Of Cutting, Competition and Connections

BUFFALO, N.Y. -- University at Buffalo researcher Catherine P. Cook-Cottone knows what works to stop the self-destructive cycle of teenage eating disorders. Now, she's expanding that protective web to help teenagers and parents cope with other demons that too often follow the wholesale pressures of growing up -- to win at sports, to be smart, to look good.

"Disorders and problem behaviors such as substance abuse can evolve from children's attempts to master their overwhelming stress," says Cook-Cottone, an associate professor of counseling, school and educational psychology in UB's Graduate School of Education, whose research on teenage eating disorders has been cited in national media and professional journals. "These disorders and problem behaviors are painful, but the kids feel as if it is better to be involved in pain and stress -- which they believe they are in control of -- rather than the overwhelming and unmanageable stress they perceive in their world.

"Many of these kids are emotionally sensitive children who need consistent caring and connection."

Going back to school is another ritual that can ratchet up the stress, according to Cook-Cottone. While students face increasing pressure to succeed and fit into what Cook-Cottone calls a "sexualized and consumer-oriented media culture," the current financial pressures most families are going through mean less time and energy to spend on meaningful direct interpersonal connection.

Nevertheless, Cook-Cottone believes the stress virtually all students shoulder can be addressed, and the solutions have more to do with healthy choices and becoming closer to those who love them than any pill. Her work deals with "emotional regulation," and through that, children with the help of their families and teachers can make real strides in healing.

Just how children, parents and educators can come together to help kids master emotional regulation and bloom more as people was a topic Cook-Cottone addressed in the following Q&A.

Media may contact Cook-Cottone at (716) 645-1128 or at cpcook@buffalo.edu.

How common is stress among teenagers going to school these days? Is it increasing?

Cook-Cottone: Teenagers today can experience stress from many different sources -- academic, social, familial and cultural. With full-scale adoption of high-stakes tests in U.S. schools, worries about college and the future, competition in sports and an increasingly image- and media-oriented culture, teens feel pressure to succeed on all fronts. Providing an additional layer of stress, media culture is sexualized and consumer-oriented with less emphasis on community and spiritual connections.

Many believe that schools and churches have lost their central role as socializing agents. Further, there is little social support. Families are overextended with work and financial pressures. As a result, there is increasingly less direct interpersonal connection.

What problems do these stressful and achievement-driven academic environments breed?

Cook-Cottone: We are seeing increases in self-harming and self-destructive behaviors. In a manner of speaking, the kids are taking control of their stress.

Facing overwhelming stress and feeling out of control, they find ways to get through the day, and some of their techniques are not healthy. Some kids do well. They ask for help and tell the people around them that they are overwhelmed. These more resilient kids find healthy coping strategies such as moderate exercise, self-care and strong social support to get through high-stress periods. Other kids make different choices -- often because they feel like they don't have a choice. These kids may drink, engage in substance abuse, cut (self-harm) or engage in eating disordered behaviors. What we've learned is that we can teach these kids how to be resilient and that we can teach kids how to be resilient before they struggle.

What do you mean by emotional regulation, and how does that fit into what we're talking about as far as the byproducts of stress?

Cook-Cottone: Emotional regulation refers to the ability to be aware of, identify and respond to emotions. Emotions are viewed as important pieces of information about our internal and external status. Accordingly, emotions are as valuable as our thoughts and cognitive assessments in decision-making. When someone has good emotional regulation skills, they are able to be mindful of their emotions and use them to make choices in conjunction with their thinking skills.

Teaching kids emotional regulation skills helps them acknowledge and value their emotional experience. This helps prevent disorders that are caused, in part, by dys-regulated emotions --substance abuse, anxiety disorders, eating disorders and other self-destructive behavioral disorders.

What can parents do to stop the toxic effects of this stress?

Cook-Cottone: My research team at UB currently is implementing a school-based prevention program designed to increase wellness and coping, and decrease kids' perceptions that stress is unmanageable. This program teaches emotional regulation, yoga, stress reduction techniques, problem-solving, assertiveness and self-care. A component of this program is a series of four parent workshops that teach parents the same emotional regulation and self-care skills we are teaching the fifth-grade students in our program. Our program has been successful in decreasing risk factors associated with eating disorder, and we are hoping that by integrating the parent workshops and enhancing our emotional regulation curricula we will be able to prevent the wider set of self-destructive behaviors, as well as anxiety disorders.

Parents often do not realize how important their role is in helping kids manage stress. The most important thing a parent can do is to model good coping skills -- to model emotional regulation. A parent who comes home and has a few drinks in order to decompress from work is modeling the use of alcohol as a way of regulating emotions. A parent who anticipates stressors, plans, takes breaks, has a regular exercise program and a good social support network is modeling good coping and emotional regulation skills. I think this modeling is reflected best in a quote that is said to come from Gandhi: "What we do speaks so loudly to children, that when we talk they cannot hear us."

Second, parents can provide the structure and support that kids need to get their academic work completed. This includes modeling academic behavior -- reading, integrating education in trips, learning about family history, and creating meaning and demonstrating a curiosity in daily living. It also includes daily quiet time to complete homework with parents reading or writing too. How we spend our time reflects our values. If we want to show our children what we value, we need to do it.

Lastly, parents can teach their children coping skills. These include setting manageable goals, chipping away at goals a little bit every day, breaking down big projects into stages and setting goals for each week, preparing for exams and helping children study, reviewing children's notes and helping quiz them for exams. Over time, kids learn to do these good practices on their own. They will become lifelong learners and perhaps someday parents that will model these same skills.

How can teachers help?

Cook-Cottone: Teachers, like parents, are extremely powerful role models. Already so many teachers are doing the right things. We see this in our prevention work in the schools. Many teachers not only teach curriculum, but teach the children the practice of learning. These teachers believe the practice of learning is a daily task. They show the kids how to break their work down into manageable steps and accomplishable goals. There are teachers who teach deep breathing and help the kids relax before exams. Also, they teach curriculum in the context of life meaning and model their own personal love of learning.

And how about the students themselves? What can they do to be their own best advocate?

Cook-Cottone: Students who succeed see learning as a daily practice. They anticipate large projects and big exams, and work each day to prepare. They also balance this work with down time, exercise and they take care of their bodies. Also, successful students choose a manageable schedule -- a combination of sports, academics and work. If there is not enough time, they scale back. Success is not success at any cost. It is success within the context of self-care and balance. If the academic and athletic goals are such that the student can no longer take care of themselves, the goals are reconstructed.

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