Last month CE4Less.com was kind enough to offer a free class on treatment for PTSD in veterans in honor of Veteran’s Day. I learned so much from this class that I’ve changed my strategy in dealing with trauma in general. While we rarely work with veterans at Teen Therapy OC, it has been easy to apply the techniques to adolescent and young adult clients.
The class introduced Cognitive Processing Therapy. This is a prescripted, step by step process of working through trauma that has led to nightmares, flashbacks, intrusive thoughts, hypervigilence, fear, anxiety, insomnia, and/or the depression associated with PTSD. So far my clients with PTSD have responded positively to this protocol.
I think in the case of my clients who are in the middle of the CPT treatment, they feel better because CPT doesn’t require them to talk directly about the events that occurred. It instead allows the client to explore how the events are affecting them today. It lets them find out what internalized messages related to trust, relationships, self-governance, and boundaries have come out of the trauma. Many clients don’t realize they are living by a set of “rules” they created for themselves as a result of their trauma. These rules are almost always self-protective in a way that doesn’t adapt well to their current life.
Here’s an example modified to keep complete confidentiality for my clients: When Jane was 16 she got drunk at a high school party. She was not so drunk that she blacked out the experience. She remembers making out with a guy who nobody else seemed to really know at the party. He convinced her to go out to his car. When they were there, Jane was assaulted by this guy and it really scared her. She got home safely, but Jane didn’t tell anyone what happened. A few months later she began to have nightmares. She became jumpy when friends at school tried to hug her. She started to feel withdrawn, fearful, and powerless. She also felt paranoid each time she saw a black SUV drive by that it could be this guy in his car. Six months after the assault, Jane felt like she’d lost herself to a prison of anxiety, flashbacks, and a sense that the world could not be trusted.
Jane came to counseling and was diagnosed with PTSD. She was relieved to know there was an explanation, but she didn’t know what to do to get her life back. She didn’t feel ready to share details of the event because that felt too overwhelming. She was thankful she could start CPT without going into detail about her trauma. She was able to complete the first steps (impact statement and stuck points) and already see there was a light at the end of the tunnel.
In no way do I profess to be an expert at the administration of CPT just because I took one class. There are therapists with more training in this treatment protocol. I do have extensive experience with teenagers though, and some begin therapy to talk about what they think is bothering them only to discover their symptoms are in response to a trauma. I’m incredibly grateful to have this tool available to help. It seems to be working well. I’m also grateful to the Dept. of Veteran’s Affairs for making these tools free to clinicians so they can guide their clients through this process.
I have heard more isolation stories from clients starting school last week than in all my previous years of practice (14). One teen told me how she plans to sit in the library for lunch. Another told me he is never invited to anything with his so-called “friends.” A third talked about how she feels like all the friend groups are already formed and she has no way to get into one. In every single case, their hearts are broken and they don’t know how to fix it. I feel their internal anguish as I listen to them give me the details about their worlds. They feel as though they are looking in on a world where everyone is smiling, but that they are stuck outside. They so desperately long for even just one person to show the interest, love, and compassion that they see other teens so effortlessly get.
What gives? Why are some outsiders despite every effort and others insiders even without trying?
1) Charisma: A few people have a lot of this character quality. Most have some. Then there are those who have almost none. You know the type: They just can’t seem to say the right thing at the right time. They make others feels awkward with their awkwardness. It is easy to pick up on the fact that they are not entirely comfortable with themselves.
2) Social Awareness: There are people who lack this very important character trait. They talk too loudly, they don’t know when to drop a discussion topic, they stand too close to people…they just cannot seem to read a room. Teenagers are very socially aware and they often reject the child who has not figured out social awareness.
3) Projected Confidence: Teenagers who walk with their heads up and scanning for eye contacts project more confidence. This is attractive to others. When eye contact is made, these confident teens will wave or smile. People reflexively smile and wave back, which makes everyone like each other more. Think about all that is missed for the teen who walks with eyes downcast.
4) Respect: Adolescents who know where they stand on an issue and are not swayed by the crowd’s opinion are more respected. Have other respect you translates into them being more inclusive.
5) Going Where You’re Wanted: This is the #1 most important thing teens do who fit in. They do not try to force themselves in where they are not obviously included. Teenagers who go with the other teens that already like them are happier. This is likely a life attitude of being content with what you have.
Here are some other thoughts on the struggle for an adolescent wanting to fit somewhere:
1. Faith in God: If faith is important to you, then you have to model it, not just say it. It is easy to say something like, “I don’t want to force my kid to believe a certain thing. I’ll let them decide when they grow up.” In the meanwhile you don’t really expose them to your faith because you don’t want to be pushy. Please just know that if this is the tack you take, you’re kids will probably grow up not believing in any kind of organized religion. You need to model a strong faith in God if you want your kids to grow up with faith. Your teenagers pay astute attention to whether you react with anxiety or prayer. They notice whether you devote your spare time to helping others or doing what feels good for you. They are watching to see if you turn to scripture or if you turn on the news for your hope in the future. Every single day there are a hundred little choices we have to make to turn towards God versus turning towards ourselves, and your kids see almost every decision you make. They copy you. In their future they are more likely to choose a faith if they have been shown how by your example.
2. Finances: Do you buy things you can’t afford? Do you pay for little extras like a daily cup of coffee and then dismiss the cost because “It’s just a few dollars?” Do you get your hair done each month even though there really isn’t a college fund set up yet? Your teenagers are paying attention. They believe they can have anything they want right now it if that’s the example you set. If you are intentional about saving up for things like vacations and a car when you need one, they will learn that behavior instead. When they want something nice, if you help them map out how to work for it and save for it, they will start to really value what they have, and will start to think carefully about how they spend their money. Your kids are also watching to see how you give and how you save. If you invest wisely for the future, and talk about it a little all along the way, they will learn this is important. When you prioritize giving to others, they will value giving. You have a HUGE influence on your teens by your example with finances.
3. Humility: Your teenagers learn an immense amount from you on how to behave in relation to other people. If you are humble in your relationships, your teens will start to act with humility as well (Rick Warren explains humility to mean, “It’s not thinking less of yourself, it’s thinking of yourself less”). I have a neighbor who is constantly doing small things to help out other people. She makes food if you feel sick; she watches your kids for a few minutes if you have to get something done; she asks about that thing you complained about 5 weeks ago to see if it’s better. She is constantly thinking of others. She is subtle in how she does it, and it is certainly not so people will like her. In fact, she isn’t thinking of herself at all. She is simply the walking definition of humble. As her kids have gotten older they have become more and more kind. They are both incredibly sweet to the younger kids on the street. They are polite. They seem to automatically look for ways to serve someone in the smallest things. When they were trick-or-treating last Halloween they both made sure other kids got their candy at the door before they put their hands out. I don’t think they are even conscious of their kindness. I think it’s something they are learning from their incredibly humble mother. These children know how to behave in relation to others. Imagine these two when they are teens. Don’t you want your teenagers to be like that? They are watching what you do, and they are learning.
This blog isn’t written to condemn you for all the things you’re not doing right. It’s tough to be perfect. We are all doing the best we can. All I’m asking of you is to be intentional. Make sure you are showing your children the kind of adult you hope they become. Don’t raise your kids without intentionality, because the default is to let screens and peers raise your teens. Instead, I want you and your values to the most significant influence in their lives.
Helping teens grow and families improve connection,
I want to call a therapist and ask about what’s going on with my kid, but I’m not sure my kid really needs therapy. I don’t want to get talked into bringing them in if it isn’t necessary. I don’t want to start spending a lot of money and having my child get attached to a therapist if they don’t actually need to be there.
This is the thought process many parents go through when deciding if they should call. I understand it. I feel like that when I call the pediatrician’s office to see if one of my kids needs to come in. I wish they’d just tell me if it’s not necessary.
I’m writing all this because I want you to feel at ease to call. I personally return almost every phone call about counseling that comes our way. I do this because I don’t want you to bring your teenager in unless it’s necessary. Of course I can’t always tell that on the phone, but I do regularly tell people it’s not yet time to start counseling. I promise you the same courtesy.
I had a call last week from a couple of concerned parents. It was hard for them to witness their daughter struggling with friends at school. She was feeling isolated and left out. Once we talked for a little while on the phone, it seemed to me this problem might resolve itself if given a little bit of time. I asked the parents to wait a few weeks and see whether things improved for their daughter. If not, there might be something worth digging through in therapy. For many though, a little bit of time salves a lot of wounds.
This is not an uncommon story when you call to talk to us. You also might hear from me that nobody on our team is the right fit for your situation. It doesn’t help your teen if he or she is paired with a therapist who doesn’t have the right training/experience for your issue. We usually have good outcomes for our clients because we are very picky on the front end about who we see. That is why people in the community trust us and trust is the MOST important ingredient in a successful counseling experience.
Depression can be devastating to those who suffer its insidious greed for life, engagement, and joy. Teens who are depressed feel lackluster about their world, their future, and themselves. Often slogging through each day without hope, depressed teens contemplate suicide as a means of relief from the relentless blandness of a life without color.
Watch this short video for three signs your teenager may be afflicted with depression:
