How Your Teen Gets In Their Own Way And How To Help Them Stop Sabatoging Themselves

istock_stockphoto4u-1-teen-girl-hugging-knees-looking-sad-cWorking with teenagers for as long as I have, I realize that many of them come with various challenges, from emotional and educational challenges to family issues that seem to drag them down. However, in a majority of the cases I’ve worked with, the teens themselves are usually the ones who are getting in their own way of success and happiness.

They often don’t see it that way and will blame their family, their friends, their environment, any and everything, but themselves and it will take many sessions before I am able to help them realize that they themselves are indeed the cause of their problems through self-destructive and self-defeating behaviors and thus are also the answer to their problems.

Most people who have been around adolescence know that many times they get in their own way and do things that are self-defeating or self-destructive. Self-defeating behaviors are behaviors that get in the way of constructive action while self-destructive behavior generally causes some type of harm to the person.

In early adolescence for example, teens often start focusing more on friends, fighting with their parents and other adults as they try to discover their own identity and may end up struggling in school in response to paying more attention to friends than to their grades.

During this time of conflict, (ages 9-13), it is common for certain self-injurious behaviors to start occurring, such as cutting as a way to deal with much of the psychological conflict and pain, especially with teenager girls while teenage boys may do things such as punching walls, getting into fights or destroying property even if it’s their own.

During mid adolescence, ages 13-15, friends are generally ultra important and so is being accepted by your peers. This is the age that teens are going to high school for the first time and can be overwhelmed by the pressure to fit in.

When a teenagers faces feelings of inadequacy about their self-image they may shy away from their peers and develop anxiety issues and/or depression or even self-destructive behaviors such as eating disorders and suicidal thoughts.

During late adolescence, ages 15-18, teenagers may engage in self-defeating behaviors that include more risk taking such as drugs, alcohol, and sex simply for the excitement of it and not considering the dangers that can happen.

This is the age that I worked with the most to either help them stop drinking or using drugs, or to help them with issues surrounding sex including pregnancies, sexually transmitted diseases and even rape.

As someone who has worked with teens for a long time, it can be very frustrating to see a young lady with endless potential, waste it because she wants to be liked by her friends or a boy or she doesn’t like herself. The same rings true for many of the young men I worked with who were more concerned about having a  “tough guy” image, than actually doing something positive with their lives.

Parents indeed find this self-defeating and self-destructive behavior frustrating, but what can they do? Often times teenagers are too defensive to actually take and listen to advice from their parents so parents often would bring their children to me and then wonder what it was about me, or what did I say that got through to their teenager that they couldn’t and I would always tell them that they had to practice objective parenting.

They had to work on not telling their teenager what to do and think or what not to do or think, to not judge, but instead simply draw conclusion between their choices and the consequences of their choices in an empathetic and objective way, and then let their teen decide to either continue the behavior or to try something different.

This is often hard for parents to do because they would like to control their teenagers choices, but they can’t. They have to allow their teenager to make their own choices, however, parents can continuously attempt to put healthier and more constructive choices in front of their teenager for them to accept or not to accept.

The more healthy options you place in front of a teen, the more likely they are to accept at least some of them. As a therapist that is what I did. I would know that I wanted a teen to stop doing a particular self-destructive or self-defeating behavior, I would share my observations about what they are doing and what they are getting (or not getting) from their actions and then attempt to continuously give them multiple alternatives in hopes that they would try at least one.

For example, one teenage girl was obsessed with trying to get pregnant simply because she wanted a baby. I tried to help her see how having a baby would hinder many of her plans and goals for the future, but she didn’t really see that. I then gave her many other things she could be doing instead of trying to get pregnant and she finally decided to try one which is playing softball. She tried out for the team, made the team and two years later graduated from high school with a scholarship to play softball and never got pregnant.

While her mother thought I had worked some type of miracle (she was sure her daughter wouldn’t finish high school without getting pregnant) all I did was give her an opportunity to try something new and that ended up being self-affirming and she basically did the rest.

As a therapist, it is easy for me to be non-judgmental, to allow teenagers to continue making mistakes and learning from them while still giving them healthy alternatives until they finally realize that what they are doing isn’t working and are ready to try something different.

For parents, it’s hard for them to have that same amount of patience because the attachment they have with their teen makes it much more painful for them to witness their teenager continuously sabotage themselves by making poor choices. It’s very difficult for them to be as objective as I try to be.

Because this is very difficult for most parents to do, seeking help from a therapist is often the best solution, especially if the behavior is self-destructive such as cutting, suicidal thoughts, eating disorders, etc.

A book I recommend for teenagers who are constantly self-sabotaging themselves is How to Get Out of Your Own Way by Tyrese Gibson.

The Basics of Behavior Modification Techniques

Behavior modification techniques have at times been controversial.

Many people believe that they don’t work in the long run, but I know when done correctly, they can be an effective tool to curve undesired behavior and increase desired ones.

A Very Brief History

Behavior modification is largely derived from tenets of a psychological approach known as operant conditioning created by B.F. Skinner, which proposes that behavior can be shaped by reinforcement or lack of reinforcement.

Behavior modification techniques have been used successfully with adults and children to help with conditions such as attention-deficit/hyper-activity disorder (ADHD), obsessive-compulsive disorder (OCD), generalized anxiety disorder (GAD), pervasive developmental disorders, phobias, and many others.

Reinforcing Positive Behavior 

Reinforcing consequences are anything a person receives as a result of their behavior, that increases the likelihood of that behavior occurring again.

For example, if a child gets a laugh from a parent when they swear, they are more likely to do it again. Or if they get praise for bringing home good grades, they are more likely to continue trying to bring home good grades.

Reinforcers, as the name suggest, reinforce behavior. Some good behaviors, some bad behaviors.

We use reinforcers all the time, often without realizing it. As the saying goes, we teach people how to treat us, because we often reinforce their behavior towards us, good or bad.

When people, especially children hear the word consequence, they usually assume that it is something negative, but consequences can also be positive.

Positive reinforcers are consequences a person wants to receive. They are used in behavior modification to increase desired behavior, usually through a reward system.

Behavioral contracts can be used to outline details of the reward system. As an example, a reward could be one hour of video games per day if all homework assignments for that day are complete, or all chores are done.

Sometimes negative behavior is also unintentionally rewarded. As an example, if a child yells enough and the parents gets annoyed and gives in to the child’s demands, that child is being reinforced to yell whenever he/she doesn’t get their way.

In these cases, the unwanted behavior needs to be stopped through what is called “extinction”.

Extinction

Extinction is basically stopping an undesired behavior by removing it’s rewards. Examples of rewards for undesired behavior include getting what they want after:

  • pleading
  • crying
  • throwing a tantrum
  • yelling
  • withdrawing

Time-out is one of many effective techniques used to extinguish undesired behaviors by removing the person from any rewards.

As I stated before, the saying “we teach people how to treat us” comes back to this, even as adults.

In a relationship, if our partner is being insensitive to our needs, yet we cling to them more and shower them with attention, then we are rewarding their behavior.

Negative Consequences for Behavior

Penalties, punishment and negative reinforcement are all forms of negative consequences.

Penalties are when someone loses something as a result of a behavior, such as the removal of a favorite toy or a privilege.

A punishment is when someone receives a consequence for a behavior that they don’t want, such as a spanking.

Negative reinforcers include the withdrawal of a privilege or addition of extra chores/assignments.

Differences Between Negative Reinforcement and Positive Reinforcement

Punishment, penalty and negative reinforcement usually result in minimal effort on part of the person to achieve the desired behavior.

Positive reinforcement is the only method that will encourage people to give voluntary, extra, enthusiastic effort to achieve the desired behavior.

The key to behavior modification is to use negative consequences as necessary, but to focus more on positive reinforcements.

The Five B’s of Effective Parenting

Lastly, the five B’s are very important when it comes to using behavior modification techniques with effective parenting:

  1. Be positive– try using positive consequences more than negative
  2. Be specific– be specific what behaviors are being punished or rewarded
  3. Be certain– your child should know without a doubt what to expect from you        based on their behavior.
  4. Be consistent– if you don’t apply rules consistently, your child can never be certain of what to expect
  5. Be immediate– act immediately when your child deserves a positive or negative reinforcer.

When used correctly, behavior modification techniques are positive tools and great ways for kids to learn in a rather safe environment about consequences.

They learn that in life, often there are no right or wrong decisions, but they have to be able to deal with the consequences (positive or negative) of their decisions.

One Mother’s Experience with Bipolar Disorder and the Importance of Support Groups for Caregivers

The other day I was fortunate to have the opportunity to speak with a former client’s mother about her experiences dealing with her now 19 year old daughter, who was diagnosed with bipolar disorder at the age of 8.

This girl from what I knew of her was extremely unstable, as could be expected from a teenager suffering from bipolar disorder.

Unlike other people suffering from bipolar disorder, teenage girls tend to be even more fickle when you factor in the normal hormones of teenagers as well as social pressures that make even some non-bipolar teens act and feel erratic.

This girl was prone to bouts of depression, mania, impulsivity and explosive anger.

At home her mom had done everything she was supposed to do to support her child including psychotherapy, family therapy and medication, but her daughter was still a hand-full.

When she was in her manic states she tended to have anger directed towards her mother and would at times try to get physical with her and had to be hospitalized several times for suicidal/homicidal ideations.

Her mother tried all she could to pacify her daughter, including painting her room the pretty purple she wanted, only to come home one day and find nearlyevery inch of that wall covered in permanent marker with words directed towards her mother such as “bitch”, “whore” and “I hope you die”.

On top of that she was extremely needy, wanting to be up under her mom 24/7 to the point that she got angry whenever her mom left her and would tear up the house or refuse to go to school.

When she was depressed she would self-mutilate and attempt to kill herself. Her mother would be afraid to leave her alone.

“My biggest fear, even today, is that I will come home and find her dead”, the mother told me.

The biggest thing this mother did that made the most difference was getting educating herself on her daughter’s illness and counseling for herself and joining a support group.

Support groups are invaluable resources that often aren’t utilized enough by those living with or taking care of people with mental illnesses or substance issues.

Through counseling and the support group she learned that she was not alone, that many other parents were on the same roller coaster ride she was on.

She also learned how to change the way she had been dealing with her daughter.

If what you are doing isn’t getting you the results you desire, you have to try something different.

She started accepting that her daughter was going to have good days and bad days, and sometimes within the same day. She also had to understand her role and limitations as the mother of a child with bipolar disorder.

She had to accept that some days she might feel like giving up, or not care when her daughter threatens to hang herself, and that doesn’t make her a bad mother, but it is a sign that she needs to take a break, regroup and seek support herself.

At the end of our reunion I was happy to see that a mother, who just a couple of years ago who was so flustered, angry and exhausted, had turned into a woman not only surviving, but thriving with a daughter suffering from bipolar disorder.

Her and her daughter are doing better, but they are still taking it one day at a time.

Understanding Teenage Girls: Motivations and Psychological Meanings in Relating to Males

The other night I happened to catch a television reunion of the reality show Love & Hip Hop Atlanta.

I stared at the screen in not so much as shock as pity as I watched four different women vie for the love and affection of two guys who treated them more as if they women were merely whores, and the guys were their pimps.

The guys seemed to think the heartache and embarrassment they caused these women by their ongoing cheating, lies and manipulations were funny, while the women basically said that no matter how bad they were being treated, they weren’t going to leave their “man”.

One said it was because of good sex, money and furthering her her music career. Another said it was for love and yet another said it was because she had a child with the guy.

To me, none of these were reasons to stay with a man who obviously saw them as being little more than sexual toys to be used and abused.

Still, this got me to thinking.

Working with teenage girls I am always keenly aware of some of the internal conscious and unconscious motivations that effect their decisions, especially in relation to dating, sex, and self-esteem.

As a girl learns about sex, she is also learning about other things such as giving and receiving affection, self-worth and what she means to others.

She also learns about trusting and honesty (or dishonesty) through the ways she is first introduced to sex, especially through the ways she is protected or not protected from being exploited.

“I learned about sex from my dad. I never had a chance for my first time with my boyfriend. Who knows, maybe I [would have] wanted to wait until I got married. But no, I never got to have that chance. I don’t even remember the first time… I feel it ruined my life.”  -Anonymous Teenage Girl, Young Poor and Pregnant: The Psychology of Teenage Motherhood by Judith Music

Shame, fear and guilt are also valuable lessons, as they will (if she is fortunate) help her learn how to keep herself from situations and feelings that may be too painful for her to deal with physically or emotionally.

When these life lessons are learned and experienced in ways that inappropriately shape her sexuality developmentally, they are likely to have far reaching consequences through out her life in the way she perceives her world and those in it.

This effects such a major part of who she is that it also effects who she thinks she can become, what she is capable of and her ability to show and receive love as well as her ability to take control of her destiny.

For girls who grow up in disadvantaged situations, inappropriate sexual socialization is usually the final breaking point to other risk factors such as poverty, unstable family environment, fatherlessness and lack of appropriate nurturing, that already have made this girl vulnerable to men (and teenage boys) looking to exploit her.

This added with social isolation from other people (outside of her family and community) and institutions, becomes a recipe for disaster (often disadvantaged girls are only exposed to people in their immediate communities where important social services are either absent or insufficient).

Social isolation and psychological vulnerability mean that many disadvantaged young women will be controlled by their relations to men not only in the bedroom, but also in the classroom, the street and eventually even the work environment.

“The adolescent female’s sense of self in relation to males is the internal representation of her past experiences with men and- perhaps equally important- of her mother’s roles and relationships to those and other men.”  -Judith Musick

It’s sad to see teenage girls who grow up with a damaged sense of self because of their past relationships to men either directly or vicariously.

These young girls often turn into teen mothers, get stuck in poverty, abused by men, single mothers with a multitude of children by different fathers, abuse drugs, or get caught up in one of various avenues of the sex world such as prostitution.

It’s important that we protect these young girls as much as possible from being exploited and abused, physically and mentally. It is also important that we help build their self-esteems, educate them and teach them the their value is priceless and doesn’t depend on a boy’s, a man’s, or anyone else opinion of her.

The Relationship Between Anger, Control and Fear

A lot of times when I am working with people with anger problems, I realize that two of the main sources of their anger come from either the need to control other people and fear.

Anger and fear are part of our natural flight or flight responses. The problem is, we are genetically geared to survive real threats that our ancestors who had to deal with threats to their lives on a daily basis were designed for. Today we don’t have to constantly worry about getting attacked by a leopard or the tribe across the river attacking us, and so our mind often generates fear and anger even when it is unnecessary or the threat is just imagined.

Anger in it’s self is not a bad emotion and can actually motivate people to make changes for themselves and their environment. The Civil Rights leaders in our recent history were angry and so they marched, protested and boycotted to make changes. Anger can make you write a letter voicing your disappointment in a company’s costumer service department or make you search for a new job instead of taking the abuse from a harsh boss. It can make you leave a bad situation, stand up for something you believe or protest against something you don’t.

However, anger can be destructive if it’s not dealt with in a healthy way which is when people run into problems.

Most of my clients with anger problems, once they get to the point where they can verbalize and dissect where their anger is coming from, are actually afraid. They are afraid of losing control, being taken advantage of, being ignored, etc. Take a client of mine who got into a fight while standing in line at a burger joint when he felt someone had blatantly skipped him. Does it make since for a grown man to get in a fight over a $5 hamburger because he had to wait an extra two minutes? Was it worth him going to jail and having to take anger management classes? Of course not, but to him at the time it was. He was eventually able to tell me that the reason he got so angry so quickly is because when he got skipped it made him afraid that he was invisible, that he would be seen as weak, and that he wouldn’t be respected. His fear is what made him so angry and caused him to act in an irrational way. At the same time, his need to be respected caused him to want to control the situation by making the other other person respect him and beating him up until he did.

Often times clients tell me, “She ignored me so I hit her”, “He came home late so I burnt his favorite shirt”, “He didn’t say excuse me when he brushed my shoulder so I had to push him”. All of these statements show both fear and control. Fear of being ignored, fear of being cheated on or left by a spouse and fear of being disrespected. They also show the desire to control the other person, to make them pay attention, come home on time and say “excuse me.” The problem is, we can’t control other people, just ourselves. The desire to control other people will always end up stressing us out, making us angry and causing us to act in irrational ways.

Another example is the constant wars that are waged across the world. People are afraid of losing their religion or xenophobia (the fear of people different from you), and will fight and kill out of that fear and the desire to control other people by either making them convert, conform or leave a region.

Lastly, a client of mine and her teenage daughter got into a very big fight after she found her daughters diary and read it. She didn’t like what she read in her daughter’s diary and decided to confront and punish her for the contents of her diary. Now nothing in that diary was life threatening or even “bad”, they were just her daughter expressing how she really felt about her mother and some of the things her mother did. I felt it was wrong 1) for the mother to have read the diary and 2) for her to try to punish her daughter for her private thoughts. Eventually the mother expressed to me that she felt like she had little control over anything in her life except her daughter, and she was terrified of losing control over her daughter. That need for control was actually pushing her daughter further away as well as causing the mother all kinds of anxiety and anger issues.

We have to understand that the only people we can control is ourselves and that if we can’t change a situation, we have to change the way we think about it. Wasting our time trying to change other people or change a situation instead of changing the way we think about it or removing ourselves from it, will only cause us to develop angry feelings as we try to control what we cant.

Not Catching the Ball: A Form of Self-Care

I’m not the first to say this. Matter of fact, I heard this from one of my mentors who is a successful therapist, but even before her, I can swear I might have heard it on Oprah or somewhere, but the fact remains it is a powerful statement that has helped me in many situations.

Often in life we get swamped with obligations that we’d rather not do. I don’t mean the things that we have to do like take care of our kids or pay the bills, but I mean things such as running an errand for a friend that would really inconvenience us, or dealing with someones emotional instability that we know will suck us of any energy we have, but we may feel obligated to listen, or help, or volunteer, or say “yes” when we really want to say “no”.

The thing is, these things asked of us by friends, family, neighbors, co-workers, or who ever, is like them throwing a ball to us and we often feel obligated to catch it, but we don’t have to. We can say no, we can politely turn down that invitation to a Christmas party we really don’t want to go to, quite simply, we can just let the ball pass or bounce on by us instead of feeling obligated to catch it.

I had to explain this to a client recently who gave a guy her number when she didn’t really want to, but didn’t know how to say no, and now when he calls she doesn’t really want to answer, but does so to not be rude. I had to tell her that just because he was throwing the ball to her, didn’t mean she had to catch it. The same goes for someone giving you a bad attitude, negative energy or whatever. Just because they throw that negative ball your way, you don’t have to catch it and throw it back, you can just let it pass on by you.

Many times we feel the need to, and sometimes out of habit (or reflex) catch balls we really shouldn’t and sometimes even throw them back. People will always throw balls at us and if we try to catch them all we’ll eventually end up dropping everything.

So I think it’s important from time to time to practice not catching the ball, which will allow us more time and energy for what we feel is most important to us.

On Childhood Disintegrative Disorder


We conclude our discussion on the Pervasive Developmental Disorders with a brief overview of Childhood Disintegrative Disorder.

Introduction

Childhood Disintegrative Disorder (CDD), is also known as Heller’s Syndrome and Disintegrative Pschosis.  It is a rare Pervasive Developmental Disorder that affects about 1 in 100,000 children. CDD resembles many of the other disorders on the Autism spectrum in the fact that it involves developmental delays, impairment in communication and social functioning, but most closely resembles Rett syndrome in that it almost exclusively affects boys whereas Rett syndrome almost exclusively affects girls. New research suggest that while CDD affects boys more than girls at a rate of 4 to 1, it is thought that girls diagnosed with CDD most likely should have been diagnosed with Rett. There is also further talk that in the future Rett and possibly even CDD won’t be separate diagnosis, but that they will both be collapsed into the Autistic category as low functioning forms of Autism.

Symptoms

Children with CDD develop normally up until about ages 2 to 4 years of age (rarely there are cases of delayed onset up to 10 years of age), and then start regressing, losing previously acquired developmental skills with in a few months to years, including language, non-verbal communication skills, motor skills and social skills.

Symptoms include:

    • Delay or lack of spoken language
    • Impairment in nonverbal behaviors
    • Inability to start or maintain a conversation
    • Lack of play
    • Loss of bowel and bladder control
    • Loss of language or communication skills
    • Loss of motor skills
    • Loss of social skills
    • Problems forming relationships with other children and family members

Causes

There are no known causes of CDD although abnormal electroencephalograms (EEG), epilepsy, Lipid storage diseases (excess build up of toxic fats in the brain and nervous system), Tuberous sclerosis (benign tumors that may grow in the brain and other vital organs) and Subacute sclerosing panencephalitis (chronic infection of the brain due to a form of the measles that damage the brain) all appear to be associated with CDD.

Treatment

There is no cure for Childhood Disintegrative Disorder and the treatment for it is similar to the treatment for all of the Pervasive Developmental Disorders with the addition of trials with steroid medications to try to slow down the progress of the disorder.

Diagnosis

Physicians will use some of the same assessment tools used to diagnose the other Pervasive Developmental disorders with the inclusion of all the symptoms listed above and impairment in normal function or impairment in at least two of the following three areas:

  • Social interaction
  • Communication
  • Repetitive behavior & interest patterns

The main symptoms to look for in diagnosing CDD is the loss of previous learned skills in at least two of these areas:

  • Expressive language skills (being able to produce speech and communicate a message)
  • Receptive language skills (comprehension of language – listening and understanding what is communicated)
  • Social skills & self-care skills
  • Control over bowel and bladder
  • Play skills
  • Motor skills

If your child has any developmental delays or starts to lose developmental functions previously learned, it is vital to talk with your physician in order to rule out  CDD or any of the Pervasive Developmental Disorders or mental retardation. The faster any illness is discovered and treatment begins, even if there is no cure, the better the prognosis or at least the slowing of the progress of the disorder. Some children with similar, yet less severe symptoms may have a learning disability or something much less serious than a Pervasive Developmental Disorder, but it is important to have everything ruled out for the best care of your child.