Home   |  Issues  |  The Daily Star Home | Volume 5, Issue 22, Tuesday, June 1, 2010


Dear Dr. Nighat,
I am a 14-year-old; about to be a 9th grader. My problem is with my family (mother, father, brother and sister). I really don't like them.

Lets begin with my dad - he's an industrious businessman. Ever since I was very young I have been real formal with him. I can never have a friendly chat with him. I admire him but have never been able to interact with like average children do with their fathers. It's really frustrating.

My mom - she's the person who is on the top of my 'the-people-I-hate-most' list. I just can't stand her! She, like every other typical woman, has a weakness towards the eldest son, my brother. And since my sister is the youngest in the family, she loves her a lot too! She herself admitted that to me.

I always take her side when my parents fight. I (used to) share the secrets of my friends and their boyfriends with her and that just made things worse for me because she then starts to suspect me.

She has problems with everything I do. I go days without talking to her, months maybe after the fights we have. It's like she's one of those evil mothers-in-law in those Hindi serials!

She even cursed me once saying I'll never be established in my life, I'll remain a failure (despite the fact than I'm a straight 'A' student) because I had a fight with my sister.

My brother - he's...a clone of my dad. He doesn't talk much and a complete introvert, which is really embarrassing. When my friends talk to him he doesn't reply, rather walks away thinking of himself to be too cool! He's totally uncouth and thinks this makes him look real smart. What annoys me is that he says that I'm unsocial when he's like that!

My sister - she's right after my mom in my list. She, like my brother is an introvert; worse than my brother. Both of my siblings think they are good in English yet they don't talk in English. They say that they don't like to show off. This makes me angry. We have fights at least five times a day and I don't remember the last time we talked in a friendly manner.

I just want to get out of this family! I envy the happy families around me. I'm not as serious about my studies as I used to be and this is scaring me because I'll have to sit for my O-levels a year later.

I thought of committing suicide a couple of times! I even tell my friends about this quite often. They think I'm joking around as I have a great sense of humour around them! I'm totally through with this. What should I do?

Dear Young Lady,
You have written eloquently about family dysfunction and its impact on your mental health. I believe this is not an uncommon scenario though many dysfunctional families manage to put up a facade of “happy family” in front of others while it is a different story behind closed doors. It is easy to get deceived by families maintaining double standards.

Your anger and resentment towards your family is not baseless. Although people often frown and say, “Your family is your well wisher, so suck it up and move on”, it is easier said than done! I know you would if you could! This is surely not fun to be stuck between a rock and a hard place.

Emotions tend to be all over the place during teen years. If negative emotions get an upper hand it can take one on a downward spiral. Suppressing these negative thoughts don't seem to work either. Feeling consumed by these negative thoughts is interfering with your schoolwork. The brain can only handle so much!

Instead of fighting at all fronts, pick your battles. Family-fights are mostly lose-lose games, without any winners! Your siblings think that speaking English is showing off. Well, everybody is entitled to have an opinion, you can agree or disagree with due respect.

You have come up with your “people-I-hate-most” list; it might help to come up with a “people-I-like-most” (e.g. grandparents, aunts, uncles, friends, neighbours, teachers, etc.) list as well and spend time with supportive people.

It is probably worth mentioning here that daughters of emotionally absent fathers are at a higher risk of prematurely looking for love in men much older than them. Children who feel like a misfit in the family also tend to go for wrong crowds to feel accepted.

You have rightly pointed out the dysfunctions that are going on in your family. Parents fighting in front of children, an emotionally distant father, sibling jealousy arising from mother's favouritism, maternal failure to convey unconditional love and communicate effectively with children, silent treatment (a power game), etc., are all creating a chaotic environment at home.

Children failing to develop a secure attachment (ref: Attachment theory of John Bowlby, 1950) with their primary caregiver tend to suffer emotionally and mentally in later years of life (e.g. depression, personality disorder, substance abuse, etc.). Emotional intelligence (EQ- the ability to identify, use and re-channel emotions correctly) seems to get affected the most.

A mother's neglect or ambiguous response to her child's basic needs is particularly associated with disorganised attachment. If the mother (the primary caregiver) habitually fails to respond appropriately when the child is frightened, hurt and ill in very early years of life, the “attachment system” in the brain (neuronal circuits of Orbito-frontal area of the brain) remains un-nurtured.

Inadequate stimulation of “attachment system” can lead to atrophy of that brain area.

Emotional abuse or neglect has a worse outcome, if “amygdala” (part of limbic system of brain) gets affected; these children perceive negative emotions in a disorganised way.

Although these damages are not totally irreversible, it takes a lot of work to undo the faulty patterns.

Considering life situation and individual capacities, your parents are probably doing their best, which is definitely not enough to meet your basic needs and promote healthy emotional growth.

Instead of getting caught in a blame game, it will be important to learn how to change self-destructive behaviours to build a better future. I think you are a very intelligent (high IQ - straight A student), assertive and social person. I believe, therapy sessions to work on “frustration tolerance level” (e.g. lowering expectation, maintaining boundary etc.), anger management (e.g. competitive sports, exercise, creative activity etc.) and cognitive re-structuring will benefit you immensely.

A proper psychiatric assessment will be helpful too. Self-defeating thoughts (including suicidal ideation) are signs of failure to cope and requires due attention.

While navigating through this difficult phase of life, you need some important life skills to get a grip on things. This world is not necessarily a fair place but one has to try hard to get the best out of it.

Finding a reading partner, going to the library or to a friend's place to study together and being transparent about your whereabouts might help. Relaxation practice, meditation and having a hobby might also work.

Like a typical middle child of a highly dysfunctional family, it seems that you are coping with the stress by taking up the role of a “scapegoat” (e.g. Feeding on negative attention, easily feeling rejected, hurt, lonely and angry, etc.). It also appears that you are using humour at times to hide this pain (role of a mascot).

These are your survival tools when you are at your wit's end to cope with life. Therapy is essential to learn better and healthier coping strategies for future.

Families shouldn't feel embarrassed to seek help when things start going out of control.

If parents are non-cooperative or oblivious to the mental health system of their children, social services should have proper legal and financial coverage to reach out to children who need extra help.

Dear Doctor,
I am a 47-year-old man. My wife is 12 years younger than me. It has not bothered me before but lately I have been feeling that I look older than my age. I have developed wrinkles on my forehead and around my eyes and also the folds along the sides of my nose seem more prominent than before. Also there are bags developing under my eyes. Can anything be done to reduce these?

Thank you for your query. Some surgical and non-surgical procedures are available. For the wrinkles around the forehead and eyes, we can use Botox. This is a non-surgical procedure where a solution is injected around the wrinkle line and causes it to flatten. This is a very safe and popular procedure for the removal of wrinkles. If given properly by trained hands there are no side effects at all. The wrinkles disappear after 3-4 days.

As for the prominent nasolabial folds, it depends on how deep they are. Here we can use fillers to fill them up.

Fat from your own body, as well as artificial fillers, can be used. Again this is a non-invasive procedure but local anaesthesia is used. If the depression is too deep and sagging then thread facelift can be done to lift up the fold.

This is also a non-surgical procedure. Here threads are used to lift the sagging portion of the face making it look younger.

All these procedures are outpatient or office procedures and no admission is needed. Patients can come in, do the procedure and walk out within an hour or so. These procedures are not permanent and last only six months to one year. Then they can be repeated according to the patient's choice.

For permanent or long lasting effects, surgical procedures are available. Bagginess develops under the eyelids due to redistribution of fat under the eyelids and there is also loosening of the skin due to aging effect. These need to be removed surgically.

It can be done by local or general anaesthesia. An incision is made along the crease line of the lower lid so no scar remains after the surgery. Recovery takes around 6-10 days. The final effect is impressive, as the patient looks years younger after the procedure.

Also, for excess sagging of facial skin along the nasolabial folds or jaw line, a facelift operation can be done. Here the sagging skin is lifted and excess skin excised.

The recovery period for this surgery is about 10-15 days and the effect stays for more than six to seven years.

One thing we should all remember is that although we are reversing the effects of aging by surgery, our bodies do not stop aging and so the effects still go on but at a slower rate.

I am sure that if you consult with cosmetic surgeons, they will be able to advise you on which procedure is right for you and solve your problem.


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