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Teenager...angst Vs. Mental Health Issue

Question:

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p>We have a 16 year old son. He does well in school and sports. He isn’t violent or abusive. Our concerns are as follows:

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p>1) He seems to have no social skills. He always seemed uncomfortable–even resentful–when his friends came over (at age 4-

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p>5). Since kindergarten, he has never once invited anyone over. He has been invited to friends’ homes, and goes, but this doesn’t happen often. He can name friends if asked to, but there is no socializing with anyone outside of sports.

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p>2) He speaks mostly in grunts. He CAN talk, and make eye contact, if someone else initiates it. Teachers have never mentioned this as a problem. From a distance we’ve seen him conversing with teammates and coaches. People do comment on how quiet he is.

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p>3) When he was about 11 I was reading an article about a soccer player with OCD. I showed him the article, thinking he would be interested in the sports aspect–he told me he thought he had the same problem. And, it’s true, he has these weird quirky things that he must do every day. Some have gone away, some have remained. Websites seem to suggest if it doesn’t interfere with everyday life to just wait-and-see. He used to keep his room spotless..now it’s as bad as his sisters’! I don’t know if I should be happy or not about that!

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p>4) A sister-in-law recently commented that it wasn’t normal for a 16 year old to sit so close to his mother. I couldn’t remember what she was referring to, but I think he sat down by me on the couch in front of her and had me scratch his head. He likes it when I do that. Should I not do that? I didn’t think it was so weird. However, I was one of four girls and I have 5 daughters and only 1 son. I don’t know what is normal for boys or not normal!!!

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p>He is more standoffish from his dad now, although they get along fine. I have noticed that he will stand by me, ask me to pass food to him at the table (even if the food is right by his dad instead), and generally seems more comfortable with me than with his dad. He and his dad have always enjoyed a close relationship in the past, so this saddens me. Is it normal for boys to start pushing their dads away?

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p>5) Finally, there is definitely a history of depression in our family. Two of his sisters have been diagnosed with depression. He has not exhibited any of the same problems they had shown.

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p>I don’t know if he’s just being a normal teen or if there is something we should address! Any input would be appreciated. Thank you

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Answer:

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p>It does appear that your son may have some problems. I would suggest that you drop the word “normal” or “abnormal” since these words have no meaning. Rather, to what degree are your son’s behaviors adaptive? In other words, is he functioning to his fullest capacity or is something interfering with that functioning?

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p>In several ways, this young man is demonstrating healthy and adaptive behaviors for his age. He is involved in sports, does talk to people in school, particularly those involved with him in sports and he gets good grades. The fact that he “grunts” is not so unusual. I hear this complaint from many parents of teenagers. They report that their teenagers provide them with grunts when asked questions at home. Yet, at school and among friends they are fully capable of speaking normal English.

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p>However, in other ways you describe the fact that your son has never really socialized or brought friends home from his earliest childhood. If you read the essay on the web site called “Shame and the Avoidant Personality” you may get some idea of what I believe your son may be struggling with. It is possible that he experiences some type of social phobia or has an avoidant personality disorder. They are closely related to one another and can include feelings of depression. It is not unusual for a person to be extremely intelligent, high achieving, athletic and, yet, socially fearful and wanting to stay at home and avoid interaction with others. The fact that your son may have some obsessive and compulsive symptoms only supports the notion that he experiences a high level of anxiety.

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p>Another and closely related possibility is that your son is very shy. People who are socially shy often get labelled as “quiet.” Whether shy or socially avoidant, he can overcome these issues with psychotherapy. More will be said about this at the end of this letter.

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p>I want to stress the fact that you and the family stop inspecting every piece of this adolescent’s behavior in search of something pathological about him. The fact that he sat near you, his mother, and asked that you scratch his head means only that he is very fond of you. What is wrong with that?

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p>In addition, it is not unusual for a male adolescent to become from his father. As Mark Twain is reported to have said, “When I was sixteen I was embarrassed about how much my father got wrong. By the time I was twenty five years old I was impressed by how much he had learned.” This has been true throughout the ages and is sometimes referred to as “the generation gap.”

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p>I would suggest that, if your son is motivated to do so, that he be seen by a Clinical Psychologist and be evaluated. Based on that evaluation, he might start a course of cognitive behavioral therapy and behavior modification to help him work at building his social skills and reducing his anxiety. If the evaluation shows that there is some other disorder at work, then he can be treated for that.

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