Ask Therapist Laura

ASK THERAPIST LAURA
By
Laura Schultz M.A. MFT
May 2010

The following is a new column by licensed Marriage and Family Therapist Laura Schultz. Each month I will be answering your questions and concerns related to your children, family or other relationships. It is my mission to facilitate effective communication skills that open a dialogue about your concerns with loved ones, friends and colleagues. Loving, clear communication is a very effective tool that can slowly repair and rebuild relationships.
Disclaimer for “Ask Therapist Laura” 

Disclaimer: The information contained in this column is not intended to be a substitute for one-on-one psychotherapy with a licensed professional in your area. My purpose is to address general issues that appeal to a wide audience, so not all questions may be answered in this forum. I will protect the confidentiality of all the parties that ask questions. If you are experiencing an emotional crisis or would like to explore your own personal growth in depth, you would be better served by consulting a therapist or mental health center in your area. For more information visit the website www.therapistlocator.net for a list of licensed professionals worldwide.

If you have an issue that you’d like me to address, please send your question in a concise manner. 

Question: My teenage daughter recently told me that she feels she was born in the wrong body and believes she can only be happy if she can surgically become a boy. I have no idea what this means, and if it is a phase she will outgrow later. Is this a common problem or is something seriously wrong with my daughter?

Answer: I realize that this situation is a deeply personal and difficult one for parents as well as for a teen who has these feelings. Often parents blame themselves in these situations and it is important for you to know that there is no blame to be cast here. A person’s discomfort with their gender or the desire to become the opposite sex can create a great deal of distress for them and can greatly affect their ability to function socially and psychologically. Known clinically as Gender Identity Disorder, these feelings can occur in either childhood or early adolescence. For most of us, our physical appearance matches our inner sexual identity, but for others there is a mismatch between a person’s identity and their bodies. Some people who feel this way are satisfied by dressing in clothing that represents the gender they are more comfortable with.  Others will decide that hormone therapy or sexual reassignment is the only way for them to be comfortable.  The best course of action at this point is probably to encourage your daughter to seek counsel with a licensed professional who is trained specifically in gender issues. Treatment by a professional will help her sort out her feelings so that she will become comfortable in deciding the right path for her. It might behoove you also to speak to a professional so that you can come to terms with her situation and learn how best to love and accept your daughter no matter what she decides.

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Question: I am very concerned about one of my sisters who drinks very heavily most of the time. It became so uncomfortable for me during the holidays that I confronted her and told her I thought she was an alcoholic. Of course, she denied having any problem with alcohol. I love her very much and am very concerned that she will hurt herself or someone else. Can you tell me how I might get her to stop drinking?

Answer: First, I applaud your courage to ask this question and to reach out for guidance. I know it is difficult to talk about these very personal issues. As a therapist, I have witnessed first-hand the pain and anguish that family members endure who are dealing with a beloved relative’s drinking. They want desperately for the person to get help and are frustrated and angry with the person - who seems not only unaware that their drinking is a problem but also how it affects the rest of the family. Loved ones often blame themselves, feeling that somehow they are the cause and that they have some power to cure the problem – or, the family may believe that the alcoholic is doing something to them personally and if “they loved me enough and would just listen to me that they would change.” Caught in this cycle of regret or blame families lose hope.
There are many myths surrounding the disease of alcoholism, but the most common one is that people still believe that alcoholics are people who live on the street and have lost everything. However, less than 3% of those who have alcohol problems are living on skid row. Most have jobs, families and are respected members of their community. It is also true that just as many women have drinking issues as men, but women are usually less likely to get help due to the remaining societal stigma attached to being a female alcoholic. There is also the mistaken belief that alcoholism is due to a lack of will power or a moral weakness of some sort. Addiction can be viewed as a chronic illness, like diabetes, and most likely cannot be treated through sheer willpower alone - no matter how strong the desire is to stop using the substance.
The first step in solving a problem is usually to educate oneself about an issue - and alcoholism is no exception. There is a great deal of good literature and many resources in this arena. I would suggest starting with Alcoholics Anonymous, local mental health centers, or the National Council on Alcoholism. Also, a consultation with a family doctor, clergyman, or therapist may be helpful. It is important to see the alcoholic as a person who is also suffering in order to realize that compassion and support can enable the family to become part of the solution. In a pamphlet entitled “Understanding Ourselves and Alcoholism” produced by the Al-Anon Program (a worldwide family 12-step support group founded to help family members and friends of alcoholics) it says that:

Alcoholism is a family disease in which those who care the most are affected the most by
the disease. They are ashamed of the public scenes but in private they try to handle it. All
their thinking is directed at what the alcoholic is doing or not doing and how to get him/her to stop. This is their obsession. While the alcoholic doesn’t seem to be concerned with the bills, the job, or his/her health people around them worry. They make the mistake of covering up, tell little lies to mend damaged relationships and worry some more. This is their anxiety.

And often, family members want to strike back and punish the alcoholic pay for the hurt they have caused.
Now that I have described some of the issues that affect the family, I’d like to give some suggestions to facilitate empowerment in the situation:
1. Usually the best time to approach a loved one about seeking help is when both parties are in a calm period. It may be helpful to tell the person that you are concerned about their drinking and want to be supportive in seeking treatment options. If the person acknowledges they want to stop, one may mention that there are alternatives - but it is probably ineffective to mention specific details or force the issue unless the person asks. Having some literature in a place where they can read it if they decide to explore the possibilities, is one suggestion. Alcoholics Anonymous has wonderful pamphlets for this purpose.
2. An alcoholic has to want help for him/herself - not for someone else; thus, the family may have to wait for him/her to reach what is
called “a bottom” or crisis to make her realize that she can’t stop without help. A person often seeks help when they have to deal with the consequences of their own behavior.
3. A family member can take steps to protect themselves or the children from harmful situations such as not driving with a person who has had too much to drink.
4. Some families, with the help of a professional, join together as a loving unit to conduct what is known as an intervention. This may or may not facilitate the person seeking treatment but at least the group will be united and feel some sense of empowerment.
5. Most importantly, whether the alcoholic family gets help or not, the relatives may benefit from the encouragement and support of people who are going through the same ordeal. Al-Anon is for spouses and significant adults, Alateen for teenagers, Alatot for young children, and ACOA for adult children of alcoholics are all groups that enable people to understand that they are not the cause of the problem, nor can they cure it… but they can take steps to take care of themselves and indirectly help the drinker. Often they feel for the first time that they are not alone. Everything said in these groups is confidential and they have a policy of anonymity.
Becoming aware, education about alcoholism, and reaching out for help are the first steps to growth and recovery for the entire family, including the alcoholic.

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 Question My 6 year old son recently asked me “what the word sex means?” How do I explain this in a way that might make sense to him?

 Answer: The “birds and the bees” discussion with children is often postponed as long as possible by parents which, in my opinion, is not a wise decision. Often times this delay is due to a parent’s discomfort in acknowledging that their child is a sexual being.  Also if an adult is not comfortable in their own skin about sexual topics they are usually uncomfortable discussing sex with anyone let alone their child. It appears that even though we like to think we are “cool” about sex in  most corners of the world today, parents seem to be just as anxious about discussing sex with their children as parents in previous generations were.

 The honest answer is that as a parent of a young child you do not have to wait until you feel comfortable about the subject of sex to approach the subject because you may never feel comfortable. But more issues will arise if you avoid the questions. Children will likely look to others for answers if they are not forthcoming from you and depending upon who they ask, it is quite possible for them to receive grossly inaccurate information. Children at 5 or 6 are becoming very curious about sex. So what’s a parent to do?

 First, it’s okay to acknowledge that you may be anxious but try to proceed gently anyway. What I  mean by proceeding gently is that approaching the subject in small bits over time works very well for several reasons: 1) A 6 year old’s attention span may only be a few minutes on a topic that can also be uncomfortable for him, 2) A parent can’t possibly answer all the questions he might have  in one sitting that will inevitably arise from what seems to be a basic question from him now.  It usually takes several times to thoroughly cover the topic of sex, as with anything else that is new for a child. I suggest you set a time when you won’t be interrupted, answer your son’s questions at her level of understanding, listen carefully to all of his concerns, and in your discussion use the proper names for body parts so that he will have correct information as he  proceeds in her education about sexuality. I would also suggest that you pick up a book called  “Everything You Never Wanted Your Kids to Know About Sex, but Were Afraid They’d Ask” by Dr.Richardson and Dr. Mark Schuster.