Young People Up Close

Working with adolescents

The Danger of Medicalising Adolescence

'Experts' aren't the only ones capable of understanding

When young people are angry, we tell them that they need ‘anger management’. When they’re miserable, we tell them that they might be ‘depressed’. We spend an increasing amount of time medicalising adolescence as if growing up was a kind of illness, as if anger was unhealthy, as if being miserable wasn’t inevitable at a time in their lives when young people have much to be angry and miserable about. Of the diagnoses I’ve heard recently, my favourite is something called ‘Oppositional Defiant Disorder’. With this, what seems to happen is that you find a young person who’s just had another row with his parents and tell him that, unfortunately, he’s suffering from a condition called ‘Oppositional Defiant Disorder’.

Most of the young people I’ve worked with over the years have had ‘oppositional defiant disorder’ and rightly so! They’ve challenged things; they’ve got angry; they’ve disagreed with their teachers; they’ve had furious rows with their parents: not because they’ve been mad or bad, but because they’ve cared, because they’ve been testing their strength, because they’ve been separating from their parents and becoming more independent.

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The journey through adolescence is long and hazardous. There’s no way of avoiding certain difficulties. But in referring angry or miserable young people to ‘experts’ rather than listening and trying to understand them ourselves, there’s a danger of implying that these young people have developed some kind of illness. At best, we add to their worries; at worst, we drag them to the doctor as a way of deliberately scaring or shaming or taking revenge on them.

I picture the poor doctor, expected to treat a bad dose of adolescence, knowing that there’s probably an underlying family issue which he or she is never going to be told about: rows between the parents, someone having an affair or having problems at work, middle-aged life losing its sparkle. But doctors have to be careful. They also know that occasionally young people do get depressed and that psychiatric problems can sometimes start young. So they hedge their bets. They suggest coming back in a few months, or, pushed by parents, they might offer to refer the young person on to someone else.

Usually, the young person is left none the wiser. “Am I normal or is there really something wrong with me?”

My answer is almost always, “You’re normal. Utterly normal. Which means that you get angry. You get sad. You feel like giving up sometimes. You hate people sometimes. That’s what normal is!”

When it comes to human distress, experts have a vested financial interest in remaining experts. I get fed up with those psychiatrists, psychologists and therapists who disempower human beings with their jargon, with their list of qualifications and insistence on medicalising human experience. ‘Oppositional Defiant Disorder’, for heaven’s sake! Feeling understood is what most powerfully precipitates change in human beings and understanding our fellow human beings is everyone’s potential expertise: understanding another person’s anger or sadness or frustration or sense of injustice. Once we start believing that, as mere humans, we’re incapable of understanding each other, we’re on a slippery slope.

Nick Luxmoore is a counselor at King Alfred's College, in the UK.

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