Posts Tagged ‘Teens’

Living in a Virtual War Zone: The Children and Adolescents of Domestic Violence

Wednesday, April 25th, 2012

A 2006 survey of American households revealed that nearly 30% of children, many of whom are very young, live in homes where there is some form of intimate partner/domestic violence. Children and adolescents who witness or experience trauma, including domestic violence, display increases in stress hormones comparable to those displayed in combat veterans. This research finding makes sense from the perspective that these children and adolescents are living in a virtual war zone! Children and adolescents may experience long term effects from chronic exposure to domestic violence which may include: impaired academic performance; reduced levels of motor and social skills; behavior problems; substance abuse; self-harming behaviors; changes in brain physiology and function; and emotional difficulties including depression, anxiety disorders and post-traumatic stress disorder.

Many times the question that people ask is, “Why doesn’t she just leave?” By the time the family reaches the point where this question is being asked, the family is deeply entrenched in the cycle of violence and abuse. The mother and children are living in a constant state of fear and anxiety and they are dominated by responses of flight, fight or freeze. The neurobiological impact of trauma and the emotional, cognitive and behavioral adaptations that the family makes impacts their ability to makes decisions, develop safety and exit plans, and to fundamentally believe in their own ability to find safety. The ability “to leave” is profoundly trumped by the need “to survive”.

The coping strategies that families develop may help them survive the abuse and violence in their lives and those strategies will often go on to create patterns that wreak havoc on the rest of their lives.

On June 1st, at my workshop at the Institute entitled, “The Impact of Domestic Violence on Children and Families,” we will identify maladaptive coping strategies that families develop to manage their reactions to abuse and violence. We will identify interventions that reinforce positive and nurturing parenting skills and explore stress reduction strategies to address the neurobiological, emotional, somatic, and cognitive aspects of traumatic stress they have experienced. We will focus on enhancing self-regulation skills and skills that support social and peer group competence. We will focus on collaborating with families in their healing from domestic violence by supporting secure attachment between children/adolescents and their non-abusive parent as we enhance their safety and stability.

The Impact of Sandusky on Clinicians and Clients

Wednesday, December 21st, 2011

I can only imagine how the Sandusky scandal has impacted your practices. For my clients it has been profoundly triggering. The ongoing reality that children continue to be betrayed and violated while adults look away- minimizing, rationalizing, and denying the unimaginable horrors that someone with power can inflict on innocent lives –has opened healed wounds and caused new ones. My clients get angry all over again, and re-connect with the grief, despair, and helplessness they experienced in childhood. For them, the onslaught of new disclosures and the tepid empathy shown towards the victims reinforces the relentlessness of their own experiences, and the lack of protection and compassion they felt from others whenever they did find the courage to come forward with their trauma narratives.

As clinicians we have a difficult task ahead of us. It is unclear how this story will play out in the media and the courtroom. How vocal and articulate will Sandusky’s supporters be? How much “blaming the victim” will be woven into the story? Will his attorneys attempt to distort the truth, downplaying the seriousness of his offenses or the long-term adverse effects on his victims? Will Sandusky take any responsibility for his actions or be held sufficiently accountable in a court of law? And what will be the short and long-term effects on our clients?

As is often the case, I find myself confronted with the reality that there are many things that happen in this world that are not within our control. And there are some things that are- including the meaning we choose to attach to events, the extent to which we learn and grow from them, and what we do with them once they have occurred.

I encourage my colleagues to use this very difficult event as an opportunity to continue educating both clients and the community at large about the dynamics of abuse and victimization. Focus on the innocence of children and the need to proactively protect them from predators. Let it be known that “looking the other way” makes you an accessory, and is an unacceptable and unconscionable response. Challenge the media when they use the word “relationship” to describe “rape.” Empower survivors of sexual abuse to find the courage to share their experiences, ending generational cycles of secrecy and denial. Educate anyone who downplays the severity of what was done to these children. Keep the discussion alive- it not only validates experiences, it gives survivors a voice and communicates to them that we care, deeply, about their pain and believe, deeply, in their capacity to transcend it and heal.

Addressing Adolescent Suicide

Wednesday, October 26th, 2011

Recently, there have been tragic incidents of teenagers taking their own lives. Although this is sadly not a new phenomenon when another life is lost I think one of the conversations it reignites within the mental health community as well as society at large, is who are the kids who are at risk, and why are they not getting the help they need? There’s no question that when we look at kids “at risk” there’s a certain universality to the profile that emerges. These are teenagers who are often totally emotionally overwhelmed with the stressors of being an adolescent including: the process of individuating from parents; conflicts in interpersonal relationships; rejection and intense bullying by peers; academic pressures; the uncertainty of evolving identities; and even body changes.

Teens who are at higher risk often don’t have healthy ways of coping so they self-medicate and numb with drugs and alcohol. They typically have undiagnosed and untreated depression, anxiety, or other mental illnesses. Many high risk teens are not adequately supervised, don’t feel supported by their families, are bereft of resources, and feel isolated as they try to navigate through the intense challenges of adolescence. And then there is exposure to violence either at home or on the Internet, or relentless personal or cyber-bullying. Suicidal teens may have untreated histories of sexual, physical or emotional abuse, neglect or trauma, struggle with sexual identity, or may have family histories of addiction, attempted or completed suicide- all of those things up the ante in terms of risk.

Start with those potential issues and then add the confluence of what we now understand about the developing adolescent brain. It is still rooted in all/nothing, black/white dichotomous thinking, and it experiences time-limited pain as never-ending. The pre-frontal cortex is still evolving, so their capacity to assign analytical reasoning to things is compromised as well as their ability to understand “cause and effect.” This is why when parents ask impulsive teens, “what were you thinking?” the answer is “they weren’t thinking.” Their brains are fundamentally impulsive, aggressive, and pleasure seeking. Taking all of this into consideration, we start to understand why so many kids struggle and why they attach a permanent solution- committing suicide- to a temporary problem.

When they don’t get the help they need it may be because their pain is not being taken seriously enough. I want to stress that although teens can definitely be moody, (if you live with one you know that’s true!) being “depressed” is NOT a normal part of adolescence, so it should never be minimized when an adolescent presents with symptoms of hopelessness, helplessness, excessive guilt, sleep or eating disturbances or feelings of worthlessness. When a teenager suddenly falls apart academically, has serious changes in his or her personality, begins to talk openly about a pre-occupation with death, is spending a lot of time getting drunk or high, begins posting distressing and depressing things on their Facebook page, we need to see these as serious red flags and ask, directly, if they are having suicidal thoughts. Do they have a plan? Do they have the means? Have they ever rehearsed it? What would prevent them from following through with their plan?

Asking does not give someone the idea to do it- it may, in fact, be the key to intervening in time and helping to prevent an attempt. So above all else, TALKING to teens about the red flags that we see, expressing genuine, non-judgmental concern for their behaviors AND for their pain, and offering them resources for comfort and connection are the essential first steps in tackling this issue in our society.

Click here for an audio recording of Lisa Ferentz’ presentation on Teens and Self-Harm.