“I Don’t Want to Do Life Today”: Helping Adolescents Save Face in Treatment and Recovery

Is life so difficult for some adolescents in America that they don’t want to get out of bed each day? While presenting a clinical workshop at a long-term residential treatment center I met a young man, Drew, who was nearing the end of his treatment and was enthusiastically looking forward to starting a new life. He knew he would be leaving soon and that he now believed that he was in control of his life. He shared his story with me, telling me that he began using various drugs and drinking at age fourteen. In a short time that is all he wanted to do. He lost interest in everything except getting high. He was in and out of treatment during the next four years of his life, but had no motivation to change. He was in treatment because that’s where everyone thought he should be. I asked him what finally made the difference. He replied that one morning he awoke and said to himself, “I don’t want to do life today.” It was at that point he knew he wanted help. 

 

Unfortunately, the story of Drew is not that unusual. Like many other adolescents, he did not want to face the world that day, and he did not want to face himself. In this article I will discuss the developmental tasks and social problems challenging adolescents and address techniques for helping adolescents save face in treatment and recovery. 

 

Developmental Tasks and Contemporary Adolescent Problems   

 

The problems for adolescents in contemporary America are growing as our society has become more complex and as youth are engaging adult behaviors and experiencing problems at younger and younger ages. More adolescents are in therapy today than at any other time in American history. One of the fastest disappearing things in America society is childhood. As early as the 1980s, David Elkind wrote The Hurried Child about the problems youth were facing as the period of childhood was getting shorter and shorter (1981). At the same time, young adolescents found themselves engaging in behaviors that they were not mentally or emotionally prepared for. 

 

However, we must remember that the catalyst for many of these changes was the accompanying changes of adult behavior, especially those that had negative impacts on youth. Family structure, the necessity of two-income families, increases in the divorce rate, domestic violence, addiction and the family, changes in sexual mores, and other changing norms had profound influences on our youth. These social changes resulted in adolescents trying to adjust or overcome situational crises at the same time that they were attempting to resolve normal developmental crisis of being an adolescent. These developmental crises have been referred to as “developmental tasks” by Robert Havighurst (1948; 1953). He believed that during the period of adolescence adolescents needed to resolve certain tasks in order to successfully adjust to this period in their lives. At the same time, he believed that the successful resolution of these tasks would prepare the adolescent for adulthood. These tasks were:

 

• Accepting one’s physique and using the body effectively
• Achieving new and more mature relations with age mates of both sexes
• Achieving a masculine or feminine social role/gender identity
• Achieving emotional independence of parents and other adults
• Preparing for an economic career
• Preparing for partnership/family
• Desiring and achieving socially responsible behavior
• Acquiring a set of values and an ethical system as a guide to behavior—developing an ideology

 

 

Since Havighurst’s work there have been a variety of adolescent developmental theories and most of them subdivide into the areas of biological, psychological, cultural, and emotional development. The point, however, is that theorists agree that adolescence is a unique period of development with its own unique tasks and that the ultimate challenge is the formation of one’s identity. However, what is the impact of unwanted problems such as depression, cyber addiction or family problems on the resolution of normal developmental tasks, and does this create another set of tasks to deal with the crisis situation? Is the resolution of normal developmental tasks arrested or impeded due to the presence of situational crisis? Do the adolescents progress only to a certain point of developmental resolution and then stop or continue at an incredibly slow pace? If children are forced to grow up too fast, is the resolution accelerated and thus the young person is overloaded with issues that she or he should not have to face at their age? All of these impediments to successful resolution of developmental tasks leave adolescents unprepared for the next stage of their lives. 

 

Adolescents today face a variety of problems. Some of the most common are as follows:

 

• Stress
• Bullying and cyber-bullying
• Low self-esteem
• Alcohol use
• Smoking
• Drug abuse
• Sex behaviors
• Abuse, including dating abuse
• Eating disorders
• Unwanted pregnancy
• Peer pressure
• Cutting
• Family problems

 

 

Although many teens struggle with these problems, it does not necessarily mean that they view them as problems. They don’t see that they might be getting in their own way or cause their own problems due to self-defeating or self-destructive behaviors. On the other hand, they might realize the problems, but hesitate to confront them or share them due to fear of losing face. 

 

Saving Face  

 

Perhaps more than any other clinical technique for working with adolescents, I believe allowing them to save face is the most critical variable in the adolescent therapeutic alliance. This alliance must develop before any change is possible. It is the prerequisite. Remember, how adolescents see their problem is not initially as important to them as how they perceive their friends see the problem. For example, over 70 percent of teenage girls between fifteen to seventeen years of age avoid activities, including school, when they feel bad about their looks (“Brands in Action,” 2014). Additionally, 70 percent of girls do not believe that they are good enough for others due to their looks, school performance, and relationships with friends and family (Council on Alcoholism and Drug Abuse, 2013). Perception is everything and most adolescents feel as if they live in a fish bowl. They see themselves as they perceive others see them, even if the perceptions are distorted.  

 

Saving face for adolescents is really about saving or maintaining identity. Iidentity is developed by the role or roles that people perform. Thus, adolescents understand the concept that “all the world’s a stage” perhaps better than people of any other age. In his book The Presentation of Self in Everyday Life, noted sociologist Erving Goffman described how human expression is constantly “giving” through talking and “giving off” through such things as tone, posture, gestures or facial expressions in the presence of others (1959; Smith, 2011). It’s the old idea of not just what you’re saying, but how you’re saying it. All adolescents know what “playing the role” means. This can be a difficult task to maintain, especially if something happens to discredit the role performance. Adolescents will then use every strategy to save face. They often believe that they must play their role perfectly. This is an impossible task because a person can’t be wrong—not even once. After all, reputation is on the line. 

 

Maturity begins to occur for adolescents when they realize that not only are they not perfect, but also when they learn to accept their humanity and limitations and to lighten up on themselves. Goffman pointed out that although a person can perform a role it doesn’t mean that he or she is always sincere about their role (1959). In fact, he indicates that they could be cynical in that they really don’t believe in what they are doing, but do it anyway. Although his book was written in 1959, it is very applicable to the modern adolescent. Unfortunately, with today’s technology adolescents can feel as if they are continually being watched. No pun intended, but Facebook isn’t helping matters. Saving face has become a twenty-four-hour job. The following are two examples of trying to save face behavior. 

 

Getting Picked Last  

 

Do you remember picking up sides for teams when you were a kid? Have you ever thought about the fact that the next to last kid was actually the last one picked? The last kid was never picked. The team with the last kid never expected much from the last kid and as a result the last kid never expected much from him- or herself. If he or she messed up, it was simply because he or she wasn’t very good. Thus, he or she met everyone else’s expectations. Or maybe the number of children playing wasn’t even and thus the odd number child would never be picked. In this case the odd number child often made excuses about really not wanting to play or about having to go home anyway. It was a way of trying to save face. Either way, the truth is that no one ever rises to low expectations.

 

I Could Have if I Wanted to  

 

In a high school classroom a teacher is giving back an examination to the students. When it comes to the student known as Mr. Bad Attitude, the teacher puts the exam on his desk. Mr. Bad Attitude glances at the results written on the first page and sees that he has received a twenty-eight out of one hundred score. He throws the exam on the floor and casually says to the other students, “Twenty-eight! I got a twenty-eight and I didn’t even read the book; tough course!”  So, what is he doing? He is discounting the importance of the accomplishment in order to save face. However, it is more than that. Suppose on the next test he actually tries and he receives a sixty-eight. You say, “Wow, a forty-point improvement!” But is it really? It is still actually failing if seventy is the minimum score to pass. The twenty-eight-point score allows him the illusion of control. He can tell himself and others, “I could have passed if I wanted to, and who cares about this stuff?” The sixty-eight-point score means he tried, but he failed and thus the teacher is in control. Saving face and being in control are often seen as one and the same thing by adolescents.    

 

In the book Treating the Unmanageable Adolescent, Neil Bernstein offers some suggested questions and techniques for working with resistant adolescents (1996). These are helpful in order to begin a therapeutic alliance that initially allows the adolescent to be in control and save face: 

 

• “It must be hard for you to imagine your life being any different.”
• “It must be difficult being you.”
• “You look ticked off. Who has been hassling you? How can I help you?”
• “If you don’t want to talk, how can you convince me that you don’t need to be here?”
• When the adolescent doesn’t want to be involved in treatment, tell them important decisions about them will be made in their absence.
• Avoid jargon and sarcasm
• Develop a balance between authority and tolerance
• Don’t ask “yes” or “no” questions.
• Ask them to talk about their life, who they hang out with, etc.
• They are more present-focused than on past or future
• How long with this last? It depends on their effort and willingness to change.

 

 

Each of these questions or suggestions reflects elements of saving face for the adolescent while allowing the therapist to begin an alliance dialogue. The opposite of being in control is being vulnerable and adolescents are very self-protective and fear their own vulnerability.

 

 

 

[H1]Working with Adolescents in Groups and Saving Face

 

Obviously, adolescents and adults often view things very differently. For example, when adults participate in a support or self-help group that they find satisfying, they often indicate that one of the most beneficial things they learned was insight about themselves. However, personal insights about themselves do not rank high on an adolescent’s list when it comes to gaining something worthwhile from being in group. Adolescents indicate that the most beneficial thing they get from a group experience is behavioral techniques. For example, one adolescent describes a situation that she or he was in and the first thing they are asked is, “What did you do?” Questions such as, “What were you thinking?” or “What were you feeling?” are not at the top of the list. They want to know how someone handled the situation, especially if others were watching. How they act takes precedent over how they feel. Feelings can be dealt with later or only expressed appropriately according to the adolescent world. Getting angry is acceptable, breaking down is not. Thus certain behaviors save face while others lose face. 

 

 

Using a Group Interactive Contract  

 

I find that developing an interactive contract is a good technique for working with adolescents in groups. Initially it is very behaviorally oriented and provides an external mechanism (i.e., the contract) for developing boundaries for the group and keeping behaviors socially acceptable. The first part of the contract involves developing guidelines for how members of the group want to be treated.  

 

I start by asking the group members, “How do you want to be treated in group?” I use a flip chart to record their answers. These might include such things as respect, no put-downs, nothing goes outside of the group or being treated as adults. However, I never simply record a response and move on. For example, I always ask the adolescent specifically what he or she means by “respect.” This not only clarifies the concept, but allows the adolescent to define their meaning, gets them to begin talking, and allows the members to listen to each other’s perspectives. Once all of the requests are made and written down, I then add two of my own requests. The first one is “amendment.” This means that the original contract can be amended at any time by the group. The second one is a risk clause. This clause is related to the group process for discussing topics. Every member of the group has a chance to comment on every topic as it is passed around the group from member to member. If an adolescent does not want to comment, that is her or his right. In order not to comment the individual says, “I don’t want to risk that” and it goes to the next person. The risk clause means that adolescents have a right not to comment and more importantly they know that the group will not pressure them to reply, make fun of them, be sarcastic or disrespect their rights to privacy. I have found that stating “I don’t want to risk that” is a very powerful statement and also provides a safety procedure for adolescents not to risk vulnerability and to save face.  

 

The second part of the contract involves a participation commitment. In other words, “What are you willing to give to get?” At the top of the second paper I write that and clarify to the adolescents that they have indicated how they want to be treated and, therefore, what are they willing to give to get it? Again, I record their responses and ask for clarification and meaning. In many cases the adolescents indicate that they are willing to give what they are asking for, such as if they want respect they are willing to give respect. Some indicate they are willing to show up and thus give their time, while others say they are willing to listen, not judge each other, not to fight or break the code not to share information outside of group. 

Once both parts of the contract are completed I sign and date it and ask each adolescent to do the same. Thereafter, at the beginning of each new group I put up the contract to remind the group of our agreements and ask if anyone would like to amend our contract. I find that the interactive group contract is a great way to lower anxiety about how the group will function, provide guidelines, create balance among members, assure equal opportunity to participate, and provide a mechanism of control for each member. 

 

Bibliotherapy  

 

Bibliotherapy involves using books, articles, writing, and other literature to help individuals solve problems and contemporary issues. It utilizes reading materials relevant to a person’s situation. The term “bibliotherapy” was first used by Samuel Crothers in 1916. However, the idea of using literature as bibliotherapy can be traced to the ancient Greeks, who thought that it was psychologically and spiritually beneficial to read. In fact, the sign that they posted their over libraries described them as a “healing place for the soul” (Sullivan & Strang, 2002). In the United States the use of bibliotherapy began in the 1930s (Abdullah, 2002).  

 

Although you might not think that adolescents want to read, “bibliotherapy” can be a very effective clinical tool to help adolescents solve problems. If you work with adolescents who resist reading a book, use shorter assignments. For example, in group I often use a one-page story about an adolescent who is confronted with a difficult situation or problem followed by a series of questions of what the individual should do. This is also a good mechanism to allow adolescents in the group to save face. They can discuss someone else before they risk discussing themselves. 

 

The benefits of bibliotherapy occur in several stages: identification, catharsis, and relational insight. Identification occurs when adolescents can relate to the people or situation that they are reading about. Catharsis occurs when adolescents begin to share some of the same feelings and thoughts similar to those they are reading about. Relational insight occurs when adolescents realize that they relate to the characters in the literature. For example, it is believed that bibliotherapy can help children and adolescents by offering coping skills, offering problem solving skills, reinforcing creativity, and reducing feelings of isolation (Berns, 2004). 

 

On the other hand, I believe that bibliotherapy can help adolescents save face while working on their own problems either individually or in group. Adolescents don’t often see their own situation as a problem, but might see it more easily in others. Thus, seeing it in others might increase the probability that if they share the same situation, they too might have a problem. Initially, however, by examining someone else’s problem they are able to keep the problem at arm’s length and not necessarily admit their own situation. In group, I often use some of the following questions to begin a discussion about the story or situation that the adolescents just read:

 

• How would you describe the situation for the person in the story?
• Have you ever been in the same situation?
• What do you think the person in the story should do?
• What would you do? 

 

 

These and other questions are intended to allow adolescents to offer suggestions without owning the problem. In this manner, adolescents can save face and still practice problem solving skills. 

 

Final Thoughts  

 

Helping adolescents with their problems takes patience and an understanding of their worlds. It also takes an appreciation for the importance of saving face. Adolescents want to make the right choice, but they want to save face even more. They might fight against the very things they need, but persistence can overcome resistance. The above techniques are but a few suggestions. It is important to remember that although adolescents think they are constantly being observed and judged, so are we by them. Never underestimate the importance of the behavior you model. Your willingness to be there when they need help speaks volumes and sometimes we speak the loudest when we listen. 

 

 

 

References  

 

Abdullah, M. H. (2002) Bibliotherapy: ERIC digest. Retrieved from http://files.eric.ed.gov/fulltext/ED470712.pdf

 

Berns, C. F. (2004). Bibliotherapy: Using books to help bereaved children. OMEGA—Journal of Death and Dying, 48(4), 321–36.

 

Bernstein, N. (1996). Treating the unmanageable adolescent. Northvale, NJ: Jason Aronson.

 

“Brands in Action: Dove.” (2014). Retrieved from http://www.unileverusa.com/brands-in-action/detail/Dove-/298217/

 

Council on Alcoholism and Drug Abuse. (2013). Image and self-esteem. Retrieved from http://mentor-center.org/image-and-self-esteem/

 

Elkind, D. (1981). The hurried child: Growing up too fast too soon. Boston, MA: Addison-Wesley.

 

Goffman, E. (1959). The presentation of self in everyday life. New York, NY: Doubleday.

 

Havighurst, R. J. (1948). Developmental tasks and education. Chicago, IL: University of Chicago Press. 

 

Havighurst, R. J. (1953). Human development and education. New York, NY: Longmans, Green. 

 

Smith, G. W. H. (2011). Goffman, Erving (1922–82). In G. Ritzer and J. M. Ryan (Eds.), The concise encyclopedia of sociology (pp. 269–70).