Teen Trauma

Nick: Welcome to the Ascend Health Show. I’m your host, Nick Angelis. I’m a Nurse Anesthetist and one of the owners of Ascend Health Center. And I’m here with Cheri Weisend, a licensed professional Clinical Counselor from To Go Development and Counseling. How are you today?

Cheri: I’m doing well. How about yourself?

Nick: I really like your shoes.

Cheri: Oh thank you.

Nick: They can see them.

Cheri: Oh they can.

Nick: It’s uh, so we try not to date these shows, so we can pretend that they’re evergreen and we can talk about whenever, but it’s kind of fun since Jeff Bezos went to space yesterday and here you are with your space boots.

Cheri: I know that was the only reason that you invited me on was for my fancy shoes.

Nick: Yeah, we’ll, we’ll, we’ll do Moonwalking later on in the show. It’ll, it’ll be a great time.

Cheri: Okay I look forward to it.

Nick: Absolutely. So I want to start with — because we know that some of these shows are on the internet and people only watch this for two minutes and then they’ll go to the cat videos again. So we had to sort of get right to it. So tell me right away about teen PTSD, because you think of teenagers and like, what happened? Did they get ramen and served ravioli, like, why are they so stressed out? What sort of thing, what trauma could have happened in their lives, but that’s sort of your specialty?

Cheri: Yes it is.

Nick: So, what’s it all about?

Cheri: Okay. So, it’s really interesting that you asked that, because a lot of teens can actually deal with some really hefty issues, especially with COVID occurring. It has, it was really traumatic for, especially a lot of them to be dealing with the transition of school closings. Yeah, not being able to get together with family, friends, loved ones that really impacted them. And also it really depends on the person, because just like with anything else, any other sort of trauma that someone may go through, you know, whether that is physical abuse, emotional abuse, sexual abuse, whether that is parents getting a divorce, whether it’s dealing with death, bereavement, loss there’s a variety of things that people can go through.

And also, I mean, some of those, some of what I listed, obviously, there was a continuum regarding, I guess, the, the extreme, of what people could face and then other people can get traumatized by events that may not be as significant, you know? And because trauma is so subjective, it’s really going to depend on the person as to whether they end up experiencing trauma or PTSD from it.

Nick: So it’s really an, and obviously your definition of course, be superior to mine since my training is more with anesthesia and that sort of thing, but trauma is essentially something that your brain can’t process, like there’s not a slot to put in, because we say this with our ketamine infusions, because it’s such an intense psychedelic like yet ethereal type of experience that I say a lot of times, it’s almost as if all the books have fallen on the floor and this kind of helps you order it. So trauma is almost like, okay, we’ve got our bookcase, here’s all the memories of my life. This book doesn’t fit anywhere. I can’t find a way to explain it to everything else that’s gone on in my life. It just unexplainable, it just doesn’t fit with everything else that’s happened. Almost like an injustice that you just can’t get over.

Cheri: That is a really great analogy by the way. I’ve actually never heard it described like that.

Nick: I’ll probably forget it. So you need to keep it because at least one of us–

Cheri: I’ll put it in my memory bank.

Nick: Good, good.

Nick: Yes, because here’s the thing with trauma is it literally impacts every area of our life emotionally, physically, psychologically, especially when, you know, especially if we’re talking about adolescents here and it’s already such a crucial time and there’s already so many transitions and changes in their lives. And then we, we add something like trauma that, you know, may have happened, whether it was, during childhood or in their adolescent. I mean it whichever right. On top of it, and you’re just adding insult to injury, especially when we think about how their brains aren’t fully developed yet. And they don’t fully develop until we’re 25 years old.

Nick: Uh-huh.

Cheri: And so we add that impulsive or maybe what looks like to us maybe like recklessness or self-destructiveness that may end up being a result. One of the ways that I typically describe trauma to people is I, I normally say that it’s something that you go through in your life where you feel like you don’t have the resources in that moment to be able to deal with it. And if you are noticing like long-lasting effects and sometimes it’s, it’s even delayed trauma. So whether it’s directly after or even within six months after it occurred that was probably going to be something that needs to be addressed and it’s important for it to be. But yeah, I really, I really do like your analogy with the way that it does, because people’s lives, it’s like it does a complete 180.

Nick: Sure. So you’re saying it’s almost like a, free-fall like a moment when you have no support when there’s nothing to help you, that that can imprint your brain. Does it, does it stop development? Cause I know that’s true with addicts where a lot of times their emotional development stops at the age at which they started using?

Cheri: So that actually, that that does happen. And that’s why I have a lot of empathy for even adults, especially because if, if I look at an adult or it doesn’t matter an adolescent, anyone just because someone may chronologically be 18, if the trauma occurred when they were 13 and they never had any help 0and again, like I said earlier, it is very subjective. Trauma is very subjective and it can be one, one event that was, you know, like maybe chronic and really impacted a person. It could be a bunch of like little events that add up.

But either way I might, I might have really a 13-year-old like maturity-wise, that’s actually in front of me, even though the presenting age, maybe 18. So it’s really something to be mindful of, which is probably why, I don’t know if you’ve ever seen grown adults kind of act like children or maybe not be able to —

Nick: I’ve seen myself do that actually.

Cheri: Exactly. It’s I’m just like, you know what, sometimes I wish when I see that, like two or three-year-old–

Nick: Preaching to the choir.

Cheri: -having a temper tantrum on the ground in the middle of the store, I’m like, I feel that I wish I could do that with you right now.

Nick: If it wasn’t for these sore knees, I’d be down there too, because I also want those crunch berries, captain crunch.

Cheri: I’m just like you know what, we just need to get the knee pads. That’ll be fine we can do the same thing,

Nick: Right. Except no, one’s going to listen it’ll just be like, well, let’s avoid aisle five.

Cheri: That person’s crazy it’s fine, it’s fine guys. It’s just, it’s just a breakdown.

Nick: Well, it was probably harder in today’s society, because we have such a diverse society. It’s not work on the farm until you’re 14 and get a job at the factory at this age, because we know 45-year-olds that they like to play video games and we know 18-year-olds that have excelled and have a resume that will get them into Yale or whatever. And so it takes some time to get to know people and their maturity level and it’s quite different. So it probably makes it even harder and its — sorry go ahead.

Cheri: Oh no, no, you’re good. You’re good. One of the phrases that I love to use is growing old is inevitable and growing up is optional. But again, one of the main things that I wish people understood was I, I do think that overall as a society, as a society that we do have maybe more of an understanding or maybe more empathy if a child is acting out and it’s like, “Oh, okay, well that’s a child.” That’s what they’re expected to do. Right? Because they can’t communicate.

They more, I mean, depending on the age, but a lot of them do communicate through their behaviors. And yet when we see an adult that is doing the same thing, we don’t, we don’t tend to give people the benefit of a doubt. I, I think that there’s sometimes in society, again, depending on the person that maybe we — like we blamed them, or we were just like, what is going on with, we tend to be more judgmental or critical.

Nick: Right.

Cheri: When at the end of the day, I don’t know what you’ve gone through. I don’t know what your life experience is. Like, I don’t know what you’ve gone through. And I, I don’t want to base my experience with maybe if it’s, especially, if it’s like maybe a one-time occasion, you just see someone doing something you don’t, you don’t know that. I don’t want to base that one experience on who you are as a person, for all I know you just found out that your wife died. Like, I, I don’t know that. So I really like to maintain a more open-minded and curious perspective when it comes to just anyone that I see in general including people in everyday life.

Nick: That’s a good philosophy though, because if you stay open and curious, you’re, you can better see what exactly is going on and it’s interesting. So on this show, we kind of talk about whatever we feel like it, it’s not very censored. But with a lot of the movement about police brutality, one of the points that came out was if you see someone acting weird, maybe just ignore, maybe don’t call the police, maybe something bad will happen. And it’s simply, because somebody was acting weird and it made you uncomfortable, because that’s the common –. You know, none of us are, well, I guess you are qualified, but it’s unnecessary to be like, well, okay, is this a criminal behavior? Is this person acting weird, is this mental illness? And sometimes it is, well, this is strange, but they’re not hurting anyone. So I’ll just move about my business and keep on going.

Cheri: Yes. Oh my gosh and it’s so interesting that you say that, because I really wish that society in general was able to distinguish, like, what is a crisis and when do we step in and when is it that I can just go about my day. Because sometimes it seems like people are interfering way too much when they don’t need to. And then other times where something like actually may be a crisis, isn’t someone that — then people just mind their business. And I, and I understand that to a certain extent, because they’re fearful and they don’t know what’s going to happen.

And it’s our, you know, natural instincts as humans, you know, we gravitate towards things that cause us pleasure and we tend to avoid things that are going to cause us some sort of pain. But I really do try to look at people almost as an extension of myself. And if I see that I am judging someone or I’m not accepting whatever’s going on I like to look inward and think to myself, “Okay, what is it that’s going on with me that I feel critical or judgmental towards this person.”

Because a lot of times, and one of the things that I tell clients even is, you know, if you’re getting triggered by something, if something is, is bothering you, which I mean, and a trigger, you know, with anything could be even just experiencing something more intensely than maybe what, like the average person, whatever that means may experience.

Nick: I’d bet that’s probably not either of us.

Cheri: Yeah. Yeah. It’s not, yeah. Those people, aren’t fun. I can tell you that right now. We don’t want anything to do with those people. But for those, for those of us that do okay, so that I don’t know.

Nick: Yeah, no, but you’re right, because you can also do it the opposite way too, where you still have to have some sense of self preservation. So the last time we went to the airport, the TSA agent was explaining why they checked my bag, I was like, “Look at me, look at my beard, my darker skin. I’m perfectly fine with you checking my bag. I want you to check my bag.”

Cheri: Yes. Yes.

Nick: So we do have to also be careful that we’re not so, okay, well maybe this person is going through such a hard time, but yet where is that line? Cause especially since we started talking with adolescents, everyone is so versed, you know, terms like gas lighting are used on a daily basis now, where do we find that line of, “Okay, here’s where you take personal responsibility for your actions and even if you have this labor, this diagnosis, you still have to do the things.” And when is it more appropriate to be like, “Oh, well, you’ve had some trauma, so let’s make this a little easier for you.”

Cheri: You know what I think that it really is about getting to know that individual person, because and the more that, like the more time that I take as a therapist to get to know like each individual I really think that that’s going to be important to know, okay, how much of this, and it’s never going to be perfect or just the here and even like, act like I know would be a joke, like, come on. It’s like, listen, I’m just in this game of life with you, we’re just all at these different levels trying to survive here.

Nick: All right.

Cheri: But once, once you really start, and honestly, Nick, a lot of it is about trial and error and trying different things. But if you really listen to people and really just take the time kind of like, as I was saying earlier to really understand as opposed to just trying to be understood or acting like I’m the one that knows best when it’s like you are the author of your life.

Nick: Uh-huh.

Cheri: And nobody is going to know what is best for you other than you. Granted that’s also going to depend a certain extent, right on the person and on the age group. Because some people might — like the adolescents, they, they think they know what’s best for them, but we take that within, within reason. And as I said before, there’s no like one, like, I don’t think there’s, there’s not an end all be all approach that’s going to work for every person. So it’s really just about being mindful about that.

Nick: That makes sense. I mean, I, I distinctly remember at age five thinking I’m, I’m a smart as I’m going to be like, this is it I’ve reached the pinnacle of what I know what I’m going to be. I was like, I think I’ll grow a little bit before I turn 18, but I think, I think I’ve reached it. So even more so adolescents.

Cheri: So yours was at five? I feel like, I feel like mine was probably 17.

Nick: I was a weird philosophical 5-year-old.

Cheri: I was going to say, I was like, you must have just been a very precocious child, but I, yeah, I think that that’s also human nature though. I think that there’s times in our lives where we want to feel like we have the answers, because it gives us a sense of control.

Nick: Sure.

Cheri: Especially when we’ve had a lot of times, especially with people that have gone through trauma, when they’ve had maybe times in their life where they were helpless or they felt hopeless or powerless we just want to be able to make sense of this world.

And again, I go back to balance and moderation when it comes to that. Because I think that sometimes people will take radical approaches to trying to have answers to things that they don’t understand. Or — and they may — that may end up making them more closed minded, because then they’re not open to listening to anyone else or anyone else’s feedback or opinions.

Nick: Right a lot of times on the show, we’ll say things like, “Okay, you need to listen to your body and you’ll know your health better if you can understand what’s going on.” But sometimes the mental health, there is a limit to that because like, “Oh, I’m feeling some anxiety right now,” or “I think I’m really depressed today.” It can become such an exercise of exactly what is my brain doing, that you can’t actually participate in life, because you’re so concerned with exactly what the neurons are doing up there.

Cheri: Uh-huh.

Nick: You know, it’s, it’s almost as if, “Okay, my ankle is sprained, let me will it to health.” It’s like, no, like sometimes you need to just take the medicine or go to therapy or do the thing. It’s not as easy as let me see what my mind is doing and then change it immediately.

Cheri: Yes. And, and you know what, I wish that people understood that, especially in today’s society where we want that instant gratification, I want it and I want it now. And it’s like, well, here’s the thing. And I can, I can tell you, I can like, literally walk you through step by step how to do it, but it’s like, but I just want to get there. I don’t want to have to do the work. Right?

Nick: Right.

Cheri: And it’s, it’s really difficult, especially when, you know, in a lot of ways if I were to narrow down healing, especially, especially when it comes to trauma, related to how you would do it. And this is the most like simplest way. I think it’s a really gonna be about like, self-love.

Nick: Right.

Cheri: I think that when people go through these, these events in their lives, that, especially along the way, right. A lot of times it’s, it’s other people that may cause that damage.

Nick: Uh-huh.

Cheri: That it’s really important to remember that if we can be hurt by others and they can cause like this, this much pain that there’s going to be other people that can create healing and growth and opportunities. And it doesn’t matter I don’t think how much people have experienced and how much adversity they have. A lot of my clients I’ve looked at them and I’ve said, “You know, despite this, this and this that’s been done to you I don’t think that there’s anyone in this world who is more critical or judgmental or self-deprecating like, it, it, than you, like, that’s what it is, it’s, it’s ourselves.

And it’s because that’s what a lot of it’s been learned when we go through trauma. And that’s why I tend to tell them, you know, if you do notice that, you know, you are experiencing more intensity or severity to a situation and you are getting triggered to either look at, “Okay, what is it about myself that I can’t accept?” Like, “What is it that maybe this person is showing me that like, I don’t want to accept these like, traits about myself?” “Or what is it about this person that is remind me from someone in my past who’s hurt me?”

Nick: Yeah. That makes sense. There is a pastor who told me once what offends you, reveals you, meaning that whatever triggers you, whatever, “How could they do such a thing?” Like it says something about your own heart. And so many times we have layers around who we are and we’re afraid to see exactly who we are. So we have these personas of, “No I’m this way, or I’m that way.” And I’ll hear a patient describe themselves. And those tend to be the patients that we do give the Spravato or the Ketamine treatments to, because that’s the way that it’s almost like a mirror of like, here’s the truth. And some patients do really well with that and others, it’s a stepwise process of, “Okay, are you ready to face this or not?”

Cheri: Yes and it’s so interesting when you get to work with a variety of people and you get to see like their, their subjective realities. And it’s interesting like when I look at this person and I’ve said to so many people, if you could just see yourself, like even half of the way that I see you, like just, just half of what I see you would view yourself so differently. Because for me, it’s so easy to see like their, their potential and how beautiful and just like who they are compared to who, who other people, again, a lot of times, because it does start in childhood a lot of times, you know? And, and when we go through trauma that this is what I’ve been told, or this is what this experience has told me that I am. And it’s really unfortunate.

Nick: Uh-huh.

Cheri: But that’s why I really believe that the more that we heal ourselves the easier that the world around us tends to be for us to manage. I think a lot of people in society, we want to look for external sources of happiness, right.

Nick: Right.

Cheri: But at the end of the day, what are we going to do? You know, especially with, with COVID when we didn’t have, and I’m, I’m so huge like on social support, I like, I advocate for that. Like, it’s such a huge thing. I’m like a big proponent of mind, body, spirit the whole trifecta. And I was like, wow, this, it really emphasized for me personally the need for us to look inward and to maybe look at more like mindfulness and meditation. And it’s, it’s like, what is it I can do for myself? Because we’re very limited in the amount of support that we have right now.

Nick: Exactly. Everyone’s defense mechanisms are taken away from them. They couldn’t go out and drink. They couldn’t do this, they couldn’t do that. And people were falling apart, because it’s like, “Well, this is how I deal with stress, I do this thing and now I can’t do the thing.” Sometimes we don’t like to be alone with ourselves, because you’re right our identity has been externalized where my — I’m a good brother and that’s what defines me, or I’m a business owner and that’s what defines me. So until we find that worth outside of how others define us, it’s very hard to find healing.

Cheri: I agree with that wholeheartedly. Especially when people are telling me, you know, about like how much money they’re making or what their job is, or I’ve, I’ve literally had people come in and they have these perfect lives, like the, like the whole shebang, you know, the, the big house, the white picket fence, the two kids. And they’re just looking at me like, “What is wrong? Like what — what’s going on?” And I’m like, “Well, let’s start from the beginning and I will break it down for you, what’s, what’s going on because it’s not about these external sources.”

Now, granted, I’m not sitting here saying that external sources do not have an impact on us. Okay, because they, they absolutely do. We’re human beings, we’re not robots. But at the same time, the more that you are focusing on, like self-actualization and really just trying to be your optimal self and knowing that every day is an opportunity for you to do something more or do something better. Like, I, I literally wake up and I’m like, “Okay, I want to be a better person today than the person I was yesterday. And I want to try to be a better person tomorrow than the person that I am today.” Like it it’s just like the thought process.

Nick: Absolutely. And if you fail, you can say, “Well, I always have tomorrow to try this again.” And that’s important too. So if anyone who’s watching wants to get in contact with you, wants counseling from you, what’s the best way to go about that, because our clinics are neighbors, you’re just up the street of the main.

Cheri: Yes.

Nick. Because there’s construction. It’s a little bit of a detour, but normally you can just go up the street from us and find you, so it’s togocounseling.com.

Cheri: Yes or they can call the office 330-310-9878.

Nick: Yeah. That’s great. And same with us. We do a lot of work with chronic pain, non-opioids of course, psychiatrist and nurse practitioners, therapists as well. And we do have the TMS and the Spravato and the Ketamine. And those are, it’s kind of, like you said earlier where there’s still a journey to healing. Like none of it is easy. None of it is pain-free and I don’t mean physical pain, it’s just that it often took a lot to get someone to an unhealthy state. And so it’s not a sprint to get them healthy, because we certainly have ways to get them healthy very quickly, but is it sustainable?

It can start that way, but there’s times when I tell a patient, I can actually make you feel like everything is great, but it’ll wear off in a few weeks. So what works with your budget and what the goal is, and how quickly can you form an identity? That’s not about how well you are or how sick you are or how your family views you. So once you have a firm foundation, there’s much more potential for healing too.

Cheri: I really, again, I really strongly agree with this. So for me, one of the things that I talk to people about, okay, I tell them some of the biggest regrets that people have when they’re on their death bed which tends to be living their lives for others. Working too much, not spending enough time with family, friends, loved ones and not doing things that are on their bucket list or things that they say like, “Oh, I’m going to do this tomorrow.” And then it turns into, you know, next month and it turns into next year and turns into never. And you’re right about this in terms of the pain that we experience, there’s, for me, there’s no other way to really deal with the core than to go to the pain, the only way to get through this, I mean, you have to go in it.

And that’s where sometimes you’re going to lose people, because they don’t necessarily want to do the work. And that’s, and that’s really hard. That’s really difficult, because I have gotten to a point in my career where I’m like, “Listen, you know, I’m not going to sit here when, when you can come in and tell me each week, like exactly what the problem is. And I can already tell you before coming in exactly what you’re going to say, this is an issue. I’m not — you’re not going to get better. This is me putting a Band-Aid on a bullet wound.” That’s exactly what that is. And I say, so “If you’re not willing to use the coping skills and we’re not willing to do any,” but my specialty is somatic — like a somatic therapy.

“If we’re not willing to do these things,” again especially with trauma, “I’m not going to be able to help you,” you know, like there’s, there are a bunch of other therapists out there that, that they will take your money and then they’ll just, they will listen to you all day. I’m like, “That is not me. I’m not going to take advantage of the situation. It is a waste of your time, energy, effort, and I’m not going to do it to you. So if, if you want to receive therapy, it’s going to have to be with someone else cause I’m not doing it.”

Nick: Well, that’s a good lesson to end with too, that sometimes if people feel so good about just talking about what they can do or just talking it through, but at the end of the day, we still have to do the work. So we’ll leave you all with that. This has been the Ascend Health Show and go out there and do the work and I’m kind of preaching to myself right now.

Cheri: Thank you.

Nick: Thanks for being on the show.

Cheri: Okay.