Anxiety
Anxiety is typically a very functional experience. It can be the very thing that motivates us to study for an exam, or it can be a message that we should leave an unhealthy relationship. Adolescence is often associated with increasing experiences of anxiety. Usually these experiences are normative responses to the rapid pace of emotional, psychological, social and physical development but sometimes anxiety becomes a prominent feature in a person's life and an overactive stress response begins. Everyone feels anxiety in different ways.
Typical cognitive presentations include rigid views of self that cannot be reassured, racing thoughts, frightening intrusive thoughts and fixed ideas about things that don't have much flexibility. Physiological experiences are also a feature of anxiety. Presentations include panic, increased heart rate, fainting, stomach aches, sudden complaints of aches and pains and changes in attendance to social events due to fear that their body will not cope. Behaviourally, people who feel continuous anxiety may use avoidance as a coping strategy and may exhibit outbursts of anger and rage. These are reactive responses to flooding and is typically a person's current repertoire to cope. Masking anxiety can often be seen in high achievers and perfectionists. School refusal can also occur.
At Real Therapy, the client is provided with psychological education on the functionality of their anxiety and facilitated with fostering skills and tools to decrease the intensity and frequency of anxiety. Often, this is done by magnifying the clients personal creative potential to healthily adjust to stressors.
Self-harm and Suicide Ideation
Self- harm is a coping strategy typically used to communicate distress or to generate a feeling of respite from emotional pain. It can often be a way to feeling something or to feel nothing. While it can be a distressing discovery for parents, remember that this is your child's best attempt at coping right now. In therapy, the client is gently and sensitively introduced to alternative coping methods in a tailored therapy plan informed by a sensory profile. Parents are briefed on how to respond to self-harm and are often surprised to hear that it is not always wise to ask their child to stop self-harming. At Real Therapy, we go through the reasons why and identify ways to support the person who is self-harming. Suicide Ideation is not intrinsically linked with self-harm, although people who self-harm may experience suicide ideation too.
Suicide ideation and having thoughts about suicide does not always mean that there is a high risk, but where there is a plan or intent, a crisis needs crisis intervention. At Real Therapy, we will work on strengths based, solution focused dynamics before uncovering a longer term trajectory towards a more meaningful life.
Trauma
Trauma is an emotional, psychological, physiological response to an event or events that are overwhelmingly distressing and shocking, cannot be made sense of and where the body cannot complete it's instinct to run away from or fight the problem. Post traumatic stress refers to the trauma response that is experienced as a person's nervous system continually uses hardwired instincts to adapt in a perceived or actually threatening world as though the original traumas are ongoing. Trauma is one of the most misunderstood epidemics of this world and largely assumed to be an emotional experience. While this is somewhat true, it is only one component in a complex set of experiences that requires specialised intervention rooted in a solid knowledge of neuroscience.
At Real Therapy, I acknowledge that adolescents can develop PTS and PTSD in response to anything ranging from bullying/exclusion, adverse childhood experiences, medical surgeries and procedures, separation and divorce, transitioning from primary to secondary education to grief and loss. My work is trauma informed, applying interventions in the hierarchy of the developing brain and providing clients and their parents with ample information that provides them with knowledge of the feedback loop of trauma responses and on a deepening awareness of to move through it.
Other
In my family based approach, I maintain regular contact with the systems that the adolescent is developing in, all the while, honoring the sacredness of the adolescent's confidentiality.