Cognitive Behavioral Therapy (CBT) Dialectical Behavioral Therapy (DBT) Mental Health Obsessive-Compulsive Disorder (OCD) Recovery Therapy

Body-Focused Repetitive Disorders

Trichotillomania (TTM) is a type of body-focused repetitive behavior (BFRB) specifically characterized by impulsive pulling out of one’s hair from the scalp, eyebrows, eyelashes, or elsewhere on the body. According to the DSM-IV of the American Psychiatric Association, TTM must meet the following five criteria:

  1. Repetitive pulling of one’s own hair that results in noticeable hair loss.
  2. A feeling of tension prior to pulling or when trying to resist the behavior.
  3. Pleasure, gratification, or relief while engaging in the behavior.
  4. The behavior is not accounted for by another medical (or dermatological) or psychiatric problem (such as schizophrenia).
  5. Hair pulling leads to significant distress or impairment in one or more areas of the person’s life (social, occupational, or work).

Though this criteria is useful, there is some debate within the clinical and scientific communities about whether or not all five of these criteria are present in every case. Since there are many who suffer from debilitating hair pulling behaviors but don’t meet all of these criteria, efficient and effective treatment is still paramount to one’s health and well-being.

Signs and symptoms of Trichotillomania often include:

  • Repeatedly pulling your hair out, typically from your scalp, eyebrows or eyelashes, but it can be from other body areas as well;
  • A strong urge to pull hair, followed by feelings of relief after the hair is pulled;
  • Patchy bald areas on the scalp or other areas of your body;
  • Sparse or missing eyelashes or eyebrows;
  • Chewing or eating pulled-out hair;
  • Playing with pulled-out hair;
  • Rubbing pulled-out hair across your lips or face.

Onychophagia (nail-biting) and Dermatillomania (skin-picking) are other BFRBs but are characterized by compulsive skin picking and nail biting. Nail-biting is the most common of “nervous habit.” I’m not talking about the occasional cuticle or hangnail, or the occasional blemish that someone may pick or squeeze. Instead, someone who suffers from onychophagia picks or bites their nails or skin until they bleed, finding themselves using Band-Aids like accessories. As those suffering from TTM will wear hats to cover bald spots and the like, nail-biters will keep their hands in their pockets, sit on them, wear gloves or those Band-Aids I mentioned. Those who excessively pick at the skin on their faces will try to cover up with makeup or when things get really bad, go so far as to stay inside and isolate. I mention these two together, because they often make intermittent appearances in the same individual.

Nail-biting (onychophagia) facts include:

  • Common in individuals of all ages.
  • Up to 33% of children ages 7-10 bite their nails.
  • Nail-biting can be triggered by stress, boredom, or nervousness.
  • About half of all children between the ages of 10 and 18 bite their nails at one time or another. Nail-biting occurs most often during puberty.
  • Some young adults, ages 18 to 22 years, bite their nails.
  • Only a small number of other adults bite their nails. Most people stop biting their nails on their own by age 30.
  • Boys bite their nails more often than girls after age 10

Chronic skin picking (dermatillomania)is characterized by:

  • Inability to resist urges to pick at real or perceived blemishes in one’s skin
  • For some, mounting tension before one picks
  • For some, gratification and relaxation while picking
  • Noticeable sores or scarring on the skin
  • Increased distress and/or interference with daily life

BFRBs have been linked to obsessive-compulsive disorder (OCD). They can sometimes be linked to a sign of emotional or psychological disorders. They are all compulsive disorders, but their manifestations have varying presentations: For some, the picking or pulling will occur during sedentary activities like watching TV, reading, driving or being a passenger in a car, talking on the phone, sitting in class, or sitting at a computer or a desk. At times, there might be focused intent which drives the behavior–for example, planning on picking or pulling at an area as soon as one arrives home. At other times, it’s happens without conscious awareness, and the individual only realizes they’ve picked or pulled when they see the resulting pile of hair, open scabs or bleeding fingers.

This can feel overwhelming, but there is help. For starters, you have to say something to someone and let them know you’re suffering.  Your doctor and/or therapist will then work with you and help you redirect the negative behaviors and create new, innocuous behaviors.

The following therapeutic modalities are typically used to treat BFRB:

(Sometimes, elements from some or all of the aforementioned modalities are used to meet the BFRB client’s needs.):

Alternative therapies are also used, but are not as researched or predictable in terms of their success.

Support groups can provide a wonderful place for fellowship and to create positive social reinforcements.

Keep in mind, What works for one person may not work for another. The key will be in finding the treatments that do work and committing to them. Nothing is impossible, but everything takes effort. Feeling better is worth your treatment endeavors.


For more info, check out:

Mayo Clinic

ADHD Mental Health Recovery

ADHD: More Than Statistics

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There’s no doubt there’s an ADHD epidemic. It’s the diagnosis most often handed out when a child is struggling in school with fidgets, a short attention span, hyperactivity, et al.  Typically prompted by a complaint from a frustrated teacher, parents are lead to take the first step toward finding a behavioral solution.  A visit to the pediatrician will include having parents and teacher separately fill out a questionnaire. The questions tend to be specific and general–all at the same time.  On occasion, the answers fall in line with one another, but sometimes, they do not. In fact, at times, a child will present one way at school and another at home. For example, where the parents’ answers may not indicate the inability to focus, fidgeting or any other emotional anomalies common with ADHD, the teacher’s findings may say otherwise. Theirs may indicate negative, disruptive behaviors present, which are impacting the classroom dynamic. Because ADHD is a real illness and one that debilitates those who have it and creates challenges for those directly effected by it, there needs to be care and diligence when diagnosing it. Is the teacher overreacting? Are the parents not being entirely honest with themselves? Is it a little of both? It takes a skilled mental health practitioner and patience to sort that out.

Keep in mind, some behavioral challenges may be as simple as a child not being mature enough to “handle” the expectations thrust upon them by a numbers-driven educational system or by the institution of school itself.  Or it may be the prevalent learning style isn’t compatible with your child—some kids are tactile learners, others are visual, and others can memorize with ease. Learning isn’t a one-size-fits-all experience.

Regardless, ADHD continues to be a widespread diagnostic phenomenon. According to the CDC, “The American Psychiatric Association states in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) that 3%-7% of school-aged children have ADHD.  However, studies have estimated higher rates in community samples.”  This statistic is just for the United States alone.

Recent data from parents, which was also gathered by the CDC shows:

  • Rates of ADHD diagnosis increased an average of 3% per year from 1997 to 2006 and an average of 5.5% per year from 2003 to 2007.
  • Boys (13.2%) were more likely than girls (5.6%) to have ever been diagnosed with ADHD.
  • As of 2007, parents of 2.7 million youth ages 4-17 years (66.3% of those with a current diagnosis) report that their child was receiving medication treatment for the disorder.
  • Rates of medication treatment for ADHD varied by age and sex; children aged 11-17 years of age were more likely than those 4-10 years of age to take medication, and boys are 2.8 times more likely to take medication than girls.

Read here for a more extensive listing of statistics.

While there are legitimate diagnoses of ADHD, a question of misdiagnosis has arisen. According to new research by Todd Elder, a Michigan State economist, “approximately 1 million children in the U.S. are potentially misdiagnosed with ADHD.” His argument brings up the issue of giftedness and behavioral issues having resulted in a misdiagnosis of ADHD. Are they valid? We’ll see as I explore this idea in another blog. In the meantime, if you suspect your child is having difficulties, get them help. There is far more internal stigma that occurs when a child is struggling with an untreated mental health issue than the stigma that may occur with the diagnosis itself. It’s up to us as parents, teachers, caregivers, therapists, and counselors to see to it that the youth of our future have their needs met in the way that best benefits them.

When we are able to manage our symptoms, we have a better chance of getting to the root of the cause.

Mental Health Recovery Self-Care

Beware: Ridiculousness May Lead to ROFLMAO

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Osho said, “You cannot live without laughter.” He has a wonderful point! When I got sober, it wasn’t the war stories that hooked me but the echoes of laughter in those dungy, smoky meeting halls. For one thing, there were others there who could relate to the mistakes I made and my subsequent suffering. It was there that I discovered my ability to laugh, not at others, but at situations and circumstances otherwise too dark to face. Ultimately, this is what initially gave me permission to begin the letting-go process regarding my shame and fear.

So, a funny thing happens when we introduce something like a laughing practice or laughing meditation in a recovery setting. Initially, it might be awkward for some of us to laugh for no real reason, but then a transformation happens: the laughter becomes genuine laughter, and the tension held within our bodies begins to unravel. Try it: laugh. You can laugh about the ridiculousness of laughing. At some point, the inevitable will occur: the guise of false perception will melt down, and along with the side cramp, you might find you are able to let go of what you think you “should be” and come to find solace in who you are.

According to Osho, there are three kinds of laughter: the first is laughing at others. This type of laughter is inherently unkind and unhelpful, yet also the most common in human behavior. The second is when laughing at ourselves; this type of laughter is definitely something to strive for. It’s not only beneficial but it really helps us lighten up a bit. The third type of laughter is when we laugh–not at others or ourselves, as outlined in the first and second types–but just to laugh. I imagine this type of laughter to be the most freeing of all. I have always been guilty of two things: seriousness and ironically, spontaneous and unfettered bursts of laughter. I rather prefer the latter: it’s proof that laughter allows us to soften and simultaneously open up enough to finally begin to take the world less personally.

Don’t forget,  Rule #62 in the 12×12 says, “Don’t take yourself too damn seriously.”

Mental Health Recovery Self-Care

Pursuing Happiness: Is Your Glass Half Full?

Sometimes I think attitude really is everything. I mean, if we walk into a room with a sour face and a negative attitude, then we are bound to gather the attention of our fellow sourpusses and their pals. These sorts of things act much like Velcro, fastening together similar minds and ensuring an acidic atmosphere remains intact. This trait, in its sheer nature, is not beneficial–to anyone. Yet, despite the knowledge that a change in attitude can purportedly change the outcome of a situation, it’s not always easy to do.

Enter the burgeoning practice of Positive Psychology: According to the University of Pennsylvania, “Positive psychology has three central concerns: positive emotions, positive individual traits, and positive institutions. Understanding positive emotions entails the study of contentment with the past, happiness in the present, and hope for the future.” At the core of positive psychology is a desire to encourage individuals to enhance their strengths in order to be their best selves. This differs from the psychology we are most familiar with, which aims to discover and treat dysfunction. In contrast, this relatively new field of positive psychology places its focus on helping people lead happier, more fulfilling lives. Both of these pathologies are important: when there’s dysfunction, we need to learn how to care for it, which leads to healing. At the same time, we must also learn to acknowledge our strengths so we can expand on them and live more joyfully. Lest we forget, our reactions to pleasant and unpleasant things are a direct result of our experiences; therefore, it’s not uncommon to get lost in the past, disabling one’s ability to thrive in the present.

This is where positive psychology gives us the opportunity to expand on our optimism in a potentially pessimistic, emotional environment. Part of gaining a positive mental attitude is realizing we are not our circumstances. Instead, we soon discover that we can hold those very predicaments with care and intention without getting lost in our feelings about them. Wayne Dyer says, “When you change the way you look at things, the things you look at change.” What a wonderful opportunity to begin to skillfully govern our difficulties! At the same time, this doesn’t mean we should be positive by being insincere or pretending to be happy about something we actually find disdainful or troubling. In other words, you don’t have to eat a crap sandwich and pretend you like it. If anything, this is a chance to garnish it with something you do like, including not having that sandwich at all.


Inspired by this: Shawn Achor: The Happy Secret to Better Work

Interesting articles and info about Positive Psychology:

Claremont Graduate University

Mental Health News

Pursuit of Happiness

Cognitive Behavioral Therapy (CBT) Dialectical Behavioral Therapy (DBT) Mental Health Personality Disorder Therapy

Personality Disorders: Finding Solace in Therapeutic Care

According to the DSM-IV, “Personality Disorders are mental illnesses that share several unique qualities.  They contain symptoms that are enduring and play a major role in most, if not all, aspects of the person’s life.  While many disorders vacillate in terms of symptom presence and intensity, personality disorders typically remain relatively constant.” Further, the DSM-IV says that in order to be diagnosed, the following criteria must be met:

  • Symptoms have been present for an extended period of time, are inflexible and pervasive, and are not a result of alcohol or drugs or another psychiatric disorder. The history of symptoms can be traced back to adolescence or at least early childhood.
  • The symptoms have caused and continue to cause significant distress or negative consequences in different aspects of the person’s life.
  • The symptoms are seen in at least two of the following areas
    • Thoughts (ways of looking at the world, thinking about self or others, and interacting)
    • Emotions (appropriateness, intensity, and range of emotional functioning)
    • Interpersonal Functioning (relationships and interpersonal skills)
    • Impulse Control 1

In layman’s terms, someone suffering from a personality disorder often views the world in their own way. Because the perceptions of those around them are often skewed to meet a reality only they see, the subsequent social issues stemming from the inability to interact with others appropriately is troubling–both for the one afflicted and those on the receiving end of the negative behaviors and perceptions. For the Borderline Personality Disorder (BDP), the major symptoms revolve around interpersonal interactions, negative sense of self, significant mood swings, and impulsivity. Where Narcissistic Personality disorder presents itself as grandiose and uncaring yet hungry for recognition, Borderline Personality Disorders can often be summed up like this: “I hate you…don’t leave me.”

Unfortunately, personality disorders are sometimes used as a quick label for a difficult client. However, the criteria are pretty significant and the diagnosis itself should be made after significant assessment by a qualified professional. Those ensconced in the emotional turmoil of a legitimate personality disorder need be able to find some solace in their psychiatric care and trust in the individuals providing care, especially since treatment for personality disorders are long term. The type of therapeutic treatment used depends upon the type of personality disorder being treated. The various types of therapy used to treat personality disorders may include:

  • Cognitive Behavioral Therapy (CBT)
  • Dialectical Behavioral Therapy (DBT)
  • Psychodynamic psychotherapy
  • Psychoeducation

Personality disorders are tricky and can be hard to address. Applying DBT, for example, has shown positive results in the treatment of BPD–recent studies have shown lower suicide rates, less self-harming incidents, and less self-removal from treatment. We must remember that psychiatry is a relatively young science, so the growth and change is happening quickly as practitioners eagerly seek resolution to some of the most challenging psychological quandaries. A therapist once said to me, “If someone were to observe a given client in a single session, they could come up with a variety of diagnoses, when the fact is, that client could have just been having a bad day.” So, whether a client is simply having that bad day or truly struggling with a bona fide disorder, it’s befitting to remember the words of Hippocrates as we unravel the mysteries of mental illness: “Cure sometimes, treat often, comfort always.”


Additional articles of interest:


Personality Disorder – What Is it, and What Does Diagnosis Mean?

With Mental Illness, “Serious” is a Slippery Term

Addiction Depression Mental Health Recovery

Privilege Doesn’t Mean Easy

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Sometimes, teen angst is obvious. It shows up as truancy, poor grades, and sullen or surly attitudes. But sometimes, it’s subtle, and easily missed by parents desperate to feel their child is doing all right. After reading this remarkable article by Dr. Madeline Levine, I was reminded about the elusive nature of teen angst and the parental actions taken to limit pain, sadness, fear, and frankly, some of the pertinent life experiences which are part and parcel to learning about the human condition. Dr. Levine noted how common this is amongst those more privileged when she states, “It would be a stretch to diagnose these kids as emotionally ill. They don’t have the frazzled, disheveled look of kids who know they are in serious trouble.” In these cases, it takes time to really unravel the problem because the outsides are masked so skillfully. Levine notes this as well, “After a few sessions, sometimes more, the extent of distress among these teenagers becomes apparent. Scratch the surface, and many of them are, in fact, depressed, anxious and angry.” She also notes the fact that it’s the kids requesting help, not always the parents recognizing there might be a problem.

Many parents will say,  “I just don’t want my child to feel pain or be sad, or get hurt.” While parents are providing tremendous resources and attention to these kids, there is still an internal sense of strife felt in many of them. This additional desire to protect and fix things with materialistic items is just a another way of muffling the reality of whatever it is we’re dealing with.  An iPod, or a new pair of Uggs won’t fix the emotional pain and loneliness of social anxiety or lift the spirits of the depressed. Sure, the thrill of getting something new may make us temporarily feel good, but those feel-good moments start to fade and we’re still left with the feelings we were trying to run away from in the first place.

This presents an interesting conundrum when it comes to asking for help. The suffering isn’t as obvious for these teens, and it becomes harder still to determine the root cause when the issues themselves are concealed. In this sense, the “privileged” may find it harder to reach out for help because their ability to acquire bigger and better things is easier, and their academic and social resources are more viable. In this case, the ability to stuff feelings comes at a higher price, both literally and figuratively.  And while some may view those who are more privileged as spoiled, I hesitate to think this is entirely the case. In fact, I would venture to say some of this is the manifestation of a larger issue: parental denial, a need to run from feelings and the financial ability to do it in bigger and more aggrandized ways.

Sometimes it’s harder to ask for help when it looks like you have it “together” from the outside. The assumption is that one is doing well because they may not have lost everything, or because they appear fine solely because their outsides are seemingly put together. Unfortunately, the outsides don’t always match the insides. I can’t tell you how many times I’ve felt low but was complimented on my appearance. It’s a trick we play to hide what’s really going on. That “trick,” however, leaves us lonely and sometimes isolated from the very people who can help us. Our kids need us to be there for them, but we can’t always intervene. In doing so, we teach helplessness, when what we really want to do is provide a safe foundation at home so our kids can develop the tools they need to experience life. As Hodding Carter once said, “There are only two lasting bequests we can hope to give our children. One of these is roots, the other, wings.”

Read the article in its entirety (I highly recommend this).

See here for more information about The Price of Privilege.

Mental Health Recovery

Facing Our Fears & Meeting Our Grief

It takes more strength to feel your feelings than it does to hide them. As counterintuitive as it may seem, I’ve found this to be true. Because we encounter so much anxiety and depression in our lives and in our recovery, it ‘s appropriate to also notice the element of grief which often acts as the undercurrent and silent driving force. If there’s a history of abuse or abandonment, neglect, or bullying, there is grief. If a parent suffers from a mental illness and/or addiction, there is grief. If there’s social anxiety, there is grief. It’s a pervasive feeling, and one which we often ignore or pass off as a phase, something that happens in passing. But in recovery, be it from addiction or mental illness or both, we need to address it.

How do we face our fears—especially when they are paralyzing? How do we defy this part of being human which urges us to avoid pain at all costs? We eat to feel better, drink and smoke to feel better, have sex to feel better, live on our phones to feel better, surf the Internet to feel better, ad infinitum. We do whatever it takes to go as far as possible from that nagging pain in our guts. With the addictive personality, this behavior is even more pronounced. If there’s a mental illness co-occurring but not acknowledged, the desire to resist the fear and feelings might be even greater. It can get pretty darn lonely, especially when one’s ego and fear kick in, coupled with a refusal to ask for help.

Certainly, there is an imperative to face these fears and the grief associated with them, but we can’t do it all at once. Since it requires us to look deeply within, I have found it far more beneficial to do in pieces. Even in a therapeutic environment, one doesn’t address every single issue at once. The trouble is, addicts and alcoholics don’t like to do anything in pieces. It’s usually all or nothing. It takes a new outlook and a commitment to slowing down to start to change that perspective. But it is possible.  Keep in mind, alcoholism and addiction are oftentimes symptoms of a much greater problem. The question is, are we brave enough to determine what that problem is?  If it’s a mental illness, do we have the courage to take care of it appropriately?

Instead of attempting to lift a tree to see its roots, try lifting one leaf at a time. Eventually, when it’s time to lift the tree, it may not be as heavy.



America’s #1 Health Problem

A new CASA (The National Center on Addiction and Substance Abuse) report on adolescent substance abuse hit the wires today. Their findings were disheartening, stating, “Adolescent substance abuse is America’s #1 health problem.” The report studied smoking, drinking, the misuse of prescription drugs, and illicit drugs. CASA also delved into the science of addiction itself, identifying it as a “complex brain disease with origins in adolescence,” and going on to document how “adolescence is the critical period for the initiation of substance use.” They not only looked at the drugs being used or the age of the user, but at American culture itself—for example, the way the media romanticizes the use of alcohol in its advertising.

Here are some highlights from their report:

  • 90 percent of Americans who meet the medical criteria for addiction started smoking, drinking, or using other drugs before age 18.
  • 1 in 4 Americans who began using any addictive substance before age 18 developed an addiction, compared to 1 in 25 Americans who started using at age 21 or older.
  • 75 percent of all high school students have used addictive substances including tobacco, alcohol, marijuana or cocaine; 1 in 5 of them meet the medical criteria for addiction.
  • 46 percent of all high school students currently use addictive substances; 1 in 3 of them meet the medical criteria for addiction

The ads we see plastered on enormous billboards on the busiest corners in Los Angeles are there to intrigue us. They aren’t just selling a beer, or some whiskey, they’re selling a lifestyle: one that’s full of handsome men and gorgeous women, all ready and willing to party at will. Life looks perfect in those ads, but we all know it is anything but perfect. It sure can seem alluring, though, particularly when we’re young, rebellious, and feeling the pressures of growing up and being “cool.” The intrigue is also directly fueled by the current generation’s perpetually perceived boredom, which stems from our culture of instant gratification. In our current climate, drugs and alcohol are culturally accepted: we have medical marijuana and a pill for every problem.

Our brains are vulnerable in adolescence and at the height of development. In fact, they aren’t fully developed until we’re around 25! As we spoke about in our recent post, once we begin indulging in the use of mind-altering substances, we are essentially performing science experiments on ourselves.

Susan Foster, senior investigator of the study, notes: “By recognizing this as a health problem and respondingto it, we can actually make the difference by improving the life prospects ofteens and saving costs in society.”  This brings us back to what I always say, get involved and start talking to your kids! Teens are under an inordinate amount of pressure: school, peers, hormones, et cetera. At some point, we have to start looking at how those we love are actually managing such an incredible stress load. I once heard a therapist say, “Little people, little problems; big people, big problems.” She was specifically talking about the value in addressing issues when they begin rather than waiting things explode. When we’re trying to preserve and heal family dynamics, it’s far less challenging to deal with an angry 8-year-old than a drug-addicted teen.

Related articles:

Study: Drug Addiction Among Teens On The Rise (

Addiction Starts Early in American Society, Report Finds(

Addiction Adolescence Mental Health

Doctor, Doctor, Gimme the News

Image by WhatDaveSees via Flickr

Is your teen playing doctor? Surely, this is an appropriate question for parents of adolescents who are concerned about teens entering a sexually intimate relationship before he or she is ready.

Unfortunately, this is not what I’m addressing. John Lieberman, our Director of Operations sees quite a bit of this and is concerned that “adolescents are literally playing doctor in the worst way, taking both prescribed and over-the-counter medications to treat perceived illnesses and issues.” They are reading information on the Internet, getting advice from peers as to what medications they should take, and they’re often mixing and matching drugs while they’re at it. While some of these Internet sites have some valuable information regarding symptom checks and corresponding information about illnesses, they also present a danger. Any time we look at something from the perception of a layperson, we risk finding and relating to symptoms within the descriptions of many illnesses. That’s what real doctors are for: differentiating reality from the natural misinterpretation from those of us lacking the vital MD title. Pharmaceutical-related overdoses have increased, proving the increasing danger in this behavior, and spurning an all out war against the pharmaceutical industries.

Drugs like Vicodin, Oxycontin, Percocet, and Demoral are all opium derivative drugs. This particular class of drug is highly addictive and can easily lead to an overdose. Xanax, Ativan, Klonopin, Soma, Lunesta and others are benzodiazepines. These, too, can create a physical addiction in a short period of time and in worse cases, cause death. Adderal, Ritalin, and Vyvance are amphetamines primarily used to treat ADHD and are subsequently very powerful drugs that can cause heart attack and stroke, particularly when used inappropriately. The latter are often traded amongst kids in an effort to get high, or even as an attempt to increase their focus at school.

Our kids are playing doctor with quite a varied array of drugs, and this does not take into account the rampant abuse of illicit drugs or alcohol. According to John Lieberman, “Our teens are using very powerful psychoactive drugs during a time in their lives when they are emotionally vulnerable and when their brains are in a major stage of development.” According a 2010 statement by the APA:

“The brain’s frontal lobes, essential for functions such as emotional regulation, planning and organization, continue to develop through adolescence and young adulthood. At this stage, the brain is more vulnerable to the toxic and addictive actions of alcohol and other drugs.”

This isn’t just about playing doctor, kids are also doing chemistry experiments…with their own brains.

This blog was co-written by John Lieberman, our Director of Operations.

Additional links:

Causes of Increase in Opioid Deaths Probed

Be the Wall

Partnership for a Drug Free America

Body Image Eating Disorders Mental Health

Graduation: Europe or Lipo?

“Kid, you’ll move mountains!
So…be your name Buxbaum or Bixby or Bray or Mordecai Ale Van Allen O’Shea, 
You’re off to Great Places!
Today is your day!
Your mountain is waiting.
So…get on your way!” – Dr. Seuss
Image by MarinaCr via Flickr

Certainly, for some teens, plastic surgery can be positively life-changing. For example: a child who’s subject to excessive teasing because of an inordinately large nose may positively benefit from rhinoplasty; a burn victim can return to relative normalcy with appropriate plastic surgery; a breast reduction can allow a young girl to exercise without neck and back pain. On the other hand, what lies beyond what’s necessary for some is the skewed perceptions of beauty and perceived normalcy inadvertently thrust upon teens through social and mainstream media.  The innate dissatisfaction with how we look contributes to how we meet the world. To really illustrate this, we can look at the recent uproar that came about when a mother defended her decision to give her 8-year-old daughter Botox injections. Makes you wonder: What 8-year-old has wrinkles? Better yet, what 8-year-old is even aware of wrinkles?

“Statistics gathered over the last several years indicate a decrease in the overall number of cosmetic (aesthetic) surgeries of teenagers (those 18 and younger) having cosmetic surgery, with nonsurgical procedures including laser hair removal and chemical peels being the most popular in 2010.”

These statistics are both good and bad. I mean, the fact that less invasive surgeries are on the decline is certainly positive, but I am concerned about the remaining high numbers of girls seeking these procedures.  We know teens are up against extraordinary pressure to look and be a certain way–some of it is normal adolescence–but when parents start giving their kids gift certificates for a new nose or new breasts, the lesson becomes less about self-esteem and more about trying to attain the pop-culture paradigm of perfection.

So, what does this mean from a recovery standpoint?  Well, if we start by parenting our children with this idea that they aren’t enough, we end up sowing the seeds of self-hatred and dissatisfaction. Instead of laying a foundation of confidence and positive self-esteem, we end up paving a rocky road to addictive behaviors, which inevitably contributes to disordered eating and eating disorders alike. There’s no reason why this can’t be a springboard to have a heart-to-heart with your teen. It’s also an opportunity to look at what messages we are trying to give our kids. Being a teen is tough; let’s not contribute to the social tyranny by fanning the fires of social awkwardness. This too shall pass.

Bottom line? There are far more appropriate gifts for your teen than going under anesthesia and accumulating scars, no matter how small they are.  

Links that may be of interest: