Q&A: Addressing Drug and Alcohol Use with my Teenager

Two parents have asked similar questions about teenage drug and alcohol use, and I’ll address them both in this Q&A

1. My 15 year old son just started in high school this year.  He has always been a good student, but this year his grades have dropped and he is hanging around with friends that I’m not sure about.  He is also giving me some attitude lately, which is not like him.  When I ask him about his grades, he makes excuses and blames the teachers.  I’m worried that he might be getting involved with alcohol or drugs, or something else.  I am tempted to look at his e-mail account and his phone. I have already looked around his room, and felt terrible afterward!  What should I do?  When is it okay to invade my son’s privacy?

 2. Dear Dr. Nagpal,
How do I explain the dangers of drugs and alcohol to my teenage son without sounding like a fuddy duddy? I want him to enjoy the company of his friends but I worry about the dangers he will be exposed to. Thanks,Laura

 As I discussed in a previous Q& A, Struggling with 16 year old, adolescence is a time when identity development is a significant task and figuring out “who am I” becomes a primary question. Therefore, it is not unusual for kids who have normally been “good kids” to start engaging in some behaviors that are new and different for them, and frankly, alarming for their parents. Your concerns are real and justified, based on the behaviors you have described. However, it is an art to challenge these behaviors in a way that doesn’t alienate the teenager and engage their oppositional tendencies.

 As someone who was a very rebellious teenager, I can guarantee that misguided attempts to exert parental control are a sure way to alienate your teen. As a parent who has raised a spirited teenager, I can relate to the anxiety that is produced when kids start to “grow up” and act in ways that are new and different. As a professional, with my years of working with families, I will tell you that it’s well worth learning some skills that are designed to address teen behaviors that raise “red flags,” and our anxiety level right along with it. Even with the alarm bells going off, it is important that we step back and figure out the best, age-appropriate approach. 

For instance, taking a cue from the tone of the second question – “how do I explain the dangers of drugs and alcohol to my teenage son without sounding like a fuddy duddy?” bringing up the issue for discussion, before making further choices to breach your son’s privacy, can be a helpful strategy. While I wouldn’t jump to any conclusions, substance use (alcohol or drugs) is a very real possibility at your son’s age. Many teens use drugs and alcohol as a way of dealing with stress – and the transition from middle school to high school is indeed one of the risk factors for underage drinking.

Although not all teens drink, the percentage who has tried alcohol increases with every year after age12, when it is around 10%. By age 15, 50% of teens have tried alcohol at least once. Most underage drinking happensThis type of information can provide a starting point for a conversation with a teenager. In fact, the SAMHSA’s Too Smart To Start website also provides a wealth of other information on the effects of underage alcohol use as well as tips for parents on how to talk to their teens.

Here is my Readers’ Digest version of how not to sound like a “fuddy duddy” (I love that term!), when you talk to your kids about drugs and alcohol use:

1. Start with a caring approach – expressing you are aware that their life is changing. Ask questions about stressors, and really try to listen to the teen’s point of view rather than minimizing or judging what might be stressful to them
2. Then state what you have observed, and your concerns for your teenager’s well being.
3. Emphasize that you are no stranger to the idea that teens drink and use drugs
4. You may use you knowledge of the facts about underage drinking to challenge any defensiveness you encounter
5. Do not give suggestions or try to “fix” the problem, unless asked, but do let the teenager know the household rules about underage use of alcohol and drugs.
6. Related to # 5, consider the rules you want to have in place prior to having a conversation with your teen. Do make sure you have clear, fair, and enforceable consequences for breaking any of the rules you make.

As far as snooping goes, whether directly searching your child’s room or checking his cell phone or email, opinions vary about the appropriateness of this approach. Spying on your 15-year old may be unnecessary if you communicate your concerns and your son responds in a positive manner. In my opinion, breaching your child’s privacy should be used only as a last resort. However, let’s be clear that safety comes before privacy, and privacy is a privilege. If your child does not respond in kind to your attempts to communicate with care, honesty, and openness, by all means, do what you need to do to keep him safe, even if that means checking-up on him. In fact, let him know up front that you will be doing this, and refuse to be manipulated by statements like, “but that’s my phone, you have no right to look at it,” or “if you look in my room, you’ll just force me to hide stuff elsewhere.” That may be true, but you can only do what you can do, and certainly you must do what you can do. On that note, please be aware that teenagers are most likely to obtain alcohol from within their own homes. So, be sure you are not inadvertently providing access to the very substance that you are trying to restrict you child from using. 

If you discover that your fears are unfounded (and I certainly hope this is the case), remember that prevention is better than remediation. I encourage you to face the facts about underage drinking and make sure you are discussing this important topic in a straightforward way. April is Alcohol Awareness Month. This could be the perfect opportunity to talk to your teenager about the dangers of underage substance use.

Disclaimer: My responses in this column are for educational purposes only and do not imply a professional relationship. Any contact you have with me through this column does not constitute a client-therapist relationship. It is not possible for me to know your personal situation from the question/s you ask, and therefore the information provided by me should not be considered psychotherapy. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding any mental health symptom or medical condition. Never disregard professional psychological or medical advice or delay in seeking it because of something you have read in Q&A with Dr. Nagpal. Neither myself nor Still Waters Counseling, LLC, or any other entity involved in the creation, support, maintenance, or provision of this column will be liable for any incidental, consequential, or punitive damages arising out of your access to, or use of, this column.

What “Should” Moms do on Mother’s Day?

Sleep in

Have breakfast in bed

Go back to sleep

Wake up around noon, to the sounds of laundry being done and dinner being made

Hang out

Have leftovers for lunch

Take a nap

Wake up and go for a nice long walk

Read

Read some more while you wait for dinner

Eat dinner

Watch your favorite T.V. shows

Go to bed and sleep for 9 hours

This is what all mothers SHOULD do on Mother’s Day, right? Or something like it.

Here’s what Dr. Seuss might say about mothers. Moms come in all shapes and sizes. Working moms, career moms, and stay-at-home moms. Wanna-be moms, moms with lots of kids, moms who have lost a kid, moms raising kids with special needs. Step-moms and foster-moms. Gay moms and single moms. Or something like it.

Considering there are all types of mothers in all types of situations, what “should” mothers really do on Mother’s Day? Clearly, a one size fits all recipe isn’t going to work. Or is it? Hmm.. I do wonder what the world would look like if ALL moms all over the world stopped doing what moms do, just for one day! Can you picture the headlines the next day? Kids with Dirty Diapers Wander Streets, Teachers Upset as Kids Show up Without Homework, Hungry Children Look for Food but Restaurants Closed, Wall Street Collapses as No One Can Make a Decision (tongue in cheek). Truly, this is in no way meant to diminish what fathers contribute to families and society, but I do have a hard time imagining what the world would look like if mothers stopped doing everything they do for one entire day!

The question really is, should moms stop doing what they do for an entire day? I think not. Moms need to do what moms need to do, whether it’s on Mother’s Day or any other day. No, the world would not come to an end, but do we really need to feel like we “should” be having the perfect day, even if that isn’t what we need or want to be doing? And how many moms feel badly because that perfect day isn’t really happening for them? And, isn’t that missing the point? Should moms be appreciated and made to feel special on Mother’s Day for what they do – yes, absolutely! And on every other day as well!

So, what do mothers REALLY do on Mother’s Day? Well, it depends. But here’s one scenario:

Wake up to crying baby (or screaming kids)

Feed baby (or kids)

Try to get some more sleep

Get up and eat Something.

Get all those things done that didn’t get done during the week, if you don’t want to have to do those things during the week when you will already have more than enough to do

Juggle these tasks with getting kids to Activities – (yes, they have those even on Mother’s Day)

Eat dinner (somehow)

Read Mother’s Day cards (hopefully a few)

Go to bed exhausted, but happy to have been appreciated, and happy to be a mom

Happy Mother’s Day. Hope you had a good one!

Q&A: Internet-Induced Trauma after Boston Bombings?

Q&A: Internet Induced Truama after Boston Bombings?

 Hello Dr. Nagpal,
Last week, after the Boston Marathon bombings, I became complete engrossed
with the “who done it” aspect of the story. I followed along on Reddit.com’s “FindBostonBombers” forum, where users posted picture after picture of the scene, looking for people who came with backpacks and left without. Many pictures were post explosion, and showed the gruesome carnage. I listened to the Boston police scanner during the shootout and manhunt, while following updates on Twitter and elsewhere on the internet. This week, I feel like I’m in a fog. I don’t know why, but I feel certain it’s related to immersing myself into the tragedy in Boston. Recently, I was in a crowd, and for a brief second, I visualized the crowd as if I was studying the picture on the Internet. That’s when I knew I’d overdone it. So I have two questions: 1) What drives me (and others) to devote the better part of a week to trying to live inside a tragedy? And, 2) Can consumption of information over the Internet cause a mild form of PTSD?

 

Dear Well-Intentioned but Foggy:

Thank you for sharing your story with us. You are right. Engaging in the type of obsessive behavior that you did, following the Boston Marathon bombings, is the likely reason for your “fog,” and most certainly the reason you found yourself scanning an unrelated crowd. Many are driven to these types of behaviors after a senseless tragedy, typically out of a desire to do something to help. In this instance, there was a specific request by law enforcement to have the general public assist in finding the “Boston Bombers.” You fell prey to the urge to find these people who caused so much harm, and find them fast! The mix of grief and anger that followed this tragedy, the desire for justice to be done, and in this case, the possibility of being able to contribute something to make this happen, are likely what drove you (and countless others) to “live inside” this tragedy for “the better part of a week.”

However, as your hours and days in front of the screen might testify, not many of us have the same talent at breaking code as mathematician, John Nash, in A Beautiful Mind. John Nash did, indeed, “lose his mind” in his quest to find the “hidden clues” in newspapers and magazines. The fact that John Nash had a mental illness to begin with, is a different matter.

The truth is that many of us will develop signs of Post Traumatic Stress disorder, or PTSD, when focusing on images of a tragedy. It seems like Reddit.com’s forum not only showed pictures of people during the race, but as you said, also of the “gruesome carnage” afterwards. I am afraid that you did, in actuality, start suffering from a form of PTSD that can affect those not directly impacted by the tragedy, but who are viewing images of the experience. The most common recommendation to recover from this is to stop or reduce exposure to media images of the event.

Fear can also be a common response to unexpected violence and another reason why we might continue to watch internet or television stories long after the event is past. Somehow, if we know more, or so we reason, we can prevent this from happening. Not true, but it sure is a common response when an event like the Marathon Bombing leaves us with a sense of vulnerability, a possibility that “it could have been me,” or that a loved one might have been hurt. I can tell you this was true for me, with my son being about 3 miles away from the bombings, and in residence at a University through which the bombers later led the police in a chase. Although, fortunately, he took great care to keep me informed of his safety, I did notice myself following the various news stories and being at a greater than normal “alert” level, until after the second bomber was safely in custody.

I know that some of you might have had loved ones who were even closer, or you yourself were present at the Boston Marathon. The closer you were, the greater the likelihood of trauma. However, sometimes an event such as this one can simply serve as a trigger for a past traumatic memory. I can only imagine what some of the victims and families of past bomb attacks are going through. Whatever the reason for our trauma response being triggered, it is important that we recognize when we are being affected. Here are some additional recommendations for dealing with any post-traumatic responses we might be experiencing:

1. Try to continue with normal routines. There is something quite grounding about routines.
2. Try to get enough sleep. Lack of sleep can be disorienting in itself.
3. Talk to someone you trust about your feelings. Then try to reduce the “head time” you are giving to the event. In other words, try to move to another topic or distract yourself if you find yourself thinking about the event.
4. Stay connected to loved ones and friends. Isolation can increase the sense of trauma and close off avenues for healing.

Again, thanks for writing in with this question. There will no doubt be more photos and stories about the Boston Marathon bombings in the weeks to come. I hope that realizing what you did about your own reactions, you have been able to re-direct you attention away from the media, or at least stay away from the media stories that continue to aggressively portray images of the Boston attacks. 

Home for the Holidays...and Beyond

   It’s been nice having our 18-year old back home for the holidays. I am also acutely aware that the pain of parting is in my near future. Christmas is traditionally the time in the United States when many young adults travel home for the holidays -- whether it be from college or from the place their job has taken them --and then a few days or a few weeks later, they leave again. That my 18-year old will be heading back soon, is a fact. 

     I can either focus on this fact or, to take a tip from the mindfulness class that I, myself, have been teaching, and focus on the present. Conversations around the dinner table, discussions in the car driving to family events, and late night movies and talks are all becoming part of our “home for the holidays” family rituals, with a young man who (fortunately) likes to talk and share. It is nice to also feel his comfort at being home, which isn’t always the case for young adults who experience the push-pull of independence vs. dependence. Stress free times are also hard to come by. I find myself enjoying the time with my young adult child, even as I hear the, now faint, tick-tock of the clock in the background.

     Yes, young adult child. You heard right. Young adults are still our children. Research has now verified what many parents have known all along - that the human brain doesn’t really develop fully until the age of 25, and sometimes not until 30. What is also a fact today is that many young adults are staying home longer. And, contrary to popular belief, this is not a bad thing.

     Karen Fingerman, a professor at the Universityof Texas, Austin, states that she was actively skeptical of the trend of more help flowing from parents to grown children in this generation. Does it really help? Or does it just encourage kids to remain kids for longer? This is what Fingerman found, “The fragile economy could exacerbate the phenomenon of delayed adolescence, keeping Americans in their late 20s and even early 30s dependent on their families for years.” However, despite her own initial bias, Fingerman’s research showed that young adults who receive support from their parents have a higher life satisfaction and report clearer goals.

     Another good read is Setterson and Ray's book, Not Quite Adults, on this same topic. Their message is clear also. That the new generation is staying dependent longer, but this is a good thing. Pew research shows that the generation gap the Woodstock era folks felt with their parents, appears to be a thing of the past, and may in fact, have been an anomaly in some ways.

     A recent AARP survey shows that parents and kids talk more often, get more “face time,” and even live together more often than the boomer generation. But the survey also showed that a significant number of parents (37%) feel negatively about this new trend. I wonder why? Widespread stereotypes that the young generation is selfish and apolitical, and just like to mooch off their parents, may be responsible.

     The good news really is that parents can stop worrying if their young adult child still depends on them for emotional, financial, or day-to-day support. Its not an abnormal thing and its good for both generations. Frankly, it all rings true from personal experience. While many of us wish our adult children to act as independent as possible, as early as possible, a lasting parent-child bond and ongoing parental support cannot be replaced and should not be underestimated.

     My adult child is home for the holidays,…and beyond… 3 more joyous weeks! Woo hoo for institutions that have long winter breaks! In the spirit of “how to eat a raisin” (Jon Kabat-Zinn), I intend to mindfully savor this favorable fact and reflect on this quote:

"There are two lasting bequests we can give our children: One is roots, the other is wings.”

Is There a Santa Claus?

        “Yes, Virginia, there is a Santa Claus,” goes the famous line in the Sun editorial of 1897, written by Francis P. Church, who goes on to give an answer that is brilliant in its simplicity. And all in a days work, the story goes.

       Now I wish that I could say I received a question in the year 2012 from an 8-year old asking, “Is there really a Santa Claus?” But I would be lying. First, I haven't been writing blogs long enough to get those kinds of questions. Second, in 2012 the question would likely be Googled, not asked to a writer. So, the issue becomes a bit more complex and challenging. I’m going to tackle it by first asking a couple of questions. 

       Questions like, what is Virginia’s question really asking? What prompted Virginia’s letter to the Sun? One rendition goes something like this. It was Virginia’s birthday and she had received some gifts. Instead of enjoying her presents, she panicked, wondering if she was going to get any more gifts for Christmas. Some of her classmates were telling her that Santa Claus was a myth, which to an 8 year old could mean –“what, no presents?” So, Virginia decided to ask her father, who deferred the question to the Sun, saying, “If you see it in the Sun, its so.” Not a great parenting strategy, in my opinion, but it satisfied Virginia for the moment.  

        So, was Virginia really curious about whether or not Santa existed? Did she just want to know whether she was going to get cool stuff for Christmas? Or was she asking if there’s a magical way in which all of our wishes can get fulfilled? In the realm of magical wish fulfillment, I can see a couple of child psychologists calling the Sun’s answer, “dangerous stuff for young minds.” Would this create the idea that wishes can be fulfilled in magical ways by mystical creatures that travel in the middle of the night via uncanny means approaching the speed of light? You can see where a psychologist might not support the Sun’s response, and answer instead, “ No Virginia, there is no Santa Claus. Its just a story made up by your parents to make you behave. And parents, if you need to make up a story to discipline your kids, perhaps you should enroll in some parenting classes instead.” End of story, and Virginia’s innocence lands on the floor next to the Christmas tree with a resounding crash.

        Now, perhaps it is true that in the world of iPhones and Google, no child can really be as innocent as Virginia, and certainly no child is likely to be traumatized by finding out that Santa doesn’t really exist – at least not in the flesh and blood kind of way. So, is the question even relevant today? My answer to that is, yes, a thousand times, yes. As we find ourselves grappling with the dark side of human nature in the wake of the Sandy Hook tragedy, adults and children alike want to know the answer to Virginia’s real question – is there a reason to believe in the giving spirit, in the spirit of love and generosity? As we struggle with the reality that many children in our communities still live in poverty, and many parents continue to be unemployed or underemployed, yes, the question is more relevant than ever before.

        So, is there a Santa Claus? Or perhaps a better question for today would be, “who is the Santa Claus?” If Robbie Parker, the father of a Sandy Hook victim, with love and generosity in his heart, can challenge us to be compassionate toward all the suffering families, including the family of Adam Lanza, then is he the Santa Claus? Is Mr. Macy the Santa Claus for donating a million dollars in response to Santa mail from a million children? Is Jack Fagin, a Rotarian from Saline, who matches donations every year from other Rotarians to have children enjoy a Christmas shopping trip at Meijer, the Santa Claus? Is Mr. Meijer, who donated a $1000 toward the Fagin challenge this year, a Santa Claus? Are the Saline Area firefighters, paramedics, and friends who have over 800 toys ready for delivery to local families, the Santa Claus?

 

        Folks, I’ll leave it for you to decide. As for me, the correct answer is (e), all of the above. As long as there are Jack Fagin’s and Saline firefighters, and Mr. Meijer’s, and Mr. Macy’s out there, I can answer truthfully, as did the editor of the Sun, over a hundred years ago, “Yes, Virginia, there is a Santa Claus. He exists as certainly as love and generosity and devotion exist, and you know that they abound and give to your life its highest beauty and joy.”

How to Help after a School Shooting

There are no words to quite describe the tragedy that took place at Sandy Hook Elementary in Newtown, Connecticut today. A tragedy that brought the president of the United States to tears, and to state, “our hearts are broken today.”

In the aftermath of the shooting we must handle our own reactions, which can range from sadness, to anger, to shock, to worry for our own children. It is also our task to help our kids process their reactions. Not all kids will show their reactions outwardly. It is important to ask what they have heard and how they feel.

The American School Counselor Association provides some simple guidelines for helping kids during crisis, http://www.schoolcounselor.org/content.asp?contentid=672, some of which I list below:

·        Try and keep routines as normal as possible. Kids gain security from the predictability of routine, including attending school.

·        Limit exposure to television and the news.

·        Listen to kids’ fears and concerns.


·        Reassure kids that the world is a good place to be, but that there are people who do bad things.


·        Assess your own response to the crisis

The last point is very important. Be aware of how you talk about the event and cope with the tragedy. Children learn how to react to the situation by watching your responses. Limit exposure to television images and news coverage. The graphic images and repetitive scenes can be disturbing for children.

Do talk honestly about the incident, without graphic detail, and share some of your own feelings about it. This can help your child open up as well. Listen to how they feel, and try to answer the questions they might have. For children who are too young to talk or don’t feel comfortable expressing their feelings through words, don’t be afraid to use expressive techniques such as play, art, or music.

When children do express their feelings or ask questions, acknowledge the frightening parts of the event. Be honest. It is okay to say you don’t know the answer to a question. Reassure them they are loved and will be cared for. If they remain concerned, encourage them to share their concerns about school safety with school personnel also.

If your child becomes preoccupied with the event, has sleep or eating disturbances, starts having nightmares or intrusive thoughts or worries, becomes focused on death or dying, or is having difficulty going to school, please take advantage of your community resources for mental health support. This support can be sought through the school counselor, your family physician, pediatrician, or a trusted mental health professional in the community.

The Pursuit of Having-ness

           …’tis the season. The season of Christmas, of Santa’s elves and reindeer bells, of carolers singing Silent Night and Christmas trees with colorful lights, of beautiful gingerbread houses and winning prizes. This is the season when the Christmas story is told over and over, reminding us of the simple way in which the Christ child came into this world. In other households, the story of Hanukkah reminds people of the miracle of the oil witnessed by the Maccabees.

           

And yet, it is also the season of Black Friday, Early Bird specials, and early, Early Bird specials. It is, what I call, the season of having-ness. I must admit to indulging in some of these guilty pleasures. Of shopping the Midnight Madness sales and gleefully finding treasures. Of sipping hot chocolate at Starbucks after a long night of downtown shopping. I am not alone, I find. According to some financial pundits, holiday spending is projected to return to pre-recession levels. The average shopper plans to spend $854 on presents this year, approaching the $859 that the average shopper planned to spend in 2007. Spending money, however, is not the only way we display our pursuit of having-ness.

            There are many other subtle, but pervasive, forms of having-ness. Are we having the best party in the neighborhood? Do we have the best cookies at the cookie-swap? Have we found the best present of the year for our children or grandchildren? Speaking of the “best” gifts, have you heard of the “Elf on the Shelf?” This toy, as I understand, is not only a “must have,” but now we have opened ourselves up to another level of having-ness. Because, you see folks, the elf does not just sit on the shelf. It moves around the house, doing naughty things, and this, of course, means having the greatest ideas on what those naughty gimmicks are going to be. And I’m not talking easy here folks. Some of these involve the elf having a marshmallow fight, or a feather pillow fight, or baking cookies and leaving a mess -- for mommies and daddies to clean up, of course. You get the idea…

            So, why is it that despite much evidence that having more does not contribute to being happier or more satisfied, we continue this pursuit of having-ness, season after season? Is this now the tradition? Or is it easier than figuring out what will actually make us happy? I can tell you, as someone who devours literature on happiness, it is indeed not straightforward to figure out what might actually make us happy. I mean, we have complex equations out there like H = S+C+V (from Jonathan Haidt, the Happiness Hypothesis), and then we have some simple (or is it simplistic) rules like “just act happy, it will make you happy,” (David Myers, Psychology Today). There’s even some research out there suggesting that pursuing happiness actually makes it harder to achieve happiness. Happiness seems to be more of a byproduct of doing certain things, perhaps engaging in certain pursuits. Generally, these seem to fall along the lines of exploring personally meaningful goals, engaging in social activity, and volunteering for worthy causes.

     

            Hmm.. maybe there is something worth pursuing after all this holiday season. Maybe there’s a way to get the best of both worlds, having-ness and happiness. The formula would seem something like this, SL(Shopping Less) = HMMTWLO(Having More Meaningful Time with Loved Ones). I will confess, in trying to honor multiple family traditions, not to mention keeping up with the deals and the delicacies out there, its hard to stay true to myself and the meaning of the season. But, its time to make a choice folks, and  I don’t know about you, but this year I might just pass on the deals and have a more relaxed holiday season. Pass the pie please, I’m having more…