Different types of Neglect

Different types of Neglect

This is a very good way to look at neglect

There are three main ways we can observe neglect:

1. Material neglect involves a child being left without food or clothes or medical attention.

2. Circumstantial neglect occurs when a child is loved by both parents, but is expected to take care of themselves during some part of the day. It’s clear to the child that their parent(s) value attachment behavior, but circumstances such as work prevent them from being around as much as they want. When they are home, though, they offer a secure-functioning relationship.

3. The more disruptive kind of neglect is associated with parenting styles that are dismissive or derogating of attachment values.

These parents can be home physically all the time, but their child will few (if any) have autobiographical memories. An example you might hear would be, “Mom was always home working, she just didn’t like to be interrupted… ever.”

The child generally is expected to perform a certain function for either or both parents, often related to parental self-esteem. Islands (avoidants) tend to report more neglect than do partners with other organized attachment systems.

Facts about Teenage Boys Using Guns Across the United States

Facts about Teenage Boys Using Guns Across the United States

With the significant increase in mass shootings and the recent shootings in Gilroy, Texas and Ohio, I hear many children and teens talking about their safety at school and around town while they are playing or hanging out. Many teenagers seem to believe if they have a gun that will keep them safe. While researching this issue I read an article by Cody Fenwick regarding children and gun violence. His article was very alarming. September is dedicated to suicide prevention and October is dedicated to the issue of bullying so this month and next month are dedicated to safety issues involving teenagers and children. Therefore, it seems appropriate to address the issue of guns because they are a popular method of suicide and they can be used to bully kids too. In addition teenagers who cannot tolerate the bullying they have to endure every day often use a gun as their method of suicide. Some may use a gun to act out their frustrations too.

Many of us feel because we live in Pleasant Hill, Walnut Creek, Lafayette or Orinda that our children and teenagers do not have to worry about gangs or gun violence. Unfortunately, this is not the truth. According to a new research study in the Journal of Pediatrics, guns continue to be the third-leading cause of death for Americans younger than 18 years old, killing around 1,300 children and teenagers a year in the United States. In addition, almost 6,000 children and teenagers are injured per year. Many teenagers are permanently disabled from these injuries. For teenagers who commit suicide, guns are the second-leading cause of death. The CDC has recently moved suicide as the third-leading cause of death for teenagers to the second-leading cause of death. This is a scary fact that the rate of teenage suicides are increasing not decreasing.

The study examined data from the Centers for Disease Control and Prevention and the Consumer Product Safety Commission between 2002 and 2014. The study found that boys, especially older boys such as teenagers and minorities, were much more likely to be the victims of gun violence. The study did not say anything about where the boys lived. The facts are children who are male and teenagers, are at a higher risk for becoming a victim of gun violence regardless of where they live. Therefore, teenagers in our area are at risk of becoming a victim of gun violence.

The study does indicate there has been a decrease in accidental deaths such as boys cleaning a gun. However, the rate as a method for suicide has increased. I have mentioned before that suicide is no longer the third leading cause of death for 10 year old boys. It is now the second leading cause of death for boys 10 to 18 years old. This study confirms that statistic and indicates the preferred method of suicide for boys and teenagers are guns. According to Katherine Fowler, one of the lead researchers at the CDC, “Firearm injuries are an important public health problem, contributing substantially to premature death and disability of children.” Understanding their nature [guns] and impact is a first step toward prevention.”

When we look at these numbers, can anyone argue against taking steps to protect our children? Can you imagine a 10 year old boy using a gun to kill himself? Can you imagine a 10 year old boy feeling that his life is so bad at the age of ten that death seems like a better option than living? At the age of 10, he has given up hope for a decent life. This is a sad fact.

The study also indicates that in recent years guns were responsible for a large number of adolescent, males who were murdered. The study documented that deaths in the category of murder for boys under the age of 18 years old decreased to 53 percent. This is a decrease yet the rate is still 53%. The other causes of gun-related deaths include:

• 38 percent — suicides

• 6 percent — unintentional deaths

• 3 percent — law enforcement/undetermined cause

The study found 82% of deaths by guns were boys. This means 82% of gun deaths were boys who were children or teenagers. Putting it another way, this means these boys were not even 18 years old yet at the time of their deaths. The study also found that white and American Indian children have the highest rate of suicide using a gun.

We also like to think that the United States in one of the most advanced nations in the world. However, the statistics show that the United States has the highest rate in the world for children under 14 years old committing suicide. Again, the United States has the highest rate of children under 14 years old using a gun to commit suicide. That number scares me and is appalling to me. However, as an adolescent and child psychotherapist, I do not doubt it. I have heard 6 year old boys seriously discussing suicide.

Furthermore, I hear teenagers routinely talking about needing to carry a knife or gun with them for protection. They tell me you never know when you will be jumped or there will be a mass shooting and you need to be able to protect yourself. In fact, a few years ago a teenager was shot on his front door step in Danville over a marijuana deal which went bad. When I mention to teens the risks they are taking, they tell me there is no guarantee they will live until 30 years old. They would rather die protecting themselves than doing nothing.

As a society, we need to look at these numbers and ask ourselves some questions. What are we going to do in order to improve gun safety? How are adolescent boys getting access to guns? Most importantly, why are children as young as 6 years old thinking about suicide? Also what are we going to do so that children who are suicidal have access to mental health care? This is our problem because it does happen in Pleasant Hill, Walnut Creek, Lafayette, Orinda and Danville.

Dr. Rubino has 20 years experience as a psychotherapist working with children and teenagers. For more information about his work or private practice visit his website at http://www.RubinoCounseling.com or his Facebook page http://www.Facebook.com/drrubino3.

Hate is The Problem Not Mental Health

Hate is The Problem Not Mental Health

The United States has an epidemic of mass shootings. According to the CDC, there is a mass shooting every eight days. Furthermore, since Columbine 214,000 students have experienced a school shooting with over 141 students killed. With the shooting at the Gilory Garlic Festival, in El Paso, Texas, Daytona, Ohio and last night Philadelphia, Pennsylvania, the statistics from the CDC seem to be right. Since the shooting in Parkland, Florida, teenagers have been marching and contacting Congress to pass sane gun laws. Unfortunately, their requests have been ignored. Instead, the President has decided to blame people who have mental health issues.

Today he again blamed people with mental health issues and said the answer is we need to build more mental health asylums. According to him, these people all need to be locked up. His idea and approach to these mass shootings has only served to increase the negative stigma about mental health issues and those people who are dealing with mental health issues. Besides the solution he proposed, the language he uses reinforces the negative stigma. He has referred to some of the shooters as “sick puppies.” These shooters who have committed these terrible crimes have done horrific things to families and communities, but they are still human beings.

His idea that all mass shooters have a mental illness is ignorant and wrong. Most mass shooters have been single, white males. Additionally, the Chairman of the American Psychiatric Association issued a statement last week documenting that most people with mental illness are dangers to themselves more than others. I have been treating people for various mental health issues for over 20 years. During that time I have dealt with many patients who were suicidal, cutting or burning themselves and trying to starve themselves. They were all hurting themselves and did not want anyone else to get hurt. I have never had a patient threaten to hurt others physically. Therefore, my work and the work of my other colleagues support the statement by the American Psychiatric Association. Patients with mental illnesses are rarely violent to others they tend to be dangerous to themselves.

Many people are afraid to seek help for themselves or their teenagers for fear of what will happen if they are diagnosed with a mental health issue such as depression. They are afraid of losing health insurance, not being able to get a job or their teen may not be able to get into a college. Overall they are afraid of becoming society outcasts and losing their rights. The way the President has referred to shooters as “sick puppies” has only served to reinforce the negative stigma about mental health issues. If he is saying people with mental health issues need to be locked up in asylums, people are going to be less likely to seek help. Suicide is now the second leading cause of death for teenagers. If we take the President’s approach, it will become the number one cause of teenage deaths.

The President did get one aspect of the shootings right. He stated hate is involved. When these shooters are investigated they all have hate towards certain groups. These mass shootings are hate crimes. Hate crimes were created for people who are victims of a crime due to their ethnic background, religion or sexuality. To be charged with a hate crime you need to hate someone not be mentally ill. The Klu Klux Klan has been terrorizing and killing people for years due to someone’s ethnicity or religion. No one has ever called a member of the KKK mentally ill. People refer to the KKK and other groups like them as hate groups not mentally ill groups. So instead of blaming mass shootings on people who have mental illnesses, why don’t we address the source of the problem? Everyone of these shooters have left writings and social media posts showing their hate for a particular group and their plans to kill as many people as they can that belong to this group. Hate is the problem.

We do not need asylums to help people with mental health issues. We need more community based programs and we need insurance companies to cover the necessary treatment a person needs if they have a mental health issues. Most people are born with mental health issues such as depression or develop an issue such as PTSD or traumatic brain injury from a car accident or being exposed to a traumatic event. Therefore, mental health issues are really not that different than physical health issues except there is funding to treat physical health issues and not enough to treat mental health issues.

If you are dealing with a mental health issue, please ignore the President and seek treatment. You will not be put into an asylum. If you are having issues, the sooner you seek treatment the better. The only time a person is hospitalized is if you are actively suicidal. This means you have decided to kill yourself and have everything ready to do it. Otherwise, you do not need to worry about being hospitalized.

Please write your Senator and demand that they pass sane gun laws so children are safe to go to school. Also ask for stricter laws for perpetuators of hate crimes. Finally ask for funds for community mental health centers and mental health education. We need to educate the public about mental health issues so we can remove the stigma the President is promoting.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating teenagers and children. He is also a founding member of the National Street Soldier Advisory Board, a community based program for teenagers. For more information about his work visit his website http://www.RubinoCounseling.com or his Facebook page http://www.Facebook.com/drrubino3

Why Boys Feel Emotionally Isolated

Why Boys Feel Emotionally Isolated

We know the traditional male stereotype is unhealthy for men & boys. I have many parents bring their teenage boys in for therapy due to depression. I have also heard many boys tell me they feel empty and numb. They tell me they can’t describe how they feel.

If I ask if they ever cry, they look shocked. Boys are not allowed to cry. While they can’t tell me how they feel they can tell me all the rules about acting like a man. They also discuss how they don’t really talk with their friends. They say they joke around with their guy friends. As a result, they never know how anyone is feeling and they feel lonely at times.

Here is another article discussing how living by the stereotype leads to a feeling of isolation for teens. This increase the odds of drugs, fighting & early sexual activity https://www.theatlantic.com/family/archive/2018/06/imagining-a-better-boyhood/562232/

Every Parent Makes Mistakes

Every Parent Makes Mistakes

This weekend we celebrate Father’s Day and last month we celebrated Mother’s Day. These days are set aside to provide us time to tell are parents how much they helped us as children and how much they mean to us. However, not everyone feels this way about their parents. Some people have a parent who abandoned them and others have parents who were physically and emotionally abusive. Therefore, Father’s Day and Mother’s Day are not happy days for many people because they had parents but their parents were not there for them. As a result, many people are angry and hurt by their parents and don’t want to celebrate their relationship with their father or mother.

While this is true that many parents were far from perfect parents, at times there are reasons why parents acted the way they did as a parent. I do not say this to excuse their behavior and parenting style because they are responsible for how they decided to act and parent. I say this to help people, who had abusive parents or parents who were not emotionally available, understand why their parents acted the way that they did. Many people who had less than perfect parents tend to blame themselves for their parents actions. This often results in people carrying around hurt, anger and shame that they do not need to. Also they tend to make excuses for their parents behavior because they are afraid what other people will think of them not their parents. They feel people will assume they must have been terrible kids to raise so their parents actions were justified. This only adds to their hurt, anger and shame.

The truth is many parents abandoned their children or are physically and emotionally abusive because their parents were the same way, but worse. They had no role models showing them how responsible parents should act. Also our society provides little assistance or education to new parents. Therefore, they are left on their own to figure out how to act as a parent. This is a difficult task and then when you add the pressures from work and paying bills some parents cannot tolerate the stress. They use whatever is easiest for them which is usually using the same techniques that their parents used.

As a psychotherapist when I work with a patient or a teen, I do a family history. I find out from the adult what life was like when they grew up and what life was like when their grandparents grew up. If I’m working with a teen who is dealing with substance abuse or physical or emotional abuse at home, I find the pattern in the family history. Typically, the pattern goes back to the great grandparents if people can remember that far back. This means we are dealing with a problem that has been going on for over four generations and being transmitted from generation to generation.

How can this happen? It can happen very simply. In the early 1900s very, very few people believed in psychotherapy. In the 1950s people still did not believe in it except for “really crazy” people who were locked up in hospitals. This stigma still continues to this day. When people call to schedule a psychotherapy appointment for their teenager, many ask if they come to therapy will it prevent their teenager from being accepted to colleges or getting jobs in the future. If a teenager contracts a sexually transmitted disease, these questions are not asked. In fact, many middle schools give condoms to sixth graders. Our priorities are off if we don’t worry about a sixth grader’s future when we give them a condom, but we worry about their future if they go to psychotherapy to improve their lives.

Therefore, the main point is that our society to this day still places a negative stigma on psychotherapy and getting help. Therefore, many parents in the 1950s had no help when they became parents. Children do not come with instructions and there were few parenting classes at that time. Therefore, few parents knew what to do as a parent and there were few resources available to help parents who were overwhelmed.

Bottom line, your mother or father may not have been perfect and may have mad a lot of terrible mistakes, but they did the best they could at the time with what they knew. I have found this many times when I have interviewed the parents and sometimes the grandparents of a teen I’m seeing in psychotherapy. They admit they made mistakes, but they did not know what else to do at the time.

Therefore, for those of you who had abusive or neglectful parents, you are entitled to your feelings, but try to understand they did the best they could do. Maybe you can’t forgive them, but don’t blame yourself or feel ashamed. You did nothing to create the situation and there was no way you could have made it better. For teenagers today, again you did not create the problem and the problems have nothing to do with you as a person. Also you cannot change your parents. You can try to understand that they did their best in the past, however, now that you are in therapy they have an option to improve the situation. They can begin their own psychotherapy and address their own issues.

Decade after decade we are seeing the same parenting issues being passed down from generation to generation. We need to stop this pattern. We must remove the stigma associated with psychotherapy and the stigma associated with needing assistance with problems. No child comes with a parenting guide when they are born. As a result, parents will and do make mistakes. Instead of making them feel ashamed and embarrassed, we need to provide parents with options for seeking help such as more parenting classes. We need classes which focus on raising a toddler and other for adolescents. Also for parents who were abused themselves they need individual and group psychotherapy. Why do we keep repeating these mistakes and allowing the cycle of abuse to be transmitted to another generation.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating children, teenagers and their families. For more information regarding his work or private practice visit his website http://www.RubinoCounsling.com or his Facebook page http://www.Facebook.com/drrubino3

Teens Ask Please Accept Me For Who I Am

Teens Ask Please Accept Me For Who I Am

Being a teenager in today’s world is very difficult. Teenagers face expectations regarding needing to make money to be a success. They face stereotypes about how boys must act if they want to be men and girls face stereotypes about how they must act to be considered women. I hear teens tell me everyday how overwhelmed and confused they are trying to fit into all the necessary stereotypes. They feel overwhelmed because at times they are not sure how to act and confused because at times they don’t agree with the stereotype. If they don’t, they are not sure what to do. This is a lot of pressure for a 13 year old child to be trying to cope with on a daily basis. It’s no surprise that many teens turn to drugs as a way to cope. It is also not a surprise that Cutting is at epidemic rates for teens and suicide is now the second leading cause of death for teens (CDC)

Now what if you don’t fit into the stereotypes? What if you suffer from depression? If you have a learning disability? Or if you are homosexual or bisexual? What do these teenagers do? This is how they were born and they cannot change that fact. Many of these teens will struggle trying to fit the stereotypes and also try desperately to hide from friends and family that they do not fit the teenage stereotypes. Some are lucky and parents or a teacher intervene helping them to get the help they need. Many are not so lucky and often choose suicide. Teenagers who are homosexual or questioning their sexuality are five times more likely than the average teen to think about and attempt suicide (CDC). These are very scary and sad facts.

The CDC found one in five teenagers are dealing with mental health issues such as depression, anxiety or stress. Many may think about psychotherapy but quickly block that option. Only “crazy people” need psychotherapy. If they had to go to therapy they are really a “loser.” For teenagers who are willing to try therapy, they often cannot find a therapist who treats teenagers or their family cannot afford it. Also for many cultures such as Latin or Asian, they believe that personal issues need to be resolved within the family and you would never share intimate family issues with strangers. Therefore, for these teens psychotherapy is not an option.

However, as a psychotherapist who specializes in treating teenagers, I hear daily from teens that all they want is to be accepted for who they are and they don’t want to have to always hide. The teen with depression or the learning disabilities wants to be considered just as important as the star quarterback on the football team. They want this from their school, their friends, society and finally from their families. Is this too much to ask for?

These teenagers are not stealing or doing anything to be ashamed of, they are being themselves just the way they were born. Why can’t they be accepted and celebrated? The answer is they can! It is something I teach them in every session we have together. There are organizations such as Alive and Free in San Francisco and Challenge Day in the San Francisco Bay Area who work with teens and society so these teens can feel accepted being themselves.

Another organization addressing this issue is called Born This Way. It was started by Lady Gaga and her organization works with teens and society so all teens feel accepted for who they are just the way they were born. Lady Gaga explains the mission of her foundation this way, “Safety, skills, and opportunity. Number one, I want everyone to feel safe in their community: school, home, whatever city you live in. Two: developing the skills that are needed to be a loving, accepting, and tolerant person, and to also inject that sentiment into all the people around you, being a supportive human being. And the third is opportunity. I believe once you feel safe in your environment and you acquire the skills to be a loving and accepting person, the opportunities for you are endless to become a great functioning human in society.”

For people who do better by hearing something or seeing it, I have included a link to a YouTube video where Lady Gaga explains Born This Way, https://youtu.be/

The concept really is very simple. Why can’t we accept children and teenagers just the way they were born. Every person is unique and everyone has talents to contribute to the world. So why do we pressure boys into the stereotype the must have big muscles and play sports to be a man? Why do we tell girls that boys are smarter and if someone touches them in a way they do not like it is their fault because of the clothes they are wearing. This is insane!

If we do away with the stereotypes and focus on teenagers liking their own personalities and bodies, we would have less cutting, suicide and drug use. We would also have many more teenagers who are happy and successful at life. Being happy is a successful life not a big bank account. Therefore, let’s get started on helping teens. We need people to support more organizations like the ones I named above. If we do we can eliminate the stereotypes and stigma of not fitting a stereotype. We also need to make psychotherapy more accessible to all teenagers and remove the negative stigma associated with mental health care. Now some people may think what I am proposing is impossible and just a dream. However, you are seeing more groups like the ones I mentioned open every year. We are seeing teenagers and parents being attracted to them. It is possible to improve the lives of children and teenagers. It may need to start with a dream. Dreams do come true look at what Walt Disney created with his dream.

Dr. Michael Rubino is a psychotherapist with over 20 years experience working with children and teenagers. He is on the nations advisory board for Alive and Free. For more information about his work and private practice visit his website http://www.RubinoCounseling.com or his Facebook page http://www.Facebook.com/drrubino3 or on Twitter @RubinoTherapy.

Eating Disorders Impact Boys Too

Eating Disorders Impact Boys Too

Eating disorders and body image issues are a major problems for teenagers. Despite what most people may think, these issues impact girls and boys. Most people assume eating disorders only impact girls, but they impact boys too. Boys worry about their abdominal muscles having the “six pack” look and how strong they are compared to other boys. Also for some sports such as wrestling they must make a certain weight to compete. Therefore, they worry about their weight. So eating disorders impact boys too.

Looking at the prevalence of eating disorders in teens can be very difficult. Some break the statistics down to diagnoses such as anorexia. While some focus on under eating, teenagers who over eat can also have an eating disorder. Another classification is unhealthy eating that many teens engage in. Some may skip meals or some may consume to many calories to make weight for their sport and then go days without eating. Therefore, eating disorders can take many shapes and forms. Overall, it is estimated that eating disorders impact 5% of female teenagers and 1% of male teens (NIMH). However, the number for males is considered to be under reported. This assumption exists due to the belief many have that eating disorders only impacts girls. Therefore, there is an assumption that the 1% for boys is an underestimate due to under reporting. Working with adolescents I am sure the 1% is incorrect. I hear many teenage boys complain about their bodies or needing to make weight for their sport. I also hear things they do such as only drinking water a week before a weigh in or loading up on protein drinking before working out. What they report may not fit the picture of anorexia we have, but it definitely is not healthy and is involved with body image. This is a major factor in all eating disorders whether it be anorexia or over eating.

One reason I’m addressing this subject is as I stated above most people assume that eating disorders do not impact boys. Eating disorders impact boys and teens from every economic level, ethnicity and religion. They are an equal opportunity disorder. Another reason I’m addressing this issue is suicide is the number one mental health issue killing teenagers in our country. Eating disorders are the second leading mental health issue killing teenagers. It is estimated that every 62 minutes someone dies from an eating disorders (NIMH). The death may occur after someone has received treatment and is considered in recovery. Eating disorders take such a toll on teenage bodies they may die even though they are considered to be recovered. The singer Karen Carpenter is a prime example. She struggled with an eating disorder for years and struggled with treatment too. However, she finally reached a point where she was considered recovered from her eating disorder and started to resume her life. Unfortunately, she died suddenly one day from a heart attack. The toll the eating disorder put on her body weakened her heart severely. So severely that it caused her to have a heart attack even though she was in recovery.

This is a very sad story and fact. We can avoid these issues by early diagnosis and treatment. We also must realize that eating disorders impact boys too. If we do not we are not addressing the entire problem. We need to address how our society look at men’s bodies and women’s bodies and the expectations we place on both genders. No one can live up to the female and male stereotypes we have created. In order to change these stereotypes we need to start with teenagers and provide them with enough self-esteem to reject the stereotypes.

As I stated early treatment is necessary. To have early treatment we must have early diagnosis. I have included a link to a video by Dr. Pooky Knightsmith which discusses the ten common warning signs of an eating disorder in teens and children, please watch this video https://youtu.be/nKwbE8mP_PA.

If your teen or child displays any of these warning or signs or if you feel your teen maybe struggling with an eating issue, make an appointment with an adolescent psychotherapist who specializes in adolescents and eating disorders. Do not feel ashamed or embarrassed. A mental health issue is no different than a physical health issue. We only believe their is a difference due to the stigma we have created. However, keeping this stigma is endangering the lives of many teens so help your teen and ignore the stigma. Help them deal with their health issue.

Dr. Michael Rubino is a psychotherapist with over 20 years experience treating teenagers and children. He also treats teens including boys with eating disorders. For my information about his work and private practice visit his website http://www.RubinoCounseling.com or his Facebook page http://www.facebook.com/drrubino3.