Monday, September 03, 2007

How to Raise Teenagers: I Must Have Slept Through That Lecture

Those of you who are regular readers may recall that in addition to being a psychiatrist, writer, and podcasting blogger, I am also the mother of two teenagers. It's okay, no surprises here, after all I went to medical school and I'm a psychiatrist which means I'm an expert in human behavior, those teenage years being just part of the developmental process. I know exactly what to do and say to assure that I have wonderful, happy, mentally healthy, well-adjusted, and successful children who glide through life glitch-free and openly share with me any of the little bumps they might encounter along the journey.

And now let me tell you about this little bridge I have for sale, it's a great bargain.

And let me tell you what they teach you about raising children in Medical School and Psychiatry Residency Training Programs. They don't teach you anything, at all, ever, about normal developmental adolescent behavior. Somewhere along the line I learned that babies develop a social smile between 5 and 8 weeks of age and they should be fed whole milk until age 2. Either the information stopped there, or I blocked everything else out.

Pediatrics rotations in medical school take place on an inpatient medical unit. I saw children with leukemia, babies with failure to thrive, kids with acute abdomens, and inevitably half of morning rounds went like this: "Bed A suffered burns on her right arm when mom's coffee spilled on her, Bed B has burns on his left leg from dad's spilled tea...." I did learn that parents should be very careful about hot beverages, hot bath water, and space heaters (--there was a major burn unit in the hospital where I studied). We had lectures on diarrhea while we sat around a table eating cookies. Not once did anyone tell me that it's completely normal for formerly articulate, intelligent boys to suddenly stop speaking and merely grunt for years at a time. Nor was there a course that mentioned how it's impossible for the mother of a teenage girl to dress right...or even breathe right. Honestly, I thought my own mother--who handled my obnoxious teenage years with grace-- embarrassed me because she was embarrassing. It didn't occur to me until I had teenagers of my own that it had more to do with me than with her.

Three months on an inpatient child psychiatry unit, with shifts in the pediatric ER, didn't help. I met kids who were completely out of control, chronic runaways, children who'd been violent in their group homes. In the ER I saw suicidal teenagers and had no where to place them --try finding an inpatient bed for an uninsured suicidal teen who's parent says they've had it won't take them back. Not only did I not learn a thing about normal adolescent development, but I saw the worst case scenarios of children who'd had lives that were tragically devastated at young ages, already paragons of loss, chaos, and upheaval. It wasn't a setting filled with hope; it takes a lot for a child to end up in an inpatient unit in an inner city teaching hospital.

Okay, so teenagers, this is the thing I'm figuring out: It's a stage, it's its own distinct thing, and being a psychiatrist, I have this tendency to look at my teenager's behaviors and extrapolate them to adulthood. I'm just getting it that a lot of normal teenage behavior looks surprisingly like impending disaster. Nothing about being a doctor helps with this, most of what I've learned being a psychiatrist makes it hard to keep things in perspective, especially when living with a teenage boy.

I'm not much for How-To-Raise-'Em books. Mostly, I thought we were doing fine by gut, but lately I've decided we could use a little help. I bought some books, I even read them, and I thought I'd share my thoughts about these books with you.

This was my favorite:
Get Out of My Life...but first could you drive me and Cheryl to the mall?
by Anthony E. Wolf, PhD.

This book was laugh-out-loud funny with descriptions that resonated so strongly I was left to ask how this guy knew my kid.

"What happens is that teenage boys develop terminal lethargy. They seem to catch a lengthy case of sleeping sickness. They appear to do nothing. If the normal speed of human activity is one hundred rpm's, teenage boys seem to go at around six."

You mean that's normal??? Why didn't anyone tell me? What a relief! And the list continued. I won't say I agreed with every thing Dr. Wolf says-- he sounds more willing to tolerate certain behaviors than I would ever be, but overall this was a quick read and did more for cuing me into Why I Shouldn't worry, What I Can't Control, and Why I need to Let Go, more than psychiatry ever has. Relief: yes. Sadly, I'm left knowing that my children are pushing me away because they are growing up and doing all the things they should be doing, and while it's always been easy to rejoice in their milestones, these stages entail a bit of quiet grief as I come to terms with the fact that my children will never have the relationship they had with me when they were little.

I Wanna Be Sedated, edited by Faith Conlon and Gail Hudson, is a collection of 30 essays by professional writers all on parenting teenagers. Okay, I admit it, I bought the book because the title was irresistible and at the moment I was surfing for books about raising teenagers, I really did want to be sedated. Some of these stories were hysterical-- we had both our kids read "How To Lie To Your Parents" by David Carkeet. "Mom? Everything's Okay, but..." by Linda Rue Quinn was funny even though neither of my children have actually set any part of our house on fire. The stories varied: funny, poignant, sad, even boring, but for the most part it was a compelling read. There were no parenting tips, it really was just the sharing of stories, and a reminder that teenagers, while in many ways alike in their stages, differ greatly in how easy or hard they can be to raise and what kind of people they actually are. The honesty of the writers was brutal at moments, at many points I was simply thankful not to share their problems, at other points I felt I'd found a kindred spirit. I smiled at Stephen J. Lyon's essay, "Commuting With Rose." He writes, "Anyway, as a parent of a teenager, you are always off balance--grasping at straws, parenting books, or a bottle of Zoloft. So you ten to stay with any small success. Sociologist love to rattle off statistics about how many minutes per day fathers spend with their children, always discounting the power of silent communication and the value of mere presence, along with the all-important fatherly stare and raised eyebrows. And they rarely speak of how little or erratically a teenager wants to relate with any parent."

Finally, I looked at Staying Connected to Your Teenager by Michael Riera, Ph.D. This is a more conventional How-To book and I had a harder time staying with it. In the first chapter, he suggests trying to talk to your teenager after midnight, and for a while, I'd try to stay awake that long. I made smores one night with my son and he recited to me the Shakespeare he'd had to memorize for school--it was definitely worth staying awake for and not a conversation that ever would have been had at a more civilized hour. Otherwise, though, it felt like the author had all the answers and I think my challenge has been to make peace with the fact that there probably are no real answers.


Dr. Shock said...

I can imagine what you're going through, been there. Didn't know what to do myself although I am a psychiatrist. People think you know what to do with this difficult age group because you're a psychiatrist.
Since I am to give a lecture about depression and adolescents I got interested in normal brain development of teenagers (rationalizing?).
Even made a post about it on my blog
Regards and thanks for your excellent post,
Dr Shock

Dr. Val said...

Dinah - just for some reassurance: I didn't learn ANYTHING about normal teenage behavior in medical school either. Guess it's gone missing somewhere with the nutrition curriculum... Funny that the Kreb's Cycle made the cut though... :) Analyze that!

Dinah said...

Wow, Check out Dr. Shock-- a psychiatrist who blogs about ECT and Chocolate--does it get any better than that?

Val: funny, I was thinking I never learned about normal development or vitamins, except that one can get vitamin D intoxication from eating too much polar bear liver (and let me tell you how useful knowing that has been in Baltimore). I guess vit B3 (niacin) for hypercholesterolemia.

Please note to all: there are a lot of pretty wonderful things about the grunting teenagers.

ClinkShrink said...

Actually, it was Vitamin A toxicity from polar bear liver, although I prefer arctic fox liver myself.

And anyone who blogs about chocolate is a friend of mine. Welcome Dr. Shock.

Dinah said...

Why did I think it was Vitamin D? No wonder I'm having so much trouble. Got any good polar bear liver recipes? Will the teenagers like it?

Rach said...

I love hormones with legs! especially when you feed them greasy pizza and soft drinks and then sit them in front of a computer for hours on end and tell them to fix the problem with the whosit in your software, and the 15 year old rolls their eyes at you... Because you're soooo dumb and everyone knows how to fix whosit problems in random software!


Otherwhys said...

Rach--my "hormones with legs units" are on offer to you for assistance with computer problems. It won't take em hours on end and they prefer water, but the pizza is still a good idea.

Sarebear said...

My teenager parental challenges will have some different aspects due to dd's autism (very high functioning). She's starting to do that, c'mon, mom, you are SO behind and it's frustrating, thing (not in those words, but in behaviors, interactions, and other words), that exasperated impatience/frustration which you seem to know too well.

My baby is almost 9. We're starting the pre-teen years here, I guess, and some of the new and different challenges in parenting, teaching, guiding, instructing, interacting, fumbling around for a rational discipline scheme that fits into it the fact that there are some types of things/changes/situations that do an end run past what coping mechanisms "neuro-typical" kids would have, for tolerating change, transitions, etc. (I don't know if that's the proper term, but I saw another parent of an autistic child use it; I don't like to use normal as terminology, because that implies that my daughter is . . . less than, defective, not normal . . . . Autism isn't who she is, it's just a part of how she interfaces with the world, but I still haven't figured out how I feel about the whole thing, it's kind of a big issue (other than, of course, loving and accepting her completely!!!).

Anyway. As parents, we question ourselves enough as it is, ie, did I do the right thing, was I too harsh, too lenient, too empathetic/friendlike when I should have been more something else, etc. . . . and the extra layers of questioning and doubt that trying to accomodate her needs while trying to discipline and yet allow for behavior that in a non-autistic child would most likely be cause for discipline from most anyone's point of view . . . . trying to figure out if you're coddling, or not accomodating enough, and what harm getting these things wrong might be doing . . .

Agh! Anyway, I'm not saying all this to say my situation is more challenging; just to empathize as , this last year, the pushing against boundaries/authority etc. stuff has started, in subtle ways but growing less so . . . . I've been so blessed that in so many other ways, she's been an easy child (such as sleeping through the night starting at one month old!) . . . . I guess I just take a deep breath and do the best I can. And know that, while stuff my parents did, and didn't do, while I was growing up, caused me harm, they didn't INTEND any . . . . I don't know if that's an excuse, but I know that with so many variables, and as my daughter's personality and independence grow, strengthen, develop, and emerge more, that I'll make a zillion mistakes. I guess all I can do is just work with my husband (although we frequently disagree on child-rearing issues, ugh!) and try our best and try not to obsess about my shortcomings as a mother.

Urk. I just wrote a novel. And then, as innocent as she is, I worry that people will manipulate her into situations and things that she's not equipped to handle. I actually give her MORE information on some of these things than one might think to, because she's VERY bright, and I hope that that, combined with the right kind of info, will help protect her in a world where my ability to protect her decreases the older she, and especially her peers, who have such potential to harm, grow.

Ok, more than 'nuff said . . . . I believe that s'mores/Shakespeare thing is one of those, as Mastercard says, "Priceless" moments.

Dinah said...

Sarebear: EXACTLY! why didn't they come with an instruction manual?

Anonymous said...

EEK, Raising an austistic (even a high functioning one)is much more challenging that raising a "neurotypical" child and don't let anyone tell you otherwise.
And as for information my seven year old boy has asked me what Levitra does. (he sees these ads on TV) As much as I'd like to tell him, I worry he will go to school and tell his second grade class that Levitra make your "peenie big". Life is hard there is no way around that. Love abf

Olive said...

Sadly, I'm left knowing that my children are pushing me away because they are growing up and doing all the things they should be doing, and while it's always been easy to rejoice in their milestones, these stages entail a bit of quiet grief as I come to terms with the fact that my children will never have the relationship they had with me when they were little.

All true, but eventually you will be able to have adult-to-adult relationships with them.

I'm 25, and I get along really well with my parents, but I did go through a period around maybe 14-19 where I was convinced I had nothing whatsoever in common with my parents. But I came back around; your kids probably will to.

Fat Doctor said...

It used to crack me up when I was a PCP in the office that people would bring their teens to me and basically say, "Fix them." Uhmmm...with what? A wrench? I didn't learn nothing 'bout raising no teens in med school. I only hope I figure it out in the next ten years or so before I'm actually responsible for one.

Sarebear said...

Where is that wrench when you need it? The all-purpose, handy dandy, fits hex, allen, phillips, minus sign(?), bolts, is adjustable, ratchets, is angled for those really difficult tight spots like when your teen calls and they're at a party and the friends who drove them have had a beer and they don't want to get into trouble but could you come get them (said wrench magically zaps some courage to them to help overcome the fear of calling the parent in said situation), handy for those teen girl hormone "but I want to learn about sex too but not from my mom and why do people overlook boys finding out and talking about it but think a girl is bad if she has the same urges" and how to handle THAT uber-thorny situation (oh, and the wrench magically lets you know that this is going on . . . .)

Woohoo. THAT wrench would sell for a billion jillion dollars.

Can't find IT on ebay, though, DANG it all . . .

Thanks Dinah.

Thanks anonymous. I do sometimes wonder (again, I don't regret her or not love or accept her fully or anything) how and why the universe/God/deity/spiritual force/karma/happenstance/SOMETHING thought I could handle a special needs child along with everything else . . .

Oh, and I always forget when my mother hit me. I don't think she intended to hurt me, as a person, though, she was just angry, and I was some THING for her to oppress, to try to control, to try to make me not disagree with her or something.

I dunno. It's odd, how I always forget that she hit me during a period (well, the parts that I remember) of pre-teen through late teenagerhood.

teen said...

The teen years are quite a difficult period in one's life .

Ed Levitra said...

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