PI Brief Update

Working with Emotional Teenagers

12/01/24. Dr. Mark Burgin BM BCh (oxon) MRCGP identifies the three main causes of emotional distress in teenagers and explains how generalists approach psychological work.

The transition from childhood to adulthood is characterised by the changes in the way that their brains work due to neurodevelopment and hormonal effects.

Although many neural pathways are present in children their function changes during puberty causing a dramatic increase in thoughts about sex and disgust.

Talking with teenagers is difficult because the embarrassment causes distress even when the generalist uses an open and straightforward approach.

A more effective strategy is to talk about the teenager’s emotional responses without reference to the subject matter so that they feel safe in having a discussion.

Icky

Whilst teenagers may struggle to explain why they find a subject disgusting they can readily identify when it is ‘icky’ and emotionally unsafe.

Discussing why something that is icky leads to strong emotional responses and why these feelings can be seductive and difficult to resist reduces the associated guilt.

A teenager who has succumbed to the dark side may feel that their identity is defined by that choice rather than having experimented they can now reject that choice.

By assuming that everyone makes mistakes helps the teenager normalise their own feelings and recognise that they can say no to things that they do not like.

Morality

Many teenagers develop a strong belief system and become involved in actions which can put them against society, their family or their peers.

Their beliefs are typically at the extremes whether considering human rights, protecting their family or immigration policies.

Whatever the generalist’s own point of view attempting to challenge the teenager’s belief system is less useful than showing them how to think ethically.

It is important that you know what you believe but you cannot force everyone to believe the same and understanding why people hold damaging beliefs is the first step to changing them.

Bullying

Learning to manage bullies is more difficult in a school environment where criminal behaviour is often tolerated leading to victims resorting to extreme responses.

Carrying knives and other weapons, joining gangs who provide protection and causing problems at school so that they can be excluded from the school are common approaches.

The generalist often finds that the teenager has already taken reasonable steps to approach the school and has fully explored the other alternatives that they can take.

Understanding bullying is best achieved by referring to the legal system - some bullying must be tolerated as everyday life, some is criminal and other bullying is tortious.

Conclusions

Teenagers find it difficult to talk with anyone about their problems so a generalist should use strategies that avoid requiring disclosure of the details of their problems.

Looking at the emotions that underlie their problems can reduce the guilt associated with making an icky mistake and empower them to make better choices.

Teenagers often hold strong views which should not be attacked but instead developed and made more complex and richer by introducing simple ethical concepts.

Teenagers need to understand that bullying remains an intractable problem in many institutions as well as schools and society is still struggling to find solutions.

Doctor Mark Burgin, BM BCh (oxon) MRCGP is on the General Practitioner Specialist Register.

Dr. Burgin can be contacted on This email address is being protected from spambots. You need JavaScript enabled to view it. and 0845 331 3304 website drmarkburgin.co.uk

Image ©iStockphoto.com/Drazen Zigic

This is part of a series of articles by Dr. Mark Burgin. The opinions expressed in this article are the author's own, not those of Law Brief Publishing Ltd, and are not necessarily commensurate with general legal or medico-legal expert consensus of opinion and/or literature. Any medical content is not exhaustive but at a level for the non-medical reader to understand.