Who Influences Teens More: Peers or Family?

Harvard psychologist Howard Gardner states in his book Changing Minds that by about age 10 a child’s peers rather than parents assume primary importance in the child’s decisions about what to do, especially in the United States. They are, he says, inclined to imitate those peers. This has become almost conventional wisdom in a lot of psychology schools. 

Well of course peers do have a significant influence on kids, especially teenagers, but the question of who has more influence on them is quite a bit more complicated. The most obvious complication is that in the United States of recent years, there are a lot of different peer groups from which to pick. So what determines if a kid wants to be, say, a Goth or a jock? Even back when I went to high school back in the mid sixties in Southern California, there were surfers, greasers, jocks, “brains,” “soches,” guys in rock bands who wanted to grow long hair like the Beatles but were told by the boy’s vice principal to cut it, theater people, churchy people, and a lot of kids who didn’t fit any of classifications or straddled two or three of them.

With which peers adolescents choose to associate is not an accident of fate or necessarily the inclination of the developing child’s true-self tendencies. If their parents were pretty good about letting them learn to lead their own lives and develop their own opinions, then which peers they hung out with was most likely a result of their own developing self-actualization. But in more dysfunctional families, the kids’ behavior, as I have repeatedly discussed in this blog, is designed to stabilize unstable parents and maintain family homeostasis. If this is the case, the parents’ seeming needs steer kids in certain directions regarding their peers. For example, it may determine which kids turn into bullies and which turn into the bully’s victims.

This sort of question has been relevant in psychiatry also. In the past, parents would allow their acting-out teens to be placed in psychiatric hospitals, where shrewd but unethical hospital administrators and psychiatrists blamed the adolescent’s emotional problems and misbehavior – or even their suicide attempts - on cultural phenomena such as heavy metal music. This way, the parents would not feel that they were being scrutinized or blamed, and would gladly pay up.  Some hospitalized kids were kept there for months until their insurance ran out and then summarily discharged. Peer pressure was another scapegoat offered up by hospitals to these parents.

Gardner also mentions how American children even by pre-adolescence have “evolved strong preferences” that may not align with those of their kin and/or ethnic group, and can often state their opinions strongly and stand their ground in disputes. Again, I can’t argue that this doesn’t happen, but IMO this is way over-generalized. They may do that with certain opinions and planned activities, but not dare to question others. Opinions and plans are hardly an all-or-nothing phenomenon when it comes to potentially challenging family homeostasis. If an opinion is expressed and in response Mom sticks her head in the oven while other family members massively invalidate the person expressing the opinion, children standing their ground is almost never the result. And families are all completely different from one another when it comes to which shared internal conflicts are present over certain things, how severe those conflicts may be, or how many of them exist.

Book Review: Building a Life Worth Living: A Memoir by Marsha Linehan

The predominant and most widely-used school of thought in use for the psychotherapy of borderline personality disorder (BPD) is called dialectical behavior therapy (DBT). Marsha Linehan, a psychologist at the University of Washington, was the person who came up with the theory and treatment ideas. The treatment paradigm has been shown in studies to be somewhat effective in reducing some symptoms of the disorder, but mostly ineffective in helping patients solve their problems with love and work.

She believes that a combination of a genetic propensity to be over-reactive combines with a so-called “invalidating environment” to produce the disorder. Studies  that attempt  to identify genetic propensities tend to have a major flaws in distinguishing normal neural plasticity in response to the environment from purely genetic effects, although the combination of a baby that tends towards being reactive and a parent with attachment issues would be problematic – an example of gene-environment interaction rather than just genetics.

The invalidating environment is clearly that in the patient’s family of origin, although this is seldom spelled out in the DBT literature.

Interestingly, in 2011. Linehan, in a story in the New York Times, “…admits that when she was younger, she "attacked herself habitually, burning her wrists with cigarettes, slashing her arms, her legs, her midsection, using any sharp object she could get her hands on." She added, “I felt totally empty, like the Tin Man."  Self injurious behavior and feeling empty are two of the hallmark symptoms of BPD.  Did she have the disorder?  According to the article at least, BPD is a diagnosis "that she would have given her young self."

So I was intrigued when she recently published her memoir. I was particularly interested in hearing about her family of origin and hints of any shared psychodynamic conflicts they may have had, a phenomenon that she appears to be clueless about with her patients. I had wondered why, if she came from such a family, she rarely wrote about how to address invalidating family members, as opposed to merely teaching patients “radical acceptance” of their parents’ ongoing behavior so they react much less.

So if she herself had BPD, and if an invalidating environment is one of two main causes of the disorder as she theorizes, I've long wondered how come she does not address this very much in her treatment plan. She says she sometimes does family therapy, but mentions it only briefly and without any details both in her memoir and her primary book about DBT.

While I cannot be certain of anything about her family based just on what she chooses to reveal in her memoir, the family’s conflicts over gender roles – particularly career aspirations for women – and religion just seem to jump off the page of her memoir. So the following forms the basis for my speculations.

She herself draws the parallel between her mother’s experiences growing up and her own conflicts with her mother. The mother’s parents were described as having lost their fortune and died young. The mother then took a job to support her two younger brothers but later moved in with a maternal aunt, who drilled into her head that she was to be a social butterfly and attract a successful businessman for a mate. Which she did. Yet she never seemed particularly enamored with her husband.

In particular, her aunt told her she had to lose weight to be more attractive. She did that. She never again had a paying job, but was extremely active doing charity work and also painting. Her art was admired and was hung up prominently in their house, but Marsha only found out that she was the artist much later. I guess traditional women could work as long as they didn’t get paid and thereby threaten their husband’s traditional image. Mom did all this work despite having six young children.

The author writes that marriage and children were most important for mother as they generally were for her generation where she grew up. But were they really, or was she just following her family’s rules?

When Marsha was a teen Mom tried compulsively to get Marsha to do the same thing her aunt made her do - unsuccessfully. Marsh was compared negatively with her younger sister who followed the supposed family philosophy re marriage and work. In particular, Mom constantly nagged Marsha about losing weight. Marsha was the only child in the family with a weight problem, so perhaps that wasn’t “genetic.” Marsha writes that the thing she wanted to do more than anything was to gain her Mom’s approval, but somehow she couldn’t manage to do this one simple thing - that her Mother had been able to do - in order to get it.

Marsha writes clearly that she knew that Mom’s relationship with her great aunt was the reason her Mom was so critical of her, but she seems to not understand exactly what made her family act out this issue in the first place nor exactly how it might be transmitted from a previous generation to her. Again, her solution in DBT seems to be “radical acceptance” – you just use mindfulness to accept this reality without trying to change anything, and to stay calm.

If she were my patient, I would start to explore the possibility that she actually was doing what her mother seemed to need her to do - in effect acting out her mother’s repressed ambition, so clear in her non-family activities – so mother could experience her success vicariously. And then trying without success to put up with her Mom constantly invalidating it. Meanwhile, sister Aline was acting out the other side of conflict and appeared to be Mom’s favorite. Mom even told Aline to stay away from Marsha. Aline late apologized to Marsha for this but only after Mom had passed away.

When it comes to religion, Marsha’s description of her behavior seems even more conflicted. She was a practicing Roman Catholic throughout her life, and says that her mother “gave” that to her. However, in the book she frequently criticizes the church for such things as its rampant sexism and for the belief of the Pope’s infallibility. She disputes the circular argument heard by many fellow parishioners that God is real because it says so in the Bible. She later started to mix Catholic ideas about God with Zen Buddhist ideas about the ultimate oneness of everything in the universe in ways which are basically incomprehensible.

Further evidence of conflicts over beliefs and how they may have played into her issues regarding marriage: she couldn’t marry the guy who she most loved because he wanted to enter the priesthood. Even though he didn’t and eventually married. She wouldn’t marry her next boyfriend because he was an atheist. Going from one extreme to another and ending up in the same place - single - is a hallmark of an intrapsychic conflict.

Mixed messages from parents conflicted over the role of being parents is in my theory the hallmark of families with BPD members, and this one seems to qualify. Her mother having six children and no apparent career might be evidence for such a conflict. Dr. Linehan was hospitalized with self cutting and suicide threats for over two years just weeks before finishing high school.