Ask A Therapist: What to Do When Your Teen Doesn't Want You at the Doctor, and Setting Boundaries with Negativity

Counselors Roy Fisher and Liz Covey answer two questions each month for South Seattle Emerald's "Ask A Therapist." Have a question about a relationship? Wondering about the struggles of being a parent? Others likely have the same questions and Covey and Fisher bring years of professional experience to provide their insights.

This month, readers asked the Emerald what to do when your teenager doesn't want you at the doctor anymore, and how to set boundaries around negativity with family members.

If you have a question, please click here and let us know.* We will select two questions each month to answer. The form requires no email address or identification and is completely anonymous. If you are in crisis or in immediate need of care, please contact Crisis Connections at 1-866-427-4747.

My kid is old enough to prevent me from joining her on doctor visits — and she does. How do I continue to participate I her healthcare without this access?

Not knowing what is going on with our children, regardless of their age, can be challenging for parents. In the natural course of the parent-child relationship, there will be multiple points where the child will look for ways to assert their autonomy. Cultural differences will impact this process, but there are some things we have come to expect.

Here are some examples all parents can relate to: once children figure out how to use a spoon, they want to feed themselves. Once they learn to stand up, they want to walk by themselves. How many times have we seen a 3-to-5-year-old pulling their hand away from a caregiver? This is not because the child is being obstinate; the child may only be attempting to find their independence. As they get older, teenagers may close doors or rail at us for asking too many questions about their friends, what happened at school and what they are up too. Frustrating, yes, but an expected part of their development.

Dictionary.com defines "participate" as the action of taking part in something. As parents and caregivers, we should consistently evaluate what it means to "take part." As a child mental health specialist, I work with parents to "get out in front" of their children. We have been kids and based on whatever developmental stage they are in, we have a general idea of what is going on with them and more importantly, we know what's coming next.

The way we can "take part" is to prepare them for what lies ahead. For example, when a child is learning how to walk, we participate by creating an environment that allows them to safely learn how to navigate their surroundings. As they get older, we participate by giving them information; we talk to them about the importance of looking both ways while crossing the street, obeying traffic signs, etc. The ultimate goal is to feel comfortable knowing that when the child Is not with us, we have provided them with the information needed to help them be successful. Children go through several developmental stages on their way to independence. Depending on which developmental stage our child is in determines how active our participation is. For the infant we are constantly making sure they are safe, but as they get older, we should be giving them more space.

The rules of privacy/confidentiality, as they relate to medical and mental health treatment, are straightforward and should be honored. Any effort to push for information may result in a response similar to the 3yr old pulling their hand away. You can take part by providing your daughter with language on how to advocate for herself, the importance of regular medical exams and by sharing some of your experiences. You don't need direct information from her doctor's visits to be a resource.

As parents, our jobs should be to effectively prepare our kids to take on the world without needing us there. Ultimately, parents can take part by witnessing, by supporting and by cheering on their children. Perhaps most importantly, we take part by being there when they need us. While not guaranteed, when we give our children space to explore, their journey often brings them back to us.

—Roy Fisher

I'm worried my mother's negative talk about other people will affect my kid. My mom is a complicated person — she has dealt with emotional trauma throughout her life and has taken away a natural tendency to be incredibly critical of others. She thinks people purposefully hurt her or are purposefully rude. She then is extremely critical and talks negatively about those people constantly, including family members. My mom and I are not close (we have had our ups and downs, and I was her emotional support for many years while she struggled as she was single), but she lives here in Seattle and loves spending time with my toddler, and he loves spending time her. But after she babysits, she lingers afterwards and then complains about her day and life to me will bring up something about my stepsister that bothers her. I have shared that I don't like her complaining to me about my stepsister, but it keeps happening. I now interrupt her every time she starts to tell me something about my stepsister or someone else I know. What I'm most worried about is that she will talk negatively about people and family to my kid, who is not yet 3. Talking to my mom about how hurtful and painful her outward criticism of others to me hasn't changed her behavior. Will she be more receptive if I frame it in a certain way? Should I debrief with my kid after she babysits? Or is there nothing for me to worry about?

Dear Reader,

Years ago there was a movie in the theaters about an eccentric family called "The Royal Tenenbaums". I don't remember much about the movie itself, but I do recall the tagline, which was a succinct axiom about families and a perfect way to approach this question about your mother: Family is not a word, it's a sentence.

As most of us have figured out by the time we are fully grown, we are indeed given a life sentence when it comes to dealing with our families and their inherent (meaning inherited) problems. There is a lot of talk today in psychology about "Epigenetics" or Intergenerational Trauma. Often, this looks like what you have described above: a pretty unhealthy yet needy family member is in our midst, and we fear that they will be the vector that will spread the contagion to our kids. We also know in our bones that our formation was imbued by this virus too, the one that carries the hardship of our people, in the specific way they have lived, suffered, and lost. Life is hard, y'all.

This worry is shared by many, and yet somehow the species evolves, and mostly improves, from one generation to the next. Generally speaking, family dysfunction decreases over time, though the improvements can seem painfully slow and incremental, which, in fact, they are. Martin Luther King Jr. famed remarks about social change applies here as well: "The arc of the moral universe is long, but it bends toward justice." Families tend to have an arc toward health, but it too is lengthy. You find yourself today in one particularly formative spot on that arc, and it hinges on you doing some bending.

What that bending looks like is what we therapists call developing healthy boundaries. But let's be more specific. Boundaries that are too firm cause a hardness in the person who holds them. Conversely, if they are too loose, they cause the person to feel victimized by the other's actions. The healthy line is drawn where you can know what is best for your family, get centered in that spot, and act in accordance with it, come what may.

When it comes to the influence on your toddler, remember that primary caregivers are the sun and moon in a child's universe, and others, like his grandmother, are but stars in the galaxy. If that star is too bright, you can limit contact, or remain present while she is around so that you can mitigate possible harm. Regardless, he will have many negative relational experiences along the way, and if you help him to make sense of how he feels about it, and adjust his exposure to negativity, he will be just fine.

The second entendre to the movie's tagline is that this one word ("family") carries so much meaning. I hope that this letter affirms that your family's meaning is mostly determined by you and your actions in bending the arc toward health, as you already seem to do. By continuing to do so, you will show your son a brave way to navigate the choppy, inevitable waters of dysfunction. I can't think of a more important life lesson, can you?

—Liz Covey

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Liz Covey, LMHC, LMT, is a counselor and parent coach with a private practice in South Seattle working in the specialty area of attachment, adoption, and trauma, with children, families and individual adults. She is also a trainer, presenter, and writer on topics related to the changing face of mental healthcare, disseminating ideas and practices aimed at improving mainline therapeutics so that they are more inclusive, holistic, and effective. Liz is a Rainier Beach resident, and the extremely proud parent of two incredible school-aged kids.

Roy Fisher has a BA in psychology from the University of California, Berkeley, and a MA from Pacific Lutheran in Marriage and Family Therapy. With over 10 years of experience in various roles as a clinician, consultant, supervisor, and teacher, Roy has seen the positive impact of engaging others in thoughtful dialogue.

*South Seattle Emerald's Ask A Therapist advice comes from professionals and are provided for informational purposes only and do not constitute medical advice and are not a substitute for professional mental health care. By submitting your question, you are agreeing to let South Seattle Emerald use it, in part or in full, and it may be edited for length and/or clarity.