The Reason I Stopped Treating Teenage Mental Health. (It’s not because of the teens)

It’s good to know your strengths and weaknesses. I am brutally honest with myself so I am generally aware of my own. Strength- baking. Weakness- brownies. I can never get them right. I’ve tried. So I don’t try anymore. Ask my sons. They didn’t even know what a brownie was recently when my Mom brought them some. Banana bread, yeast breads, cakes, frostings, ganache, chocolate chip muffins, etc. I can nail anything else. Not brownies.

Strength- Fighting and working hard for underserved communities. Weakness- general annoyance sometimes developing into anger toward entitled non-underserved individuals.

My friends and many of the therapists I work and collaborate with know this about me. The white cis-het male APRN who works for me knows this about me. Because as I’m passing him all the cis-white-het males who call for intakes I am…maybe complaining about them. I do apologize for dissing “him” in a general vague sort of way. He laughs it off and keeps working for me. I dunno; I give good bonuses.

The last year has highlighted the strengths and weaknesses (great chasms) of our healthcare system. Strength- Our healthcare workers. We rock. Weakness- Our infrastructure, our costs, insurers, and the lack of support financially, emotionally, and every way you can possibly imagine for our healthcare workers, and the complete inadequacy of our mental health services and systems.

I receive upward of five calls a day for adolescent referrals. I’m closed to adolescent referrals.

Strength- Love the teens and they usually love me or hate me initially then grow to respect/fear/love me. Weakness- Fucking parents. I generally rub them the wrong way eventually. For my trans teens I tell their parents to stop being transphobic. God forbid. For my teens depressed because their parents scream at each other daily- I tell their parents to stop screaming at each other daily and to maybe recognize the impact they are having on their teen’s mental health. Strength- Honesty. Weakness- Honesty.

I had a parent tell me that if they started using their child’s preferred pronoun and gender “they win”. I’ve had parents tell me, “I know you think it’s all because of the stupid sexual abuse. You think I haven’t heard that! I’m not getting a divorce. They are going to have to learn to live together.” If you are thinking the worst case scenario you are correct. That is not the first nor the last parent treated who has forced their child to continue to endure close contact with a known perpetrator (yes investigations were done etc. etc. this was always reported to the appropriate authorities).

I recognized in 2020 that the parents were burning me out. Not the teens.

I saw too many teenagers over my career destroyed by their parents physically, emotionally, and in so many other ways. After I became a parent I became more horrified than I used to be at parental behavior.

I’m no angel as a parent. I yell sometimes. I talk loudly and firmly when we are in public if they are misbehaving. I have no shame in reprimanding them in front of other people because if they can act the fool publicly they can be corrected publicly. I also have spent more time with my kids in the last twelve months then I imagined I ever would. I have to be honest though I never got too sick of them. We keep busy and those little buggers know how to get to my heart with their hugs and snuggles and dimples. I unashamedly mushy gushy love my kids.

I would never knowingly harm my child though physically or emotionally or otherwise. I also would not invalidate them by not respecting their preferred gender/pronoun/name and I hope I would never invalidate them by not believing them or ignoring them if they disclose something to me. And if I knew some one was harming my child; well I would go for the throat.

Strength- Fierce love and loyalty for my family and few close friends Weakness- I would totally land in jail if some one messes with some one I love.

I found in 2020 so many things about myself. Strength I didn’t know I had. Weakness and empathy I didn’t know I could still access. I also recognized that treating teenagers, and in turn their parents, as a parent, was burning me out. Because I could not ever imagine treating my children the way I have seen so many children treated. Literally right in front of me. There are no filters in the psych world.

When people ask why there is such a shortage of pediatric providers it’s not because there is a dearth of actual providers who can treat children. There is a shortage of providers who have the stomach and heart to stick with it for years, through their own parenting journeys, because the transference and counter-transference is real and it’s not helpful or healthy.

One of my greatest strengths has always been recognizing my limitations. This was a hard one because I so enjoy working with teenagers. But I needed to distance myself from parents. Because they were breaking my faith in humanity.

Hearing accounts of sexual abuse and physical abuse from children and teens is heart wrenching. Hearing that they have told their parent and their parent confirms this, and that their parent doesn’t believe them makes me ill. I’ve had to tell grown adults that children generally don’t make up sexual assault and rape stories. The number of kids who have not been believed by their parents is staggering.

I’ve tried to figure it out. I’ve wondered if it’s generational. Most parents of teens are now born between the 70’s-80’s. I try and figure out what the hell happened to those people. Then I wonder if it’s a white suburbia thing. Most parents center themselves and is that a symptom of white entitlement? But I treat minorities also and this issue is not confined to white families. By September of last year I stopped trying to figure out why and stopped taking teenagers. The why doesn’t matter. The result of me being burned out mattered.

My days are less interesting with fewer teenagers in my schedule because they are fun. I can’t be as sarcastic with any other age range than the teens. I also love that little smirk they try and hide when they hear me call their parent out on bad behavior. It’s like they finally are being seen and heard and justice has come. It’s tough work getting to that moment with the parent and the kid. They both have to be comfortable enough with me that they won’t get mad when I call them out. They have to be open enough to change to really hear me. It’s a labor of love because the reimbursement will just never cover the emotional energy that goes into treating teens and their families.

But I’ve selectively only taken adult LGBTQ clients for intakes which makes me happy. Some day I’ll circle back to the teens but for now I need a break. I need to stop trying to figure out a generation of parents and focus on my own kids. Who I love. Who will never know how good they have it thank God. Because I would never want them to have it so bad.

If you are reading this as a parent I hope you do not identify with any invalidating behaviors I’ve mentioned. If you do I’d encourage you to explore that part of you. Is it shame that is coming up? Fear? Avoidance? Don’t turn away from that dark part of yourself. Be honest with yourself. Be honest with your teen.

If you are reading this as a teenager or former teenager and you identify with this; I’m deep from my gut sorry. But I promise you that your life can go on even with an experience of emotionally abusive or unavailable parents. Watch “Hanging Up” with Meg Ryan. It’s from the 90’s; obviously so out of date. But there’s this scene where she’s talking about her messed up alcoholic father and she says, “This! This is what I’ve got as my Father! This is it! This mess!” It’s a beautifully done scene and movie about acceptance of our parents faults and about not letting our parents faults define us or break us.

I feel like I’ve spent the better part of seven years helping teenagers see that they may have a mess as parents but they are still valuable and worthy and deserving of love. It is hard to let that go but I know it will only be for a while. In the mean time. Parents let’s get our shit together. Our kids deserve the best parents we can be. Play to your strengths. Acknowledge your weaknesses. And be nice to their therapists otherwise there won’t be any of us left.

2 thoughts on “The Reason I Stopped Treating Teenage Mental Health. (It’s not because of the teens)

  1. My child was confused about her sexuality (I’ve shared this with you earlier) a few years ago. Now I think she identifies as cis-het, but sometimes harbours doubts. I try my best to be supportive. So, it’s not in sexuality that we have problems.
    But she is a teen. And I am a perimenopausing mom. God, we fight. We also hug and laugh, but we fight like maniacs. I am terrified that it is affecting her, but I also wonder if this is what normal relationships are – fight, hugs, laughters, tears…
    See, my mom died when I was 13, so I don’t even know what normal is.

    Liked by 1 person

  2. Thank you for affirming our TNBY kids and the entire alphabet mafia. The heavy lifting is hard. I try to remember the starfish story, I may not be able to help them all but if I can impact just one, I have done good. Keep up the good fight.

    Liked by 1 person

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