Dear Emuna,

How do I know when it's time to take my teenage daughter to therapy?

A Parent of Teens

Dear Parent of Teens,

Details please. It’s an elusive question that may depend on your daughter’s actions and attitudes.

In the extreme situation where your daughter is engaged in behavior that is either destructive to her or to others, I assume you would not be writing to me. It would be clear to you that the time has come.

On the other hand, it is possible that there is no extreme or dangerous behavior but that your daughter finds this time of her life to be particularly difficult (as is the case with most adolescents), is anxious and confused and requests that you make an appointment for her with someone. (In one recent situation I dealt with, the young girl’s friend actually confided to her how beneficial she found therapy for herself, thereby encouraging her friend to give it a try.) If your daughter requests it, even though her problems are not atypical for her age, it is also time.

The real challenge is in the middle. And, of course, because it’s the real challenge, I can’t give you a definitive answer. It really does depend on your coping skills. And on hers. On your level of anxiety and frustration. And on hers. On the amount of angry and defiant exchanges. On the level of hostility.

One helpful key may be how she behaves outside the home. If her friends’ parents find her to be helpful and polite, then don’t worry. She is just working out her issues in the safety and security of her own home. It’s not pleasant but it’s probably not cause for concern.

But if her negative adolescent behavior generalizes to her friends’ homes and to school, then I think it’s time.

Proceed slowly and carefully. Present it as an opportunity and not a punishment. Make sure you find a competent therapist (easier said than done) whose philosophy matches your own.

If presented properly (maybe along with some stories of your painful teenage years!), it shouldn’t be a hard sell. There’s nothing teenagers love more than an interrupted hour of talking about themselves.

Re-Establishing Contact
with Negative Mom

Dear Emuna,

When I was a young, my parents were divorced and my dad remarried. My birth-mother isn't the best of people and is a bad influence, but sometimes I wonder if I could influence her to be a better person. I feel hesitant to have any contact with her because of the problems she caused throughout my later childhood, but at the same time I wonder if I could help her be a better person. I'm not sure where to go with this, but what do you think I should do?

Concerned and Still Caring Child

Dear Concerned Child,

Once again I am left with very few details. What do you mean by “isn’t the best of people?” In what way is she a “bad influence”? And has she requested contact?

You also haven’t revealed anything about your current personal situation. Are you married? Do you have children?

If your goal is to change her (“help her” as you stated), then there is no point in contacting her. You will not be able to change her and will only end up frustrated and hurt. No one can change another person. That’s a choice she has to make for herself.

Assuming she is still capable of being a bad influence on those around her, then, depending on what that means, I would probably advise keeping her away from your children (if you have any) as well.

So what’s left? She is still your mother and you still owe her a debt of gratitude. If you feel that, as a mature adult, you are at a place in your life where you could express your gratitude to her and have some type of limited relationship without damaging personal consequences, then, of course, go ahead and initiate contact.

But only if those conditions are met.

High Anxiety

Dear Emuna,

I am always anxious. Whenever I resolve one issue, another arises. I am never at peace. What should I do? Do you recommend medication?

Fretful in NY

Dear Fretful,

This seems to be my week for general questions with few pertinent details. Unfortunately that also leads to very general answers.

Do you need medication? That is something that I can neither diagnose nor prescribe. Although the world is full of general practitioners who had out prescriptions for psychiatric medications like candy, I would recommend an appointment with a psychiatrist for a full evaluation if you are seriously considering this route.

It is impossible for me to gauge the severity of your anxiety. But I will say that some underlying anxiety is normal and that most people in today’s world live with and tolerate it.

Since your anxiety seems to move from one issue to the next, it seems that it’s an underlying condition and not related to specific situations. It’s just free-floating anxiety that settles on the most convenient target.

Outside of pharmaceuticals, the best way of conquering or at least taming anxiety is to work on your relationship with the Almighty. Reminding ourselves that He is in control, that He wants our good, that we have a personal relationship, should take the edge off. But it requires constant work. (Read this article on the subject.)

My husband suggests that every time we feel anxious we should say, “The Almighty should help me,” so that we use our anxiety to connect to the Almighty and deepen our relationship. It also helps us remember Who’s in charge, thereby diminishing or alleviating the pain.

An anxiety-free life is almost impossible. So don’t let your anxiety make your anxious! But if you really work to develop a relationship with the Almighty and to understand what that means, if you turn to Him in all your travails, then you should certainly be able to lead a “normal,” healthy life. Just like all the rest of us anxious human beings.