s a great YouTube video my teen clients often like on the subject) and a still-developing brain and it’s a recipe for potential trouble. 
  3. You don’t need to tiptoe around the topic of suicide. It’s okay to say “have you been having suicidal thoughts?” This will not plant the idea of suicide in anyone’s mind and it may be a relief to have someone ask directly.
  4. The suicide case that I started this post with is the exception, not the rule. Many of the teens I’ve counseled over the years have risked important friendships by telling a parent or teacher when a friend has been depressed or suicidal. On the whole, teens, like adults, typically do the right thing — even when it has the potential for major social consequences.

Testing, Testing – Tips for Parents

Posted on by Dana Goldman

These last few weeks, I’ve seen kid and teen clients’ stress skyrocket as a result of mandatory statewide testing. It reminds me of my own days as a student in DeKalb County schools taking the Iowa Test of Basic Skills way back in the 1980s. You may have a similar memory of using #2 pencils to bubble in answer sheets or long hours of boredom ctesting, testingoupled with the pressure to do well. As far as I can tell, none of that has changed.

It’s easy to be sympathetic to these clients and their anxiety. Tests can be confusing, and often don’t reflect what my clients have learned throughout the school year. Multiple studies over decades have shown that race and socio-economic class can impact scores, raising significant doubts about validity.  

And yet, even when these smart, savvy kids have this information, they still feel tremendous pressure to do well on these tests. For some, these test results make up a significant portion of their final grades in school. For some, their performance impacts eligibility for talented-and-gifted programs. For many, it’s easy to tie self-worth to scores — which means even more pressure to perform.

In my years counseling teens and kids, many parents have come to me saying, “my kid seems more irritable around testing time.” This is not a surprise. When we’re anxious and don’t feel a lot of control, that can come out as irritability or efforts to control other parts of our lives in constructive or not-so-constructive ways. 

So here’s what I tell parents:

1. Recognize that your child is likely feeling anxiety and pressure. They may not tell you that they’re anxious, but you may be able to tell if your child is acting out more than usual. Any perceived pressure from you may feel like “too much” to them, since they’re already worried and negatively anticipating the test.

2.  Help them prepare in practical ways (getting a good night sleep and eating a good breakfast beforehand). If their school allows books or other materials for in-between testing times, help them select something that will reduce boredom.

3. Reassure your child that you love them and that testing is much less important than other things (their character, perhaps, or their overall effort during the school year).

4. Make plans with your child to do something fun after testing is over. 

And, thankfully, testing will be done soon!