The Edge FHC: Sport Psychology

No one looks the way I do. I have noticed that it's true. No one walks the way I walk. No one talks the way I talk. No one plays the way I play. No one says the things I say. I am special. I am me. Gen Y - people born between 1978 and 1997 - grew up singing that nursery song. Today many parents and psychologists wonder if songs like that were not big mistakes. In the 1980s world of child rearing, the catchword was "self-esteem." Unconditional love and being valued "just because you're you!" was the prevailing philosophy. In practice, it involved constantly praising children, not criticizing them under any circumstances, emphasizing feelings, and not recognizing one child's achievements as superior to another's. At the end of a season, every player "won" a trophy. Instead of just one "student of the month," schools named dozens. Teachers inflated grades from kindergarten through college: "C" became the new "F." No one ever had to repeat a grade because staying behind caused poor self-esteem. The result of these child-rearing practices has been a measurable increase in narcissism and a generation that has a deeply embedded sense of entitlement, according to authorities like Dr. Jean Twenge, author of Generation Me: Why Today's Young Americans are More Confident, Assertive, Entitled and More Miserable Than Ever. Dr. Twenge of San Diego State University studied more than 16,400 students who took the Narcissistic Personality Inventory between 1982 and 2006. In 1982, only a third of the students scored above average on the test. Today that number is over 65%. The new trend toward self-centeredness and self-love might be bad for society. Dr. Twenge warns that narcissists lack empathy, overreact to criticism, and favor themselves over others. They are incapable of cheering anyone else's success. Ultimately, they led miserable lives because they cannot form and maintain healthy relationships. According to a report in the Wall Street Journal, corporations like Lands End and Bank of America are hiring "praise teams" to keep up with Gen Y's demand for constant positive reinforcement. Other generations believed that as long as no one fired them, their work must be okay. Gen Y needs constant praise in the form of emails, awards, celebration balloons and other such tangible recognition of their work or they become anxious. The constant stream of praise has resulted in what psychologist Dr. Linda Sapadin calls "a runaway inflation of speech." No girl is pretty: she's drop dead gorgeous. That guy is a genius (not merely bright). Dr. Sapadin says the word "nice" is a put-down. Gen Y's need for affirmations often accompanies an intense sense of entitlement. A therapist with the Aspen Education Group describes it as "I want it now! Now! I have to have it right now!" A Gen Y with a sense of entitlement will also refuse to take responsibility when he makes a mistake. For example, if he gets a speeding ticket, he expects his parents to pay for the ticket and increased insurance premiums and to keep on driving as if nothing happened. Refusing to stand up to the demands of Gen Y is causing financial problems for many parents. Ian Pierpoint, an executive with market research company Synovate, coined the phrase "gold-collar kids," who insist on expensive brand names like Versace or Dolce and Gabbana. The problem is that many gold-collar kids have blue-collar parents who go into credit card debt to meet their children's demands (many of whom still live at home well into their twenties). Because Gen Y parents have always treated their children as friends and equals, by the teen years they have learned to use bad behaviors to get what they want. As Dr. Susan Jennings says, "If the kid gets what she wants, she's all sweetness." If not, she'll tantrum, sulk, and otherwise torture her parents until she gets her way. Therapists who work with troubled teens often talk about their sense of entitlement as a major hurdle in the struggle to help them. Teens feel entitled to their life-styles, no matter how self-destructive. If a parent reared her child with the attitude "I don't want to interrupt his happiness for even one moment," the teen will have a hard time establishing the discipline and willpower necessary to work through addictions and behaviors such as alcoholism, substance abuse, promiscuous sex, mismanagement of anger, compulsive shopping, and so forth. The advice from experts is for parents to "toughen up" by following some general guidelines:

• Put limits on spending by giving your teen an allowance. When it's gone, there's no more until next time. • Let your teen face the natural consequences of his behavior. If he bangs up your car, let him pay for it.

• Teach your child to apologize to others, to understand their point of view, and otherwise demonstrate "emotional intelligence."

• Watch how you use praise. The late prominent educator John Holt warned parents that praising a child is a massage to parental egos: building up the child becomes a form of building up yourself. Give specific praise for a specific piece of work or action. For example, tell the child, "You did a great job on that picture," and not "You're a great artist." Don't use praise to manipulate as in "You're so brilliant, you could be a doctor."

• Let children earn self-esteem from working hard and achieving in a real way. The bad news is that most Gen Y parents will be unable do these things. "You have to be willing to have your kids not like you," Dr. Jennings said. "Today's parents aren't willing to do that."

Pediatric Points

By Carolyn Roy-Bornstein,

MD Doctor-Teen Confidentiality Deconstructed

In my many years as a pediatrician I have seen thousands of children through the transition from childhood to adulthood. While the teenage years can be trying and chaotic, they also hold great opportunity for growth and new understanding. But whether I’ve known families since the children were born or only for a few years, I still sometimes struggle with how to present the subject of teen confidentiality. State statutes, federal funding regulations and case law including Supreme Court decisions all govern doctors’ legal requirements for treating minors. There may be differences in these various dictates, but the overarching principles are the same. Teens need to be able to confer with their health care providers, to confide in them without fear of reprisal and to seek medical care for various conditions and behaviors. Our goals with teenagers are to promote health and prepare children for adulthood. Learning to communicate effectively with their doctor is part of the process. Most importantly, teenagers deserve the same privacy, respect and individual attention a doctor gives to any patient. But the doctor-teenaged patient relationship is complicated. My relationships with teens and their families go far beyond who can say what to whom. Parents have always been an integral part of the doctor-patient relationship I have with children. Often I’ve known the parent longer than the teen, either by way of a prenatal interview or through the teen’s older siblings. In some cases, the parents and I have been through this before. In other situations this is brand new territory. When my patients were little I relied on their parents for most of the history, letting them tell me what’s going on with their kids. During the early school age years, I talk mostly to the kids themselves, letting parents add or correct as needed along the way. But with teenagers, things change. There may be things they want to discuss with me that they’re not quite ready to share with their parents. And that’s where things get tricky. That’s where I have to ask parents to trust me. I try to assure families that we all have the same goal: to keep their kids safe and healthy in a sometimes scary world. I usually start the interview with everyone in the same room. Sometimes parents have called me on the phone beforehand to voice concerns about their child or to ask me to bring up certain topics (invariably already on my agenda, too.) I ask about sex, drugs and alcohol, often to the wide-eyed incredulity of the teen. But I do it for a reason. I want to show parents that it’s okay to talk about these things with their kids. And I want the kids to know their parents aren’t going to drop dead at the mention of the unmentionable. I talk about confidentiality: which things I have to disclose (like if I feel the teen is a danger to himself or others) and which ones I don’t (like a request for contraceptives or testing for sexually transmitted infection). Then I suggest that perhaps the teen would like to talk to me alone. But, I never throw parents out of the room against their or their child’s will. I repeat the same questions I asked in front of the parent, not because I assume they’ve lied the first time around, but to give them the space and time to bring up their own issues, ask questions they may be too embarrassed to ask anyone else and get answers they need to make healthy informed decisions about their lives. Our conversations aren’t limited to sex and drugs. We discuss education and exercise, relationships with teachers and peers; basically anything they want. Despite my obligation to maintain a confidential relationship with my teenaged patients, I always encourage them to confide in their parents. I offer to do that with them if they like. “Oh, they’ll kill me,” is often the response I hear from a newly sexually active teen. I understand they may know their parents best. But I like to think I share a perspective with their parents that they don’t. After all, I’m a parent, too. I try to offer the alternative possibility that although their parents may have some initial reservation or even dismay, they usually adjust quickly to the new reality and can provide much needed of emotional support to the teen in transition. In fact parents are often in the long run pleased that their son or daughter is taking steps to keep themselves healthy and safe. The transition from teenage years to adulthood is a scary and wondrous time in a parent’s life. Remember the first time your child, maybe at the age of two or three, came out with a word you know didn’t come from you? It’s a sobering moment, one that places the child squarely in the context of a larger community. We have to get used to the fact that we parents are not the sole influence in our children’s lives any more. In the teen years, there’s that same sense of wonder and trepidation. It all comes down to trust. When I go into that room alone with their child, I am asking parents to trust me. To trust that I have their child’s best interest at heart. To trust that I will give their child the same good guidance and advice that they would. My basic philosophy for raising children (and being a pediatrician for that matter) is this: the more caring adults we can surround our children with, the better. The more caring adults, the more good role models. The more caring adults, the more resources teens have to rely upon in times of need. Those caring adults may be teachers, guidance counselors or friends of the family. The point is, as a pediatrician, I would like to count myself among the caring adults in the lives of my patients. Carolyn Roy-Bornstein, MD, is a board-certified pediatrician in private practice in Haverhill, MA.