Seasonal Affective Disorder: Light Therapy

Seasonal Affective Disorder: Light Therapy

Let’s talk about winter. Hot chocolate, sledding, and crackling fires can make us feel all warm and cozy, but having fewer and fewer daylight hours takes its toll. As Daylight Saving Time ends in early November, and our days become even shorter and darker, it is important to have tools in place to combat the downside of the season.

One such tool is called Light Therapy. Light therapy consists of indirect exposure to bright UV-free light. It is primarily used for the treatment of the winter blues and sleep problems. Clinically speaking, there is a type of depression known as Seasonal Affective Disorder (also called S.A.D. or Seasonal Depression; learn more here). The dramatic reduction in sunlight during Minnesota winter months causes our hormones, brain chemicals, and daily rhythms to get out of whack. All of those changes can lead to sleepiness, fatigue, and sad moods, which are symptoms of Seasonal Affective Disorder.Light therapy, cozy by the fire

Spending time with a specially-designed light box can help reverse these symptoms by tricking our brains and bodies into thinking we are getting the sunlight we need. Research consistently shows that regular use improves energy and mood. https://www.mayoclinic.org/tests-procedures/light-therapy/about/pac-20384604

Light therapy boxes with 10,000 LUX, the optimal amount of cool blue light that looks and feels like the blue sky on a summer’s day, can trigger biochemical changes in your brain. The right amount of full-spectrum light helps regulate melatonin and boost serotonin, giving you a better chance at restful sleep and a happy (or happier!) mood all winter long.

Light therapy is most effective when used for 30 minute periods several days or every day of the week. When using the light box, sit 20-30 inches away from it, and go about your business–read, study, work at your computer, or eat dinner. The light is meant to enter your eyes indirectly. Just like the Sun, never look directly at the light!

Always follow the manufacturer’s directions for your specific light. Although side effects are rare, they can occur, so make sure to pay attention to how you feel when using your light.

Has light therapy been helpful for you? If not, what has helped during these long winter months?

Blog written by Sentier therapist, Sarah Souder Johnson.

Preventing Social Isolation to Protect our Mental Health

We are living in an uncertain time. Today’s children will tell their grandchildren about the COVID-19 pandemic of 2020 and how everything stood still for a period of time: schools and libraries closed, store shelves emptied, and almost everyone stayed home. The purpose of this “social distancing” was to protect one another and stop the spread of disease. 

That’s where we are today, and putting space between us will work to flatten the curve if we all do it. With that said, there are some real downsides of staying apart even for relatively healthy people with safe homes, Internet access, and plenty of food.* Interpersonal connection is a key component to human wellbeing, and social isolation is a risk to mental health. At a time when it is absolutely necessary to socially distance, many more people than usual will experience the rippling effects of loneliness.

Depressed Teen Impacts School Performance

The good news is that there are ways to decrease the effects of social isolation. Here are some strategies for staying well while figuring out this (temporary) new normal. 

  1. Ramp up your virtual communication with friends, family members, and co-workers. This is especially effective if you can see one another, so try using apps like Skype, Facetime, and Zoom for video calls and conferencing whenever possible. We are also seeing an increase in individual and group therapy sessions taking place online so that people can start or maintain mental health care. Here is a listing of virtual recovery meetings, for example: Online AA Meetings During COVID-19
  2. Get outside. Interacting with others even from quite a distance is beneficial to our wellbeing. Waving to people across the street or when biking past them gives our brains the feeling that we are interacting and boosts mood. Try some Spring yard cleanup, pulling the bikes out of storage, or even some apartment building sing-a-longs like we have seen from our friends in Italy.
  3. Create a schedule and shared objectives. It may go without saying that people do better with routines, but did you know that working toward common goals with others is also a protective factor for health? Work on a puzzle with your roommate. Play board games or trivia in teams via Google Hangouts. Create a solo workout plan that a friend will also follow and then check in on your mutual progress each day. Plan, start, and finish a project around the house. (Give an air high-five when you check it off your list!)

Most importantly, remember that this situation is new, and we are all just figuring it out as we go. Taking daily actions to stay connected will protect our individual and collective mental health. And then, perhaps, the ways we pulled together – from a distance – to prevent social isolation will also be part of the pandemic story for future generations. 

What are you going to do to take care of yourself during this hard time? 

Blog written by Sarah Souder Johnson, MEd, LPCC, therapist at Sentier Psychotherapy

*For local readers in the Twin Cities, here are some helpful links to food and safety resources:

Free meals for kids at local restaurants

Child care services division of Department of Human Services; hotline: 651-297-1304

Expanded hotspot capabilities for internet access

Mindfulness During COVID-19 Pandemic

How to Stay Grounded During this Stressful Time

In the United States, we are in the midst of a nationwide response to the COVID-19 pandemic. Though necessary, being apart from others comes with a significant risk to mental health. Many people are also experiencing increased health anxiety in general. Others have new or continuing financial insecurity or even loss of jobs. Not leaving the house removes the ability to escape from problems at home when home isn’t a safe place. And the necessary “social distancing” we all have to do promotes withdrawal and the loneliness that can follow. (Read our other blog post about social connection.)

It is normal to feel out of sync with yourself at this time. Thankfully, there are some relatively simple ways to connect with yourself and start to feel better. One way to do so is through a practice called mindfulness. 

Mindfulness is the state of being aware. A leader in the field named Jon Kabat-Zinn says that mindfulness is awareness of the present moment without judgment. It is when we purposely pay attention to what is happening in the here and now without a determination that anything is right or wrong. It helps us respond wisely to things that are happening to us instead of just reacting blindly. Since a lot of things are currently happening to us that are not within our control, we can all benefit from starting – or increasing – our mindfulness practice. 

We wanted to share a few resources we often use in therapy and suggest for our clients at home: 

Here is a basic video describing mindfulness:

Why Mindfulness is a Superpower

Here is a brief video about mindfulness and meditation:

Headspace Meditation Tips

Your breath is one of the most important tools for achieving a calm state. Try this simple Breathing Box technique:

  • Inhale for 4 counts
  • Hold for 4 counts
  • Exhale for 4 counts
  • Hold for 4 counts
  • Repeat

Yoga is a spiritual practice that promotes mindfulness and connection between the brain and body. Here are a few video sites we use:

Cosmic Kids Yoga

Yoga with Adrienne

Yoga Ed.

Dr. Dan Siegel is a leader in the field of neuroscience and the brain-body connection. His website is full of wonderful resources including Everyday Mindsight guided meditations.

Apps we like:

Headspace
Calm
Mindfulness Daily
Welzen – How Are You?
#Mindful
Insight Timer
Reflectly 

Some books we like:

The Gift of Awareness: Mindfulness Guide for Women (it applies to everyone!)
By Caroline Welch

Mindsight: The New Science of Personal Transformation
By Dan Siegel

I Am Peace
By Susan Verde

This one is great for children! Here it is read aloud by the author: https://www.youtube.com/watch?v=hXA3837uv3w

We hope you will build some mindfulness into each day as we face uncertain times ahead. A person’s body and mind are interconnected; you actually strengthen your immune systems when you use mindfulness, so it’s a win-win! What will you do to help yourself today?

Blog written by Sentier Psychotherapy therapist, Sarah Souder Johnson, MEd, LPCC

Home (from college) for the Holidays

Home (from College) for the Holidays

Winter break is around the corner. You imagine having time to unwind, sleep in, and decompress after final exams. You want to reconnect with high school friends and maybe just hang out with the family pet. Maybe you’ll work at your old job a bit to make some extra spending money for next semester or stop by your old high school to say hello. It all sounds pretty dreamy, but being back at home can be more challenging than many anticipate, especially for first-year college students.

Although many students welcome the thought of spending some quality time with their family, parents can have a much different idea of how much time together constitutes a sufficient amount to be “quality.” The long and short of it is that they might expect things to go back to how they used to be before you moved out. This can be very frustrating for a college student who is in the throes of becoming an independent adult (and seems to be doing a pretty good job at it thankyouverymuch!)

Here are some common scenarios that you might encounter going back and tips for how to handle each one:

  • You are exhausted after a difficult semester, and all you want is to catch up on your sleep. Parents may see this as laziness and wonder if all you do while at school is sleep. Obviously not—you work hard for school because you like it and it is important. Ask them not to come in and open the blinds at 8AM please—this is a VACATION after all—but you appreciate their hospitality and will of course help with some chores later.
  • If you have siblings at home, the family structure might have to reconfigure. For example, the middle sibling is now used to being the eldest, and for them it may be more of a drag than a delight to have big brother or sister home again. Let them know not to worry, because you’ll be out of the house soon enough. A friendly game of Monopoly or a trip to the mall together might break the ice and make it fun to be around one another again.
  • Be prepared to discuss money issues openly. Becoming financially independent is a process—a journey, really—with a lot of opportunities to learn and make mistakes. Maybe you bought 87 pizzas this semester when you only had enough money to buy 64. Budgeting is important—ask your parents to help you out or give you some pointers…not just more money.
  • Again, time may be an issue. You may be grabbing your coat to leave as your flabbergasted parents were about to get in bed. As author Karen Coburn state in Letting Go: A Parent’s Guide to Understanding the College Years, “It’s tough on parents because even though they have grown used to not knowing what time their child comes back to her room when she’s away at college, parents can’t turn off their ‘worry button’ when it’s 2AM and the car isn’t back in the driveway. Parents don’t stop being parents. They worry about their child’s safety. It helps to come to an agreement that recognizes their child’s growing independence, as well as their own need not to worry.”
  • Talk to your parents about your experiences in college. Parents err on the side of educational and professional progress (i.e. asking about grades, teachers, and goals), so tell them about your favorite subjects, books, performances, or pieces of music that changed your life. Tell them the highlights of your semester and how you’ve changed; it can be rewarding for both of you to acknowledge your accomplishments. 
  • Try to make plans in advance. Family gatherings might interfere with social gatherings, so try to talk about things ahead of time so conflict is kept to a minimum.

Basically, the key is communication. Don’t be afraid to express how you like to do more things on your own now and to kindly request respect for your need to develop independence. That being said, try to also respect your parents’ necessity to be parents and to look out for your safety, success, and well-being. Do you feel equipped to head home for the holidays?! Good luck!

Blog was written by therapist Sarah Souder Johnson, MEd., LPCC 

DBT Therapy – What is it?

DBT Therapy – What is it?

Everyone’s talking about DBT, but what is it, exactly?  

You tell your friend about the recent behavioral issues your teen has been having, and they tell you that their child was in DBT (Dialectical Behavior Therapy) and that it really worked!  They tell you that you should consider putting your child in DBT.  Your doctor refers your teen to DBT after he discover she has been cutting herself.  Your cousin, who is a therapist, suggests you look into DBT for your daughter after your daughter has an emotional outburst at the family reunion.  

Young teenager girl typing and messaging on her smartphone

You Google “DBT” online and find the same information over and over: It’s a cognitive behavioral treatment that was originally developed to treat borderline personality disorder and people who were chronically suicidal.  It’s now been shown to be effective in treating a wide range of mental health issues such as depression, anxiety, PTSD, eating disorders and substance use disorders.  It teaches mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness skills.  While all of the above is accurate and informative, chances are you still don’t have a clear understanding of what it is your teen will actually be getting out of DBT or how it will help your teen.  Let me try to help.   

DBT is a treatment approach meant to help those who might be more emotionally sensitive and reactive than the average person.  What do I mean by emotionally sensitive?  People who are emotionally sensitive tend to experience emotions more frequently and more intensely than others.  For example, when the average person gets cut off in traffic, they will likely feel frustrated or mad for a short time and then go back to thinking about what they were thinking about before they got cut off.   A person with high emotional sensitivity, however, may react by cursing, flicking the person off, and speeding up to pass and cut them off.  They may think about the event for hours after it happened. Another example is a person who plays the wrong key at their piano recital.  The average person would be embarrassed or disappointed in themselves, think about it for the evening, but sleep on it and move forward within the next couple of days. A person with high emotional sensitivity may become depressed, suicidal, and internalize this mistake by telling themselves that they are a screw up, a failure, and don’t deserve to be alive.  These intense feelings and thoughts may lead a person to engage in behaviors such as isolation, self-harm, substance use, or other unhealthy behaviors.  

The examples above show how being emotionally sensitive can negatively impact a person’s life. However, being emotionally sensitive can also be a very positive quality.  Feelings such as love, happiness and joy are felt more often and more intensely.  People who have high emotional sensitivity often exhibit characteristics such as kindness, creativity and empathy.  The goal of DBT is not to get rid of a person’s emotional sensitivity, it is to help a person learn how to manage these extreme emotions.  

A full DBT-intensive outpatient program includes weekly individual therapy, phone coaching calls between client and therapist and a weekly skills training group.  Typically these programs are anywhere from 6 months to 14 months in length.  Some programs, however, adapt DBT to fit the population in which they are serving.  For example, there are DBT groups that have been developed specifically for people struggling with substance abuse.  Many eating disorders treatment programs have been incorporating DBT into their programming to address problems specific to eating disorders.  We have adapted DBT to be more teen-friendly and meet the needs of adolescents who don’t need an intensive DBT program. What this means is that we don’t do coaching calls, we only meet once per week, and the teen is not required to be in individual therapy to be in the group. Our model is less intensive, more user friendly for today’s busy teens, and focuses on learning skills. Click here for more information about our next Teen DBT group in St. Paul.

This blog was written by a therapist at Sentier Psychotherapy

What can my Teenager do this Summer?

Summer is a time that almost all teens look forward to and almost all parents… well… look forward to, too. Teens often end up with a lot of “down time” which can lead to changed sleeping patterns and a change in diet, which then changes mood, etc. Though we want our teens rested, too much sleep is not always good, either.

I am writing this blog post to announce a group that I am very excited to be doing this summer. I am facilitating a group in St. Paul, MN that is called “Getting What You Want: A Group for Teens to Explore Happiness.” This group is for teens who want to better understand how to be happy. We will watch the documentary, “Happy” during the first group session and will then focus our next five groups on the main themes that the Group of teenagers meditating.documentary covers: Community, Movement, Defining Success, Service, Gratitude, and Self-Awareness. We will spend one session learning Laughter Yoga… and YES, I will be participating! Group members have the option of participating in the Color Run on July 14th (they can walk it, run it, or volunteer to dump colored powder on runners!). This group is going to be a lot of fun.

Please contact me with questions or to see if a teen you know will be a good fit for my group.

See you this summer!

Megan 🙂

My Teenager is Cutting Herself (Himself) – What Do I Do?

Self-harm (I am going to call it Nonsuicidal Self-Injury, NSSI) is a foreign concept to many parents and it can be very scary to discover. Historically NSSI was never as transparent as it is today. If you look, you will find young people (and now not so young) who have scars up and down their arms and legs. Please be aware that cutting is not the only type of NSSI. There are many other ways that people harm themselves, but cutting seems to be the second most common (in my practice). First, of course, is chemical use. I will blog about that later.

So why does Nonsuicidal Self-Injury happen and what does it mean?

I have seen three main reasons for NSSI/cutting:

1. Teens want to feel more. They feel numb and want to feel something. Anything.

Cutting self-harm

2. Teens want to feel less emotional pain. They engage in NSSI in order to feel physical pain, which they use to temporarily replace emotional pain. Physical pain is easier to tolerate than emotional pain for this teenager.

3. Teens are afraid to speak up about their needs, and use NSSI as a way to communicate anger/sadness (as well as pain/lonliness/loss, etc.) to specific people. Please do not interpret this as: Teens are cutting for attention. This is not what I am saying. I am saying that if your teen is cutting for this reason, please understand that they are using NSSI as a way to communicate.

There are other reasons that teens/people cut themselves, but these are the most common reasons I have seen in my practice. Please note: NSSI is *almost always* NOT a suicide attempt. Generally people who are injuring themselves do not have any intention to die. That being said, people DO die by self-harm. It is usually an accident; a cut that went too deep/in the wrong place. NSSI must be taken seriously, but the best response is generally not to call an ambulance and have your teen taken to the hospital (unless they are badly injured, of course).

What should you (as a parent/guardian) do?

1. Try to talk with your teen. See if they will talk with you about why they are hurting themselves. Express to them that you love them and that you are very scared and worried about what is going on.

2. Ask them what they need. They may not know, but they might surprise you. Be careful with this one. (Begin my rant): If your teen is self-harming because they did not get what they asked you for (i.e.: a new pair of jeans) and then you ask them what they need and they say, “That pair of jeans,” this is a different situation altogether. Do not get the jeans in this instance. I urge you to meet with a counselor in order to work with your teen on limit setting and coping skills for your teen. (End my rant). If your teen expresses that they need to talk with someone, that they hate themselves, that they don’t feel anything, that they feel too much, I urge you to find a counselor for your teen. If they need something that is impossible, “I need you and dad to be back together again,” they are hurting themselves because they do not know how to manage their intense emotional pain.

3. Do not punish your teen for NSSI. NSSI (though it often results in temporary relief for your teen) is a form of self-punishment. Additional consequences tend to make things worse.

4. Find a therapist for your teen. Your teen needs professional help and they need some skills they don’t have. They need a place to go where they can be honest and open about how they feel about themselves and who they are in the world. For starters, you can read my blog about how to find a good therapist for your teen.

5. I don’t want to sound too negative in this blog, but your teen needs help. Do not laugh off this behavior or get angry and tell your teen that they are cutting for attention. Teens die every day by accidently slicing an artery. Teens feel alone when they cut, and they are trying to tell you that they need something more. A good therapist will be able to figure out what that is.

What else do you want to know about how to help your teen decrease and stop NSSI?
——————————————————————————————————————–Read about Megan Sigmon-Olsen, M.S.W., LICSW, who is a therapist for teens and families in St. Paul, MN.

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My Teen is LAZY!

It happens with at least 50% of the families I see.

“Megan, I hate to admit this, but my teen is LAZY. I can’t get him/her to do ANYTHING at home.”

First of all, you’re not alone! Second of all, parents need to challenge themselves to look at this issue differently.

Often times, teens do not prioritize a clean house. I will admit that I can’t site any research about this topic this morning, but I’ve worked with enough teens to know that cleanliness is often not a priority to them. So, I ask parents how they frame “chores” to their teen at home. 

If you (as a parent) want their room picked up, their towel off the floor, their dishes in the dishwasher, this must be communicated as a requirement, not an option. When something is a requirement, there are consequences when the requirement does not get met.

If it is a requirement for your teen to empty the dishwasher twice per week, I encourage you to reward their efforts at home with something they care about. I’m not suggesting that you pay them $20 for unloading the dishwasher, but be reasonable. If your teen has a decent list of chores at home, they will be much more likely to complete their requirements if there is incentive. The kicker? You need to follow through with the rewards. On time. As you promised.

Also, you need to follow through with the consequences. If the consequence is that your teen does not earn the weekly “allowance,” then don’t give them the money. For this to be effective, you can’t hand them $5 here and there during the week. Their allowance money should be their spending money. If they don’t earn their money for the week, they don’t spend money that week. Simple. If the only consequence to not completing chores is that they don’t earn an allowance, don’t add more consequences. Also, you may have to deal with the fact that their room stinks because they didn’t clean it up this week.

That’s fine. They’ll learn from this eventually. Shut the door and move on with your life. They are hurting because they didn’t earn their money (or they lost their cell phone for the week, or whatever the consequence is) and you’re hurting because their room stinks. Do your best to let that go.

Last quick pointer: If your teen earned their weekly allowance (for cleaning) and their behavior stinks in another area, do not take their cleaning reward away. Consequence them in another way. If you take away something they legitimately earned, they will probably stop cleaning.

It’s important for you to follow through. Have a pay day. Be prepared to pay them and don’t engage in “all or nothing” thinking. If they did half their chores, give them half their money. You want them to succeed in order to build more confidence.

What are some of the creative ways you have gotten your teen to do their part in keeping the house clean?

He/She Always Slams the Door!!

Ah… door slamming. Talk about the ultimate conversation stopper and trigger for parental anger.

Teens do not generally slam doors just to irritate you. In general, they are slamming the door to tell you that they need a TIME OUT. Don’t take the bait and follow them into their room. This is the ultimate fight escalator. Your teen needs space and generally speaking, you need to allow them to deescalate in their room.

First things first. Teens are impulsive as their brains are not yet fully developed. They may slam their door and think to themselves, “Why did I do that?”. They are still using the more primal part of their brain (prefrontal cortex) during this phase of development, which means that doors are going to get slammed sometimes. This part of their brain also often misreads attention from others as negative, which is why your random questioning of your teen often triggers somewhat of a blow-up. Again, just a normal part of development (though not the most pleasant for parents).

Teen slams door - Angry teenager

Two more pieces to door slamming:

1. Plan a time to sit down with your teen and talk about the expectation that your teen not slam the door. Do not have this conversation during any kind of argument. Everyone needs to be calm to have this discussion. Talk with your teen about what the consequence of slamming the door will be for the future. Allow your teen to have a say in what an appropriate consequence is. If you notice that your teen really works hard to shift this behavior, compliment them on their efforts to not slam the door!They need to be noticed for positive changes in behavior, not just negative. ALWAYS follow through with the consequence that you and your teen agree on. If you do not follow through, your teen will push the limits and the rule will go out the door. You’ll be back at square one.

2.  Always revisit the issue that resulted in your teen slamming the door. Your teen may only need 20 minutes to calm down, and I’ve seen teens who can’t calm down for hours. Regardless of how much time your teen needs, have the conversation (when you’re talking about #1 above) about how the expectation is that the issue which resulted in door slamming must be revisited within X number of minutes/hours. You must work on problem-solving with your teen, or the door will simply get slammed the next time this issue gets brought up. It is critical to complete this step once the emotion of the moment has passed.

Good luck!! Remember this takes time and consistency. This behavior will not change as soon as you sit down and talk about it. It requires parental follow-through and time.

How do you handle door slamming at your house?

Help for my High Achieving Teen

How to Help My High Achieving Teen

Swim team captain. First chair violinist. Quiz bowl champion. Straight A student. Perfectionist. Anxious. Sad. Withdrawn.

Teens who are high academic achievers are often also heavily involved in extracurricular activities and leadership roles. Add a job or volunteer work, lessons, or a college search to that and you may end up with a teen who is overwhelmed. This is often when they end up in therapy. Sometimes clients come into therapy because they are having trouble sleeping or they have started experiencing panic. Others have started using drugs or withdrawn to the point of isolation. Once-happy children have become overachieving teenagers, and the idea of success that once drove them has led them to feel highly anxious.

Parents and other adults can help teens in a few simple ways:

  1. Support balance in their lives, and make sure to include their social life. Spending time with friends and having a sense of community outside of their home is an important and appropriate part of healthy development for teens.
  2. Teach them how to manage a heavy load. Help your teen to learn about time management, time away from social media, and prioritizing tasks.
  3. Dispel the myth of perfectionism. Describing the concept of “good enough” can help them address obsessive thoughts that may lead them to never feeling good enough.
  4. Give them permission to say no. High achievers are also often over achievers who have never been told that it’s okay to turn down opportunities.
  5. Model all of those things for your child. There is a strong chance that a child with perfectionism learned by watching. How can you model balance in your own life? Talk to your teen about your own struggles with these steps.  

With support and guidance, teens can recognize their inherent value regardless of achievements, grades, and trophies. They will start to see the beauty of mistakes and the value in downtime. Most importantly, they will develop healthy insight and a stronger sense of self-worth.

How have you been successful at helping your teen achieve balance? Contact one of our school specialists to help your teen: Katie Fleuriet, M.S.W., LICSW

Blog post written by Sentier therapist, Sarah Souder Johnson, MEd, LPCC

Communicating with your Teenager – Do’s and Don’ts

“I don’t know how to talk with her anymore.”

“He’s so moody.”

“She doesn’t want to share anything about her life with me like she used to.”

“I can’t get him to say more than ‘My day was fine.’”

Parents frequently call me and report struggles similar to those listed above. They wish they had the ability to transform their relationship back to the way things were before their adolescent began puberty, and they ask me for help.

The reality is that teenagers are supposed to go through this change. They are supposed to start distancing themselves from parents a bit – it is developmentally appropriate. They are undergoing many changes: physically, emotionally, and mentally. During this wonderful time of change, teens:

  • Will want more privacy.
  • Will want more time with friends.
  • Will often change the way they dress, etc.
  • Will experience many physical changes in their bodies.

I have seen many parents attempt to exert higher control during their kids’ teenager years. This is the opposite of what parents want to do. Remember, your home is your teen’s training ground for the world. The interactions you have with your teen are a large contributor to how your teen learns to treat other people. Having a general acceptance that you may talk less with your teen during this time in their life will save you some aches and pains. This isn’t personal. They don’t love you less. Their priorities are shifting as they are learning to be adults.

The best way to stay connected with your teen (The Do’s):

  • Respect their privacy. They may go to war with you if you don’t.
  • Listen when your teen talks. Consider their opinion a valuable one.
  • Be a good listener. Reserve judgement and keep some of your opinions to yourself if you want them to talk with you again.
  • Accept your teen’s feelings. Don’t try to change their experiences; just offer support.
  • Apologize when you’re wrong.
The Don’ts of communicating with teens:
  • Nag, preach, lecture. They don’t listen for long and it just hurts their feelings and frustrates you further. My Teen Hates Me
  • Use guilt and/or shame as a parenting strategy. It doesn’t work.
  • Use a lot of “shoulds.” This is one way of using guilt/shame. This can be very damaging.
  • Share with others personal things your teen has shared with you (unless, of course, your teen is in danger, etc.).
  • Hound them with questions when your teen has broken a home rule, etc. Know when you can talk with your teen and respect this boundary.
  • Again, I don’t have a canned strategy for talking with teens. Some teens and parents will go to family therapy to work on applying these strategies, which is often a good idea. Other times these tips are enough. Good luck!

Teen Expectations

One of the things I work on with parents of teens is expectations. I often find that parents assume teens “just know” what is expected of them at home, at school, and in the community. It turns out that teenagers often do not know what is expected of them short of, “Be a good person,” “Do well in school,” and “Don’t do drugs.”

Rules for teens teenagers

It is important that teens know what you expect of them. It is also important that they know what will happen if they fall short of your expectation. If your teen breaks a rule of yours, the consequence should be known ahead of time. As a parent, this will also help you not be “too emotional” when a rule is broken. Here’s an example:

Your teen arrives home two hours past curfew. The first assumption I am making is that you had an agreed-upon curfew. My second assumption is that you discussed consequences of broken curfew before your teen left for the evening. Assuming you discussed consequences ahead of time, you know exactly what to do when they come home:

  1. Wait to discuss consequences until the next day.
  2. Remind your teen of your already-agreed-upon consequence the following morning. The reason this is easier on parents is that you are not expected to come up with a consequence when you are angry. If you come up with a consequence when you are waiting for your teen (at 1:00 in the morning) you will likely come up with a consequence that is too severe. After all, you’re upset! A few days in to enforcing the consequence, you will realize the consequence was too extreme, and stop enforcing it. This will teach your teen that your consequences will not be followed through and that if they beg to get off consequence you will probably give in (because after all, extreme consequences also consequence parents!).
  3. Your message as a parent is: I love you, I was worried about you, I do not support the decision you made to stay out past curfew, and you have chosen to be on ___________ consequence for __________ amount of time.

These interactions don’t have to be ugly! You want to maintain connection with your teen during these teaching moments.

How do you stay connected when your teen has broken a rule or pushed a boundary?

Why Does My Child Misbehave?

When children are given the opportunity to succeed, they generally will. According to author Rudolf Dreikurs, “A misbehaving child is a discouraged child”. Children tend to want to do well, and they want to be successful. As parents, caregivers, or other significant adults in a child’s life, it is our job to do our best to see to it that that happens. Dreikurs talks about the Four Mistaken Goals of Misbehavior: Attention, Power, Revenge, and Inadequacy. These are the things children do to get and unmet need met:
1.  Attention: To be noticed
2.  Power: To be the boss
3.  Revenge: So you can feel as badly as I feel
4.  Inadequacy: To be left alone or feeling discouraged

Below are some charts to explain the Four Mistaken Goals of Misbehavior. These charts describe what your child may be actually needing from you, and ways to respond to your child to help them get their needs met in healthy, adaptive ways. 

http://choices4children.blogspot.com/2015/06/parenting-0-5-why-kids-misbehave.html
http://hopeandafutureministries.blogspot.com/2010/09/goals-of-misbehavior-with-your-kids.html

Please note that children are generally not AWARE that they are doing these four things when they are doing them. It is not intentional until younger children are older. These behaviors are almost a reflex to not having their needs met. It is also assumed that children are well-rested, fed, etc. when considering the Four Mistaken Goals of Misbehavior. 

Children do best when they are encouraged and when they feel that they are being successful. Dreikurs states, “ A child needs encouragement like a plant needs water”. Finding everyday ways to help encourage your child to succeed is essential when helping little humans grow into young adults. 

What are some barriers you face when trying to help your child be successful?

So You Just Had a Baby…?

So You Just Had a Baby… !?

This baby feels like… a lot

Discovering that you are going to become a parent is filled with endless emotions. Yes, there is joy and excitement – A baby! They’re so cute..and squishy..and their squeals…gah! But there are also questions of uncertainty and often trepidation – How will I/we pay for this? Will I go back to work? Will my partner go back to work? Will I breastfeed? What if they cry all the time? Are we going to be bonded right away? I’m going to miss my friends. And, wait, do I need to set up a nursery?? 

Immediately following the arrival of a baby is also a time of increased emotion…You may feel like they’re the cutest human on the planet (they are!) or that they smell amazing (they do!) and that they are the sweetest (for sure!). But, you may also feel overwhelmed by the drastic changes  in your life. You’ve swapped out evenings with friends on restaurant patios with bouncing a baby on an exercise ball while simultaneously Googling the best burp cloths, diaper creams and swaddles. Or, you may feel like you’re just not bonding with your baby like you should (those Instagram moms made it seem different…). 

These shifting environmental and social stressors coupled with the hormonal changes that occur both during and after pregnancy are difficult to manage! You are not alone. This adjustment is hard…for everyone. Say it with me, “I am not alone. This adjustment is hard…for everyone.”

It’s important to take care of yourself as you go through this adjustment. Here are my top 5 tips: 

  • Accept help. There is truth to the “it takes a village” saying. Accept those offers for keeping you company, bringing over dinner, folding laundry, etc. 
  • Go on walks. Getting outside can be so helpful! If you have a newborn in the winter and it’s not too cold, bundle up! Trust me on this… we live in Minnesota!
  • Join a mom’s group. Whether it’s your 1st child or your 5th child, every baby is different and can present new challenges. 
  • Communicate with your partner and family about what you need. As much as we wish mind-readers existed (especially in this phase of life), they don’t; so speak up and let people know what you need from them. 

Remember to be kind to yourself. You are doing the best you can and this will get better. 

Sometimes, it is also really helpful to connect with outside support. It may be that a postpartum doula would be helpful. Or, it may be that talking to a therapist would be helpful. Research shows that 1 in 5 women develop a Postpartum Mood and Adjustment Disorder (PMAD), so it’s more common than we think!  If you think this would be helpful, please give me a call: Katie Fleuriet, MSW, LICSW. Additionally, be sure to check out Postpartum Support International for more resources. 

My Teen is Queer – I’m Confused.

I don’t know what my teen means by asking me to use new language to identify them! Help!

Has your teen told you they would prefer if you used gender-neutral pronouns from now on? They’d like you to use “they/them” rather than using “she/her.” Or maybe your teen has told you they are Androgynous and you have no idea what this means. Maybe your teen is mad at you because you refuse to use their new name; to you they will forever be “Andrew,” but they now want to be called “Andrea.”

androgyne boy posing on street. look. grey t-shirt, black shorts. tail hairstyle

If this sounds familiar, you are not alone. Gender is complex in our society today. More people are recognizing that trying to constrain people to two categories does not work. Today I am writing about gender identity, which is different than assigned sex at birth, sexual orientation, gender expression, or gender roles. Gender identity refers to how an individual perceives themselves and what they call themself. This can include male, female, a blend of both, neither, and many more. It can shift over time. A variety of terms encapsulate gender such as queer, gender-neutral, non-binary, cisgender, gender fluid, bigender and transgender. What’s more confusing is that these definitions are ever-evolving and may mean something different to each person. Below I have provided definitions of terms commonly used when referring to gender identity. My hope is that these definitions will help make conversation about your teen’s gender exploration easier and more comfortable.

Queer– This is a general term for people who identify their gender and/or sexual orientation as something other than cisgender (see below) and/or heterosexual. Queer is a term used to identify oneself as outside of society’s norms, without having to state a specific identity.

Gender Neutral– This is a term that people who do not feel they have a gender (or that their gender is neutral) use. Some people may feel some connection to the concept of gender but feel they do not have one. Others cannot understand what gender is as they do not experience it within themselves. Other terms synonymous with this definition are: agender, gender free, non-gendered, genderless.

Non-Binary- An umbrella term for gender identities and expressions that are not exclusively male or female. People who are non-binary may feel that they are both male and female, neither male nor female, or something else all together.

Cisgender- This is a term used for people who’s gender identity correlates with their assigned sex at birth.

Gender Fluid/Agender-Fluid- A person who is gender fluid has a gender or genders that change. Gender fluid people move between genders and tend to experience their gender as something dynamic and changing, rather than static.

Bigender/Multi-Gender- Bigender people identify as two genders. It does not necessarily mean they identify as a man and a woman, just that there are two distinct genders with which they identify. They may identify as both at the same time, flow between genders, or feel they are a blend.

Androgyne/Androgynous- Androgynes feel themselves to be simultaneously masculine and feminine, although not necessarily in equal parts. They frequently have both female and male gender characteristics. Some feel they are a blended gender, neither masculine or feminine.

Transgender/Trans- This can be used as an umbrella term to describe an individual who’s gender identity differs from their assigned sex at birth. The term trans and transgender are sometimes used interchangeably to describe all gender identities that are not cisgender. Transgender can also be used to refer to people who experience deep feelings of incongruence with their assigned sex and associated sex characteristics, and feel alignment with what many often think of as the “opposite sex.” Being trans or transgender does not imply any specific sexual orientation.

As I mentioned above, this is by no means an exhaustive list of gender terms and definitions. It is only the beginning. If your teen has come to you about gender identity issues, chances are they have done a lot of thinking and research already. Your teen likely does not expect you to know every definition by heart or be an expert on the topic. What they do need from you, however, is your willingness to support them through their journey of their gender development and exploration. They need to know they can trust you to be a safe person for them to talk to. Being a teen is hard. It’s a time where they are exploring who they are, comparing themselves to others and being compared to others. When someone identifies as anything outside of societal “norms,” being a teenager becomes even harder. Transgender and non-binary teens are often the victims of harassment, bullying, discrimination, assault, and other forms of violence. It can be a very lonely time, as they may not know anyone else who is similar to them in this way or they may be scared to reach out and talk about it. All of the above make your teen more at risk for low-self esteem, depression, self-harm, and suicide. Which is why, as a parent, it is crucial that you begin to feel comfortable dialoguing with your teen about their process… even if it makes you uncomfortable.

Your teen needs to know that you are on their side and that you are not trying to “fix” them. So, if you are confused, ask open-ended questions. Let them know you are listening and seeking understanding. Some examples of questions you might ask are: “When you imagine your future, what do you see? What gender do you feel you are? How would you describe yourself.” Or, “Do you know when you first started questioning your gender identity? When did you start to realize that your gender might be different from what I and others told you?” Additionally, be sure to ask your teen how you can be supportive and what it is that they need from you. Let them know you support them, no matter what. Honor their requests and use their desired pronouns. Educate yourself. These are all ways that you can let your teen know that you love them and that they are not alone.

If you are still confused and feel like you need additional help in supporting your teen, there are a number of good books out there about transgender and non-binary teens. Therapy is also a good option. It is a place where you can explore your thoughts and feelings without judgement. If you have questions, your therapist can help guide you and work with you to better understand your teen and what it is they are going through. It is crucial that you get the help and support you need so that you are able to be there for your teen in the best way possible.

Blog written by a therapist at Sentier Psychotherapy (www.sentiertherapy.com)

Source: The Transgender Teen: A Handbook for Parents and Professionals Supporting Transgender and Non-Binary Teens (2016) by Stephanie Brill and Lisa Kenney.

My Teen is Depressed – How This Impacts School

My Teen is Depressed – How This Impacts School Performance

If you are reading this, you are among the many parents whose teens likely have depression. This can be SO frustrating and hard to watch as a parent, especially when your teen’s academic and social life are impacted by symptoms of depression. 

The number of teens reporting depression has drastically increased in recent years. Between 2005-2014, teens reporting a major depressive episode increased 37% (Source). With more and more teens reporting depression it’s important to know that depression can significantly impact school performance. Cognitive and behavioral symptoms can make a seemingly typical academic setting feel daunting and overwhelming . Below are just a few symptoms of depression that are most impactful when it comes to school.

  • Trouble Concentrating
  • Memory Difficulties
  • Loss of Motivation
  • Decreased Interest in Hobbies/Extra-curriculars
  • Social Withdrawal
  • Feelings of helplessness and hopelessness
Depressed Teen Impacts School Performance

Depressed teenage girl is isolated and withdrawn at school

Symptoms can play on each other and ultimately lead to declining grades and increased absences. The dates and events in history class can seem impossible to keep straight and devoting the time and energy to sort it out can be rife with interruptions and feel just plain exhausting. Additionally, the thought of making small talk with peers or being around friends that don’t seem to understand what’s going on leads to social isolation.

If you are noticing symptoms of depression or suspect that depression may be a factor in your teen’s declining school performance, talk to your teen about it. And if they don’t feel comfortable opening up to you, encourage them to connect with a school counselor or outside counselor to gain support around their changing school performance.

What have you done as a parent to help your teen get through a period of depression during the school year?

Blog written by Sentier therapist, Katie Fleuriet, MSW, LICSW 

My Daughter Says She Is Gay

“… and I don’t believe her. I do not believe that my daughter is gay.”

Okay. Hold on for a second and take a big, deep breath.

I don’t know if your daughter is gay. I don’t know if your daughter is “just experimenting,” or if she is bisexual. One thing I DO know is that your response to her recent disclosure is critical. If you show anger, hurt feelings, sadness, or disgust… this will have a negative impact on your beautiful “child.”

All teens go through a period of sexual identity formation. All human sexuality exists on a spectrum. In other words, most people are not 100% gay or 100% heterosexual. There is a lot of grey area here. You went through this process, and so did I. This is simply part of being human. If you are heterosexual, you may not even know that this was something you went through. But, you did. You figured out your preferences, your attractions, and your “type” for dating.

This is exactly what your teen is going through. She is exploring what type of person she is attracted to, why she is attracted to that kind of person, and she is trying to figure out what the appropriate response is to each of her attractions. She may be questioning if she is gay, confused about if she is gay, or she may know she is gay. She has chosen to disclose something very personal to you, and this is a big deal. Many teens do not talk with their parents about sexuality at all, so be happy she came to you!

My daughter says she's gay

If you tell your daughter that you know she is not gay, and that you know she is “just experimenting,” or that she is confused or ridiculous, please know that your response has the potential for devastating (and long-term) psychological and emotional impact. The most common side effect of parental rejection is low self-esteem and complete distancing from parents. Your part in this can easily be prevented. Your response will help her move through her confusion (if she is in stages of identity confusion or identity comparison) or it will help her realize that she is okay, she is lovable, and she is not the only person out there who is gay. Take-home message: DO NOT SHAME YOUR DAUGHTER FOR DISCLOSURE.

Many kids know they are gay between the ages of 7 and 9, and choose to not come out to family until the age of 13 and older. Kids are often taught that being gay is “wrong” or shameful to the family. Because of this, they hide or try to change their sexuality. Much research shows that trying to change a person’s sexuality is damaging and ineffective. We cannot change our children’s sexuality more than we can change whether or not they have natural talents in math or gymnastics. We do not control our children and who they become at all.

I cannot tell you if your daughter is gay. I can tell you that this is not for you to figure out. This is her journey, and she has come to you telling you that she is gay. Please support her in her process. Please do not try harder to get her to fit in with her heterosexual friends (if your daughter wants to try harder to fit in with gay/bi/queer friends). She will see this as rejection of who she is. This will also prevent her from connecting to a community (and resources) that will include her and help her understand her sexual development. Teens who do not gain support at home are much more likely to have depression, attempt suicide, use chemicals, and are at much higher risk for HIV and STDs.

Follow your daughter’s lead. If you feel fear, sadness, anger, shame, worry that you will be judged, please do not try to work through this with your daughter. Work with a therapist who has knowledge about gay/bi/queer/trans populations. Talk through this and work out your own emotions so that your daughter does not end up needing to worry about your feelings about her sexuality. Her sexuality is for her to figure out, just as your sexuality was yours to figure out.

Be kind to your daughter and kind to yourself.

All my best to you,
megan

**Source: Ryan, C. Supportive families, healthy children: Helping families with lesbian, gay, bisexual & transgender children. San Francisco, CA: Marian Wright Edelman Institute, San Francisco State University, 2009.

A Normal Teenager?

Many parents contact me in order to arrange psychotherapy for their adolescent/teenager. I generally complete my first session with both the teen and parent(s) present. This first session reveals a lot of information to me (what the teen sees as the “problem” vs. what the parent sees as the “problem,” relationship dynamics, etc.) but the most striking hidden question I often hear parents asking is, “Is my teenager normal!?!?”

Does my teen need therapy?

Often times there is an urgency and fear that I hear in the parents’ voice(s). Teenagers are so… foreign. Unpredictable. Different.

When I hear the urgency and fear coming from parents, I talk with the parents alone. Then the questions fly: “Is my kid going to end up in counseling forever?! What do I do about _______ behavior?! She wants to dye her hair PURPLE! How do I deal with him? She’s sooo rebellious! He won’t even talk to me anymore!”

I do not believe there is a “normal” teenager. Teens are on their own, unique journey. Raising a teenager is about balance. They are starting to break away from parents a bit. Parents are learning to let go. Teens use their own voice. Parents learn when not to use theirs. Teens make mistakes that parents could likely have prevented. Parents don’t say, “I told you so.” Instead, parents guide in the learning process or shut up. Teens have problems with friends and partners. Parents walk alongside their teen on their journey. When teens make choices that go against familial beliefs, parents hold their teen accountable with the message being, “I love you and that is why I am holding you accountable.” Again, parenting a teenager is about balance and a clear message.

Now… the purple hair. Do you fight him/her on it (which will make your teen fight more) or let them dye their hair? I don’t have a canned answer that will fit for all teens. The best thing I can say is: pick your battles. There will be more to come!

What strategies have you seen or used to keep balance in your relationship with a teen?

Parenting During a Pandemic

If you are reading this, please stop and take a deep breath before you continue. This is hard, we are three weeks into physical distancing and the novelty of it has definitely worn off. Fatigue and exhaustion are setting in and families are feeling it. There are a lot of lists circulating right now about how to support your kiddo during this time (we will talk more about those below) but the most important way you can help your kid right now is to take care of yourself. You are your family’s nervous system. This does not mean you need to be calm all the time, because let’s face it, you won’t be! However, the more you are able to stay regulated, the more your children will be able to. So let’s let go of the idea that good parenting equals being selfless. Kids learn by your modeling and them watching. So if you’re feeling unbalanced, stressed, or a bit unhinged, here are a few ways to get regulated:

  1. Increase Your Movement: There is a lot of pent up energy from being cooped up all day. Release this through moving your body. Take a family walk, turn up the tunes and have a dance party, or do 10 jumping jacks.
  2. Find Some Alone Time: Easier said than done right? Relationships are meant to have ebbs and flows, and we are not used to being together this much, try to find a few minutes to yourself, even if this means locking yourself in the bathroom for 5 minutes.
  3. Create Predictability: The brain does not like when things aren’t predictable, it signals to the body that this means danger. One of the hardest parts of this pandemic is the uncertainty, what’s going to happen next?, when will it be over? Create a schedule to give the brain some predictability, but keep it flexible.
  4. BREATHE!! It sounds simple and cliche, but even breaths in and out signal to the brain that it is safe. Throughout the day stop and breathe. Set a timer on your phone once an hour with a reminder if you need to.

This is an incredibly stressful time. We are all experiencing collective trauma and grief. We are all going to feel emotional ups and downs. Perhaps you’re even feeling heightened anxiety, emotional overwhelm, or shut down. You do not need to hide your emotions from your children. They are perceptive and can sense your feelings even if you slap a smile on your face and tell them everything is ok. Share with them (in an age appropriate way) how you are feeling. You can follow it up with how you are supporting yourself through these feelings. For example:

  •  “Mommy is feeling overwhelmed by the news today she’s going to turn it off and take a few deep breaths.”
  • “‘Daddy is feeling sad that we had to cancel our trip, I’m going to let myself feel sad about it today.”

And lastly, when you snap at your kids, which you will!, be sure to come back together with them and reconnect.

How are you managing this time as a parent during the COVID-19 pandemic?

Blog written by Annalise John, MSW, LICSW, therapist for kids, teens, families, and young adults.

My Child Has Depression

How Can I Help My Child Who Has Depression?

Depression is a serious illness that can make it difficult for children to engage in school, create meaningful relationships, and enjoy life. If untreated, it can have lasting effects on their growth and development. If your child is depressed, it can be overwhelming knowing how to support them. How can I help my child who has Depression?

Here are some ways to support your child and yourself when navigating depression:

  • Validate Your Child’s Feelings
    Many children and teens in therapy describe how the adults in their lives minimize and dismiss their struggles. In an effort to make their child feel better, well-meaning parents can do this by trying to find the silver lining for their child. Sometimes parents will say things such as, “You’ll feel better tomorrow”, “This isn’t a big deal” or “It could be worse.” Instead of saying these things, acknowledge that the problems in your child’s life matter, even if they may seem trivial to you. Give your child permission to feel what they feel, and do so in a non judgmental way.  When talking with your child, avoid asking too many questions or trying to solve their problems. Listen, be with them, and empathize. When your child feels validated, it not only strengthens their sense of self, but also strengthens your relationship with them. This makes them more likely to be open and honest with you in the future. Validating your child’s feelings is important in helping them build self-esteem and promotes emotional health.
  • Spend Time With Your Child
    Your depressed child might have a tendency to isolate. Spend time with them. Social connection is an important aspect of healing depression. Try not to turn this into a power struggle. Meet them where they are at, and engage in activities you can both enjoy.
  • Seek Professional Help
    Seek out a mental health professional to support your child and family. If your child is old enough, involve them in treatment choices. Research a few therapists or counselors and get a feel for their style/approach to therapy. If your child doesn’t connect with one, try another.
  • Don’t Keep it a Secret
    Respect your child’s privacy but don’t keep their depression a secret. This can lead to further feelings of shame. If your child is comfortable let a trusted teacher or school counselor know so that they have support in that setting as well. Be open with your child’s siblings, they will know that something is ‘wrong.’
  • Don’t Ignore Worsening Symptoms
    You know your child better than anyone. Trust your gut, if you feel that something is off it probably is. Do research on symptoms of depression and suicide. Notice changes in behaviors and emotions, increase in complaints of aches and pains, increased social withdrawal, increased feelings of guilt, shame, and worthlessness. In younger children notice changes in their play. If your child says phrases like “I wish I was dead” take it seriously.
  • Take Care of Yourself
    Having a child with a mental illness is not easy, take care of yourself. Seek out your own support and be honest about your feelings. Children notice SO much of what adults do. One of the best ways you can help your child is to model good self care. As much as possible, engage in movement, good nutrition, and regular sleep.
  • Be Patient and Hopeful
    Children can recover from depression, but it won’t happen overnight. Be patient and be hopeful and focus on healthy lifestyle for yourself and your child.

What have you done to help your child with depression?

Blog written by Annalise John, MSW, LICSW. To schedule an appointment for yourself or your child with Annalise, please visit our website.