Eating Disorders


(415) 820-3920

San Francisco
3236 Sacramento St.
San Francisco
CA 94115

3155 College Ave.
CA 94705

23 Altarinda Rd.
CA 94563



leaf interruptedADOLESCENTS

Yes, there are two paths you can go by
But in the long run
There’s still time to change the road you’re on
And it makes me wonder

—  Led Zeppelin

Adolescence is a time of great change, both physically, emotionally, and psychologically. This can be a very tumultuous time, as children start to pull away, as their bodies change during puberty, and as peer groups increasingly become more important in their lives.

Four fundamental tasks have been identified as key to adolescent development. They are:

    1)   To stand out, develop an identity and pursue autonomy
    2)   To fit in and find acceptance and affiliation with peers
    3)   To develop competence in the world and find a way to achieve
    4)   To develop beliefs, values, goals and activities

At any point along the way, the capacity to develop can be thwarted by risky behaviors, such as substance use; the development of an eating disorder; stealing and truancy; cutting; extreme defiance and rebellion. Or adolescents can become crippled by extreme anxiety or depression, which derails them from participating in the important journey they need to make in order to become successful adults. Such behaviors or symptoms reflect the difficulty these tasks pose in a cultural climate where there is tremendous pressure to succeed, to be perfect, and where everyone is so aware of every step you make and is only too happy to judge or condemn.

I see this in my office all too frequently.

Today’s teens are far more stressed than they have ever been because they feel so much pressure, both internally and externally, to compete and excel and be good at everything — and many never learn how to fail or find resilience in the face of disappointment, adversity, or setbacks. They don’t really get the chance to know themselves more deeply, to find a core sense of self and identity, to understand what their real values are or what is valuable about themselves beyond the grades and the extracurricular activities. And without a more solid inner core, they are at risk of being thrown off the path altogether.

Adolescence is also a very challenging period in life because it's a time in which there is an exquisite vulnerability. Will you fit in? Will you find your place in a peer group? Can you become your own person and handle the responsibilities that are being asked of you? Is it safe to grow up and be an adult, dealing with complex issues around sexuality and sexual identity? Can you find your voice and will anyone listen? These vulnerabilities can seem daunting, and young people can feel lost at sea without a proper compass.

The adolescents with whom I work come to my office with myriad symptoms:

In my work with pre-teens and teens I am very interactive and engaged. I try to create a safe space to explore the vulnerabilities they can’t express or metabolize — issues so difficult to deal with that the young person manifests them as a symptom or behavior. I work on the level of the symptom, but also go to the heart of the matter, to any underlying fears, frustrations, anxieties, or losses. In addition to deeper inquiry and exploration, I also use tools for grounding, such as Mindfulness Based Stress Reduction (MBSR), a meditative framework that focuses on awareness of the present moment, and our capacity to observe thoughts and then let them go, focusing again on present moment and on the breath.

I also work closely with parents in order to educate them and to help them to help their child. As a parent, I empathize: I understand that parenting is a messy, complicated and ever-changing process. And I get how hard it is to be a parent in today’s world, where there are so many scary realities and so many confusing messages about how to truly help our children.

I really enjoy working with young people. I try to meet them where they are at — and generally connect well with them. I also really enjoy working with parents and feel that I strike a good balance with all members of the family system, each of whom is critical to the success of the treatment.



Copyright © 2017   Lisa Bograd, MA, MFT

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