Encouraging Teenage Joy

Have you ever had high hopes for an event only to be sorely disappointed? Or perhaps you came with very low expectations and were pleasantly surprised.  Expectations can make or break a holiday season. High expectations for the holidays can steal joy in anyone. On the other hand, can low expectations turn you into Scrooge no one wants to be around? While predicting doom and gloom may not be the solution, it is important to sit down and discuss what is realistic.

As each family member has their own ideas about the season, stress, disappointment, and miscommunication are common joy thieves.  Teenagers may be grieving the magic of holidays as a child, while struggling with more grown up responsibilities. With school out for a couple of weeks, more family interaction can lead to more conflict than yuletide joy. As adults we want to encourage joy, thankfulness, and peace more than ever. In this particularly busy season of the year, how do we encourage teenagers to develop true joy when we struggle to maintain our own joy?

Look out for joy robbers

• People who won’t take no for an answer-- Its okay for you and your family to need down time and not participate in every holiday activity. It may not make you as popular but a hectic schedule is the quickest way to lose your joy. 
• Financial stress—agree and stick to a realistic budget. Don’t forget to factor in extra money for gas, holiday cooking/baking, secret Santa, and decor. 
• Commercialism have you down? Adopt a needy family through your local church, volunteer at a homeless shelter, reach out to the elderly, foster care children, or lonely people in your life. Focusing on other's in need reminds your teen and family of the true values of the season.

Be a joyous role model

• Schedule down time—teenagers often want to be in the middle of all the fun, robbing them of sleep and, sometimes, sanity (we all go crazy without sleep). 
• Keep up your healthy routine: exercise, eat those veggies, fruits, sleep.
• Limit your alcohol use—Let teens know alcohol is not needed to celebrate or find joy (Teens often are peer pressured to use alcohol (and drugs)  more often during the holiday break.).
• Look for joy in the little things: cup of cocoa, child's smile, frost lined country side, a favorite carol, warmth of a fire.

Let go

• Romanticized ideas about holidays and family life lead to let down—let them go; it’s not real anyway.
• Recognize you are human and can only do so much.
• Realize other’s moods and emotions are under their control; ultimately, it is not your job to make other’s happy—that’s their own job.
• Resolve potentially explosive family differences during a better time.

Each day we have is a gift. Recently, I came across this quote: 

"If you have food in your fridge, clothes on your back, a roof over your head, and a place to sleep, you are richer than  75% of the world. If you have money in the bank, your wallet, and some spare change, you are among the top 8% of the world's wealthy. If you woke up this morning with more health than illness, you are more blessed than the million people who will not survive this week. If you have never experienced the danger of battle, the agony of imprisonment, or torture, or the horrible pangs of starvation, you are luckier than 500 million people alive and suffering. If you can read this message, you are more fortunate than 3 billion people in the world who cannot read it at all."

Perspective is every. Enjoy a blessed holiday season. 

Helping Teenagers Cope with Holiday Blues

As long as I have been in the field of mental health, I have observed a significant increase in new clients starting around Halloween and lasting through Valentine's Day. While there are multiple factors contributing to this phenomena (e.g. more rain and clouds, school), a significant source of distress seems to be the holidays. Teenagers can feel this most keenly as they have little power over their circumstances and are old enough to know what expectations the holidays bring. Two huge contributors to holiday gloom are finances and loss.

Finances—Many teenagers are intensely aware of the family's financial situation. If it is hard for caregivers to make ends meet during the year, this is amply magnified during the holidays. They may know they will have food but dread hearing about all the electronic and expensive gifts their peers receive. They may sit quietly in shame, or lie about the reality of the holidays to avoid pity. Often, they won’t share this feeling with anyone because they don’t want their caregivers to feel worse about tight finances than they already do. While it can be character building to recognize the greed of "keeping up with the Joneses", teenagers who get next to nothing during the holidays may feel unimportant or even unloved. 

What can help: Encourage teenagers to pick up holiday jobs, babysitting, yard work to earn some extra money. It empowers them and increases self-esteem. Encourage volunteer work in local homeless shelters. Seeing those who struggle to have a roof , puts our own wants into perspective. Be a listening ear to financial struggles.  Find an organization who can sponsor families with limited income (i.e. your local church, Salvation Army). What other ways have you found to help encourage teenagers when finances are tight at home?

Loss— Loss comes in many forms. For children with divorced parents or foster/adopted children, the holidays result in missing a parent and/or family traditions. For families who have had a loved one die, the holidays highlight that pain deeply. Even for the lonely or isolated teenager, never it is more felt than the time of year we gather together to celebrate the holidays.

What can help:  One of the best ways to help a teenager struggling with loss is asking “What would make it feel like ___________ (holiday of your choice) for you?” Even the opportunity of expressing their desires helps them process the loss. Encourage the teenagers to set aside some time during the holiday to honor their loss through writing a letter to the one they miss, looking at photos, listening to music, or even creating a “loss box” where they can put in something to represent the loss and review it at their leisure. By setting aside time to honor the loss, it helps the teenager regulate their grief; it help to move on with the day rather than trying to push aside thoughts or focusing on the loss all day. Mourning is different for everyone. Allow people to choose how they want to honor their losses. For a lonely or isolated teen, invite them to join in on a holiday activity. Giving a teenager a place to belong is a priceless gift. Regardless of the type of loss, be available to talk to and make sure they know they are important to you. What other ways have you found to support teens experiences loss during the holidays?

The Oyster: Changing Pain to Beauty

Every once in awhile, I run across a story that must be shared. Nancy Davis, Ph.D. creates a story of changing identify from worthlessness to one of value. Its too good not to share.

The Oyster

Once upon a time an oyster lay on the bottom of the bay. Oysters are very rough on the outside and not very colorful. The shell of an oyster is often ground up into small pieces and used to make roads. People and vehicles ride and walk all over roads made out of oyster shells.

This oyster was no different. "I am designed to allow people to walk all over me because I'm just a yucky, ugly oyster," the oyster told herself day after day. "I was created for people to walk on me." The oyster had also heard that people sometimes become poisoned from eating oysters. So she told herself, "I'm really worthless; all I do is make people sick."

Often when oysters are served at restaurants, people remark, "Yuck, oysters are slimy, they're yucky. Why would anyone want such a repulsive thing?" So the oyster would say to herself, "They're right, I'm not worth anything, I'm slimy, people hate me, and I am worthless."

It was not surprising that the oyster was always feeling sad.  "Why couldn't I have been something different? Why couldn't I have been a diamond or a ruby? Why couldn't I have been a sand dollar or have a shell that could be made into earrings? Why, why, why?" the oyster asked, as she thought a lot about what she wasn't. She told herself over and over that she was ugly and awful and slimy and made many people sick.

One day a fisherman threw a net into the bay and caught this oyster in his net. The oyster was even more upset and cried out, "This is exactly what I was afraid of. Now I'm caught and everyone is going to discover just how ugly and repulsive I really am."

The fisherman had a different way of looking at things than the oyster. Finding the oyster in his net, he opened the shell with a knife. From deep within the shell, he pulled out an exquisite white pearl. This discovery surprised the oyster. She had paid no attention to the hard pearl as it grew within her. "Isn't it amazing that you can have something so valuable within you and not even realize it? How could this be?" asked the oyster. "How could I have this beautiful pearl inside me when I am so ugly?"

Because the fisherman had spent his life on the sea, he sensed the oyster didn't understand how a pearl is formed and he began to talk to her. "Long ago, when you were very little, there were things in your life that were very irritating and scary and sad and painful. To deal with this, you began to build a covering around your feelings. You wrapped and wrapped all your pain and sadness to protect yourself. This was really helpful when you were young and the pain was very real. What you did not realize and now you can see, is that you changed this awful pain into a valuable pearl. You found a way to take your pain and sadness, crystallize it and change it into something exquisite. this pearl was within, just waiting to be discovered."

"Wow", cried the oyster, "that's very surprising." Then the fisherman broke away the shell from the outside of the oyster because she didn't need that anymore. He removed the yucky, slimy part because she didn't need that anymore either. Then he polished the pearl allowing the beauty and luster to shine through. The fisherman gave the pearl to his daughter. She wore it on a necklace of gold and prized it dearly.

"Isn't it amazing?" the little pearl remarked to herself.  "I never realized that I am special. I was unaware that deep within there was a pearl waiting to shine like a jewel." As the pearl continued to think about life, she realized the most valuable jewels are often buried and are just waiting to be discovered and polished.

Davis, N.  (1996). Once upon a time...therapeutic stories that teach and heal. Burke, VA: Nancy Davis, Ph.D .

Handling "My therapist said...."

Have you ever had a teenager tell you “My therapist said….” followed by something bizarre, confusing, or conflicting with your values/rules? Even as adults, people will explain a change in behavior referring to a counselor's direction. And it is true counselors may say or ask clients to change thoughts/behaviors/emotions for a variety of reasons. There is an assumption if someone is in counseling, they want life to be different. This only comes with change. But what do you do when the “my therapist said…” statement challenges your values/rules? Without any context, it can be upsetting to have your values/rules challenged by someone who influences your teenager. Typically, therapists do not work to undermine parent’s/caregiver’s authority.

However, with teens, it is not uncommon for context to be excluded when talking about something their counselor said. Other times the original intent has been skewed for a variety of reasons.  Sometimes it is intentional. Other times it is accidental. While still other times, it is truly misunderstood. 

For example: In one session, Mary and I were talking about the importance of expressing her emotions in a safe way. One of the suggestions I offered was a password protected writing program (i.e. Microsoft Word). Later at home, Mary’s parents asked her for her phone password. Mary told her parents "My therapist said I should have privacy on my phone." and refused to comply. Naturally this was confusing for the parents. Mary had chosen to journal on her phone and consequently privacy should extend to her whole phone. Fortunately, the parents asked me about it and I was able to clear up the miscommunication while discussing with Mary alternate places to confidentially express herself (parents should have access to phone passwords with any minor in their care).

If you hear “my therapist said….” from your teenager and what follows does not keep with the family values, please clarify. Start by responding "Hmm...that sounds interesting. Tell me more about that." If what is relayed continues to be conflicting with values/rules even with more context, ask to talk to the counselor. Teenagers discover the therapist may hold a lot of weight with their parents and intentionally mislead them. Other times they may have misinterpreted the counselor’s intent. Teenagers may mistake validation as approval or agreement. To get the most out of the counseling experience for your teenager, good communication and clarification are vital.  

If your teenager will not let you talk to their therapist to clarify, let them know you will be unable to make or support any changes without clarification as it goes against family rules/values.  But, let them know you would be very willing to listen and clarify if you could talk with the therapist for one session or even half of one session. Some teenagers are more willing to agree if they can still be present with the parent and counselor.

Be careful not to bad mouth the counselor or contradict what they have said without clarifying because it undermines your teenagers therapeutic progress. If no resolution or clarification can be attained, respectfully say, "Everyone has a different opinion"  or "I'm not sure how that will work in our home." Don't let the counselors 'advice' become another area of conflict between you and your teenager.

A teacher once told her children’s parents at orientation “I promise not to believe everything they say about you, if you promise not to believe everything they say about me.” While counselors validate and accept what their teenage clients say, they also take it with a grain of salt. People have different perspectives and are entitled to their opinion. This is true with all clients not just adolescent ones. Counselors recognize they often are only seeing one point of view and encourage parental involvement whenever possible to more efficiently resolve the presenting issues. Ultimately, the caregivers/parents make the rules of the household not the counselor. 

The Science Behind Self Injury

Researchers have been studying non suicidal self injury (NSSI) for over 20 years. Only within recent history have they been able to look at the physiological and chemical differences in individuals who engage in self harm. It is an exciting time as the science behind the behavior can help clinicians and doctors learn to more effectively treat self injury. With more knowledge comes more understanding for parents, teachers, youth leaders, and peers who often feel confused and discouraged by the self-injury behavior.

The Brain

In the limbic system, researchers saw a hyper aroused state in those who engage in self harm. As the limbic system involves emotional regulation, in a hyper aroused state the individual is upset and may try to calm down. When the scientists applied a painful stimulus, they hyper aroused state came down. This appears indicative of NSSI as a coping skill for emotional regulation. In other words, the brain supports a common teenage assertion they actually feel better, calmer, release, and/or relief after engaging in the self injurious behavior.

The Altered Chemical Levels

Researchers have also found altered levels of cortisol response. They are uncertain if the behavior causes the altered levels or if the altered levels increase vulnerability for the behavior. Cortisol is associated with stress (Think of the commercials about cortisol/stress keeping us from losing weight.). It makes sense individuals engaging in self injury often have difficulty regulating their internal and environmental stress. We can see it in the altered cortisol levels.

They also found lower levels of endogenous opioids affecting pain perception and addictive behaviors. There have been rumors NSSI can be addictive. If the Endogenous opioid levels are lower, it is possible there is an addictive quality to some severe self harm. Also, if pain perception is altered, there is potential truth in someone who engages in NSSI stating they don't feel the pain of their actions. However, once the behavior no longer exists, the lowered pain perception does return. Others have suggested NSSI may increase serotonin or dopamine levels in the brain creating an addiction but research does not support the hypothesis consistently at this time.

Nutritional Deficiencies

Research has found successful treatment of self injury in increasing the Essential Fatty Acids (found in walnuts, leafy greens, fish, flax seed, etc...) in the diet. People who engage in self injury have lower levels of Essential Fatty Acids. In one research project, the control group was given a placebo while the other group was given Essential Fatty Acids regularly. After 12 weeks, the experimental group saw a marked decrease in depressed feelings and suicidal thoughts in comparison with the control group. Even adding a supplement such as Omega 3 and 6 capsules (fish and flax seed oil) increase the amount of Essential Fatty Acids in the body. I am continually amazed at how important good nutrition is to the overall health of the mind. While improved nutrition may not cure all diseases, increasing Essential Fatty Acids will improve depressed moods and suicidal thoughts based on some of the most current research.

Effective Counseling

Dialectical Behavior Therapy (DBT) is one of the most evidenced based forms of counseling treatment with self injury. Ask your teens counselor if they utilize DBT. If they don't, ask them if they would be willing to learn (by books or trainings). A counselor doesn't need to be a purely DBT clinician to be effective as long as they are familiar with the basic principles and can use DBT when needed to decrease NSSI. You want the counselor to be DBT influenced. Remember, even with the most effective counseling, NSSI is not a short term issue and there is no quick fix. DBT clinicians recommend preparing for 3-12 months before treatment is successful depending on severity, intensity, and duration of the NSSI.

Prevalence

Don't buy into the belief NSSI is increasing. Much of the literature supports a consistency in the prevalence of NSSI since 2005. It is possible we are more aware of the issue as teenagers open up about the historically hidden behavior. In the United States, up to 37% of high school students have engaged in self harm behaviors at least once. For more information on the research check out these websites:
http://www.suicidology-online.com/pdf/SOL-2012-3-24-32.pdf 
http://www.jabfm.org/content/23/2/240.full 
http://www.capmh.com/content/6/1/10