Parenting Lessons From My Dog

On Saturday, my family came home from a soccer game to an unexpected addition. The dog we adopted 6 weeks ago, the one the Humane Society and 2 vets assured us was spayed, had given birth to a puppy while we were away. We found mother and pup holed up in a “nest” area she had made with shreds of newspaper inside an over turned garbage can. She had licked the pup clean and was lying on her side nursing him. It immediately struck me how my dog had instinctually known what to do. Not only does she know when to nurse him now, she’ll know when it’s time to wean him. And when he’s old enough, she will no longer see it as her charge to protect him. When he appears ready, she will begin to regard him as an independent dog, just another member of her pack, sooner than we can imagine.

I spend much of my professional time with the parents of teens and young adults, often advising them on how and when to let their kids go. For humans, it seems the process of nurturing and releasing children is far less instinctual than for my dog and her pup.

Humans have books and mentors. We have the Internet, parenting magazines, and mommy groups. In infancy, we seek guidance on how often to feed them, managing their sleep, and all the ways to ensure babies stay safe. As kids become more independent, parents ask how to get kids to follow rules and how to discipline them when they don’t. But we don’t talk much about (and our instincts seem unable to guide us through) how and when to begin to let our kids go a little.

Maybe the instinct for when it’s time to let go lies more with pups than with parents. Teens and twenty-somethings tell me often that they feel frustrated and resentful of their parents’ ways of relating to them. When kids are young, they say we talk at them. We try to fill their empty buckets with our ideas and rules. We “put” our ideas upon them, sometimes with force. But when they get older, when they become teens, something begins to change. Teenagers start feeling like they have their own minds. They have ideas of their own. They have preferences, likes, dislikes. They begin to know who they are inside.

When that happens, and thereafter, they don’t I like it when adults “put” and impose and force ideas at them. After they feel a sense that they “inhabit” their own minds, they want us to listen. They want us to really listen. They want respect. They want us to know and understand who they are as people, and what they need and want and desire, but they want us to know because we are asking and looking and listening to the answers rather than because we are using past knowledge or intuition. Even though we have known them their entire lives, they begin to change in adolescence, or at least they want the opportunity to explore different identities. And in order to let them explore, we must not assume we know everything about them.

And when we don’t listen? Our teens and twenty-somethings begin to withdraw from us. They get angry, resentful, and frustrated. We become triggers for them to feel sad, withdrawn, or aggressive. They just don’t like us very much anymore.

Maybe we should take notice when the instinct of our teenagers and twenty-somethings tells them it’s time to let go. And then we should become better listeners, first by erasing what we thought we knew. Starting over. Interviewing them. Being truly curious. Rather than thinking we know anything inside their minds, we need to explore what’s there with real openness and let them reveal it to us just as they reveal it to themselves. Maybe they will uncover the person we thought we knew from birth to that point. Or maybe they will unearth someone far more wondrous than we ever could have dreamt. And maybe that’s why they only make this change when they grow older, when they can begin to dream their own dream. Before that, we dreamt for them and what they could become as limited by our adult imaginations. Now it’s their turn. Let’s see what they have to offer. Don’t let your expectations get in the way. Open your minds and be curious. And let go!

 

Dr. Deuter is a psychiatrist who specializes in the care of emerging adults.

Posted on September 29, 2014 .

Beat Family Burnout

 

Burnout is all over the news media these days, and it’s bad for your family’s health. American’s work long hours, rush around and juggle hectic schedules, and push ourselves, even our kids, to the limits of our capacities. The result? Too many of us are experiencing burnout. Medical sites around the web have added “burnout” to their list of problems you should guard against. The Mayo Clinic (http://www.mayoclinic.org/) cautions that becoming burnt out can lead not only to depression and anxiety, but also leads to insomnia, alcohol abuse, diabetes, or even stroke.

Sure, we all need to slow the pace, but sometimes the frenetic lifestyle is beyond our control. We can’t all change our work or extracurricular schedules when we need to relax. What can you do to protect yourself and your family?

Steps to protect against family burnout:

Ask for a hug
    Numerous studies have shown that close physical contact is good for your health. Hugs are a great way to be close- for you, your kids, your spouse or partner, or your friends. Hugs are almost always well-received, and they benefit the giver and the receiver as a tool for lowering stress. Not sure when it’s appropriate to offer a hug? Just ask.

Get moving
    Sitting on the sofa, staring at television, zoning out may feel like a temporary escape, but too much sedentary time isn’t good for stress management. During downtime, families can improve the health of every member, from toddler to grandparent, by getting up and going out to play. Toss a ball around on the lawn, go explore at the park, or host a rocking dance party in your living room on a rainy Sunday afternoon, but get the family moving. In addition to the fun you’ll have today, you’ll reap long term health benefits as well.

Catch some rays
    Sun exposure is no longer the enemy it was once thought to be. In small amounts, sunlight has a number of health benefits. A little sunlight raises vitamin D levels, which is good for your mood and for your general health. And sun exposure via the eyes or “phototherapy” is a well known treatment for depression and seasonal affective disorder (related to that dip in mood in the fall and winter). So if it has been a hard week and you need to relax, spending time outside can do wonders.

Count your blessings
    Gratitude is good for you. We have all heard that being grateful is good for us. And it’s true. Counting your blessings can boost your mood quickly and remind you how fortunate you are. Rather than sitting at your desk feeling victimized by all your work (or homework), try tallying up all the things that make you feel fortunate today. Teach even young kids how to use gratitude to refresh their moods. Your whole family will feel better. And you’ll have that to be grateful for, too.

Get a few extra Z’s 
    When life gets hectic, it becomes tempting to shave a little time off your sleep. We tell ourselves that that extra half hour returning emails or working on a school project is going to lower our stress, but it never quite turns out to be true. Chronic sleep loss is associated with poor health, contributing to accidents, obesity, mental health disorders, and heart attacks (and many more health problems). So do yourself a favor and stick to your bedtime. Most adults need around 8 hours per night, and kids, even teens, usually need 9 or more. If the hectic pace interferes with sleep during the week, make sure to sleep in on the weekends or catch an afternoon nap. Your family will feel better with a little more rest.

Expand your circle of support
    Human beings are social creatures and being social is good for our health and well being, but when we’re too busy, we really don’t have time to give or receive support from the people in our lives. Sure, we see people- at work, at soccer games and swim practice. We see the piano teacher and the colleagues we pass in the hall at the office. But to stay healthy, we need to take time to connect. If you’re family is feeling burnt out, maybe it’s time to host a cookout or invite the neighbors to hang out and watch the game. Take a little time to expand your circle beyond the nuclear family. It will be worth the extra effort to kick back and relax with friends.

Strive to meet a new goal
    One of the bet ways to re-invigorate yourselves is to take on a new challenge. Maybe you’re tired of the day-to-day responsibilities, but you could get excited about beginning something new. Maybe the family needs to take an art class, or learn a language, or design a birthday project for grandma. Whatever the challenge, striving to meet a new goal can energize the whole family.

 

Dr. Deuter is a psychiatrist who specializes in the care of emerging adults.

 

Posted on September 22, 2014 .

Youth In Recovery, Maybe You Can't Go Home Again

Returning home can be a trigger for an addict. Visiting childhood homes can leave even the healthiest of adults vulnerable to regress into adolescent emotions and behaviors. Familiar cues induce emotional memories, and we all return to the past to one degree or another.

When Jacob went off to a treatment center for opiate addiction & depression, he was sixteen. He expected to stay away 30-90 days and then return to his hometown, his high school friends, and his bedroom at his parents’ house. But his counselors at the treatment center recommended an aftercare program. Experience had shown them that 30 days was often not enough to ensure long term recovery. In total, he spent 18 months away from home. And then his father unexpectedly lost his job, cutting off the funding source for the program. Jacob left care abruptly and returned home. By then he was approaching his eighteenth birthday.

A recent article in the British Journal of Social Psychology entitled Breaking Good: Breaking ties with social groups may be good for recovery from substance misuse asserts that changing one’s social identity and social ties may be the best course of action for sustainable addiction recovery. So perhaps it should be no surprise that Jacob returned home, and in spite of his year and a half of abstinence, he relapsed within the first month. He had re-entered a system where he knew how to get prescription drugs with a simple phone call to an old friend.

Unfortunately, Jacob’s story is not unique. The return home after addiction treatment is an especially vulnerable time at any age, perhaps more so for teens and young adults who are driven to pursue social relationships and may not have formed solid self-identities or goals for the future. Treatment centers make recommendations upon discharge like, “Find Sober Friends” and “Move if Necessary.”

For young addicts and individuals who suffer from mental illnesses, going home can be an emotional trigger, a return to an old social identity, or can provide ready access to unhealthy resources like addictive drugs. Perhaps the recommendation from professionals should be that after recovery, you just can’t go home again.

 

Dr. Deuter is a psychiatrist who specializes in the care of emerging adults.

Posted on September 15, 2014 .

Catch or Release: Gatekeeping in Mental Health

Last week a long time patient asked me about my blog. He had been reading it, but wondered why I focused on writing about teens and young adults. Why not write about some of the issues we were working on for him: relationships, divorce, or PTSD? After all, he said, he is no longer a young adult (he’s 35) and I still treat him. Why not write about midlife?

I considered his question for a long time. Why focus primarily on teens and young adults?

The care of young people, often new to the mental health system, presents special issues. The decisions mental health professionals make regarding these young people have big consequences. On the one hand, if the system can help a kid after he tries heroin the first time, and not wait until his third ICU stay from overdose; or likewise treat a college student with depression when it begins, and not wait ten years until hopelessness has robbed her of the ability to function and left her perpetually wishing for death, offering early treatment can save lives.

Yet it’s not just prevention that makes the care of young people distinctive. Screening folks in or out of care is unique to newcomers into the system. Young people come into mental health care, brought by families, and decisions we make will determine whether they stay in care or move on to have lives free of mental health contact. Young patients may have transient problems or the beginnings of lifelong illnesses. Our assessments and diagnoses, the education we provide families, and the expectations we set as clinicians can influence long-term outcomes profoundly.

Many young people come in to the system due to worried parents and stage of life bumps in the road, and their care must be approached differently. Unfortunately, many professionals are using a cookie cutter approach to all patients who enter the mental health care system. Teens and twenty-somethings are given too much medication, given serious and scary diagnoses and prognoses, and when the treatment is excessive, the patients deteriorate rather than recover. Mental health care involvement for healthy young people is essentially making things worse.

Early detection and early treatment can drastically improve outcomes for those with real illness, but early treatment can worsen outcomes for the bumpy stage of life group. Mental health practitioners and advocates need to re-think an overly inclusive model of mental health care. We need to protect healthy young people from excessive care, and make room in the strapped mental health care system for the people who truly need the vital but limited resources. We need to allocate the resources to the right place.

 

Dr. Deuter is a psychiatrist who specializes in the care of emerging adults.

 

 

Posted on September 8, 2014 .