Category: Depression

Over-Control: When Self-Control Becomes a Problem

During a recent CERTS Parent Education Webinar, Robbi O’Kelley the Executive Director of La Europa Academy presented on the topic, “Over-Control:  When Self-Control Becomes a Problem.”  Robbi explained that at the CERTS Programs and specifically at La Europa Academy we are seeing more and more students admit with over-control issues.  Students with over-control issues often need a different type therapeutic support than students with under-control issues.  Many of the evidenced based treatments are designed for under-control individuals.  Many treatment programs for teenagers suffering from depression, trauma and anxiety deal specifically with emotional dysregulation, poor distress tolerance, and poor impulse control.

Over-control is a problem of emotional loneliness, secondary to low openness and social signal deficits, whereas under-control is a problem of emotional dysregulation secondary to poor distress tolerance and lack of poor impulse control.  The chart below demonstrates the different dynamics between a student who presents with under-control issues and over control issues.

Under-Control Dynamics  

Over Control Dynamics

 

Difficulty regulating emotion Difficulty showing emotion
Allow mood to dictate actions Rigid rule governed behavior
Difficulty self-soothing Bitterness, envy
Poor Impulse Control Lack of Openness
Relationship difficulties Distant relationships
Use of external items to manage emotions—substances, food, etc. Hyper-Perfectionism
Low Distress Tolerance High Distress Tolerance

Defining Over-Control–Four Core Deficits

Receptivity and Openness:  Manifested by high risk aversion, hyper-vigilant for threat, avoidance of novelty, and automatic discounting of critical feedback.

Flexible Responding:  Manifested by compulsive needs of order and structure, hyper-perfectionism, compulsive planning/rehearsing, rigid rule-governing behavior, and moral certitude.

Emotional Expression and Awareness:  Manifested by inhibited expression, and/or disingenuous expression (e.g smiling when distressed), and a minimization or low-awareness of stress.

Social Connectedness and Intimacy:  Manifested by aloof/distant relationships, high social comparison, envy and bitterness, and low empathy and validation skills.

Helping Over-Control Clients

The focus of treatment is the correcting the over-controlled coping style. One of the best treatment options is Radically Open Dialectical Behavioral Therapy (RODBT). Radically Open Dialectical Behavior Therapy (RO DBT) is a new evidence based treatment targeting a spectrum of disorders characterized by excessive self-control, often referred to as over-controlIt is supported by 20 years of clinical experience and translational research that parallels established guidelines for treatment development (e.g., UK Medical Council, 2008; Rounsville & Carroll, 2001; 2006).   Treatment that focuses on changing this style and “becoming part of the tribe” ameliorates the symptoms.  Therapists need to teach radical openness rather than avoidance.  They can teach clients to embrace emotions as an important system of information for making decisions.  Therapists also need to focus on teaching and modeling flexibility in thinking and actions.  Parents can also model this type of flexibility to their children with over-control struggles.  Therapists can also target social signaling as a primary intervention.  This is important because a teen with over-control issues often find that they are “on the outside” of social interactions.

To learn more about Over-Control, you can watch Robbi’s entire webinar on the CERTS Parent Education Channel at:  https://www.gotostage.com/channel/certsparenteducation.

 

 

 

 

Understanding Teen Depression

Understand the struggles of teen depression

We all know that teenagers are known for being moody, rebellious, egocentric and emotional. This is just normal adolescent behavior. However, major depression is a common mental disorder that affects an estimated 3 million American adolescents between ages 12 and 17. There are various reasons why a teenager will develop depression, these include:

Biological chemistry

Neurotransmitters are naturally occurring brain chemicals that carry signals to other parts of the brain and body. When these chemicals are impaired, the function of nerve receptors and systems can change, leading to depression.

Hormones

Teenagers experience rapid hormonal changes, which have been shown to cause or trigger depression.

Inherited traits

Depression is more common in teenagers whose blood relatives also have the condition.

Early childhood trauma

Traumatic events during childhood, like physical or emotional abuse or the loss of a close family member may cause changes in the brain that make a teen more prone to depression.

Learned patterns of negative thinking

Teen depression can be linked to learning to feel helpless, rather than learning to feel capable of finding solutions to life’s challenges.

Know the symptoms

Moodiness isn’t the same as depression, so how do you tell the difference between normal teenage mood swings and depression? Pay attention to whether or not there’s been a real change in the functioning of your child’s behavior. Notice changes in appetite and sleep, poor school performance, an inability to concentrate, lack of interest and withdrawal from regular social activities. Also look for irritability and agitation in your teen. If the depression lasts longer than two or three weeks, you should really pay close attention.

Be aware of comorbidity

It’s rare for a teen to solely struggle with depression. These symptoms are always part of a bigger picture. Depression and anxiety often come hand-in-hand, and this combination can lead to coping mechanisms like self-harm, eating disorders and substance abuse.

Depression is treatable

Many think that depression and its coexisting problems are difficult to treat, but with the right kind of therapy, mild to moderate depression can handled. The CERTS Group’s residential treatment programs are specifically designed to treat depression and the self-destructive behaviors that result from it. These programs provide intimate therapy sessions and individually-tailored programs to treat your teenage daughter’s specific behaviors.