Decoding the Adolescent Brain, and why I love working with Teens (and their parents!)

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You may have heard the saying that men are from Mars and women are from Venus, but I’m here to offer the third and final declaration of this adage – teens are from Pluto. Or at least it can feel this way, as parents tell me time and time again - the happy go lucky child they once knew, transformed into a person they no longer know how to interact with. A child that once felt so close now seems a solar system away.   

In my career as a child and adolescent therapist, I have worked with hundreds of teens and have come to appreciate both the challenges and joys associated with this stage of development. Teens invariably bring fresh energy and a unique perspective, and I’ve come to learn that understanding them, the changes in their brain, and the developmental tasks they have to go through, has gone a long way in helping me provide support to young people and their caregivers.

While I’ve been told that it can be a challenge for parents to get teens to *come* to therapy, one thing that has struck me is how much teens revel in feeling seen, heard, and supported by someone who, by virtue of being a neutral third party, will be less impacted by the intensity of the emotions they experience. Indeed, a central tenant of adolescence is that the intensity of uncomfortable emotions (sadness, anger) can be very intense. At the same time, what we know of affective states is that they are quite literally contagious. When parents see their teens struggle emotionally, often parents themselves become overwhelmed with worry, and they require some support to parent in the most helpful way.

And of COURSE parents would be worried about their teenagers! In his book, “Brainstorm”, child psychiatrist Dr. Dan Siegel highlights some pretty frightening truths – while 12-24 makes up the most physically resilient age group, this is also the highest population with avoidable causes of serious injury or worse. With the onset of risk-taking behaviour, adolescence is a period in which young people can alter the course of their lives in irreversible ways. Okay.. now that I’ve scared you, there is good news! And here it is: while adolescents may never tell you that they want your help, I promise – with unequivocal conviction – that they absolutely do. That’s right. YOU, as a parent, absolutely have the power to positively influence your teen to make good decisions to make it through this tumultuous period of life.

Therapy with teens:

The cornerstone of my work with adolescents lies in allowing teens to have a safe and confidential place to explore their thoughts and feelings, while incorporating their parents into the work we do together. Did you know that in Ontario, you can see a health care practitioner without your parents’ consent at the age of twelve? (twelve!). Although the law stipulates that young people can seek out their own mental health treatment, best practices maintain that young people are treated in the context they exist in, and this means the family system is a significant piece of the puzzle.

Family therapy with adolescents doesn’t have to include teens and their parents in the same room. Often, even teens who refuse to have a joint session with their parents will almost always give me permission to lead a “parent education session”, where we don’t talk about the content of the sessions with teens, but instead work with parents to help them understand what is going on for adolescents and how to best support them.

Parent psychoeducation:

So! How can caregivers best support their kids, you ask? An important starting point is to understand the central tenants of this stage of development, which I’ve outlined below (and taken from Dr. Dan Sigel’s book, “Brainstorm: the Power and Purpose of the Teenage Brain”):

Teens have a lower dopamine baseline –

  • Dopamine is the neuro-transmitter responsible for the feeling of pleasure. In adolescence, teens start to require more novel experiences in order to raise dopamine levels, and this would explain why teens seem to feel bored easily and why they take more risks. While seemingly scary, this hormonal change is  necessary to ensuring that young people don’t stay in the comfy-cozy-confines of their familial homes forever, and is a necessary precursor to individuation and independence.

Attachment to peers:

  • I often hear concern from caregivers about the company that their kids keep. These associations make sense, though, as young people struggle to figure out who they are and try to find a place where they belong in the world. Unfortunately this can land them in relationships with peers who may be less than ideal.

  • The key here is to understand an adolescent’s associations with their peers, favorable or otherwise, as serving a crucial developmental function. I can’t stress this enough – when young people need certain shoes, clothes, or any other social status symbol, it quite literally is programmed into their brains that if they don’t belong to a “pack”,  their survival is on the line as a matter of life and death.

  • Here is the bottom line: we need safe and trusting attachment relationships until the day we die. What changes in adolescence is who the attachment is focused on. The switch from parents to peers is a necessary genetically programmed function that, again, helps ensure that kids can someday go out into the world and be independent.

  • When kids associate with undesirable peers, we must understand that they are doing the very best they can to fit in. Parents must respect the yearning that adolescents have to belong, even if they don’t approve of their friends (or buy the shoes, for that matter).

Intense Emotions:

  • During this stage of development, the prefrontal cortex (the area in the brain responsible for decision making, understanding risk and reward, planning and organizing) is developing rapidly until the age of 25 (25!). At the same time, the limbic area – the part of the brain that triggers emotions, especially emotions related to danger, is well developed and working over-time. This means that young people can experience intense emotions without the ability to fully understand and process them.

  • That’s where parents come in - I recruit parents to be their children’s “emotional coaches”. Parents often tell me that they feel like they have “no influence” or “have lost all control”, but the truth is that learning about how to teach their adolescents to manage intense feelings and helping their adolescents co-regulate has been the single most influential piece of work I’ve done that has positively influenced teens.

  • That’s right - parent work can have a tremendous impact on the well-being of a teen who is struggling. While a therapist will see a child for an hour a week, parents see their kids on a regular basis, and parents will always be more influential to their kids than a therapist will ever be.

Anger, Anger, Everywhere:

  • Lastly, and perhaps my favorite bit of research regarding adolescents: Adolescents are significantly more likely than adults to perceive ANGER in the expression of a person (read: parent) who is portraying a neutral expression.

  • That means that young people are using incorrect data (i.e. perceiving anger where there is none) to inform their relationship with the world around them. This may account for young people becoming emotionally activated by parents who ask as benign a question as – “how was your day?”.

  • What’s helpful here is to understand that if a teen is reacting in a way that is bizarre, this can be explained by changes in the brain, and caregivers can react to these outbursts in planned and purposeful ways, discussed at lengths in parent-sessions.

So there you have it! All these factors add up to ensure one thing - parenting a teen is by no means easy. However, armed with the understanding of the changing adolescent brain and the support of a therapist, parents have the fundamental ability to help their teens grow, help “coach” them emotionally, flourish, and succeed.

I am committed to working with teens individually and working with parents to ensure that they are providing skilled support during this difficult time. And if you need some hope about the trajectory of your relationship with your teen, I will leave you with this Mark Twain quote:

“When I was a boy of fourteen, my father was so ignorant I could hardly stand to have the old man around. But when I got to be twenty-one, I was astonished at how much the old man had learned in seven years.”

If you are interested in learning more, please don’t hesitate to contact me: info@jennsophieshields.com.

 

 

 

Trauma Therapy, and why I decided to give Internal Family Systems Theory (IFS) another chance

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Have you ever read something and had it go right over your head, only to return to it years later and have it speak to you in a profound way? Have you ever felt so excited about something you’ve come across that you want to write a blog post about it and share it with the world?

This, my friends, was my experience with Richard Schwartz’s (Ph.D. in Marriage and Family Therapy) theory of “Internal Family Systems” (IFS) – a theory that lived very much in the peripheral sphere of my therapy “toolbox” until I could actually figure out what it meant and how to use it. Most notably, IFS has helped me support clients to be kind and compassionate to the “parts” of themselves that act in ways that aren’t helpful to them, and this theory is deeply aligned with helping clients build the essential practice of self-compassion.

My understanding of developmental trauma:

I promise we will get to what IFS is…But first! Let me take you back to the foray of my career as a trauma-focused therapist, and why an understanding of trauma that is rooted in theory is helpful in supporting healing.

I became aware of the concept of “trauma” while working my first job as a social worker in a residential treatment program.  For those of you who don’t know what that is, residential treatment is a program that sees kids placed in a group-home where they are cared for by staff who are trained in responding to challenging behaviors in helpful ways (read: small child to staff ratio, lots of staff support, supervision, and training). At the same time that kids aren’t living in their homes, therapists work with these kids’ caregivers to help them understand the needs of these young people who present with behaviors that can be seen as “destructive”.  Ultimately the goal is to have caregivers understand the behavior as a function of the young person trying to get their needs met and keep themselves safe, and the goal is to return kids back into their homes or see them placed in another well-prepared setting (with extended family or foster-care placements).

Spoiler alert: this job was not easy.

The challenge is that you have stressed families who are tasked with responding to kids who are engaging in behaviors that are extremely difficult to manage. Let me paint you a picture – you have a child who is regularly trashing a classroom (and their school provides you with photos to show you how bad it is…), kids who threaten their classmates with sharpened popsicle sticks during art activities, heated outbursts in very public places to the dismay of those responsible for said kids, and a whole host of other socially undesirable behaviors that trigger caregivers into despair for very good reasons.

As this was my first job fresh out of grad school, I was eager to learn as much as possible about trauma– what was out there in the research that could support me to help these kids, and how do I look like I have a semblance of what I’m talking about when tasked to provide my expertise to teachers, principals, and children’s aid staff?

Cue my introduction to reading everything I could about developmental trauma.

Developmental trauma is trauma that exists as a result of a disruption in a child’s early relationships, which has profound impacts on how these kids develop and relate to themselves and the world around them. Instability in early relationships has the potential to fundamentally reorganize the nervous system to perceive threat where there may not be any (hence, angry outbursts “for no reason”) or, alternatively, causes a person to be desensitized to very real threat. In any event, the body’s “danger alert’ system” has been impacted.    

By definition, each child who comes to residential treatment is experiencing some sort of disruption in their care. My work in the field of developmental trauma has included work with kids in residential care, foster care, young offenders taken out of their homes and placed in custody, children who have witnessed domestic violence, and children who have themselves been survivors of abuse - all of these experiences mark early disruptions with later life impacts.

The Body Keeps the Score:

This line of work has led me to the purchase, read, re-read, and downright comb-through of my favorite trauma book – Bessel Van Der Kolk’s “The Body Keeps the Score”. The Body Keeps the score is divided into several parts – a helpful retelling of the historical views of how trauma has been understood, current research on trauma, and an overview of several different modalities used to promote healing. I have used many modalities in this book to treat trauma, but it is only recently that I’ve connected to the theory known as IFS, laid out in Chapter 17 of Van Der Kolk’s book.

So, what is IFS, you ask?

In his book, Van Der Kolk  devotes a whole chapter to Richard Shwartz’s theory of IFS, and explains that every major school of psychology recognizes that people have subpersonalities.

 In the theory of IFS, there is a central “self”, and three major sub-personalities that exist outside of the core “self”:  

1) Managers

2) Firefighters

3) Exiles

Stay with me, people. I, too, distinctly remember the names of the sub-personalities as being the reason I put this theory on hold for a few/five years and moved on to other modalities of treating trauma.

And yet, I’ve been looking for modalities for treatment that are at their core non-pathologizing, and IFS not only fits the bill but also provides a creative way to understand trauma and the behavior that I see so commonly in the clients I work with.

Here goes nothing - a cursory explanation of the “self” and the three sub-personalities that exist in the theory of IFS:

The self:

IFS maintains that there is a central “SELF”, and that there is a part of us that can observe our other “selves”. This would be similar to the part you access in meditation when you watch your thoughts float by, if you’ve ever had that experience.  IFS maintains that within everybody lives this “self”, and that the" “self” has the fundamental desire to be safe, happy and calm, without exception.

It would then follow that people would only do what’s best for them, right? Eat well and exercise, avoid harmful substances, avoid unhealthy relationships. And yet, time and time again I see people who are engaged in behavior that is counterproductive to wellness. IFS maintains that the reason for this lies in understanding that there are MULTIPLE parts to us that truly are doing their best, and these “parts” are listed below: 

1) Managers:

 Managers are the “part” of us that keep us safe by being proactive – they control relationships to make sure people don’t get too close or too distanced, try to control your appearance, and criticize you when you make a mistake.  While seemingly “positive”, when this part takes over it can be relentless  – think perfectionism, the part of you that wants to control everything to be perfect and feels out of control when things don’t go as exactly planned.

2) Firefighters:

This is the part of us that is the “emergency responder” that acts impulsively whenever triggered – this part will do anything to not feel an uncomfortable emotion. This is the “part” of us that engages in what may be called “self-destructive” behaviors, including binging and purging, acting out in anger, abusing drugs and alcohol, etc.

The important thing to note is that these parts have a FUNCTION, and the function is to try and keep the third and final sub-personality from experiencing deeply rooted pain. The third and final “part” is known as the exile.

3) Exiles:

Exiles are hurt parts of us that we often carry from childhood. These are parts of us that feel afraid, ashamed, and hurt. When the exile is triggered, the nervous system becomes completely dysregulated and truly fears annihilation.

Ultimately, the parts of us that act out destructively and the parts of us that are constantly trying to control our lives are just trying to make sure we don’t feel so hurt that we quite literally become too overwhelmed to go on.

IFS - from theory to practice:

So! We have different parts that have funny names. So what? How is this helpful in practice?

Since learning about IFS, I have found a new framework to talk to my clients about behaviours that they so badly want to change. I work with clients with disordered eating, or clients who feel the need to control every single aspect of their lives, leading to rigid thinking and anxiety.

The point is to understand that when people do things like abuse substances, the “firefighter” part is working hard to ensure that the body is regulating emotions in the best way it knows how, through using substances, and.. that’s okay. It’s only through the acceptance that we are doing the best we can that things ultimately start to shift.  When clients try to control every aspect of their lives, this is the “manager” trying to keep the client safe and regulated, and that’s okay, too. Ultimately all behaviors are seen with compassion and understanding, and this really fits for me.

Understanding unhelpful behaviors as “protective” is helpful for adults and kids alike – instead of judging people, can we instead curiously explore why this may be happening?

Befriending the different parts:

IFS explores these “parts” as, quite literally, distinct “people” with distinct characteristics, hence the name of the internal FAMILY system. The theory sees the distinct personalities as having a mind of their own.

I work with my clients to explore the following questions: What triggers the firefighters/managers to come out? What age do they act like? What kind of language do they use? What behaviors do they engage in?

We also look at what these parts are trying to “protect” – what are some unhealed wounds felt by the “exiled” part, the part of us that is so badly hurt that we will engage in “unhelpful” behaviors to not have to feel what is there?

 The results have been such that clients can meet the parts of them that they so badly want to ignore, show them compassion, thank them for the work that they’ve done so far, and literally ask the parts for permission to take a step back. People start to understand that the adaptive strategy that may have been helpful historically is no longer helpful.

There are many ways to communicate with the parts – this can be done with “chair-work” to speak to the parts in an empty chair, or communication/exploration can occur through journaling exercises. What’s fascinating to me is seeing the nervous system’s reaction to asking a part to please take a step back, the same way you would ask an unhelpful family member to leave a therapy session and wait in the waiting room. There is a dialogue that can happen between the selves, and it can be truly transformative.

And we’re learning and we’re growing:

And so it goes that each and every year I do this work I find new ways of understanding the complexities of human behavior, and creative ways of exploring all the ways we try to understand the past, function in the present, and heal so we can move on with the future.

My next task it to read Lisa Spiegel’s book, “ Internal Family Systems with Children” to see how this theory is applied to young people who are struggling. I’ll let you know how it goes!

Do you have experience or interest in IFS? I’d love to hear if you do, and the populations that you have found helpful to work with this theory.