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If you have models for how life works, you feel a sense of mastery and power because, as a result of knowing, you can adjust your thinking and behavior to make yourself less vulnerable. This is a critical component of building resiliency in bereaved adolescents.

Helping adolescents develop and understand models of how life and death operate, for example, aids in the development of their cognitive capacity to understand where overwhelming feelings originate and how to control them. By being able to talk about patterns in life--that predictability marks some but not all events and that fairness and justice mark some but not all outcomes, as per the Fleming/Adolph construct--an adolescent gains some frontal lobe understanding of the emotional storm that has been set off by the death.

Through that understanding, the adolescent becomes better equipped to actively respond to the emotional storm rather than passively reacting to it. Thus, instead of "feel and react," the adolescent learns to "feel, stop, think, then act consciously." In this way, therapy can help guide youth to engage in acts of mastery and self-control over their grief, which translates into a sense of power and self-confidence.

The simple act of feeling connected to an empathetic therapist who can name and understand the adolescent's pain and who provides a safe environment in which to ask the "Why me?" question and make the "God is not fair" accusation helps relieve the pain. It can also play an important role in mitigating the issues that can plague grieving adoles cents, including self-consciousness; fear of being labeled abnormal; feelings of detachment shame, and guilt; behavioral disturbances; alcohol and drug use; violence; and sexual acting out.

The need for such a connection is especially improtant as adolescents move through developmental stages and achieve different levels of understanding. Hhaving a safe place in which to revisit the death and fit the accompanying emotions into the bigger grief puzzle gives the adolescent insight into the complete picture.

DR. BELL is chief executive officer and president of Community Mental Health Council Inc. in Chicago and serves as director of public and community psychiatry at the University of Illinois at Chicago.
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Title Annotation:make adolescents good
Author:Bell, Carl C.
Publication:Clinical Psychiatry News
Geographic Code:1USA
Date:Sep 1, 2008
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