Dr. Henry Paul, MD

Psychiatrist, Author and Educator

DISCIPLINING YOUR TEENAGER

September 22nd, 2014

In the light of all the discussion about disciplining your child that the NFL has created, I think this is a good time to talk about how to discipline teenagers, since it is very different from how you would discipline a young child.

When disciplining a teenager you need to remember that the actions that you take when your child breaks the rules are actions that will hopefully help your child learn. Parents question how much “rope” to give a child, worrying that there might be too much, and the child will “hang himself.” Other parent’s worry that being too strict will result in their teen rebelling, losing respect, and not loving them. Others consider rebellion and defiance to be “normal” in teenagers and thus may rarely take a teen’s misbehavior seriously. While to some degree rebellion and defiance are natural, it has been found that excessive rebellion and excessive defiance are usually indicators of an oppositional defiant behavior disorder and are not necessarily associated with health.

The problem is that most parents only have the model of discipline that was meted out to them as children and teens. For many, identification with the normal rebellious and defiant aspects of the teenage years has never been normalized by mature growth; thus they either subtly (or not so subtly) stimulate “bad behavior,” only to follow it, in their own anxiety and confusion, by administering punishment to the adolescent. Not surprisingly, this causes the teen perplexity, anxiety, and confusion.

On the other hand, constructive discipline tends to result in the development of a mature young adult by the end of the adolescent passage. It helps a teenager control his impulses, cooperate with other people, and be patient. The aim of discipline should not be to develop a homogenized and completely socialized teenager; parents should always stress the uniqueness of their teenage sons and daughters. Rather, discipline should result in a teen taking a wholehearted and responsible approach to life. Disciplining a teenager is different from disciplining a younger child since the teenager is more mature, more reflective, and more able to enter into discussions and negotiations. This means that discipline can and should always be enlightening to teenagers, never a means of deriding, shaming, or making them feel as if they are “bad.”

What to Do

  • Don’t be a cruel parent. Don’t humiliate, criticize destructively, physically attack, or try to cripple your teenagers will just in order to make him conform to certain rules.
  • Make expectations and rules clear to your child.
  • Don’t be scared to set limits.
  • Do not make rules arbitrarily, even if you feel strong about them; they should involve some give and take.
  • Understand that whatever teaching and disciplining you do, most teenagers will mature through trial and error.
  • Reward constructive behavior rather than criticize bad behavior.
  • Be a role model for your teenager.
  • Be compassionate and patient when it comes to discussion of family rules and responsibilities.
  • When punishing your teenager it is best to withdraw privileges. However, make sure to not over-punish because you are angry.
  • Never use physical or mental torture.
  • Don’t give in to tantrums or loud and intimidating behavior, and don’t allow guilt to cloud your judgment.
  • Remember, teenagers test the limits. You will be tested!

In the end, be compassionate and empathetic and remember what it was like to be a teenager. Your greatest influence on your child doesn’t come through your punishment but through your being a good role model and your ability to understand the situation and act appropriately.

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

WE NEED TO HELP THE ABUSERS, TOO!

September 20th, 2014

In the cases of both Adrian Peterson and Ray Rice, we need to look at how we can help the abuser. Both domestic violence and child abuse are unacceptable, and make no mistake, the focus on the victim is first and foremost. Their safety and well-being as a victim of domestic violence or child abuse is of the utmost importance.

Having said that, as a medical professional I think we also need to use this opportunity that has thrust this issue into the national spotlight to focus on the impaired perpetrators. Ironically, these are often the people that need the most help, but they usually are held in disdain for their actions, arrested or neglected. There needs to be more attention paid to these pariahs in order for us to truly make a difference in stopping domestic violence.

Researchers and practitioners need to focus more attention on identifying ways to improve domestic violence treatment outcomes. We need to help abusers stop being violent and abusive and help them learn how to relate to their partners in a respectful and equal way. We need to show them non-abusive ways of dealing with difficulties in their relationships and coping with their anger in order to keep their partner safe.

The NFL today outlined a plan to create a conduct committee to make sure that players (and anyone associated with the NFL) are always living with the best practices. The NFL can be a role model and set the agenda for what is and isn’t acceptable. Let’s see if the NFL can implement the right policies and procedures to be a leader in dealing with domestic violence and child abuse. Only time will tell.

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

DO NOT CONFUSE DISCIPLINE AND PUNISHMENT

September 20th, 2014

The sad story this week that surrounds NFL player Adrian Peterson has reignited the ongoing debate over whether-or-not to spank your children.
I believe that children should never be spanked. They should not be pushed, slapped, grabbed, shoved or hit period. Why? Because it teaches violence. It gives the message that violence is a valid way to communicate. It causes fear, shame and helplessness. Children who are often spanked develop anxiety or depression later on, and spanking a child can also easily lead to severe injury and even death by accident.

The problem is that most parents only have the model of discipline that was meted out to them as children and teens. Such says Peterson about using a tree branch as a “switch” to punish his four-year-old son. There really is no good that can come from spanking or hitting your child. What is important is to understand the proper methods for disciplining children both young children and teenagers. I raised two children of my own, so I not only speak as a medical professional but as a parent.

Unfortunately, parents often confuse discipline for punishment. The goal of disciplining children is not to punish them, but with a young child it is to help them learn good behaviors. Bad behavior for children between the ages of two and six is expected, so the discipline is different from how you might discipline your tween or teen. With teenagers and older children, you want to guide them toward the development of responsibility, morals, and ethics.

One of the reasons that parents are so anxious about discipline is because of the conflicting messages that society sends to both parents and children, particularly teenagers, about what appropriate discipline ought to be. The clear message to take away from the Adrian Peterson case is that corporal punishment is not discipline and is never acceptable. NEVER!

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

MY CHILD IS OBESE. WHAT DO I DO?

September 15th, 2014

Obesity is a major public health problem in the United States, and I applaud First Lady, Michelle Obama, for leading the charge to educate the public about childhood obesity. As I stated in my last blog, there are a lot of reasons for obesity in children and teens. In some rare cases, obesity is caused by a physical condition, but more often it is simply caused by overeating that is often the result of an underlying emotional problem. An important first step is helping a child recognize the problem. So, what do you do if your child is overweight?

  • First, schedule a visit with your child’s doctor to make sure that there is no underlying medical condition that is causing the problem. Then educate your teenager about the importance of healthy eating. Understanding portion size, calorie intake and the value in making healthy choices about what they eat are most important.
  • Make sure to provide a good example of healthy eating for your children. Leading by example is much more powerful than lecturing. You must walk-the-walk.
  • Never criticize or put your teen down for overeating. Remember that there are almost always emotional problems underlying their urge to overeat. Open up the channels of communication to encourage your teen to talk to you about it.
  • Consulting with a nutritionist provides a great source of information on healthy eating and can be an aid in helping you to formulate a healthy eating plan with your teen.
  • Make sure that you reinforce the message to your teen that eating healthy is about better overall health, and not about turning them into a magazine model. Those images are often unrealistic, photo-shopped and just add to the anxiety your child already feels. The goal is that by eating healthier your teen will become happier with themselves.
  • With the new changes implemented in school cafeterias this school year, make sure that you understand and talk with your child about the advantage to making healthier choices. Just because the healthier food is offered it doesn’t mean they will choose it.
  • Lastly, if the obesity is severe you should meet with a medical professional.

There are some wonderful references on the Internet to help you plan healthy meals. There are apps for tracking calories and for recommending better choices. Also, visit First Lady Michelle Obama’s website Let’s Move Program for ideas and support. Changing one’s diet is not something that happens overnight. Look at eating better as a lifestyle change – one that you and your child will have for a lifetime!

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

WHAT TEENAGERS REALLY NEED TO HEAR ABOUT WEIGHT!

September 12th, 2014

A study by UCLA psychologists that was published in the JAMA Journal of Pediatrics says that girls who are told by a parent, sibling, friend, classmate or teacher that they are too fat at age 10 are more likely to be obese at age 19.

“Simply being labeled as too fat has a measurable effect almost a decade later. We nearly fell off our chairs when we discovered this,” said A. Janet Tomiyama, an assistant professor of psychology in the UCLA College of Letters and Science and the study’s senior author, in a UCLA press release. “Even after we statistically removed the effects of their actual weight, their income, their race and when they reached puberty, the effect remained.”

The study, according to the UCLA press release, included more than 2,300 young girls in California, Cincinnati and Washington, D.C., who had their height and weight checked when they age 10 and again at age 19. At the start of the study, 58 percent of the girls had been told by a parent, sibling, friend, classmate or teacher that they were too fat. Those girls were 1.66 times more likely to be obese at age 19 than other girls, the University of California, Los Angeles (UCLA) researchers found.

It is no secret that most teenagers are concerned about appearance to a heightened degree (compared to other times in their lives), especially a teenage girl. Being overweight is what they are most concerned about. Teens will respond to their anxiety over appearance in a number of different ways. Some become anorexic, others bulimic and others overeaters. Many of us are familiar with anorexia and bulimia because of the media attention given to these disorders over the years because they have afflicted so many high-profile celebrities, but there have been fewer discussions about overeating; that is until now.

Celebrities like Adele and Melissa McCarthy have changed that. McCarthy was recently on the cover of PEOPLE magazine where she talked about her struggles with weight and feeling accepted. “I’ve never felt like I needed to change,” she says in the article. “I’ve always thought, ‘If you want somebody different, pick somebody else.’ But sure, criticism can sometimes still get to me. Some things are so malicious; they knock the wind out of you.”

Often teens who overeat to the point of obesity are worried that they, too, will never fit in or “make the grade.” What this study has shown is that positive reinforcement is needed. Whether a person is too thin or overweight negative comments hurt, and only make an already anxious teen feel worse. When it comes to weight, what teenagers really need is understanding and support. Reach out to your teen, and remember that there is almost always an underlying emotional issue that affects your child’s eating. The most important piece to take away from this study is that negative comments only make matters work. For the better health of your teen, parents, family and friends need to be supportive.

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

GETTING CHILDREN BACK TO SLEEP AS SCHOOL STARTS

September 5th, 2014

School Daze: Getting Kids Sleep Habits Back on Track (CBS News) offers suggestions for getting children back into a normal sleep routine after the lazy days of summer. Staying up late and sleeping until noon, no longer works when you have to get up for school.

Make sure that your children get enough sleep – at least eight hours. Talk to them about the importance of sleep on their overall health and their performance in school, both academically and on the athletic field.

If you suspect more serious sleep issues make sure to contact your pediatrician. Here are some blogs that I recently wrote that look more closely at sleep disorders and how to treat them.

Email me if you have further questions. I hope this is a safe and happy school year for all of you and your children.

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

 

CHILDREN WITH AUTISM HAVE OVERSUPPLY OF SYNAPSES, SAYS NEW STUDY

September 3rd, 2014

Study Finds That Brains with Autism Fail to Trim Synapses as They Develop — Now a new study suggests that in children with autism, something in the process goes awry, leaving an oversupply of synapses in at least some parts of the brain.

The finding provides clues to how autism develops from childhood on, and may help explain some symptoms like oversensitivity to noise or social experiences, as well as why many people with autism also have epileptic seizures.

It could also help scientists in the search for treatments, if they can develop safe therapies to fix the system the brain uses to clear extra synapses.  The New York Times

This is a very interesting article showing some of the latest research on Autism. The study, recently published in the journal Neuron, involved tissue from the brains of children and adolescents who had died from ages 2 to 20. About half had autism; the others did not.

The study suggests that children with autism have an oversupply of synapses in some parts of their brain. These synapses are normally “pruned” during childhood and adolescent development so different areas of the brain can develop specific functions without an overload of stimuli. When that pruning does not happen, and there is a continued overload of the synapses, the research suggests that this might be the cause of autism. If safe therapies can be developed to clear these synapses, there might be new hope for treating autism.

What I find interesting about this study is that there has been an ongoing debate in the medical community for years as to whether autism is a problem of too little, too much or a combination of connectivity in the brain.

In the NY Times article, Ralph-Axel Müller, a neuroscientist at San Diego State University, said, “Impairments that we see in autism seem to be partly due to different parts of the brain talking too much to each other. You need to lose connections in order to develop a fine-tuned system of brain networks, because if all parts of the brain talk to all parts of the brain, all you get is noise.”

The research is very interesting. What needs much further study is rapamycin, a drug that has serious side effects, and which is being discussed as a form of therapy for this neurological finding. Finding the cause is the beginning of finding a cure. Best not to jump too quickly looking for a silver-bullet cure, however. Let’s all follow the research.  I am sure this will open up a much wider debate on the cause of autism and how to treat it.  Stay tuned!

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.