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January/February 2015 Issue

Mental Health Monitor: Reconceptualizing Adolescence
By Liza Greville, MA, LCSW
Social Work Today
Vol. 15 No. 1 P. 30

Daniel Siegel, MD, a clinical professor of psychiatry at the UCLA School of Medicine, an internationally acclaimed lecturer on the topics of brain development and interpersonal neurobiology, and bestselling author, takes on the emerging adolescent mind in his newest book, Brainstorm: The Power and Purpose of the Teenage Brain.

According to Siegel (2013), "Life is on fire when we hit our teens. And these changes are not something to avoid or just to get through, but to encourage."

Siegel contends that the phase of adolescent development, spanning the ages of 12 to 24, is often misconstrued, and fraught with unnecessary misunderstanding and conflict, due to three pervasive myths.

The first misconception is that teenagers fall victim to raging hormones that cause irrational and erratic behavior. While teenagers do experience the hormonal changes that accompany puberty, it is not, Siegel states, these hormonal changes that account for changes in behaviors.

A second myth promotes the idea that adolescents are simply immature and need to "grow up" while adults endure this difficult period with their teens. Siegel finds this a limiting idea that fails to appreciate the potential of young people to thrive in adolescence.

Finally, the myth that young people should exit adolescence completely self-sufficient and independent of adults is not helpful because it forecloses the possibility of nurturing the interdependent relationships that ultimately are necessary for a fulfilling life.

In contrast to the tumult and negativity invoked by these myths, Siegel conceptualizes adolescence as a unique period of intense development with the potential to shape the very characteristics of mind that will have direct bearing on the creation of a meaningful adult life. He acknowledges that the intensity and rapidity of change may challenge adults supporting adolescents. In response, Siegel hopes that emerging theory and research can help adults better understand this developmental phase, respond to teens in constructive ways, and be present through the inevitable stress that accompanies growth.

Brain Changes
According to Siegel, brain changes beginning in the early teen years catalyze four distinct processes that become prominent organizing themes for adolescent thought, feeling, and behavior. He defines these themes as novelty seeking, social
engagement, increased emotional intensity, and creative exploration. Understanding these processes, along with the positive and negative potentials that accompany them, is essential to understanding adolescents.

• Novelty seeking: An increased drive for reward (discussed below) emerges in adolescence, and causes teens to be more receptive to adventure and engagement with life, often leading to the discovery of lifelong passions. The risk of novelty seeking is a tendency to overemphasize the thrill or reward of a new experience while downplaying negative factors, and acting impulsively on that assessment.

• Social engagement: As connectedness with peers and new friendships take predominance, teens have the possibility of developing broad networks of support, and supportive relationships are well known to predict happiness and well-being across the life span. However, when those networks develop isolated from adult input, knowledge, and reasoning, the likelihood for risk behaviors increases.

• Increased emotional intensity: Life feels more charged to teens, whether in the form of energy and zest for life or moodiness and reactivity.

• Creative exploration: Increased development of the prefrontal cortex of the brain increases capacity for conceptual thinking and abstract reasoning which allows teenagers to broaden their perspectives and think in new and creative ways. This can lead to perceiving a world of expansive possibilities, but also invite struggles with finding identity, direction, and purpose.

Another factor contributing to shifts in behavior during adolescence is a distinct increase in the brain circuitry that utilizes dopamine, which is the neurotransmitter that mediates the drive for reward. How adolescents experience reinforcement changes because of the activity of dopamine in the brain. Siegel (2013) notes, "Research even suggests that the baseline level of dopamine is lower—but its release in response to experience is higher—which can explain why teens may report a feeling of being 'bored' unless they are engaging in some stimulating and novel activities." This change in the ways the brain processes dopamine and the sensation of reward manifests in the following three important ways:

1. Increased impulsiveness: When the reward is greater, the urge to seek it is stronger, and this can lead adolescents to jump into action without pause to process and consider consequences of the action.

2. Susceptibility to addiction: Addictive behaviors and substances involve increased dopamine release. Novelty-seeking adolescents are more likely to experiment with substance use, and are more prone to respond with an enhanced dopamine release, which can lead to addiction. Four drives can motivate increased drug use during adolescence: experimentation, social connection, self-medication, and addiction.

3. Hyperrationality: In instances of impulsive behavior, a teen takes action without thought or reflection. In contrast, hyperrationality describes a process by which adolescents fully recognize the possible negative consequences of an action, but de-emphasize them while simultaneously overemphasizing the possible positive consequences. The risk seems worth it, because of a positive bias that amplifies the pros and downplays the cons of a given action.

In addition to the changes in circuitry involving dopamine, another critical process of neural integration takes place during adolescence. Neural integration involves the creation of linkages between different areas of the brain and happens in two ways. First, during adolescence, "pruning" occurs; this is the process of decreasing excess connections in the brain to leave behind the circuitry which is most utilized. This process is both genetically controlled and influenced by experience. Thus the patterns in which adolescents focus their attention are crucial to shaping the growth of the mind. The second significant brain change involves "myelination," which is the process of the brain sheathing the membranes among linked neurons in myelin, thus allowing more seamless, efficient flow.

The overall consequence of more integrated brain development is better cognitive control (and a decrease in impulsivity) and better perspective-taking skills (and a decrease in hyperrational thinking). In sum, teenagers are in the process of developing judgment.

Impaired integration may result in chaos, rigidity, or dysfunctional mood or thought that disrupts adaptive functioning. Impairment may be temporary and further development may resolve the dysfunctional consequences. Alternatively, severe mood or behavioral issues may indicate the onset of a psychiatric condition that requires evaluation by a mental health professional.

Therapeutic Activities
Siegel recommends adolescents engage in specific activities that facilitate physical and emotional health and ongoing integrative brain development by stimulating neuronal activation and growth. He sees fragmented attention, multitasking, and being overwhelmed by information as impediments to optimal brain development, and encourages seven essential daily activities. When practiced regularly, these practical skills strengthen the mind and one's own awareness of it. They are summarized at www.mindplatter.com in a useful format for presentation to adolescent clients or parents:

• focus time, "when we closely focus on tasks in a goal-oriented way, taking on challenges that make deep connections in the brain";

• play time, "when we allow ourselves to be spontaneous or creative, playfully enjoying novel experiences, which helps make new connections in the brain";

• connecting time, "when we connect with other people, ideally in person, or take time to appreciate our connection to the natural world around us, richly activating the brain's relational circuitry";

• physical time, "when we move our bodies, aerobically if possible, which strengthens the brain in many ways";

• time in, "when we quietly reflect internally, focusing on sensations, images, feelings, and thoughts helping to better integrate the brain";

• down time, "when we are nonfocused, without any specific goal, and let our mind wander or simply relax, which helps our brain recharge"; and

• sleep time, "when we give the brain the rest it needs to consolidate learning and recover from the experiences of the day."

The upsides of the developmental processes occurring in adolescence, Siegel says, form the very essence of a fulfilling adult life. Siegel (2013) speculates whether "some of the tension that I see in parents as a reaction toward adolescents is at times a deep longing for these very features they themselves may have lost." For example, he questions whether the emotional spark of adolescence could be threatening to a parent who feels emotionally dull or whether the level of social engagement of a teen could, by contrast, cause a parent to recognize a sense of his or her own disconnection. Siegel encourages the "adult-who-was-once-an-adolescent" to recognize the developmentally necessary changes of this phase, approach challenges constructively, and most importantly, keep lines of communication open so that the novelty, engagement, intensity, and creativity that adolescents are prone to can come to fruition in healthy ways.

— Liza Greville, MA, LCSW, is a therapist in full-time clinical practice and freelance writer based in rural, northcentral PA.

Siegel, D. J. (2013). Brainstorm: The power and purpose of the teenage brain. New York, NY: Penguin.