Opioids And Substance Abuse: What Can We Do?

Opioids and other substances that alter how we feel, think and act have overtaken our culture, and have been declared a public health epidemic. We are losing our loved ones, friends, co-workers and neighbors to these substances. But we have yet to implement the solutions that will beat back this epidemic, as we have so many others, like HIV/AIDS, polio, smallpox and tobacco.

Substance use and abuse—of opioids, heroin, cannabis, stimulants, alcohol, etc.—is universal and the casualties of drug addiction affect all classes, races and regions of the U.S. These substances are too frequently used as an answer to pain, mental and physical, and have become a cure-all for people who’ve fallen on hard times. That’s why so many people use them and that’s why so many people become addicted.

Substance use disorders commonly co-occur with mental health conditions, especially serious mental illness like schizophrenia, bipolar disorder, depression, eating disorders, PTSD and other forms of trauma. People with mental illnesses often turn to drugs and alcohol to quiet their symptoms, and drugs and alcohol can adversely affect our nervous system and increase risk for mental illness.

The Solution

We are failing with this epidemic because of this country’s dogged attachment to policies and programs that have never worked for addiction. Vast sums of money continue to be wasted on campaigns of drug control and on public messages, especially for youth, that rely on scare tactics. We can and must do better. We can beat this epidemic with three public health approaches.

  1. Prevention. This includes school-based programs that provide youth with decision-making skills and methods of controlling their moods and impulses. One proven program is called the Life Skills Training. Prevention also extends to the family, such as “positive parenting,” or actively modeling and teaching children about positive behaviors. Big Brother/Big Sister programs—where an older youth of the same background takes on a younger, high-risk child—is also highly protective. These prevention programs work, and we have hardly started to apply them.
  1. Screening. Early identification of a problem means early intervention, before the substance use disorder becomes more firmly rooted. We have good screening instruments, (such as the Alcohol, Smoking and Substance Involvement Screening Test), and need to make them standard practice in schools, pediatric and family medicine offices.
  1. Treatment. Families and people affected by addiction should advocate for the strong, comprehensive treatment approach they need. Effective treatment means first detecting the presence of a co-occurring mental (or physical) condition and assuring it’s also treated. Treatment for a substance use disorder should then combine:
  • Cognitive therapy that focuses on reducing the triggers of relapse
  • 12-Step programs like Alcoholics Anonymous and Narcotics Anonymous
  • Family education and support
  • Medications

This public health epidemic that is seizing our country can be beaten. And by following these steps, we save lives, help families and restore communities.


Dr. Sederer is a psychiatrist, public health doctor and medical journalist. His new book is The Addiction Solution: Treating Our Dependence on Opioids and Other Drugs(Scribner, 2018). www.askdrlloyd.com.


You Can Be Prepared For Crises

Each year, there are about 5 million visits to emergency departments due to mental illness. Five million people whose symptoms escalate to the point of crisis. Five million people who don’t understand what’s going on or what to do and rush to the ER.

However, this number doesn’t include the people who experience mental health crises without going to the ER—people who are scared and unsure if their situation is a “true emergency.” This number also doesn’t account for the caregivers and loved ones of those experiencing a mental health crisis, standing beside someone they care for, watching them struggle, unsure of how to help.

Mental illness is unpredictable by nature and crises can, do and will happen. Although these crises can’t always be prevented, it is possible to be prepared.

Learn As Much As You Can

The first step in being prepared is gathering any information, resources and support that is available. Start by fully understanding your loved one’s condition: What are the primary symptoms? How can you tell if symptoms are getting more severe? What can you do to support them? And the list goes on. It can be helpful to go with your loved one to see their mental health professional, so you can ask these questions and any others you may have.

Next, learn more about what a mental health crisis is and what to expect when one occurs. NAMI’s new guide: “Navigating a Mental Health Crisis: A NAMI Resource Guide for Those Experiencing a Mental Health Emergency” is a great resource. This free, downloadable guide offers practical strategies on how to deescalate a crisis, information about available resources, tips for advocating for a person in crisis and a sample crisis plan. Details like these are often critical in supporting your loved one during a crisis.

Make A Crisis Plan

Creating a crisis plan should be a collaboration between your loved one and you. The best time to develop this plan is when things are going well. Take the time to ask them questions that will help build a crisis plan, like: What would be most helpful for you? What would you like to do? Who would you like to call? Waiting to ask these important questions can make it difficult to make decisions during a crisis episode.

A crisis plan should include:

  • Your loved one’s general information (date of birth, social security number, insurance information, etc.)
  • Current medications and dosages
  • Current diagnoses
  • History of suicide attempts, drug use or psychosis
  • Addresses and contact information for nearby crisis centers or emergency rooms
  • Contact information for health care professionals
  • A determined behavior/symptom that would prompt going to the hospital or calling 911

Once you create a plane, share it with family members, mental health professionals or anyone else you think should have it. Make sure to update it whenever there is a change in diagnosis, medication, treatment or provider. A crisis plan can be a life-saving resource, so keep it up-to-date and in a safe place.

Notice Behavior Changes

A person with mental illness will typically experience changes in their behavior before a crisis occurs, such as sleeplessness, mood swings or paranoia. These changes are warning signs and shouldn’t be ignored. “Psychiatric illnesses, for the most part, evolve slowly, so there’s going to be a lot of warning,” says Dr. Daniel Lieberman to U.S. News and World Report.

If you notice warning signs, talk to your loved one and encourage them to visit their treating mental health care professional or doctor. “If somebody has a relationship with an outpatient psychiatrist, that’s the first place to go,” Lieberman says.In many cases, there might be enough time to get in contact with a provider before escalating symptoms become a crisis.

Mental health crises can be frightening for everyone involved. However, being prepared can take away some of the fear and uncertainty around what to do and how to help your loved one. Your preparation and support alone can help deescalate a crisis situation—just knowing you’re there, as a stable force, can be an enormous comfort.

By Laura Greenstein


Why Do We Have The Feeling That We Are Not Enough?

Mike believed he had a good life and felt lucky for all the things he had. He was married to a loving wife, had a good job, owned a nice house and had three healthy kids.

Despite all his good fortune, Mike could not shake the nagging feeling that he wasn’t enough: “I should be more successful. I should make more money. I should be where my boss is. I should have a graduate degree. I should have a bigger house. I should have more friends.” These were some of the “shoulds” that plagued him daily.

“Could I get you curious about this part of you that feels inadequate?” I asked Mike during our first meeting. “Let yourself travel back in time. How old were you when you first felt ‘not enough?’”

He paused to reflect. “It’s definitely been with me a long time,” he said. “Maybe six or eight years old?”

Mike’s father had become extremely successful when Mike was six years old. Because of his father’s new job, his family moved to an exotic country where no one spoke English. Mike was scared and felt like a stranger. Even though he attended an international school, he had no friends for a long time.

His parents pushed him; they meant well and were trying to encourage him. But feeling scared and overwhelmed by the many changes in his life, he misinterpreted their words as disappointment that he wasn’t enough—it was the familiar feeling he still had today.

Showing Self-Compassion

We are not born feeling inadequate. Life experiences and emotions create that sense within us in a variety of ways. For example, when we were little, and we felt afraid or anxious, our mind told us something was wrong with us, not our environment. A child’s mind, not yet rational, concludes, “There must be something wrong with me if I feel so bad.” That’s why children who were abused or neglected grow up to be adults who carry so much shame. They likely spent years telling themselves: “I must be bad if I’m being treated badly.”

As adults, armed with education on emotions and how childhood adversity affects the brain, we can understand that feeling “not enough” is a byproduct of an environment that was insufficient. We are in fact enough! Yet to feel more solid, we must work to transform that “not enough” feeling.

One way to transform old beliefs is to work with them as separate parts of ourselves. With some mental energy, we can externalize ailing parts of us and then relate to them in ways that heal old wounds.

For example, I asked Mike, “Can you imagine that the 6-year-old boy inside you, who feels ‘not enough,’ is sitting on my sofa over there so we can be with him and try to help him?”

With practice, Mike learned to connect, listen and communicate with that part of himself. Offering compassion to the child inside himself helped him feel much better, even though he had struggled with the concept initially.

Since emotions are physical sensations, another way to work with wounded parts is through the body. Mike learned to recognize how “not enough” physically felt. “It’s like an emptiness—like a hole inside. I know I’ve been successful at times, and I believe my family loves me. Emotionally, it doesn’t feel that way at all. Good stuff comes in, but it goes right through me like a bucket with a hole. I’m never filled.”

To help patch the hole in his bucket, I helped Mike develop his capacity to hold onto good feelings by noticing them. “If you recognize and validate your accomplishments, what does that feel like inside?”

“I feel taller,” said Mike.

“Can you stay with the feeling of being taller for just ten seconds?”

Like a form of training, he built his capacity to experience positive feelings. Going slowly, we practiced noticing sensations associated with pride, love, gratitude and joy—getting used to them a little at a time.

What Else Can We Do To Help The Parts Of Us That Feel “Not Enough?”

  • We can remind ourselves again and again that our feelings of “not enough” were learned. It’s not objective fact, even when it feels so instinctually true.
  • We can connect to the part of us that feels bad and offer it compassion, like we would for our child, partner, colleague, friend or pet.
  • We can practice deeply belly breathing, five or six times in a row, to calm our nervous system.
  • We can exercise to get adrenaline flowing and create a sense of empowerment.
  • We can remember this very helpful phrase: “Compare and Despair!” When you catch yourself making comparisons to others, STOP! It only hurts, by fueling feelings and thoughts of “not enough.”

In the long run, we heal the parts of us that feel inadequate by first becoming aware of them. Once aware, we can listen to them and try to fully understand the story of how they came to believe they were “not enough.” Over time, by naming, validating and processing the associated emotions both from the past and present, “not enough” can become enough.

(Patient details are always changed to protect privacy)


Hilary Jacobs Hendel, LCSW, is the author of  It’s Not Always Depression (Random House & Penguin UK)a book which teaches both the general public and psychotherapists about emotions and how to work with them to feel better. She received her BA in biochemistry from Wesleyan University and an MSW from Fordham University. She is a certified psychoanalyst and AEDP psychotherapist and supervisor. She has published articles in The New York Times and professional journals. Hendel was also the Mental Health Consultant on AMC’s Mad Men. She lives in New York City. For more information and free resources for mental health visit: https://www.hilaryjacobshendel.com/

Why Suicide Reporting Guidelines Matter

Many people have a difficult time understanding why the words we use are so important, especially on a topic like suicide. How can certain images or words influence a person’s willingness to take their own life? How can one suicide lead to another? How can conversations, articles, personal stories and media coverage about suicide carry so much influence?

The fact is: how we talk about, write about and report on suicide matters. For someone already considering suicide, it’s possible to change their thoughts into action by exposing them to detailed suicide-related content, including graphic depictions or explanations of the death or revealing the method used. The recent tragedies are an unfortunate example of this. Two days after the media irresponsibly reported on Kate Spade’s death by suicide, Anthony Bourdain used the same method to end his life.

Tragic events like this are why leading experts in suicide prevention, international suicide prevention and public health organizations, schools of journalism, media organizations, key journalists and Internet safety experts all came together to create research-based recommendations on how to safely report on suicide. The suicide prevention guidelines exist for a reason—to save lives.

Suicide Contagion Is Real

According to the Recommendations for Reporting on Suicide: “More than 50 research studies worldwide have found that certain types of news coverage can increase the likelihood of suicide in vulnerable individuals.” This phenomenon is referred to as suicide contagion and “the magnitude of the increase is related to the amount, duration and prominence of coverage.”

A key phrase here is “vulnerable individuals.” The people affected by suicide contagion are likely already thinking about suicide. They may be experiencing a mental illness or substance use disorder and be switching medications and be in a fight with their spouse or parent and be struggling to make ends’ meet and then they’re prompted to end their life because of what they saw on social media while scrolling through their news feed. In other words, suicide is usually the result of a multitude of factors—and the media’s irresponsible reporting can be one of them.

“The outpouring of collective grief, the tendency to present or discuss the person in almost beatific ways and physical memorials or ceremonies celebrating their lives are common practice,” says psychologist Paul Surgenor, suicide prevention expert. “And unfortunately, for someone who can only see pain, isolation and rejection, this level of adoration may seem preferable to their current state.”

Seeing sensationalized headlines and reporting about a celebrity who ended their life can make a person who’s already struggling believe that they can do it, too. That “it’s okay.” That “it’s easy.” And not only that but learning the method of how a person died by suicide shows how to do it—what “works.”

When Robin Williams’ died by suicide in 2014, suicides using the same method increased by 32% in the months following his death. That’s not a coincidence. It’s also not a coincidence that suicide contagion is also known as “copycat suicide.”

How To Talk About Suicide

The main message of any article, video or TV show about suicide should be to encourage people to get help when they need it and where to look for that help by including local and national hotline numbers or other crisis resources. Here are some other important recommendations to follow.

Inform, Don’t Sensationalize

  • Don’t include suicide in the headline. For example, “Kate Spade Dead at 55.”
  • Don’t use images of the location or method of death, grieving loved ones, memorials or funerals; instead use school, work or family photos.
  • If there was a note from the deceased, do not detail what the note contained or refer to it as a “suicide note.”

Choose Your Words Carefully

  • When describing research or studies on suicide, use words like “increase” or “rise” rather than “epidemic” or “skyrocketing.”
  • Do not refer to suicide as “successful,” “unsuccessful” or a “failed attempt.” Do not use the term “committed suicide.” Instead use “died by suicide,” “completed suicide,” “killed him/herself,” or “ended his/her life.”
  • Do not describe a suicide as “inexplicable” or “without warning.”

Report on Suicide as a Public Health Issue

  • Include the warning signs of suicide and a “what to do” sidebar, if possible.
  • Do not report on suicide the same way you would report a crime.
  • Seek advice from suicide prevention experts rather than quoting/interviewing police or first responders.

Suicide is not a subject that should be avoided, but rather, handled carefully and thoughtfully—the way the suicide guidelines have clearly outlined. For those who believe the recommendations were created to prevent offensive language or spare people’s feelings, please keep in mind that their purpose is so much more than that. This is not a matter of being “politically correct.” It’s a matter of saving lives.


If you are thinking about suicide, please call the National Suicide Prevention Lifeline at 800-273-TALK (8255).


Laura Greenstein is communications manager at NAMI.


6 Homeless LGBTQ Youths Share Their Stories

When photographer Letizia Mariotti began meeting homeless LGBTQ youth in New York City, she felt a duty to help spread their stories.

She began photographing the queer youth she encountered at LGBTQ gathering places and interviewing them about their experiences. All of the subjects of her photos live, or at one point have lived, at the Ali Forney Center, which serves LGBTQ youths in New York. The majority of them have faced rejection from their families because of their sexual orientation or gender identity.

“I want parents of LGBTQ kids to understand the tragic scope of this problem and the profound influence family acceptance plays in the lives of the LGBTQ youth,” Mariotti told HuffPost. “I want them to understand that an indecently high percentage of the LGBTQ youth suffer emotional abuse and violence first from their parents, relatives, and the communities they live in.”

With 40 percent of homeless youth identifying as LGBTQ, Mariotti hopes her project can help others see these individuals clearly and compassionately.

“People need to be less judgmental and more accepting,” she said. “People need to stop seeing the world in stereotypes, stop trying to define what ‘normal’ looks like.”

Check out photos and excerpts from interviews with the young people featured in Mariotti’s project below.

  • Alexander, 24 (Man With Trans Experience)
    “I started transitioning at 18. In Florida, at the time, trans-identified people were not really protected. I was diagn
    Letizia Mariotti

    “I started transitioning at 18. In Florida, at the time, trans-identified people were not really protected. I was diagnosed with schizoaffective disorder and also gender identity disorder. Nowadays they categorize it as gender identity dysphoria. It’s a big difference.

    “My mom was not accepting of me. But me liking someone of the same sex or gender was not the biggest issue. The problem was more me representing very masculine. She said to me once, ‘If you are going to like girls, then why don’t you look like one?’ She couldn’t understand. She was abusive both verbally and physically. After a while, it got to a point where it was too much. I couldn’t be myself. So I left.

    “My time as a homeless was hard. I didn’t know if I was going to make it. Many times I thought my mental health was not going to allow me to get out of this situation. What kept me going is the knowledge that I had goals. I really wanted to get out of the shelter system.

    “For a lot of people, what is missing is the hope. And hope is necessary to get out of these situations.”

  • Cyrus, 18 (Trans Male)
    “I didn't even know what being gay or being trans meant until I was about 15 years old because it was a bad thing to kn
    Letizia Mariotti

    “I didn’t even know what being gay or being trans meant until I was about 15 years old because it was a bad thing to know in my family. Even though I knew my whole life that I was attracted to women, I didn’t know there was a label and I didn’t know it was normal.

    “Before I came out as trans, I was identifying as a lesbian. And when my parents found out, it didn’t go well at all for me. They deleted all my social media accounts and they wouldn’t let me leave the house alone. I was not allowed to see my friends anymore. So, after a while, I got so angry that I got into a huge argument with my mom. We got a little bit physical and my dad decided to send me into a psychiatric hospital. In total, I went to five of them.

    “Because I wanted to further my transition, get surgery and start hormones, I knew I couldn’t stay at home. My dad doesn’t want me confusing my younger siblings or our family members. So I had to go.”

  • Frankie, 19 (Non-Binary Trans)
    “My parents tried to ignore what they called ‘my lifestyle’ and pretended that it would go away. Growi
    Letizia Mariotti

    “My parents tried to ignore what they called ‘my lifestyle’ and pretended that it would go away. Growing up, I started to be more unapologetic with who I am. I wasn’t hiding. So the tension at home just kept rising until one day my mom just exploded on me. She told me to leave and not come back.

    “Being homeless is very scary. You have no security and you can only keep what you can hold in a bag or a suitcase. Money is also a problem. I did sex work for a few months. It was dangerous. I had a lot of encounters that were very bad, but I made money from it and I was able to buy food.

    “Now I am lucky I don’t have to do it because I have a stable housing and a job.”

  • Eli, 17 (Gender Non-Conforming)
    &ldquo;I grew up in an Orthodox family. So when I was discovering my identity, I had to keep a lot of things secret. ...<br><
    Letizia Mariotti

    “I grew up in an Orthodox family. So when I was discovering my identity, I had to keep a lot of things secret. …

    “During my last year of high school, I came out to my parents. They weren’t supportive of it. They thought it was a phase that would go away or something that I should religiously keep under wraps and not act on it. Most of the times, they pulled the insanity card, saying things like I am not thinking clearly or people that I am around changed my point of view. …

    “This has been really hard for me mentally. I was sent to a religious school in Israel. But I got kicked out after just two days because of my gender identity. I told one of the social workers there, because I didn’t want to keep it secret anymore.

    “I booked a plane ticket and instead of going back home, I came here to New York City. I guess you could just say I ran away.”

  • Rose, 19 (Trans Woman)
    &ldquo;I realized from a very young age about my trans identity because I was surrounded by a lot of things in my childhood t
    Letizia Mariotti

    “I realized from a very young age about my trans identity because I was surrounded by a lot of things in my childhood that forced me to mature early. I think that is why I began transitioning so young at age 13. After my parents’ death, I socially came out.

    “When I started transitioning, I was mostly on my own because I didn’t have anyone to talk to. So it took me a while to figure things out. I knew about hormones and I wanted to go on them, but I couldn’t see a doctor. At 14, I managed to get black market hormones. But since I wasn’t able to get a steady supply, it didn’t last long.

    “Only at 17, I was able to really start and stay on hormones. For a while, my cousin took care of me, but she didn’t know how to help me and she didn’t have any understanding for me being trans. That made things tense and difficult between us. So last summer, I came to the Ali Forney Center to try to get myself together.

    “To get money, I was doing sex work. I did it on and off because I have a lot of social anxiety in general, so trying to find clients to have sex with for money was difficult for me. I would get a lot of money for it … but then I wouldn’t see anyone for weeks after that. And when I was really broke, I just went back on doing it. Sex work is very prevalent in the trans community.”

  • Je’jae, 24 (Non-Binary)
    &ldquo;At 18, I was sent to Israel on some heritage trip like a lot of young Jewish people do. The religious community where
    Letizia Mariotti

    “At 18, I was sent to Israel on some heritage trip like a lot of young Jewish people do. The religious community where I lived forced me into it. It was also a period where I was really struggling with my sexuality. And within an environment that was telling me that I should feel ashamed, I started feeling really suicidal.

    “I went through two years of shaming from our rabbi ‘therapist’ in Israel. It’s what they call ‘conversion therapy.’ In other words, it’s only physical and emotional abuse. I felt scared and trapped. It took me nearly two years to have the courage to leave that place and to tell my ‘therapist’ that I didn’t want to hide anymore. … This man, who was supposed to be my mentor, shamed me. He said that I would grow up being alone, that I was a sick and an unnatural person.

    “When I came back from Israel, as I was more open about my gender identity, my mom really started to have greater problems with me and she became even more emotionally abusive. And a year and a half ago, she locked the door on me.

    “That’s when I became homeless for three months.”

    #TheFutureIsQueer is HuffPost’s monthlong celebration of queerness, not just as an identity but as action in the world. Find all of our Pride Month coverage here.

A Therapist’s Journey: Learning The Art Of Self-Soothing

One day, I was standing on the back of my pickup truck and throwing away trash at the town dump when I had an experience that’s hard to describe. My head was swimming, my body felt electrified and I felt detached from the world and myself. A memory then trickled in: I was nine years old, being hit repeatedly by my father one evening because he thought I had lost a 25-cent screwdriver. I remember being scared that he was going to kill me. I remember going numb.

Thirty years later, there I stood, scared and numb again—wondering how or what to do to get out of this state, wondering if I would ever “come back.” I was by myself that day, and not only was nobody home, but I had no one to call. None of my friends had the kind of inclination toward giving me the help I needed, and I also wasn’t in therapy at the time. I was stuck—in more ways than one.

It would take me quite a while before I learned how to soothe myself when I wasn’t doing so well. And I’m still not always the best at it. The old phrase of “physician, heal thyself” rings true for me. Being a therapist, I sometimes think, “Jeez, if my clients knew how difficult it is for me to calm myself down sometimes, I’m not sure they’d keep coming to me.”

Working Through Challenging Symptoms

Therapist or not, learning to self-soothe is hard, but it’s something we all should learn how to do—especially if we have mental health conditions or traumatic pasts. Over the years, I’ve mostly grown past, but I’ve never forgotten, the harshness of my father. That doesn’t mean all my insecurities have gone away, and I don’t expect they ever will; it just means that I’ve concentrated on working toward being independent enough from my experiences. That way, I don’t get so wrapped up in my symptoms of depression and anxiety, and in the fears I still carry around.

Instead of being ruled by these symptoms like I have in the past, I have “worked” psychologically, spiritually and practically to learn and practice the art of self-soothing. I remember when I first started practicing, I latched on to one technique, thinking it would be the answer: breath. I would sit quietly, usually in the morning, and I would breathe in and out, paying attention to the noise of my breath passing through my nostrils. When I became aware of my mind wandering, I would try to refocus. I found this exercise helpful—for a little while.

The sense of peace and calm I once got during the exercise vanished one day, so, I started looking for other ways to self-soothe. This became my pattern. I try a self-soothing exercise, and it either helps me or it doesn’t, then after a stretch of time, I move on to something else.

Over the years, I’ve tried numerous self-soothing techniques. For about a year-and-a-half, I did daily meditations from A Course in Miracles, and once it became too spiritual for me, I stopped. I rode my bicycle for a couple of years. I took up “intentional walking” (a kind of meditation in movement). I tried yoga. I attended spiritual retreats. Jogging was more work than soothing. Walking did not work when I was in my 40s, but was effective in my 50s. Sitting quietly with my legs crossed in meditation was more painful than anything. Qi Gong was not helpful. Tai Chi did not work.

Now, in addition to swimming at the YMCA a few times a week, I meditate while stretching for about 30 minutes in the morning. I also read, at times, from spiritual, poetry or philosophy books, and when I get an “ah-ha” moment, I stop and repeat that saying or sentence or concept throughout the day. I also like to go to the movies and “lose myself” in what’s happening on the screen.

Getting Started

I think one of the most important aspects of self-soothing I’ve discovered is that not every technique works for everyone and it’s unlikely that one technique will be the only technique you ever use. I know that I will likely continue using different techniques, probably for the rest of my life. My initial belief that I would find “one answer” to my anxiety, obsessions and fears was a myth.

I see that a lot in my practice, as well. People want one solution to feel better: one medication, one single action to solve all their problems. The fact is, that’s not how life works. We have to try all kinds of solutions; some will work, some won’t, and some might for a period of time and then stop. Some might not work now, but might later.

That’s a difficult concept to get across to clients and even to myself. I want to feel better right now and forever. But that’s unrealistic. That’s why part of therapy is helping people be realistic in their expectations and to realize that growth, becoming more peaceful and calm as well as happier, is a process that evolves over time. Self-soothing is one of those things as well: It evolves over time. If you’re going to take on learning the art of self-soothing, I have a few pieces of advice.

Realize The Value

Too many of my clients hesitate to take time away from our sessions to practice self-soothing. They have convinced themselves there is little value in learning how to calm themselves when actually, self-soothing can help the recovery process immensely. When you are upset or stressed, it is important to know positive ways to cope on your own—that’s a skill important for our individual growth no matter who we are. Finding ways to self-soothe can help you feel at ease when you are dealing with frustration, excitement or having intense emotions. It can also reduce the amount of worry and fear we carry around with us.

Use Simple, Everyday Experiences

You don’t need to be a guru on the mountaintop raking sand to self-soothe “the right way.” A friend once told me she meditates when she irons. Try to think of something simple you do that you can focus on to relax and find some peace of mind, even if just for a short time.

Adopt A Calming Word Or Phrase

Finding words or phrases that help shift you to a calmer state is like having the right tools for a job. You can find these words, phrases or concepts by reading books or articles or daily meditations, by listening to podcasts or videos, or by making them up yourself. When you find something that makes you feel at ease, stop reading or listening and repeat it a few times to commit it to memory. Repeat the word or phrase periodically throughout the day during stressful and non-stressful times; it will likely bring you a sense of calm.

Practice Makes Perfect

Self-soothing is like any other exercise. The more we do it, the better we get at it. You don’t practice running for a marathon by only running the marathon. You practice by jogging shorter distances and building up stamina. When we practice self-soothing techniques even when we don’t “need” them, we are building a skill and more of an automatic response for when we do need them.

Therapy Can Help

I have used therapists in the past as coaches, supports and idea-generators. My therapists have given me great insight into the kinds of situations that trigger me, and helped me learn how to manage those triggers. Learning to manage my triggers reduces the need to self-soothe in the first place.

As you begin this adventure, remember to be patient. Self-soothing is a skill that develops over time. I’m still learning. But through my learning, self-soothing has helped me be calmer in my day-to-day interactions with people, and I’ve found that I’m more prepared for experiences like the one I had in the back of that pick-up truck.

Learn how to soothe yourself. It could make a difference in your life. I know it did for me.


Larry Shushansky has helped thousands of individuals, couples and families over 35 years as a counselor and public speaker. He has developed the concept of Independent Enough and shares this when giving talks to businesses, nonprofit organizations and educational institutions. Learn more about him at www.independentenough.com.


Is It A Mental Health Problem? Or Just Puberty?

We’re seeing epidemic levels of stress in children and teenagers, with increasing rates of clinical depression, anxiety and other coping problems. Fear, uncertainty and lack of control—factors that power stress—are ramped up in times of rapid, unpredictable change. And puberty is a time of massive change: hormonal, physical, sexual, social, cognitive and neurological.

Puberty brings a level of volatility in attitudes, behavior, responsibility and moods that can look and feel like mental illness. Most parents experience at least some moments of concern for their children’s mental health during the puberty ages of 11 to 14. But, should you? Or is your child experiencing a normal transition into adulthood?

It isn’t always easy to distinguish between the typical moodiness of puberty and mental health conditions that require professional attention. If you’re wondering about your child’s behaviors, here are some questions to ask yourself. They provide a good starting point for understanding how serious the problems might be, and whether you should seek professional help:

  • Does your child have at least one good friend? Although most young teens prefer popularity, one close friend is enough to get through puberty with resilience. If your child has no friends, that’s often a sign of isolation, and a strong reason to consider professional help.
  • Does your child have at least one adult they can talk to? This might be a parent, another relative, a teacher, or someone else—someone who can provide wisdom and support.
  • Does your child have at least one activity that engages them? One productive area of interest can sustain a young person through tough times. It might be a sport, the arts, a school subject, gardening, anything that involves thinking, learning and developing competence.
  • Is your child ever happy? It’s normal for pre-teens and early-teens to express more irritability, annoyance and anger (especially with their parents). But if your child never seems happy or contented, that is cause for concern.
  • Is your child engaging in self-harm? This includes alcohol, drugs and other toxic substances; cutting; sexual promiscuity; and self-sabotage like skipping school. It’s normal for a child to be curious about these things, but it’s time to seek help if you think your child’s well-being is threatened by dependence on any of these activities.

If your child does have an effective network of social support—including at least one friend and one adult they can talk to—is happily engaged in one or more productive activity and is not engaging in self-harming activities, you’re likely dealing with “normal” puberty. However, that doesn’t mean your child doesn’t need your help.

How To Support Resilience In Your Early Adolescent

There has been considerable research done showing that parents can make a difference in their children’s ability to handle stress, thereby minimizing the likelihood of mental health difficulties. Here are some ideas for supporting resilience in your child, whether or not they’re experiencing a mental health condition:


Being available when your children need you can make the difference between a good decision and a dangerous one. Be fully present when your teen wants to talk and be fully positive. Tweens are painfully aware of others’ perceptions and believe that everyone is looking at them with critical or even mocking eyes. Make sure your teen feels your positive gaze. No criticism, no judgement, no distractions.

Strive For Balance

We all need balance in our lives, but that’s especially true for early adolescents. Make sure your young teenager has opportunities for quiet reflection, ample sleep, regular outdoor exercise and good nutrition. Practice breathing techniques, and other mindfulness skills. You’ll be better at managing your own stress, and you’ll provide your teenager with a good model of coping with their ups-and-downs.

Welcome Conflict

Respect your child’s need to create their own unique blend of mainstream values with your family’s values. If you’re an immigrant, single parent, member of a cultural or religious minority or in a same-sex relationship, your child may feel a conflict between their home values and their peers’ values. A friendly debate is a great way for your teenager to discover what you care about, and why it’s worth caring about. You’re likely doing a good job of parenting if you and your teenager can argue, but there’s still love and warmth in your home.

Own The Parenting Space

Tweens and teens can appear to take pleasure from pushing your buttons. But on a deeper level, they need you to stay strong and calm. Just like a toddler who challenges the rules, teens feel safest when they know they can trust you to be solid no matter what grief they give you. That applies whether or not your child is dealing with a diagnosed mental health condition.

The years from 11 to 14 can be highly stressful for children as well as their parents. Unfortunately, there isn’t an easy or simple template for parents to determine whether or not their child has a diagnosable problem—that’s something only a mental health professional can do. You can, however, support your child’s resilience, and help them get through adolescence as smoothly as possible.



Dona Matthews, PhD, has been working with children, adolescents, families, and schools since 1990. In addition to running a busy private practice, she was the Executive Director of the Millennium Dialogue on Early Child Development at the University of Toronto, and the founding Director of the Hunter College Center for Gifted Studies and Education, City University of New York. She writes a regular column for PsychologyToday.com, has published dozens of articles and book chapters, and is the co-author of these books: Beyond Intelligence: Secrets of Raising Happily Productive Kids; Being Smart about Gifted Education; The Development of Giftedness and Talent across the Life Span; and The Routledge International Companion to Gifted Education.