Summer Activities and Head Trauma

It is summer time and school is out.  Many children are engaged in summer activities such as swimming, water skiing and diving.  Others are preparing for next year's football season and cheerleaders are preparing too.  While we use to assume these activities were safe, we now know they can be dangerous.

Many parents of high school athletes are aware of the dangers of concussions.  Even one concussion can cause permanent damage according to recent research studies.  However, there is another condition that parents need to be aware of when their child plays sports.  This disorder is CTE.  CTE is Chronic Traumatic Encephalopathy (CTE) it is a progressive degenerative disease of the brain found in athletes (and others) with a history of repetitive brain trauma, including symptomatic concussions as well as asymptomatic subconcussive hits to the head.

Our brain sits in our skull surrounded by fluid.  Therefore, any time anyone hits their head or their head is jarred around, the brain moves in this fluid hitting the front and back of your skull or the sides of the skull depending on what direction the force came from. When the brain hits the skull it can cause bruising and microscopic tears of very fine nerve fibers.  Nerve fibers that are too small to be seen on an MRI or a CT scan.

Physicians have known that CTE effects boxers for many years, however, it was just recently that evidence showed that football players are at risk too.  This was the main focus of the movie, Concussion, starring Will Smith.  The NFL did everything they could to stop the filming of this movie.  The movie shows how CTE results in the patient becoming severely depressed and psychotic.  Many of the patients with CTE commit suicide.  Also many CTE patients were football players.

Why is this important for parents to know?  It is important because CTE is caused by chronic head injuries.  Head injuries that date back to when a teenager was playing high school sports.  Therefore, it is important for parents to ensure that their teenager's school is using the latest safety gear, especially for the head, and to take any head injuries seriously.  There is no way to tell what will happen when these teenagers become adults.

For many years, football and schools have reported that they are developing helmets that protect the head better.  However, these safer helmets are not being used in high schools or professional football.  Schools and professional football are monitoring players closer after a head injury, but still little to nothing is being done to protect the brain prior to an injury.

As an adolescent psychotherapist who has been practicing for 20 years, I am seeing more evidence of this every year.  Every year I am seeing more teens with Post Concussion Syndrome.  This may occur after a concussion and can be associated with headaches, mood swings and memory difficulties.  The teenagers who experiences this Syndrome become very frustrated because they are aware of the changes and because no one can say how long the symptoms will continue.  In fact, no one can guarantee that the symptoms will disappear.

This becomes very frustrating to the teenager and their parents.  Some teenagers are so overwhelmed that they start self-medicating with drugs and alcohol.  Anything that they think might help.  Others become so depressed because they fear that the symptoms are permanent that they become suicidal and may attempt suicide. 

For many years these head injuries in teenagers were down played because there was not enough evidence to indicate that teenagers could be impacted by head injuries.  Well the research clearly indicates that teenagers can suffer long term results from a single concussion.  Additionally, this can create symptoms that are overwhelming for the teenager and their family.  Imagine being a parent and you see your child suffering with Post Concussion Syndrome and there is nothing you can do to stop it.  Parents also become depressed and nervous that their child may never recover.

Another issue to consider, in CTE, patients have mood swings and feel like they are going crazy.  They do not understand what is happening inside their head.  Many teenagers who act out often report the same feelings and the fear that they are going crazy.  Many of these teenagers have had head injuries.  It is possible that teenagers may also suffer from CTE?

Everyone's brain is different and so is the recovery process.  This means we have no way of knowing how many Concussions or head traumas it takes before CTE is started in someone.  It also means we have no way to determine how long it will take for someone to recover from a concussion or if they will have permanent impairments.  We only can tell after it occurs not before.

We do know that patients recovering from Post Concussion Syndrome or dealing with CTE can benefit from psychotherapy.  Often this option is not given to teenagers because again many people believe teenagers are very unlikely to suffer with these issues.  However, if you look at the research it indicates that teenagers can and do suffer from Post Concussion Syndrome and teenage head injuries can cause CTE.

 As a psychotherapist who treats teenagers with head injuries, I strongly encourage every parent to watch the movie, Concussion.  Also before your child starts playing any competitive sports, such as football or soccer, go online and research head injuries and signs and symptoms of concussions.  Also if you teenager does sustain a head injury while playing sports or just playing have them evaluated.  You never know how severe a head injury is by just looking at someone. A few years ago an actress fell in the snow and her friends said to go to the doctor she said she was fine.  Two hours later she was dead.  When she fell she caused her brain to bleed and she died.

Above all, use your best judgement as a parent.  Do not be afraid to ask for a CT scan or an MRI if your child suffers any type of head injury.  If your teenager does sustain a concussion and you notice a personality change or memory issues do not hesitate to seek psychotherapy for your child and for yourselves.  Also don't hesitate to talk to your teenagers high school.  If the teenager is having problems concentrating after a head injury, the school may need to provide them with accommodations until the child recovers.

This can be an overwhelming and frightening topic to consider but the more you educate yourself, the easier it will be to manage.  If you have additional questions regarding the personality changes or neuropsychological changes with head injuries, please feel free to contact me.

Dr. Michael Rubino has been treating children and teenagers for over 20 years.  He also has training in neuropsychology.  For more information about Dr. Rubino's work or private practice visit his website at www.RubinoCounseling.com or his website that deals with accommodations at school www.LucasCenter.org. 

Alarming Facts About Boys and Guns

I recently read an article by Cody Fenwick regarding children and gun violence.  His article was so alarming that it inspired me to write this article.

Many of us feel because we live in Pleasant Hill, Walnut Creek or Lafayette that our children and teenagers do not have to worry about gangs or gun violence.  Unfortunately, this is not the truth.  According to a new research study in the Journal of Pediatrics, guns continue to be the third-leading cause of death for Americans younger than 18 years old, killing around 1,300 children and teenagers a year in the United States.  In addition, almost 6,000 children and teenagers are injured per year.  Many teenagers are permanently disabled from these injuries.

The study examined data from the Centers for Disease Control and Prevention and the Consumer Product Safety Commission between 2002 and 2014.   The study found that boys, especially older boys such as teenagers and minorities, were much more likely to be the victims of gun violence.  The study did not say anything about where the boys lived.  The facts are children who are male and teenagers, are at a higher risk for becoming a victim of gun violence.  Therefore,  teenagers in our area are at risk of becoming a victim of gun violence.

The study does indicate there has been a decrease in accidental deaths such as boys cleaning a gun.  However, the rate as a method for suicide has increased.  I have mentioned before that suicide is the third leading cause of death for 10 year old boys.  This study confirms that statistic and indicates the preferred method of suicide for boys and teenagers are guns.  According to Katherine Fowler, one of the lead researchers at the CDC, "Firearm injuries are an important public health problem, contributing substantially to premature death and disability of children.”  Understanding their nature [guns] and impact is a first step toward prevention.”

When we look at these numbers, can anyone argue against taking steps to protect our children?  Can you imagine a 10 year old boy using a gun to kill himself?  Can you imagine a 10 year old boy feeling that his life is so bad at the age of ten that death seems like a better option than living?

The study indicates that in recent years guns were responsible for a large number of adolescent, males who were murdered.  The study documented that deaths in the category of murder for boys under the age of 18 years old decreased to 53 percent.  This is a decrease yet the rate is still 53%.  The other causes of gun-related deaths include:

• 38 percent — suicides

• 6 percent — unintentional deaths

• 3 percent — law enforcement/undetermined cause

The study found 82% of deaths by guns were boys.  This means 82% of gun deaths were boys who were children or teenagers.  Putting it another way, this means these boys were not even 18 years old yet at the time of their deaths.  The study also found that white and American Indian children have the highest rate of suicide using a gun.

We also like to think that the United States in one of the most advanced nations in the world.  However, the statistics show that the United States has the highest rate in the world for children under 14 years old committing suicide.  Again, the United States has the highest rate of children under 14 years old using a gun to commit suicide.  That number scares me and is appalling to me.  However, as an adolescent and child psychotherapist, I do not doubt it.  I have heard 6 year old boys seriously discussing suicide.

As a society, we need to look at these numbers and ask ourselves some questions.  What are we going to do in order to improve gun safety?  Most importantly, why are children as young as 6 years old thinking about suicide?  Also what are we going to do so that children who are suicidal have access to mental health care?  This is our problem because it does happen in Pleasant Hill, Walnut Creek and Lafayette. 

Dr. Rubino has 20 years experience as a psychotherapist working with children and teenagers.  For more information about his work or private practice visit his website at www.RubinoCounseling.com. 

Allowing Teenagers to Make Decisions

Working with teenagers, I hear very often from parents that they feel their teenager is not responsible and they have concerns about trusting their teenagers.  I also hear from teenagers how they are upset with their parents for not trusting them and not allowing them to make decisions.  I understand the parents' concerns, but at times they are being unfair and unrealistic about their ability to control their teenagers' decisions.

We routinely tell teenagers that they need to be responsible for their choices and actions.  However, we seldom allow teenagers the ability to make their own decisions.  It is not uncommon that parents have set rules and curfews for their teenagers.  Also with the advancement in technology many parents have software installed on their teenagers' cellphones so they can read their teenagers' emails or texts.  Also they have GPS programs so they can determine where there teenager is and try to figure out what they are doing.

Teenagers are aware that their parents have software programs on their cellphones so they can read their emails or texts or use a GPS program to determine where they are and what they are doing. This usually makes teenagers upset that their parents do not trust them.  Teenagers' tell me if they want me to be responsible how can I be responsible if they do not give me a chance? Also most teenagers have found ways to bypass these programs or they have developed a Texting code so parents will not know what they are texting about to their friends.

Teens there are some facts you need to be realistic about too.  You cannot demand that your parents treat you like adults, but if you get into trouble, you want mom and dad to fix it.  If you want people to respect your choices and opinions, then you must be prepared to accept the consequences and reactions from other people regarding your choices and opinions.  You cannot have it both ways.

The other fact that parents need to accept is you cannot control everything your teenager is doing.  You can monitor your teen all you want, but if a teenager wants to do something they will figure out away to do it.  Also if you want your teen to be responsible you have to learn to accept their decisions and the consequences that may result from their choices.  Additionally, your teenager needs to learn their decisions have consequences and teenagers need to learn to accept the consequences for their actions.

What parents need to do is have a calm conversation with their teenager.  During this conversation you discuss issues that your teenager will be facing such as alcohol, drugs, sex and their futures.  Explain what you expect and what you are willing to do or not to do.  Therefore, they may begin to understand what consequences they will face depending on the decisions they make.  They also may start to understand that you will not always be able to solve their problems.  If they want to be treated as adults, they need to be able to deal with the consequences of their actions.

This is an important lesson for teenagers to learn.  They need to understand that their actions have consequences and they are responsible for dealing with these consequences.  One consequence may be that as parents you may be upset with their decision.  This is a consequence that they need to be able to accept.  Not everyone is going to always accept or approve of your choices.  Teenagers need to learn this fact.  It is important that they understand that their choices have consequences and they are responsible for their choices.

It is important that parents learn to accept the fact that they cannot control their teenager's choices.  Allowing them to learn from their choices is the best way for them to learn responsibility.  It is also away for parents to learn to allow their teenagers to grow up and be responsible adults.  Yes at times this may be difficult, but parents need to be realistic that they cannot control their teenager.  Also it is better if they make mistakes before they are 18 years old.  Typically these mistakes can be resolved easier if they are under 18 years old.  When they are over 18 years old, they face the same consequences as a grown adult.  Parents it is important to remember that part of your teenager becoming an adult is allowing them to make choices and to learn from those choices.  Also the time to start educating them about choices and right and wrong is when your child is in elementary school.   If you wait until they are teenagers, they think they know more than they do and they are less likely to listen to you.

Dr. Michael Rubino has over 20 years experience working with teenagers and their families.  He is considered an expert working with teenagers.  For more information regarding Dr. Rubino's work and private practice visit his website at www.RubinoCounseling.com or his Facebook page at www.Facebook.com/Drrubino3. 

Dealing with Grief

It is graduation time which means graduations and also end of the year parties.  Unfortunately, this also means teenage deaths due to car accidents, accidental drug overdosages and accidents.  When this occurs no one knows what to say or do.  Many patients have asked me about what to do in these situations. While doing research regarding grief for patients, I found this information from the grief center.  I think it is very good information and very easy to understand.  Therefore, I will present the information in three sections.

The 10 Best and 10 Worst Things to Say to Someone in Grief

Sheryl Sandberg’s post on Facebook gave us much insight into how those in grief feel about the responses of others to loss. Many of us have said “The Best” and “The Worst.” We meant no harm, in fact the opposite. We were trying to comfort. A grieving person may say one of the worst ones about themselves and it’s OK. It may make sense for a member of the clergy to say, “He is in a better place” when someone comes to them for guidance. Where as an acquaintance saying it may not feel good.

You would also not want to say to someone, you are in the stages of grief. In our work, On Grief and Grieving, Elisabeth Kubler-Ross and I share that the stages were never meant to tuck messy emotions into neat packages. While some of these things to say have been helpful to some people, the way in which they are often said has the exact opposite effect than what was originally intended.

The Best Things to Say to Someone in Grief

1. I am so sorry for your loss.

2. I wish I had the right words, just know I care.

3. I don’t know how you feel, but I am here to help in anyway I can.

4. You and your loved one will be in my thoughts and prayers.

5. My favorite memory of your loved one is…

6. I am always just a phone call away

7. Give a hug instead of saying something

8. We all need help at times like this, I am here for you

9. I am usually up early or late, if you need anything

10. Saying nothing, just be with the person

The Worst Things to Say to Someone in Grief

1. At least she lived a long life, many people die young

2. He is in a better place

3. She brought this on herself

4. There is a reason for everything

5. Aren’t you over him yet, he has been dead for awhile now

6. You can have another child still

7. She was such a good person God wanted her to be with him

8. I know how you feel

9. She did what she came here to do and it was her time to go

10. Be strong

Best & Worst Traits of people just trying to help

When in the position of wanting to help a friend or loved one in grief, often times our first desire is to try to “fix” the situation, when in all actuality our good intentions can lead to nothing but more grief. Knowing the right thing to say is only half of the responsibility of being a supportive emotional caregiver. We have comprised two lists which examine both the GOOD and the NOT SO GOOD traits of people just trying to help.

The Best Traits

Supportive, but not trying to fix it

About feelings

Non active, not telling anyone what to do

Admitting can’t make it better

Not asking for something or someone to change feelings

Recognize loss

Not time limited

The Worst Traits

They want to fix the loss

They are about our discomfort

They are directive in nature

They rationalize or try to explain loss/li>

They may be judgmental

May minimize the loss

Put a timeline on loss

The above information is meant to be used as a guideline. Everyone goes through the grieving process in their own way.  It is very important to understand that point.  It is also important to remember while the above is a guideline, the most important thing is your intent. So if you say a worse thing but you said it out of love the person will understand. The guideline will hopefully make you more comfortable to offer support to your grieving loved one or friend.  Because someone who is grieving need people to talk to without people feeling awkward.  Also everyone is around immediately after the death and through the funeral services.  Most people then go back to their normal lives.  However, those who were really close to the person are still grieving and trying to figure out how to proceed with life.  So don't forget the person who is grieving can use emotional support for the first year especially.  Therefore, do not forget to call, send a card or stop by occasionally. Especially around the holidays and birthdays.

Dr. Michael Rubino has over 20 years experience treating adolescents, children and their families. For more information regarding Dr. Rubino visit his website www.rcs-ca.com or on Twitter @RubinoTherapy

What Teens Need to Know About Texting

In today's world texting has become a very common way for people to communicate with each other.  If I go to a baseball game or the theater, I see adults texting the entire time.  I have even seen people fired via text.  While it is becoming very common with adults, it is even more common with teenagers.  The teenagers I see for psychotherapy text all the time.  It appears that texting is now the preferred way that teenagers communicate with each other.  If you remove their cellphones and they cannot text, many teens become very upset and I have seen many become violent.

While technology is advancing at a fast pace, our laws and ethics are having a difficult time keeping up with the latest advances.  However, when laws are passed or ethical standards set, many teenagers and adults are not aware of the new laws.  This is creating a tremendous problem for teenagers and their families.  I have worked with many teenagers who are struggling with an issue due to texting and they had no idea they were doing anything inappropriate.

First, it is important to note that any time you post something, tweet or text, it is on the internet forever.  This is why many celebrities have won very large monetary judgements against people who have posted false or embarrassing material.  You can remove it from the site it was posted to, but it still can found on other sites.  Therefore, if a teenager post something, they need to think about the fact that it will be out there forever and anyone can see it.  This may lead to embarrassing situations.

Let's consider the most common problems that teenagers encounter.  The first one is texting sexually explicit photographs to their boyfriend/girlfriend.  At the time they think it is no big deal.  However, high school romances typically do not last.  If one of the individuals feels hurt, they can post that sexually explicit picture all over the Internet.  It can be sent to their families and friends.  In fact, their entire school could see it.  This would be extremely embarrassing.  Even if the person who posted the picture is punished, the picture is still out there and the damage is done.

Additionally, teenagers fail to think about the fact that they are under 18 years old.  Therefore, they could be violating child pornography laws by sending the picture or by receiving it and having a copy on their cellphone.  In fact, Congress is trying to pass stricter laws regarding teenagers texting sexually explicit picture.  Therefore, besides being very embarrassed, the teenagers involved might find themselves facing legal charges for violating child pornography laws.

The second major issue is harassment.  Friends get mad at each other or often one teenager is singled out and they become the object of numerous texts telling them they are ugly, no one likes them etc.  These texts can be sent so often and by some many other teenagers that the teen who is the target commits suicide.  There are numerous examples of this and a common one is accusing a teenager of being gay.  This is not harmless teenage game playing.  This harassment can be vicious.  They are also cases where the teenagers sending these texts have been charged with stalking or more serious charges if the teenager committed suicide.

When this occurs, the teenagers are shocked.  They think they were just teasing another kid and it was harmless.  They have no idea what this teenager is already dealing with in their life or what it can be like to have numerous classmates texting you every day all day long.  It is not harmless teasing, but because technology has increased so quickly it is not the same teasing that use to occur at school.  We have not had enough time to think about this point.

The last major issue is that texting is an excellent way for schools or police to arrest teenagers for dealing drugs, buying or using drugs.  I have worked with many teenagers from numerous schools where the school catches someone using or selling marijuana on school grounds.  The school then checks the student's cellphone and looks at the text history.  The school then starts calling in the student's on the text history and asking about drug use or selling.  One teenager getting caught at school can result in ten teenagers being expelled.  The teenagers are usually in shock.  First, they never thought they were doing anything wrong and they never thought a text could get them in trouble.  However, it can and it does.  I have seen many teenagers for psychotherapy because of a text found by the school.

Parents, we see adults getting into trouble due to texts they have sent, what makes us think that teenagers can't get into trouble too?  Remember they are not grown adult yet, so their ability to think logically as an adult is not fully developed.  Even if it was, technology is moving so fast that adults are getting into trouble due to texting.  Therefore, we cannot expect teenagers to be able to sort all of this out on their own. Talk to your teen about texting, you may need to monitor their texting.  There are apps that can help teenagers identify texts that may be inappropriate.  Bottom line teenagers need to support and guidance from their parents regarding the ever evolving technology that we are facing.  If we cannot keep up with the ethical issues, how can a teenager?

Dr. Michael Rubino is a psychotherapist with 20 years of experience working with children and teenagers. He also treats Internet addiction.  For more information on Dr. Rubino's work or his private practice visit his website at www.RubinoCounseling.com or his Facebook page at www.Facebook.com/drrubino3.  

Teenagers and Vicarious Trauma

In light of more terrorist attacks on London and Pairs and especially the attack on the concert in Manchester, England, it makes sense to remind parents how children and teenagers are being impacted. I have been seeing more and more teenagers who are complaining of anxiety and depression.  Many of these teenagers are also afraid to go to school too.  I have also been seeing more teenagers being placed on home/hospital for school. This means a teacher comes to the house once a week instead of the teenager going to school.  This is an alarming trend.

I have also been hearing more teenagers talking about needing to carry a knife with them for their own safety. They tell me you never know when someone might try to attack you.  These are not juvenile delinquents or gang members, these are average teenagers.  They come from healthy families and are doing well in school and not involved in drugs. This need they feel to protect themselves is an alarming trend.

However, if you take a step back and look at what these children have seen over their lives it makes sense.  Most of these teenagers were very young on 9/11, or were not even born yet, when the United States was attacked.  Since 9/11 they have also seen two wars and heard on the nightly news about numerous terrorist alerts or attacks around the world and here in the United States.  They also hear how the TSA are putting tighter security on travelers and places such as Disneyland are increasing security due to concerns about terrorism.

In addition to terrorism, this is the first generation growing up with mass shootings.  According to ABC News from 2000 to 2015 there have been 140 mass shootings and since January 1, 2016, there have been more mass shootings than the previous 15 years.  According to the statistics on mass shootings every day 36 people are killed in the United States by a gun. This does not include suicides.  For the group we are discussing, suicide is the third leading cause of death for children between 10 and 18 years old and using a gun is one of the most popular methods of suicide.  Also because of school shootings, students have seen increased security on their school campuses.  Many campuses have metal  detectors that students have to pass through as the enter the campus and there are police officers assigned to school sites due to the fear of violence.

  

Now, in addition to these facts stated above, think about what these children see on the news nightly and the video games they play daily.  Anytime there is a shootings incident in the United States, or any where in the world, there is pretty much 24 hour news coverage of the event for days.  Also when there are bombing or shootings in Europe there is 24 hour news coverage for days too.  And now we have moved on to covering funerals.  When the officers were killed in Dallas the memorial was televised nationally.  If we look at the video games these kids are playing most have to do with killing and death.  And since computer graphics have significantly improved, many of these games look real.

Additionally, children in the fourth and fifth grades are telling me they are worried about our election results.  They have heard what the President has said and they are afraid other countries attacking us or that the President  may start a war.  Also Hispanic children who are legal citizens are afraid that they will be deported.  This is a great deal for a nine or ten year old child to worry about.

Looking at all of this it begins to make sense why I am seeing more depressed and anxious teenagers who fear for their lives.  These teenagers are being traumatized.  They may not be experiencing the trauma personally but they are experiencing vicarious trauma.  With all of the pictures on television and news reports and realistic video games these teenagers are playing, they are being traumatized vicariously.  We have never had a generation of children grow up with the amount of trauma that these children are growing up with in the world.  Even children growing up during World War II didn't experience this amount of trauma.  We didn't have instant access to news nor did we have the graphic videos being shown by the news media.

The question now becomes, what do we do?  Well we can not change the world unfortunately. However, we can monitor how much exposure our children are receiving to mass shootings when they occur.  We can monitor the video games they are playing and limit access to games that focus on violence and killing.  We can demand that the Congress pass gun control laws that make sense.  No one needs an assault weapon to hunt a deer.  We can also listen to what our children are saying and talk to them about their concerns.  When a mass shooting occurs we can ask them how they are feeling, ask if they have any concerns and reassure them that you are there as their parents to protect them.  Also try to become active. Look for sites by the Red Cross or the benefit concert for victims of the Manchester incident.  Making a donation helps children to feel there is something they can do instead of just being a victim.

Finally, if you start to notice a change of attitude in your child that you are concerned about have talk to your child or have them assessed by a psychotherapist.  I have included a link to an article by the American Association of Child and Adolescent Psychiatry which describes what parents can do http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Talking-To-Children-About-Terrorism-And-War-087.aspx.  There is nothing to be ashamed of if a child needs therapy.  We are exposing children to situations that most adults have problems dealing with themselves. You may find it very upsetting to talk to your child about these incidents.  For these reasons and many more, if you feel your teenager has been traumatized vicariously make an appointment with a psychotherapist who specializes in treating teenagers and victims of trauma.  Our kids have had to deal with a lot. We can help make it easier for them growing up in this time by providing the help they need.

Dr. Michael Rubino has over 20 years experience treating children and teenagers and is an expert treating victims of trauma and also performs Critical Incident Debriefing. For more information about his work or private practice visit his website at www.RubinoCounseling.com  or on Twitter @RubinoTherapy.

How Feeling Loved Can Change A Teenagwr

Many of the teenagers that I see for psychotherapy come to therapy believing that no one loves them.  They tell me their parents don't love them, their siblings don't care about them and no one at school cares about them.  They feel they are unloveable and no one cares if they live or die.  Because they have this belief, they don't care about themselves. They don't care how they are doing in school and they see no future for themselves.

There are many reasons why children have this feeling about themselves. For some their parents were drug addicts, for some they were sexually or physically abused, some have gone from foster home to foster home their entire lives.   Why teenagers have developed this attitude is not always the most important issue. What matters is they have this belief and what this belief is doing to their lives.

Many teenagers who feel unlovable turn to drugs or alcohol to numb these feelings.  Some turn to self-mutilating behaviors such as cutting again as a way to numb these feelings or punishing themselves.  Many usually become sexually active at an very early age.  They equate sex with love.  Also many of these teens become involved with gangs and bullying.  The gangs serve as a psedufamily for the teenagers.  In fact, gangs consider their members as family members.  Bullying is another way teens numb out their pain.  They believe by making someone else look weak that it makes them look strong and people will respect them and love them.  It is sad that some teenagers are so desperate to feel loved by a parent figure.

The above are a few ways that teenagers deal with feeling unlovable.  However, the number of teenagers who feel this way are creating numerous problems for everyone.  As a result of teens feeling unlovable, we have a severe drug problem in the teenage population.  Teenagers are dying from accidental drug over dosages at an epidemic rate. According to the CDC the number of teens using drugs, such as heroin and meth, is at an epidemic rate.  Cutting, suicide and being murdered are all at epidemic rates for teenagers.  All because many of them don't feel loved.

We are receiving this message in many ways. In Disney's movie, Frozen, they mention that people make poor choices and do hurtful things because they feel unloved.  The movie goes further to say that if people feel loved you would be amazed at how they can change.  Oprah in her last show commented on one thing she had learned from her show was that everyone wants to know that they are important to someone and that someone sees them and cares about what they say and do.  Challenge Day, a program designed to work with teenagers, believes all teens deserve to feel loved and cared for by people.  I have worked with Challenge Day and I am amazed every time that this big, tough teenager ends up crying on the floor when he realizes that someone cares.  We really are getting the message, when teenagers are saying to people that no one cares about him.  I have teenagers telling me they are willing to take a chance of overdosing just so they can escape the pain of feeling abandoned and unloved.  It is heartbreaking to hear a teen tell you this as they try to hide the fact that they are crying.

We know love makes a difference to many people so why not teenagers?  The teenagers I work with don't really want to be the tough guy.  They want to know that they are loved.  When I tell a teen I'm working with in therapy that they deserve to be loved, they think I'm crazy.  They test me in numerous ways to get me to throw them out of my office.  They are testing the point I made that they are lovable.  They try everything they can think of to prove me wrong.  However, in reality they are hoping to fail and prove that I am right that they are lovable.  So, I hold strong and tell them I won't change my mind and I will not give up. I will not throw them out of therapy. If they decide to walk out that is their choice and I can't stop it.  I also let them know if they do walk out that my door will always be opened to them.

After testing me, many of these teens decide they are worth it and decide to make a future for themselves. It is amazing to see and it is very nice to see.  However, there are those teenagers who walk out and that is very disappointing. It's not disappointing because I lost it is disappointing because the teenager will continue to live in pain.

The main point is that Challenge Day, Alive and Free (another program for teens) and other therapists like myself cannot be the only ones trying to help teenagers.  We need everyone to help. Parents, teachers, physicians, psychotherapists, the juvenile justice system and our communities.  We need to let children know from the day that they are born that they deserve to be loved and that they are important members of our society.  We cannot continue to wait until these children are teenagers to tell them they are lovable. As a teenager it is too easy not to listen. If we start when they are babies, they will grow up with a sense that they are important and deserved to be loved.  This could help reduce how many teens turn to drugs or violence.

So, think about how you can show a teenager that they deserve to be loved and that they are important. If everyone starts with one teenager, you would be surprised the changes we can make in someone's life and the world.

Dr. Michael Rubino specializes in treating children and teenagers.  He has over 20 years experience treating teenagers.  If you want more information about Dr. Rubino visit his website at www.rubinocounseling.com or like his Facebook page www.facebook.com/drrubino3.