Need Help with Niece's Hygiene and Self-esteem Issues

It sounds to me like she is depressed and the medication is not working for her. IF depression sets in her outside appearance will not be a concern for her regardless of what and how you say it. I am hoping that she is still in therapy, with a good therapist who will be working on her ADL Skills as a goal. For now support and understanding is the best you could for her. Good Luck
LeeAnn

Sounds like Emily doesn't feel very good about herself. Instead of focusing on the poor hygiene, the girl probably needs some old fashion hugs (if this doesn't scare her), a gentle pat on the arm or back, a smile and some personal attention from the older people that are in her life. When Emily feels that she is important to her family and gets the right personal attention she will feel better about herself. Praise for the good things she does will also mean a lot to her.

If Emily doesn't get this attention from her family, she may go looking for love in all the wrong places.

First of all, she is so lucky to have you. You are a wonderful person for caring so very much. Now, the way she dresses and takes care of herself is a direct result of the depression, molestation, etc. She's sub-consciously doing this. It's not only showing how she feels on the inside, but it keeps people away from her.. away from hurting her and makes her unattractive to others so she won't get hurt/taken advantage of sexually. Therapy is so so important for her at this time.

Like someone else suggested, perhaps inviting her out for a day of beauty. You and your mother-in-law shoudl splurge on a girls day out and take her to a spa for a facial, massage, mani, pedi, haircut, etc where she can really be pampered and feel better physically. Then go to lunch. Just relax. Don't talk about her problems, etc. just relax and enjoy the peace. Perhaps this will help. You could also give her a pretty gift basket with some nice products for her hair, skin, body including other stuff like nail polish and a nice body spray along with a teen novel. I bet she'd like that.

Best of luck. My heart goes out to her.

Hi H.,

My heart goes out to this girl. To have gone thru so much at a young age much be very difficult.

I've had NO experience dealing with teens with mental illness. I do have 2 pre-teen daughters that have had a few hygiene issues and who occassionly dress like slobs.

The best advise, the more you push, the worse the situation will get.

I few thoughts -
Forget the gift certificates. This is not the type of girl who will use them. A better approach would be to ask Emily if she'd like to go to the hairdresser with you. Maybe while Emily is there, she'll get a haircut too. The same would apply to cloths purchases.

I think the best way to deal with the situation is as it happens or to make it happen. For example if Emily mentions that someone made fun of the cloths she was wearing, at that time you need to say "I'm very sorry to hear that. Why don't we go shopping for a new outfit? We could go tonight after dinner or tomorrow after school." Make sure you go right away.

Try to bring up the subject of hygeine by asking Emily for her opinion. Something like "Emily, I'm thinking of trying a new shower gel. What do you use?"

Remember to compliment Emily as much as possible. When she does dress nice, tell her "you look really nice today". If possible, ask a friend/family member to also make a similar comment "nice shirt, that color looks great on you".

Last Christmas I gave my daughters and nieces personalized toiletry travel bags filled with travel/trial size products (not for hygeine reasons, but because they go to overnight field trips and summer camp). The bags were a big hit.

Try taking Emily out to the movies or lunch. Then mention you're out of shampoo, can we stop at the store really quick. While you're in the beauty section, ask Emily if she needs anything.

Also, I would hope that Emily is still receiving some type of professional counceling. Maybe consider mentioning something to the councelor.

Good Luck.

My best advice is honesty and compassion...telling her that although it shouldn't matter what you look like on the outside first impressions mean a lot...you don't have to be a movie star or waif thin to be attractive...just put together. Hey...she might not notice the B.O. and I would tell her, no one wants to be offensive...I know everytime I was pregnant I had to switch deoderant because it was no longer effective and a few weeks after giving birth the same thing, I'd have to switch back...I know and understand this poor girl has been going through hell but you can't handle everything too carefully...telling her you love her and want to help her is enough...then make a day of it(you don't even have to tell her before)...maybe even for mother's day so she thinks the focus is on someone else but do a "spa day"...hair, nails, lunch and go shopping...you could always throw a Mary Kay or Avon party at home ... if she has a close friend invite her to come along...once you start the ball rolling and she starts to look better she'll start to feel better too...one last thought...if she was sexually abused she maybe making herself unattractive on purpose...as to not attract anymore unwanted attention...if she's not still in therapy, maybe she should be...I am sure there are support groups out there. Goodluck, my thoughts and prayers are with your family.

This is not something that you should even attempt to solve especially when there are mental issues involved. Emily needs a therapist that SHE likes, and she may need a different psychiatrist. The best thing you can do is support your mother in law in her caretaking and support your neice by affirming her positive actions, and not giving attention/reinforcement to the negative ones. Please do not misunderstand: if she says she is having thoughts of suicide, or her actions are dangerous to her or others, you have a duty to call a docter for her as she needs that support. Keep in mind, this task may be bigger then your in laws can handle but they made the decision to take this on and should get the proper family therapy that they need to create a more functional healthy family.

By the way, who could blame her for not wanting to be attractive to anyone, especially if she was molested. I understand that people feel horrible about themselves when this happens. She needs to develop her own sense of self and work through her self hatred. Of course it would help to have that parental support to do it. And this will only happen through her actions and your in laws hard work.

I wish you the best and love in working through this incredibly tough time.

I am far from an expert, but one idea I thought of was to perhaps make up a basket of "hygiene" goodies for her? I would also try to think of an occasion of sorts to give it to her so she doesn't view it as you being pushy?
I realize this is just a very 'on the surface' response, but it was an idea that popped into my head while I was reading it...
Good Luck!

I do hope Emily is seeing a good therapist at least once a week. It's going to take her a very long time to heal and she's going to need a great deal of support. Also group therapy with other teenages with similar problems might be helpful.

I tend to think that Emily first needs to establish not only feeling safe and trust among family members, she also needs to learn that she is an important member of the family and that she is loved and this takes a lot of time and patience.
Everyone in the family should spend quality time with her alone, doing something she might enjoy as well as she should attend a lot of family activities. So get the family together for Picnics, games, cook-outs, sit down dinners, bowling, movies, day trips etc. and ask her for help in getting things ready..."come Emily, help me set the table"..."help me load the car" etc..and always let her know what a big help she was. Then you might say, come Emily, lets wash our hands before we sit down...and even if she doesn't end up washing her hands, she sees the process as you are talking to her....

Next time you go to the hair dresser ask her to come with you to keep your appointment. Don't ask her to get her hair done....just let her watch everything around her while you get your hair cut etc....and then take her out for lunch and go window shopping with her....Play the game of "Oh, I love that...which one do you like..."

you might ask her to sleep over...Prepare a bubble bath...don't ask her to get in...but invite her to sit in the room with you while you are in the tub...mention how great it feels and then talk to her about what she's learning in school or something she might like talking about.
or have her join you in the room while you are brushing your teeth, or scrubbing your face or applying make up.

the point is the more she see's of grooming, and different styles of clothing, she might begin to want to follow up on it on herself.

You might also buy her some teen magazines which always covers grooming ideas, style of clothing and then a few days later ask her what she enjoyed about the magazines.

In terms of landing that job, you might sit her down to talk if she doesn't land one...ask her what she thinks the problem is, what she thinks what went wrong with the interviews and what she thinks she might change that will be helpful in landing a job. Listen to her answers, her feelings....then ask her if she's willing to listen to some suggestions. She might consider the help you can give with this...or not but it's a start in planting some seeds into thinking differently about it..

I don't think that her classmates poking fun of her is helpful at all...but nothing for this as that's what kids do. But when she talks about it ask her what she thinks she can do to change this from happening...listen and then make a suggestion that the best way she can put a stop to it is if she wants to, by grooming herself. And if she wants to go up that road, let her know you'll be happy to help her with it.
Depends on how far she wants to take it. She might not know where to start or have the money for these things she needs to get started with this.

First, try to figure out what she's good at. By asking her to complete a task that she's already mastered may boost her self asteem a little. As far as hygeine issues, the answer isn't to buy her gift certificates. It sounds like she really needs someone to spend quality time with. Someone that will take her to get her nails done, or to go to the mall with. If it's made into a special outing, it might make her feel good that she's worth someone's time. As far as the acne, plenty of celebrities have it. It's a touchy subject, but maybe if she knew of a product that worked for someone famous, it could work for her too. Has she ever tried Proactive? Once she starts looking better, she'll start to change the way she feels about other things as well.

Hi H.,
This is an issue that you may not be able to address. This young woman is mentally ill- and if she has been sexually abused, it is not uncommon for women to make themselves unappealing by not washing, gaining weight, generally not caring for themselves. It makes sense if you think about it from their perspective. In the meantime, just give her your unconditional support and love her. Know that she may not always be able to return that showing of love because she sounds very depressed. But stay with her- and you'll be glad you did.
Take care,
Clarie

H. it seems like you've already taken the first step by caring. She needs therapy which she is probably already in and she needs to start feeling self worth again. This is the hardest age under the best of circumstances, I can't imagine what the poor girl must be going through. Focusing too much on her appearance might just make her sink further into isolation, though it is understandable if things are that bad. I can only suggest that perhaps she try something to boost her confidence adn give her a sense of safety like martial arts or even a self defense course. Also perhaps a mentor that has been through what she's been through but isn't a family member. Her doctors can probably steer you in the right direction. Seeing someone that has been through it all and come out okay can really make a difference. The hygeine issues are a cry for help and not the real problem. Help her through the emotional turmoil and the rest will follow.

You're a great Aunt and I wish you all and Emily the best.

Hi H.,

Is Emily currently in counseling? Further counseling may help her deal with her traumatic experiences as well as improve her self esteem etc. Best of luck.

Hello H.
I want to start by saying that I have not dealt with this issue myself, so can not relate in any way. Yet I am really pleased that you are available to help your niece and that she has a lot of supportive people in her life right now. Although I have no qualifications I personally think your nieces weight gain and lack of personal hygiene is a way to make herself unnatractive to other men who may take advantage of her. So at this point gaining her trust first, by spending time doing things that teenagers do, is a step to building her confidence. Subtle hints like haircuts and body lotions may only make her feel that whats on the outside is more important than whats on the inside. Focus on something she is good at, school work, art, driving, and give praise for that. Building self esteem starts from the inside out. If your not sure how to work on this Dr Phil probably has information on his website www.drphil.com or look into a support group in your area, if your niece doesn't want to attend with you, maybe you and your mother in law can go and gain some valuable information from other young girls or their family. I wish you the best with your niece H.. If this helps at all let me know if there is anything else I can do for you. Also, congratulations on your new addition to you family. R..

Hi H.,
Wow your young niece has a real sad life at this point in time. Is sound to me like she is depressed and has very low self-esteem as you said. Have you tried to talk to her? With such trama in her life she needs someone that she can come to and talk. Maybe you could tell her you are taking her for a surprise day out on the town. Go for a hair cut, maybe get your's done at the same time, get both of your nails done, buy some pretty makeup and go for a lunch and then maybe go and buy her a nice outfit that the two of you pick out. I know all of this can get expensive but it may be what she needs to feel better about herself. I think she needs a friend and confidant and what better then a young aunt. Your mother-in-law sounds like she's tried a lot of things to help her out. You are closer to her age and she can probably relate to you easier. You mentioned that she is in a new school and things have already been hard for her there. I think, maybe, if kids tell her that she smells that could be an influence to do something about it. I think the biggest problem is that she is depressed and when people are depressed they often live in their own world and filter out the rest. If you do take her out, I guess you could ask her how she feels about herself, let her know of your concern and love for her and that you are available for her if and when she needs you. Then some how you could get on to the topic of her hygiene and self-esteem issues. Has she gone to a Dr in reference to this? Maybe a talk to the Dr before she is seen would be good. You could mention the hygiene and self esteem and he/she could talk with her. If she has terrible acne there are so many new products on the market that she could try. Many are prescription and that would be one thing that coule make her feel better about herself if when she looks in the mirror sees a pretty face looking back on her. I feel for your niece. Does she see her Mother. I am assuming not. If she was sexually abused as she claims, she may feel that she is useless and not worth anything so she doesn't take care of herself. H., I hope that some of this may help and I wish you and your niece luck in this matter. If you could let me know how it all goes, I'd appreciate it. Good luck, D. S

She is not looking at life the way we are. The issues of hygiene are so far down on her list. You right she is protecting herself from hurt with the weight gain and all of it. The only way I now out of depression is new interest in something. Working with animals because they are unconditionally loving can sooth raw nerves. There isn't anyway to get her to change. She must choose to. She has to have something to look forward to. Then she will change on her on. Photography where she is looking at the world rather than feeling looked at could be another option. She does need an adult outside the family to begin to trust again, preferably a great therapist. Even an alternative therapist where she has homework to engage in the world in between visits or a body oriented therapist, Rubenfeld Synergy or other technique. I was your niece and it is possible to come the other side.

blessings
T.

Hello H.,

You sound like a caring aunt, and your niece is lucky to have a supportive family.

Is she in counselling? If she has mental health issues, this is a priority, a must. Her custodial parent can contact her school social worker for referrals - and the social worker in school may be able to be of some assistance to her as well, this is what they are there for.

She is 16. I think your MIL, while well meaning, underestimates her maturity. A 16 year old isn't going to be swayed with pretty lotions and body sprays, that's more like an 11 year old who hasn't gotten the hygiene thing figured out yet. Your niece knows, and she is choosing not to do anything about it. If kids are making fun of how she dresses, she can choose to buy new clothes as long as she knows someone will help her pay for them. She probably does not want to go to the mall because the same kids who make fun of her will be there! I think that she does need help with her self-image. Does she see a dermatologist about the acne? If not, why not? That's an important first step. If she is unhappy about her weight and body, then maybe a session with a nutritionist. Is she interested in working out? Find out if she'd like to come over a couple of times a week and do an exercise video with you or go to yoga class together.

Good luck!

Hi H.,
You don't say what credentials you have that your MIL would be looking to you for help. Are you a psychologist? If not, I would consider each of the family members seeking out the help of psychologists so they learn how to interact with this girl.
Good luck.
L.

My heart goes out to Emily and your family. She has bee through much more than a young person should have to endure. Your family's attempts seem on target to me. I would make sure that Emily has ongoing psychotherapy, preferably with someone who has experience with adolescents. A frequent and comprehensive review of her medications is also sensible. Many meds prescribed for depression were created with adults in mind. Using them on developing adolescent brains presents a more complicated picture. That being said, your family should probably continue to try to have patience and provide a stable, supportive environment around her. It is very difficult for most people to understand depression, but try to keep in mind that it is like a rage turned inward. It's probably extremely difficult for her to feel pride in herself and her accomplishments. This may defy all reason at times. Others may see wonderful qualities in her that she just simply can't see or feel. Patience, encouragement, safety and security are what she needs. Your mother-in-law can try to reassure her that she is loved and is a valuable member of the family. Spending time with Emily, and communicating an interest in her is the best way to help her. Hygiene is often such a touchy subject, but the reality is that all people have odor if they don't take proper care of their bodies. Regular bathing is not optional, like regular eating is not. Depressed people might need coaxing to complete basic self care activities. I think you hit the nail on the head with saying that this needs a gentle but direct approach. Will Emily respond to a simple reminder like "ok, time to shower, here's fresh towels"? Adherence to regular, expectable routines (mealtime, bathtime, bedtime...) will help keep hygiene from feeling like too sensitive an issue and also create a predictable environment. If your mother-in-law can establish a trusting relationship with Emily, that will be a tremendous accomplishment. She may need some support and encouragement herself as I'm sure this has not been easy. Recognizing Emily's strengths and nurturing the things she enjoys could be helpful too. Don't become discouraged if she does not seem to heed advice, part of and adolescents job is to reject adults' advice and make your own way. Just provide a clear line as to what is non-negotiable.

Both Christina R and Lori M offer some wonderful advice.
Your neice needs to want to do all the wonderful things that are spoken about in these 2 suggestions. When you have a mental illness, it is important to remember that the people we see and love are not who we would like them to be, not because they don't want to be, but because there is an illness standing in the way of them becoming who you would like them to be. As parents, aunts, uncles, grandparents, we want nothing but the best for our children. We want them to be so much more than us, we want them to aspire to be everything they want to be. With a mental illness she needs the help of a therapist, and no matter what you would like to do for her or with her that is pro active or positive, her illness will always impede your loving efforts. One of my best friends experienced the exact same thing and she tried her hardest to make her daughter over. Trips to the mall, presents, spa dates, make-over dates, salon dates, trips for the weekend to lift her spirits, girls day out, and no matter how hard she tried, it did not work. Her daughter was over shadowed by issues of self esteem and weight and it was something she had to over come within herself with the help of a therapist. When my friend attempted any type of bonding, her daughter would take it personal and it would only create more tension. I hope your neice is under the care of a therapist, she may prefer a female as a male may present a problem with the sexual molestation issue. Until your neice is comfortable in her own skin, and understands her illness, you can try your hardest but she will not respond. She seems to be at a point where she does not trust, therefore a surprise spa day may turn out to be the opposite of what you are expecting. Remember, you are dealing with an illness of the mind and as above mentioned, alot of trauma, not a young lady that is having a bad day. I wish you all the luck as I have been there for my friend through some very trying times and know where you stand. It all has to come from within her first, the rest will follow. Have patience above anything else and the rest will fall into place. Find her a good therapist and show your support that way first. Good Luck to you and your family H..
PS - I am happy to say, that with the help of a therapist and medication, my friends daughter is a happier person. I wish the same for you.