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 She started to feel withdrawn, fearful, and powerless.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.
Stress is tough on teens. Image courtesy of David Castillo Dominici / FreeDigitalPhotos.net
Teenagers these days are stressed out! So are we all. We’re short on sleep, overscheduled, and overstimulated. Here are the top 5 stressors my teen clients talk about:
1. Looking good: Teens don’t yet know what makes them unique and special. They haven’t established a career or any specific knowledge that gives them an identity. They’re receiving a general education in middle and high school, so there is very little that distinguishes them from their peers. As a result, many teenagers spend an extraordinary about of emotional energy on wanting to be the best looking of their peer group. Girls try to be thinner, and boys try to look stronger. Pimples are akin to a nuclear crisis. This is a regular source of stress for your teenager.
2. College: There is an incredible amount of pressure on Orange County teenagers to achieve in high school so they can get into a great university. The problem is, they really don’t have a concept of what makes a university great. They tend to just assume schools with prestige and difficult admission requirements are what defines their entire adult future. Please help your teenager avoid buying into this lie. Different colleges excel at different things. Your adolescent’s success in college has more to do with matching the right kind of school to their personality and values than anything else. For example, I have one client who is achieving very high grades in high school, but his personality is such that he flourishes in an environment where he is one of the top students. He would really struggle at a UCLA type school even though he could get in there. He’s intentionally choosing a much smaller private school for this very reason.
3. Sports: Playing sports is very good for teenagers. It’s really beneficial for them to get exercise, be around friends, and learn discipline. But, we have many teenagers who are forced to take sports a little too seriously. They have multiple hours of practice per day, private coaches, weekends dominated by travel and tournaments, and constant pressure to play at a very elite level. What is all this for? These teens are training like professional athletes, often at great financial and emotional expense, just to make a college team? It’s one thing if your teen is truly passionate about their sport, and you couldn’t keep them from practicing if you tried. It’s completely another thing if you’re the one pushing and they only “like” the sport. This kind of pressure ends up equating to stress. In fact, many teenagers confide in me during a counseling session that they actually hate being an intense athlete.
4. Social media: Without a doubt your teenager stresses about social media (if they use it). Adolescents are truly bothered every time they logon to Instagram and see several of their friends in a photo without them. They feel compelled to check their social media multiple times per day. They are bolstered or discouraged by comments made on their posts. They use social media as a means to compare themselves to others.
5. Homework: This one won’t surprise you. It likely caused you stress as a teenager too. Teenagers are assigned a lot of homework. It is stressful to be at school all day, and then have to come home and work on it for many more hours. Now that adolescents feel they have to take harder and harder classes to stand out, their homework load has become extremely burdensome.
Stress in small doses actually motivates us. It’s good to learn to manage stress. When your teenager becomes overly stressed though, they can be irritable, frustrated and anxious. Knowing some of the things that cause them anxiety can help you help them. One of the big skills you have to teach your child before he/she flies the coop is how to keep life in balance. Help your teenager know they simply cannot participate in, or be the best in everything.
Helping teens grow and families improve connection,
I have dealt with two simple phobias in my lifetime, and both terrified me enough to significantly alter my behavior and well-being. One was a fear of sleeping at other people’s houses and one was a fear of vomiting. I will share about the fear of staying at other people’s houses because it’s a little bit more common for kids and teens.
When I was 8 I used to spend the night at Tracy Hall’s house. She was my best friend at the time. We spent hours imagining games, creating “newspapers,” and torturing our parents with plays we had written and acted in. One night I couldn’t fall asleep. Tracy always left Nickolodean on her TV throughout the night. I watched show after show. I saw reruns of all kinds of old programs where gak (sp?) was being dropped on families, Lucy and Desi were arguing, and whatever else you can think of. Eventually this not sleeping was making me anxious. I could’ve slept if the TV were off, but I was afraid to turn it off because Tracy (very bossy) had told me I wasn’t allowed to turn it off or she couldn’t sleep. When I went home the next morning I was an exhausted, emotional wreck.
The following weekend when I tried to sleep at Tracy’s I ended up calling my parents to go home. From then on it started happening no matter where I slept if they weren’t there too. It grew into an uncomfortable separation anxiety that was only quelled if I KNEW I could be home and in bed by 8:30pm.
There are two ways to overcome a simpe phobia. One is to rip off the band-aid, feel a flood of anxiety, and stick it out until the anxiety finally passes. The other is to face it gradually. I wish my parents had known about the gradual approach but after a few years of this fear, we went at it 100%. They told me when I decided to spend the night there would be no coming home no matter what. They made arrangements with a good family friend and sent me over. I cried, panicked, and had one of the worst nights of my life. Eventually morning dawned and I still remember how proud I was, “I’m over my fear of spending the night!”
How surprised I was when I went to stay at another friend’s house and I was afraid all over again. I couldn’t believe it! I was incredibly frustrated. My parents didn’t let me come home and I found it was a little easier to cope. It ultimately took 11 nights at other people’s houses before I didn’t experience anxiety any longer. If I went too long between sleep-overs the anxiety would start to creep in again. I had to inoculate myself by spending the night somewhere about once per month.
What I hope you can see from this post is that overcoming a simple phobia isn’t simple. I actually hate that term. It prevented me from staying at birthday sleepovers, sports team sleepovers, going to friends’ houses late in the evening, and prevented me from ever enjoying summer camp (although I still went).
When you or your child begins the process of facing a simple phobia you must be dogged about not backing down once you start the process. You have to be consistent and you have to do it many more times than you think. In this post I have given you the flooding approach, which is terrifying but effective. In the next post I will explain the gradual approach, which is much more gentle.
I once had an OCD client who had a teacher yell at her. She became fearful of this teacher and started having obsessive thoughts he would pull her out of class to threaten or scold her. Because he had yelled at her once, her obsession was based on a good-sized kernel of truth. However, as often happens to people suffering with OCD, the obsession was a gross exaggeration of the realistic risk. She struggled immensely with discerning what was realistic and what was intrusive. How does one begin to tell the difference?
Academics overwhelm every teenager at some point. Image courtesy of luigi diamanti at FreeDigitalPhotos.net
One thing all adolescents have in common is that at some point or another school stresses them out. They are given an assignment that really stretches them, or have to make a certain grade on a final exam to get a passing grade in a class. Every kid runs up against a class where they don’t understand the material and feels completely lost. Middle school and high school can be a huge challenge for your kids.
Here are 5 tips to help your teenager cope with school stress:
Help them keep the big picture in mind. A high school grade or class doesn’t in any way define who they are as a person. The effort they make, and the ability to cope with challenges does define them. That’s where your focus needs to be as a parent.
Give them guidance on how to seek out the help they need. As your teenager gets older and older, you should do less and less of the actual calling/emailing teachers and tutors for them. Help them find the information they need to seek out help, but get them to do it themselves because that also builds character.
Help them learn to break problems into small pieces. If your teen is given a 10 page research paper, then it’s your job to help them learn to break it down. Help them make a check-list of steps that get the paper done. Kids who learn to patiently outline papers, research carefully, write a draft, edit their draft, and then turn in their papers get better grades. They also learn huge life skills about time management and planning.
Help your teenagers learn to pace themselves slowly. A teen who studies consistently for a couple hours per day is a better student than one who studies in spurts. It’s hard for teens to learn that there are days when they have no homework assignments, but they should still be working on school. If they take the time to work when there’s no work assigned, then they can stay ahead a little bit. This reduces future stress.
Learn to study in groups. It makes it more fun, and it makes it easier to stick with it for longer. If your child is stressed about how to handle a difficult class, one of the best things they can do is get together with a few of their friends who also have the class. Different students understand different parts of the material. If they work together they can help each other learn.
The bottom line is that school is overwhelming sometimes. It gets to every student from the 2.0 student to the 4.0 student. One of the best things you can do is to help your adolescent have a strategy. Recognize that teenagers aren’t always great at carrying out their strategies, so you will have to gently help them stay on track. It’s also important for you to recognize the limits of your child’s abilities. If your teen is working as hard as they can and getting a 2.5 GPA, then don’t push them to be a 3.5 student; they will start to feel like you are never satisfied with them.
Helping teens grow and families improve connection,
Hello, I’m Lauren! If you notice your teen struggling, you might be feeling helpless, hopeless, frustrated or concerned as a parent. Try to remember, there is hope. I want to help your adolescent feel better. My hope is for them to enjoy their life again. I want them to feel confident they can handle whatever situations arise.
