An Open Letter to Mental Health Professionals Who Work With Teenagers: 7 things you ought to know

March 2016

Dear Mental Health Professionals,

1: I appreciate all you are doing to help us:

Thank you! I want to thank you for the work you do. Every day you face struggling adolescents with a vast array of issues and needs. When you go to work you may very well be saving lives, but you also carry with you the stress of knowing that you may lose a life as well. You have been well trained for your job; you have procedures that you follow because mistakes in your line of work can lead to tragedy. I have a master’s degree in counseling, and I have to a very limited extent sat in your shoes. I understand having teenagers sign contracts agreeing to not commit suicide. I understand the issues of confidentiality laws and trying to carefully maneuver sharing with parents and maintaining a working relationship with your adolescent client. I even understand some of the ins and outs of DSM diagnosis and medication. Unfortunately, I am now sitting on the other side and my perspective has changed quite a bit.

2. I am more invested than you are:

As a mother of a struggling teen, I want to provide you with some advice from the other side. You are seeing our teenager at their worst. You know this in your head, but let me tell you that even if our child has been in a nearly non-stop crisis for the past 2 years, we had 12 or 14 years with that child before they came to your office. If the mental health issues have been long term, we may have parented this teenager through a difficult childhood as well, but there is so much more. We have watched them open stockings on Christmas morning, and taken them to Disney World. We have held them when they were sick and cheered them on at soccer games. We have taught them to read and corrected them when they lied or cheated or disobeyed. We have a history with our child and we are more deeply invested in their mental health than you will ever be. We lay awake at night worrying about them. While the years may very well have birthed some unhealthy family communication patterns, and we are coming to you because of your impartial stance, you must understand that you can close the file and go home at night, but we can not. This child is our life.

3. I have already beaten myself up, so you don’t have to:

There is no question you can ask us that we have not asked ourselves. We have already berated ourselves and wondered a million times over if this is “all our fault.” What if I was a better parent? Maybe if I were more patient or never screamed, than things would be different. Was I too lenient or too strict? Maybe if we hadn’t moved or gotten a divorce or changed this child’s school or … then they wouldn’t be here right now? Was it my fault that they inherited the genes that are leading to this diagnosis? If I had been more watchful or observant could I have seen this coming? Could I have done a better job monitoring my kids cell phone use or friendships? Was I too intrusive and pushed them into secrecy? Should I have not left them alone so much? Could I have prevented some trauma that occurred to them? Was that assault on them my fault? Should I have locked up the medications or alarmed their windows so they couldn’t sneak out in the middle of the night? Yes, we already think we are the worst parents in the world. We already are entering into mental health care because we feel that this problem is out of our control, and we are already feeling like a failure.

4.Your words matter to me just as much as they do to my child:

 If you are seeing my child on a long-term basis and you are developing rapport with that child, then you are probably also seeing me on occasion as well. Take a moment to think how difficult this is for both parties. You might not be the first counselor/therapist/psychiatrist we have been to. Maybe our previous experience wasn’t all that great. We know that you are going to find fault in our parenting. We do. It’s not a surprise that we have failed, because we are seeking assistance to do the job better. We are mentally preparing for this. It’s still going to be painful to hear, but we are willing to hear your critiques because our child is worth it. There is, however, a way to share your concerns with parents that doesn’t sound like, “Your child feels no emotional connection to you.” Ouch! Yes, I’ve been told this in these exact words. You’re telling me what you heard my child say in a session(s) that they undoubtedly believed at that moment and may feel regularly. But you are missing a few things. First, I do have an emotional connection to my child and you just shattered my heart. And second, that child who doesn’t have the warm fuzzies for me right now and hates my guts because I took their cell phone away doesn’t actually fully understand their emotions. Their brains aren’t fully formed. If I got hit by a bus today, I am confident even my angry teenager would be heartbroken because they do in fact have an emotional connection with the two people who have spent every day of that child’s life devoted to their care and upbringing, even if those two people have blown it big time.

5. This was a huge risk for me:

We have taken enormous risks as parents in bringing our child to you. We know that we have no control over what is said behind closed doors and our inability to get our child to talk to us leaves us wondering what they aren’t telling us and worried about what they are telling you. We never know if in that room they are making confessions about sexual assaults, bullying, addictions, or a million other things that we don’t know about. We want to know about them, but we can’t get our child to tell us so we have resorted to professional help. We know that our child’s perception of reality is distorted to some extend by the nature of their place in life, and we know that ours is as well. We already believe that we are the cause of some of our child’s problems and we are already beating ourselves up about that. We hate that we can’t know what you are finding out. We hate that our child would rather tell you their deepest thoughts instead of telling us; we who love them. We also fear that we will be blamed for those problems in therapy, and our past experience may very well support that fear. You have all these nice books and research. Eating disorder: blame a controlling dad. Arson: blame sexual abuse. Suicidal: blame parents with unreasonably high standards. We risk you calling the authorities on things we might have no idea about. We risk the therapy making matters worse. We can never be sure if we are doing the right thing, if you are the right person for the job, if you are any good at your job, or if this will ever get better.

6. There is a time and a place for your “investigation” into the root causes of this problem, and the psychiatric ER is not one of those places:

The questions you ask us and the manner in which you do so can make a huge difference in whether or not we as a family get the help we need to handle the crisis we are facing. I know that you see cases of abuse and neglect probably very often in your work. You don’t know if the teenager who is abusing drugs or trying to commit suicide is reacting to a dysfunctional home life. I get that, but if that is the case, you are likely going to get that information slowly over time and those abusive parents aren’t likely to be the ones providing that information. The rest of the parents, the vast majority of parents struggling through their mediocre lives and blowing it as parents everyday because of the chaos that has erupted from raising a mentally ill or struggling child, these parents don’t need to be grilled by you or treated with suspicion and disdain. Do you have any idea how difficult it is to bring you child to an ER in the middle of the night because you fear they might harm themselves? That is not the time to ask a parent why they don’t have a pad lock on the Advil. Really? Do you? This is not the time to ask them why during the fight that led up to this moment of crisis you say something unkind to your child. If they just recounted the story in enough detail where they admitted their own failings then you can be pretty sure that they are either ashamed of their response, are blaming themselves for it, or both. This the time to remind them how rare it is for a parent to take the steps to love their child enough to risk the embarrassment and stigma of seeking help. This is the time to reassure the parents that mental illness can be treated, that there are often medical reasons for this that are totally out of the parents’ control, and that you are there to help.

7. I need mental health care and support as well, but I really cannot get it right now so you are it:

Parents are often told how important it is for them to get proper care for themselves and take time to rest and rejuvenate so we can be the best parents for our kids. The problem with this sentiment, which I fully support in theory, is the reality of executing this principle. See, my life is in turmoil and I’m the one whose job it is to hold things together. I may very well be juggling work and a family. This child whose crisis is tearing them apart may only be one of my children, and I am desperately trying to keep things as normal as possible for the rest of them. I am still running to scouts and sports practices, but now I have counseling and psychiatrist appointments in the mix. I am still helping all my kids with homework and taking care of cleaning and cooking. Chances are, if my child is in crisis, home life is not the only thing that is being impacted. I may very well be dealing with school issues and parent teacher conferences. Maybe there are legal or court issues I am trying to navigate on their behalf. They might have high risk or impulsive behaviors that mean I am back to finding babysitters, or taking them with me when I leave the house. I would love the luxury of sharing my deepest darkest hurts and fears with someone, but I’m already dropping a lot of money and time on my child and like any good parent, if I need to chose between me and them, I choose them. Yes, my getting therapy might be really helpful for them, but I can’t. I just can’t right now. So you are the only therapist I am seeing and that might be for 30 seconds when I drop off and pick up or for 60 minutes in a family session. No one will ever tell us that we did the right thing in bringing our kid into therapy or the ER or anything else. You might be the person who gets the chance to encourage us because we are having just as hard a time as our child is as we struggle to raise them. Yes, you can still tell me that seeing a counselor or joining a support group would be the best thing for my child. And I may still not go not because I disagree or don’t want to, but I just can’t. So tell me to reach out to my friends and family. Ask me to get some help making dinners and running carpool so that I can get a break from life in the least disruptive manner. Remind me that if I was the worst parent in the world I wouldn’t be here with my child. Tell me this is not a defeat, but a step towards healing. This is the most courageous act of parenting and the greatest symbol of selfless love. Remind me of this because this is really what I need right now.

Sincerely,

A mother