Adolescent Awkwardness

Anna is a 13-year-old girl. She started grade 8 at the beginning of the year at a new school. Anna was a sickly child who required several long-term admissions to hospital, but she seems to have outgrown a lot of her early medical problems now. She used to be a bubbly, happy- go-lucky girl who was open about her feelings. She enjoyed spending time with her friends and family alike. She also loved dancing and singing. Anna generally is a high achiever in the academic context.

Recently, Anna seems to have become very quiet and withdrawn. She rarely spends time with family, preferring to isolate herself. She spends long periods of time alone in her bedroom. She no longer communicates openly with her parents and seems to be apathetic and irritable a lot of the time. She insists on wearing long-sleeved garments all of the time and when asked why, she becomes angry and defiant. Two weeks ago, Anna fainted at school. Her parents were called and they took her to an emergency department so that she could be medically assessed. During her physical examination the doctor noticed several healed scars on her arms and thighs as well as some newer fresh wounds. Anna tearfully admitted that she had inflicted these injuries on herself.

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Anna’s parents feel horrified, confused and guilty. What made their beautiful daughter do this to herself? Was it something they had done wrong? Were they to blame for not being more observant? Perhaps they hadn’t told her enough how much they loved and cared for her. They have no idea what to do next. The doctor in the emergency room has suggested a psychiatric assessment but even this makes them feel bewildered and afraid… they really don’t want Anna to get a label for being “crazy.”

Many people who suffer emotional and/ or physical trauma as children can develop “maladaptive” coping mechanisms in their daily activities. These kinds of trauma may not always be obvious, but may result from birth trauma, attachment difficulties, prolonged separations from caregivers and an array of physically or emotionally challenging situations during which the children involved perceive the environment as threatening and unsafe. Children who feel under threat react in an instinctual manner which is geared towards survival. This activates the flight/ fight response in the child’s brain and body.

In the absence of supportive or corrective experiences to the contrary, flight/ fight mode becomes the default setting for these children in response to every challenge that they face. Even seemingly small or insignificant triggers can provoke a massive surge of adrenalin in someone with these default coping mechanisms, which can make them appear irritable, moody, unstable or apathetic. A lack of awareness surrounding the underlying problems often results in people with these coping mechanisms feeling misunderstood and hurting themselves in order to try and deal with the mental anguish they feel. They frequently do harm to themselves by inflicting injuries, taking drugs or using food to try and gain control of the situation. The most common diagnosis given in these situations is one of Borderline Personality Disorder, but a multitude of anxiety disorders and impulsive behaviours can also result from circumstances such as the ones described above.

People who have Anxiety Disorders, Borderline Personality Disorder and many other similar disorders are often extremely sensitive, kind and caring people, who are able to understand others very well. They can do well in caring roles and in acting or entertainment.

Some famous people who have experienced these kinds of difficulties include: Princess Diana; Angelina Jolie; Marylin Monroe and Pete Doherty. With the appropriate care and management people with such difficulties can be incredible.

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