Dr. Andrew Smolar: The balancing act of parenting adolescents

The task of parenting adolescents has changed a great deal, given how fast the world is moving. For one, information is plentiful and immediately accessible. When I was 17, we checked card catalogs and descended into the library’s catacombs to research a subject. Now, with the stroke of a thumb, adolescents can check for information on Reddit, post on Instagram or solicit advice from friends on their text threads.

Partly out of concern and partly stemming from improved parenting education, parents tend to hover over their adolescents. Often now, when I interview adolescents in a first session, I’ll ask something about their early life, and they will reflexively whip out their phones and call their mothers, seeking the information. I’ve learned to be ready to say I’ll be satisfied with their own memories.

Interestingly, however, modern-day parents tend to miss some of the basics, such as occasionally saying “no.” In my practice of psychotherapy and while raising children over the last 30 years, I have been amazed by the autonomy claimed by adolescents of this generation. Examples include their trumpeting on social media, decorating their bodies with tattoos and piercings, taking stands on guns and climate, and sequestering their college grades from parents.

The downside is they sometimes fancy themselves experts while overlooking the wisdom borrowable from people who’ve lived longer. They also sometimes get into trouble thinking exploration may be fun when a situation turns out to be treacherous.

Thinking back, my parents emphasized different principles. They didn’t track where I rode my bike or whether I wore a helmet. They weren’t focused on nutrition. They didn’t attend school programs about the drunk-driving epidemic. However, they assured The New York Times lay around the house. They installed a curfew when we began to drive. They required deference toward our grandparents. And there was no doubt about who ran the familial democracy.

I’ve been reminded through practice that adolescents are only pseudo-autonomous. They are busy consolidating their individual identities while incrementally separating from parental attitudes. Joining peer groups and deciding which large groups provide a secure anchor. Learning the strengths and limitations of their bodies and defining their sexuality. Extending their intellectual capacities. And throwing in some hobbies for fun.

One hazardous test for adolescents is their experience with substances. Partly to match peers, partly to challenge authority, partly to venture and sometimes to numb psychological pain, they are drawn to altering their minds with them. This tendency isn’t new, although the range of substances available for use has expanded. And fentanyl poses a risk for lethal overdose that wasn’t present when we were kids.

How do I handle their circumstances? I caution patients about the dangers of alcohol given that some adolescents — depending on genetic and developmental influences, and psychological traits — will not be able to regulate its intake. I tell adolescent patients that exposing their young brains to marijuana is more dangerous than waiting a bit and watching the amount. That it is hard to predict what amount will turn out to be safe. That some people get sick with depression or psychosis if they smoke it regularly. I tell them research is ongoing. They usually come to appreciate my imparted knowledge as a protective boundary, and not as parental judgment.

The Adolescent Brain Cognitive Development (ABCD) study initiated by NIH in 2018 will follow nearly 12,000 adolescents — including 2,100 twins and triplets — over the next 10 years and should tell us more about the risks of cannabis. With some legitimate motivations, a political movement to legalize cannabis for adult recreational use has been successful in 21 states and D.C. However, the proportion of adolescents with marijuana use disorder has increased in those states.

My observation is that in Pennsylvania, where medical marijuana cards are granted almost automatically — even when there isn’t a bona fide medical need — adolescents have easy access to edibles. Given that THC today is more potent than the THC of our youth, and given that experiments show damage to rats’ brains when they are exposed to THC during the equivalent of early-middle human adolescence, we ought to temper the push for non-medical legalization in Pennsylvania. We should have learned from the pandemic that policies sometimes result in harm when they precede clarification of scientific facts.

It is natural for adolescents to buck authority as they forge their own paths. It may also be natural for adults to clamp down too hard or to be a bit too lax when it comes to guiding their adolescents. Their kids need a balanced perspective to thrive. What we’ll need as a society is collaboration, implicit in projects such as the ABCD study in which each generation learns from the other.

Andrew Smolar, M.D., is a clinical associate professor of psychiatry at Temple University School of Medicine.