Tag Archives: Pain

Helping Teens with Their Mental Health

Therapy doesn’t come without resistance, especially when you’re dealing with a teenager.  It can be very difficult to get a teen on board with therapy because there’s usually a lot of defensiveness.  I want to discuss a handful of reasons why teens resist treatment:

1. Social stigma.  Anything associated with therapy or mental health issues is a little bit of a taboo.  Kids worry about people pointing their fingers and saying they’re crazy. 

2. Rebelliousness.  No matter what you suggest, some kids will just go against you because you’re an authority figure to knock heads with. 

3. Poor insight.  Teenagers have a limited capacity to look at themselves honestly or realistically.  They often don’t understand how their behavior or problems are affecting them.

4. Fear.  They’re afraid of being “crazy,” that others will perceive them as such, or that they can’t get better.  They also may be scared to death of having to take a deeper look at themselves or their problems.

5. Embarrassment.  They’re embarrassed that they can’t straighten themselves out, and therefore, accepting help from others can be difficult.

6.    Facing their problems may be too painful or overwhelming. 

7. Misconceptions.  Most teens don’t know how psychotherapy works, and they’re worried about what will happen if they admit to things.  They don’t know that the therapist cannot give their parents the information (therapist-patient laws prohibit that, even with minors).

8. Concealment. They don’t want to admit that they’re hiding something – cutting, abusing drugs, etc.  

9. Holding on.  This is what my book, Bad Childhood – Good Life, is all about.  They’re holding on to the drugs or other habit.  They’ve become so dependent on a way of thinking and behaving that it has become their identity.  They’re scared to death of giving up their self-protective mechanism of hiding from reality because it means they will be stripped naked in their own mind, and that’s pretty scary. 

10. Unworthiness. Some kids get so beaten down and depressed that they don’t feel like they’re worth much or that anyone would care about them. 

So, those are some of the main reasons kids resist treatment.  But the question still remains: How do I get my child to attend therapy?

First off, don’t trap them.  For example, don’t say you’re going to the mall and then drop them off at a therapist’s office.  That doesn’t work well.  There are two really good techniques I have always suggested to parents:

1. Make it a team effort.  Say something like, “You know, you and I have been fighting a lot lately, and there’s just so little happiness in the house.  So, I’m thinking if you and I went into counseling together, maybe a therapist could help us sort all this stuff out and make things better.  You’ll be happier and you’ll be able to do all the things you used to enjoy and probably miss.  I’m not sure how to make things better myself, but a therapist could help us work it out.”  That way it’s not, “You wacked-out kid, I’m putting you in therapy because I can’t stand it anymore.”  Make it about how “we” – you and me – can’t figure it out and that you need to get somebody who can help. 
 
2. Make a definitive statement (e.g. “I’m going to schedule the appointment so we can sort it out together”) and then talk about it in the days before the appointment.  For example, say, “Are you a little nervous about the therapy?  Because I am.”  If you tell your kid that you’re having apprehension about the therapist saying you didn’t do everything right, they are going to look at you and think, “All right, this is more even-steven. It’s not only about me.”  The fact that you are both feeling discomfort will be comforting to them. 

When they start therapy, tell your child you want them to go to four sessions, and then after that, you, your child, and the therapist will discuss if there is more to do.  During the first session, your teen will usually be angry.  I remember I used to have so many kids come in to my office and just sit there and glare at me for an hour: “Is it over yet?!”…”Is it over yet?!”…  The second time they come in, there will typically be a little less anger and more movement toward talking about their pain.  At that point, a good therapist will say, “You know, last week you were pretty angry about having to be here, and I don’t blame you.”  The kid is immediately going to be surprised: “She doesn’t blame me?!”  Being forced to do something you really don’t want to do and open up to a stranger about very painful things (which you really don’t want to do), is hard.  However, a good therapist will make your teen feel like they’re not being forced to do any of that, and instead, simply help them be happier and figure out their parents better.  Slowly but surely, by the third and fourth sessions things will be less forced and more about reducing the pain. 

While your child is in therapy, the family has to be very supportive at home.  They should never ask what happened in therapy – that’s none of their darned business!  Instead, it should be all about subtle reinforcement (e.g. “You seem more creative and relaxed right now, and I think that’s wonderful”).  Remember: a hug and a kiss can go a long way.

Laughter Is the Best Medicine

In my opinion, laughter really is the best medicine.  Like a steam bath, it opens up all your pores and lets the bad stuff roll out.  That’s why I use humor on the air – it’s a diagnostic which makes your body, psyche, and soul all feel better.

Laughter seems to have an evolutionary benefit.  Laughter is a feature that we share with other great apes such as the chimpanzee and gorilla, which suggests that it is an ancient behavior.  People of all ages and cultures laugh spontaneously, and they spend quite a bit of time doing it.  Interestingly enough, if you ask most women what traits they want in a man, a sense of humor is usually first or second on the list.

Laughter also operates as a social connector.   Groups are important for human survival, and across evolutionary time, groups got larger and socially more complex, which raises the interesting question about how these groups could be held together. Other primates groom each other to smoothen social interactions, but this is impossible when groups get really large. One solution to this problem is laughter. Through laughing, we can quickly establish a good relationship with each other, and because it is so contagious, it can quickly spread through a crowd.   For example, if you’re watching a movie with other people and someone laughs, there is an instant connection. 

In addition, laughter helps facilitate your capacity to learn new things.  When somebody teaches you something with humor, you usually retain the information better.  That’s why, for example, kids learn faster and better through play-learning. 

Lastly, laughter helps alleviate pain.   When you laugh, endorphins are released in the brain and act as a kind of legal drug inside your head.  According to studies conducted by researchers from Oxford and VU Amsterdam, being exposed to comedy can raise your pain tolerance as much as 50 percent.  I believe the same is true for emotional pain as well.  Humor opens up people to hear things that they are often uncomfortable hearing.  There is even some research on patients which shows that exposure to humor and comedy helps them reduce their medication intake.

Without humor, life would be quite dreary.  Laughter works in the same way as a good massage or an intense jog (but without all the stress on the knees).  It’s relaxing, social, and there are no side effects other than the occasional bad joke.

Getting the Most Out of Therapy

Once I started becoming more “known” from my radio program and books, I had to give up my private practice.  Folks would come in for sessions and expect me to work magic in three and a half minutes.  It became clear to me that I couldn’t be as effective one-on-one anymore.  So instead, I wrote books and did my show because I thought that those were the best ways I could help people.  

However, there are times on my program when I tell callers that they need to do a little more extensive work.  I can give them a jump-start, but they need to pick up where we left off in therapy.

Therapy can be a very complicated process, and there aren’t many therapists who do it well.  When looking for a therapist, there are a few things you need to do.  First, and most importantly, you have to form a relationship with your therapist.  When people call in to my program, they generally have listened to me for a while.  This means that they have already developed a kind of relationship with me in their minds.  When you go into somebody’s office for therapy, it usually takes a while to form that relationship. Without it, there isn’t going to be trust.  Although it seems like I receive instant trust from the people who call in to my show, that’s not really the case.  Most callers have been listening to me for a long time (sometimes 20 years or more), and therefore, the trust part is pretty much all squared away. 

Your clinician also needs to be a good fit for you.  Not every therapist makes the same choices or has the same personality and expertise. For example, when I was involved in private practice, I would not deal with anyone’s insurance companies.  They paid for their sessions, and I signed the insurance papers for them to submit.  I did this because I didn’t want my fights with an insurance company to interfere with our relationship.   

In addition, I believe that your first session should be free and on the phone.  It’s not really a session – it’s simply you asking a lot of questions.  You can always look up somebody’s license and credentials, but you still need to ask them about their expertise.  A lot of people get psychology licenses of various kinds and then claim that they can do anything.  However, there are specific areas of expertise.  Make sure you ask.  If you’re nervous about asking questions, first write them down on a piece of paper.  You may be less afraid to ask them if you put them in writing. 

This process may be uncomfortable, but if you don’t feel safe and comfortable with the therapist at first, you are not likely going to meet your goals with them later. 

Personally, I think that if you are seeking marital therapy, you should ask if the therapist is divorced.  Statistically speaking, when a therapist is divorced, he or she is more permissive of divorce.  And if they’re more permissive of divorce, it may impact how you perceive your marriage.  It’s the same old thing – if other people have done it, we feel like it’s more acceptable.  So, be sure to ask if they’re divorced and for how long.

Also ask about their ethics and how they’ve continued their education.  Once you’re done asking everything you want to ask, repeat this process with three to five more therapists.  See who gets defensive and who answers your questions openly. 

I know it can be intimidating or feel like you’re being impolite, but you must ask questions.  The truth is, your therapist is your hired help.  And if you do hire them, you’ll want to be able to ask them honest questions later, such as, “I don’t understand how this is helping; can you please explain it to me?” 

Nevertheless, you must also remember that the therapist does not assume the entire burden.  Therapy is hard work, and in order to improve, you have to do the work.  It’s the same principle as playing the piano – if you don’t practice, you’re not going to play very well.  You may notice that I often give assignments to callers on my program.   That’s because change doesn’t happen in one session – it happens outside of the session.  It’s an active process.  You can’t expect to go to therapy once a week and then not give it a moment’s thought until the next session.  The sessions are important but so is your effort to reflect on the content of those sessions and apply it on a daily basis. If you don’t make progress, it could very well be your own fault.  As I’ve said many times on the air, “Hey, I’m not going to work harder on your life than you are.” 

Finally, you need to expect that at some point during therapy, things could become extremely painful, uncomfortable, or unpleasant.  There are often blockages you have to work through.  You may start placing some of your past relationship issues on your therapist or treat them as if they were your mother, father, sister, etc.  Sometimes you’ll want to quit therapy or wonder why you’re bothering to spend money to be in pain.   You might even develop a habit of arriving late to sessions as a mechanism of avoidance.  However, when you start freaking out or getting defensive, you absolutely must go back and talk to your therapist about it.  Say, for example, “After opening up to you last time about ___, I became very vulnerable.”  Really good therapists are trained to understand and deal with your concerns.   

To bring it full circle, this is why establishing an initial relationship with your therapist is important – you need to be able to discuss anything and everything.  If you don’t trust your therapist or don’t feel like they believe in you, there will be no change.  You’ll simply reenact the same patterns with them and everybody else.

Video: Use Hypnotherapy to Transform Pain

This listener, Lidia, was severely injured during her naval service. Her surgery and rehab were botched and, on top of that, her family never visited while she was in the hospital. 

Twenty-five years later, her rage over these incidents has returned and she’s not sure if this is post-traumatic stress disorder (PTSD).  In my opinion, it’s not about her injuries or rehab, it’s about her feeling abandoned by her family. I’ve got a way to transform that pain into something else…