Teenage Boys and Cutting

As a psychotherapist who works with teenagers, I have observed the increase in teenage cutting over the years. I have also observed that a behavior that once was believed to occur mainly in girls is also occurring in teenage boys. From what I have seen it appears that just as many boys are cutting as girls.

The first question I often receive when I mention cutting is, what is it? Cutting is any behavior that a person engages in with the goal of self-mutilating. Teenagers cut with razors, knifes, paper clips, staples, using erasers or even scratching themselves. These are just a few ways teenagers have found to self-mutilate themselves. Since this is an activity associated with a great deal of guilt and shame, I am sure there are more ways that we have not learned about yet.

Also because cutting is associated with a great deal of guilt and shame our statistics on how many teenagers cut are not entirely accurate. Most recent studies indicate that approximately a third of all teenagers have tried cutting or actively cutting. If you noticed the research shows a third of all teenagers, which means boys too. I have more and more teenage boys who say they are cutting, have cut or are thinking about it. Cutting occurs in boys too. We need to be aware of this fact. Cutting can lead to accidental suicide attempts if an artery is cut or permanent damage if nerves in the arm or legs are severely cut. These are things that teenagers and parents don’t think about.

Why do teenagers cut? The reasons I commonly hear is it is easier to deal with the physical pain than the emotional pain they are feeling. Teens who are severally depressed state that cutting reminds them they are alive. They are so depressed that they feel nothing, but when they cut they feel. Also teenagers cut as a way to punish themselves because they are ashamed about something they did or they feel they have let their parents down. Cutting is a way to deal with the guilt and shame they are experiencing.

If we look at how boys are raised, cutting is a good fit for boys. Most boys grow up learning that boys can’t cry and if you express feelings of sadness or disappointment you are weak. Teenage boys are always supposed to look like life is perfect and they can handle anything without help. Cutting allows them to express sadness, fear or embarrassment in private. No one knows they are cutting or how they are feeling. Unfortunately, this leads to a vicious circle where emotions can get out of control and a boy may end up doing something he never indented to do.

At this point, most people working with teenagers consider cutting an epidemic and the little research we have about it supports this idea. When I mention cutting to a teenager now, they don’t look shocked and discuss it like the weather. They often tell me about friends who are cutting too.

Cutting can be a very dangerous behavior and does need to be treated with psychotherapy. If you feel your teen may be cutting talk to them in an understanding manner. Do not give them any reason to feel guilty or ashamed if they say yes. As I stated above, the teen already feels a great deal of shame and if they feel they will be looked at in a shameful manner or that you will be shocked they will never open up to you. You need to reassure them you love them and you only care about their safety.

I said it needs to be treated with psychotherapy. Find a psychotherapist who specializes in treating teenagers and in treating self-mutilating behavior. This is very important because if the therapist acts negatively or shocked, the teenager will shut down and therapy may not work with any other therapist. I have had teens test me in various ways because of what a previous therapist said about their behavior or what the therapist said to their parents. They need to feel safe and accepted by their therapist if therapy is going to work.

I have included some risk factors and warning signs for you to be aware of in case you think your teen might be cutting:

Risk Factors

Knowledge that friends or acquaintances are cutting

Difficulty expressing feelings

Extreme emotional reactions to minor occurrences (anger or sorrow)

Stressful family events (divorce, death, conflict)

Loss of a friend, boyfriend/girlfriend, or social status

Negative body image

Lack of coping skills

Depression

Warning Signs

Wearing long sleeves during warm weather

Wearing thick wristbands that are never removed

Unexplained marks on body

Secretive or elusive behavior

Spending lengthy periods of time alone

Items that could be used for cutting (knives, scissors, safety pins, razors) are missing.

While this is a scary subject, I have worked with many teens who have overcome this issue. The important thing is as parents you are accepting and non judgmental. Also you need to be aware that this issue does exist. My last point is that boys cut too. Girls are not the only teenagers engaging in this behavior.

Dr. Michael Rubino has over 20 years experience treating children and teenagers. He had treated many teenagers who cut and is considered an expert in this area. For more information regarding Dr. Rubino visit his websites www.rcs-ca.com , www.RubinoCounseling.com , or his Facebook page, http://www.Facebook.com/Drrubino3

How to Reduce Stress during Thanksgiving and the Holidays

This is an article I have written for past Holidays, but it is still relevant. The Holiday Season is coming up fast. For many people this is a happy time and for others it is a stressful time. The Holidays can bring up family issues that have not been resolved yet or everyone is trying to make the day prefect that it becomes a stressful day not a happy one.

Thanksgiving is coming up first so let’s deal with that day. Thanksgiving with family can mean an increase in chaos and stress. Having a Thanksgiving plan can reduce anxiety, decrease the likelihood of arguments and increase the likelihood that everyone has a happy and enjoyable Thanksgiving that they were expecting.

Lori Lite who writes about stress uses the acronym G-R-A-T-E-F-U-L as her Thanksgiving stress guide. It helps her and others get through the day in a peaceful manner. Each letter reminds you of something to do or a way to view the day so you do not get upset.

So here is how to use Gratitude as your Thanksgiving Stress Reliever.

G- Gratitude is the opposite of stress. It is difficult to feel stressed out when we are feeling gratitude.

R- Relax your expectations and let the day unfold. You might be surprised by the outcome.

A- Acceptance is the opposite of judgment. If we accept our family member for who they are and what they are capable of we can relax and enjoy ourselves.

T- Teens can be a part of Thanksgiving. Ask them what they would like to bring to the table. Let them bring it.

E- Empower children and let them help with age appropriate assignments. Putting the nuts out or making the centerpiece. Let them do it their way…not your way.

F– Focus on family for this day. Put all work and worries on the shelf

U– Unplug the electronics for dinner so that everyone can be fully present.

L- Love is often overlooked when we are busy. Cook with love… Speak with love… Show your love and gratitude for your family on this Thanksgiving Day.

This might seem very simple and obvious, but at times the best solutions are rather simple. Also you may want to practice using this in your daily life. It may seem simple, but it may be harder to do than you think because you are accustomed to doing things and viewing life in a certain way. This idea may challenge you to reassess how you approach life in general. Also this acronym may be helpful in your daily life.

Many of us are not use to looking at our lives in terms of what we have to be grateful for. Also many of us have a hard time relaxing and not worrying about work or other things we need to do. I have found that just being in the moment is difficult for most people. Most of us believe we always have to be doing something. This creates stress and disappointment. Finally, since we feel we must always be doing something, disconnecting from cellphones and other electronics can be very difficult for many people. However, think about it? How can you have fun and enjoy the day with your family, if your mind is not fully present? You can’t. Furthermore, this can create tension for others because they feel ignored and for you because you feel they don’t respect how important what you are doing at the moment is to you. As a result, you have stress which can turn into an argument and everyone is upset. A day of happiness becomes a day of anger and disappointment.

Therefore, in order to avoid this possibility trying use the word GRATEFUL and following its guidelines for the day. What do you have to lose?

Dr. Michael Rubino specializes in working with children, teenagers and their families. He has over 19 years experience. For more information about his work or private practice visit his website at http://www.RubinoCounseling.com or visit his Facebook page at http://www.facebook.com/drrubino3.

Fair Fighting Rules for Families

The Holiday Season is around the corner which means family time and often family arguments. This can make the Holiday’s a stressful time. Furthermore, as a psychotherapist who works with teenagers and their parents and couples, on of the most difficult issues that people encounter is clear communication. Based on how we are raised in our society, most of us do not receive education on communicating with each other. As a result of this, miscommunication is very common between people and this typically results in relationship difficulties and hurt feelings.

Another common issue regarding communication is fighting or disagreements. Many people feel that a disagreement or fight is always a bad thing for a relationship. However, this is not true. If you handle a disagreement or argument fairly, it can be a very healthy thing for a relationship. It can help you overcome past miscommunications or help you to resolve a problem.

Parents who are dealing with teenagers need to remember that for teenagers their Frontal Lobes in their brains are still developing. Therefore, they cannot always reason like adults and often have difficulties having fair disagreements. I have included a list by TherapyAid.com which explains fair fighting rules.

Yes this might sound odd, but you can have a disagreement that is fair. You do not always need to use insults or not listen to each other. By using these rules, you and your teenager may be able to resolve an issue or at least come to an understanding without saying things that will hurt one another.

Parents what I suggest is that you sit down with these rules with your teenager and discuss that you would like to start to using these rules in your family. Take the time and go over each rule so you both understand the rules. Also make a copy for yourself to keep, your teen to keep and a copy to put on the refrigerator to remind everyone. Remember, these rules will be a change for both of you so don’t be surprised if it takes you some time to get use to these rules and use them on a regular basis. Change usually never occurs over night.

While these rules are beneficial for parents and teenagers, these rules are also useful for couples. Very few people in our society were brought up learning how to clearly communicate. Just look at how many arguments occur due to miscommunication if you need proof. For couples I would recommend the same steps as parents and teens. First sit down and go over the rules so you both have the same understanding of the rules and keep a copy for yourselves. The next time you have a disagreement practice using these rules. Keep practicing until you become comfortable using these rules.

Fair Fighting Rules

1. Before you begin, ask yourself why you feel upset.

Are you truly angry because your partner left the mustard on the counter? Or are you upset because you feel like you’re doing an uneven share of the housework, and this is just one more piece of evidence? Take time to think about your own feelings before starting an argument.

2. Discuss one issue at a time.

“You shouldn’t be spending so much money without talking to me” can quickly turn into “You don’t care about our family”. Now you need to resolve two problems instead of one. Plus, when an argument starts to get off topic, it can easily become about everything a person has ever done wrong. We’ve all done a lot wrong, so this can be especially cumbersome.

3. No degrading language.

Discuss the issue, not the person. No put-downs, swearing, or name-calling. Degrading language is an attempt to express negative feelings while making sure your partner feels just as bad. This will just lead to more character attacks while the original issue is forgotten.

4. Express your feelings with words and take responsibility for them.

“I feel angry.” “I feel hurt when you ignore my phone calls.” “I feel scared when you yell.” These are good ways to express how you feel. Starting with “I” is a good technique to help you take responsibility for your feelings (no, you can’t say whatever you want as long as it starts with “I”).

5. Take turns talking.

This can be tough, but be careful not to interrupt. If this rule is difficult to follow, try setting a timer allowing 1 minute for each person to speak without interruption. Don’t spend your partner’s minute thinking about what you want to say. Listen!

6. No stonewalling.

Sometimes, the easiest way to respond to an argument is to retreat into your shell and refuse to speak. This refusal to communicate is called stonewalling. You might feel better temporarily, but the original issue will remain unresolved and your partner will feel more upset. If you absolutely cannot go on, tell your partner you need to take a time-out. Agree to resume the discussion later.

7. No yelling.

Sometimes arguments are “won” by being the loudest, but the problem only gets worse.

8. Take a time-out if things get too heated.

In a perfect world we would all follow these rules 100% of the time, but it just doesn’t work like that. If an argument starts to become personal or heated, take a time-out. Agree on a time to come back and discuss the problem after everyone has cooled down.

9. Attempt to come to a compromise or an understanding.

There isn’t always a perfect answer to an argument. Life is just too messy for that. Do your best to come to a compromise (this will mean some give and take from both sides). If you can’t come to a compromise, merely understanding can help soothe negative feelings.

Again, this might seem simple to some people, but communication problems are one of the biggest problems I encounter as a psychotherapist. We simply don’t educate children about clear communication, which creates problems when these children become adults and try to talk with each other. So don’t be embarrassed or assume you do not need help in this area. Simply read the rules and try them in your life and see what happens.

Dr. Michael Rubino is a psychotherapist with over 20 years experience. He specializes in treating teenagers and families. For more information regarding his work or private practice visit his website at www.rubinocounseling.com or his Facebook page at http://www.facebook.com/Drrubino3.

Bullies are Looking for Love

October is dedicated to preventing bullying and domestic violence. However, as a psychotherapist who treats teenagers these two issues are related to a number of other teen issues. They are related to teenage suicide, cutting (self-mutilating), drug use and early sexual behavior. These are a few of the teenage issues that result from children exposed to bullying or domestic violence.

I have been working with teenagers for over 20 years. In those years I have seen many teenagers for many different reasons. However, when the teenager tells me why they are doing what they are doing, I often hear very similar answers for a number of different issues. It sounds odd and surprising, but when you look at it from the teenager’s point of view it makes sense.

What I have heard very often over the last 20 years is that the teenagers who are bullying, cutting, depressed, using drugs or having sex, do not feel loved by their families. In fact, they feel no one cares about them and no one cares how they feel or what they do. Therefore, they act out. They have decided negative attention is better than no attention. So if they are bullying someone, coming home high, threatening suicide or having sex, they will get attention for their negative behavior.

Furthermore, teens are now forming friendships with other teens who bully, use drugs, are suicidal or sexually active. This common bond makes them feel someone else understands and cares about them. This is how gangs form and pressure members to do things they usually would not do. The teenager feels they have a family and people who care about them. They are so desperate for love that they will do anything to stay as a gang member. They will do anything to avoid that lonely, empty feeling.

This really should not be surprising. We have seen and heard about this is in the popular media for years. The Disney movie, Frozen, mentions that people make poor choices and mistakes if they do not feel loved. The movies, The Breakfast Club & Good Will Hunting, both demonstrate the point of teens acting out and doing anything for friends so they feel loved. The play, West Side Story, is another good example. Also in her last show Oprah said that one thing she had learned is that everyone wants to know, “am I important to you, do you hear me, do you see me?.” The teenagers that I have worked with all tell me the same thing. Also it is amazing that when they test me enough and they see that I do care how they are willing to try to change.

The problem is that with society today everyone is concentrating on their own lives and they have little time to acknowledge the people around them. Parents are having to work two to three jobs to support their families. Parents assume that their teenagers will see how hard they are working and know their parents are working that hard because they love them. However, teenagers’ brains are not fully developed yet so their reasoning skills are not like an adult’s reasoning. Teenagers need to hear, I love you, from their parents and need one on one time with their parents.

Parents cannot be the only people letting teenagers know that they are important. We are asking too much of parents to be the only ones. Teachers need to show they care by staying after school to help teens who have questions or are confused or need to talk. We need to look at the movies, television and music that teenagers are listening to. Also we need to look at society. Society gives a message of looking at for number one. There are not a lot of role models encouraging teens to accept one another as they are and to support each other. Just look at the election this year and how minorities and women were insulted.

What is the answer? We need to change our priorities and tell our teenagers and children that we love them and care about them. Schools need to bring in programs such as Challenge Day which teach teenagers to accept each other and care for each other. We need to encourage our teenagers to follow the Harlem Globetrotter’s program. They refer to it as the ABC program. A is for being assertive, B is for being brave and C is for compassion. In other words, when you see someone being a bully or harassing someone, speak up and say it is wrong, report it and show the victim some compassion. If every time a teenager notices that someone in their class seems down and they ask the person if they are alright we can make a big change in these negative behaviors such as suicide, bullying and drug use. Also if parents ask their teenager how they are doing without judgement or fear of punishment we could change a lot of these negative statistics. Think about it, why would a teenager say yes I have been using drugs or cutting if they are afraid of getting into trouble?

Summing it up, if we are going to solve issues such as bullying, domestic violence, suicide and cutting to name a few, we need to all work together. We need to let people know that we care and show it. We also need to be brave enough and assertive and speak up when we notice someone being bullied or report when we have noticed someone vandalizing someone’s property. We need to provide teenagers with positive role models and insist that our schools use programs such as Challenge Day and Alive & Free. We all need to work together and speak up about things that are wrong if we want things to change.

Dr. Michael Rubino is a psychotherapist in private practice with over 20 years experience working with teenagers and children. He is considered an expert in the treatment of teens and children. For more information regarding his work or private practice visit his website www.rcs-ca.com or visit his Facebook page at http://www.facebook.com/drrubino3.

The Facts About Sexual Activity in Middle School

Would you give a boy in the 6th grade a condom? San Francisco Unified School District and other school districts now provide 6th graders with condoms. All students need to do is talk to a school counselor and a 6th grader can get a condom.

Why are schools considering this option? They are considering this option because research is showing that teens are becoming sexually active at younger and younger ages. It is not uncommon for kids in the 6th grade to be sexually active. Research studies show 5% of 6th graders are already having sexual intercourse. This is not taking into account oral sex. When I work with middle school and high school students these days I need to ask are you sexually active? I also need to ask are you having oral sex? I often hear yes to oral sex and I am told but that is not sex. When I ask what it is, I am told we are just messing around. Many middle school kids equate oral sex with kissing. This is not reality.

I understand that the San Francisco Schools are trying to protect their students, but I don’t think this is the best way to do it. From my experience working with teens, they usually start thinking about birth control after they are all ready sexually active. Also how much information can be provided in one 30 minute talk. The kids can be told how to use a condom but no one will be discussing the emotional issues and responsibility involved with sex. Also no one will be asking the child if they are ready for this step and are they prepared if the girl gets pregnant?

If we want to keep our children safe then we need to stop making sex such a forbidden subject. The kids need classes in 4th and 5th grade which explain in detail about different sexual acts and the risk they are taking even if they use a condom. For 6th graders to think oral sex is the same as kissing is crazy. It is also crazy why we are saying don’t have sex, when society is telling boys if you want to be a “man” you can’t be a virgin and girls are told if you want a boyfriend you have to give him sex.

Also we need parents not to be embarrassed or shy about talking to their kids about sex. Parents cannot wait until their child starts High School anymore. By the time many kids start high school, it’s too late to be discussing sex. Sexual activity should be something you discuss with your child from preschool on. Of course not going into specific details, but talking at an age appropriate manner. Start educating them about their bodies. If a child sees you are not embarrassed or ashamed they will be more likely to ask you questions before they do something. If parents act like sex is something to be ashamed about a child won’t ask their parents questions.

Also parents you must start the conversation. Many parents tell me they will discuss sex with their child when s/he asks questions until then they will wait. I have teens telling me they won’t ask their parents because it’s too odd talking to their parents about sex. If they don’t ask an adult they are going to learn by trail and error. I have had to become comfortable discussing the subject because many parents tell their teen to ask me. Yes they are getting the information, but they really prefer talking to their parents. I often encourage teens to try talking to their parents explaining that their parents feel just as awkward as they do, but the embarrassment will pass.

The main problems I see with the school handing a 6th grader a condom is no one is really discussing with the child, are they really ready to be sexually active? There is a great amount of responsibility that goes along with being sexually active. You can still catch an STD using a condom so the 6th grader needs to tell their primary care doctor they are sexually active. A girl can still get pregnant using a condom. Are the boy and girl prepared for this situation if it occurs. This is a huge decision to make and I don’t think a 6th grader is mature enough to make it. Also 6th graders are not always paying attention so they may not know how to use a condom appropriately.

Yes it is shocking that 6th graders are having sex. I think a better way to handle the issue is to look at what we are teaching them in the movies, television shows and video games they are watching and playing. Sex is not a game and we are treating it like a game. This doesn’t help kids in 6th grade. We need real sex education in school and at home.

In therapy often boys will tell me they think they are ready for sex. I ask them are you sure this is the girl you want to have your first time with? I also remind them they only have one first time. I also ask are they ready for the emotions that go along with sex? The biggest one I ask is are you prepared to handle if she gets pregnant? Condoms are not a 100% guarantee. The question that always gets me is when they ask how they can get a condom? I tell them you can buy them at any drug store. I often hear I would be too embarrassed to go buy condoms. My response is if you are too embarrassed to by them then in my opinion you are not emotionally ready for sex. In my opinion handing 6th graders condoms will result in more teens being sexually active who are not emotionally ready to be sexually active. We need to think about that point.

Parents you also need to let your child know they can discuss sex with you. May be you may not agree with them about their opinions, but they need to know they can talk with you and don’t have to be afraid of getting into trouble. The main reason I hear from teens about why they don’t talk to their parents is they are afraid their parents will get mad, they will get a lecture and get into trouble.

I don’t think anyone feels a 6th grader is ready for sex, but it is happening every day. If we are going to do what is best for kids, we need to help them feel safe to discuss sex with us. If we don’t the consequences can be severe for everyone involved.

Dr. Michael Rubino has over 20 years experience working with teens in middle and high school and is considered an expert in this area. For more information about Dr. Rubino and his work visit his website at www.rcs-ca.com or visit his Facebook page at facebook.com/drrubino3 or on Twitter @RubinoTherapy.

Teenagers take A Risk being Sexually Active

Many parents assume that when teenagers have sex pregnancy is the only thing to worry about. However, parents do not realize that teenagers can risk being convicted of sexual assault or worse when they have sex or text sexually explicit pictures to a boyfriend or girlfriend.

Parents watch this episode of “This is Life with Lisa Ling,” you need to know the risk your teenager takes being sexually active or texting sexual photos. This is Life with Lisa Ling Season 4 Episode 3 Age of Consent https://youtu.be/QB1fs-TxmGA via @YouTube explains the risk.

Mental Health Awareness Day

In our society there is a huge negative stereotype about mental illness and treatment for mental illness. Given we live in the United States in the 21st century, this is quite surprising. Especially since statistics show the 1 in 5 people could benefit from psychotherapy (CDC, 2014). October 10, 2017 is dedicated to mental health awareness and removing this negative stigma.

Most people when they think about psychotherapy or mental illness, think of someone sleeping in the street or some one with severe schizophrenia. Because of this stereotype many people feel ashamed or embarrassed if they are told they need therapy. Family members also feel ashamed and embarrassed and never mention it to other people if someone in their family needs psychotherapy. People are afraid that other people will think they are “crazy” too, if someone in their family is going to therapy. However, most people who need treatment for a mental illness need treatment for depression or anxiety not schizophrenia.

Research studies show that most depression is due to a chemical imbalance in brain. Diabetes is due to the pancreas not being able to coordinate glucose levels in the body. We don’t make a person with diabetes feel embarrassed or ashamed so why do we make someone dealing with depression feel embarrassed or ashamed?

What is the cost of this stereotype? People who have depression are at risk for suicide. The 2014 Center for Disease Control statistics show that suicide is the third leading cause of death for people aged10 to 24. Yes ten year old children are suffering from depression and are killing themselves. One of the most common methods is a gun. People assume this is a guarantee. Wrong, a gun is not a guarantee. Quite often the gun jumps and the person lives. However, they have to undergo multiple surgeries to try to rebuild their face. However, no matter how good the surgeon, the person is left with multiple permanent scars. Psychotherapy and medication might have prevented the suicide attempt.

However, because of our negative stereotype, depression and suicide have never been taken seriously. The Golden Gate Bridge is the most common place in the world for people to jump off when they are trying to commit suicide. It wasn’t until just recently that the Bridge District voted on what type of anti-suicide barrier they are going to build. However, even though they have voted for an anti-suicide net, last week they were still debating the details. The Golden Gate Bridge is 78 years old. It has taken 78 years to do something about a life or death issue and they are still debating over minor details. BART has been around for decades and people have been jumping in front of trains for years. This year BART is starting an anti-suicide campaign. How many lives were lost needlessly to suicide, prior to this campaign and why have they waited so long to put one in place?

Often we assume it is a money issue. Only poor people commit suicide because they cannot afford treatment. The suicide of Robin Williams destroys that myth. He had plenty of financial resources for treatment and had been in and out of treatment centers for years. In an interview with Dyane Swayer he described how overwhelming depression is, he said, “no matter what there is always that little voice in the back of my mind saying jump.” If that voice is always there but society is saying there is something wrong with you for having depression in the first place or because you have not over come it, are you going to ask for help or keep seeking help? No.

Yes society often blames the patient. Why don’t they try harder? Why didn’t they think of their family? After Robin Williams’ suicide a number of comedians and actors talked about their silent struggle with depression. Rosie O’Donnell stated it best, “when you are that deep down in that black hole with intense emotional pain, the only think you can think about is how to stop the pain. You don’t think about your family or anything else.”

Again, October 10, 2017 is World Mental Health Awareness Day, think about your opinion or thoughts about mental illness. Think about a 10 year old boy feeling that suicide is the only way out of his pain. Think about the fact that he is dealing with a medical diagnosis similar to diabetes or high blood pressure. If this is right, why is there this negative stigma about mental illness? If a child has diabetes he receives medical treatment, there are summer camps and there is no shame put on the child or the family. Think about the fact that the bill President Trump is pushing would make Depression and anxiety pre-existing conditions so insurance companies could deny people health care.

We need to make a change in how we view or react to mental illness. We live in the United States of America and we are supposed to be the super power in the world. You wouldn’t think that in the most powerful nation in the world that the third leading cause of death for our children is suicide. We must change this ridiculous stereotype we have about mental illness and start providing people and children with appropriate treatment for their mental illness. The life you save might be your’s child’s life or the life of a family member or friend.

We may want to look at England. The Duke and Duchesses of Cambridge and Prince Henry have formed a program called, Heads Together. The goal of the program is to eliminate the negative stereotype about mental health and to make sure people who need psychotherapy receive it. In fact, the Duchess of Cambridge said publicly that if either of her children ever need psychotherapy that they will receive it. We might want to follow their example.

Dr. Michael Rubino specializes in treating children and teenagers. He is very active in eliminating the stereotype about mental health. He is an active member in Heads Together in London, a non-profit founded by Prince Willam, Henry and Princess Kate to help people understand that people need mental health care. For more information about Dr. Rubino’s practice or his work visit his website at www.rubinocounseling.com or follow him on Twitter @RubinoTherapy.

The Difference between Discipline and Punishment

As a psychotherapist who works with children and adolescents, I often hear how their parents are too strict and unfair. Many children and adolescents feel their parents punishments are not appropriate and their parents are out of touch with today’s world. I also hear parents tell me no matter what rules or punishments they impose that their children refuse to follow the rules. Yes this is a common argument but let’s look at the situation closer.

From my experience, one of the major issues in this situation is the difference between discipline and punishment. Many people may feel there is no difference between the two concepts. However, there is a major difference between the two terms.

Discipline is used to teach a child or teenager about rules and life. Punishments are used to tell a child or teenager they did something wrong such as breaking a house rule. However, punishments often have no association to the broken rule and often make a child feel like they are bad and they often don’t know which rule they broke. Punishments do not teach they only make a child feel bad or angry. For example, if it was the child’s turn to take out the garbage and they forgot and went to a friend’s house instead. Discipline would be having them take out the garbage and clean the dinner table for a week. A punishment would be that they were grounded and had to stay in the house for two weeks. What connection does the grounding have to forgetting to take out the garbage?

Research has shown that discipline is a more effective way to teach children\teenagers about rules and appropriate behavior. The discipline needs to have some association with the rule that was broken. A punishment which tends to make a child think they are bad and has no association to the rule they broke typically teaches a child nothing. What it typically does is make a child feel like they are a bad person and they often don’t understand why they are being punished.

I had a fourth grader ask to come to therapy because they were tired of getting in trouble at home. They felt like they were a bad person and he had no idea why he was doing bad things at home on a regular basis. Therefore, the punishments taught him nothing except it did lower his self-esteem. Research also has shown that children and teenagers who feel they are bad people are more likely not to graduate high school and to get involved with drugs and alcohol. They feel they are bad so they feel they should be doing things associated with “bad kids.”

As I stated discipline has been shown to be more effective with children and teenagers. However, before a parent imposes discipline there are important steps for the parent to take:

1. First, the parent needs to let the child\teenager know that they love them and that the child\teen is not bad, but they made a mistake.

2. The parent needs to explain what mistake the child made and why it is a mistake.

3. Explain that they are imposing the discipline to help the child learn from their mistake and hopefully they won’t make the same mistake again.

4. Let the child know when the discipline starts and ends. Also do not make it too long or severe. It should be in proportion to the mistake. It should also needs to be age appropriate.

5. Finally, ask the child if they understand and if they have any questions.

One thing that makes disciplining a child or teenager easier is having a behavior contract. It is important if parents sit down with the child or teenager and develop a behavior contract and consequences if the child violates the contract. Therefore, if your child makes a mistake, the consequence is already known because it is in the contract. Therefore, it is less likely that the child will feel like a bad person or confused about the consequences because everyone in the family agreed to them.

I recommend contracts on a regular basis. The contracts help reinforce the discipline that choices have consequences. Therefore, the parent is teaching a child to think before they act. Thereby, significantly decreasing the odds that they will make a bad choice. It can also help a child deal with peer pressure because you have already discussed what you feel is appropriate. They also help to reduce arguments at home. If everyone agrees to the contract and a teenager violates the contract they cannot blame Mom and Dad for the consequences. Mom and Dad are only enforcing the agreed upon contract. The teenager needs to take responsibility for their choice.

Dr. Michael Rubino is a psychotherapist with 20 years experience treating children and teenagers. For more information about Dr. Michael Rubino’s work visit his website at www.RubinoCounseling.com or his Facebook page, www.Facebook.com\drrubino3.

Helping Children Cope with the Las Vegas Tragedy

In light of the terrible attack in Las Vegas where a man shot at families, teens and adults enjoying a concert killing and injuring hundreds of people. It makes sense to remind parents how children and teenagers are being impacted by news about such events. I have been seeing more and more teenagers who are complaining of anxiety and depression. Many of these teenagers are also afraid to go to school too. I have also been seeing more teenagers being placed on home/hospital for school. This means a teacher comes to the house once a week instead of the teenager going to school. This is an alarming trend.

I have also been hearing more teenagers talking about needing to carry a knife with them for their own safety. They tell me you never know when someone might try to attack you. These are not juvenile delinquents or gang members, these are average teenagers. They come from healthy families and are doing well in school and not involved in drugs. This need they feel to protect themselves is an alarming trend.

However, if you take a step back and look at what these children have seen over their lives it makes sense. Most of these teenagers were very young on 9/11 when the United States was attacked. Since 9/11 they have also seen two wars and heard on the nightly news about terrorist alerts or attacks around the world.

Now, in addition to these facts stated above, think about what these children see on the news and the video games they play. Anytime there is a shootings incident in the United States there is pretty much 24 hour news coverage of the event for days. Also when there are bombing or shootings in Europe there is 24 hour news coverage for days. And now we have moved on to covering funerals. When the officers were killed in Dallas the memorial was televised nationally. If we look at the video games these kids are playing most have to do with killing and death. And since computer graphics have significantly improved, many of these games look real.

Additionally, children in the fourth and fifth grades are telling me they are worried about our election results. They have heard what Trump has said and they are afraid other countries might attack us or Trump may start a war. Also Hispanic children who are legal citizens are afraid that they will be deported. This is a great deal for a nine or ten year old child to worry about.

Looking at all of this it begins to make sense why I am seeing more depressed and anxious teenagers who fear for their lives. These teenagers are being traumatized. They may not be experiencing the trauma personally but they are experiencing vicarious trauma. With all of the pictures on television and news reports and realistic video games these teenagers are playing, they are being traumatized vicariously. We have never had a generation of children grow up with the amount of trauma that these children are growing up. Even children growing up during World War II didn’t experience this amount of trauma. We didn’t have instant access to news nor did we have the graphic videos being shown by the news media.

The question now becomes, what do we do? Well we can not change the world unfortunately. However, we can monitor how much exposure our children are receiving to mass shootings when they occur. We can monitor the video games they are playing and limit access to games that focus on violence and killing. We can demand that the Congress pass gun control laws that make sense. No one needs an assault weapon to hunt a deer. We can also listen to what our children are saying and talk to them about their concerns. When a mass shooting occurs we can ask them how they are feeling, ask if they have any concerns and reassure them that you are there as their parents to protect them.

Finally, if you start to notice a change of attitude in your child that you are concerned about have them assessed by a psychotherapist. There is nothing to be ashamed of if a child needs therapy. We are exposing children to situations that most adults have problems dealing with themselves. You may find it very upsetting to talk to your child about these incidents. For these reasons and many more, if you feel your teenager has been traumatized vicariously make an appointment with a psychotherapist who specializes in treating teenagers and victims of trauma. Our kids have had to deal with a lot. We can help make it easier for them growing up in this time by providing the help they need.

Dr. Michael Rubino has over 20 years experience treating children and teenagers and dealing with victims of trauma. For more information about his work or private practice visit his website at www.RubinoCounseling.com or on Twitter @RubinoTherapy

How to Help Children Cope with Traumatic Events

We have all heard about the tragedy in Las Vegas yesterday and the fact that many families were present it makes sense to remind parents about how they may want to respond to their children. In addition to how Trump is reacting to North Korea and the news is covering the story 24 hours a day, it makes more sense to remind parents how children and teenagers are being impacted by traumatic events. I have been seeing more and more teenagers who are complaining of anxiety and depression. Many of these teenagers are also afraid to go to school too. I have also been seeing more teenagers being placed on home/hospital for school. This means a teacher comes to the house once a week instead of the teenager going to school. This is an alarming trend.

However, if you take a step back and look at what these children have seen over their lives it makes sense. Most of these teenagers were very young on 9/11, or were not even born yet, when the United States was attacked. Since 9/11 they have also seen two wars and heard on the nightly news about numerous terrorist alerts or attacks around the world and here in the United States. They also hear how the TSA are putting tighter security on travelers and places such as Disneyland are increasing security due to concerns about terrorism.

And now, children are hearing all day long how we are on the verge of having a nuclear war. Our President is making threats that are terrifying everyone, including children. Furthermore, we then have the attach in North Carolina. As a result, children are afraid that the end of the world is around the corner.

In addition to terrorism, this is the first generation growing up with mass shootings. According to ABC News from 2000 to 2015 there have been 140 mass shootings and since January 1, 2016, there have been more mass shootings than the previous 15 years. According to the statistics on mass shootings every day 36 people are killed in the United States by a gun. This does not include suicides. For the group we are discussing, suicide is the third leading cause of death for children between 10 and 18 years old and using a gun is one of the most popular methods of suicide. Also because of school shootings, students have seen increased security on their school campuses. Many campuses have metal detectors that students have to pass through as the enter the campus and there are police officers assigned to school sites due to the fear of violence.

Now, in addition to these facts stated above, think about what these children see on the news nightly and the video games they play daily. Anytime there is a shootings incident in the United States, or any where in the world, there is pretty much 24 hour news coverage of the event for days. Also when there are bombing or shootings in Europe there is 24 hour news coverage for days too. And now we have moved on to covering funerals. When the officers were killed in Dallas the memorial was televised nationally. If we look at the video games these kids are playing most have to do with killing and death. And since computer graphics have significantly improved, many of these games look real.

Additionally, children in the fourth and fifth grades are telling me they are worried about our election results. They have heard what the President has said and they are afraid other countries attacking us or that the President may start a war. Also Hispanic children who are legal citizens are afraid that they will be deported. This is a great deal for a nine or ten year old child to worry about.

Looking at all of this it begins to make sense why I am seeing more depressed and anxious teenagers who fear for their lives. These teenagers are being traumatized. They may not be experiencing the trauma personally but they are experiencing vicarious trauma. With all of the pictures on television and news reports and realistic video games these teenagers are playing, they are being traumatized vicariously. We have never had a generation of children grow up with the amount of trauma that these children are growing up with in the world. Even children growing up during World War II didn’t experience this amount of trauma. We didn’t have instant access to news nor did we have the graphic videos being shown by the news media.

Finally, if you start to notice a change of attitude in your child that you are concerned about have talk to your child or have them assessed by a psychotherapist. I have included a link to an article by the American Association of Child and Adolescent Psychiatry which describes what parents can do http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Talking-To-Children-About-Terrorism-And-War-087.aspx. There is nothing to be ashamed of if a child needs therapy. We are exposing children to situations that most adults have problems dealing with themselves. You may find it very upsetting to talk to your child about these incidents. For these reasons and many more, if you feel your teenager has been traumatized vicariously make an appointment with a psychotherapist who specializes in treating teenagers and victims of trauma. Our kids have had to deal with a lot. We can help make it easier for them growing up in this time by providing the help they need.

Dr. Michael Rubino has over 20 years experience treating children and teenagers and is an expert treating victims of trauma and also performs Critical Incident Debriefing. For more information about his work or private practice visit his website at www.RubinoCounseling.com or on Twitter @RubinoTherapy.

Dr Michael Rubinio

Understanding Your Teenager

Month: October 2017