This blog is written by the clinicians at Jonah Green and Associates, a mental health practice based in Kensington, MD that provides quality services for children, teens, families, and adults. It is intended as a resource for families who are seeking to expand their knowledge about mental health and mental health services, and also as a resource for families who are seeking quality mental health services, especially in the mid-Atlantic region. Please feel free to post questions and comments on any of the entries as well as on any topics or articles from our companion web site www.childandfamilymentalhealth.com.
When a newborn arrives, it calls out into the world. As her parents take her into their arms and provide care they learn to respond to her cries. When she is hungry she is nursed or bottle fed. When he is uncomfortable his diaper is changed. Sometimes the young baby is carried on the parent’s shoulder, patted and whispered to, and the crying stops. The parent feels connected and accomplished. Their love builds with their ability to understand and respond to their infant.
The holidays are upon us, and for many, it is a joyous time filled with many wonderful things. You enjoy special time making memories with friends and family. You might spend time baking, cooking, and eating delicious and indulgent holiday favorites. You and your family might also spend time searching for and buying the perfect gifts for each other to show how much you care. You might also hop from party to party to celebrate the season amongst close family and friends.
Autism is on the rise. The CDC reports that ASD is up from 1 in 68 in 2016 to 1 in 59 in 2018. That’s 15% in just 2 short years. Most people either know someone in their family or have someone in their community who is impacted by this disorder – we are interacting with people on the spectrum every day. I work with many individuals and families seeking help, focusing on an array of challenges, including the particularly common side effect of social isolation. Children on the spectrum often display a strong desire to connect with peers but have a lack of skill to appropriately do so. This means that they very much want to have friends and engage in social activities, but do not have the innate social radar that their neurotypical peers are born with. Thus, when they make social snafus they are continuously told what not to do and struggle to tweak their behavior for better results. It is critically important to build soco-emotional tools for those with ASD, as co-morbid mental health disorders are high; 20% of young adults with ASD report depression, and 29-50% of those with ASD report anxiety, compared to 18% of the general population.
When I was an adolescent my sister-in-law taught piano lessons out of my parent’s home. She and I developed a weekly routine. I would babysit her infant daughter while she taught, and afterward, she and I would sit down at the kitchen table and chat until dinnertime. I look back on those afternoons with such warm feelings. Like a typical middle schooler, I was struggling with exploring my identity, maintaining friendships, and establishing some independence from my parents. Unlike other adults, I remember Amy patiently listening as I talked and talked and talked. I felt so important and grown up. Even though I was much younger, I considered Amy to be a close friend. She knew the power of listening and I was so grateful to experience that.
A composite of several conversations between parents and a sexual health educator/family therapist
Parent (P): My children just turned eleven and fourteen. Should I be speaking to them about sex?
Therapist/Educator (TE): This is such an important question. I am so glad you are asking yourself this question because the quality of your relationship with your teens, as they grow through mid and late adolescence, depends on how you choose to answer it.
Adolescence is a life phase when we discover our own talents and competencies when we learn to focus our energy on work and get a sense of what we want our future to look like. It is also a moment when we learn about love outside the family and about sex. Adolescents “practice” romantic relationships by flirting and dating. Adolescence is normally the time of the first crush and the first kiss. Most adolescents, if you look at the statistics, have their first sexual experience by the age of 19.
So when you ask yourself “Should I speak to my kids about sex?” the answer depends on whether you want to be a support to your kids as they prepare for these developmentally crucial experiences? And if your answer is “Yes”, then it is crucial that sexuality and relationships become a topic of family discussion just as much as SATs and college essays.
P: But I don’t know what to say, or how much. I am concerned that if I sound too open about sex, my kids will think I am giving them permission to have sex.
TE: Parents are often anxious about the adolescent sexual activity. There are good reasons for this: first, sex is risky – for everyone- and can have life-changing consequences; secondly, adolescents do not have a good reputation for managing risks responsibly. So it is completely understandable that you would be protective of your teens. How do you imagine yourself talking to your teens about sex?
P: I would find it very important for them to know the risks of sex. I would tell them about contraception and STDs. And I would talk to both my son and my daughter about consent.
TE: Yes, this makes sense. You know about sexual risks, so you want your kids to be aware of these risks and be capable of managing them.
But let’s take a step back if that is OK with you, and look at what happens typically when parents, who love their kids and want to protect them as you do, try to have such a conversation with their teens.
What I have seen and what the research suggests is that parents’ anxiety about sex has an insidious impact on family conversations about sex. Parents focus on the dangers of sex, STDs and unwanted pregnancy. They present sex as negative, frightening and dangerous. Even the most laid-back parents become domineering and raise their voices in these conversations. The “sex talk” then feels to the teen more like a sermon or lecture than a true dialogue. The problem is, and I see this all the time, when parents lecture, they stop listening to their kids. And when parents stop listening to their kids, kids stop listening to their parents. Kids then look for other sources of expertise to answer their questions. Often, this means they turn to the internet and to porn… The research shows what the actual impact is of these stern and anxious lectures about sex: kids who have been subjected to them initiate sex at exactly the same average age as their peers but they are more likely than their peers to engage in sexually risky behavior (such as engaging in unprotected or unwanted sex).
So, to answer your question, even though it seems to be common sense to lecture your kids about the risks of sex, I would encourage you to model your conversations about sex on the other open conversations you have had with them about non-sexual issues, like school or friendships. I have seen you compassionately engaging your kid in a conversation about her experiences and helping her become aware of her feelings and form her own opinions. The same attuned, supportive dialogue would be ideal here. But anxiety makes this very hard. Are you able to contain your anxiety? Are you able to talk about something that makes you anxious and still remain open and curious about your child’s experience, feelings, and opinions?
P: You don’t understand. It’s not just the risk of sex that I worry about. It’s about values. Sex is special. We believe it should be reserved for a special relationship. If I am open to my kid now, will it divest sex of its sacredness or mystery? Will it strip my kid of his or her innocence?
TE: Tell me more about your values and the kind of person you hope your child will become. Tell me about what events in your life have made these values so important to you. Did something happen to you or someone close to you that brought this value home for you? Such stories help me understand where you come from. Your teen needs to hear them too. Often these stories involve a mistake or a close call the parent or friend was able to learn from. If you do not tell your teen how you subjectively came to these values yourself, your teen has no way to relate to these values. By being humble and open in this way, you are giving your values the power to impact your teen’s behavior and you are teaching them about learning from experience.
Conversations about “values” backfire however when they are shaming. If teens get the message that sex is wrong or dirty, they will become ashamed of their sexual feelings and longings. And if by chance, they have sex one day with a peer, as statistics suggest they will, they are likely to believe that they would be rejected if their parents or religious leaders knew, that they do not truly belong in their own community. This has a chilling effect on teens’ sense of self-worth, their sense of belonging to a family and community and their acceptance of their own sexuality.
P: There are so many pitfalls to avoid! How do I start having constructive conversations on this topic then?
TE: OK. Let’s change perspectives on the “sex talk”.
Think about your own parents and how they did or did not talk about sex with you, as you were growing up. What was the implicit message you got from them about sex? Were your sexual feelings normalized or did you learn to be ashamed of them? Were you able to be open to your parents about your experiences or thoughts? Or were you afraid to tell your parents what was really going on for you? How did these feelings impact your overall relationship with your parents?
In the documentary film “Let’s talk about sex” (See the full movie: https://www.youtube.com/watch?v=6TsEBgyanb0 ), a seventeen-year-old girl tells the story of her first sexual experience: she had sex with a boy she had met three days before and had no romantic relationship with. “It just happened. I was drunk and I thought that was how it was supposed to go”. Because her story does not fit her mother’s standards about a “first time”, she says: “I could never tell her I had sex… It would be the end of the world”. On her side, the mother is convinced that her daughter is a “hopeless romantic”, “knows that she is not ready to have sex” and is “waiting to fall in love” before she will have sex. The mother’s words reinforce the daughter’s shame, self-criticism, and regret about her first experience. They also maintain the daughter’s belief that she could never tell.
This disconnect between parent and adolescent about sex has a huge impact on family dynamics. At this crucial developmental stage, the parent is completely ignorant about the important changes the adolescent is dealing with. The parent cannot be a relevant support or a resource for the teen if he or she has to deal with a consequence of a sexual encounter, like an unexpected pregnancy or a heartbreak. Conflicts and distrust often emerge when parents find out that their adolescent was lying or secretive about their sexual behavior; while the teens describe themselves as “obliged” to lie because they do not trust their parents to be compassionate allies. It is heart-breaking to witness.
So let’s go back again to your own adolescence. What would you, as a teenager, have liked to ask an adult about sex? Perhaps you needed someone to normalize a disappointing first time? Or you might have liked someone to walk you through how to responsibly prepare for a sexual encounter? Or you would have liked more support in understanding and managing your sexual longings in the context of a family where abstinence before marriage was the expectation? Think back about yourself at mid or late adolescence, what would have helped reduce your shame and increase your ability to make decisions you were comfortable with?
P: Are you saying that I should be compassionate to my teens and talk to them openly about whatever they want? That I should not impose on them my views about sex or try to scare them about the risks? How am I protecting them if I do that?
TE: Your kids need to hear your point of view. Family discussions are crucial for communicating facts, values, and opinions. But more importantly, your kids need to learn how to make their own conscious and discerning choices about sex. For that, there is no other way than to support their reflection as they develop their own opinions about sex. Listen compassionately, be a sounding board and a devils’ advocate as they reflect on these issues. Their opinions are likely to be half-baked. But the goal is not for you to convince them that you are right about sex, but for you to challenge them to think further, more intelligently or compassionately, about their sexual experiences.
For example, a 16-year-old boy told me in a session about his first kiss. He had previously disclosed having sexual thoughts and longings as well as his desire to experiment with a girl. This first kiss, he said, involved a girl he had never met before. They had been set up by a common friend. To his own surprise, he had not felt aroused or even enjoyed by the experience. He was confused about what this “failure” meant about him as a sexual being: did he have a sexual dysfunction or was he not attracted to girls? I gave him some facts about how arousal usually works for men and women and encouraged him to reflect on the details of his experience: what might have made arousal difficult for him? In our conversation, he came to see that he had assumed that he would feel an attraction to any pretty girl and would enjoy kissing her even if he had never spoken to her before. He realized that kissing can be unpleasant for him if he does not feel close and safe with the person. He reserved judgment about his sexual orientation until after he experimented further with a person he felt emotional intimacy with. This boy then began talking about longing for a girlfriend (or a boyfriend) he would be in love with, rather than simply someone to kiss. If he had not found a compassionate adult with whom to process his experience, this boy would have continued to be confused and embarrassed about the experience. He would not have been able to come to his own conclusion that sex makes more sense for him with someone he feels close to. He would have learned nothing developmentally worthwhile from his experience.
In the end, as a parent and a therapist, I would say there are three crucial elements in a conversation with your teens about sex. You should try to (1) contain your own anxiety and (2) be compassionate and (3) collaborative in processing sexual questions or experiences with your teens. Another way of remembering this is to think of the “three C’s” of a constructive sex talk. As you go about your conversation, ask yourself “Are the three C’s present?”
P: Ok. I think I get it. If I want to protect my kids and if I have high standards for the sexual behavior of my teens, trying to convince them that sex is dangerous or wrong will actually backfire and make my teens less aware and more vulnerable. Instead, you advise me to be as compassionate and collaborative as I can in my discussions about sex with my teens. What if I don’t know the answer to some of their questions? And how do I make sure my anxiety doesn’t trick me into lecturing them just when they begin to open up to me?
TE: These are very good questions.
A therapist trained in sexual health can be a great resource about sexual topics. And family therapy can be a safe place where parents can practice how to answer questions as well as learn how to contain their anxiety about sexuality. There is so much taboo in this society about talking about sex. Often adults do not feel comfortable speaking with their sexual partner about sex, so talking to their children about sex might feel impossible. A family therapist can be a coach or a mediator for parents who want to engage with their adolescents and support them as they learn to make conscious and discerning choices about whether, when and how to engage in sexual activity.
-Posted by Emilie Gomart, a Licensed Graduate Marriage and Family Therapist and a trained Sexual Health professional.
Bibliography:
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