If this were my kid…

Advice-giving:  some therapists claim it should never be done; therapists-in-training are eager to leap in with advice before they know enough about a situation to offer it.  The stance on advice-giving has its roots in various philosophical approaches to therapy.

For those of a more psychoanalytic bent, it is the role of the therapist to push for deeper self-exploration and understanding, with that “a-ha!” process leading to more responsible, better-informed decision making.  Insight leading to action is a vital part of maturation; the alternative is an adulthood of adolescent reactivity and self-absorption.

Psychoanalytic insight may not do a frustrated parent any good at the moment they are figuring out how to handle the upside-bowl of cranberry sauce on the floor. Again.

In solution-focused brief therapy, the emphasis is on searching for times when a problem is absent or much reduced and breaking down the details of those situations, especially in regard to clients’ behaviors. This process empowers the client to realize that s/he is already equipped to deal with much of the situation(s) at hand and develop plans to do more of what already works.

This is a very helpful process, but sometimes people want a little more guidance.

Psychoeducation – teaching, basically – is different than telling a client specifically what to do. It provides information, refers to scientific data, often linking particular actions to help with problems.  Education is part of holistic counseling approaches to many concerns, including depression, anxiety, eating disorders, and problematic insomnia.

All of which brings us back to the question of advice.  I am not a new therapist, and people are not coming to see a therapist with 25+ years’ experience and some white hair so I can look vaguely concerned and steeple my fingers and murmur, “Hmmm, how do you feel about that?” when they express anger and shame over their inability to get a five year old to comply with bath and bed routines.

So, I am, at least for the moment, breaking the invisible fourth wall – the wall first broken in literature by Charlotte Bronte in the final chapter of Jane Eyre – and say, straight out, “If this were my kid…

“I would take away all electronics for at least six weeks.  Maybe longer.  Not even any television/movies unless a responsible adult is with them.”

Yes, they are going to be bored. They will be angry. If they have been playing video games, they may become aggressive and destructive – be prepared for this.  If they have been using pornography, it could be even worse. Fists and feet have gone through drywall over losing access to video games and phones.  If your child becomes hostile and aggressive (not just normally angry), it is evidence you are doing this late in a problematic process.  What are they going to do?  Play other games. Make art. Play the instrument that is gathering dust. Exercise. Do chores.  Read.  Libraries offer books, puzzles and games to borrow: no cost, little effort.  Try a family book club to introduce them to a broader range of reading.  Help them learn how to have a conversation in full sentences, complete with eye contact. The possibilities are boundless.

If they need a device for school, it can be carefully monitored and programs to limit access (such as Covenant Eyes) are available to try to control what is going on. 

“I would have them do chores.  No, ‘school is their job’ is not a good idea.  Do you want to be married to someone who goes to work, comes home, and expects to be waited on, because they did their job?”

By 13, an average, healthy child should be competent at all the basic skills of housekeeping. That means, able to clean any room without having to call in HazMat; sorting, washing, appropriately drying (read the tags), folding and putting away laundry (I give everyone a pass on fitted sheets, and yes, that reflects on my clumsiness); plan, execute, cheerfully serve and thoroughly clean up simple and nutritious meals; do most of the tasks of pet care; be able to handle trash, recycling and compost duties.  Would you want to be roommates or married to someone who can’t do these things as a young adult?  Your future daughter- or son-in-law will appreciate it.

“I would have them get an hour or two more of sleep, every night.”

According to the CDC, children age 6 to 12 need 9 to 12 hours of sleep per night. Teens need 8 to 10.  Odds are, your child is not getting enough sleep and you are already saying this is ridiculous and impossible; how are you supposed to do this?

Insufficient sleep has an almost immediate detrimental effect on brain structures and functions critical for focus, memory and mood:  factors that teachers and parents spend a lot of time complaining are deficient in children.  You know what you’re like when you don’t get enough sleep; foggy-brained, irritable and looking around for caffeine and sugar.  Your children are like that, too, except you are probably keeping the little ones away from triple-shot lattes.  If your teen has to be up for school by 6 AM, then they have to be in their room without electronics sometime between 8 and 10 pm.  The math is easy; accepting that something has to give is the hard part.  Make it an experiment to accompany the electronics question and see what child you meet after a few weeks.

“I would have them learn to use a planner.”

Unlike the early years of school, and even a lot of secondary classes, real life – adult life – requires strategic planning.  By middle school, students should be learning how to break down tasks into manageable, realistic chunks and follow those plans, adjusting as necessary.  That means writing down “Social studies test tomorrow” Thursday night is not good enough.  It means figuring out how much review needs to be done each night of the week to be adequately prepared, and adding that to Monday through Wednesday’s plans.  Even outside of school, the skill of planning is useful.

For example, many people get into power struggles/arguments/endless debates over dinner. The frequency with which this particular power struggle erupts in therapy would astound non-therapists.  I do not understand the surprise that dinner must be had.  Name a date in the future – any date – and if I am not deceased, unconscious or doing colonoscopy prep, I will expect to eat.  The need for a meal at night will never catch me by surprise.  Yet this recurring surprise is apparently part of the annoying texture of life for many families. Model the benefits of planning.  Get the week’s meals worked out, and streamline evenings.  There is an immediate benefit: instead of arguing about “what to do” and wasting two hours around it, have a quick, planned meal and then have time to do something fun, like watch a parent-approved movie together, fold that pesky laundry, and push around more pieces on the 2000-piece puzzle of a Tiffany window that seemed like such a great idea at the time.

I’d make some good memories, I’d say, if this were my kid.

An Echoing Silence

Does anyone ever admit that they are not exactly the best communicator around? Maybe even that they are crummy conversationalists, incorrigibly competitive, and a bossy know-it-all, too?  Probably not.

Wouldn’t that be nice to hear sometimes?  Someone freely admitting the “communication problems” are at least a little bit on their side?

Maybe you think there are communication problems – the person in question (spouse, friend, child, parent) “never talks with me.”  It may be on their side, certainly – most problems have multiple factors, and communication is no exception. However, you only have control over you – not them.  So, if the communication problem falls into the “we never talk anymore” column, perhaps the following might offer perspectives.  If it’s possible it might be you…

Are you the Conversation Hijacker?  Does every topic offer you a possibility to wrestle control of the conversation, taking over, changing direction and refusing to yield to the other people in the conversation?  They bring up the local baseball team and you take “sports” and launch into a detailed analysis of an entirely different game, the season ahead, and every stupid mistake the nearest team made when adding new players.

Perhaps you are the Professor. You don’t discuss, you lecture: expanding on your opinion, the evidence as you see it, and what’s wrong with other people’s positions, beliefs, or behaviors.  Expertise is wonderful; battering people with it is not nice.

Related to this, perhaps you become the Guidance Counselor or Coach: giving unsolicited advice, suggestions, and explanations of the person’s “problem” and the solution as you see it.  You don’t stop to be sure you have enough information to even begin to formulate advice; in your unconscious arrogance, you assume you have perfect-fit prêt-a-porté advice for every occasion.

Or, perhaps you are the Competitor.  They have a headache? You’ve had a migraine for days.  Their beloved pet died? You have three sad stories to top their heartache.  They have a muscle ache, but YOU need physical therapy.

Do you just launch into a monologue, barely taking a breath and not allowing the usual give-and-take of conversation?

Sometimes, the echoing silence on the other end of the couch is really on that end – your wife is lost in thought, your husband is anxious, your parent is depressed, or your teenager is preoccupied with stressors.  Perhaps there is some unresolved hurt between you. Perhaps, though, the person you love has fallen silent because they cannot trust you to stay in the conversation with them; they expect you to take over.

COVID-19: Surviving and Thriving

We’re worried about our loved ones, our own health, our school work or livelihood and what the months ahead will hold for our families, our communities, and our world. Being separated from one another makes it harder. Here are some strategies that can help:
1. Establish a daily routine and keep regular hours. Get up at your usual time; go to bed as usual. Use a checklist, a schedule or whatever structure helps you stay focused on positive, constructive actions.
2. Pray! Pray alone; pray on video-conferencing with friends and family; pray while watching livestream worship services. Include in this: daily periods of silence – not just telling God what you want done; instead, begin learning to sit quietly, observe your zigzagging thoughts, and not immediately take all your ideas so seriously.
3. Physical activity: an hour or more of physical activity, if you have medical clearance to do so, will help reduce the physical and mental effects of chronic stress. If you are able to be outdoors without being in danger of infection – enjoy a walk in nature. If not, seek opportunities indoors: walk in place; dance with your kids; be creative!
4. Reach out to someone who needs encouragement every day. Call, email, text, video chat, or send a note in the mail – be a light for someone who is alone and discouraged.
5. Check for news updates twice a day – more than that and you are often reinfecting yourself with the same negative news. Even if your logical brain recognizes it as last hour’s news, your emotional brain is again jolted with a bit of fight-or-flight about the pandemic and its consequences.
6. Odds are, you have more time on your hands than usual. Why not pick something to learn about on your own, with family, or with friends as an online/videochat study group? Can you practice a new skill, start a book club (hello, e-reader plus video chat!), or study a long-neglected area of interest? If you ever purchased arts and crafts supplies for “someday,” bought and neglected a language-learning app or fondly recall an elective course you’d wished was your major – it’s time to bring those interests into the light of day.
7. Take some time each day to journal about the experiences you are having during these strange weeks. Writing things out may help you clarify your emotions and thoughts, and help you see your experiences from a slightly “outside” perspective. Close your daily journal entry with a few things for which you are grateful.
There are lots of other ways to survive and thrive as people maintain social distance, self-isolate, and shelter in place…while we can’t control everything, we can exert control over our responses. Pick the story you want to be able to tell yourself, and others, about how you handled the COVID-19 crisis. Are you going to be able to tell a story of faith, compassion and grace under pressure – the year you became passable in Portuguese, started a book club via Skype or Facetime, and became a hula hoop expert? Or will it be the year you zoned out in front of 24/7 news for untold days, slowly becoming more burdened with ennui and inertia?
Choose to persist in faith, maintain your healthy habits, nurture others and grow in wisdom.
Choose life!

Two Old Ladies

There is a kind of dignified poverty encountered in 19th century British literature. Clean, neat, quiet, well-read, hard-working and uncomplaining, these people, dwelling on the fringes of society, are portrayed as reading classics by candlelight after a long day of work, perhaps aloud, while another family member darns a tired sock for the umpteenth time. They take in mending and other tasks from their social betters, and are sometimes invited to large gatherings where they meekly take seats on the periphery. They are fictional creatures, bound up as minor characters in musty books.
My (great-) Aunt Ann and Aunt Marion lived that dignified poverty, although it was the 20th century, in the cold water flats of Jersey City. My grandmother’s younger sisters, their time spanned Jersey City’s deterioration and ended before its re-gentrification.
Passing them on the street, you would not notice them: two older maiden ladies, often arm in arm, purses tucked under their coats in fear of purse-snatchers. Who would give a thought to two old ladies? They kept an extra dollar in one shoe, just in case. They dressed neatly, and well, and cared for their few possessions so that they could be worn for many years. Cursed with a genetic tendency to lose their hair in middle age, they wore demure, neatly styled wigs. Aunt Marion, being a bit flashier, had sparkly corners on her cat’s-eye glasses, and a preference for the color red. They worked in sweat shops and at other menial jobs. Aunt Ann, for a long time, operated the elevator in a business office skyscraper, an opportunity to work in a cleaner, quieter environment. Neither had an 8th grade diploma – the meaning of “graduation” in their time and place. They could not drive. They traveled little, to visit family sometimes. Their tiny apartment was sparklingly clean. They read classic literature, were knowledgeable about history, current events, and the activities of the people they loved. They loved, it seemed, everyone. They were cheerful and generous beyond their means, unflaggingly loyal to their nieces, their nieces’ children, and their children. Devout Catholics themselves, spending considerable time daily in prayer for others, they were remarkably tolerant of astonishingly stupid and bad behavior among their extended family. It mattered not how grievous the misdeeds: the errant youth was, at heart, Aunt Ann and Aunt Marion would assert, “a good girl,” or “a good boy.” After all, look how good she is to her mother; see how thoughtful he is towards his sisters. Anyone whose deity is harsh and unforgiving never met someone like Ann or Marion. The closest they came to criticizing was sharing a sidelong look and a single, slow nod, a kind of connection possible between two sisters who grew up together, raised two nieces from ages 8 and 15 together when one of their older sisters died, and shared the same ancient double bed most of their lives.
Strolling past, you would have looked through them, and unless you are a very special person indeed, you have looked through, perhaps, thousands of people like Aunt Ann and Aunt Marion. Not out of meanness, but because the people of the remnant – that pure and poor bit of holiness – are so often, apparently, invisible. Besides that, both poverty and old age frighten people, and thus we look away. If not away, exactly, then certainly not directly at them.
They have been gone for many years now, and I still regret that I was not a good-enough niece, certainly not worthy of the fondness and praise they heaped upon me. From Florida, I sent some homemade cookies now and then; a randomly spaced letter between birthday and Christmas cards, small gifts that I thought they might like at Christmas. I mentioned, during their lifetimes, my befuddlement at their level of praise for what a good girl I was to my mother, who loved them dearly and called them often. She stopped what she was doing to look at me and said, “Please. Do you think anyone else gives a thought for two old ladies?”
A sad question, that: who gives a thought for two old ladies, or an old man or two?
How hard is it, to give a thought for any other person? “People will not remember what you said or did, they will remember how you made them feel,” is the theme of the “most important award” at our granddaughter’s Catholic school, and one we were proud to hear she had won at the end of second grade. It is good to know that the kindness and sweetness we experience from her flows outwards, beyond the family. Her precocious insight into human nature is something she wields only with compassion. At seven, viewing Goodbye, Christopher Robin, she watched WW I veterans stomping balloons and announced, “They are doing that to learn not to be scared. “ She makes people feel special. Perhaps she has a touch of her great-great-great aunts’ spirits.
The gift of presence is that quality of attention: the attention that lets someone know that right now, they are the most important person, and whatever they are doing with you is most worthy of their attention. (My aunts, having read Tolstoy, could have told you all about it, but only if you brought it up first. They would not show off, and they would never broach a subject that might embarrass someone else.)
How powerful their capacity for presence within their humble, dignified way of life, a life that seems invisible to those who will not look at them. Then again, who would give a thought for two old ladies?

That’s Confabulous!

That’s Confabulous!

Your favorite uncle entertains every family gathering with the same stories.
His listeners realize they are not the same stories. The tales shift…small flourishes are added, details are lost and later denied (“Uncle, what about the cow? You mentioned the cow in the marsh last time.” “No, no – there wasn’t a cow. It was a goat. It’s always been a goat. Why would there be a cow in the marsh?”) Emotions intensify, diminish, and intensify again; the who, when and even the where are wobbly.
Is your uncle a pathological liar?
Well, he might be.
More likely, he’s a normal human being.
Memory is not a video recorder from an omniscient position. Our memories are constructed. Because it’s imperfect – and our brains want things to make sense – we fill in the blanks. There’s a little of filling-in-the-blanks in almost every memory, and in extreme cases, it is called confabulation.
Karl Bonhoeffer, German psychiatrist and father of martyred pastor Dietrich Bonhoeffer, coined the term. Confabulation, properly used, is the unconscious attempt to fill in the blanks in memory with made-up details, identified most with alcohol-related forms of dementia. The speaker believes it’s all true – but it’s not. Brain damage causes inevitable errors in processing and storing memories, and the brain valiantly attempts to weave a story out of scraps.
Related to confabulation is the tendency to “fill in the blanks” where there is no dementia and no logical reason to do so. People make up stories about other people, ruminate on them, discuss them with their companions. Later, when the subject comes up, the remembered imaginings are woven into whatever sparse facts were originally available. Electronic media has speeded up a process that used to require substantially more time and effort. The possibility of interrupting the downward spiral is much diminished.
A nearly harmless example: last year I moved my office from the high rise where I’d been for 19 years to two parish-based offices. My old office furniture was not needed in either location, so I gave it away to my parish, where it is apparently very popular with the youth group at their Sunday night meetings. Imagine my surprise when I heard from various sources that I had closed my practice, semi-retired, stopped working…you see the drift. People took one fact (she gave away her old couches and tables) and built a story around it (she retired). I have no idea how many referrals have not come my way due to someone’s – or several someones’ – confabulous storytelling regarding my work.
Less benign are the tendencies of unhappy people to ruminate and stir in speculations, scraps of other unhappy memories, fears and grudges, creating a new and often sinister narrative about a situation or people. This seems to be most effective when done in dyads or slightly larger groups. My observation, at least, is that the more shared memories, the more believable the confabulous concoction of “truth” that emerges from the co-rumination. Motivations are attributed with no evidence; “facts” are mutually invented and, since someone else believes or remembers the same exact thing – why, clearly, it must be true.
If this has ever happened to you, often in the context of perpetually unhappy coworkers, family members or friends, you know how useless it is to fight against the creative power of two or more brains that have mind-melded a mutual mural about…you. The only useful thing one can extract from the misery is a warning against being part of that type of dismal discussion.
Even with honorable intentions, memories shape-shift over time.
Emotion tints memories. Next time you are in a generally happy mood, pull up an old memory, perhaps a time shared with a loved one who has passed. In contentment, reflect on the events of the day and the joy you felt with that loved one. Really sink into the memory. Next time you evoke that memory, it will have shifted a bit to emphasize the joyful aspects – the smile, the warmth of heart – whereas if the same memory came up when you were sad, somehow it would be tinted. You might notice that other memories that feel the same way easily come to the surface: that’s another aspect of memory. Our memories are linked by emotional flavor, not just content. That’s why someone who is angry at you seems to have a boundless recall for every stupid and disappointing thing you have ever done.
Words also shape how memories are shaped and stored. A car comes up from behind, passes you, enters your lane and, a half-mile later, ends up in the ditch. You pull over to call 911 and see if you can be of assistance. Later you are questioned about your observations. How much did the car swerve? If asked, how much did the car fishtail…your memory will subtly adjust. The next time you recall it, the film may contain a touch more veering about.
Personal beliefs and biases enter the picture, too, and help form “memories” that are less than precise. It might be as subtle as “assuming” that someone meant something and then sliding into believing that they implied it, and subsequently taking offense by something that was unsaid as if it had been a slap. It could take the form of filling in the blank in someone’s appearance or comportment based on biases. Alternately, beliefs or entire cosmologies are attributed to someone based on scraps of “evidence” and then merrily embraced as “truth.”
It’s an interesting dilemma, encompassing the Commandments (Thou shalt not bear false witness) and Pilate’s coyly avoidant, “What is truth?” False witness, after all, is not just perjury. It comprises gossip and unnecessary tale-telling, both inevitably not the whole truth, as any elementary school teacher can attest. It’s all the ways in which we might fill in the blanks, perhaps consciously but, I suspect, as often reflexively, justifying our own emotional wallow with imagined and projected details.
Isn’t that confabulous?

What would you do?

What would you do if…
You weren’t afraid of failing?
Didn’t care if people thought you were weird?
Really believed the things you say with the crowd at your weekly worship service?
Had six months to live? (and how do any of us know we even have that long?)
You would do something differently. You might stop doing something, start something else. You would shake up your life without much trepidation.
So, tomorrow (or in five minutes), do one thing a little bit differently…a little bit more as if you were free from fear, from the need for constant approval, from doubt.
Follow that up with one more little thing, one more step.
Maybe you will do something you didn’t think you could do, without worrying about others’ opinions, and find out your faith is stronger than you’d thought.

Meet Them Where They Are

Three times each year, our parish runs Alpha, an eleven week program for people who are open to exploring the basics of Christianity, starting with elemental questions such as, Is there more to life than this?, or Why should I believe in God? The chair of the committee running this, and our other evangelization programs, was accosted by a fellow parishioner after Mass one morning. The parishioner had a list of grievances, particularly that the program wasn’t “Catholic,” citing various deficits, in the complainant’s mind, such as a lack of Marian theology. Besides her apparently unchristian behavior, she had missed the point of meeting people where they are. Many people are skeptical about the existence of God because they have been sold a bill of goods about faith and science being incompatible; it is hardly useful to wrestle them into a dialogue about the Blessed Mother and the Virgin Birth, or Transubstantiation. We must meet them where they are. They are wondering if there is a reason to believe in anything or any One, and rushing somewhere else won’t help; it simply truncates the conversation before it begins.
Just so, in our daily lives, we must meet people where they are…
It may well be that the child you permitted to walk all over you is now grown, or nearly so, and the rudeness and demanding behaviors that you thought were funny at age 2, and tolerable at age 4, are grinding you down now that the child is 18 or 21 or 30. It does little good to beat yourself up because you were not willing to foresee this problem; you need to deal with the situation as it exists, or choose not to (and continue to be ground down by caustic, toxic offspring). Attempting to have what you think is a perfectly reasonable conversation about your expectations and anticipating you will receive thoughtful, considerate responses is, well, sad and silly. You will have to meet them where they are: as a very large toddler who needs clear rules and near-immediate consequences. You will also have to have a plan as to how you will cope with an adult having a temper tantrum. There will be displeasure about any limits you set:
“We are no longer going to pay for your cell phone. You can come with me to [provider’s storefront] after work on [specify date] to switch the number to a new account in your name, or I will simply close that number.” You will hear how unfair this is, how unreasonable – you know how much their student loan payments are, right? – and how ridiculous and selfish it is for you to bring up their prodigious spending on entertainment and other technology.
“You are an adult, and this is our home. No more overnight guests.” Well, this is unfair, too; how are they supposed to, well, whatever? Other people’s parents are reasonable. Besides, it’s the 21st century; what’s next, bundling?
…and so it goes. You will get pushback and you will either stay firm – something apparently quite difficult, because if it came naturally, you would have put a stop to this behavior, oh, say, 20 or 25 years ago.
Many people are unhappy about the state of their marriages, and there, too, is a problem that is best met where it is. The typical couple puts their relationship almost entirely aside when children come along, neglecting it sorely, and then are surprised, dismayed and resentful at the state of things. They barely speak; they have nothing in common; each wonders, how could I have chosen such a miserable person? The relationship is anemic, neglected, and easily startled; like a once-beloved pet banished to the back yard pen for months or years, it hardly knows how to behave in the house. Treat it with gentleness, patience, and consistency. The friendship must be rebuilt; meet that process with good will rather than sarcasm and cynicism. Use Gottman’s research and books; use Chapman’s 5 Love Languages; use a good therapist: do something, be consistent, and begin at the beginning, with careful nurturing of the abandoned friendship. Perpetual complaints about what it “should” be like are worse than useless; just meet the marriage where it is.
You may need to meet yourself where you are, too.
You might like the idea of being physically fit, self-disciplined: the sort who enjoys vegetables and exercise. That’s all very nice…and, if it is not true, you will have to meet yourself where you are and begin teaching the actual you – not the imaginary, idealized version of you in your head – how to be self-disciplined, how to gradually become physically fit, and how to appreciate the subtle flavors of vegetables after assaulting your senses with however many years of packaged and fast foods.
Perhaps your vision for yourself is more spiritual. You might like the idea of yourself as a truly good person, the kind of person who enjoys engaging in loving service, doing without for others, and understands what it is people are talking about when they discuss having a “prayer life.” Meanwhile, you are stuck with a few rote prayers and still think Job and Jonah are supposed to be historical reports. Well, you must meet yourself where you are. If your spiritual training ended at 7, or after your Confirmation, Bat Mitzvah or Bar Mitzvah, your stunted spiritual age is where you begin.
Meeting ourselves, and others, where they are doesn’t mean “settling” unless you are content to stay there. It can mean having a real conversation, and a real chance for positive change. Flashes of insight are not change; they are the precedent of change. Change happens only where we are.

Every parent’s nightmare

All good parents – and most not-very-good-at-it parents – want what is good for their children. They would like them to grow up happy and healthy, to have a comfortable life, stay out of jail, etc. A few grandchildren and regular calls and visits would be nice.
Often unspoken, but definitely there, is the desire that their child not be what they might call “crazy.” It’s not my word – I’d use depressed or anxious, or having a psychotic episode – but for parents, one of the greatest fears of all is that their child grows up to be mentally ill, with hallucinations and delusional beliefs – to be out of touch with reality, to be, in short, psychotic.
Psychotic doesn’t mean “violent and crazy,” as it is so often misused. It means to be out of touch with reality, often with some sort of hallucination (hearing voices, seeing things that aren’t there, or some other sensory misinformation) and/or delusional beliefs (paranoia, which may mean being persecuted or it may mean an unrealistic arrogance, belief in one’s special powers, or that one is in fact someone of great power and importance).
And, it turns out, psychotic symptoms are a risk factor for two common substances in the lives of young people: methylphenidate, a commonly prescribed drug for ADD/ADHD, and cannabis.
The research on methylphenidate has been ongoing, in some cases for decades, and while you cannot do experiments to “prove it” (who would volunteer to try to have their child rendered psychotic just to see about a drug’s effects?), researchers scour multiple studies following up on children and teens prescribed methylphenidate, and find that 1 to 2.5% develop psychotic symptoms. That’s up to more than one in 50. The latest meta-analysis was published this summer in the Scandinavian Journal of Child Psychiatry and Psychology, using multiple studies with over 77,000 young people in all.
The link between cannabis and later psychotic symptoms, as well as anxiety, for young people has been known for years, but often studies began in the mid- to late-teen years and it was difficult to determine if those who were prone to mental disturbances were more attracted to cannabis than healthy teens, or if otherwise healthy teens were developing psychosis as a result of cannabis use. With studies beginning earlier – in 7th grade – researchers feel confident asserting there is an increased risk for psychotic symptoms within a year after a teen begins using cannabis. This is for all teens, not just those with family histories of psychotic illnesses such as schizophrenia.
What should parents and other caregivers do?
If your child is being treated with methylphenidate, work closely with the prescribing physician to monitor side effects, be honest about what you observe, and do not panic. Remember that counseling and neurofeedback, provided by experts, can help someone diagnosed with attention deficits develop skills and neurological adaptations to reduce symptoms. Seek a referral from your child’s physician.
In terms of illegal drug use…assume no “safe” amount of an illegal substance. The fact that many states have legalized or decriminalized marijuana has misled many people to believe it is “safe.” It is not. The American Medical Association and the American Psychiatric Association both have published strong positions warning about the use of marijuana.
Parents and caregivers also need to be mindful that the drugs used for ADD/ADHD, and methylphenidate as an illegal substance, are popularly misused, sold, or shared among young people. According to studies published as recently as last autumn, 5 to 10% of high school students and 5 to 35% of college students use, or have used, prescriptions for ADD/ADHD illegally as “smart” or “study” drugs. This may be regular use, or may be occasional to get through end-of-term crunches with minimal sleep. Side effects include sleeplessness, agitation, anxiety, dizziness, headache, sweating, appetite loss, elevated blood pressure, and psychosis.
Be alert for subtle changes in behavior and do not be afraid to be assertive about this. Your child’s physical and mental health may depend upon it.

Go and Do, for Me and You

Verbs, like “go” and “do”
In a recent on-air segment, Jamie and I (he’s the afternoon radio talent for Spirit FM, the local Catholic radio station/Christian pop music station where I’ve been volunteering since 2009) were discussing various social protests. He had asked me how to handle the flood of social media, with people posting/re-posting/re-re-posting, and the pressure to have some sort of opinion/assert some stand on perpetually protesting celebrity.
I try, but don’t always succeed, in preferring action verbs. Like, “go” and “do.” I don’t much care for meetings. I don’t like sitting around talking about how we can help the homeless and severely mentally ill. I went and did (full time work, almost 5 years). Jesus didn’t say, sit around and have lots of committee meetings. He said, pretty much, Go… (He also had something to say about babbling on and on, so I will move along.) I would rather teach than talk about teaching, do art than sit around talking about art…you get the idea.
So my thoughts are, go and do. It would be far more helpful – if, for example, we are talking about the real and obvious pain in poor neighborhoods – to go and do. Mentor a kid. Be a Big Brother/Big Sister. Organize a community watch organization. Do pro bono work in your field. Provide free tutoring. Be a Guardian ad Litem. Etc., etc. Go and do. Standing around getting attention for taking a public position that costs nothing seems a little self-serving.
It reminds me of the time a woman I knew criticized me for failing to wear red on some arbitrary date publicly announced to be the day to wear red to support women’s heart health. The only woman whose heart I have much influence over is my own. I had already exercised, gone to church, had good conversation with my husband, eaten a healthy breakfast – in other words, it was 8 AM and I had done all I could for THIS woman’s heart health. Nothing I was going to do, besides pray and try to set a half-decent example, would help anyone else.
It also brings to mind the big test for reports of visions of the Blessed Virgin Mary. Such a report requires much evidence, but a primary benchmark requires that Mary points towards Jesus. There is no credibility if the reported vision does not direct people towards Jesus. Such an experience is not something from the Good side. It might be a well-intentioned, innocent delusion, but it is not Mary. Mary doesn’t showboat.
So…if terrible injustice moves you, go and do something concrete, specific and clearly helpful for one particular person. Keep the meme to yourself.
…and more on “Go” and “Do”
Teen and young adult mental health took a drastic, terrifying turn for the worse beginning in 2007 – and the stats keep worsening, especially since 2012. This, according to a lot of research, can be traced back to the smart phone, according to San Diego State University professor, researcher and author Jean Twenge. Her recent book, “iGen: Why Today’s Super-connected Kids are Growing Up Less Rebellious, More Tolerant, Less Happy – and Completely Unprepared for Adulthood – and What that Means for the Rest of Us,” provides the results of not just her original research but meta-analysis of generations of data on the pattern of mental health and activity for youth.
It seems like constant connectivity has led to less “go” and “do” and more detachment and isolation. It’s a double-dose of negative: the ineluctable distance created by screen-based communication and a deficit of direct experiences. We were not designed to sit and click; we are made to go and do.

Dr. Lori Puterbaugh, LMHC, LMFT, NCC

Posts are for entertainment and not meant to be construed as treatment or professional recommendations. If you need mental health assistance, please contact a licensed professional in your area.

To Live Long, To Live Well: The Ongoing Research

Cognitive decline – dementia – Alzheimer’s disease – senility – to lose our independence, our memories, our minds – our “selves.” This is one of our greatest nightmares. But, what if this precipice – the thing people seem to fear worse than death – is almost entirely avoidable by changing how we live?

The Alzheimer’s Solution: by Dean Sherzai, MD, PhD and Ayesha Sherzai, MD (2017) asserts that this is indeed the case. You won’t find wishes, a few convenient anecdotes and flimsy, recent research. The doctors Sherzai tie together decades of substantive research from multiple, credible sources (including ongoing Blue Zones research) and their own research and medical practice. The result of this work: a straightforward and remarkably simple (albeit not easy) recipe for long, healthy mental functioning.

Unfortunately, it requires that we do stuff. Differently. In a lot of cases, way, way differently.

Here’s a synopsis:

They use the helpful and appropriate acronym NEURO: Nutrition, Exercise, Unwind, Restore, Optimize

Nutrition: quite specific nutritional guidance – recommending a largely vegetarian diet high in specific types of nutrients.

Exercise: not just a regular appointment at the running path or the gym, the research emphasizes activity throughout the day on a frequent basis.

Unwind: Managing stress healthfully and living with purpose.

Restore: Enough good quality sleep (this is a tough one for me). There is no substitute for sufficient sleep in terms of long-term brain health

Optimize: a lifetime process, and never too late to start: complex, creative, learning and doing. While the puzzles we encourage elders to do to keep their minds nimble are a small part, greater benefit comes from ongoing learning, complex tasks, mentoring/teaching and other activities that use multiple skills.

The book, published this past summer, includes interesting case studies, questionnaires and specific recommendations to make changes as needed on a case-by-case study. It’s helpful to remember that, all over the world, there are “Blue Zone” communities – places where most people live long, robust lives free of chronic diseases and dementia – where these lifestyle choices are just “normal,” not sacrifices. At least, I tell myself it’s helpful.

My challenge, which I share and dare towards you: do some investigating on this. If you’re intrepid – seek your physician’s guidance and take it from there. If you’re a little timid, hesitant or just plain skeptical, pick one piece that’s easy to do, get the medical OK, and go for it.

Dr. Lori Puterbaugh, LMHC, LMFT, NCC

 

Posts are for entertainment and not meant to be construed as treatment or professional recommendations. If you need mental health assistance, please contact a licensed professional in your area.