Anxiety, Angst, and Attitude

ANXIETY, ANGST AND ATTITUDE:

HOMEOPATHIC CASE TAKING FOR ADOLESCENTS

Louise Sanchione, ND, MS, MA

 

KEY FACTS AND STATISTICS

- One in five children has a diagnosable mental, emotional or behavioral disorder. And up to one in 10 may suffer from a serious emotional disturbance; 70 percent of children, however, do not receive mental health services (SGRMH, 1999)

- Attention deficit hyperactivity disorder is one of the most common mental disorders in children, affecting 3 – 5 percent of school-age children. (NIMH, 1999)

- As many as one in every 33 children and one in eight adolescents may have depression. (CMHS, 1998)

- Once a child experiences an episode of depression, he or she is at risk of having another episode within the next five years. (CMHS, 1998)

- Teenage girls are more likely to develop depression than teenage boys. (NIMH, 2000)

- Children and teens who have a chronic illness, endure abuse or neglect, or experience other trauma have an increased risk of depression. (AACAP), 1997)

- Suicide is the third leading cause of death for 15-24 year olds and the sixth leading cause of death for 5-14 year olds. The number of attempted suicides is even higher. (AACAP, 1997)

- Alcohol, marijuana, inhalants and club drugs are the most frequently used drugs among middle and high school youth. (SAMHSA, 2000)

- Children and adolescents increasingly believe that regular alcohol and drug us is not dangerous (SAMHSA, 2000)

- Young people are beginning to drink at younger ages. This is troubling particularly because young people who begin drinking or using drugs before age 15 are four times more likely to become addicted than those who begin at age 21. (SAMHSA, 2000)

- More than 389,000 children and teenagers were treated last year with Risperdal, one of the five popular medicines known as atypical anti-psychotics. Of those patients, 240,000 were 12 or younger. In many cases, the drug was prescribed to treat attention deficit disorders. (New York Time, November 19, 2008)

- The average annual increase in the percentage of children with all diagnoses of ADHD (with and without LD) was 3% from 1997 through 2006. (CDC, 2008)

 

 

 

CASE TAKING TECHNIQUES BEFORE THE CONSULTATION

- Try to establish some form of contact before the interview.

- Discuss issues of confidentiality with the parents and your client before the interview.

- Discuss how the first consultation will take place.

- Ask the patient to record any dreams he/she might be having or have had in the past.

- Send information about homeopathy to the patient along with some research studies.

 

DURING THE CONSULTATION

- Be yourself – authentic and empathic – from the first introduction in the waiting room to the final good-bye.

- Establish a rapport. Stress the importance of honesty. Stress that you are not there to judge but to help. There is no right or wrong here – it’s not like school. (Aphorism 83: “examination of a disease case demands nothing except freedom from bias and health senses…”)

- Talk about why they have come for the consultation. Establish expectations.

- Be acutely aware.

- Have a sense of humor….or make an attempt at it if you don’t have one… remember, be yourself.

- Listen first….no matter how painfully quiet it may become in your office. Wait. (Aphorism 84: the physician keeps silent allowing them to say all they have to say without interruption.)

- Talk about physical complaints first.

 

QUESTIONS THAT ARE HELPFUL TO ASK DURING THE CONSULTATION

- What do you love to do? What is your favorite thing to do?

- What role do you play in the group? (leader, comedian, follower etc.)

- What is the one thing you would like to see changed in the world today? How would you change it?

- What do you worry about the most?

- What’s the most significant event in your life so far? Why? What was your reaction?

- What person do you admire the most? Why?

- What’s the most important thing you want changed within yourself to make you happy/ happier/ more content?

- What have been your strongest fears throughout your life? What are they now?

 

 

CHAT BEGAN AT 21:00 EDT

 

Moderator: Welcome, Dr. Louise Sanchione. Dr. Louise is a Naturopathic Doctor whose specialty is homeopathy. She has been practicing with homeopathic remedies for 20 years. We are pleased to bring you tonight's topic - teenagers!

 

Dr. Louise: Hello everyone! Yes, teenagers...the age we never want to be again. Most of my practice is working with children and adolescents with AD/HD, Autism and other behavior and learning problems. I am also a former Special Education teacher so I really understand what's going on in the classroom.

 

Majmorey: What is a good remedy to prevent nervousness during written exam times?

 

Dr. Louise: Remedies for performance anxiety - especially exams - Gelsemium and Arg. nitricum

 

Dr. Louise: What are some particular challenges you all have with taking a case with a teenager?

 

Chris: Do you take the teenager's case AND the parent(s)' case?

 

Dr. Louise: Not really. I usually can get a good case from talking with parents and my patient. I have found that there is sometimes a difference in what the patient wants help with and what the parents feel is important to change. For example, a mom brought her daughter in for a somewhat problematic skin problem. But when I interviewed the daughter, she was extremely unhappy. Her mom had no idea.

 

Dustylib: How do you deal with attention and focus, and feeling overwhelmed?

 

Dr. Louise: While these are important symptoms, they are very common symptoms of patients with AD/HD etc. What is more important in these cases is what is strange, rare and peculiar about the person. What are his/her dreams, fears, hobbies, etc. Symptoms of hyperactivity, lack of focus can be considered if they are very extreme. If the patient is overwhelmed, ask why, why, why?

 

Nanna: My 20-year old is having a really tough time at college, actually dropping out. I'm not told what is going on. He's broken up with his girlfriend, and I suspect he drinks and uses marijuana. He claims he no longer believes in God, but I think that's so he can continue doing things he knows I don't like, but underneath he feels guilty. He won't tell me anything.

 

Dr. Louise: I hear this often from parents. The first step is get him to agree to come for a consultation and impress upon him that is confidential. He won't have to tell you anything.

 

Nanna: He can't seem to decide whether or where to attend school next semester. He is or should be brilliant, unless the drugs are influencing this. I have no proof of the drugs, but I wonder about his rants that we should legalize marijuana.

 

Dr. Louise: I guess we weren't able to upload a page that I submitted. I had a description of what is normal behavior for adolescents. It's important to understand these phases so we don't misinterpret them as pathology.

 

 

HOMEOPATHIC CASE TAKING FOR ADOLESCENTS

NORMAL ADOLESCENT DEVELOPMENT (from: American Academy of Child and Adolescent Psychology)

EARLY ADOLESCENCE (12-14 yrs) MIDDLE ADOLESCENCE (15-16yrs)

LATE ADOLESCENCE (17-19yrs)

Movement Toward Independence

- Struggle with sense of identity

- Moodiness

- Improved abilities to use speech to express oneself

- More likely to express feelings by action than by words

- Close friendships gain importance

- Less attention shown to parents, with occasional rudeness

- Realization that parents are not perfect, identification of their faults

- Search for new people to love in addition to parents

- Tendency to return to childish behavior, fought off by excessive activity

- Peer group influence interests and clothing styles

- Self-involvement, alternating between unrealistically high expectation and poor self-concept.

- Complaints that parents interfere with independence

- Extremely concerned with appearance and with one’s own body.

- Lowered opinion of parents, withdrawal of emotions from them

- Effort to make new friends

- Strong emphasis on the new peer group with the group identity of selectivity, superiority and

competitiveness.

- Periods of sadness as the psychological loss of the parents takes place.

- Examination of inner experiences, which may include writing a diary.

- Firmer identity

- Ability to delay gratification

- Ability to think ideas through

- Ability to express ideas in words

- More developed sense of humor

- Stable interests

- Greater emotional stability

- Ability to make independent decisions

- Ability to compromise

- Pride in one’s work

- Self-reliance

- Greater concern for others

 

Career Interests

- Mostly interested in present and near future

- Greater ability to work

- Intellectual interests gain importance

- Some sexual and aggressive energies directed toward creative and career interests

- More defined work habits

- Higher level of concern for the future

- Thoughts about one’s role in life

Sexuality

- Girls ahead of boys

- Same-sex friends and group activities

- Shyness, blushing and modesty

- Show-off qualities

- Greater interesting privacy

- Experimentation with body (masturbation)

- Worries about being normal

- Concerns about sexual attractiveness

- Frequently changing relationships

- Movement towards heterosexuality with fears of homosexuality. (Great article in Sunday New York Times Magazine, 10/4/09)

- Tenderness and fears shown towards opposite sex

- Feelings of love and passion (Watch movie Dan In Real Life)

- Concerned with serious relationships

- Clear sexual identity

- Capacities for tender and sensual love

 

Ethics and Self-Direction

- Ability to make independent decisions

- Ability to compromise

- Pride in one’s work

- Self-reliance

- Greater concern for others

- Development of ideals and selection of role models

- More consistent evidence of conscience

- Greater capacity for setting goals

- Interest in moral reasoning

- Capable of useful insight

- Stress on personal dignity and self esteem

- Ability to set goals and follow through

- Acceptance of social institutions and cultural traditions

- Self-regulation of self-esteem

 

Nanna: before college, I took him for a consult and he wouldn't talk to the homeopathic doctor he'd known all his life!

 

Dr. Louise: Maybe someone outside the family sphere might be more appropriate. Drug and alcohol abuse is a very serious societal problem. We have to ask why kids are starting to drink at younger ages.

 

Krishnaonkar: Is there a remedy to use when one sibling senses rejection by the mother?

 

Dr. Louise: There are many remedies that address conflicts between mothers and children. Sometimes, the Lac remedies are indicated, but not one particular remedy.

 

Chris: When working with teens who will NOT give up caffeinated soft drinks (and you suspect they are 'sensitive' to them), do you select particular potencies and frequencies of dosage? They can go from 'dragged out' to 'super alert' with one can of the beverage, and choose to do this every morning so they can get going.

 

Dr. Louise: If you find the right remedy, they will likely loose interest. If it's a matter of antidoting the remedy, then lower potency and more frequent dosing might be helpful. If it's “Bolt”....no wonder!

 

Kristy: Do you attempt to give nutritional advice?

 

Dr. Louise: Yes. I wait for the second consultation. I ask that the patient NOT start anything new when he/she takes the first dose of the remedy.

 

Essential fatty acids, with a higher ratio of DHA than EPA is highly recommended for anyone with focusing, memory etc. issues. Also, I can ATTEMPT to give nutritional advice....this is a time of asserting independence so I don't expect too much on this front. Really depends on the patient.

 

Nanna: Thanks for volunteering to chat! Remedies are great.

 

Chris: Do you have some insights on how to deal with classroom teachers who try to 'guilt' parents into having their slightly ADHD kids put on Ritalin or others drugs?

 

Dr. Louise: This is actually against the law is some states. I tell parents to trust their instincts and give them as much information and research about homeopathy that I have. I also offer to talk to pediatricians or the family's PCP who are skeptical.

 

If any of you are interested in giving talks about homeopathy, a very good group to speak to is school nurses. I did this last year, and I still get occasional referrals from school nurses.

 

Dustylib: How effective is homeopathy in treating ADD? Where do you start?

 

Dr. Louise: Homeopathy is very effective in treating AD/HD. I would refer you to Judyth Reichenberg-Ullman and Robert Ullman's book - Ritalin Free Kids. Can you be a little more specific about “where do I start?”

 

Dustylib: Who gives the diagnosis? a medical doctor, a counselor, a psychiatrist?

 

Dr. Louise: A counselor cannot give a diagnosis, only a medical doctor or psychiatrist. Also, a diagnosis is not important here. What is important is finding out what makes this kid tick. The parents usually have a good sense is something is out of proportion or if the teacher just has classroom management problems.

 

Dustylib: I'm the parent (I'm not a practitioner).

 

Dr. Louise: So, do you feel there is a problem?... if you feel comfortable to talk about it.

 

Dustylib: We're dealing with what we consider "disproportionate" responses to situations, usually with anger. Of course, he's 13, but normally very measured and calm.

 

Dr. Louise: This is something I ask about often...is the response out of proportion to the situation?.....is the moodiness persistent?....

 

Dustylib: Not moody usually, but often the reaction/response is out of proportion to the situation.

 

Dr. Louise: I would also want to know what the antecedent event is....what sets him off and how is the anger manifested....throwing, cursing....this information helps to determine the remedy....it's putting pieces of the puzzle together. When I see the chilld, I always start with what they love to do rather then what the problem is.

 

Dustylib: So making a list of interests and skills/strengths is a place to start? Then what?

 

Dr. Louise: It's not so much asking for lists but having a conversation with the patient. This is the homeopathic process. You never know what a patient is thinking and how they are feeling until you spend time with them and listen to what they are saying and asking why they feel or certain way, or love a certain video game. I had one patient who loved video games about WWII. But until I asked him which character in the game he wanted to be I didn't know why he loved the game so much. Turned out he didn't want to be a general or a soldier...he wanted to be a medic so he could save people's lives. This gives me more information when I select a remedy.

 

Chris: Can you get enough information from parents or others to start working on a case if the patient is so silent and sullen that they will not talk at all during the consultation?

 

Dr. Louise: This is when info from the parents, teachers, and siblings, can be helpful. But I can get information by just observing how the patient is being silent and sullen...it's not all the same.

 

Moderator: Thank you, Dr. Louise, for answering our questions this evening!

 

Dr. Louise: You are all most welcome. Please feel free to email me or check my website. I will send you a copy of “Normal Adolescent Development” if you send me an email.

Email: drsanchione@earthlink.net  Website: www.thenaturalhealingconsultant.com    

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