Meds, Counseling, and No Change


The Healthy Family Connections Podcast

Episode 164 · Duration: 00:20:31

Meds, Counseling, and No Change

What do you do when your daughter is hibernating in her room, has a history of cutting, is on meds, in counseling, but remains depressed?

Today we’re hearing from Marta of Houston, TX. Marta writes:

Meds, Counseling, and No ChangeOur 15 year old daughter has serious mental health problems. She’s taking antidepressant medication and when we can get her to go she sees her counselor, nothing is changing. She rarely comes out of her room, she even refuses to eat dinner with us. She does most of her schoolwork but she doesn’t participate in class; she’s very smart and it’s easy for her. Our biggest concern is her cutting. She was hospitalized in January. Things got better for a while but now we’re back to the same old thing. She doesn’t talk to us, rarely showers or washes her hair. We worry because she’s cut herself in the past and we can’t tell if she’s doing it again? We never saw this coming. She was always a good student and received praise from her teachers. She was an avid reader and excelled in English and writing. She was never the most popular kid but that never seemed to bother her. She always had a best friend but she won’t connect with any of her previous friends. Some have reached out to her but she doesn’t answer them. She’s on her phone a lot with people we don’t know and we worry about that. Where do we go from here? We’re lost.

Thanks for submitting your question, Marta. It’s clear that your daughter needs some real help. Your question begins by stating that your daughter has serious mental health problems and that the treatment in place for her mental health problems is medication and counseling.

Achieving Mental Health

What’s the opposite of mental health problems? That’s easy, mental health, right? So rather than think about how to treat our daughter’s mental health problems, let’s ask the question, how do we help our daughter achieve mental health? If we ask the right question, we’re more likely to get the right solution.

Now, is medication helping her achieve mental health? Apparently not. Is individual counseling helping her achieve mental health? If she doesn’t go, apparently not. What will help her achieve mental health? Now we’re getting somewhere. She will achieve mental health when that’s her goal and she wants to achieve mental health. Right now, she and you are in a Control Battle where you are worried and trying to encourage her to get better and she is resisting your efforts, and that is a Control Battle. Now how are we going to end the Control Battle and empower your lovely, bright talented daughter to achieve mental health for herself?

Your teen will achieve mental health when that’s their goal and they want to achieve mental health.Click To Tweet

Marta, I have a new fabulous resource for you, It’s the Ending the Parent-Teen Control Battle course that I’m releasing this month. You and others have been listening to my podcast for a few years now and I love hearing from you and answering your questions. You may have read my book, Ending the Parent-Teen Control Battle, which if you haven’t by all means please do. The book and this podcast are terrific and often, folks contact me and let me know how helpful it’s been.

Sometimes we also consult together and actually, after a number of sessions, they’re able to do just that, end the control battle and effectively address the problem they were facing. Now, I have this new self-paced course to help you identify and end the Control Battle in your family.

When folks come to me for consultation, they’re at their wit's end. They’ve struggled with their teenager and are often feeling burned out, frustrated, hopeless; nothing they’ve tried has worked. As much as I’d like to, I can’t consult with every family and this course may be the perfect resource to help families achieve the changes they want and need. The result can be an empowered teenager back to learning and growing and empowered parents to enjoy their family again.

Remember, the course is not a substitute for therapy, yet it can complement your treatment or even guide your treatment with the help of a therapist. It can even keep parents out of Control Battles before they start, and that would be a really smart thing to do.

Feeling Empowered To Make A Change

As I said, your bright, talented 15-year-old and her parents are in a Control Battle and the mental health resources aren’t helping because you want your daughter to get better, and she’s proving to you that you can’t make her get better. And she’s right, you can’t. All the medicine and counseling we give her won’t work unless she wants it to. So how do we change this dynamic and inspire your daughter to want to do her best and get back on a path to mental health?

Let’s take a quick look at what mental health is comprised of:

  • A certain amount of self-awareness and self-acceptance. Nobody is good at everything, but everybody is good at many things. Kids need to know this about themselves and become comfortable with who they are and aren’t.
  • Passion and goals. We all need to have something that we care about and look forward to getting up for every day.
  • Emotional management skills. Every day, all of us are going to have a certain amount of good feelings and a certain amount of unpleasant feelings. If we have skills for managing the unpleasant feelings without letting them overwhelm us, we will get through them, perhaps learn from them, and move forward.
  • The ability to manage responsibilities. Life can become overwhelming if we can’t manage our basic responsibilities. All teenagers will need some support in this area, some a lot of support in this area.
  • Relationship skills. Of course, teenagers are on a learning curve for how to have healthy relationships and some kids are a lot better at it than others. That’s understandable. All kids will need some friendships and some success in this area.
  • Faith is a critical mental health skill. Faith in themselves and faith that things will come out okay. Faith helps us keep moving forward in the face of adversity.

Marta, medication isn’t going to deliver any of these skills. If your daughter wants to get better, medication can take the edge off of her depression and give her a chance to work on these things. Counseling could help achieve these things, but only if she is willing to invest and wants to achieve these things.

If your teen wants to get better, medication can take the edge off of their depression and give them a chance to work on their mental health. Counseling could help achieve this, but only if they are willing to invest and wants to achieve this.Click To Tweet

Let’s look at how my new course will help.

Marta, the course will help you renew faith in your daughter as well as in yourselves as a family. This is a critical first step and we’ll help you get there. We’ll identify the exact behaviors you want her to change, the ones you don’t want, and the ones you want to see instead. For instance:

  • No cutting.
  • Using healthy emotional management skills when she’s feeling bad or like she wants to cut.
  • Coming to the table for dinner and being pleasant at dinnertime.
  • Engaging in some positive social activities with her school and her healthy friends. (This is, of course, within the COVID-19 guidelines, but connecting within whatever the protocols are).

Next, we’ll look at the pattern of interaction that takes place around the behaviors you want to see changed. That pattern is where the Control Battle lives and as you may know because Control Battles are so destructive, I refer to it as The Beast. Let’s say in your case, Marta, and of course, I’m just going on many families I’ve worked with, you call your daughter to dinner, and she refuses. You’re pretty fed up and tired of being rejected, so you ask her father to go ask her. He goes to her room and comes back and said she has a stomach ache and that maybe he’ll bring her some soup later. You get upset with him, because it seems he’s easily manipulated by her. A version of that scene occurs over and over again.

Then we look at the three major Beast Feeding Behaviors, and which ones you as parents tend to engage. Now, it can be pretty darn hard to change an automatic personal behavior, so we take a deep dive into what’s driving it and how to change it.

We then look closely at self-esteem and happiness and in that, the importance of having high standards for kids.

Next, we build a strong understanding of the concept of Earned Privileges. And then is: how to have what I call The Talk. The Talk will begin a whole new way of relating, it will bring new healthy standards and expectations and new healthy boundaries.

The Talk is how to put it all together and shift out of the Control Battle and on to teen growth and development and healthy family functioning, even positive, happy family experiences.

Now let’s see how shifting out of the Control Battle with the talk might work for you and your daughter, who I will call Laura.

You and her father go to her room at a neutral time, not a time when you’re fighting or asking her to do something. Here’s how The Talk might go:

Mom: Laura, We need to have an important discussion. Your Dad and I are concerned that you aren’t doing some very important things, things that we need you to do for yourself, that are tremendously important.

Laura: Get out of my room. I want my privacy.

Mom: We want to honor your privacy, but not your avoidance of important issues and there’s never a time that you’re available to listen to us, so we’ve chosen this time.

(Laura’s head is down not looking at her parents.)

Mom: Things have not been improving for you the way we’d hoped they would. You’re a fabulous young woman. You’re smart, very insightful, sensitive, and a talented writer to name just a few of your amazing qualities. We need you to believe in yourself and build your happiness and your future.

Laura: My happiness is my business, stay out of it.

Dad: We’d love to stay out of it and simply enjoy you. But you aren’t taking care of your happiness. Hiding out in your room, not connecting with friends who care about you, always being angry, not coming to dinner, not participating in classes.

Laura: I’m passing, how I am in class doesn’t matter. Those kids are idiots and I don’t want to get involved with them.

Mom: Laura, we can talk about all those things, but first we need to be able to talk, and any time we bring anything up, you close down and hide out in your room, and that’s going to stop.

Dad: We owe you an apology. We’ve been letting this go on too long without telling you what we expect and holding you to that standard. Instead, we’ve either been fighting or leaving you alone without helping you get better and like Mom says, we’re going to do better as parents and as a family. First of all, we need you to join us and your sister for dinner when we call you and stay until dinner is over. We expect you to be positive at dinner and not be as miserable as you can be so that we send you away. We expect you to keep all of your counseling appointments and we are going to participate at the beginning of the next one to talk about your learning and using healthy emotional management skills. Cutting is an unhealthy way to deal with painful feelings and if you continue to cut, we will need to take stronger action. We expect you to get involved with some healthy social activity. There’s a writers’ club at school and I recommend that but anything else you choose is fine as well. All electronics are now going off at 10:00 PM and you need to bring your phone to the kitchen and put it in the charging stand. If we have to fight with you about that, the phone will go away entirely. You have a phone to help you connect in a positive way and if it’s overused or misused, then it’s a privilege that you won’t have. We should have had this much sooner, but from now on we will have family night with no electronics by anyone including the parents. We can play board games, cards, or possibly watch movies together.

Laura: You never watch movies I want to see.

Mom: You’ll have input and even be able to choose the movie if it’s appropriate for the rest of us.

Dad: As we said, these are things that should have been in place for a long time, and somehow, we let go of our standards and got scared by what was going on with you. We sincerely apologize for that. You deserve fearless parents, and that’s what you’ll have now. Even with depression, cutting, and feeling like you don’t belong with your peers, you still deserve parents who believe in you, and that’s us from now on. Also, if we tell you that you need to clean up, shower, clean your room, we mean it. One last thing, exercise needs to be 2 times a day. Taking Coco for a 20-minute walk can be one of those times, but you’ll need to have another activity as well. There’s online yoga, dance, jazzercise, Zumba, you name it, so we’ll take a look at what’s offered together, and you can choose what’s most appealing.

Marta, you get the idea here, once you and your husband have taken the course and geared up to this point, then the delivery won’t be so foreign to you and you’ll feel completely ready for it. Now I don’t have a lot of information about your situation beyond the paragraph you wrote.

This could possibly go easily as in a couple of days of your daughter really struggling and being angry and then shifting and joining with you and flourishing and doing much better. In many cases, parents report that after they shifted out of the control battle and re-established high standards and faith in their teenager, they suddenly had a different, happy young person in their family. In other cases, things have gone more slowly with perhaps another visit to the mental health unit at the hospital. That’s happened as well. Yet once you’ve made this shift, Marta, your daughter will join you. When you are clear where you’re going, she will most definitely come along. She needs it and at some level wants it too. Now with your support and structure, your daughter will build her mental health skills.

With your support and structure, your teenager will build their mental health skills.Click To Tweet

A special thanks to you Marta for her question. I want to invite you all to take advantage of the new resource I’m offering, the Ending the Parent-Teen Control Battle parenting course. It is my first version and for that reason, it is extremely comfortably priced. You can have it for life, so you can buy it now and take it later. Or better yet, buy it now, take it now, and let me know what you think.

With COVID surging and the election and political discord taking place, our anxiety and emotions are running high so please, please, take care of yourselves. Don’t hesitate to reach out for help. Your local mental health resources are very much there, mostly using video platforms, and that works just fine, phones work too. Sometimes you can be seen in person as well.

If you're looking for a resource to help keep you productive at home while also helping you become a better parent, I've prepared a free gift just for you. It’s called Parenting Through Your Child's Second 12 Years. I know you’re thinking, "What the heck, 12 more years of parenting?" Adolescence neurologically, socially and emotionally, and often financially goes to around age 24. Yes, parenting your 20-year-olds is different than the teens. Download my gift and read and learn about the different stages of adolescence and critical strategies parents can use to avoid control battles and best support their adolescents’ quest for happy successful independence.

Again, please, take care of yourselves; you need it, you deserve it, you’re worth it. Bye for now.

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