Recognizing Emotional Needs

«It is not enough to simply question consumption; rather, we must ask what emotional need lies behind it.»

Not all substance use constitutes an addiction. However, when substances, media habits, or certain stimulating behaviors become increasingly important, parents are right to be concerned and feel challenged. Boris Schößler, a pediatrician and specialist in child and adolescent psychiatry at the Filderklinik near Stuttgart, is convinced that when discussing addiction, trust, genuine interest, and a willingness to listen carefully are essential. As their children grow into adulthood, many parents are confronted with questions surrounding risky behavior and addiction. This includes both substance addictions—such as drugs—and non-substance addictions. Non-substance addictions, in particular, play a major role among adolescents and are often recognized too late. These include self-harming behaviors such as cutting, media addiction, and anorexia. «One possible definition of addiction is the continued use or continuation of harmful behavior despite the affected person’s knowledge or awareness of negative consequences», explains Boris Schößler, a child and adolescent psychiatrist who also runs an outpatient practice. «But not every instance of use constitutes an addiction or dependence. Hedonism in our society has taken hold across all generations and has broken down many taboos; it may simply be a matter of enjoyment», he emphasizes. However, if a pattern becomes entrenched, it’s important to take a closer look and seek advice.

When you talk to young people about addiction, you’re not just talking to a single child—you’re often touching on an entire network of relationships. Addiction diagnoses are serious illnesses that require well-founded medical and therapeutic treatment—just like any other illness. This is especially true when they occur during childhood and adolescence, as they can hinder development and ultimately cause irreparable damage to both body and mind. When experimental or occasional use turns into an addiction, it is not uncommon for traumatic experiences to lie at the root of the problem, with the individual using substances to cope with the consequences of those experiences. Or, mental health conditions may already be present prior to the onset of the addiction.

Questions instead of accusations

According to Schößler, immediately linking a parent’s concern during a conversation with a teenager to a negative judgment of substance use is not a productive approach. It is more helpful to first demonstrate trust and openness and to assume that the teenager possesses a certain level of competence when it comes to substance use. «However, if an addiction truly exists, the substance or behavior in question holds enormous power and significance in the person’s life», says Schößler. «Parents need to be aware of this when they engage in dialogue with their children; they shouldn’t pin their hopes on an authoritarian approach. The conversation must be handled as sensitively as if you were talking about a new love, a new boyfriend, or a new girlfriend.» This is because drug use—much like falling in love or intense group experiences—can create strong physical, emotional, and social bonds that then shape daily life and decision-making. It’s not enough to simply question the use itself; rather, one must ask what emotional need lies—or lay—behind it. Instead of reproaches and accusations, open-ended questions are helpful. What does this mean to you? What does it represent for you? What do you hope to gain from it? But also questions like: Can you live with this addiction—or is that perhaps impossible? What is the cost? Once these questions have been clarified, the search for alternatives can begin—alternatives that trigger similarly positive feelings or fulfill the need underlying the problematic consumption in other ways. In doing so, parents should become clear about the positive expectations that may lie behind the consumption: the need for happiness, relaxation, a sense of belonging, intensity, or even as a coping mechanism for a lack of control or self-regulation. Schößler advises not to focus solely on weaknesses, but to recognize existing strengths and address the young people’s self-esteem as well as the sense of personal responsibility that develops. The doctor considers the notion that addiction is an expression of weak will to be problematic. Willpower plays a role when someone wants to overcome an addiction. But it does not explain why someone becomes addicted.

Protective factors

«The ability to cope with boredom is one of the most important protective factors against addiction», says Schößler. «Equally important is the ability to draw courage and strength from fear and loneliness. This allows children and adolescents to discover their own strength and perhaps also develop a better sense of their bodies. In this way, they can learn to distinguish between genuine and superficial joy—that is, between what suits them and what isn’t good for them.» Parents can help their children develop these qualities by taking their children’s enthusiasm for their own unique interests and activities seriously from an early age, supporting them in these pursuits—and also allowing them to experience failure. In this way, children can build resilience; they learn to persevere and to accept defeat from time to time. Sports and free play are excellent opportunities to explore boundaries and get to know one’s own body, at a time when physical experiences among children and adolescents tend to be on the decline, yet are simultaneously glorified. Schößler also mentions another important protective factor: connection. Connection to other people, but also connection to action, to a beloved activity. School can play an important role here. Year-long projects, various internships, or public presentations—which are firmly anchored in the Waldorf curriculum—provide a framework in which children and adolescents must face challenges. They can test their limits, experience effort, boundaries, and successes. Schößler, however, takes a critical view when young people—out of fear or social insecurity—are increasingly guided into well-intentioned «safe spaces» where stress is viewed as inherently negative. He argues that the group is an important learning environment. Children and adolescents need spaces for experience where they can express themselves, fail, pick themselves up again, and feel that they are supported.

Addiction today

Non-substance-related addictions—such as media addiction, gaming addiction, and anorexia—are particularly prevalent among adolescents. An increasing number of girls are being treated in hospitals for eating disorders. The number of cases among 10- to 17-year-olds has doubled within twenty years; girls in this age group account for nearly half of all those treated for eating disorders, and an entire ward at the Filderklinik is dedicated to them. With regard to substance addictions, Schößler points out that doctors are constantly confronted with new substances. Modern morphine derivatives and potent amphetamine-containing substances are now even readily accessible to users via the Internet. Medication abuse among adolescents is often overlooked and is less well documented than, for example, the use of alcohol or nicotine, which has decreased significantly over the past twenty years. Physical dependencies often begin with a form of «self-medication», in which adolescents attempt to combat sleep disorders, social anxiety, or symptoms of ADHD with substances—or at least to take a «break from the symptoms». In such cases, an underlying mental illness may also be present, which should then be addressed as a priority in therapy.

Warning signs

«If a child finds joy in many aspects of life—not just one—and if they have the ability to tolerate frustration and emotional depth, then everything is fine», says Schößler. Parents should take a closer look if they lose touch with their child and notice monotonous behavior or a persistently low mood. The issue of addiction acts like a seismograph for the parent-child relationship. It reveals whether trust, connection, and openness remain even during adolescence—or whether mistrust and distance prevail. Sometimes parents, too, are called upon to change, Schößler notes. An important question for parents might therefore be: Would I be someone my child’s friends would call in an emergency? Can I be trusted from a friend’s perspective?