Sound Advice Sigman v3 by HC121001093650


									Sound Advice

This is an edited transcript of a telephone interview recorded in August 2011.

Garry Sigman, MD, FAAP, is a specialist in adolescent medicine and an associate
professor of pediatrics at Loyola University Health System in Chicago.

Q: Adolescence is a big time of transition. What do parents need to understand about
their teenager’s emotional health?

Dr. Sigman: Well, the first most important thing to know is that teenagers are not
adults. Even though their bodies are changing to adult bodies, and their height is
increased and maybe even go beyond the parent’s height, it takes a period of at least 10
years from the onset of puberty, maybe a little more, for emotional development to
resemble adult emotional standards. And by that I mean there’s a period of
experimentation, learning about how to understand one’s own feelings and be aware of
one’s own feelings, and finally how to control one’s feelings in a way that makes them
effective communicators and effective problem solvers.

Q: What role do peers play in adolescents’ emotional and social development?

Dr. Sigman: Quite a bit—quite a large role. Peers are kind of like the stepping stone
from dependent child who’s learning about the world and learning about how to help
themselves or learn about the role through their parents. Peers are like the first window
to the outside world, but a safe one. They choose their own friends, and so teenagers
and their friends become in effect kind of a large learning lab where teenagers can learn
about their identity in relationship to others. How their behavior affects others. What
they can learn from others. They can possibly learn how to be interdependent and
mutual with other people, and without that peer inter-involvement during that period of
adolescence, they become less able in their adult life to carry out adult activities.

Q: You’ve describe very positive influences that peers can have. Are there also
problematic influences that friends can have as well?

Dr. Sigman: Most definitely. Because teens are working on their identity and they
want to be liked, they might be susceptible to doing things or behaving in ways that
some of their friends show them or lead them into, that might go against their own
moral standing but the influence of the peer might override it. So it’s important that
parents stay involved with kids’ lives and understand, as much as possible, what the
peer influence is. Know their friends. Be able to create an open conversation so that the
kids can kind of explain what’s happening, what their influences are, what they’re
learning, because the world out there might not be as safe as it was when the children
were at home without peer influences.
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Q: Do you have some advice on how parents can encourage open communication with
their teenager?

Dr. Sigman: There’s a lot of things that parents need to learn to do to be optimal, and
some parents find this almost comes naturally, but others have to work at it. Number
one step is—and this is similar to when we as physicians say, “In order to take care of
patients well, physician heal thy self.” Parents have to heal themselves first. Parents
need to model good behavior. If they don’t want their teen smoking they shouldn’t
smoke. If they want their teen to eat healthy they should exemplify those behaviors.
Then, also emotional behavior. They need to use “I” statements. Meaning like “I feel that
your behavior was upsetting or I feel that you didn’t take me into account when you said
that” versus “you” statements, which say, “You are this way,” that you don’t want to talk
to your teen as if they have a characteristic that is negative.

Parents need to learn how to listen to what the teen is saying without immediately
verbalizing back so that the teen feels free to say what they need to say. It might make
the parent feel bad or feel scared, but if they answer back and try to demand certain
behavior before the young person is finished expressing themselves it won’t be a safe
place for the teen to discuss these issues.

Parents should also be moderate about their limit setting. There have to be rules. Rules
are important. Teenagers need rules to grow up healthy, but parents can’t control
everything. Parents should make their top list of things that are most important to
them, and then learn to not say about things that are solely irritating but less important.

I, for instance, have parents in my practice who sometimes have rules on drugs and sex
and curfew, which is good, but they also add on things like standing up straight and
making sure that you’re dressed properly, and making sure your room’s clean and
everything. I’m not saying those are important, it’s just that if you try to control every bit
of your teenager’s life they start listening less often.

Q: What about stress? A lot of teenagers have a job, they go to school, they have sports,
other activities, they’re trying to apply for college. Is it healthy to have this much stress?
What is a parent’s role in helping teens manage their activities?

Dr. Sigman: Well, the first role is to set limits on how much activities the teen is
allowed. Sometimes the young person has too many things in their agenda because it
creates some self-esteem for the parent. So the parent has to recognize that the teen’s
accomplishments are their own, not the parents, and so they might not need to do
everything that the parent wants them to do.

The teen themself sometimes wants to do more than is healthy. They have to also have
time to rest and to have a little fun and to relax, learn how to stress-reduce, so the
parent has to set limits if the kid wants to do more than is healthy.

              John Ystrom   Producer/Recording Engineer   773-252-8070
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In addition, stress reduction is also learned in the home. If the parent is a workaholic or
shows poor coping skills by either getting grumpy or screaming or yelling or by using
substances like alcohol or by avoiding other people during times of stress, the teen will
learn that too. So parents need to set limits on how much activity. They need to model
good stress-reducing behavior, and they need to acknowledge and listen if the teen is
under stress so that they can offer helpful advice.

Q: What are some warning signs that a teenager might be struggling? If a parent notices
that what are the first steps they should take?

Dr. Sigman: Well, sometimes it’s hard for parents to tell the difference between
normal teen behavior and problem teen behavior. Certainly there are some natural
changes that occur during teenagehood if you compared a teenager to themselves when
they were younger. They will be a little more secretive. They will demand a little more
privacy. They will not want to share everything with the parent.

On the other hand, the parent needs to watch their mood, if they seem sadder than
normal. If they seem much worse communicating than in their previous weeks. If they
start procrastinating much more, don’t wake up or don’t do what they need to do for
their school or for their chores —those could be signs of depression coming on. In
addition, if they get much more cranky, if they get much more irritable, fly off the
handle compared to their normal personality, that could be a clue.

Finally, if they become much more secretive where they feel put out if you ask them
where they are during the day, what time they’re coming home, who they’re with, that
could also be a sign that they’re moving into some areas with peers, which could be
problematic, like using drugs, etcetera.

Q: What steps should a parent take then if they notice some of those things?

Dr. Sigman: They should try to engage in conversation and remember that I said the
ways to do that are to just listen. Try to listen to what the young person’s saying before
you rapidly give back a response. Try to let them know that you’re concerned about
them and that you’re not talking to them to lead to information that could lead to
punishment or consequences. That you want to understand what’s going through their
head at the time and why they seem different to you.

It usually takes one or two emotionally healthy parents to approach them in this healthy
way, and if you find that difficult you should get help either from other parents or role
models or mental health or medical professionals.

Q: Can we talk a little bit about bullying? What are some signs that your child might be
a victim of a bully or a bully himself?

             John Ystrom   Producer/Recording Engineer   773-252-8070
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Dr. Sigman: First of all bullying is much more common in this day and age then it was
in the previous generation because of social network sites and computer
communication. Teens spend so much time on these sites and sometimes they have fun
by saying things about others, and it might not be true, and then one teen might find
that they’re the victim of this. It’s important for parents to understand the teenager’s
computer time as well as their away-from-home time so that they can create a balance
for the teen.

If they are being bullied they could talk to them and help them recognize the likely
transient nature of that bully and the best way to cope with such feelings. Occasionally,
if it’s much worse, if it’s systematic and doesn’t go away it’s helpful to explore with the
school administrators what’s happening in the school. Is it being supported or is the
school aware of it. But most importantly it’s helping the teen cope. The world can be a
wonderful place but the world can be a cruel place and teenagers are—it’s a period of
time where they learn about it.

Q: What can parents do to build their child’s self-confidence?

Dr. Sigman: Oh, a lot. Number one is, don’t settle every problem for them but help
talk through the problems and try to build their own abilities to solve their own
problems. Number two, give them positive reinforcement but honest appraisal. Some
parents think the way to build confidence is to always say they’re great even if they
aren’t great or not great. Honest appraisal is given by saying, “Well, that was a good
effort, but if you had to do it again I might suggest you do this, this or this.” That sounds
a lot better than, “You really screwed up on that. That’s the way you are.” So those kinds
of interventions, those kind of interactions, both reality-based feedback as well as
positive feedback are the best way to build self-esteem.

Q: Doctor, in closing, what your best advice for parents to foster good mental health in
their adolescent?

Dr. Sigman: We’ve alluded to quite a few of them. Number one, be an emotionally
healthy, well-adjusted parent yourself and work on that. Be approachable, be someone
who can be talked to by being a good listener, helping your teen identify and express
their emotions. Helping your teenager problem solve. Watching you be able to delay
gratification of impulses by organizing and ordering things in an appropriate way. Show
through your own life how intimate relationships occur, where they’re interdependent
and one parent or boyfriend or girlfriend is not dominating another but is mutually
supportive of each other. All of those are important ways to help teenagers become
emotionally healthy.

              John Ystrom   Producer/Recording Engineer   773-252-8070

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