A Different World to Grow Up In

Teenagers today face challenges that set them apart from earlier generations, and many would argue that these circumstances are leaving them more vulnerable, including to difficulties with their mental health. I don’t wish to be alarmist, but my work with teenagers largely bears this out.

It can feel as if we adults no longer have a reference point for how teenagers think, react and engage with the world. Being a teenager has always been hard. Today’s circumstances seem to make it harder still.

When Parents Get in Touch

More often than not, it is a parent who contacts me first:

• “I don’t know what to do.”
• “They’re behind their phone the whole time. I can’t get through to them.”
• “She’s up all night on her computer, and I’m completely in the dark about what’s happening in my child’s life.”

Sound familiar?

Part of the reason teenagers can seem so out of reach is technology. For all its benefits, social media and the smartphone have transformed the mind and the world of the teenager, at a pace of change without precedent. If parents felt distant from their teenagers before, they may now feel as if they are in another dimension. That distance is an uneasy feeling for a parent. It is often an uneasy feeling for the teenager, too, to be so far from the people they love and trust.

What Is Going On Underneath

Adolescence sits where a surge in brain development, with the onset of puberty, meets a rapidly widening social world, more and more of which now happens through screens. Social media and the technology around it can be highly addictive, and that pull meets the brain at a particularly vulnerable stage. The same is true of how easily teenagers can now come across pornography, which I have written about in a separate article on its effects on the mind. The result is a set of circumstances quite unlike those the previous generation grew up with.

The teenage years are marked by insecurity, about body image and status; by social complexity, in the depth and breadth of relationships; and by questions of identity: who am I, really? The influential theorist and psychoanalyst Erik Erikson coined the term “identity crisis” for this period, beginning around the age of 12, when everything a young person has been preparing to be is expected to come together into a coherent whole. Erikson was writing in the middle of the last century, and even then he called this period a “crisis”. Given the pressures of today, the word may be more deserved now than ever.

How I Work with Teenagers

Working with teenagers is different from working with other age groups, because therapy often comes just as they are naturally pulling away from adults and into worlds of their own—worlds that can be both tantalising and terrifying.

Teenagers can be a little like armadillos: they need some gentle coaxing out of their shell before they feel safe enough to open up. Many are tired of being talked down to or misunderstood, and are not especially eager to talk to yet another adult who is a stranger.

During my Master’s training, a supervisor told me how, as soon as a parent had dropped off a teenager and closed the door, she turned to the young person and said, “Right, let’s talk about that person!” It was the opposite of what the teenager expected. It is not an approach for every occasion, and it was never about taking sides against a parent. It simply told the teenager that this was their space, which is often what makes it possible for them to talk at all. That, in the end, is what parents are hoping for too.

So the first session is usually light, friendly and open. Rarely do we dive straight in; we begin by getting to know one another, without an expectation that everything must be explained immediately. Parents may join us at the start, depending on the teenager’s age and circumstances, and the therapy then continues with just the teenager and me. Sessions are weekly.

Confidentiality

Confidentiality is a cornerstone of safe therapy, but with teenagers there are some important points to agree from the start.

Because teenagers are minors, I meet with parents from time to time for brief feedback sessions. This does not mean that everything said in therapy is passed on. We review the broad themes while respecting the details beneath them. Sometimes “please don’t tell my parents” really does need to stay that way, and holding that line takes care and clinical judgement.

The exception is safety. If I believe there is a serious risk of a teenager harming themselves, or of serious harm to someone else, confidentiality has to give way, as it would with any client. Even then, my aim is that only the people who need to know are involved, at the time they need to be, no sooner and no later.

Teenagers Who Have Moved to the Algarve

Adolescence is challenging enough without also adapting to a new country: a new language, a new school and new friendships, often just after leaving the old ones behind. When a family emigrates during this vulnerable period, the teenager may carry more of the upheaval than anyone realises. You can read more about therapy for expats in the Algarve, and about family therapy if the move is affecting the whole family.

What I Hope Teenagers Leave With

I hope teenagers leave knowing that there is help: that there is another place, and another mind, to turn to when things feel distressing. I hope they come to see that this is a phase of life that will pass, and that with a place to work through it, they can come out the other side more intact than they might have on their own.

Practical Details

I see teenagers in English, in person at my practice in Quarteira, near Vilamoura, and online. The practice is also easy to reach from Loulé, Almancil, Albufeira and Faro.

Sessions last 55 minutes and cost €65. Brief feedback sessions with parents are included at no extra cost. The introductory call is free, and parents are welcome to make the first contact.

If you would like to explore whether therapy could help your teenager, you can arrange an introductory call.

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