A few years ago, child psychologist Madeline Levine sat down for a therapy session with a new patient. Outwardly, the adolescent girl seemed all right, Levine said. But she was wearing a so-called "cutter T-shirt" — the kind of long-sleeved T-shirt typically worn by girls addicted to cutting themselves to relieve stress.

Levine asked the girl to roll up her sleeves, and she did. There, in the flesh of her forearm, was the single word she had carved with a razor: "Empty."

"That was my 'Aha!' moment," Levine told the overflow crowd in the sanctuary of Congregation Beth Chaim in Princeton Junction on Nov. 4. "That was the moment when what I was seeing became real to me. These are groups of kids who, for all the world, look great on the outside, but, literally and metaphorically, you roll up their sleeves and they're bleeding underneath."

Levine, who has been practicing clinical psychology in Marin County, Calif., for the past 25 years, was at Beth Chaim to convey the message of her 2006 book, The Price of Privilege: How Parental Pressure and Material Advantage Are Creating a Generation of Disconnected and Unhappy Kids (Harper Collins).

In an interview before her talk, Levine said that one of the things she has learned as she travels across the country discussing The Price of Privilege is how effective synagogues and Jewish schools can be in dealing with the depression, anxiety, substance abuse, and emptiness that can follow in the wake of materialism — "the dark side of affluence," as she calls it in her book.

"I think the pressure in Jewish families is very high, and I think that's an issue," she said. "On the other hand, there's a greater sense of community, and that's salutary."

More than 300 community members — teens, parents, grandparents, educators, social workers, and rabbis — turned out for the program, which was jointly initiated by the Principals Council of Princeton Mercer Bucks and the Jewish Family and Children's Service of Greater Mercer County.

"I think it's putting parenting and Jewish values together and being able to speak about an issue they're clearly concerned about from the framework of Judaism," said Anne Berman-Waldorf, director of lifelong education at Beth Chaim. "We see our families looking to keep it together in complicated times, and we want to give them the skills to do this — to do this in a Jewish context."

Bringing Levine in was a way to raise the awareness of parents in the community, said Debra Levenstein, director of prevention and support services for JFCS and coordinator of the program.

"While not everyone is affluent, this community has a propensity toward affluence, and we want to make sure our kids are given all the tools they need to be happy and safe and self-fulfilling individuals," Levenstein said. "It fits in well with Jewish values."

Everyone's assumption, Levine told her audience, is that affluent children are mentally healthy children.

"The fact is that upper-middle-class kids have the highest rates of anxiety disorder, depression, and substance abuse of any group in America," she said. "So the question is: Why? Why are our kids so stressed out?

"Are we known as a group for pressuring our kids and making education a high priority? Absolutely," she said. "Is there a good side to that? Absolutely. But our notion now about what constitutes success has become incredibly narrow and incredibly damaging."

All that pressure is making kids feel that doing a good job is not good enough, Levine said. "We really need to remember that when we're pushing and pushing and pushing our kids, often we're talking about things beyond a child's capability. You have to be able to see the child in front of you — who that child is, and what that child is capable of.

"That's something we have to be very careful about," she said. "It's a miserable thing to feel that love is conditional upon performance. The level of expectation and pressure kids are under now is really making them sick."

Reaching out to parents and their families is one of the most important things the community can do, Cantor Larry Brandspiegel of Beth El Synagogue, chair of the Principals Council, said in an interview after Levine's presentation.

"When JFCS said we would work together on this, there wasn't a better match than to do something like this," he said. "Obviously, from the turnout, it's something that's important to a lot of people."

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