Parental Favoritism Creates Stress, Anxiety and Depression in Adolescents

It’s very early in the school year and one thing I’ve noticed is that more and more of the students that are getting referred to me for counseling aren’t the typical “bad apples” or “lost” kids, but kids who are good students, are never in trouble, yet are miserable.

How miserable? One cuts herself and thinks about suicide often. Another felt disappointed when she found out she wasn’t pregnant because she thought being pregnant would make her feel alive and purposeful. And one is so depressed that despite appearing to have everything a 17 year old high school girl could ask for, she mopes around campus with her head down.

What do all these students have in common besides being female? They all have a sibling that they are constantly being compared to. A seemingly perfect sibling who makes their accomplishments appear minor in comparison.

These are students, who compared to most other students on campus, are successful. They have mostly A’s and B’s and no disciplinary infractions, yet when compared to a sibling who is making straight A’s , serving as class president and maintaining a thriving social life, they feel inept, especially when their parents are the ones constantly drawing the comparisons.

These students, despite doing their best, are never recognized for it since their best pales in comparison to their sibling’s best. They are often left feeling as if they aren’t good enough and have a diminished sense of self, while the favored child can begin to feel a sense of being special and entitled, often making the less favored child feel even more diminished.

Adolescents tend to be even more sensitive to favoritism by parents than younger children, since they are trying to redefine themselves from being a child to being a young adult.

In doing this they often distance themselves from parents and even have created some tension as they struggle for independence, yet they still want the approval that came along with childhood, approval that the more favored child usually still gets and it can create resentment.

What makes parental favoritism especially harmful is when it is intentional and creates preferential treatment and superiority/inferiority between children.

The disfavored child may begin to believe that they are indeed not as deserving, as good or as smart as the favored child and that could lead to a life time of self-esteem and psychological issues as well as bitterness towards the parents and the other sibling.

So far the students I’m working with, besides complaining about the favoritism and anger towards their parents and sibling, show profound anxiety, depression, self-injurious behavior, low-self-esteem, anger, suicidal thoughts, decrease in self-efficacy and drug use.  And these are the “good” kids.

Imagine if they were kids with more disadvantaged backgrounds and more complex psychosocial issues. They could be drop outs, delinquents, heavy drug users, you name it.

There are many different ways parents can show favoritism, including showing inequitable pride, attention and approval to one child, to giving the favored child more freedom and rewards.

To the disfavored child, they often feel as if their parents care for and think less of them.  This can cause the disfavored child to dislike the favored child and that can come out in the form of resentment that can continue for life.

At times parental favoritism isn’t done on purpose. It is actually very easy to unintentionally start showing favoritism to one child over another.

Parents need to start recognizing, listening to and accepting when one child is claiming to be treated unfair so that they can analyze the situation.

While sometimes it may seem like the child claiming to be treated unfairly is just nagging, they are often trying to tell the parent that they want some attention or are feeling left out.

Parents should try avoiding comparing their children and should let each one know that they are highly valued for their own unique individuality and that they are all favorites because they are all unique.

The period of adolescence is hard enough, the last thing a child needs is to feel discriminated against within their own family unit.

How Pregnancy and Postpartum are Affected by Eating Disorders

Great article!


During my vacation, Leah DeCesare from Mother’s Circle has been kind enough to write a guest post about an important topic.  Enjoy!

How Pregnancy and Postpartum are Affected by Eating Disorders

by Leah Decesare,

Over the course of a single spring, I worked with three women struggling with postpartum anxiety. During our time together, I learned that they all had a history of eating disorders.  This connection motivated me to research and talk to women about how eating disorders affected their pregnancy and postpartum experience. [Names have been changed.]

Eating Disorders as Related to Childbearing

The two most common eating disorders (EDs) are anorexia nervosa (AN) and bulimia nervosa (BN), estimated to affect 5 – 10 million females in the United States. Approximately 4.5% – 9% of women of childbearing age have a past or active eating disorder.  AN is characterized by extreme calorie restriction, obsessive dieting and loss of…

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Cognitive Behavioral Therapy, A Brief Primer Part 3: Ignoring Negative Thoughts

As we discussed in part 2 of this series, according to cognitive behavioral therapy, our thoughts control our behaviors and thus control our feelings, but sometimes it is very difficult to control our thoughts for a number of reasons.

On average, we have about 50,000 thoughts a day! Some of them, despite our best efforts, are bound to be negative thoughts that make us angry, fearful, anxious, sad, pessimistic, etc.

Ideally we would analyze, confront and dispute each of those negative thoughts to see if they are even rational, and then use cognitive restructuring (changing the way you perceive a situation), to turn those thoughts into less harmful and even productive ones.

With 50,000 thoughts a day going through our minds, it’s not plausible to expect to be able to sit down and use the ABC’s of thoughts, feelings and behaviors on each and every one of those thoughts, we can save that for some of the bigger, more damaging ones that keep us from experiencing life fully.

So what do we do with the other dozen, hundred or even  thousands of negative thoughts?

We can chose to ignore them! Yes, it’s that simple! We can chose to ignore them, pay less attention to them, dismiss them and not allow them to take over our thoughts, feelings and behaviors.

We can learn to realize that thoughts are just thoughts, nothing more.

A thought by itself is harmless until we give it power (either good or bad). The same is true with feelings. We can have a feeling enter us, acknowledge that feeling, but don’t dwell on it, and in a very short amount of time that feeling is likely to leave us.

It’s only when we ponder, over analyze and start assigning that feeling/thought meaning that we start to give it ammunition to do harm or motivation to do good.

Let’s take for an example that one day at a coffee shop writing in your blog you start thinking, “I should have been a writer. I just wasted my entire life slaving away instead of following my passion.”

If you dwell on that thought and let it torment you, you will feel like a loser and are likely to start feeling sad. Or, you can recognize that it’s just a thought and dismiss it.

This doesn’t mean that writing isn’t something you should be doing and maybe pursuing more, it just means that in this moment you are choosing not to pay attention to that thought, especially since you recognize that it’s likely to make you feel bad.

It’s not a cop out. It doesn’t mean that later on you can’t go back and apply the ABC’s of thoughts, feelings and behaviors to it, it just means that in that present moment you are choosing to dismiss it and use that mental energy more constructively.

If we paid attention to all the negative thoughts we had, we would be worn out, worthless and depressed.

It’s very important not to dwell on thoughts that have happened in the past or will may happen in the future.

It’s important to be present and dismiss those negative thoughts that come flying in about the past (even if it was ten minutes ago) or about the future.

The beautiful thing is, you’ll learn that once you start dismissing and ignoring those negative thoughts, more peaceful thoughts are likely to fill their space and you’re more likely to feel at peace with yourself and your world.

One Kid at a Time

I’ve probably mentioned about a dozen times that the high school I work at is in an inner-city area. It’s not the worst area in the world or perhaps even in the city, but it is a place where poverty, drugs and violence are considered normal.

Just four days into the school year after our school became the first high school in the county to require school colored uniforms to cut down on the large amount of gang activity at school, we’ve already had our first student shot.

A young man got into a fight right across the street from the school and was shot, luckily for him it was only in the leg. According to the news he is being uncooperative with the police as far as giving details about his shooter, which leads me to believe that this is likely gang related.

This happened on the same day that Tyrone Mosby (19) was arrested for killing

Danielle Sampson (15) when a bullet from a drive by shooting found it’s way to the back of her head as she road home from church with her family.

There are a lot of good kids that grow up in that community and that go to the high school, but many of them from the time they were born were dealt a cruel hand that had them almost destined to stay in poverty, be involved in the criminal justice system or headed towards an early grave.

The culture that keeps them at a disadvantage is so intrinsic that it’s often hard for them to see a better life for themselves. Many of them can’t imagine living life any different than from what they know. They grow up in poverty, their parents grew up in poverty and their grandparents likely also grew up in poverty. Everyone around them is either involved in criminal behavior, uneducated, unemployed and or/abuses drugs. They are exposed to all these things and more at a very early age and so psychologically they start to believe that they will be no better (and often don’t want to be much different) than anyone else in their community and thus act in ways that nearly guarantee that they won’t.

Young boys join gangs, start stealing, robbing and even killing. Young girls do much of the same with the addition of getting pregnant and giving birth to more young people who may be cursed from birth to repeat the cycle.

My program focuses on reaching the kids many thought were unreachable. The angry kids, the kids who are using drugs or have given up on school and sometimes life. Often times I lose kids to dropping out or the juvenile justice system and when crimes like the ones I’ve mentioned aren’t rare or even shocking, but “normal”, it’s easy to start wondering how effective not only am I, but also the school and other services in the community are being.

Then I have to realize that I can’t save every kid I come in contact with as much as I would like to. They all have their own lives, their own minds and will ultimately do what ever it is they want to do. I only have them for a very small amount of time during the week and often that doesn’t compare to the impact their family and community, where they spent most of their time, has on them.

I have to remind myself that it’s not about saving everyone, but about trying to save one kid at a time.

Cognitive Behavioral Therapy, A Brief Primer Part 2: The ABC’s of Thoughts, Feelings and Behaviors

Albert Ellis is the father of what is known as Rational Emotive Behavioral Therapy or REBT. Today, a lot of techniques used in Cognitive Behavioral Therapy (CBT) come from REBT and that includes much of the theory that our thoughts control our feelings and behaviors.

Most people believe that an event or person “makes” them feel a certain way, when in actuality, it’s their thoughts (perceptions) and what they are telling themselves (self-talk) that actually make them feel and thus react in a certain way.

However, REBT and CBT teaches that by controlling your thoughts, you can control the way you feel which will in-turn affect the way you feel.

Let’s take for example that you are dating someone and then they suddenly break up with you. Most people will internalize everything by telling themselves things such as “what did I do wrong”, “maybe he/she found someone better”, “I just lost a good thing” or “I’m such a loser”.

Those thoughts will then lead to the person feeling down, depressed, like a “loser” and possibly even anxious and desperate.

They are then more likely to do things depressed people do such as over eat, over sleep (or under eat and under sleep), cry, isolate themselves, turn to drugs or alcohol to numb the pain of rejection, etc.

Now let’s take that same person and the same situation, but this time after the break up they tell themselves “he/she just lost a good thing”, “Oh well, on to the next one”, “he/she must have other issues”, “now I’m free to find someone worth my time”, or “it’s better to find out things wouldn’t work out now then later”.

That person is more likely to not feel so rejected, to possibly even feel somewhat relieved or even optimistic about the future.

Because of this, that person is likely to go on with their life with little interruption, returning to life as normal, without all the negative behaviors that came along with the first example. The event didn’t change, but the thinking and perception did.

Your thoughts are so powerful! No one can make you mad, sad, anxious or whatever, only your thoughts can do that.

If I am going to speak in front of a million people and all I’m telling myself is that “I’m going to mess up. I’m not qualified to give this talk”, then I am going to lose sleep, be extremely anxious and probably stumble as a self-fulfilling prophecy during the speech.

However, if I convince myself that “I’m going to rock this. I am more than qualified to do this”, then I am likely to be much less anxious and thus more likely to actually give a great speech.

The event didn’t change (having to give a speech), the only thing that changed is my thinking!

In short, Albert Ellis broke it down into four simple rules to help evaluate your thoughts and see if they are rational or irrational.

A. Activating Event: What exactly is going on?

B. Beliefs (perceptions): What thoughts are you having about the event? What are you telling yourself?

C. Consequences (behaviors): What do you do or how do you act in response to the beliefs and thoughts you have about the event.

As a last example, let’s take something almost everyone can relate to, the terrorist attacks that happened in America on September 11, 2001, that would be our activating event.

People in the United States were angry, scared, and shocked about the terrorist attacks, while the terrorist were elated. In America we prepared for war, started avoiding certain places and even slid into a recession, that was our consequences/behaviors, while the terrorist celebrated as seen on CNN and Al- Jazerra video.

How could the same exact event have starkly contrasting reactions? The answer is the difference in the way the two groups perceived the events.

And then there is the last part of the ABC’s of thinking and that is “D” for disputing our thinking.

It is imperative that when we have thoughts that upset us that we challenge or dispute them to see if they are irrational. What evidence do we have that we are going to fail, be alone forever, not get the job we applied for, etc.

Without disputing or challenging our irrational thoughts, we’ll always believe they are true, even when they aren’t. In the next part of this series we will explore negative thoughts a little more in-depth.

My New Intern…

After years of dodging the bullet, my luck has finally run out. I am getting an intern.

I never wanted an intern. I like to work alone (most counselors/therapist do). I enjoy coming to work and not being responsible for anyone except myself, yet this week that’s all changing.

I’ve heard from fellow counselors that interns can be great assets if they are good, and major burdens if they aren’t. We are largely responsible for them and it can be like babysitting, so how on Earth did I get stuck with an intern?

Every few months as students approach their last semesters of graduate school, they have to complete approximately 1,000 hours of internship work. Usually when my company starts assigning us interns from the various masters programs, I just pretend to be busy and that has worked in my favor, up until last Monday.

As we sat in a meeting and met the interns I quickly scanned the room. There were six counselors including me, and four interns. I breathed a sigh of relief. Surely I would escape the curse of being assigned an intern once again.

As usual I sat quietly, doodling in my notebook in an attempt to look preoccupied and listened closely as the interns were being assigned.

I tried to rationalize why my superiors would not give me an intern.

  1. I was the only male there and all the interns were female. Surely they wouldn’t assign me a female intern.
  2. My office is quite small, there isn’t enough room for two people to work out of comfortably.
  3. My school is in the inner-city and has a reputation for being rough, most of the other counselors worked out of much nicer schools in much nicer areas.

My chances seemed pretty good and they were.

We were down to one last intern, another counselor and myself. I just knew they would give the intern to the other counselor, after all she has been with the company for over 17 years. If anyone could mentor, teach and guide a new, soon to be counselor it would be her.

And they did! They did give the intern to her, but then she stated she was moving offices and didn’t think she would have room for an intern. I felt gravity pulling my face to the floor. Seriously?

And that’s how I got stuck with an intern.

After they gave me my intern, we had a short meet and greet. I was not excited and my disappointment probably showed in my face and tone as I asked her why did she want to be a therapist, did she know anything about the school she had just been assigned to, a school that has seen it’s fair share of stabbings, shootings and deaths.

Yes I know I was not being as nice as I usually am, but I was annoyed and irritated.

There’s enough things to worry about working with teenagers and the last thing I wanted to be worried about was some naive intern, whose total sum of understanding human behavior and psychology mostly comes from $200 textbooks.

Don’t get me wrong, I love text books, but from experience kids in grad school tend to think they know everything because they got an “A” in a class when in all actually, they have just begun to scratch the surface of understanding human behavior with all it’s complexities.

To my surprise she stated she prefered to work in the inner-city with kids who came from violent and impoverished backgrounds.

Okay, she gets a point for that. Most interns I’ve met come from pretty prestigious programs and believe that all their clients will be upper middle class, college educated, well adjusted individuals with simple neurotic problems that can be cured at the rate of $140 an hour.

To be fair, she seems nice enough. She’s graduating from Virginia Tech so I know she should be smart enough. Only time will tell if she is capable enough to actually work with kids who live in neighborhoods that often resemble war zones.

I definitely want to change my attitude and try not to look at her as a burden. I want to teach, guide and mentor her as someone did me when I was in her shoes five years ago. So, in a way, I look forward to seeing how this plays out. I will keep you posted.


If you’ve worked with clients who have borderline personality disorder (BPD), you’ve probably had a conversation like this:

Therapist: How did that make you feel?

Client: I dunno.

Therapist: How do you think that might have made someone else feel?

Client: I dunno.

Therapist: Take a look at that list of feeling words and see if there’s anything that fits.

Client: Oh God. I can’t face that list today.

Therapist: Well… hm.

Client: You’re getting worried. You’re thinking about referring me, aren’t you?

Can people really be so oblivious to their emotions when they’re so well-attuned to yours?

Carina Frick, Simone Lang, et al answer at least half of that question in their  new study. They asked clients with BPD to receive an MRI while guessing the emotions others displayed in photographs.  The BPD clients out-guessed the control group of healthy subjects. The fMRIs showed they actually…

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Clearing The Air: Mental Illness In Relation to Smoking

The other day I was at a sports bar people watching, something I commonly do, when an attractive waitress caught my attention. I watched as she went outside on her break and then did the most disgusting and disfiguring thing, she put a cigarette between her lips and lit it.

I was shocked as I watched her inhale and then exhale a white puff of smoke. She had to be aware of the astounding amount of health issues related to smoking from cancer to cardiovascular disease, and she was smoking by herself so there weren’t any apparent social benefits, so how could someone so young and beautiful be putting that carcinogenic smoke into her body?

I immediately started thinking that she had to be self-medicating for one reason or another and that got me to thinking, is that why so many people are still smoking, can they all be self-medicating with nicotine and if so, from what?

The first obvious answer to me was stress. A lot of people smoke because they are stressed out and use nicotine to help calm their nerves. A study I read said that approximately 30% of people who smoke do so because they are depressed. For these people, nicotine actually helps them feel better, if only temporarily. These people instead of learning how to deal with their depression through counseling and appropriate anti-depressants if needed, have learned to depend on nicotine. Evidence of this came from U.S. clinical trials for Wellbutrin, an anti-depressant. During the trial to see how effective Wellbutrin was on depression, a fair number of participants who smoked suddenly stopped smoking. With drug companies being as clever as they are, Wellbuturin was soon not only sold as an anti-depressant, but was repackaged and renamed as Zyban and sold as a treatment to help people quit smoking.

Also, in an article called “Smoking in relation to anxiety and depression: Evidence from a large population survey: The HUNT study” published in European Psychiatry, it was shown that anxiety and depression were the two most common complaints in people who smoke, with anxiety being the highest complaint, followed by anxiety and depression combined and then depression by itself.

People with mental health issues, even if they are underlying, are twice as likely to smoke as the rest of the population. So it is possible that the people around you who smoke, your spouse, your friend, your family member, (or even you if you smoke) may actually be self-medicating for an untreated and undiagnosed issue that needs to be attended to. With proper treatment, they may lose the desire to smoke altogether. Encourage them to talk to their doctor, health care provider or other mental health provider about how their mood factors in with their urges to smoke.

Political Bullying: What Are We Modeling to Our Children?

As the political season heats up, I can’t help but to notice that the ads seem to get nastier and more personal, so much so that it takes me back to some of the countless meditations I’ve done with high school students and initially I couldn’t understand why, but then it hit me, these campaign ads are reminding me of bullying.

Just like a lot of the bullying that goes on around school campuses across the nation (and now across the internet via sites like Facebook and Twitter), these politicians are often attacking each others characters, credibility and other qualities.

Unlike the bullying I see on school campuses, this type of bullying is different, and yet similar. It’s different in that it is much more of a sophisticated type of bullying, but it’s similar in it’s purpose and even worse, it is bullying that is played out across the nation, on television screens several times a day for millions to see, often during the times our young and impressionable children are watching.

These kids may not care about either candidate, and they may not even realize what they are witnessing, yet they are being exposed, often several times a day,  to a form of bullying that they may subconsciously model, especially in situations where they want to make themselves look better than someone else, rather in their social circle, sports or even in running for high school level campaigns.

Two adults bullying each other may sound ridiculous, but that is exactly what politicians do all the time. John Mica, who won the Republican primary House District 7 acknowledged that during a brutal campaign, he was severely affected by the mean spirited ads and statements made not only about him, but his family and integrity.

Although many political analyst believe that negative campaigns are necessary as they tend to get more voters attention than positive campaigns (what does that say about our Nation), at the end of the day I am concerned about how much of that negativity and mean spirited attention truly affects us.

As the campaign season continues to play out and ads are likely to get even more cruel, don’t just turn a blind eye to your child sitting there as it interrupts their television show. You may want to change the channel, or better yet, use it as a teaching and bonding opportunity to discuss with your child anything from bullying, the state of the Nation, the economy, to your political views. After all, they are likely getting all that anyway from watching the campaign ads, just that the information they are getting is likely tainted and smeared in figure pointing and character bashing.