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When No One Understands: Letters to a Teenager on Life, Loss, and the Hard Road to Adulthood

When No One Understands: Letters to a Teenager on Life, Loss, and the Hard Road to Adulthood

by Brad Sachs

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When Amanda first came to Dr. Sachs for treatment, she had attempted suicide more than once. Withdrawn and cynical, she refused to speak during her therapy sessions. Determined to connect, Dr. Sachs tried something unconventional: he wrote letters to Amanda between sessions and invited her to write back, thinking she might feel more comfortable opening up in this way&


When Amanda first came to Dr. Sachs for treatment, she had attempted suicide more than once. Withdrawn and cynical, she refused to speak during her therapy sessions. Determined to connect, Dr. Sachs tried something unconventional: he wrote letters to Amanda between sessions and invited her to write back, thinking she might feel more comfortable opening up in this way—and indeed she did. This correspondence gradually built trust between them, helping her to survive and ultimately to heal.

When No One Understands consists of twenty letters that Dr. Sachs wrote to Amanda over the course of her therapy. In these letters, Sachs reaches out to Amanda with the core message that there is nothing wrong with her—that adolescence is painful, complex, and challenging for everyone and that her emotional pain deserves to be honored, openly explored, and viewed with compassion. Dr. Sachs also addresses many of the common questions and concerns shared by all teens on such topics as relationships, breakups, drugs and alcohol, parents, family dynamics, and more.

Along the way, Dr. Sachs offers adults an inspiring image of a truly open, human-to-human relationship between an adult and a teenager. Parents, mental health professionals, guidance counselors, educators, and others who work with teens will see how they might also bring honesty, compassion, and humility to bear in their interactions with young people in order to create truly healing and supportive relationships.

Editorial Reviews

VOYA - Diane Emge Colson
A teen girl called Amanda survives a serious attempt at suicide. She is unable to voice her anguish in counseling sessions with her therapist, Brad Sachs, but is able to express herself more freely through writing letters to him. This book is a compilation of Sachs's responses. Each of his letters is headed with a title that encapsulates Amanda's concerns, such as, "Why am I so lonely?" and "Why do I get high?" Sachs's letters serve as an excellent model for encouraging communication with a teen. He is always encouraging, even when treading difficult ground, such as when he writes, "[I]t was good to know that you felt that a more in-depth discussion of drug and alcohol use would be worthwhile-I think it shows a lot of maturity on your part." If all adults could incorporate this kind of intrinsic respect into their conversations with adolescents, the world would be a wonderful place. Sachs is especially adept at working through family dynamics, an expertise that is on display in earlier books such as The Good Enough Teen: Raising Adolescents with Love and Acceptance (Despite How Impossible They Can Be) (Perennial Currents, 2005). Less helpful is his take on Amanda's cutting, which he compares to transfiguration rituals in other cultures. But the real question is whether this book will be appealing reading material for teens or if it is best appreciated by adults who interact with teens in some capacity. This reviewer's vote would be for the latter.
Library Journal
When Amanda rejected the idea of talking at the therapy sessions set up by her parents, child psychologist Sachs (The Good Enough Teen) initiated a series of letters (snail mail) between the two. This book contains about half of the doctor's letters, and they are gems. We learn about many issues in Amanda's life—her artistic talents, explosive relationship with her parents, smoking pot and drinking alcohol, her boyfriends, and defiance over undergoing treatment. Then, Sachs begins to explore how the early deaths of Amanda's aunt and grandmother changed family dynamics, how cutting represented her need to shed childhood, and how tragedies can transform lives. Throughout this short book, Amanda grows and changes, as do her parents and the author himself. An epilog updates readers on Amanda's college and career paths, and three sections of notes are directed to other teens, parents, and therapists. This excellent book will be savored again and again. Highly recommended for all psychology collections.
—Linda Beck
School Library Journal

Adult/High School
Sachs is a therapist and the father of three teenage daughters. Drawing on both his personal and professional experiences, he gently guides teens toward a broader sense of their world. As a framework, he uses his letters to a patient to address the turmoil of adolescence. Overall, the nonconfrontational format will appeal to teens, but this one-sided conversation makes the work a slightly less effective aid than if readers could have the benefit of the teen's responses. Still, Sachs's paraphrasing of his patient's troubles is adequate enough to attract readers searching for advice on drugs, sex, depression, jealousy, and the changing relationship with their parents.
—Joy MurphyCopyright 2006 Reed Business Information.

From the Publisher
"A collection of sensitive, cogent, and touching observations and counsel on many of the universal themes facing adolescents as they try to navigate the tricky voyage from childhood to adulthood."—Spirituality & Practice 

"Sachs's letters are gems. . . . This excellent book will be savored again and again."—Library Journal (starred review) 

"Sachs's letters serve as an excellent model for encouraging communication with a teen. . . . If all adults could incorporate this kind of intrinsic respect into their conversations with adolescents, the world would be a wonderful place."—VOYA

"A book of unique kindness and clarity that will be comforting and illuminating to parents and teens alike."—Rosalind Wiseman, author of Queen Bees and Wannabes: Helping Your Daughter Survive Cliques, Gossip, Boyfriends, and Other Realities of Adolescence

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Read an Excerpt


One rainy November morning two taut and haggard parents arrived at my office with their sixteen-year-old daughter, Amanda, who had been discharged the day before from the hospital. Amanda had been in treatment for several years, and the week before, had made a serious attempt at suicide: after swallowing dozens of pills, some prescribed, some over-the-counter, she had washed them all down with half a bottle of vodka.

Fortunately, one of her close friends knew something was up when she tried to instant message Amanda and encountered a morbid Away message. She then alertly called Amanda's mother when Amanda didn't answer her cell phone. Her mother discovered Amanda lying unconscious on the floor of her bedroom and called 911, and Amanda was transported by ambulance to the emergency room. Once medically stabilized, she was transferred to an inpatient psychiatric unit for three days and then released with the expectation that she participate in therapy. A colleague of mine who worked at the hospital provided the family with my name, and they called the next day to schedule their initial consultation.

Amanda, of course, like most of the adolescents I see, was coming under protest. Not only was it not her wish to be treated, but according to the previous therapists' notes, she seemed to assiduously resist every effort on anyone's part to promote change. Meanwhile, she had already been diagnosed with and treated for a wide range of mental illnesses—bipolar disorder, borderline personality disorder, dysthymic disorder, major depressive disorder, schizoaffective disorder, adjustment disorder, attention deficit disorder, and dissociative disorder.

At first Amanda was no different with me than she had been with any other well-meaning clinician. It appeared that she had taken a vow of snowy silence as she sat mutely before me, both when her parents were in the room and when she was alone with me, staring sullenly at the floor and slowly bobbing her head, as if to an invisible source of mesmeric music.

No stranger to situations of this sort—just like anyone else who works with adolescents in any capacity—and knowing that unconventional therapy, particularly with teens, is often the most effective therapy, I looked for other ways to bring about some contact, some growth, and some healing. Rather than attempt to cajole her into superficial, monosyllabic conversations, I took note from her clinical records that she was an avid reader and creative writer and decided to try to embark on a letter-writing relationship with her as a less invasive, more productive way of establishing a connection. For whichever of the indiscernible reasons that account for the mystery of human behavior, she decided to join me in this shared endeavor.

Recently, and somewhat fortuitously, Amanda attended a signing that I was doing at a local bookstore. Heartened to get an update and to see and hear how well she was doing as a young adult, I left the store in a reverie, marveling that for most of the first months of our treatment together, she had not said a single word to me during any of our sessions.

As I drove home from the book signing, it occurred to me that collecting and editing the letters that Amanda and I wrote to each other might provide a useful framework in which to share my thoughts about adolescent growth and development directly with teenagers as well as with parents of teenagers and with educators, clinicians, and other professionals who have committed themselves to working with young adults.

While I originally conceptualized this book as one that would include both sides of our correspondence, after sharing that version of the manuscript with selected colleagues, parents, and adolescents and soliciting their response, I came to the conclusion that limiting the text to my letters actually heightened my capacity to speak to the reader more intimately. So after much consideration I decided to cut the book in half and focus exclusively on the words that I struggled and dared, from my most empathetic heart, to offer to Amanda, the words that became part of the rescue raft that carried and delivered her to safer psychic shores.

When No One Understands, then, is a synthesis of twenty-two of the more than fifty letters that I wrote to Amanda throughout the course of her therapy with me. While you will quickly observe that some of Amanda's difficulties and behaviors were more worrisome and extreme than those that you—or those whom you are rearing, teaching, or treating—might personally have encountered or displayed, you will gradually come to understand, as you read, that her journey serves to illuminate many of the most common and elemental conditions and contradictions inherent in every adolescent's life.

All teenagers, regardless of gender, generation, or background, must at some point engage in the universal, time-honored, and mythic struggle to navigate the bewildering, sometimes harrowing, pilgrimage from childhood into adulthood. While the specifics of that transformation will always vary from person to person and never match up precisely, there is always much more that we share and have in common than there is that is distinct and distinguishing.

So let me welcome you into the privacy of a therapeutic bond and share with you one half of the conversation that Amanda and I created together. In learning more about how our relationship unfolded, you will find yourself better able to gaze into, perceive, comprehend, and honor your deepest fears, longings, sorrows, and dreams. And this will in turn nourish my sincerest hope and belief that the words on these pages will gently guide and fortify you as you set forth through the labyrinthine passages of adolescence that ultimately yield to the remarkable birth of your singular adult self.

Chapter 1: An Invitation

Dear Amanda,

First of all, let's get something straight: you don't need to say a word to me when you are in my office. Talking is not the only way for two people to communicate with each other, to make contact with each other, to get to know each other. In fact, talk can sometimes interfere with understanding—that's one of the reasons that I'm writing to you, because I've found, over the years, that the written word often carries greater meaning and authenticity than the spoken word. Also, in looking over the clinical charts that the hospital sent over to me prior to our first session, I couldn't help noticing the consistent A's and B's in English that you have earned throughout your middle school and high school career, which no doubt means that you, too, already have a pretty good comfort level with reading and writing.

So here's the deal: you can be as silent as you want to be during our sessions, but I'd like to see if we can establish a conversation through writing to each other if we're not going to be talking to each other. I will write to you after each appointment with some of my thoughts and observations, and I'd like you to write back with yours—it's that simple.

My proposal may leave you wondering why we have to have any sessions at all if most of our dialogue is going to take place outside of those sessions. The answer is that I still want to get a look at you, even if you have nothing to say—people are always communicating, even if they're not saying anything—and also because I want to leave open the possibility for us to talk to each other, should you ever find that there is a reason for us to do so. Also, I'm still going to want to schedule meetings with you and your parents together so that I can hear what's on their minds and so that we can discuss any matters that might affect the family as a whole.

Don't misunderstand me—I am not asking you to be happy about this arrangement. In fact, I'm quite convinced that coming to appointments, and reading to and responding to a therapist's letters, are not high on any sixteen-year-old's list of fun activities. But I'm equally convinced that you are aware of the fact that your suicide attempt worried many people—your family, your friends, and your teachers—so you're kind of stuck with me for now, at least until you can prove to everyone that you no longer need to be worried about. Since you're stuck with me, we might as well see if we can make the best of the situation and learn what we can from each other. Once you've given this letter some consideration, let me know what you think, and then we'll take it from there.

Best regards,
Dr. Sachs

Chapter 2: Why Bother?

Dear Amanda,

I appreciated your response to my letter, which I received yesterday. I was glad you took the risk of being straight with me about your unwillingness to be "shrunk"; about your unhappy history with previous therapists who not only have not helped but have, at times, been downright insensitive; and about your lack of enthusiasm for any further psychological treatment. Frankly, I'd be a little skeptical if you had sounded chipper and optimistic at this point—after all, in looking over your chart, I counted up five different therapists whom you have already had to meet with over the years—so it's no wonder that you're not exactly turning cartwheels at the prospect of signing up with number six.

You wrote that you can already tell that I'm "just like all the others," and that may, in fact, be true. I certainly don't know that I am going to be all that different from any of your other therapists. On the other hand, the fact that you were so clear about what made these clinicians ineffective—their desire to "change" you, their wish to "help" you, their belief that they "understood" you, their insistence that they "know what you're going through"—does at least give me the chance to avoid repeating some of their mistakes and perhaps try something new (or at least make some new mistakes).

If you want to know the truth, I'm not interested in changing you, I'm not sure you need or want my help, I don't understand you, and I really have no idea what you're going through. I do have to confess to being interested in you and curious about what had prompted you to consider ending your life when it's clear, based on my conversations with your family and other people who have gotten to know you, that you have a wide range of abilities and talents. But I don't think it's really my job to determine for you how you should live your life as a young adult and tell you what I think best for you. Those conclusions and decisions are ones that you need to arrive at, and are always the result of a process of self-discovery rather than of being told what to do.

On the other hand, however, I would be lying if I didn't admit that I'd like you to stay alive long enough to make it through adolescence and see how things turn out—there are always some surprises along the way, and I wouldn't want you to miss out on any of them.

In any case, I was pleased that you made the time to write back and to express yourself so honestly, and I look forward to our unfolding conversation.

Best regards,
Dr. Sachs

Meet the Author

Brad Sachs, PhD, is a family psychologist and the author of The Good Enough Child: How to Have an Imperfect Family and Be Perfectly Satisfied (HarperCollins, 2001) and The Good Enough Teen: Raising Adolescents with Love and Acceptance (Despite How Impossible They Can Be) (HarperCollins, 2005). He is also the founder and director of the Father Center and an active speaker, giving workshops and talks around the country to parents and mental health professionals. He lives in Maryland with his wife and three children.

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