Teenage Boys and Cutting

Teenage Boys and Cutting

Last Sunday, I was a guest on the Street Soldier radio show on 106.1 KMEL. The topic was how teenagers are impacted by social media. The topic of depression and cutting came up during the conversation. The adults were shocked to hear about the cutting and the teens tended to feel the cutting was more of an issue for the girls. However, 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 (CDC). 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. In fact, the CDC does consider teenage cutting to be an epidemic. Additionally, the little research we have about this behavior supports this idea, but we are unable to determine how severe the epidemic is in teenagers. When I mention cutting to a teenager now, they don’t look shocked. Instead they talk about it like we are talking about the weather. They often tell me about friends who are cutting too. Most teens who cut have friends that cut. Most teenage boys who have girlfriends tend to have girlfriends who cut too. This has been my experience.

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 because the teenager now assumes everyone is judging them. 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 has treated many teenagers who cut and is considered an expert in this area. For more information regarding Dr. Rubino visit his websites http://www.rcs-ca.com , http://www.RubinoCounseling.com , or his Facebook page, http://www.Facebook.com/Drrubino3

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Teenagers Lose Themselves by Camouflaging Themselves

Teenagers Lose Themselves by Camouflaging Themselves

A new behavior for teenage and tween girls has been identified by an adolescent psychologist. The behavior that has been identified is called “Camouflaging.” This behavior left unidentified can lead to low self-esteem, depression, cutting etc. It is becoming very common. Last night I was a guest on the Street Solider Radio Show on KMEL, and the teens were talking about how they change how they dress or their opinions based on their friends. They were describing Camouflaging.

Camouflaging is when an adolescent girl changes how she looks, her opinions or things that she does in order to be accepted by the other girls. The real problem occurs when the girl is changing so much about herself or does it for so long that she forgets or losses track of her real self.

While this behavior has just been identified in girls and the research appears correct, I believe this behavior applies to boys too.

Many adolescent boys change the way they dress, their beliefs and the way they act to be accepted by their friends. I hear many of these boys telling me in therapy that they feel lost. They tell me they no longer have an idea of who they really are or believe or feel. These boys often turn to alcohol, drugs and cutting. Usually to numb out their lost feeling or to feel something.

As a result, many teens start acting like someone they are not just to be accepted. This fear of not being accepted and forgetting their real self because they has been covering their true self up for so long or denying their true feelings for so long can result in boys and girls having low self-esteem and/or feeling depressed.

This low self-esteem and depression can result in such behaviors as cutting, eating disorders, drug use, becoming sexually active etc. Often boys and girls cut just so they can feel as I stated above. The constant denying of their emotions can cause boys and girls to lose a sense of their true feelings. Therefore, cutting can occur so boys and girls feel. Denying their feeling or who they are can result in boys and girls feeling very confused. Therefore, they look for behaviors that help them remember who they are and help them identify their true feelings. They also seek behaviors that help them deal with denying their feelings or changing their behaviors. This can trigger eating disorders, drug abuse or other self-destructive behavior. This helps numb out the confusion and disappear of denying their feeling and trying to forget their true self. This can cause feelings of depression and anxiety too.

What should parents look for in their teens? If your son or daughter tries to stop wearing his or her glasses or if he or she all of a sudden changes how he or she dresses or acts these are possible warning signs. Another change could be not doing as well in their classes because they are afraid of looking too smart. Basically, if you see signs indicating that your teenager is trying to deny who they are so they will be accepted by others.

While it is normal for teenagers to make changes in their attitudes or how they dress, we are talking about something that goes far beyond normal self-expression. We are referring to changes where a teenager is trying to deny who they are because they feel they are unacceptable.

This is what we are talking about. If teenagers are changing their hair or how they dress as a way to express themselves that is normal teenage behavior. However, if teenagers are doing it just to fit in and they end up losing a sense of their true self this is camouflaging.

As I stated, Camouflaging results in depression or low self-esteem because the teenager is forgetting their true self. If they are doing it as a way of trying to experiment with their self expression, the teenager is happy and confident as stated above. This is the main point to understand. Experimenting with their dress and beliefs etc. is normal for teens and helps teenagers identify themselves, however denying or camouflaging their feelings results in teens losing themselves and many behavior problems. This is the main thing for parents to watch for in their adolescents behavior.

If you go onto Yahoo and look up Camouflaging you will find a segment on Good Morning America about Camouflaging. In fact, here is the link to the GMA segment https://gma.yahoo.com/video/parents-worry-tween-teen-camouflaging-122935763.html?soc_src=copy. Also if parents look at the February issue of Teen Vogue, you will find an article about Camouflaging.

Dr Michael Rubino has over 20 years experience working with teenagers and their families. Dr Rubino is considered an expert psychotherapist in the treatment of teens. For more information about Dr Rubino and his private practice visit his website at http://www.rcs-ca.com or http://www.RubinoCounseling.com or his Facebook page at http://www.Facebook.com/drrubino3.

The Truth about Suicides during the Holiday Season

The Truth about Suicides during the Holiday Season

The Holiday Season is just around the corner. Many people assume the Holidays and depression go together. In addition to assuming the Holidays and depression go together, people assume that suicide rates increase during this time of year. Well according to the statistics from the CDC, suicide rates actually drop during the Holiday Season. The study by the CDC is not sure why they drop but they do. May be they drop because during this time of year we pay more attention to depression and suicide. There are a number of ads and social media posts where people can call if they feel suicidal.

What the CDC did find is that loneliness increases during this time of year. During the Holidays there are songs and plenty of television shows regarding getting together with family and friends. You also have people talking about all the Christmas parties that they have to go to. However, this is not the case for everyone.

If you are a military family, a loved one may be stationed overseas and won’t be home for Christmas. Also during the year some close friends or loved ones may have died during the year. It is during this time when most people are talking about family and friends that you remember the people you have lost over the year. The first Holiday Season without a close loved one or friend can be very difficult. You may not feeling like celebrating or you may have to change Holiday traditions which can make some one feel sad and lonely.

Another common difficulty during this time of year is money. Many people feel like they need to spend a great deal of money to show love. They may just be able to pay their monthly bills and cannot afford Holiday gifts. Why do we need to spend money to show that we care? What if you write a letter to someone telling them how important they are to you and how much you appreciate them. Isn’t that the real purpose of the Holiday Season? Isn’t this the time of year we take to tell people in our lives how much we appreciate them. Also it’s an opportunity to tell people we tend to ignore, people sleeping on the street or who are dealing with mental illness that they are important too?

As a psychotherapist, I have seen that people dealing with mental illness feel lonely and out of place during this time of year. They don’t often feel the joy of the season. Sometimes they struggle just to make it through the day. Also mental illness is something we don’t discuss as a society. We tend to act like it doesn’t exist so we ignore the issue. Also since it is an uncomfortable issue for many people the feelings of shame and embarrassment become associated with mental illness. This makes it less likely for people dealing with it or families who have a family member dealing with it to talk about it or seek help. This can make people feel lonely and isolated especially during this time of year.

We seldom acknowledge the daily struggle that people and families dealing with mental illness go through on a daily basis. It is important to acknowledge that mental illness is not a weakness it is a medical condition. There is no reason to look down on someone with mental illness. We offer encouragement and support to people with cancer, why can’t we do the same for people with mental illness?

I have included a link to a video where a teenager discusses dealing with depression https://youtu.be/dAzqGcOLXBs. Listen to what he has to say and answer the question, does he deserve to be looked down upon because he is depressed?

Also remember the Holidays can be a lonely time for people. So if you see someone who looks like they are having a hard time or know someone who is struggling during this season, try to help. Do something kind for them. Another thing to remember, being kind to people should be a year round activity for all of us. We should not just be kind during the Holidays. If we try to be kind all year, we may be able to decrease how many people feel lonely and depressed. Also if we are kind and offering support year round may be we can eliminate the negative stereotype associated with mental health.

Dr. Michael Rubino specializes in treating depression and suicide especially depressed and suicidal children and teenagers. For more information about Dr. Rubino visit his website at http://www.rcs-ca.com or his Facebook page http://www.Facebook.com/drrubino3

Girlfriends and Boyfriends Are Not Necessary to Live

Girlfriends and Boyfriends Are Not Necessary to Live

“You Complete Me”

Many people are familiar with this line from the movie, Jerry McGuire, starring Tom Cruise. A deaf couple signs this message to each other in an elevator and Tom Cruise’s character assumes they must really be in love. However, this may not be the reality. In reality it may be an unhealthy relationship.

As a psychotherapist with 20 years experience treating couples and teenagers, I have observed a common mistake that many people make regarding relationships. Many people tell me they feel an emptiness inside themselves and describe it as a “big empty hole.” They assume that a relationship will fill this emptiness. In other words, they are relying on their partner to eliminate that empty feeling they are experiencing.

This is a mistake. The only person that can fill that emptiness you feel is you. When I work with couples or an individual who is experiencing this emptiness, they usually are upset with their partner. They are upset because their partner is not filling the emptiness. Also the other partner is frustrated because they are tired of having to constantly reassure their partner. They report they are tired of always having to worry about meeting their partner needs and that their needs are constantly being pushed aside.

This type of pattern is very common in relationships where there is domestic violence or a substance abuse problem. Also jealousy is a major issue in these relationships. The person who is experiencing the emptiness is very sensitive to feeling rejected or abandoned. This is usually a result from childhood issues that have never been addressed. However, as an adult, if they sense these feelings in their relationship they tend to over react to them. The person may drink excessively to reduce their fears and men often result to verbal or physical abuse. Anything that will keep their partner in the relationship and continue to fill the empty space.

This tends to occur because as we grow up there is a great deal of pressure for people to be in relationships. You see this in children in first grade or kindergarten when adults jokingly ask children if they have a boyfriend or girlfriend. If a child doesn’t they often feel there is something wrong with them.

I see this issue a lot with teenagers. I have teenagers who feel they are defective because they never had a girlfriend or boyfriend. This defective feeling increases significantly, if the teenager never has been on a date. They believe if they are going to be a “normal” teenager, they must at least be dating. Boys tend to believe they must be sexually active too. I have had teenagers tell me they felt suicidal or were using drugs because they did not have a girlfriend or boyfriend. They are willing to risk their lives using drugs or believe they are better off dead, if they don’t have a girlfriend or boyfriend. They are so tied up trying to live the stereotype, they can’t believe that many teenagers do not have a girlfriend or boyfriend and do not date in High School.

This pattern continues into adulthood. Many women feel defective if they are 30 years old and not married. Men feel as if they are not men if they do not have a girlfriend. Both men and women often settle for anyone as long as they can say they are in a relationship.

As children, we never learn how to love and care for ourselves. Ask someone if they would go out to dinner by themselves and most people look terrified by the idea. They have no idea what they would do and they are afraid about what other people with think. This is a sad state that we cannot love ourselves. If we always need someone to reinforce we are lovable, we turn our power over to strangers. If someone says something nice about us we feel good, if they say something hurtful, we feel unworthy as a person. But, why should someone else determine our value? We should be the one who judges if we are lovable or not. A relationship should add to our life like a bottle of wine adds to a meal. A relationship should not define us as a person.

As a result of this problem, many couples end up divorcing because a partner is tired of having to reassure their spouse daily. I have seen these divorces become very nasty and costly. So both parties are hurt even more and so are the children. They only people benefiting are the attorneys.

We also have this same issue with teenagers. However, when they break up it tends to be more dramatic. A teenager may start to use drugs, developing an eating disorder, start cutting, become depressed and may attempt suicide. The behaviors are not uncommon after teenagers break up.

How do we handle this issue? We need to start to acknowledge as a society that a relationship doesn’t make you a complete person. Only you can make yourself feel complete as a person. Also we need to remove the stigma of seeking mental health care. We need to encourage adults who feel incomplete without a relationship to seek psychotherapy and deal with their issues. Parents, if you notice that your teenager is desperate to be in a relationship, help them get psychotherapy so they can deal with the pain they are feeling.

Again, please remember a relationship should add to your life, it should not make you a person or define you as a person.

Dr. Michael Rubino has 20 years experience working with families and teenagers. If you would like more information about his work or private practice visit his website at http://www.rubinocounseling.com.

“Prayers are not Enough”

“Prayers are not Enough”

Yesterday we had another mass shooting at a newspaper in Maryland. Five more people killed senselessly and more family and friends lives were torn a part. This time an assault weapon was not used, a shotgun was used. The gunmen had a history of problems with the paper and planned this out. I made a point of mentioning that a shotgun was used not an assault weapon. I did this to make the point that all guns can kill not just assault weapons.

Mass shootings have become an epidemic in the United States and every year more people are being killed in mass shooting. How many people have to die before we pay attention to this epidemic. Some reporters were commenting yesterday that victims of these shootings are now saying that mass shootings are so common that we will talk about the event today and then forget until then next incident. Unfortunately, I think they may be right.

The news reported that the President and First Lady has been briefed about the shooting. The news also reported that the President and First Lady were praying for the victims. However, I think we need to listen to one of the survivors from yesterday shooting. She stated she was hiding under her desk and she was praying. She had no idea if she was going to live or die. This victim stated she did not care about the President’s prayers. She stated it was nice to hear, but his prayers were not going to help her and she did not care about his prayers. She wanted action to prevent these mass shootings.

We keep hearing this same sentiment from other victims and families. They do not want the President and Congress to pray. They want the President and Congress to take action to prevent these shootings. We need sane gun laws and more access to mental health services. However, the government fails to act. In fact the budget proposals by Congress and the President eliminate support for mental health services.

The First Lady stated she was going to focus on cyber bullying and emotional health for children. However, mental health services continue to be cut for children. In my area there use to be a decent number of community mental health clinics to serve children and teenagers. However, over the past two years most of the community resources have been eliminated. I have had severe problems getting a suicidal teenager hospitalized because the County and private hospital in our area, do not have enough beds to help suicidal teenagers. As a result, the teenager goes home and the parents have to stay awake watching their teenager.

Talk sounds nice, but it does not solve the problem. Prayers do help, but God is not going to solve the problem if we don’t make it a priority. We must take the situation seriously and act.

Therefore, parents consider who you vote for this November very seriously. Vote for someone who is willing to take action and enact sane gun laws and put more resources into mental health. Imagine if you were that woman hiding under her desk wondering if she was going to be killed in the next ten minutes, would you care if the President was praying? If your child was killed in a mass school shooting, would you care if the President was praying? The answer is no! You would want the President and Congress to take actions to prevent this epidemic.

Some people may say I have no right to speak out as a psychotherapist. However, I have an ethical and legal obligation to speak up and inform people if someone is suicidal or if a child’s safety is in danger. Since I am seeing resources cut daily which interferes with my ability to help someone who is suicidal or a child who may be a victim of child abuse, I am exercising my ethical duty and speaking up. Hopefully more people will speak up in November with their votes.

Dr. Michael Rubino has over 20 years experience in private practice and community clinics treating children and teenagers. For more information regarding Dr. Rubino’s work or private practice visit his website http://www.RubinoCounseling.com

Helping Children Cope with Stress

Helping Children Cope with Stress

Many times parents can see that their child is dealing with stress or worry that a situation may cause a child to be stressed. Many parents will ask me what they can do to help their child cope with stress or if they can prevent a stressful situation before it occurs. These are valid concerns and questions for parents to ask. Given the state of the world with mass shootings occurring at schools on a regular basis and many children are now homeless in the United States, children are experiencing many stressful situations that never existed before. Since children’s brains are not fully developed, they process information differently and coping with stress can be difficult for children. Also parents are having less control to the stress their child is exposed to due to technology we now have instant coverage of events and 24 hour media coverage which makes it difficult for parents to help their children. I recently read an article by Lori Lite with some good tips for parents to help children cope with stress. I have included these tips and information below.

Children do not think, act, or manage stress like adults; the younger the child the smaller the stressors. Help children cope with stress by realizing you can empower your children.  Arriving at school to find a  rearranged classroom or a substitute teacher can be big stressors to kids.

Young children do not yet have the ability to identify or express their own feelings of stress. They struggle with their own emotions and they pick up on their parents tension. The American Psychology Association noted that 39% of children feel sad and worried when their parents are stressed. Often a stressed out child can be detected when a teacher or parent  observes changes in a child’s  behavior.

Frequent melt-downs, sleeping problems or nightmares, clingy behavior, refusal to go to school, acting younger than their age, bed-wetting, stomachaches and headaches are  signals that your child may be experiencing too much stress. The main thing to look for is a change in behavior. Trust your instinct.

Tips to Help Stress:

1. Help children put words to their feelings. Ask them if they feel nervous, scared, or worried. Ask them what is making them feel that way.

2. Acknowledge your child’s feelings and encourage the use of positive statements. Often children do not understand the outcome of an action or change. Instead of realizing their favorite teacher will be back tomorrow..they might think she is gone forever. Create positive statements for the situation.

“I am safe. My substitute teacher is fun. My teacher will be back soon.”

3. Introduce stress management techniques to  children. Parents and teachers can easily teach and use techniques like breathing, positive statements, and visualizing on a regular basis. Lesson Plans are available.

4. Establish a bedtime routine that helps kids relax. Soothing music or relaxing stories.  Indigo Dreams: Kids Relaxation Music promotes sleep and relaxation.

5. Spend reassuring quality time with children. Parents and teachers can  laugh and play together. Singing songs like This Is The Way We Laugh And Play and If You’re Happy And You Know It can be a liberating and fun stress reliever that you and your children can enjoy together.

I hope these tips are helpful. Parents it is important to remember all you can do is your best to try to help your child. However, as I stated above, with the advancement of technology and events such as mass school shootings happening on a regular basis, you cannot protect your child from every stressful event.

Dr. Michael Rubino is a psychotherapist with over 20 years experience and he specializes in treating children, teenagers and trauma victims. For more information about his work or private practice visit one of his websites www.rcs-ca.com or www.RubinoCounseling.com or his Facebook page www.Facebook.com/drrubino3.