Disclaimer: The characters from these vignettes are fictitious. They were derived from a composite of people and events for the purpose of representing real-life situations and psychological dilemmas which occur in families.
Daniel was 16 and appeared to be doing fine. Though popular at school and well-liked, he easily felt rejected, recently feeling alienated from friends. Though no one was concerned about his performance at school, he felt increasing pressure to do well, and worried about disappointing or burdening people. Stressed and secretly overwhelmed, he stayed up all night trying to keep up with his advanced classes – and could not concentrate.
Dr. Lynn Margolies is a Ph.D. experienced, licensed psychologist and former Harvard Medical School faculty and fellow. She was trained (internship and post-doctoral work) at a Harvard teaching hospital and has been in private practice since 1989. Her experience is broad, having treated both high-functioning people experiencing life stress, transitions, crisis, depression, anxiety, relationship conflicts, as well as people struggling with more serious trauma or chronic conditions. Working with individuals, couples, and families, she offers consultation, short- and long-term counseling and psychotherapy. Her approach is active and empowering with integrity and high standards of care. Dr. Margolies’ treatment orientation is tailored to the needs of each individual patient. Her manner is skilled, respectful, empathic, strong, open-minded, caring, and supportive, with a sense of humor.
Editor: Saad Shaheed
Daniel came into therapy following a suicide attempt by overdose. In the initial sessions Daniel talked mostly about how relieved he felt in the hospital when his dad visited, especially when he saw his dad cry over him. He felt ashamed to admit this. He also recounted a dream he had prior to his suicide attempt in which he was standing on a ledge about to jump. He could see his family down below but no one noticed him or realized he was gone. He wanted to die.
Daniel’s mom, Ellen, was trained as a nurse but was a stay-at-home mom. She said that her kids were “[her] life.” Ellen saw Daniel as very much like her — good-natured and mature — a caretaker and “people pleaser.” She did not understand why Daniel would try to kill himself.
Ellen acknowledged that she was prone to depression. She spoke of how comforting it was when Daniel “cocooned” with her at home when she needed him. In tears, she said could not imagine what she would do without him.
She talked about her husband in an idealizing way and how she tried to be a good wife, catering to her husband faithfully, regardless of how he was behaving.
Daniel’s dad, Monte, worked and traveled a lot – and was not usually home. He admitted to having had a long-term affair (after having been “caught” a few years ago). Monte was a “man’s man.” He was an intimidating, outspoken presence – a military man. He criticized Daniel’s appearance and wanted to toughen him up. He had always wished Daniel were more like him, ridiculing him for being like his mother and not being man enough. When Daniel was 14, he offered him cigars and men’s magazines and talked to him about men and how they viewed women. At times he tried to get Daniel to join him in making fun of his mom.
Initially Monte was cocky in speaking to the therapist but when reminded that his son could have died, he became tearful and somber – and later revealed painful losses from his own past.
Suicide is the third leading cause of death for teens ages 15 – 24 (NIMH, 2009). Daniel’s story speaks to the insidious danger of hidden pain in teens – especially those sensing unspoken pressure to appear OK and be “good” to protect their parents – or make up for other family problems, however secret or veiled. In such situations, teens are vulnerable to using desperate measures to escape hopelessness and other unbearable feelings, or break out of their concealed inner life, and test their parents’ love.
Daniel was depressed and in turmoil. In the throes of an identity crisis, he felt lost, confused, and submerged, with nowhere to turn. Daniel’s presentation is not uncommon – a teen whose distress is unseen…the type of kid who does not cause trouble or make a lot of “noise.” Moreover, and typical of kids in this situation, Daniel even behaved in ways that seemed positive, including helping and being protective and supportive of his mom.
Daniel’s dream provides a window into his psychological world. The dream – and Daniel’s suicide attempt – offer important lessons. In the dream Daniel is invisible, utterly alone. His near-suicide attempt in the dream occurs while surrounded by his family – who do not see him and are oblivious to his distress. Sadly, the dream depicts how Daniel felt in real life and forecasts his actual suicide attempt.
It’s confusing because Daniel’s mom appeared to be devoted to her son. But this relationship was unconsciously driven by her own fear of loss and separation – and need for security, rather than by Daniel’s emotional and developmental needs. Daniel readily sensed and unconsciously accommodated his mom’s emotional needs, merging with her in a relationship of mutual devotion, in which his own experience was obliterated. After the loss of his connection to his dad, breaking away from this consuming attachment with his mom was unlikely. Having a male role model might have served as a buffer between Daniel and his mom and offered him the possibility of an identity separate from his mother.
Daniel was tormented by the shattering and dissolution of his relationship with his dad, whom he had always looked up to, and relentlessly longed to win his love and approval. In 8th grade, when Daniel found out about his dad’s affair, he was crushed and confused – suddenly seeing his dad as a different person and experiencing himself and his life as broken. Though Daniel seemed angry and indifferent toward his dad, these feelings were defenses against the painful hurt, rejection, and helplessness underneath.
After his dad’s affair, Daniel wanted to separate himself as much as possible from his dad, becoming closer with and identifying more with his mom, and emphasizing the ways he was different from his dad. He started to reject the typically “male” traits which characterized his dad. When he saw any evidence of such traits in himself – including anger, aggression, and what he viewed as “lust” – he felt revulsion and self-loathing, forcing him to disconnect from himself along with any negative feelings or anger at his mom. On the other hand, when he saw himself as behaving like his mom – being agreeable and accommodating others, including her, he felt “pathetic” and “wimpy,” which was also unbearable.
The terms of Daniel’s attachment to his mom and dad were at odds with the developmental tasks of adolescence, which require relationships with parents to be secure enough to withstand teens exploring a range of feelings and behaviors – such as anger, rebellion, healthy risk-taking and separation- without devastating consequences. With Daniel’s mom, the penalty of autonomy was her suffering and possibly falling apart. With his dad, the penalty was further rejection. Neither parent offered a viable role model and neither allowed deviation from their example. There was no space in the family for Daniel to fit.
Daniel’s recovery was facilitated by his parents’ eventual ability to take responsibility for themselves and accommodate him. Unfortunately, this change had to be forced by a dangerous wakeup call which could have been lethal.
Daniel felt driven to desperate measures in an attempt to escape unexpressed pain, and in hopes of having an emotional impact on his dad who seemed impervious to him and to emotions. Monte’s defenses against his own vulnerability broke down in the wake of having to face losing his son. Daniel and his dad had become polarized, with Daniel holding all the vulnerability and Monte attempting to banish such feelings in himself by humiliating Daniel, thereby removing himself from the feelings of helplessness and pain he harbored from his own life. Seeing – finally- in Monte’s tears that his dad cared about him and was vulnerable too, Daniel felt a connection and bridge, allowing him and his dad to bond from a newfound position of authenticity for both.
Ellen ultimately pushed herself to tolerate Daniel’s anger and even hatred towards her, beginning to permit him to separate from her. She recognized that bearing the risking of losing him (emotionally), by letting him go, was paradoxically the lesser risk – the only way she could help protect her son’s life, and the only chance of preserving any future relationship with him.
Below are some lessons from Daniel’s story and tips for parents.
- Don’t assume that a well-behaved teen is a safe or happy teen.
- Recognize signs of withdrawal and changes in behavior, sleep, appetite, motivation, mood as warning signs of depression and possible suicide risk.
- If these signs are evident, ask your teen directly if he ever feels bad enough that he thinks about killing himself. Take seriously any threats of suicide, no matter how they are expressed and seek help.
- Take inventory and ask yourself where your blind spots may be with your teen: In what ways might you be unconsciously discouraging healthy growth in your teen to alleviate your own anxiety or feel secure?
- Remember that you are your teen’s primary role model. Teens will learn from how you behave in your relationship with them and with your spouse.
- Hold on to your teen, but not too tight.
- Notice if you are using your teen as a substitute for your spouse or to make up for other emptiness or stress.
- Limit how much you confide in your teen for your own comfort. Find other supports.
- Have the courage to be curious about, and bear, your teen’s feelings toward you – including anger, hatred, and apparent rejection – without over-reacting. Remind yourself when your teen is angry that these are just feelings and will pass, that this is a part of what teens must go through (and what you must bear) in order for them to separate and develop an identity of their own. You are strong enough to bear it — don’t take it personally. There are positive feelings there too, even if they are temporarily hidden.
- Don’t take teens’ indifference or anger at face value and assume it means they don’t care about your relationship with them and don’t need you. Don’t use this as a reason to pull away or drop the ball.
- Assume your teen needs you. Show interest and make time for them to do things that they enjoy.
- Break silence and talk about things in the family you know have affected your teen. Admit to your mistakes and listen to your teen’s feelings without defending and explaining yourself.
- Don’t use negative comments about your spouse as a way to connect with your teen.
- Recognize and come to terms with your teen’s personality. Encouraging is different than needing and trying to change your child.
- Notice if your teens are the opposite of you and try to find a bridge. If you have a strong reaction to them, chances are there is something in yourself that you are trying to suppress by getting rid of it in them.