Teenagers « - Dr Alan Tepp, Ph.D., P.C.

Archive for the ‘Teenagers’ Category

Belonging

Tuesday, April 17th, 2012

The Importance of Belonging (April 2012)

We all value membership in groups. Most of us can recall middle school when we felt just that, in the middle….when we thought of ourselves neither as children nor adults; when we felt an oceanic feeling of being in-between. Recent research has shown that belonging to social groups is an important predictor of mental and physical health, even as important as diet and exercise. There is increasing evidence that the health risk of social isolation is comparable to the risks of smoking, high blood pressure and obesity. For example, in an article published in 2008 in Neuropsychological Rehabilitation by Holmes, et al., it was found that life satisfaction after a stroke was significantly higher for people who belonged in social groups before their stroke.

Many years ago I read an article written by Oliver Sachs of Columbia University. In his remarkable book, The Man Who Mistook His Wife For a Hat (1998), Sachs concluded that when determining a patients quality of life we should not look so much at the severity of the disorder but rather the person’s ability to maintain a coherent sense of self. And so it seems from numerous psychological studies, that group life and a sense of social identity have a profound influence on our abilities to maintain a coherent sense of self as well as on our general health and well-being. We understand ourselves fundamentally as humans who are social animals who live and have evolved to live in groups. Human beings who live in groups and understand ourselves within a group, see that membership in a group as being an indispensable part of who we are and an important part of our leading fulfilling and satisfying lives.

Robert Putnam, in his book, Bowling Alone (2000), wrote that if you belong to no groups but decide to join one, you cut your risk of dying over the next year and a half, by 50%. The 800 million users of Facebook clearly understand that social networks help us feel connected. We now know from research that participation in group life is actually an antidote to physical and mental health problems. All too often TV leads us down a pharmaceutical path to deal with problems. Object relations theorists have firmly implanted in my belief system that participating in activities that lead to feelings of belonging, of feeling like we are members in a group, is potentially a more effective way, and likely more enjoyable way, of inoculating oneself from problems rather than treating them after they develop. And if you struggle to easily establish membership in groups, seek out professional help for help in identifying what factors interfere with that process.

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Forgiveness

Friday, March 16th, 2012

Forgiveness (March 2012)

I have been struck by the number of patients that come to me with issues surrounding powerfully emotionally laden events in their marriages or in their relationships, that are inordinately hard for them to put behind them. Eventually, I discuss with my patients the importance of forgiveness. Countless numbers of pop-psychology books have discussed the issue and talk show hosts make the most of events demanding forgiveness, allowing their guests to engage in a free-for-alls on their stage. Sadly, few people seem to be able to develop the skills to meaningfully forgive and move on.

Much of the advice we most of us have been given about forgiveness surrounds the concept the deep hurt and anger are difficult to resolve, and that eventually the hurt and the angry feelings will settle down, and we will reach a place of forgiveness over time. We might have been told that if we try to rush the process of forgiveness, it is somehow disenguine. But what I believe is that people can forgive another person, in a true and meaningful way, when you make the decision to do so.

There are four major components I utilize to help my patients engage in the process of forgiveness. First, it is important to realize that by holding on to anger and resentment, you are participating in carrying on a legacy of hostility. Forgiving is not at all telling someone or yourself that it was ok, but rather choosing not to carry on this legacy of resentment.

A second component of effectively forgiving someone is giving up the hope of an alternate past. Much of our resentments about long ago events are rooted in unconscious or conscious hopes that we could have had a better past history. Part of forgiveness is relinquishing that hope for a better past.

A third component of forgiveness is the belief that you are in control of what you’re going to do heretofore. In essence, the adage of, “I will plant the seed that I will reap, not the seeds that you planted” is the essence of this piece of forgiveness. One must believe that you are in complete control of your feeling states heretofore and that what happened in the past is what someone else did, in the past.

The fourth component of forgiveness is the capacity to believe that you can start anew. Herein, the belief that we are in some fixed position and not in a dynamic process, is a crucial distinction. Examining your life in a way that allows you to see yourself as being on a path fosters the capacity to start again, anew, void of the anger, hostility, or resentment that occupied you previously.

Mental health can be understood as a state wherein people feel integrated along a variety of dimensions. By integrating and accepting the past and believing the future is our own to create, allows for a more integrated sense of one’s self. This process of integration allows for a renewal of your own identity, void of the anger that occupied your heart in the past. That deep seated anger keeps that part of your heart from feeling love for those people whom you do love. In that regard, forgiveness helps us at least as much as anyone else. And so, with help, we can decide to forgive.

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Meditation and Letting Go

Thursday, December 22nd, 2011

Throughout my years of practice, I have viewed meditation as a path to mindfulness and awareness, and through this, a subsequent entrée into mentalization leading to healthy attachments.

Over the years, I have engaged in both Qi Gong meditation exercises, Tai Chi (sometimes referred to as a moving meditation), and a type of meditation termed Modern-Day Meditation. All of these techniques have proven useful in helping me center and ground myself. And there are still other types of meditation that have helped countless others including Transcendental Meditation, Mindfulness Meditation, Zen Meditation, Buddhist Meditation, and Taoist Meditation. Furthermore, there are a variety of methods of meditating ranging from sitting in a fairly fixed position to more expressive meditation wherein the body can move in any manner and let anything happen, and finally to the practice of mindful meditation wherein someone can go about their daily activities in a mindfully mediated state. Currently, I engage a method of guided meditation termed Modern-Day Meditation that I have found helpful in assisting both myself and some of my patients in getting in touch with feelings along with letting go of feelings that can be disruptive to their life.

I understand all meditation as a process by which someone goes inside themselves blending one’s internal world into a depth of external consciousness. A meditation that I sometimes employ in my practice is a guided meditation technique using specific songs that help to elicit a variety of feelings unique and appropriate for a particular patient. These could be songs that have angry themes, sad themes, or painful themes; whatever songs elicit feelings that help guide my patient deeper and deeper into an emotive state that lays underneath their thinking. This is a process that requires many practice sessions in order to go deeply enough to get in touch with profound and meaningful emotive experiences. But getting in touch with these feelings is only the first step in allowing the meditative practice to help. Once in touch with deep feelings there needs to be a period of time wherein those feelings are released and then replaced with calming, beautiful feelings of light, love, care, and compassion. In so doing, there is a gradual therapeutic effect of letting go of painful feelings and replacing them with feelings that are comforting.

For many people, this type of guided meditation is a practice that is difficult to comfortably engage. It is very important for people to keep their eyes closed throughout this type of meditative practice in order to try to stay within oneself, shutting out visual cues that might take one out of his or her depth, and promoting the patient to focus inward. Riveting music can serve to help a patient go deeper and deeper into those feelings that are evoked by that music, and in so doing, promote awareness of emotional states that lay underneath one’s thinking.

Meditative practices such as the one I have described cannot simply be cathartic. Psychological research has shown that catharsis in and of itself typically produces no long term benefit. However, getting in touch with deep feelings and then actively calming oneself in the service of letting in whatever is beautiful to the individual, i.e., whatever is filled with light and love for that individual, can be powerfully therapeutic in ridding oneself of either acute or longstanding pain and sadness.

Sometimes, my patients have lives filled with pain secondary to their sensitivity and “thin skinned” nature. This has left them feeling the pain of others, both in their immediate environment as well as in the world in which we all live. Such individuals in my practice have often benefited from meditation as it has enhanced their awareness of their pain, fostered mindfulness, and provided a means to replace some of that pain with feelings of light and love. Furthermore, as an attachment-based psychotherapist, I have worked with this as a means to promote pathways to healthier attachments, a cornerstone of mental health and feelings of well being.

In closing, I want to emphasize the power of meditation. Meditation has been found to cause significant change in metabolic rate and blood pressure. Rate of respiration and blood pressure can also decrease as a result of meditation. My patients have talked with me about an overall improvement in their sense of psychological well being when they experience an increased capacity to “let go” of upsetting feelings that have tormented them, sometimes for many years. In recent years, many physicians have supported the use of meditation as a meaningful component of any integrated healthcare program. Recognizing the value of meditation both physiologically, psychologically, and spiritually has clearly been helpful to some of my patients and I am confident that it will remain an important part of my practice.

Contact Information Contact: 914-232-1000 16 Dakin Avenue, Mount Kisco, NY 10549 1073 Main Street, Fishkill, NY 12524 Olmstead Lane, Ridgefield, CT 06877 Mailing address: P.O. Box 860, Katonah, NY 10536

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The Impact of Success

Monday, March 1st, 2010

It has long been discussed that paying attention to one’s successes has a positive impact on an individual and that a focus on our own or other’s shortcomings and failures is not helpful and has the potential for souring any relationship. But recent neuropsychological research at MIT is showing that success has a much greater influence on the brain than does failure.

Neuroscientists and psychologists have studied how the brain learns things for some time now. Have you ever skied and made a series of bad turns, and on another run, felt like you were making one well-constructed turn after another? Or gone bowling and had a number of strikes and spares in a row? It seems that there is more than just luck to good streaks and bad streaks. Neuroscientist Earl Miller who leads a team at MIT recently published an article (Neuron, July 30, 2009) discussing how single cells in the brain learn from positive and negative experiences. In an experiment involving training monkeys to make a choice, researchers found that successful choices caused the level of the neurotransmitter, dopamine, to soar in the monkeys’ brains, and that this then caused the monkeys’ performance to soar. On the other hand, if the monkey made a mistake, even after the monkey had clearly mastered the task, the monkey subsequently did not do better than chance on the next trial. It seems the monkeys’ brains learned far more and far more effectively from positive learning experiences, than from mistakes.

If we look at how we interact with important people in our life, we might ask ourselves how often do we applaud success in the way a hockey team surrounds a teammate who scores a goal, or a bowling team applauds a teammate who makes a strike? In these instances, brain cells register that we have done good, and with that pleasurable feeling, and a flood of dopamine in the brain, our mind tells us to keep doing whatever it is that we were doing that led to that success.

In our day to day lives, there are countless opportunities for us to focus upon ourselves, our achievements, and our successes, and in so doing, not only decrease neediness and feelings of needing to be applauded by others, but also increase the chances for our success to continue. Looking at our successes, no matter how irrelevant to others, can help us to work toward a larger goal. Moment to moment successes at work in the gym, or elsewhere, can segue into larger and broader feelings of self-worth. In the absence of positive feedback, we are vulnerable to negative thinking and more generalized negativity. This can lead to depression as well as have a souring effect on our relationships. Much the way we might tell a child who loses the playoffs to look at the friendships that he or she created throughout the season, we must find in ourselves and in those we love, the positive, the win, the place where some success resides.

In marriages, when needs are not being met, partners are often disappointing one another, and separation is growing amongst a husband and a wife, it becomes clear that little opportunity is present from which either husband or wife can gain the neurochemical momentum to promote the behaviors and affective expression that will allow pleasurable and desirable behaviors to continue. At such times, parties need to take a step back and actively seek out successes. We need to be open to the idea of promoting and applauding our spouse as the sine qua non of happy and successful relationships. It is important to remain mindful of trying to bring out the best in our partner. Meeting the needs of our partner can give both them and ourselves powerful feelings of satisfaction and that can then spiral in a positive direction that allows the relationship to blossom and flourish.

In our children, we need to find islands of competence in which we can applaud their successes. False applause is shallow and has little meaning to a child or teen who tends to pay little attention to what he or she experiences as false praise. But fostering an ability in a child, and then paying attention to those abilities, is a clear path to promoting our children and their self-image. In addition, Miller’s work at MIT sheds light on the neural mechanisms linking environmental feedback to neural plasticity, the brain’s ability to change in response to experience. As such, our attention to success has implications for understanding how we learn, and how we understand and treat children with learning disorders.

March 2010

Posted in Children, Men's Issues, Parenting, Relationships, Teenagers, Uncategorized, Women's Issues | 10 Comments »

Emotional Intelligence in our Schools: Teaching Social, Emotional and Behavioral Skills

Thursday, February 1st, 2007

Over these past 20 years, Emotional Intelligence (EI) has gained considerable increased attention among psychologists as well as educators and the general public. EI was the feature article on a cover of TIME magazine about 10 years back, and it has been featured in many newspapers, internet websites, and trade texts dealing with self-help, management practices, and assessment.

EI has often been referred to as having 5 components: Self-awareness–knowing your emotions, recognizing feelings as they occur, and discriminating between them, Mood management–handling feelings so they’re relevant to the current situation and you respond in an appropriate manner, Self-motivation–utilizing your emotions and directing yourself towards a goal, while controlling self-doubt, inertia, and impulsiveness, Empathy–recognizing feelings in others, tuning into their verbal and nonverbal cues, and being able to communicate this awareness, and Managing relationships–handling interpersonal interaction, and being able to utilize negotiation in the service of conflict resolution.

EI’s popularity can be attributed to strong claims about its ability to predict real-life outcomes above and beyond traditional measures of intelligence. As a result, intervention programs aimed at improving students’ Emotional Intelligence have entered the curriculum in thousands of America’s schools, and many within our area. According to a recent article in the School Psychologist Quarterly, however, many of the existing programs lack consistency and clear, measurable goals.

When Goleman’s book on EI first appeared, it was criticized by some in the scientific community for not providing any empirical support for his claims (Mayer & Cobb, 2000; Mayer, Salovey, & Caruso, 2004). Critics also contended that Goleman’s definition of EI is overinclusive, incorporating aspects of cognition, personality, motivation, emotions, neurobiology, and intelligence (Locke, 2005; Matthews et al., 2002). In fact, many equate his conceptualization of EI with almost any desirable trait that is not measured by traditional intelligence tests (Grewal & Salovey, 2005). Further, his conceptualization of EI has yet to show any true predictive ability when factors such as intelligence or personality are factored out. Therefore, many feel that Goleman’s concept of EI does not actually define a unique and valid construct.

This criticism, however, has become problematic for educators that are responsible for K-12 curriculum focused upon social, emotional, and behavioral learning, e.g., an Assistant Superintendent for Curriculum, Assistant Superintendent for Special Services, or Director of Special Education. Parents who recognize the needs of their children then are left to struggle with school districts when they want EI taught to their children, or alternately put, social, emotional and behavioral skill acquisition. This often leaves parents left in the middle and their children’s needs left un-met.

My advice to parents is to be clear with administrators in their school districts about their child’s special needs and to articulate clearly how a child’s deficits in social, emotional, and behavioral skills, demand direct instruction of those skills within the child’s educational experience. It is often the case that only with strong advocacy by parents and outside professionals that a child’s social, emotional and behavioral needs will receive the attention they deserve.

References

Goleman, D., Working with Emotional Intelligence, (1998), Bantam Books

Grewal, D and Salovey, P. (2005) “ The Science of Emotional Intelligence”, Current Directions in Psychological Science

Locke (2005) “Why Emotional Intelligence is an Invalid construct”, Journal of Organizational Behavior,

Matthews, G., Zeidner, M., Roberts, RD, (2002) Emotional Intelligence: Science and Myth MIT Press

Mayer, JD and Cobb, CD (2000) –“Educational Policy and Emotional Intelligence”, Educational Psychology Review

Mayer, JD, Salovey, P and Caruso, DR (2004) “Emotional Intelligence: theories and findings”, Psychological Inquiry

February 2007

Posted in Educational Issues/Schools, Teenagers, Uncategorized | 1 Comment »

Promoting Emotional Disclosure in Adolescent Boys

Monday, May 1st, 2006

Renee Spencer recently wrote an article in, Psychology of Men and Masculinity, which discussed something that I have long felt to be such an important component of helping males develop more depth in their capacity to reveal emotional issues. Many aspects of male development are in place to foster components of masculinity that can inhibit emotional disclosure, e.g., competition, drive, and achievement. This makes it important that we look at what components of society can play a role in fostering boys’ ability to be emotionally open, and allow themselves feelings of vulnerability. This can lead to helping boys become more complete men, wherein they are able to disclose emotional components of themselves.

Spencer’s work looked at male mentoring as a means by which adolescent boys might be able to discuss more emotional components of their personality. Six major themes emerged as fostering emotional disclosure in adolescent boys: 1. The importance of relationships with caring and open adult men in young adolescent boys lives. Herein, we need to look at what opportunities adolescent boys have to accessing caring and open adult men; 2. Mentors need to be involved, committed, and emotionally connected to their male youth partners in order for the relationship to be fostering of emotional closeness. Finding such men, however, can be difficult; 3. An enduring component of the relationship is crucial. Men cannot be in these mentoring roles for the short term. Men need to see this as a multi-year commitment for their influence to be significant; 4. These relationships need safe places to allow boys to feel sufficiently safe to allow themselves to enter a position of emotional vulnerability and then ask for support, if needed; 5. Mentors and the adolescent boys with whom they develop a relationship need to expect ups and downs in their relationship in terms of how emotional these relationships can be. So many boys are most comfortable in relationships with adult men when such relationships are characterized by a shared activity. Research on adolescent girls has shown that relationships they develop with adult women are more easily established via emotional disclosure, while boys often report shared activities with adult men as the sine qua non of closeness with an adult man. As, such, men who engage boys in this relatively uncharted territory, must expect some resistance at times; 6. Both adults and adolescents need to appreciate the manner in which emotional vulnerability and closeness between the mentoree and the mentor can help adolescent males manage feelings of anger more effectively. Many boys recognize their need for “Anger Management”, particularly since the movie release with the same title in 2003. Often this awareness can help them to value emotional disclosure as a mechanism to achieve improved anger management.

So often, adolescent males have relatively few opportunities to deal with the fathers of their peers, except as coaches when they play on competitive athletic teams. Opportunities for men who wish to influence the lives of boys on route to becoming men need to be explored by all men who view a component of their role in society to be shaping the generation behind them to become honorable and caring men.

May 2006

Posted in Educational Issues/Schools, Men's Issues, Teenagers, Uncategorized | 1 Comment »

Eating Disorders: What I Need to Do to “Beat” My Eating Disorder

Tuesday, February 1st, 2005

In my 20 years of practice with patients suffering with a restrictive eating disorder, I have found a list of 12 self-statements, a sort of cognitive-behavioral plan, helpful in my work with patients. I ask my patients to keep this list with them and work on one each day, until the list is internalized:

Relax my rigid adherence to times to eat.
Stay motivated to get healthy and overcome my eating disorder.
Fight my tendency to diet or exercise excessively.
Overcome my terror of being overweight and work towards thinking about food, instead of being preoccupied with food.
Face my fears of going on eating binges. I can stop eating when I want to.
I need to realize that too much energy is going into my eating disorder, so much so, that I can’t enjoy things the way I used to.
I need to stop being so self-critical. It’s OK to make mistakes. I just need to try to not make the same mistakes, over and over again.
I have to stay in touch with all my feelings, feeling sad, feeling irritable, and feeling any way I do.
I need to gain a greater comfort level with my body. I need to be able to see myself in the mirror without clothes, and feel comfortable with myself.
I need to fight how self-conscious I am about my shape.
I need to maintain a very clear awareness of my illness.
I need to stick with my food plan and my exercise plan.

02/05

Posted in Parenting, Teenagers, Uncategorized | 1 Comment »

Homework Strategies: Making Homework a Priority

Wednesday, September 1st, 2004

It is important that your children know that you value them doing their homework. Getting it all done is the minimal expectation. Let you child know that getting it done well, is what you really expect. I’ve listed 10 ideas below that might be helpful:

Establish a study routine: children should be in the habit of studying at the same time and in the same place each day. Children and parents should decide, together, upon the study routine by taking into account scheduled activities, family commitments, and favorite TV shows.
Consider the child’s ability to concentrate at different times of the day. Many elementary school children are too tired after dinner, and evidence this by having trouble concentrating, being easily frustrated, and being slow to complete tasks.
Ideally, the family agrees upon a study hour, the television and stereo are off, phone calls are not taken, and the entire family studies, reads, or completes paperwork.
Establish a place to study with good lighting and a table or desk. Some children prefer to study in their own room. Others do better if they are studying at the kitchen table or other location near parental help.
Some children are able to study with a little background noise such as music. Few can study effectively in front of the TV and most need uninterrupted quiet. Other children may prefer to work at the library, and will need transportation.
Have supplies on hand including binders, notebooks, paper, pencils, pens, assignment books, erasers, dictionaries, a calculator, ruler, hole punch, tape, glue, reference books and/or programs.
Demonstrate that you feel that homework completion is a higher priority than other activities. A child should not watch TV and talk with friends before completing homework, unless time later in the day has been set aside for homework completion.
Reduce activities if a child has so many commitments that there is insufficient time for homework.
Have help available if a child has so many commitments that there is insufficient time for homework.
Have help available for every subject. This might be a parent, neighbor, friend, teacher hot line, and on-line homework service, or a tutor. The helper needs to be someone who is knowledgeable about the subject and who can help the child without becoming frustrated or angry.

09/04

Photo credit: spiritinme

Posted in Children, Educational Issues/Schools, Teenagers | 1 Comment »

Executive Functioning

Sunday, April 4th, 2004

I have long been interested in how Executive Functioning, or the ability to plan, organize, problem-solve, strategize, and inhibit undesirable responses, impacts both children and adults.

We need to credit Stuss and Benson (1986) for giving us possibly the most comprehensive definition of Executive Functioning. They detailed issues such as Planning and Sequencing, Paying attention to several different components at once, Grasping the gist of a situation, Resisting distraction and interference, Inhibiting inappropriate response tendencies, and Sustaining behavioral output for a sustained period of time. Harris (1991) discussed self-regulation, set-maintenance, selecting, prioritizing, organizing time and space, selective inhibition, cognitive flexibility, and output efficiency. Russell Barkley (1997) gave us a simple but truly elegant definition: “Those self-directed actions of the individual that are being used to self-regulate”. Personally I like: POPSI: Plan, Organize, Problem-solve, Strategize, and Inhibit undesirable responses. Regardless of how you want to think about executive functioning, almost all will agree it has enormous influence on how we function in life.

I began my interest in executive functioning with my training in neuropsychology and my work with ADHD Children in the early 1980′s.

In the late 1980′s, when I began working with many autistic spectrum disordered children, I began seeing how important executive functioning was in their lives, in particular, with high functioning autistic spectrum disordered children and Aspergers Disorder children. In the 1990′s, I became interested in variations in learning, and so often executive functioning played a role here as well. When I began doing Executive Coaching in 2001, I realized that many adults had very well developed executive functioning skills, but there were other things missing.

With the WISC IV revisions of 2003, and the beginning move away from the ability-achievement discrepancy model, I became confident that executive functioning would now move into the mainstream of educators’ thinking. This is so important because without it, the long established ability-achievement discrepancy model relies upon a faulty premise, that is, a wait to fail mentality.

The WISC IV has an increased emphasis on Fluid Reasoning and Working Memory, and a more clear mandate to look at how the child got the answer. This will eventually force educators to begin to look at the pre-referral side of special education. The WISC IV abandoned a Verbal IQ and a Performance IQ, and now looks at 4 Indexes: Verbal Comprehension Index, Perceptual Reasoning Index, Working Memory and Processing Speed Index. These four indices contribute to a Full Scale IQ Score. And so, now that David Wechsler is adopting executive functioning constructs as central to assessing intelligence, I believe executive functioning will come into the mainstream of educators’ thinking.

This all became crystal clear to me when my son, Jacob, went through the college application process this past year, and despite being an all around outstanding young man with high SAT’s, a 95 point GPA, excellent scores on all five of his AP exams, and being named as an honorable mention linebacker on the local football team (NCN Westchester), he certainly showed me how a very smart kid can have some deficits in executive functioning. I recalled that in the NY Times this past summer (08/26/03) Martha Denckla, M.D., was quoted “What fascinates me is kids who go off to school with perfect SAT’s and then flunk out because there is too little structure for their scattered minds. She says, “On your own” is a death knell for these kids.” I have tried to prepare my son, but we will see.

April 2004

Posted in ADHD, Children, Educational Issues/Schools, Teenagers, Uncategorized | 1 Comment »

Depression in Teens Can Affect Adult Happiness

Saturday, November 1st, 2003

Adults who experienced even a single bout of major depressive disorder (MDD) in adolescence are likely to demonstrate pervasive psychosocial impairment, according to research by psychologist Peter Lewinsohn, PhD, of the Oregon Research Institute, published in the Journal of Abnormal Psychology in August 2003.

Young adults who had experienced an episode of MDD, regardless of other factors, exhibited pervasive impairments across psychosocial functioning, including occupational performance, interpersonal functioning, quality of life and physical well-being. Most poignantly, Lewinsohn says, when other factors were controlled, adolescent MDD translated into greatly reduced life satisfaction.

The research suggests that depression in adolescence indicated a broad, lasting tendency toward psychosocial problems that should be seen as a serious, stand-alone risk factor.

September 2003

Posted in Men's Issues, Teenagers, Uncategorized | 1 Comment »

Archive for the ‘Teenagers’ Category

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