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Parents frequently ask me whether their teen’s behavior is “normal,” or whether they need to be concerned. I have come to realize these are two very different questions. We are far better served to treat them as such.
It is understandable to first ask the question of “is this behavior normal?” In DBT, we often talk about balancing the opposing tendencies of “normalizing pathological” and “pathologizing normal.” In other words, sometimes we look at completely common and appropriate behaviors as signs of a problem. On the other hand, we often turn a blind eye to problems by writing them off as “normal.” A willingness to consider each of these possibilities can assist us in maintaining a balance.
Consider the parents of a teenage girl who came to me very concerned that she had been drawing on her arm. I was slightly perplexed by their reaction. Kids draw on themselves all the time. They proceeded to show me pictures of some intricate artistic work on her arm. I have to say, I was actually impressed by her artistry. They, however, were concerned that it was a form of self-injury. Knowing the teen, I knew it was not. The parents’ anxiety was leading them to pathologize normal behavior.
The incident reminded me of when I found a somewhat disturbing drawing my then 6-year-old son had left on his floor. It depicted several gravestones. I immediately grew concerned. Was he afraid of death? Was he depressed? I asked him about the drawing. It turned out that his picture was inspired by a graveyard scene on Scooby Doo that morning. My own professional background led me to pathologize a normal behavior.
In contrast, I have met with parents who believe their teen’s behavior is “normal,” or age-appropriate when it is not. For example, increased anger directed at parents can be common. However, becoming physically violent at those times is not. Similarly, body image concerns are very common. However, I have worked with parents who viewed the progression to purging and excessive daily exercise as something “all girls do.” Viewing these behaviors as “typical adolescence” is consistent with normalizing pathological behaviors. It also results in a lack of concern where intervention would be beneficial.
It is important that we keep these natural tendencies in mind when we are thinking about the normalcy of our adolescent’s behavior. However, it is just as important to use caution when using the word “normal” to assess healthiness of a behavior or need for concern. Normalcy is not always an accurate gage for the need for concern.
It is not normal to have an above average IQ, but it certainly isn’t problematic. In contrast, binge drinking in college is “normal,” but still a risky and unhealthy behavior. Perhaps a better question to ask is whether the behavior or characteristic is causing distress. Neither the arm artistry, or graveyard picture were causing anyone distress. However, the violence caused distress for others and the disordered eating behaviors cause distress physically and emotionally to the adolescent.
As parents, many of us spend a lot of time worrying about the “normalcy” of choices our children make. We may dismiss a lot of distressing choices based on their “normalcy.” We may also worry needlessly when our kids’ behavior is atypical. A lot of this worry and dismissal is based on a lack of asking more questions.
I always suggest to parents that we approach behavior with curiosity rather than assumptions and judgements. Show interest and ask gentle questions such as “tell me about drawing on your arm,” or “what inspired your drawing?”
I had this conversation with parents who came to me concerned that their high-schooler was isolating and might be depressed. They explained that the school had reported he was eating lunch alone every day. This was not “normal” high school behavior for a kid who had always been viewed as social. Once they heard that they started focusing on the fact that he had started spending increased time in his room alone. I suggested they ask him what was going on. I did as well.
As it turned out, their son found the constant hustle and bustle of the high school day overwhelming and overstimulating. He had figured out on his own that if he took lunch to himself and used the time to re-charge, he felt less anxious. He found socializing outside of school hours more enjoyable and less overwhelming in smaller groups. Thus, when he was alone in his room, he was typically communicating with friends on facetime, or by texting. There were no other signs of depression and, most importantly, he was not at all distressed about lunch and was not feeling isolated.
When we ask questions instead of making assumptions based on normalcy, we are more able to assess its healthiness. We move away from polarized views of behavior as normal and not worthy of concern versus abnormal and concerning. We can use distress as a measure of the need for intervention. At the very least, we develop a better relationship with our teens and an understanding of their experience.
