When children encounter psychological problems, is it because of their parents?

Image source丨Weibo @hero image_dame

The picture above has recently caused heated discussions on Weibo.

The child's problem is the parent's problem;

Abnormal parents will cause children to be abnormal;

Parents are sicker;

Parents need treatment

……

There are many similar comments, is that really the case?

The psychological problems of adolescents cannot be simply attributed to parental education

Parents' nagging, accusations, high expectations, strict requirements, and even punishment may indeed have a certain impact on children's mental health.

However, in addition to contact with family members during the growth of children, they also have to face the influence of peers, school, society and other aspects, academic pressure, social pressure, etc. may also affect the child's psychology.

Simply attributing the cause of adolescent psychological problems to parents may make parents think, feel ashamed and guilty, but in fact cannot effectively help families improve parent-child relationships and solve problems.

The hospital mentioned in the popular Weibo recommended that teenage parents also do psychological assessment, not to blame the problem on the parents, criticize the parents, but to comprehensively understand the mental health of adolescents through the assessment.

Why do you need to give your parents a psychological assessment?

It is important for adolescents to visit the doctor for mental illness and assess the psychological state of their parents, which is a manifestation of the results of previous years of scientific research to guide clinical intervention.

First, involving parents in mental health assessments can provide a better understanding of the mental health status of parents.

Many previous studies have shown that genetic factors play an important role in the pathogenesis of psychiatric disorders, with the heritability of severe depression and generalized anxiety being about 40%; The heritability of attention deficit hyperactivity disorder, bipolar disorder and schizophrenia is 60%~90% [1].

Family history assessment is one of the contents of clinical evaluation of mental illness, and whether family members close to adolescents have mental illness can be used as a reference index to evaluate the severity, course and prognosis of adolescent mental illness.

Moreover, in the process of clinical work, it was found that the parents of adolescent patients did not pay much attention to and understand their mental state, and some parents often had symptoms such as mood swings, worry about nervousness, insomnia, etc., but they never paid attention to it, and attributed it to past growth, work or life events, etc., and were affected by adverse psychological states for a long time.

In another more extreme case, the parents of adolescent patients may be accompanied by grandparents or other family members, and there is a reluctance to expose or conceal the family history of mental disorders, which is also not conducive to the treatment and rehabilitation of adolescent patients.

Therefore, as first-degree relatives of adolescents, parents play an important role in assessing the psychological state of parents to assess the condition of adolescents more comprehensively and formulate treatment plans more effectively.

For example, for adolescent patients with a family history of severe mental disorders, especially adolescent patients with a family history of suicide, it is necessary to pay more attention to relevant risks during the treatment process, intervene in a timely manner, and remind guardians to do a good job in risk management and control.

The content of the parent assessment may include the assessment of parents' parenting attitudes, methods, etc., which can understand adolescents

Family environmental conditions.

Understanding the "soil" in which adolescents grow

Environmental factors also play a certain role in the occurrence and development of adolescent mental illness, and the family, as an important place for adolescents to live, learn and grow, plays an important role in the development of adolescent mental health.

As the first and most important guide of the child's life course, parents play an important role in family environmental factors such as family relationships, family structure and family parenting style.

Therefore, assessing the psychological state of parents is also a window for understanding and evaluating the adolescent family environment.

For example, you can find out whether the family structure is a two-parent family/single-parent family or a restructured family, whether it is an one-child family or a multi-child family; You can understand the parents' education level, family economic situation, husband and wife relationship, parent-child relationship, and sibling relationship; Find out if there have been significant events in the family in the past or recently...

Improving the "soil" for adolescent growth

In recent years, family therapy has been very common in adolescent mental illness interventions.

The theory of family therapy [2] proposes to use circular causality to pay attention to the cycle of interaction in interpersonal relationships, which is the product of relationship interaction, and adolescent psychological problems are the product of various relationship cycle interactions in the family environment, rather than the linear causal relationship between simple parental problems leading to adolescent problems.

This circular causal perspective allows us to get a more complete picture of family interactions and how problems are formed, not just attribution.

Starting from assessing the family structure and adjusting family relationships, we should improve the family environment and improve the "soil" for the growth of adolescents. It is not easy for family members to recognize how problems arise in interactive cycles.

In the process of clinical reception of adolescent families, there are usually such characteristics:

Parents believe that high standards and strict requirements are all because children do not manage themselves well, are disobedient, lazy, and rebellious;

Children believe that "bad emotions" are all because parents criticize and accuse, deny, do not understand, blame each other, blame each other for their own problems, and think that they will only be good if the other party becomes better.

Parents believe that the root of the problem lies with the child, bring the child to treatment, and ask for changes in the child;

Children think: the parents' unreasonable demands are abhorrent: "Why don't they change and ask me to change"...

The above linear causal model leads to mutual accusations, the more parents accuse, the more the child rebels, the more he plays with mobile phones, and the less he loves to learn; And the more children play with mobile phones and do not love to learn, the more parents blame and control level escalate.

This cycle, the problem becomes more serious, the relationship becomes more and more deadlocked, these are the results of the cycle of interaction between parents and children. Only by breaking this cycle and re-establishing positive interaction patterns can we solve problems and repair relationships.

Eliminating "stigmatizing" mental illness in the family is an important guarantee for smooth treatment

When mentioning the words "mental illness" and "mental disorder", people often involuntarily think of the pictures of various mental disorders hurting and killing people in the news, and often think that mental patients are dangerous and terrible, which is the stigma of people with mental illness or mental disorders.

Stigma not only burdens people with mental illness with various embarrassing labels, bears all kinds of discrimination and false accusations from the public, but also puts them under more pressure and adds new wounds to their already overwhelmed psyche due to mental illness.

The situation is even more acute when this phenomenon occurs in relatively vulnerable adolescents with mental illness, and family stigma is an important challenge for adolescents.

In a previous study[3], half of the teens surveyed said they had experienced stigma from family members. These teens tend to receive some negative treatment from family members:

If you are not trusted by family members, belittled or rejected by family members, etc., experience a series of negative emotions, such as feeling lonely, depressed, frustrated, etc.;

It may also lead to a deterioration of their relationship with family members, difficulty in obtaining emotional support in the family, becoming more negative, and further decline in self-esteem and self-efficacy. become less reliable in learning and other abilities, less responsible, more dangerous and indifferent to others, etc.;

These behavioral changes affect the interpersonal relationships of sick adolescents and all aspects of their learning and life, and sick adolescents will be more helpless, and are more likely to develop some bad coping methods, such as addiction to mobile phones, the Internet, etc., and the negative emotions accumulated may aggravate their own illness, and even the risk of self-injury and suicide.

Parents have the right to decide whether adolescent patients receive relevant medication and mental health services such as psychological counselling.

If parents have the wrong concept of mental illness, it is likely to delay the recovery of the sick adolescent, or even aggravate the disease, or cause him to face more pressure and produce more serious negative emotions.

The study found [4] that the higher the degree of stigma parents have about mental illness, the more difficult it is to discover that their children have mental illness, resulting in their children not being able to identify and detect problems early, reducing the likelihood of receiving help earlier and reducing the severity of the disease.

Therefore, the mental health of adolescent parents, their understanding of adolescent mental illness, and their participation and cooperation in the treatment of adolescent mental illness play an important role in the development of adolescent mental health and the early identification, early intervention, and treatment and prognosis of adolescent mental illness.

We not only need to give more love and support to adolescents, but also need to give more understanding and support to the parents of adolescent patients, so that they can have more courage and strength on the road to helping adolescent patients recover.

Resources:

[1] Cross-Disorder Group of the Psychiatric Genomics Consortium.Genetic relationship between five psychiatric disorders estimated from genome-wide SNPs.Nat Genet，2013，45（9）：984-994.

[2] Concepts and Methods of Family Therapy (11th Edition), translated by Fang Xiaoyi's Marriage and Family Therapy Research Group, Beijing Normal University Press, October 2018

[3] Moses T． Being treated differently: stigma experiences with family，peers，and school staff among adolescents with mental health disorders［J］． Soc Sci Med，2010，70( 7) : 985-993

[4] Research progress on the effect of stigma on adolescents with mental illness. SUN Zhixin,DU Yasong. J Clin Psychiatry，2022，Vol 32，No.2