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The Bergand Group – January 2016 Newsletter


Dr-Jerry-HuntBy Dr. Jerry Hunt – The Bergand Group

Clinicians are often asked by an adolescent’s parents to see their youngster for a problem with the over- use of alcohol and/or drugs. The parents may be alarmed by an incident at school or a legal issue stemming from the use of substances. The young person, while temporarily compliant with his/her parents’ desire for an evaluation, may believe there is really nothing unusual about their use. “Everyone I know drinks/uses as much or even more than I do.” And they may be right!

Currently, the over use of substances, (e.g. alcohol and marijuana, benzodiazepines and heroin) is widespread among young people in the United States and other western nations. While many adolescents do not over-use alcohol and drugs, getting drunk or “wasted” seems to normative among many young persons.

Adult attitudes toward this behavior vary. Some parents express concern but feel helpless to control drinking and drugging by their youngsters. Others feel the adolescents will “grow out of” this behavior once they get older and assume adult responsibilities. In fact, most do mature out of this behavior. However, some do not and some have their lives shortened or negatively altered by the over- use of substances.

Alcohol is a relatively benign substance for most people if used in moderation. However, its over-use is dangerous for adults and young people alike. Rather than looking the other way and hoping for the best, parents might take a consistent and unified stand against over-use. While they cannot control their young person’s behavior either at home or away, the message that “getting wasted” is not OK with them is a step in the right direction.

When Trouble Occurs. Problems at home, in school or with the legal authorities, present an opportunity to examine more closely: the young person’s use of substances, the family history of problems with alcohol, drugs and mental illness and the covert consequences that may be occurring outside of the awareness of both the parent’s and their youth.

A Collision of Worlds. However, when parents and youngsters come for a clinical assessment, sometimes a dramatic clash of two biologically-driven processes occurs. On the one hand, parents, especially mothers, are programed to protect their young. We see this most dramatically in the animal world and the human species might not have survived without “mother bears” looking out for their young.

Conversely, at this point in their life, the adolescent/ young adult is programed to separate from their family of origin and to establish his/her autonomy and independence. So these youngsters resist parental interference not only to protect their use and life style, but also out of a deeper need to establish their separateness and self-sufficiency. They often fail to see the illusion of their new-found independence and substance use often supports and extends this misconception.

Walking Between These Worlds. One analogy that may be useful in seeking to interface with these two strong, emotional commitments is learning to ride a two wheel bicycle. After the training wheels are removed, the parent holds on to the seat and walks/runs behind their child as they learn to balance themselves on the bike. When balance has been achieved, the parent lets go and the child rides independently. Sometimes the child rides off so fast, the parent can’t keep up. Sometime the child falls and physical and emotional repairs by parents are necessary. [fusion_builder_container hundred_percent=”yes” overflow=”visible”][fusion_builder_row][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”][Hopefully, bike riders always wear helmets!]

So parents can walk/run alongside their youngster in their use and over-use of substances while remaining aware of the young adult’s need for autonomy and independence. The message that parents can give is that consistent balance is required in learning to ride a bike as well as succeeding in life.

Sometimes, the youngster “falls off the bike” by getting into difficulty with the substance again. “Training wheels” may be necessary to re-establish basic rules of safety. At this point, It may be necessary to raise the level of clinical treatment (e.g. IOP, inpatient rehab).

The situation is made more complex when the parent perceives their child is wounded in some way (e.g. by a mental or physical illness.) Then parental oversight, especially by moms, can be strong, often inhibiting any autonomy by their youngster and creating instead an on-going dependence. The “child” may rebel, often using alcohol and drugs as a vehicle to break free.

The Clinical Challenge. Here, the clinician must tread carefully, keeping in mind the mother’s need to protect her young and, at the same time, the young adult’s need to be his/her own person. A conceptual understanding of what is happening to them, may be of limited value. Rather, the clinician can assist each to negotiate with the other, respectfully, recognizing each has a valid and helpful perspective. What is it the young person wants? “To be left alone to do my own thing.” What does mom want? “You have to get your act together, stop hanging out with ‘those people’ and get a job/return to school.”

Is there a middle ground here whereby parents and their adolescent can reach a compromise wherein each gets “half a loaf?” Not as much protection as mom would like and not as much autonomy as the young person would like, but more than they have now. These kinds of negotiations take time and are not achieved in a session or two. Further, patience on the part of the clinician, parents and the young person is necessary. In these negotiations, it is essential that parents be “on the same page with each other, present a unified front and back-up each other.

There is risk involved here. In his/her autonomous activity the adolescent can “fall off the bike” again. And again, emotional and sometimes physical repair might be needed. Sometimes “training wheels” in the form of additional parental restrictions in the service of safety have to be imposed. And as noted above, the clinician may suggest additional, more intense treatment. But “getting back on the bike,” trying to establish as much balanced autonomy and independence for the young person while “riding” safely is a goal worth pursuing.

Dr. Jerry Hunt
The Bergand Group[/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]

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