Every month, Dr. Peipman and Dr. Lauriola will be covering a specific topic for 30 minutes while welcoming questions from the audience!
Suicide in teens
Clinical Hypnotherapy: Q&A
Happy parents: the importance of couples’ emotional connection
Achieving success and positive self talk 101
Stress reduction 101
Healthy communication 101
Mariella Lauriola, PhD, is a skilled and compassionate clinician, joining our practice in September 2018. As a psychological assistant, Dr. Lauriola has completed her doctoral training in Italy, and has completed her internships, and practicum clinical experiences. She is accruing her hours for licensure under the supervision of Dr. Fred Peipman. Dr. Lauriola has experience and training in Interpersonal therapy (IPT) and interpersonal social rhythm therapy (IPSRT). She has worked in sexual assault and trauma response settings and is fluent in Italian and Spanish. Please visit the TEAM page of our website to learn more about Dr. Lauriola. You can also read about her training, background, and experience here.
I was fortunate to be featured in a recent article by journalist Melaina Juntti on the Fatherly website, an excellent resource on being a dad (for all parents).
Waiting in the San Diego airport for my flight back to San Francisco, I am reflecting on the level of professionalism, the evidence-based practices, and innovative approaches employed by the wilderness, residential, and therapeutic treatment programs for adolescents and young adults. A whirlwind type "speed-dating" with each program allowed me to ask the tough questions, get updates on innovations and connect with clinical and admissions folks. I had the pleasure of meeting with admissions and clinicalfolks from the following stellar programs:
- Point School in Puerto Rico
- ReSTART Internet Addiction Recovery
- Rogers Behavioral Health
- Sonia Shankman Orthogenic School
- Visions Adolescent Treatment Centers
- West Ridge Academy
- Arise Society
- Asheville Academy for Girls
- Building Bridges
- Calo Programs and Visions Treatment
- Cascade Crest Transitions
- Cornerstones of Maine
- Crotched Mountain School
- Equinox RTC
- Fusion Academy and Learning Center
- The Grounds Recovery
- Key Transitions
- New Roads to Healing
- Pasadena Village
What a busy few days! Now I am back to San Franciscoand Palo Alto for a few days ,then off to the NATSAP (National Associationof Therapeutic Schools and Programs) Southeast Regional Conference in Asheville. I will have the opportunity to tour and visit some of the above programs, including Equinox RTC, Asheville Academy for Girls as well as other such as Cherokee Creek School for Boys. A busy travel week but many new advances in treatment and excellent transition options.
1. Create a commitment statement, similar to a mission statement. A commitment statement outlines the purpose, values, and goals for the relationship. It may also include rules, requests, and boundaries that strengthen the relationship and keep it safe. What are we about? What are my requests and expectations? What am I bringing to the relationship? How are we defining commitment?
2. Greet each other personally and physically each day. Not only does hugging and kissing feel good, it gives us an oxytocin boost and facilitates bonding and closeness.
3. Talk and stay connected about hopes, dreams, stresses, etc. These topics are future-oriented; talking about the future can strengthen the current commitment.
4. Spend quality together. Making time for each other, just to check in or to have a date can strengthen the bond and reinforce your dedication to the relationship.
5. Foster your friendship. Friendship is a commitment. Friendships require cultivation, patience, understanding, and empathy. When all else fails, fall back on your friendship.
6. Memories and traditions expand commitment. Doing special things together builds and honors traditions that are important to building meaning and significance. Create positive corrective emotional experiences together.
7. Share spiritual or religious activities together to help promote individual and relationship connection. Talk about your values, hopes, aspirations.
8. Practice small act of kindness for the one that you love. While it may be easy to take advantage of what your significant other gives for the benefit of the relationship, everyone desires to feel acknowledged. Doing a chore, bringing home a special gift, or sending a loving message are all simple but effective ways of showing respect and dedication.
9. Talk about how you met and the many reasons you fell in love and decided to connect. Reflecting on reasons for committing to one another in the first place can renew desire to capture and preserve the relationship.
10. Make time for physical intimacy. This ultimate expression of commitment should be a special time that both of you can share, and it need not be sexual (although that can be wonderful too).
11. Be flexible and willing to listen, adapt, evolve together. Be aware of the fluctuations in desire, closeness, intimacy, etc.
12. Admit you are wrong (!) This takes humility and practice, but do it!
It's not "forgive and forget," although that is an admirable intention. I usually talk to people about forgiveness as a process, rather than an outcome goal. Outcome goals, by definition, have a clear ending, after which there is no need to keep working on that same goal. Process goals continue into the future or require continued work (think of something like becoming a better person, or being healthier as examples of process goals).
With forgiveness, it is important for us to forgive in the moment, or at least set the intention to do so. We must, however, remember that we are unlikely to forget that which we are forgiving. Forgiveness requires repetition and practice. We may have to forgive again if the memory, regret, or resentment resurfaces. Much like trust (which ebbs and flows depending upon factors such as time, place, and situation), forgiveness often asks us to re-visit and practice it again.
We have made it through Valentine's day, and it reminds me of a workshop and podcast series I presented several years ago on the pillars of a healthy and happy love life. What do we do when we are working on ourselves, and our romantic partner doesn't seem to follow our lead and do the same?
What if it feels like I am the only one in the relationship putting work into it? Why do I have to be the one who does all the work in the relationship? When we feel we are putting in our best (or at least decent) efforts, but our partner is not, it can lead to frustration and a build up of resentment. Do we try to set a good example? Do we complain? Do we ask ourselves "why isn't this person responding well to my attempts to control him or her?"
It is important to acknowledge, discuss, and own our desire to control certain aspects of our partners' actions, even if it is for their own good. We can ask our partners what they react to and try to control in us, and be open about what we do and do not care about in the other's behaviors. Then we can make requests (not demands) in the direction of what we would like to see.
Ideally, we would let go and allow a person in relationship with us to be whatever they want to be and work on ourselves for our own sake. This is a challenging process goal, and requires sustained and repeated effort.
Putting our own efforts into the relationship, even if it seems a little unbalanced, is not a bad thing. Working on ourselves and our interactions with others will benefit us individually in the long run, even if it isn't that way in our current relationship. If we put more effort into watching what we say to be kinder, not complaining as much, and being gentler with our words, it is to our benefit whether or not our partners follow our lead and do the same.
I do feel that intimate relationships, if they are to be sustained, require a degree of individual growth to avoid stagnation. When I see relationships struggle significantly, there often is a degree of apathy, letting go, and becoming a bit lazy in several areas, usually in both partners.
By working on ourselves as well as our interactions with our intimate partners, we become better people overall. This is practice (and requires much practicing) towards being authentic and caring, with less attachment to what others do. So acknowledge the areas where you are seeking to control, make requests, practice letting go, and keep working on yourself.
I have recently worked with several parents of adolescents and elementary school children who are wishing they had the time-out policies that they used effectively when their children were younger. I am a strong advocate for a moderated approach of the Time Out/Chill Out space.
We often send a child to a time out as a punishment, wanting them to get away from the situation and behave differently. Time outs can be very effective for this. At the same time, we want to teach self-soothing, pausing, thinking about one's thoughts and actions, and being mindful of what is going on.
Make the space a somewhat comfortable but separate space, where you as a parent can watch the child from a distance. Allow for self-soothing activities (e.g. coloring book, listening to something, etc.). Keep track of the time, preferably setting a timer for how long the child or teen should be there. Encourage the use of this space for the child to de-escalate when things are getting heated or otherwise emotionally charged. Remember: the goal is not to reward or punish, but to create a space for mindful awareness, to take a break and re-center, or to pause to reconsider one's actions and/or behaviors.
It can be difficult to find the balance between making the space pleasant and enjoyable and still a consequence for unacceptable behavior. In one classroom of fourth graders I consulted with, we created a chair in the back of the classroom where the child sent to Time Out/Chill Out could put on headphones and either color in a design or mandala, or do a puzzle. This was also something that I used in a class I taught with high-school students, and we used the same tools (it worked!).
We want to make it clear that negative behaviors (that lead to the time out) are unacceptable and will not be tolerated, but we also want to acknowledge that the behaviors (most likely) were connected to thoughts and emotions that also need some work and attention.
I love to share what I have learned from my clients, and have been contributing to a blog on Psychology Today for parenting teens.
Please feel free to check out my parenting teens blog on Psychology Today: Parenting Across the Gap
We seem to be in the time of year when so many people are frustrated with the ins and outs of everyday life. School is back in swing, work and other obligations have returned to the normal routines, and we all are less excited and motivated by the holidays.
It is important to give ourselves some time, space, and compassion through practicing good self-care during times of transition. I wanted to build a practice at one point that focused on transitions, as our emotional and mental challenges often arise at these points in our lives.
Negotiating and being able to work through transitions is part of healthy adjustment, and requires that we take a broader perspective, appreciating the positive, fun, and joyous times for what they were, while allowing for the more mundane or even less enjoyable experiences. The contrasts between the two can help us appreciate both. Without sadness or boredom, there is no joy; without joy, we cannot fully appreciate the experiences of grief or sadness. Nor can we fully empathize with those who are experiencing difficult emotions.
Take some time to appreciate contrast. Give yourself a little break and practice some self-care. Maybe some time in nature or taking care of your heart, mind, and body will help re-center you.
Dos and Don’ts For Parents with a child returning home after residential treatment:
· Do: Set clear expectations, guidelines, and boundaries ahead of time. Write them down. Share them.
· Don’t: Confuse the past with the present by letting parent trauma get the best of you.
· Do: Adjust your home plan or agreement as needed. It is a working document and should work for you.
· Don’t: Micro-manage time, structure, and schedules so much because you fear the freer environment.
· Don’t: Try to plan for every single possible negative situation or behavior in your home plan.
· Do: Provide your child with opportunities for earning privileges, freedom, and trust.
· Don’t: Yield to pressures of whining, complaining, negotiation, and emotional pleas for more.
· Do: Gradually increase freedoms and decrease restrictions as you gain trust.
· Do: Remember to use effective communication skills such as reflective listening, “I feel” statements, and validating.
· Do: Remember your sense of humor.
· Do: Practice open and honest communication between treatment providers, yourself, and your child (flexible confidentiality).
Parents often talk to me about how their teenage and young adult children don’t accept their rules. Parents complain about getting resistance to every boundary they set, be it curfews, what not to wear, or issues related to dating. What’s important for adults to understand is that this is normal. It is part of the developmental process that adolescents question, resist, push up against, and challenge boundaries set by parents and other adult authority figures.
However, boundaries should not change, just because a child or teenager is having a temper tantrum.
“My mom tells me I have to stick to her curfew and, even when I’m a bit late, if I bitch about my curfew and how it isn’t fair, she usually gives in and I don’t get in trouble.”- Eric, 16
“I try to be fair, so I was more and more flexible (with my teenage children) about rules. I let my daughter go to parties, where there was drinking, as long as she didn’t get drunk. Then she comes home and is three sheets to the wind! I never would have been allowed to get drunk at age 14.” –Amelia, mother of three.
“Every time I make a rule, I get crap about it from my kid. It happens every single time. I get tired, and then just give in a lot of the time.” –Jeff, frustrated dad.
Understanding and Setting Clear Boundaries
Boundaries are there for a reason: the safety, protection, and guidance of those who are surrounded by them. Just because a teenager pushes against those boundaries does not mean that the rules need to be adapted to accommodate an ornery teen.
Clear boundaries are necessary, because they help teenagers know and understand limits. Adult life is full of limitations and boundaries. Learning what clear boundaries are helps adolescents grow into well-adjusted and capable adults. Limits provide an opportunity or framework in which to grow, test one’s abilities, and understand and have empathy for others.
I have seen many situations where parents didn’t set clear boundaries for their children. In these cases, children have had difficulty respecting teachers or bosses, they were demanding and rude if their needs were not immediately attended to, and they carry these expectations into relationships and other settings. Re-learning appropriate boundaries in one’s twenties is much more difficult than during adolescence, when the restrictiveness of boundaries is externally applied and reinforced.
Eric was 23, and had come to therapy because he had been dumped by his girlfriend. This was a familiar story, as he had never managed to get beyond the three-month point in his romantic relationships. Eric came from a divorced family, where Mom and Dad would compete to be the ‘fun parent’. This led to Eric breaking rules and, when one parent imposed a consequence, he would go to the other. Always threatening to, “Move in with Mom!” or “Never see you, so I can live my own life at Dad’s house!” his parents caved in to his demands.
This created a very unhealthy pattern of controlling behavior and pushing boundaries. Eric learned he could get what he wanted by playing his parents off of each other. This didn’t work out well in his relationships, when he would say things like, “If you don’t want me to flirt with other girls, then I’ll find someone who doesn’t care and knows that it’s just for fun.” Obviously this was not the best approach.
Through some very candid conversations, I talked with Eric about boundaries, and how the lack of clear boundaries in his adolescence helped him to learn to manipulate. He was very wary of this, thinking that I was somehow going to talk about how he was dating women like his mother, who seemed willing, but were actually unavailable emotionally. This was probably true, but the point was that he had to establish clear boundaries ahead of time in order to know what was and wasn’t acceptable in a dating relationship.
I had him write down clear expectations, guidelines and desires, and then think about how to adjust them to the situation and to follow through. With work, Eric came to set internal boundaries for himself. He went on to date a woman, who he brought into session for help with setting up guidelines for the relationship. Although they broke up after 11 months, they remained friends and Eric is now dating again with healthy boundaries.
In order to know the rules and boundaries, and how far they can push things, adolescents push back, question, challenge and resist limits. They desperately need these boundaries, during this time of discovering themselves and their peers, in order to have structure and consistency. Structure allows us to function within a given set of expectations and consequences. When we know what to expect when we do something, we are better informed as to whether we should engage in that behavior.
Adolescents are not the best at things like planning, anticipating the consequences of their actions, and making good judgments. These are developmental tasks that are related to brain development and the growth of white matter in the frontal lobe. Because of this, we need to set very clear guidelines and hold to them.
Talk to teenagers about rules. Ask what they think would be fair. What do they think would be an appropriate consequence? You can always listen to their opinions and take them into consideration, but it needs to be established (to the extent that it’s possible), before boundary and rule violations happen. Dialogue with teens about rules and boundaries is essential, but keep in mind that you are the authority. Listen, take it in, and then think about things.
Do your adolescent children, clients, or students have what it takes to make it in the 21st century? Do you battle the eye-rolling, stalled communication, and frustrating attitudes of the teenagers in your life? Using examples from his clinical work, Dr. Fred Peipman provides solutions, ideas, and creative ways of viewing the challenges involved in working with and raising teenagers. Providing adults with practical and easy-to-apply solutions and suggestions, Parenting Across The Gap gives adults the resources they need to effectively communicate with and understand adolescents and young adults in the 21st century.
Dr. Fred Peipman is a licensed psychologist working in the San Francisco Bay area and with clients across the country. He has worked in wilderness therapy, in private practice, and in college and high school settings. Dr. Fred earned his undergraduate degree at Yale University, followed by a masters in mental health counseling from the University of Bridgeport and lastly, a PhD in counseling psychology from the University of Miami.
Dr. Fred's unique approach to adolescent, family, and individual therapy is creative, direct and honest, and offers clients new perspectives . He uses cognitive-behavioral, family systems, and acceptance and commitment therapies as well as his years of clinical experience to collaborate with clients. Using a healthy dose of humor and irreverence, he gets through to teens, young adults, and their parents in a disarming and skillful way.