“Right now, you’re okay—even if you’re not okay.”
This is a constant refrain Dr. Dorothy O’Neill shares with her clients these days.
Teens are cutting themselves more. Parents and children are struggling with self-worth as grades drop; parents feel inadequate as teachers. People have become less active in many ways, and with minds less occupied, they’re dwelling on their problems more. Families confined to close quarters are arguing more. Parents are arguing over how much contact to allow their children with the outside world.
“This has been an unbelievably different year in the kinds of relationships that people have been having because they’re being forced to stay home,” O’Neill told The Epoch Times. “I’ve never been so busy.”
Her number of first-time clients increased by about 30 percent in 2020. She has never had so many clients who are children and teens.
She described how the dynamic in family homes has gradually shifted since last March.
Initially, she said, families treated the lockdowns like an extended vacation—playing games, walking the dog together, doing calls over Zoom.
Over the months, however, “slowly but surely, what I’ve seen is they’re doing nothing,” she said. “They don’t want to leave the house. They’re not interested in things. I even hear, ‘I don’t even want to shower or clean my teeth.’”
“Their work situation has become a lot more tumultuous,” she said. “Some have lost their jobs, some of their hours have been cut. The financial side of it has really been taking a burden on how they manage what they can do.”
They used to feel this was temporary and there was an end in sight. That hope has faded.
Downhill Since November
O’Neill suspects that a number of folks reached their limit during the holidays. Many people assumed that by Thanksgiving, they would be able to see their families and reminisce about the past pandemic.
“But it wasn’t like that,” she said. “Suddenly we got to Thanksgiving, and they were separated again.”
In other cases, interstate travel left some families perplexed by California’s stay-at-home orders, which began on Dec. 6. O’Neill mentioned one family who travelled to Idaho for Christmas and were shocked that “it was like nothing was happening. It was like normal.”
“It’s really making them question, why are we where we’re at?” she said. “Why can I go to Idaho for Christmas with my family, and none of us are wearing masks, we’re all together. And then I come back [to California] and I can’t use the toilet in a Starbucks.”
That example of a closed Starbucks restroom represented a breaking point for one of her clients.
She bought a coffee at Starbucks, an act that represented a small but significant return to normalcy for her. Then, she was told that she wasn’t allowed to use the restroom.
“She said that was it,” O’Neill recalled. “It was over for her. She just put the coffee down and walked out.
“People are feeling suffocated. … Part of it is not just being locked out of life, but it’s actually the sense of disorder … and that disorder for people that have an orderly life is just one more layer of unhealthy processing for them.
“From November on, it’s just been a downhill slide. … It really began to hit home that this [is] something that we have no control over.”
Problems at Home
O’Neill said she hasn’t seen an increase in substance abuse or alcoholism in her practice, but she has noticed a surge in irritability, arguments, intolerance, emotional disturbances, an inability to communicate, and a loss of self-worth.
During ordinary times, she said, the routine of going to work, socializing with friends, going to dinner, and participating in hobbies kept couples and families too busy to engage in arguments. However, the lockdowns amid the pandemic have thwarted those regular patterns.
“Now we’ve got two people in a room,” O’Neill said. “When something comes up, it’s no longer a small situation that can be sort of worked through. It becomes the catalyst of a bigger argument.
“There’s more ability to find fault with the other person—in a couple that’s together and in couples that are divorced. It’s a fault-finding mission. And that seems to be one of the biggest things.”
For parents who are separated, O’Neill has observed how existing problems have become more complicated.
She said school cancelations have caused many divorced parents to keep their children longer or make plans that infringe on the other parent’s time frames. This child is in the middle of a “tumultuous situation that was already not good.”
You might also have one parent whose concern about COVID infections is heightened, while the other parents might have a more relaxed attitude.
“Everyone is different … in how they perceive the situation,” she said. “There’s no unified understanding. There’s no collaborative thought pattern on how we go from the beginning to the end.”
Conflicts arise, for example, if a parent takes their child to a party or a family gathering that the other parent wouldn’t have allowed.
O’Neill said this turns the child into a weapon of sorts in a battle between divorcees.
“Before the pandemic, that weapon may never have been there,” she said. “You wouldn’t have cared whether they went to a party. [But] now that’s creating huge fights between divorced parents … I call it ammunition. And that’s what it’s being used as.”
Similar problems also arise for married couples.
She mentioned one young girl who has only been allowed to leave her home three or four times since March because of her parents’ concerns about the virus. O’Neill discussed ways the child could speak to her parents about going to the park if she takes proper safety precautions, but their anxiety was so acute that her approach was shut down.
“These are not bad parents,” O’Neill noted. “They’re coming from [a place of] pure safety, pure fear. The fear in some is so high that there is no sense of avenues that you can go down to actually lower the anxiety or help them see a more rational, reasonable understanding.”
Parents Becoming Teachers
The pressure put on parents to educate their children at home has added a significant burden, O’Neill said. For some, English isn’t their first language. She has counseled others who have master’s degrees and still feel inadequate.
“They feel like they’re failing their child,” she said. “So there is an enormous sense of self-worth that’s going down the drain.
“It’s the same dialogue with every parent. My first line to them is, ‘Your story is what I hear all day long.’ So I normalize the story: You’re not alone, you are telling me exactly what I hear from others, exactly the same thing.”
O’Neill tells parents to “ease up” on themselves and relinquish the idea that they have control. Then they have the opportunity to find peace, even if their A-student is suddenly getting Fs.
“You see many parents who don’t want to be vulnerable,” she said. “They want to be that super person that has now had this pressure put on them that no parent can manage. To actually balance your own life and then be a school teacher is very, very, very difficult. So I give them a hall pass. And I tell them, ‘You know what, it’s okay. Fs are okay right now.’”
She also reminds her clients that eventually this period of difficulty will come to an end.
“We get into an abyss and then we start going down this black hole, and we can’t see the bottom,” she said. “No one knows the end, but we do know there will be an end. … They know that logically, but they don’t know that emotionally.”
Teens Driven to Self-Harm
With her youngest clients, she has seen an increase in pressure and anxiety.
“Children have no idea what to do with anxiety, and during the pandemic it’s definitely increased tenfold,” she said. “I think a lot of parents are seeing that their children are really struggling and have wanted to get their kids into therapy.”
One of the more alarming trends she’s noticed among teenagers fourteen to seventeen is self-mutilation, informally known as “cutting”—a practice O’Neill said is common among children who are desperate to relieve stress.
“Several of them have started during the pandemic, but at least a few cut before,” she said. “It’s prevalent because they can watch it on YouTube and they can see other kids doing it.”
She said children can find disturbingly specific information about cutting in YouTube videos, including what areas of the body to injure, what instruments to use, and how deep to penetrate their skin without losing too much blood.
“We know it began because they’re locked in and they’re not seeing their friends,” O’Neill said. “But how did they decide on that form of relief for their anxiety?”
O’Neill begins by helping them minimize their cutting. She compared the habit to people who are addicted to smoking.
“You smoke and you say, ‘I never want to smoke again, because it’s bad for me,’” she said. “But then you pick up that pack of cigarettes … because you have this drive to habit.”
“So it’s wonderful to say, ‘Well, don’t cut,’ but it doesn’t work that way.”
She begins by asking the child not to harm himself or herself for a week. Or, if not a whole week at a time, maybe make it to Thursday without self-harming.
When they feel the urge to cut, she tells them to contact her and explain what they’re feeling. Then they work together to slow down that behavior.
From that point, she helps them find another form of anxiety relief.
“Anxiety can only exist if we fear the past or the future,” O’Neill said. “Anxiety doesn’t exist in the present. And so when they’re focused on something … when they’re working, they’re in the here and now. … They can only cut if they’re anxious and not present.”
She encourages her clients who self-harm to keep a list of alternative activities to focus on, such as cooking, writing, journaling, doing a puzzle, or playing a game.
O’Neill also encourages them to find a single confidant they can trust rather than sharing with a group of peers: “It’s important that it’s a friend who has a more secure background, maybe more of a sense of self worth, and they can help you grow.”
O’Neill has also noticed an increase in bulimia among her teenage clients. She takes a similar approach to those who self-harm by helping them determine how to replace binge-eating with something else.
Other adolescent clients have exhibited anger management issues, dysphoria, poor sleep schedules, and a sense of isolation because “their room is becoming their only outlet.”
“They’re feeling that isolation even more as their world gets smaller,” O’Neill said. “And it definitely—without a doubt—is getting smaller.”
Children are also suffering from a “lack of connection,” she said, because they don’t have the privacy and camaraderie they experience when they’re in school. She prompts her clients to invite their siblings to watch a movie or take the dog for a walk.
“The most important thing is for children is to be talking to someone,” she said. “Do things that you can do that make you leave that bedroom.”
O’Neill said she’s grateful she can help children, especially at this time. “I feel like I’m changing lives and directing children away from that loss. … I’m actually walking the walk with them, and so I get a great sense of pride and achievement.”
Communication Is Key
O’Neill sees parents and children as living in separate worlds under one roof. Her goal is to create unity within families by encouraging communication.
Rather than aggressively checking their child’s grades and agonizing over their progress in school—a tactic O’Neill calls “shaming and guilting”—she advises parents to have an open, productive dialogue with their kids.
Gather the family together during a time that’s not stressful, with no computers or distractions, and ask questions such as: How do you see your education? How do you feel about what’s going on? Is it tough? Is it bad? What’s tough or bad about it?
“Sit down and say, ‘Let’s talk,’” she said. “‘Let’s talk about how difficult this has been and what’s going on. How do we get through this together as a family?’ I think that would be a good conversation.”
O’Neill said going to therapy for emotional problems is like going to the dentist for a toothache.
“I always tell my patients, only strong people come to therapy,” she said. “Weak people don’t come because they can’t face themselves. Strong people come to therapy because they want to change.”