«The school doesn't pick up the silent girls enough»

Mr Schulte-Markwort, you have written a book about «despondent girls» that you encounter in your therapeutic practice. What characterises them?

They are mostly teenage girls or young women who all have a kind of despondency in common. They don't feel drawn into the world by anything and describe everything as uninteresting and boring. They seem to be stuck in their development.

How does this manifest itself in concrete terms?

These girls have withdrawn into themselves, feel empty, powerless and anxious, but can't say why. They have no real social contacts and eventually stop going to school. Some self-harm or express suicidal thoughts. These girls are on average 15 or 16 years old when this behaviour usually begins insidiously. And this happens at a stage in their lives when they are actually trying to develop prospects for their own lives and break away from home or their parents.

Are these signs of childhood or adolescent depression?

For a long time, we discussed among colleagues whether this could simply be a subtype of depression. However, drug treatment does not work for these patients. They exhibit depressive behaviour that is not caused by depression or another mental illness. This affects around five per cent of our patients. So we are talking about a small group, but one that seems very remarkable to me because it highlights a social wound.

What do you mean?

These girls usually come from what at first glance appears to be an intact family in which both parents work - and the mother in particular is very challenged, sometimes overwhelmed, as she has to juggle everything: Household, childcare and education as well as her job. 70 years of emancipatory development have come at the expense of women.

This group says: "My successful but exhausted mother is not a role model for me.

Women should bring children into the world, provide for them and at the same time stand on their own two feet financially - that is the social demand. However, they are largely responsible for the success of this balancing act between gainful employment and private care work. Mothers are left alone in our society. Their daughters seem to have every opportunity to start a self-determined life, and yet a small group refuses to do so, saying: «I don't want to go down my mother's path. My successful but exhausted mother is not a role model for me.»

Why don't these girls create a counter-design?

For young girls, the «housewife» lifestyle is not an option. This role is far too important in our society. Instead, they develop various defence mechanisms with which they empty the world, so to speak, by saying «I'm not interested in any of that». These girls are characterised by shrugging their shoulders. But I would like to emphasise once again that these girls are a minority.

Basically, I have observed that children today are developing well - they are becoming emotionally smarter, more competent and more approachable. Girls are even doing slightly better than boys in this assessment. Nevertheless, we should take a good look at this small group. I therefore wanted to draw attention to their problems and initiate a social discourse.

You're talking about a new phenomenon. Are the current crises such as the coronavirus pandemic or the war in Ukraine playing a role?

In fact, we have been observing the phenomenon of these «despondent girls» for more than five years, i.e. pre-pandemic and even before the outbreak of the war in Ukraine. Incidentally, there are also despondent boys, but this group has remained roughly the same size for decades.

The quieter, more reserved girls are afraid of going under on the social media catwalk.

Your patients are mostly teenagers or young adults. What were they like as little girls, or to put it another way: was this development already foreseeable in childhood?

Of course, there is a personality component. If you ask the parents, they describe their daughters as rather timid and shy from an early age, but superficially unremarkable. These were girls who lived their lives happily and contentedly enough. And who never caused their parents or teachers any major problems.

And these well-adjusted girls suddenly get stuck in their development. In your search for the cause, you address two other important areas of children's and young people's lives in addition to the family environment: school and social media.

Schools seem to me to play an important role in this context, as they are not very focussed on picking up the silent, increasingly quiet girls. The motto is «If you don't speak up, it's your own fault» instead of «If you don't speak up, maybe you have a problem that I need to deal with as a teacher».

The school system - at least the German one - is extremely deficit-orientated and therefore not suitable for motivating children and keeping them focussed. If a child has written a bad grade, the assumption is the same: «Then it just didn't learn, it was too lazy.» When this happens in England, the teacher goes to the child and says: «I'm sorry, I obviously didn't explain the material well enough.» In addition, the noise in classes that are far too large leads to a poor working atmosphere.

During the coronavirus pandemic, lessons were often cancelled. The children and young people were at home, which was not good for them.

This assessment applies to a large group. The quieter and calmer pupils really appreciated homeschooling and digital distance learning. In my opinion, we have failed to seize this opportunity and allow children to learn in a much more self-determined and digital way at their own pace, even after the opening of schools. Hybrid teaching should have been retained where possible.

What role do social media play?

The quieter, more reserved girls are afraid of not making it, they are afraid of sinking on the catwalk of social life, of not being confident enough. Of course, this catwalk is even more intense on social media and the girls compare themselves in a world that does not correspond to reality. This can intensify negative feelings and therefore discouragement.

On the other hand, social media remains the gateway to the outside world for a girl who has withdrawn into herself and avoids real contact. We adults often underestimate this aspect, even with boys. When the son meets and socialises with other gamers in virtual spaces, he is among people.

How are the despondent girls described treated?

In all cases, this involves several years of long-term outpatient or inpatient psychotherapy in combination with socio-psychiatric elements. The latter can be, for example, school counselling or placement in a residential group if things don't work out at home. The aim is to take very concrete steps with the girl, for which you need someone like a social worker who takes the girl by the hand and accompanies her in the real world.

And in the context of psychotherapy, it will always be a mixture of wanting to understand: «Why are you emptying this world, what do you gain from not being interested in anything? What do you gain psychologically from it?» And a demand: «Look, I'm going two thirds of the way to you, you have to come the rest. If you slap my hand away now, I can't do anything.» This is often a central metaphor in our therapy sessions.

How do the girls react to this demand?

Usually with great despair, as they don't actually want to open up. This is an extremely difficult situation. However, this despair sometimes gives rise to an energy that makes change possible in the first place.

And when the girls realise that they are prepared to take part in this marathon and not give up, they take micro-steps and are eventually able to determine something like life satisfaction. «What is the source of your satisfaction in life?» is a central question.

Parents have to understand that suggestions are not helpful, they have to leave the stage, so to speak.

How are the parents of these girls doing?

They are deeply distressed. Especially when such a girl has a real «doer father» at her side, who is completely overwhelmed because he can only make one suggestion after the next and at the same time has little understanding for his daughter's behaviour. His life motto «There's a solution for everything» doesn't apply here and only leads to the daughter becoming even more isolated. Mothers are usually torn between wanting to act and realising that they have to adapt to their child's pace if they don't want to lose them completely.

What can these mothers and fathers do to help their child?

The most important thing is that parents understand that suggestions are not constructive and helpful. They need to leave the stage, so to speak, and stop giving the girls stage directions. These young people need their own developmental space in which they can act at their own snail's pace. We have to allow them that.

Only when I as a mother or father or even as a therapist can authentically recognise that they really are deeply perplexed and discouraged and don't know what to do next, does something sometimes happen. And it seems important to me that the parents don't think they are to blame for this development.

It is often very difficult for parents to distinguish between an incipient psychological problem and normal pubertal behaviour. When is the right time to seek professional help?

If a child becomes more and more withdrawn, can no longer be motivated to do almost anything and avoids social contact, parents should take notice and seek advice. At the very latest when the child stops going to school.

My daughters are now seven and ten years old. What should I look out for so that they don't become so despondent during puberty?

It very much depends on what you exemplify, what your work-life balance looks like. Sacrificing in favour of the children seems to me to be something deeply maternal. To a certain extent, this is also good and biologically necessary. But the question is: where do I stand as a person and when do I have to demand a fairer division of labour from my partner? And when is the time when I can say to my child: «I trust you to do this job now, you can do it without me.»?

Parents should create a profile: What kind of child do I have in front of me? What are its characteristics?

Self-care is a big topic. And then you should do what most parents already do intuitively anyway: create a profile of your children. What kind of child do I have in front of me? What are their personality traits? What do I do if I am such an active, successful person but have a small, shy girl? The best prevention is not to think that you can change a child's personality. It's not about turning a reserved girl into an active one, but about adapting to her pace.

What can fathers do?

Successful fatherhood and shyness or anxiety on the part of the child do not go well together. And it is precisely these fathers who are particularly called upon to look after their reserved daughters instead of immediately withdrawing when the child asks for mum - and not dad. I believe that many fathers underestimate their role and importance for their daughters. That's the personal level. But there is also the social level.

Book tip:

Michael Schulte-Markwort: Despondent girls. A better understanding of a new phenomenon - help for the mental health of our daughters Kösel 2022, 256 pages, 34 Fr.

What does this look like?

We should ask ourselves whether we really want women not to have all the choices. Is it really our wish that care work and motherhood are not worth much in our time, that women only have the freedom to emancipate themselves and be successful in their careers? And then we should seriously devote ourselves to the task of creating conditions that make family and career compatible.

As a clinic manager, for example, I have no problem at all with employees bringing their children to work when there is a childcare shortage. But there is an incredible reluctance to do so. In my opinion, we need to revisit the issue of work and burden-sharing in our society.