Adolescence and Mental Health
Exploring the challenges of raising the 21st century teenager
There has been a general upward trend in thoughts of self-harm and suicidality as well as a rise in adolescent diagnoses of anxiety and depression in recent years. Television programmes such as Netflix’s 13 Reasons Why, technological influences such as The Blue Whale Challenge and the recent spotlight on celebrity deaths and struggles with mental illness has often been linked to the increasing statistics.
Many parents have expressed their feelings of helplessness, fear, despair, paranoia and being overwhelmed at not knowing how to help and protect their child. Moreover, with the complex and varied social influences young people are currently faced with, parenting in itself has become more challenging. It is for these reasons that we as Wynberg Girls High School and professionals working with young people felt it necessary to host an information session for our parents, facilitated by two practitioners in the field to explore these dynamics and provide a more in-depth view on these issues.
The information session took place on the 3rd of August 2017 at the Wynberg Girls Junior School Hall. Attendance exceeded expectation and the feedback has been incredibly positive. WGHS is proud to take the necessary steps to bring the topic of adolescent mental health out of the shadows and to empower our parents with information and support where possible. For those who were not able to attend, the PowerPoint slides have been made available and below is a summarized version of information shared at the evening.
PRESENTED BY: CLINICAL PSYCHOLOGIST MARK DE LA REY AND REGISTERED COUNSELOR JONATHAN MITCHELL Article by: Jawaahier Petersen (CLINICAL SOCIAL WORKER AT WYNBERG GIRLS HIGH SCHOOL)
s i p u g n i w Gro g n i t n e r a P HARD!.. ! r e d r a h n e is ev It is safe to agree that parenting in this day and age is hard. VERY. HARD. It is a job done without a required license, prior training, manual or handbook and can be one of the most challenging yet rewarding roles. The current demands on both the child and parent on a personal, work and academic level are countless. The pace of life has become increasingly difficult to keep up with and has made parenting harder than it has ever been before. Societies worldwide have seen a drastic increase in the anxiety and depression diagnoses amongst adolescents which has translated into higher numbers of self-harm, suicidal ideation as well as concluded suicides confirmed by a recent study in the UK (Office for National Statistics, Great Britain, 2017)
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The influence of social media on a psychosocial level, the restructuring of the traditional family system to more single-parent households and the worrying economy are some of the identified reasons for the increase in mental health issues during the adolescent phase of development. Coupled with this is the natural hormonal shift which takes place during this stage and the usual search for selfidentification which makes adolescents so unpredictable and as high-risk as they are.
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During childhood, children are entirely dependent on their parents in order to develop a sense of security and trust in the world. During adolescence, they act out the battle for independence by wanting to be less involved with and reliant on parents. This dynamic is often described by parents as ‘She was such a lovely child up until Grade 7-always hugging me and wanting to talk to me about everything. These days I am lucky if she even greets me!” Another central psychosocial challenge which typifies adolescence, is that of identity formation. During this phase, young people are trying to answer fundamental questions such as ‘who am I?’ and ‘how do I want others to see me?’ These questions are answered through interaction with others, experimentation and exploration. Being part of something, as opposed to standing out, is what they are striving for. Thus, asking them questions like ‘but why do you need to do EVERYTHING so and so does?’ or ‘why do you have to dress like everyone else? Why can’t you be your own person?’ is often futile. Peer input and opinions begin to mean more to them than parents in terms of trust and communication as they begin to develop their sense of self, separate from the family unit.
'YOU NEVER GIVE ME SPACE' ‘But why is my child so nice to their friends and so wellbehaved and respectful when they are with their friends’ parents or at their friends' homes but the complete opposite at home?’ Jonathan and Mark explain this oftenasked question as a natural and necessary dynamic-albeit frustrating! Teenagers present their best selves to their peers because they have to hold the pose; the pose that ensures belonging and being liked. Home represents the safe space in which they can be their true selves and feel unburdened from social expectations. They then feel ‘free and able’ to express and act out their fears, anxiety, frustrations, insecurity and sadness.
‘Why can’t my child just think before they say/do something?’ Mark reminded us that young people do not possess a sense of time or consequence yet, hence their impulsivity and need to react so intensely. Jonathan used the example of your teen celebrating their ‘two week anniversary’ or knowing EXACTLY how long their romantic relationship lasted down to the second. These periods of time might seem insignificant to parents who have a broader concept and perspective of time but to the adolescent, it warrants the level of intensity as they live in that moment. They have also not yet mastered the concept of action/consequence and require repeated 'lessons' in order to master it.
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Times have changed. Comparing your child’s behavior and the challenges they are facing with comments that begin with ‘In my day or ‘When I was a teenager’ is not only unhelpful but often destructive in trying to understand your teenager. It not only minimizes their experience but creates a further boundary between parent and child that is built on judgement, criticism and an unwillingness to understand. Current social dynamics pose multiple psycho-social challenges that were not present as much as fifteen years ago (the time before Facebook and Whatsapp) and thus we, as parents, are needing to evolve our parenting styles to take cognizance of and work with these challenges.
Each child is different and therefore consequences or reactionary responses need to be child-specific. Often we feel frustrated or find ourselves saying things like: ‘Your brother NEVER did this!’ Or ‘Your sister listened when we spoke to her’. It acts as a reminder that just when we think we know what we are doing, the next child reminds us that we actually have no clue! My child is so intelligent and mature for her age-we can speak about anything and she understands but I cannot understand how she could do something like this!’. This is another comment often made by parents when presenting the conflict they face with their teens. How is it possible that a child that can engage verbally on such a mature level, can be so extreme and child-like in their emotional responses? Mark described this common misconception that if a child has a high IQ or displays an above-average intellectual capacity, this will automatically translate emotionally. He went on to explain that while your child may be smart and able to converse maturely, their brains might not have developed the necessary emotional compounds or skills to match that. This dichotomy gives rise to the conflicting psychoemotional presentations you witness.
MENTAL HEALTH CONCERNS: So why do young people self-harm? • It brings about emotional balance. • It is used as a distraction from their internal world. This allows them to; • Take control of or label a feeling they feel overwhelmed by. • Allows them to feel SOMETHING thus freeing themselves from emotional numbness. • To punish themselves. In essence, self-harm is a form of communication-a message that they wish to be heard. It acts as a symbol of emotional turmoil, however 'superficial’ it may appear.
''YOU NEVER LET ME DO ANYTHING!'
TRICKS OF THE TRADE: So how do we make our parent-child relationships better and spend less time in conflict and more time communicating and understanding one another? Enter the concept of DIALECTICAL DILEMMAS, defined as being stuck between ideas that seem opposite to each other. Does any of the following sound familiar? • ‘You’re ruining my life!’ • ‘You don’t understand me!’ • ‘Sarah’s parents always let her go out’ • 'I never get to do what other kids do'!
The conflict that lies in dialectical dilemmas is often rooted in opposing viewpoints and the challenge is getting stuck there. Jonathan suggests ‘understanding what they are going through but not necessarily agreeing with them'. Also note that young people speak in hyperbolic terms. They exaggerate situations and issues not as a means of manipulation but as an indication of the intensity in which they are experiencing it. For example: ‘I was the ONLY person who did not go to the party!’ ‘EVERYONE was looking at my pimple today!’ ‘You ALWAYS blame me!’ ‘Why do I have to do EVERYTHING around here?!”
The challenge to strike a balance between allowing typical developmental behaviours versus addressing problem behaviours, being too strict versus being too lenient and fostering independence versus giving support is often the most trying areas for parents these days. Parents also often express their exasperation at not knowing how else to modify or change their children’s behavior. Frustration mounts when they feel like no form or method of discipline seems to be working. Removing privileges and access to technology has become the first go-to in discipline and feels like a quick win, but Jonathan suggests an alternative: ‘By confiscating cell phones etc., you are relinquishing them of the responsibility for their behavior. Consider making them draw up a list of things they feel they could do, to earn their parent’s trust back’. This makes them take ownership of their actions and its’ consequences thus increasing the unlikelihood of repeated behavior. A messy or untidy room also appears to be a rather common source of frustration for parents and caregivers. A suggestion for behavior modification is to offer your teen three choices: a) If the bedroom remains untidy, no one will be allowed in there for social purposes b) Keep the room tidy and c) The door will be removed. When young people feel included, they feel validated and thrive. Getting them involved in drafting developmental-stage appropriate house rules and consequences makes them feel acknowledged and responsible. This in turn makes them more likely to adhere to the boundaries as they feel a sense of accountability to themselves and their influential role in the family.
WHERE TO GO THIS SUMMER
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Learned helplessness Another commonly identified parenting pitfall is the facilitation of learnt helplessness unintentionally developed as a result of wanting to support and protect our children. Doing their assignments for them, rescuing them from demerits or detentions, not ‘burdening’ them with chores or being prescriptive in their decisionmaking processes are some of the contributing factors to this phenomenon young people become acutely aware of when in a situation requiring autonomy. Learnt helplessness is described as children not being allowed to develop independence or skills to function and/or think for themselves because they have been overly protected or disabled by their parents. By depriving them of the opportunity to learn valuable life skills like time management, selfreliance, prioritizing and consequence, they become struggling adults who end up having a low sense of self-worth and feelings of incompetence.
'GOOD PARENT'
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‘So how does one get to be a ‘good’ parent?’ Firstly, the fact that you attended the information evening or you are reading this, makes you one. We are all doing our level best with the challenges we are faced with for the young people we love so dearly. So, let’s take a moment to celebrate our efforts rather than focus on natural shortcomings and spend countless hours unpacking what we ‘did wrong’. Ten years from now, the iPad or the latest pair of sneakers that you bought will not matter. What your child will remember is that you were THERE-just BE THERE. Be present and let them know that you are in their corner and from that place of good intention, one can do very little harm.
Jonathan and Mark are both parents themselves and have gone through the journey of raising adolescents. They both have also worked extensively at the Kenilworth Clinic Adolescent Unit (KAYA) and run the Step-upp programme for parents and adolescents. They also currently work at the Glenwood Practice: 3 Christine Street, Constantia www.glenbrookpractice.co.za Links: https://www.youtube.com/wat ch?v=JebwYGn5Z3E https://www.thesun.co.uk/news /worldnews/3003805/bluewhale-suicide-victims-russiauk-deaths/ Jawaahier Petersen and Allison Eakin both hold Clinical Master's Degrees in Social Work from the University of Cape Town and have been employed at WGHS since 2008 and 2014 respectively. Together they bring experience in psychiatry, adolescent and family intervention, group counseling as well as statutory social work.
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