How To Get Yourself To Class: Boston College Students Quick Reference Guide To Not Falling Apart The First Semester

Going to college is a big change that generally involves a brand new environment in an unfamiliar city. In general, making a big move involves figuring out living accommodations, new roommates, scheduling demands, and independence. For some the transition is overwhelming and can result in avoidance, missing classes, staying in one’s dorm, an increase in alcohol use, panic attacks, an inconsistent sleep schedule, and erratic eating habits.

Here are a few tips to help college students make the transition.

  • Make sure you are familiar with the campus. Try to find out the location of everything before you go to your first class. Find your classrooms, know how long it takes to get to different buildings, and if you can, spend a little bit of time in the buildings before your first classes. Unfamiliar situations cause more stress than familiar situations, and getting lost in new crowds in unfamiliar territory can be cause for anxiety. Don’t assume that you will just figure it all out when you get there.
  •  If you are a student who has struggled with depression or anxiety in the past, try to find the college counseling centering and see if you can set up a “check-in” session a week or two after school starts. Not having any plans to ask or get help can make everything worse. Identify your stressors and know what situations will make you likely get into a crisis. If you know any of the college counseling staff, it will be easier to reach out to them when you need them. Counseling centers can help with stress, overwhelm, demanding schedules, irritating roommates, and organization. They usually have an agenda to service as many students as they can accommodate in a given school year.
  • Try to initiate social connections as much as possible. The more people you know personally, the less stressful it will be to go to class. Try finding people who are by themselves or alone. Consider starting conversations that invite people to talk about their stress: “Are you as overwhelmed by this as I am? Are you feeling a bit lost? Because this whole college transition is a lot to take in.” Sometimes it feels good just to be able to acknowledge stress with someone else, even if you think the stress seems small or insignificant. Try to find things that you relate to and that are similar to you. Ask other students how they found and chose this college, if they’ve thought about a major, if it was hard for them to leave home, how they are finding their way around campus, what would make their college experience a positive experience, and what they are doing to help them deal with the transition. They may have some good ideas for you.
  • If you are overwhelmed by your classes and have the urge not to go, consider all the steps that it takes to get to class. If the first step is getting out of bed and brushing your teeth, do the first step. Getting out of bed and brushing your teeth is not a commitment to attend class. After you brush your teeth see if you can make another small commitment, such as getting your books together or getting dressed. Each small commitment can bring you closer to class. If you actually get all the way to the building and end up skipping class, you will at least have gone through the motions of getting yourself around campus. Moving around on campus dressed for class is better than spending the day in bed avoiding everything. Consider the short and long term cost of what you’d have to tolerate to make it through one class, and assess what you would be willing to do. Going to one class doesn’t mean going to all of them. Go to classes you enjoy and see if you can talk to an advisor about cutting back on classes that are too much. Don’t wait until you are failing. Remember that once you start avoiding one class, it will get easier and easier not to go. Don’t let yourself get into that pattern. Avoiding this problem can increase the stress, whereas admitting it is too much and dropping the class is a more proactive way to accept what is too much for you at this time. It doesn’t mean you are a failure and doesn’t mean you can’t take it another time.
  • Plan down time that is not related to school. Because school can be overwhelming, it is important to press the “pause” button by taking “time outs.” This may include a nature walk, a spiritual activity, meditation, exercise, yoga, prayer, a nap. It might also be helpful to plan a time to talk on the phone with parents, friends, or family that know you. Periodic and planned check-ins can provide a sense of stability and relief. College students sometimes underestimate their needs for leisure time and overestimate how much they can accomplish. This inevitably causes stress. Being an adult also means being able to take care of your time and your body.
  • Take care of the basics: Are you finding yourself consuming more sugar, alcohol, marijuana, or caffeine? Sometimes college is a time where you test the limits of your body as you no longer have a family time schedule to stay on track. Insufficient sleep, erratic eating, over-dependence on substances, and having too many commitments often contribute to stress. Panic attacks alone might be reduced by attending to your biological limits (eating more consistently, getting more sleep).
  • Don’t let panic attacks go untreated, because they are treatable. Panic attacks don’t go away by suppressing emotions, drowning them in alcohol, and ignoring what they may be trying to tell you. Panic attacks are often very intense experiences that include hyperventilating, shaking, racing heart, a feeling that you might pass out or die, and feeling like you can’t breathe. They can be extremely debilitating and scary if you’ve never had one. Often they are a red flag to pay attention to something that is causing you distress- more often than not, something that is easier to ignore. Panic attacks can be hard to explain or understand; don’t be afraid to ask for help. Find out what services are available at the college help center your school and use them.

 

What To Say To Your Suicidal Friend: A Resource Guide For Teens

One of the biggest problems that comes up in my therapy groups has to do with friends who take on the problems of their friends.

Often teens feel burdened, overwhelmed, and stressed when they have friends who talk about suicide, threaten to commit suicide, or end up being hospitalized for psychiatric reasons. Some times kids have problems getting off of social media, getting off the phone, saying no, asking for help, getting adults involved, or recognizing the limits of what they can do. This can interfere with sleep, concentration, homework, and grades.

Group is one unique therapeutic setting where kids who have “been there” can often dish out advice. While sometimes this advice is hard to hear, the value of being in a group increases the probability of being understood. The combination of being understood and of having practical tools for speaking up, asking for help, and setting limits creates options for practical problem solving- especially when it comes to tough conversations with people we care about.

One of the projects I have taken under my wing recently is to write a book on What To Say To Your Suicidal Friend: A Resource Guide for Teens.

Do your teens need more sleep? Feeling assured that friends are safe and having concrete resources to help their friends can reduce anxiety, increase focus and concentration, and help kids perform better in school.

Refer them to group!

Click Here if you want to be notified about the progress and availability of the book.

 

Are your socially anxious teens surviving school?

Socially anxious adolescents struggle in the presence of others. Some don’t know what to say, some become self-conscious, and some feel as if they have nothing to contribute. Others feel judged and go out of their way to avoid being the center of attention. Simple things like accidently dropping a pencil, asking to use the bathroom, or getting up to throw something in the trash are treated as a crisis. Social anxiety can create problems in other areas of life, including the inability to simply feel at peace with oneself in large groups, classrooms, and school.

The dilemma: Avoidance of social situations can result in isolation, loneliness, despair, depression, increased stress, and suicide risk. Approaching social situations, especially without confidence, can be downright painful. Classes may be skipped and grades may drop.

Individual services for social anxiety is a challenge: The task is to make a connection without overwhelming the individual. Sometimes teens find “therapy” downright painful. Sometimes it “works” for a short period, but teens also need to find their way within their own peer groups.

Groups allow teens to participate passively, contribute without disclosure, and to experiment with finding their voice. It is not all about them all of the time. What a perfect venue for providing a service that is indirect yet direct! While individual services are helpful for solving emotional problems, group services replicate reality more realistically than 1:1 services with an adult. If teens are in places where peers offer spontaneous interactions while brainstorming solutions to conflict and emotional problems, the teen will be exposed to what life could be like if they open up. The increased comfort of speaking up and participating will translate into other peer settings- including school and eventually work.

Feeling comfortable speaking up and finding one’s voice is a powerful thing!

Does your teen have debilitating social anxiety? Please don’t hesitate to contact me…

Boston DBT Parent Class: Parenting the Emotionally Extreme Teen

 How did this class help you? Here is the feedback from four parents who took the Spring 2015 class:

 

“To try and react better..To try and anticipate my daughter’s behavior triggers..try to find out what is causing the extremes and deal those triggers… By accepting emotions and where they are coming from; not to deny my emotions but they are there for a reason. To validate how I feel as well as my daughter. To be calmer. “- Parent 1

“To better understand my emotions, and that they have a purpose…To explore that purpose. Better able to identify escalation in my daughter. I’ve learned to buy time, to put some time in between responding to my daughter and others. What was most helpful was the overall impact of the course which has left me better equipped and more curious about DBT.” -Parent 2

“It made me more willing to bit my tongue, take a deep breath, and not focus on ‘fixing things’. Acceptance was important, both dealing with my own emotions and allowing for acceptance of my child’s emotions. Using mindfulness techniques to tone down my level of arousal was also important. Understanding that emotions might be valid but ineffective in some circumstances. I thought the (video content shown in class) outlined some very pragmatic examples and techniques.” -Parent 3

“To be more present with my emotion. To validate how I feel as well as my daughter. To be calmer, to think things through. Being able to listen to others’ experiences. Each class was built on each other. Have learned many skills to be more effective with my daughter.” -Parent 4

Please contact

drhoekstra@bostondbtgroups.com

 if you would like

more information about

upcoming classes.

Why does my teenager cut? A brief guide to understanding self-injury in adolescents

First of all, I’m going to say that focusing on the why this behavior occurs is probably not the most effective approach to addressing adolescent self-harm. I’ll give you some reasons why teenagers self-harm in a minute, but the one fallacy that people often have is that if they could explain why behavior occurs, then they would actually have the tools to fix or change it.  More specifically, teenagers who may not understand the behavior themselves can often be put in an awkward situation in which they are forced to explain the unexplainable. If they don’t understand why the behavior is occurring in the first place, they may end up giving inaccurate reasons simply to appease their environment.

Self-harm behaviors likely have something to do with emotional pain. Possibilities include ways to control feelings, ways to control oneself or one’s behavior, ways to increase intensity of feeling (ie, the need to feel “real” or the need to feel “something”), or ways to decrease intensity of feeling (“If I didn’t cut I wouldn’t have been able to tolerate the situation”). Understanding how emotions work and what they do for people may is critical in understanding the role of self-harm behavior. For instance, feelings are functional in that they give useful information about what matters to us, communicate to ourselves and others, and help us become organized and prepare for action. Without feelings we just wouldn’t care.

In adolescence, self-harm behaviors may play a role in identity, communication, and intimacy. Self-harm may be kept very private or it may be made public. It may be an attempt at controlling one’s environment or letting someone else know that the person doing the self-harm cannot be controlled. The function of the behaviors may communicate to oneself (I know I matter, I know what I have to say is important, I can’t stand by and let nothing happen, I am not pleased by the situation, This is my way of making a statement), or to others (Back off, This is too much, I can control your reactions, I know you will be upset and freak out, There is nothing you can do about this, You can’t claim to know me, You think you know everything and you don’t).

Treatments for self-injury are not as simple as publicizing behavior (ie, making sure that others know about it), invading privacy by doing body checks, or just stopping doing it. If there was no benefit to doing it, no one would do it! That’s just simply how it works. Knowing the benefit can help someone to organize an effective solution. Teenagers who can obtain help in identifying, accurately labeling, understanding, and communicating their feelings effectively will have more options for what they can do when the urges to self harm show up. Increasing options, understanding the short and long term consequences of this behavior, and providing alternatives for how to tolerate intense, painful, and negative emotions is certainly one way to start.

It’s important to remember that teenagers also have their own feelings about this behavior. Some are opposed to changing it, some don’t want anyone to know about it, some want everyone to know about it, and some feel really hopeless that they can’t stop doing it. Most have some degree of mixed feelings. Assuming and communicating that a teenager simply doesn’t want to change is probably not going to help solve the situation. While it might be a likely, blaming a teenager for doing it usually only serves to communicate a parent’s frustration.

Similarly so, parents have their own feelings about it and may feel disgusted, hopeless, overwhelmed, inadequate, or guilty. How parents communicate and address painful emotion will also impact the situation; and thinking through the effectiveness and intensity of one’s own responses may be part of the work involved in addressing teen behavior.

I think it is important to consider that the problem of self-harm behavior has solutions. Sometimes providers, teachers, parents, and community react with an abject horror that stirs the pot, gets everyone all worked up, and in some cases emphasizes the solution (self-harm) and not the problem itself. Emotional problem solving is really just that- emotional problem solving. If a person can figure out how to problem solve (ie, address, tolerate, understand, deal with, validate, survive) painful emotions, then their way of solving problems (ie, self-harm) may decrease. Finding effective solutions means having an adequate way to assess and address these behaviors with a skilled professional who understands the role that these behaviors serve.

When individual therapy with adolescents doesn’t work

Individual outpatient therapy with adolescents can sometimes be limited in that

1) It can fall into Question and Answer sessions-losing the spontaneity and flow of a helpful interaction

2) Adolescents have shorter attention spans, and keeping them focused on painful topics on purpose can be, well, painful!

3) Sharing personal information with an adult you don’t know, but were paired up with because your parents are making you, doesn’t always have the desired results.

4) Adolescents aren’t necessarily going to do things differently because an adult is telling them to.

Group therapy has several advantages in that

1) Its members will be able to tell your daughter if they like it, how it is helpful, and what it has done for them.

2)  It is private (no one knows each other outside of the groups) and participation can be minimal (it doesn’t have to be about you all the time).

3) Group members can help each other think things through, make decisions, look at consequences, generate feedback, and put words on experiences in way that an adult provider may not be able to.

4) Talking about peer situations leads to identifying oneself in peer situations- thus what matters is sometimes brought up by someone other than yourself- or an adult, who may not have a clue.

(Hey! I’m not in high school anymore!)

Click here to see more on what group can do for your daughter. 

10 Reasons why you need The Emotional Extremist’s Guide to Handling Cartoon Elephants book this holiday season

1. The Cartoon Elephant book, after being temporarily unavailable through Amazon, is now back on the market. The retail price is $26.95, but sometimes Amazon will let it go for a bit less.

2. Cartoon Elephants approach painful emotions with humor. If there is an elephant in the room in your family, this book is the starting point for approaching avoided conversations. You will recognize yourself and others in this book. There is no finger pointing or blaming.
 
3. Cartoon Elephants is something you can put on your coffee table. Because it is a graphic book with pictures and fun fonts, it is an easy read. The elephants will fit nicely next to big picture books about Africa and Asia.
 
4. The Cartoon Elephant book is being used to teach people in Dialectical Behavior Therapy skills groups about emotions. Loaded with psycho-educational material and teaching points, it cleverly accomplishes the task of making people think they are reading something fun yet giving them something valuable.
 
5. This book is not hard to read. There is no “plugging away” at chapters. If you want to bring something to someone’s attention in a way that is universally applicable, this book will do the trick. You don’t need to have painful emotions to appreciate elephants- you just need to have emotions.
 
6. If you are going to buy someone a self-help book for Christmas, this is safe bet.
Whether they believe it or not, everyone has cartoon elephants. The research proving this to be true is cited in the back of the book.
 
7. This book can be used and re-used, read and re-read. You can share it with family members, friends, or long lost relatives. It won’t go out of style. Emotions, as a rule, will be with you as long as you live.
 
8. You will get some food for thought about how and where you see yourself in relationship to your elephants. This is great for discussion groups, weekend retreats, and writing workshops.
 
9. This book is great for people of all ages. If you’re trying to get your kid to read something important, heavy, and deep, you can give them this book. It won’t take long to read and it is much more fun with illustrations.
 
10. The book will be the perfect introduction for my live series on emotions starting January 20, 2014. Of course you don’t need the book to sign up, but if you have the book you will have a better appreciation for cartoon elephants in general.

 

 

Starting college? Tips for managing social anxiety in new classroom situations.

Is the newness of college stressing you out? Some people have difficulty adapting to college because they suffer from social anxiety, which includes a fear of being scrutinized, judged, or standing out in the crowd. This can lead to avoidance of classes, diminished social contacts, and a slightly more difficult transition from home to college. Here are some tips for handling social anxiety:

1)   Try to find something to focus your attention on when you go to class. In most instances, people who are socially anxious become pre-occupied with self-consciousness. The focus on being scrutinized or judged increases anxiety and becomes the “problem” in and of itself. Fixing your attention on other things will help reduce anxiety by getting your attention away from all the things that might go wrong. Here are some suggestions:

  • Bring candy with a strong sensory component (mint, cinnamon Altoids, black licorice) and focus all your attention on the taste. This may work even better if you have a strong flavor you don’t particularly like- because it will be harder to ignore.
  • Put a hand on your stomach and- when you breathe- focus on bringing the air down into your diaphragm so that the hand on your stomach gently moves up and down.
  • Try to identify as many sounds as you can- and notice where they are coming from. Gently shift your attention to sounds from within the room and outside of the room. See what sounds you can hear that you wouldn’t normally because you aren’t paying attention.

2)   Keep your facial expression soft and your gaze curious. Often when people are anxious they close themselves off to social interactions. Their expression might read: Don’t talk to me. A tight and stiff posture may be how you are communicating your anxiety- even if you don’t intend it. Try to soften your face and smile gently at people you don’t know. Remember, if you aren’t looking for connections and friendships, it’s harder to make them happen- thus increasing your fear of being among strangers.

3)   Don’t skip classes and make it a point to get to class early. Telling yourself “I will go tomorrow” may be setting yourself up for not going at all. The next morning it will be easier to skip because you will feel behind. When you go early, you have the advantage of not walking in late, knowing where the class is, and gently greeting new people who walk in the door. See if you can make it a point to learn people’s names so you can greet them when you see them. Greeting people make them more likely to connect with you- and when you have friends you are no longer among strangers.

4)   If you’ve missed class already, go back. Define a small goal for yourself (ie, sitting through class) and don’t focus on all the information or material that overwhelms you. Instead, make eye contact, focus on your breathing, and sit quietly. Remember that you can solve problems later if you need to- such as meeting with an advisor or the academic support center if you need to change your schedule or drop a class.