Commentary

Effectively Reaching Out to the Angry Teen


 

How can I help parents reach out to an angry teenager?

First, determine the source of the anger. In many normal teenagers, some anger is expected, particularly if it stems from their intense drive for autonomy or a need to protect their vulnerable sense of self-esteem. Being angry is far better than being dependent or deeply embarrassed. In contrast, teens who engage in high-risk behaviors or who live with a psychiatric disorder can express anger beyond what you and a parent might be able to handle alone, and a mental health referral may be essential.

Watch for a pattern of almost daily anger, physical altercations, and/or persistent estrangement between adolescents and their families. This is a major concern, particularly when the parents feel that they’ve lost touch with their teenager, that no good connection remains between them, and that the teen is really functioning on his or her own, almost driven by anger toward the parents. An hour-long estrangement or a fight that lasts overnight can be normal. But if the estranged relationship persists day after day and week after week, the family needs additional help.

One might see such a pattern when an adolescent deals with a childhood divorce; if substances are involved; or if the teenager has an evolving problem that seems almost built in to their emerging identity and character.

It’s very, very hard for adolescents to separate from their parents and go off to a job or college when they feel estranged or bitter toward their parents. Negative feelings about their parents make their successes as young adults more challenging. These young people often do not reach – or they sabotage – their academic and interpersonal potential.

Advise parents to listen very closely to what is making the teen angry. Over several years, the parents’ job is to encourage autonomy and self-esteem in their child. The goal with 13-year-olds is to get them ready to be 18 years old, not to be 11. Parents don’t have to give in on every point, but they have to think, "How am I going to get my ninth grader to become a safe and independent college freshman?" Remind the parents that this is a process that can take about 5 years to accomplish; they don’t want to do it in 1 night, but they don’t want to take 10 years, either. Your advice for this family will evolve over time as well, because tools that are effective in helping an angry 13-year-old are unlikely to work when the adolescent turns 15 or 17. Lastly, this is a bumpy process with successes and failures. Celebrate the successes and give the failures a short life and a second chance.

Listen to parents’ descriptions of tensions with their angry teenager to figure out any real risks, such as true depression, early alcohol abuse, hyperactivity, and poor impulse control. High-risk teenagers will need more thought in terms of their developmental tendencies for autonomy and self-esteem.

On the other hand, you may encounter parents who grew up with very controlling parents themselves, or who express an abnormally high level of anxiety in your office. You need to help them to bridge the gap and arrive at some middle ground that does not completely alienate the teenager.

Balancing risk and autonomy may present a volatile challenge. You want to intervene before a young teenager’s anger drives her or him away completely. The goal is to avoid creating a situation in which a 16- or 17-year old is almost impossible to control and becomes alienated.

In terms of normal development and the angry teenager, autonomy and self-esteem are the most relevant dynamics.

Autonomy

Autonomy is probably the most central. Preteens gradually evolve from total dependence on their parents and a worldview that primarily encompasses only home and school to a much broader perspective. By their early teenage years, they start doing more things on their own, such as staying over at a friend’s house, and in general, they experience more of the world. They enter high school. They start to develop deeper relationships with same-sex peers and begin to hang out with the opposite sex, and maybe start to do more than hang out.

This can be a scary time for teenagers (and parents). At the same time, teenagers are trying to establish their identities by doing a lot of new things and competing in completely new ways. Plus, they are competing in the real world. The judgments they face are not like a second grade teacher’s saying, "You told a nice story at story time." Now they are competing for the varsity team with much of their self-esteem and identity on the line.

Pages

Recommended Reading

Youth Smoking Linked to Carotid Intima-Media Thickening
MDedge Family Medicine
Lyme Arthritis: Highly Treatable, Slow to Resolve
MDedge Family Medicine
Stronger Evidence of Circumcision Benefits Drives AAP Policy Update
MDedge Family Medicine
Therapy-Resistant Asthma May Be Neither
MDedge Family Medicine
Arboviral Disease Season: It's On!
MDedge Family Medicine
AAP Unveils Updated Obstructive Sleep Apnea Syndrome Guidelines
MDedge Family Medicine
Vaccination Exemptions at 2.2% for Kindergartners
MDedge Family Medicine
Budesonide Reduces Adult Height in Kids With Asthma
MDedge Family Medicine
FDA: Don't Give Revatio to Children With PAH
MDedge Family Medicine
Warn Parents to Beware of Button Batteries
MDedge Family Medicine