Podcast: Healthy Coping for Children and Adolescents

Episode Transcript

Jenn: Welcome to Mindful Things.

The Mindful Things podcast is brought to you by the Deconstructing Stigma team at McLean Hospital. You can help us change attitudes about mental health by visiting deconstructingstigma.org. Now on to the show.

Hi folks. Good morning, good afternoon, good evening, whatever time zone you’re in, wherever you are in the beautiful world, thanks so much for joining us today to talk all about healthy coping mechanisms for kids, teens, and young adults.

I’m Jenn Kearney. I am a digital communications manager for McLean Hospital, and I have the distinct pleasure of being joined today by Dr. Maggie Gorraiz.

Kids and teens experience all kinds of feelings. If you’re a parent, you are already well aware of this. You’re probably even more aware that they might not know how to deal with it or cope with them when all of these feelings and thoughts come up.

The thing about coping is that it requires learning. You have to learn skills. It’s how to better manage thoughts, emotions, and reactions, in ways that are healthy and productive. What’s really nice about coping skills too is, like, kind of like laying a foundation in a house, they build off of one another.

So if you learn some, you can learn more better, faster. It increases your wellbeing in adulthood too, and it can prevent unhealthy coping strategies from popping up as your kids actually become adults.

So I’m really excited to have Maggie join me today. We’re going to talk about different types of coping strategies for kids and adolescents. We’ll talk about age appropriate ways to teach coping to our loved ones and the mental health benefits that coping can actually bring, not just to our kids, but to our entire family.

So if you are unfamiliar with her, Maggie Gorraiz, PhD, is a child and adolescent psychologist and a DBT Linehan certified DBT clinician. She participates in supervision and training of clinicians in personality disorders and dialectical behavior therapy, which is what DBT stands for.

She is also the director of McLean’s School Consultation Service, which is a multidisciplinary team of providers with expertise in child and adolescent mental health. And they provide consultative services and therapeutic program development, individual student challenges, and training and dissemination of evidence based mental health interventions.

So, hi Maggie, I am so excited for you to join me today. The first question’s kind of a big one, but I just want to get started by asking like, what exactly is healthy coping?

Maggie: Well, so, first of all, I’m so thrilled to be here. I’m happy to answer any questions that come my way. And I think that’s an excellent first question that really frames our discussion here.

So, let me in short give a kind of definition, more or less, of healthy coping. And then I usually, like in DBT world, we talk a lot in metaphors, and hopefully give you a little bit of a metaphor about kind of what we think about when we think about healthy coping.

So in short, healthy coping, or you want to think adaptive or skillful, is really a process that we do with a set of strategies that we use to respond to stress, to respond to pain, to respond to painful emotions that are leaving us feeling like we still have both feet on the ground here.

We feel, like, the stress or the problem or challenge is reduced, it’s resolved. And that we’re responding in a way that feels really good to us too. And we’re not causing bigger problems down the road for us or secondary crises.

So metaphorically, I like to think about, you know, so think about, I don’t sail, okay. But it’s a metaphor I like to use. That you’re sailing on a boat here and, you know, some days it’s smooth waters and you’re going about your day, and everything’s kind of really falling into place.

And other days, you know, you’re going to have stressors, small stressors that feel like a little bit of small waves kind of coming and kind of rocking you a little bit. And some days out of your control, you’re going to have bigger waves.

It’s going to feel like tidal waves, like, really coming and kind of putting water over your boat here. And it’s going to, it’s going to hijack you for that moment here.

And so healthy coping is about whether, you know, these micro stressors or macro stressors, are about how we’re navigating those rough waters in a way that we still feel like we’re in control, and we’re moving forward towards where we want to go.

Jenn: So then what would be some of the signs that, like, a kid or teen is coping in a way that’s unhealthy for them?

Maggie: Well, so I know I have a lot of parents here, and I think parents kind of have the best assessment of this. You know your kid best, and you know your kid at baseline here.

And so I want you to keep that in mind because every kid is different and one size doesn’t fit all with, kind of, coping. And so you’re going to know best, but let me give you some concrete ways to think about, you know, ooh, when do I think like, “Oh, I’m not quite sure if my kid’s kind of coping, you know, really effectively right here in the moment.”

So the first thing we usually suggest is we want to think about, kind of, impairment in different domains of that kid’s life, okay? So you want to think at home, you want to think with, like, social relationships, you want to think of extracurricular, if they’re a little bit older and they have part-time employment, and also school.

So you want to think, like, are there any sort of impairments that are happening along those different domains? So, for example, at home, is your kid actually looking a little bit more irritable, or is there, like, more conflict or tensions with family members?

Or maybe are you observing that, you know, maybe your kid was a little bit social, and now they’re no longer engaging with some of their friends. You’re noticing some of their text messages are going, you know, they’re not responding.

Or maybe with homework, you know, not every kid, you know, it’s hard to kind of stay on top of school, you know, a lot, but you know, maybe it’s like homework incompletion, and now you’re noticing maybe some greater test, kind of, anxiety, now you’re seeing that they’re kind of skipping school, you know.

So is there kind of like escalating, kind of, impairments that are happening? The other big pieces I pay attention to is, you know, are they kind of not taking care of themselves anymore? Are they not, like, showering?

Are you seeing that they’re kind of like maybe overeating, undereating, their sleep habits are changing, and then are they, like, no longer participating in, like, their kind of favorite activities, like extracurricular activities or hobbies.

I mean, those would all be kind of impairments that, you know, birds eye view, you have it as a parent, you’re seeing. And if any of those kind of feel a little bit odd, I’d kind of look into that.

The second area I’d look into is, is what your kid’s reporting to you, if at all, anything. But if they are reporting something, you know, are they reporting they’re feeling really anxious or stressed or hopeless?

Are they reporting, you know, are you hearing them talk about themselves in a different way? Like, negative self-talk and, like, judgments. Little kids when they have, you know, if they’re not doing as well, they’ll often report a lot more physical complaints that sometimes get missed.

So physical complaints, you know, are they reporting, like, a lot of headaches, a lot of stomach aches, they’re feeling nauseous. I mean, so these would be all things I’d pay attention to, along with impairments.

And then the third piece I’d want to keep in mind is about how your kid is responding to, kind of, stressors that are happening. So every kid is different in terms of their temperament, okay? So they have different levels of, like, sensitivity.

They have different levels of reactivity. They have different levels of how long it takes them to kind of come back down to baseline. One of the things I would look for is, does that seem a little bit off? Is their response to something, like, bigger, a little bit more explosive than usual?

Does it seem like they’re kind of, like, walking on, like, on a tight rope, you feel like they’re, like, you know, they’re really highly stressed or are they kind of, almost feels like they’re losing control of their emotions sometimes at moments.

Those would all be things I’d look at. And then of course the other behaviors I’d look at, besides the sleeping and the over/under eating, I’d look at any substance use that’s also happening, and, of course, self-harm or suicidality, I would certainly pay attention to as well.

So those would all hopefully be some warning sides, but again, I’d compare it to, like, what you know about your kid at baseline.

Jenn: I know one of the things that you had just said about, like, kids reporting changes, obviously the older kids get, like, I was a teenager, you were a teenager. There’s only so much you share with your parents at that point.

If your kid isn’t reporting these changes in thoughts or feelings, but as a parent or caretaker you are noticing them, how do you address this with them? Should you start with the healthcare provider?

Do you start with them, like, initiate it in the home? Like, what’s the best plan of attack here?

Maggie: So, I love this question here. So, if you think something’s up, I think the best thing you could do is actually talk to your kid directly about it, but it’s always, like, well, how do I talk to my kid about this?

Because if I talk about my kid more, they’re going to shut down, they’re going to tell me to leave, or they’re going to get, you know, more irritable about me. And this is actually where two kind of strategies I suggest to parents come in play.

So one is going to be this non-judgmental, curious stance you’re going to take as a parent. So in order to do that, you have to be totally open that your hypotheses or what you think is happening may not be right, okay?

And that you’re going in there, and you’re totally open to whatever your kid may or may not share with you, okay?

And that you’re curious, you want to understand what’s going on here, and that you’re not going to be judgmental, and you’re going to be mindful of your own emotions that come up.

Because oftentimes if we’re worried as parents, usually fear comes up, and with fear, we have a natural urge to kind of want to get control of a situation, and then we want to, kind of, problem solve it.

Those urges are going to kind of get in the way of you, kind of, practicing that non-judgmental, curious stance and kind of patience here. So we want to keep that in mind.

And the second piece I’d use is validation, here, is going to be really critical. So validation is about, I’ll say a little bit about validation, and then how specifically you could maybe use it with your kid, okay, in these moments that they’re not sharing stuff.

So validation is about, you know, acknowledging that like, ooh, your kid may be experiencing some distress or some emotions here.

You’re going to try to figure out how that distress or emotions that they’re experiencing, you know, makes sense, given kind of, you know, their history, what you know about them, and what’s happening right now in this moment.

And then you’re going to be able to kind of communicate that, okay? That’s obviously a lot easier to do if your kid is telling you, “Hey, I’m feeling really anxious about a test.” And you’re like, “Of course, you know, that makes perfect sense.

You know, you want to do well on this test and you want to do well, it’s a normal kind of, you know, it’s normal to kind of feel worried about, kind of, doing well, you know,” maybe you would say something like this.

But what do you do if your kid’s not saying something? So, usually with parents here, I’ll give you a lot, you know, massive validation to you already, right now. That’s really hard as a parent because it’s hard to find your own parental wise mind and figure out what to do next if you don’t have all the information, okay?

So massive validation for you. And what I’d say in this moment is I would try to non-judgmentally describe what it is that you’re observing your kid doing, okay? I wouldn’t jump to, you know, conclusions here.

And then I would try to do a little bit of mind reading. And I know in like Psychology 101, we always say, don’t mind read here. But as a parent, I want you to mind read here, and I want you to kind of mind read what you think may be happening, okay?

And I don’t want you to interpret or analyze the behavior, but try to mind read what emotions they may be experiencing. So, for example, let’s just say, for example, you’re noticing your kid is watching Netflix, like, all night long and they’re not going to bed.

So, this happens a lot. You’re noticing, like, around bedtime, they’re, like, on their phones a lot, TikToks, and they are, like, not going to bed and stuff like that. And, you, again, may be seeing some impairments or, you know, other areas, you know, and you’re kind of like getting a little bit worried here.

I’d probably come to my kid’s room- not at night. I’d choose a good time that’s a wise mind time for me, a wise mind time for my kid, you know, and then say like, “Hey, you know, do you have a moment? I, you know, I want to talk about something.

You know, I’ve been noticing that, like, around nighttime, you’re watching Netflix and you know, you’re not just watching one or two episodes. You know, you’re watching, like, you know, three, four, almost, like, a whole season, I’m wondering, throughout the night.

And then I’m noticing that you’re really not going to bed until much later. So that’s what I’m noticing here. And I’m wondering, and I could be totally wrong,” so again, you always want to say that, “I could be totally wrong here.

I’m wondering if you, you know, if something’s kind of up. I’m wondering, are you feeling maybe kind of worried or stressed about something? I know that you love shows and, you know, I’m wondering, you know, are you feeling worried, stressed, is something maybe else going on that you’re, kind of, wanting to distract from?”

I would just do something like that again, totally wrong. Again, just some mind reading here of like some curious stance. If your kid says no, which they may, they may say no, you can say, “Okay, alright, I love you.”

You know, you really want to emphasize, “I love you, honey. And I hope everything’s okay here. And why don’t we check in in, like, a few days about this,” and kind of, and definitely come back to it, okay?

But again, the more and more you’re doing these little, like kind of moments of interaction where you’re kind of increasing this validation, this kind of non-judgmental curiosity, that starts to plant the seeds that your kids starts to feel a little bit more comfortable to talk to you as well.

So don’t give up, don’t despair, but certainly non-judgmental curiosity, some validation, try to non-judgmentally describe the behavior and maybe do some mind reading to try to get the kid to kind of open up.

I know that’s not sometimes a satisfactory response or a quick, you know, a quick fix here, but I think it’s a realistic one of what you can do.

Jenn: I think one of the fascinating things too about psychology in general is that there really aren’t any quick fixes that are going to truly solve a problem. I think everything is like coping skills.

You have to build a foundation first and then everything is going to come to fruition over time. So it’s really important, like in my personal opinion, that you actually addressed, it’s not a quick fix, but it is going to lead to changes if it’s done in an appropriate way.

Maggie: Yeah, yeah, yeah. No, it’s so tricky. It’s so tricky to kind of navigate adolescents, especially in the absence of information, very tricky for parents.

Jenn: So, I’m curious about, you know, you have mentioned if a kid’s staying up all night, watching Netflix for a full season, whatever they’re doing that seems unhealthy to a parent, how can they encourage their teens or young adults to actually change these patterns that may be worsening their mental wellbeing?

I know, we’ve all done it, it’s a pandemic, there’s war. There’s a lot going on. We’ve all done things that are contributing to shutting our brain off and kind of, you know, sometimes prolonging what we need to do.

How do we encourage our young loved ones to start changing these patterns?

Maggie: Okay, again, a really tricky question here. So when we think about behavior change, you want to think of, like, three ingredients that are important here, okay? One, the kid needs to have, or individual, has to have, like, some sort of mindful awareness of what’s happening here.

What is it that they’re doing, and how is it impacting them, okay? The second piece is that you need to have some sort of motivation to kind of want to target it, or some sort of collaboration, or feel like you have the resources where it’s doable, and then you really need to know, what are you going to do instead, to cope with whatever it is that you were coping with before, okay?

So you really need these kind of three components in order to move forward here. So how do you bring this up to a kid? So in the example of the Netflix, staying up at night, again, I’d talk to the kid, not during nighttime, and I would probably ask them what it is that Netflix is doing for them at night.

How is it helpful to them? So this is kind of an interesting, kind of, point of view, but I would say in DBT, we kind of have this dialectics, meaning that two things are true at the same time, you know, or can co-occur.

So, on one hand, Netflix can be really helpful in the moment for, you know, a lot of kids. I’ll just say, this is like a hypothetical situation here, but let’s say a lot of kids at night will say that, “You know, when I’m no longer distracted with school, I’m no longer, kind of, maybe interacting with my friends, you know, a lot of thoughts start spiraling in my head,” okay?

“And I start to have, you know, I start to kind of really beat myself up or I start to get really anxious about the next day, or I start to kind of ruminate on, kind of, what happened that day.”

That’s distressing, okay? That’s distressing. A lot of kids will say again, “When I’m not distracted, those show up and it makes it really hard for me to really relax and go to bed,” okay? So on the one hand, maybe this is like a kid where Netflix in the moment is helping them kind of do a little distress tolerance, when those thoughts are unhelpful.

And at the same time, what’s also true, because remember two things can be true at the same time, what’s also true is that when you stay up all night watching Netflix, you’re sleep deprived and when you’re sleep deprived, it exacerbates- and you’re sort of, like, mental health, you know, functioning that you have the next day, it actually makes you more stressed and anxious.

So I think kind of going into that, that two things can be true, that your job as a parent can be to help, to try to connect the dots here of like, what is it that this kind of coping behavior, maybe ineffective, you know, kind of for all these long term reasons, what is it at the core doing for your kid in this moment here?

And that’s really important. That’s kind of part of that non-judgmental stance here is like, “I’ve got to figure out, like, what is it that my kid’s trying to do by using this behavior,” you know? And you know, and you may do some mind reading here, you know, “I’m wondering, is it helping you to distract from something?”

So let’s say like your kid does buy into like, “Yeah, no, it’s really hard for me at night. It’s hard for me to kind of relax. You know, I have these thoughts, I start to get really anxious about the next day.”

Let’s say it is something like that. And you would say, “Oh my god, that’s so fabulous, I’m so glad you told me that. Let’s brainstorm together on how we can help you kind of, like, cope with those thoughts that do show up, but in a way that doesn’t do yourself in by, like, the sleep, because we know that sleep is so important to you.”

So by having, like, an open kind of conversation with that, you’re getting that collaboration, which is really critical if you’re going to change any sort of coping strategy or behavior among a kid.

Because developmentally, as kids get older, middle school, high school, they’re autonomous beings, as you know, with their own thoughts, feelings, behaviors, urges, desires, wishes, and it’s really important as you as a parent, that you’re kind of scaffolding what you did when they were toddlers, versus what you’re doing as an a adolescent is very different, and you’re kind of taking a step back, and you really want to reinforce, like, “How do I reinforce my kids’ wise mind decision making in these moments?

How do I kind of, like, help highlight, connect the dots?” “Ooh, you know, but when you stay up all night watching Netflix, you’re pretty irritable the next day. And I love you honey, but you are pretty irritable the next day. And I noticed you have a harder time getting out of bed.”

Kind of connecting those dots that this kind of doesn’t actually work for you here. What can we do in a way that helps you cope with what you’re kind of struggling with, but again, not in a way that, kind of, destroys or creates.

“Remember we talked about healthy coping, maybe unhealthy coping creates these secondary crises for yourself.” So I would probably do some sort of, like, reflection on that. Of course, this is very hard with a kid who’s not talking to you.

And of course, you know, versus an elementary kid, you have a little bit more control over their environment and, kind of, what you’re doing, but for a middle school, high schooler, again, you really want to try to open up that dialogue and communication because you want their collaboration in order to really, to be more impactful on the interventions or change you’re trying to induce.

Jenn: I imagine that if you go to your kid and you say, “Look, I love you. I notice that this is the behavior, like, you do this behavior. This is the thought, feeling, crankiness, mental patterns that are popping up as a result, let’s try to break out of this together.”

If you’re dealing with, like, a teenager, they might go, “Okay, like what?” So I’d love to know, what are some of the common coping strategies that we can teach kids, and how early can you get started as a parent? Is it ever too early to start teaching your kids how to cope?

Maggie: Okay, this is a loaded- I mean, this is, I have so much to say about this. And so let me first put this into context about what we do as parents, because I think this is always a question of, like, what specific coping skills am I teaching my kid? Or how early do I start?

And what can I be doing as a parent that reinforces it, especially, you know, knowing, recognizing, that my kid is again, a separate being, and what works for me may not work for them, and how do I, kind of, instill this?

So, you know, in school-based mental health, one of the pieces actually that we focus on with school staff and, you know, but this is relatable in our parent workshops as well, is this concept of co-regulation.

And if you’ve never heard of it, I’ll just kind of say briefly what it is. It just means that, co-regulation is like an interaction that you have between you and your kid, you know, as soon as they’re born here, and it’s kind of like three components of it.

One is that you are consistently being like a warm, consistent, dependable caregiver, okay? So that means that at baseline, you’re doing your best to practice your own emotion regulation.

You’re doing your best, that no matter what your kid does, how ineffective they are, unskillful, they’re not in their finest moments, that you love your kid, because you know at the end of the day, that your kid is more than just this ineffective behavior, staying up all night watching Netflix, which I did not know was going to be the example that we used throughout this whole webinar, but I’m going to go with it.

So we know-

Jenn: Maggie, we can always pick a different one if you want. It just seems-

Maggie: I’m going to choose. But no, I’m just making light of it. So we know our kids are more than this. So being a warm, consistent, dependable caregiver is like, we see the wholeness of our kid, okay? And that we’re mindful of that.

We’re mindful of our connection to our kid and that we’re going to keep that relationship, you know, at all costs, as much as we can, because at the end of the day, you want your relationship to be the most influential, you know, for this kid, okay?

So we want to practice our own emotion regulation. You’re doing that since the kid is born. Your modeling your own emotion regulation in itself is a way in which we’re already building the foundation for self-regulation there.

The second piece you’re doing is that you’re creating, as much as you can, a physically safe and emotionally safe environment, meaning that you have some sort of, like, consistent routines, predictable kind of family expectations, you know, traditions that you do.

These are all ingredients that are important to help a kid feel safe at home, help a kid be able to, kind of, make mistakes, you know, do a little trial and error without, kind of, feeling like they’re going to be criticized or going to be punished.

And you’re modeling that, you know, taking care of, like, your sleep, you know, eating, movement. I mean, these are all things that are really important in taking care of your body.

And then the third thing that you have to do as a parent, as part of this kind of co-regulation, and again, this isn’t just limited to parents. This is like teachers, like, this is coaches. This is, you know, grandparents, et cetera, you know, whoever the caregiver is in the family, and there’s kids who have many caregivers. It takes a village, okay?

But the third thing you’re doing, is that you’re modeling and teaching skill use here. So it’s not enough to do those first two. You’ve got to actually model and teach, but what you model and teach is very different at a toddler versus, like, again, a 17 year old.

So at a toddler age, you’re doing much more demonstrating, kind of modeling and demonstrating. That’s going to be important. You’re not giving them like a TED Talk or, like, you know, like, giving them, like, a self-help workbook, okay? You know, I’m not saying you’re going to do that with your 17 year old either, but you know, you’re not being that explicit, you know, about some sort of, like, direct teaching, but modeling and demonstrating is still teaching here.

And so in part of this kind of effort of co-regulation, it’s kind of like, what are you as a caregiver doing, modeling that you have big emotions too, and how are you coping with those big emotions?

And we try to say, be as explicit as possible, say out loud what you’re doing to cope with those big feelings. So for example, you know, if I’m driving, and I take, like, the wrong turn on the highway because I’m trying to watch, like, my Waze or something like that, you know, I may say, “Oh, I’m so frustrated, I just missed my turn.

Okay, let me take a deep breath.” Or “Oh, you know what? I’m going to play, like, my favorite song. Do you want to sing along with me?” These are micro interventions that you’re doing that you’re modeling emotion regulation for your kid. That’s a coping skill in itself.

It’s not formal teaching, but your kids are picking up on that. And those are great ways to model your own humanness, okay? That you have a range of emotions too, you’re not perfect at all, and you too need to use skills. That’s really important to do too.

If you have a kid who experiences a lot of shame or maybe they’re the only ones in the family who struggle, it’s really important for you to also model that it’s okay for you not to know, it’s okay for you to, kind of, make mistakes.

It’s okay for you to, kind of, have to use skills too, that everyone has to learn coping skills. And we all have to use different coping skills at different times of our lives here. So what do we do?

So, the original question. So now that we have that framework, what’s the original question was, well, what specific coping skills should we teach kids here?

So this is such a hard question to answer because there are so many fabulous coping skills to teach here, but I’m going to give you three main ones, which I would say are pretty foundational, no matter kind of what you’re doing here.

So the first one’s mindfulness, second one is, like, a self-soothing kind of self-care, and the third is, like, a distress tolerance, okay? And then layered on top of that is obviously taking care of your body. See, I already can’t limit it, Jenn, okay? I already have too many.

Alright, so mindfulness here, mindfulness is really important because if we think about, kind of, the metaphor that we started with about, like, there’s, like, small waves and big waves that kind of throw us off, mindfulness, you want to think is that anchor beneath your boat here, that’s kind of keeping you tethered to this present moment.

Because we know our minds are going to get hijacked by things in the past that have happened. We’re ruminating. It’s going to get hijacked by things that we’re worried about in the future here.

Mindfulness is about, kind of, how can we use the practice of it, which can be done anywhere, with anybody, with anything, practice being in the present moment right here, noticing that our mind’s getting hijacked. And by doing that, we’re kind of turning the lights on and having some choices here.

So why is this so important for kids with coping skills and how do you teach it? You can teach this very informally with kids. Again, if you’re in the car, it could be something like, you know, I spy, you can play a game here, any game where you’re kind of practicing intentional control.

So “Hey, you know what, I spy, can you pick out five things that are green in the yard or four things that are yellow that you see driving by.” This is you having your kid practice deliberately putting their attention on something. That’s the superpower of mindfulness here.

Can I, you know, your kids, you’re really upset. You know what, I got to do five four three two one. Five four three two one is a grounding exercise for mindfulness. I’m going to, you know, what are five things in my environment I see right now?

What are four things I can touch right now in my environment? What are three things I can hear? What are two things I can, you know, taste? And you can kind of go through your senses here. So five four three two one is really powerful.

That’s an informal way, but these are all great opportunities where you’re helping your kid to notice that I’m here right now, okay? That’s going to be a critical skill because if you’re going to do any sort of behavior change in the future, you want your kid to be, like, an independent, you know, have, like, a wise mind decision making.

They need to know what their options are at any a given moment. And the only way you know what your options are, is if you can, kind of, learn to slow yourself down and pause and think, “Oh, anxious mind is kind of, like, pulling at me right now. What can I do in this moment? What are my options here?”

So at a foundational level, any opportunity to informally practice mindfulness, and I can kind of go on and on about this, that would be really fantastic. The second piece is self-soothing skills, and distress tolerance.

This is really important, because stress activates our fight or flight response, okay? Our fight or flight response is that when we think a threat is there, whether it’s real or imagined, or whether there’s a threat to our safety or not, we start to get into this fight or flight response.

And this is where stress hormones start bathing our brain, okay? And we are a little bit more activated. And a little bit of stress is good, but too much stress will feel like it’s crushing and will break us.

And so the thing of about stress, is that we have to get really good about trying to calm our bodies down. Why is this important, again, is because when we get into that fight or flight response, the thinking part of our brain is hindered a little bit.

And our thinking part of the brain is kind of shut down because we’re kind of like in survival mode, emotions are kind of taking over, and it’s kind of getting us ready to defend, protect, you know, whatever, eliminate the threat, whatever it is.

So in order to engage our thinking part of the brain, which again allows us to have some decisions, allows us to take perspective of the problem, allows us to kind of reframe what’s happening, in order to do that, we’ve got to be able to, kind of, calm our bodies down and get us out of that fight or flight.

So, self-soothing, you know, really concretely when you’re teaching it to kids and adolescents, or even, we do it with parents too, is we think through like, what are the five or, you know, more people say six senses now.

So you want to think like, what are ways in which we can use our senses to self soothe? So this can be with, like, vision, taste, hearing, smell, touch, and proprioception, which is, like, how your body moves in your environment here.

And so what we do with that is that we have kids put together, what are some self-soothing ways you can soothe your senses in these different ways? So I’ll just give you a few. With teens, teens right now are feeling more lonely and disconnected at times than ever, especially in the pandemic.

What’s also really interesting about social media and teens is that they tend to document a lot of, part of their lives. And this can work for you. It’s really important for kids to kind of create like a- I think it’s really important- is for vision, is to create, like, a vision folder on their phone.

And this can be a series of, like, pictures of text messages that felt good to them, or pictures with their friends, pictures with their families, pictures of things that feel like they, you know, anything that they feel good about.

And so in these moments where they feel like, “Oh, nobody likes me,” or “I’m like, so disconnected, I’m so lonely.” Or maybe that fight or flight freeze is kind of like coming up right now.

I can kind of, like, soothe and remind myself, wait a minute. When I don’t feel like this, or I know in the past, these people matter to me, I matter to these people, or these things have happened to me.

So can they create, like, some sort of vision, kind of, folder. That’s just, like, one idea. You know, with little kids, we have them create, like, little, they don’t have phones usually, but they bring it in their backpack, or something in their car, they create, like, a self soothe kit, is can they have vision of like, you know, their favorite family vacation or things that, like, help, you know.

Sometimes they usually like certain TV shows or like certain, like, pictures of family members that they really like, that they feel close to. Can they create that?

You know, hearing is another one. I’m somebody for, like, self soothe, you know, I’m somebody who actually for self soothe who doesn’t like to hear anything, you know? I’m someone that, like, when I come home from work, I feel overstimulated, and I just want to listen to nothing in the car.

So I’ll drive home and I’ll just be totally silent, driving home from work. But some people, that’s for me, that’s what’s soothing for me, is like an absence of noise. What’s soothing for other people though is, like, making a playlist.

So we often, kids and adolescents make specific wise minded playlists that feel good to them, that don’t make them particularly anxious or angry, but it’s like feel good music. And we have parents play that playlist, you know, before they’re going to school, they feel particularly anxious.

Or maybe before they go to, like, their practice, and they are, you know, worried about seeing their teammates. These are all these, like, micro interventions where parents can help to kind of increase this, like, soothing kind of response to help, kind of, temper or modulate some of that fight or flight response.

So I could go on and on about that. So self soothe is really important. And I think, kind of, dovetail nicely in that, is this idea of just prioritizing, like, what feels best to me and my body right now? Like, what do I need? And that’s really what you want for your kid.

You want your kid to kind of recognize, “Hey, you know what? This feels best to me. This is actually what calms me down in a way that doesn’t create other problems for me, that doesn’t leave me feeling guilty or ashamed because of,” you know, X, Y, and Z, but like what feels good to me.

And, like, again, what feels good to me is an absence of noise. What feels good to you? I mean, these would be questions I’d be asking, “Oh, you don’t know? Let’s try it out. Let’s kind of look around the house. What can you put in your self-soothe kit?

Can we make one for school? Can we make one for in the car? Can we make one at home? You know, I’m going to make my own self soothe kit. Let’s like kind of show each other our self soothe kit, you know, let’s, like, practice it.”

These are all concrete ways. Because when we think about coping skills, it’s not enough to just learn the skill. You have to strengthen, you have to practice it. And the best way to practice it is making sure it’s readily available to you.

And that’s why, the importance of, like, a self soothe kit, so you don’t have to think. Because when you’re in fight or flight, you’re not thinking, you know? You want it readily available.

And then you have to practice it over and over and over again with a lot of model and reinforcing from parents.

And the third piece would be some distress tolerance, but I can take a break before I go into distress tolerance, Jenn, if there’s any questions about the mindfulness, self soothe first? No, okay.

Jenn: I think it’s good to keep going. Don’t slow your roll.

Maggie: Yeah, okay. So, and then the third piece is this distress tolerance. So, I think, so in DBT, I think DBT really summarizes it nicely here. DBT will say, one of the principles here, is that you can’t, you know, life is going to be full of pain, and it’s going to be full of stressors in your life.

And that it’s also going to be filled with tons of joy and excitement and pleasure. And there’s going to be things that are amazing that happen, but it is going to be filled with grief and loss, and, again, this pain.

And so we’ve got to figure out a way, how to cope effectively when that shows up. Because if we want to, again, build a life that’s really rewarding to you, you’ve got to learn how to cope with that pain and loss without kind of destroying or doing yourself in, okay?

And so, because you may do something, you know, unhelpful, ineffective, you know, or destructive to you or your friendships, or, you know, anything else. So DBT has many different types of distress tolerance skills, and many different crisis survival skills that happen.

And I’m just going to go over, like, a small part of it. And I won’t even go over, you know, this much because of the time here, but one way is to practice deliberately distracting in the moment.

Now, when you hear this, you’re thinking, wait a minute, we got to face problems head on, you know, we got to go through the water here. Yes, that is all true. Distraction deliberately is not about avoidance or repressing. That’s not what we’re talking about here.

What we’re talking about with distress tolerance is how, in the short term, am I going to pass the time without acting on some of these more ineffective urges? So, for example, with stress, you know, irritability is really strong and I have urges to lash out at my friends, urges to lash out at my family.

I’m really angry and irritable. Yes, and so that may be true. What’s also true is that when you lash out at your friends and family, you know, while in the moment it may give you relief, remember, dialectically, it may give you relief in the moment from your anger.

What’s also true is that it causes tension and conflict in your relationships. You end up feeling guilty, you know, and ashamed afterwards, you don’t feel great. Now you’ve got this other problem, now you’re angry, but also you’ve got this other problem of what to do now, after the, you know, lashing out here.

So distress tolerance is about like, “Oh, how do I, kind of, get through this moment without acting on those urges here?” And so a few ways to practice deliberately distracting in short time periods, and this is really important to note, short time periods, because kids get very good at distress tolerance skills.

Like, you teach it to them, like, once or twice, and they’re like, “I got it.” And then they end up doing it. But the thing is, you got to use other skills. You got to do some problem solving skills. You know, you got to do other skills besides this.

These are just some foundational ones here. And this is distracting. So one way to distract is distract with activities. So what’s one way I can decompress, distract with something that’s important to us.

It’s really great for a kid to have an idea of like, what activity do they really like, that they feel really masterful on, that they feel like no matter, kind of, what’s going on, they have this, like, kind of talent, skill, that they really, really do well at.

It can also be connection. It can also be, like, an activity like calling a friend, calling an extended, you know, family member. Is it an activity? It could be Netflix and we’re talking one episode, we’re not hanging the whole season.

You know, it could be any activity that is really important to them, walking the dog, any activity to deliberately distract. And that in that moment, that means that I’ve got to put mindfully my full attention on that activity.

And when my mind gets hijacked again by what I’m distressed by, I’ve got to move my mind over and over and over again, back to kind of what I’m doing in this present moment, because that’s mindfulness. That’s the intentional control here.

I may also distract with thoughts. You know, some kids find it really helpful that their thoughts, you know, again, really take control of their mind here. So they may choose to deliberately distract by focusing their thoughts on something else.

So that could be reading. I’m somebody who feels like as soon as I start reading, if I’m distressed, I’m like, what did I just read? You know, because I’m, like, so focused on what I’m distressed by.

So if that’s you, don’t do that skill, okay? That’s not for you. You know, just do a different skill that’s going to, it’s probably doesn’t feel stimulating.

So with other kids, you know, my favorite thing, like, in the car for, you know, it could be car, it could be home, that parents do. You could do, like, an A to Z list with kids, you know, when they’re really distressed.

So this would be, if you haven’t heard of it, is choosing a category. Let’s say, I don’t know, you could choose, like, Massachusetts or spring. Let’s say Massachusetts, and you kind of play, and you basically try to come up with something that reminds you of Massachusetts.

You know, I’ll start, I say A for Acton, you know, and maybe B, Jenn says Bruins. And then I say C, you know. And we keep going, you go back and forth. That is something that pulls at your attention.

It’s not going to solve the stressor, but it is going to buy you time to kind of get some space from it. And if you can buy your time to get some space from it, emotions can come down a little bit more.

And then you feel like you have a little bit more freedom about, kind of, what your choices are in that moment. Alright, so I’ll stop there. I mean, I could say a little bit more on distraction, but I’ll stop there.

Jenn: One of the things that you’ve mentioned a few times throughout our conversation is wise mind. Can you elaborate a little bit more on what that means?

Maggie: Yes!

Jenn: Like, it sounds like a really elusive thing that takes, like, years of development, but can you help bring a little bit more light to what wise mind is?

Maggie: Yes, and I can’t believe I didn’t describe this. Okay, so in dialectal behavior therapy, we say that there’s three states of mind always at play here. One is a reasonable mind, emotion mind, and wise mind.

So we’re talking a lot about emotion mind, at times, where you feel like, at any given moment, your feelings are influencing your thoughts and behaviors. And so if we think about, you know, emotion mind can be a great state of mind because it can kind of remind us of, like, love and compassion and empathy and our relationships.

It’s really important to have, like, an emotional state of mind. When we talk about it in, like, an ineffective way, like, it’s considered, like, a hot state of mind, is where we’re doing things in the short term to kind of try to get out of that fight or flight that are kind of, like, causing bigger problems down the road.

You want to think lashing out, you want to think about avoidance. You want to think about, you can think about substance use. You could think about, you know, really any other, like, ineffective behavior.

Social isolation, any other ineffective behavior that in the short term it’s kind of, like, resolving maybe some of the distress in the short term, or has some sort of reinforcing aspect to it. But the long term you have other, kind of, crises at hand.

On the other side of this, this is all important to explain wise mind, on the other side of this is reasonable mind. Reasonable mind is a state of mind where, kind of, emotions aren’t at play. And you’re really motivated by facts and logic.

It’s, when people hear reasonable mind, they’re like, “Oh, I want to be in a reasonable mind. It just seems so pragmatic and so logical,” but you can’t just be in reasonable mind because you need the synthesis of both.

You need the emotions to remind you of what’s important to you, what your values are, but you also need the reasonable mind to, kind of, think through long term and be outside just the moment and think through big picture.

Where am I going? Where am I headed? What are the pros and cons of my different actions and behaviors here? So wise mind is about how am I acting a way in my life, whether a parent or kid, that I feel self-respecting, that I feel like I’m acting aligned with my values, that I feel like I’m acting aligned with my long term goals.

So when we talk about healthy coping, that’s like, how do I find my wise mind? Pause, like, wait, what are my options here? How do I, kind of, look this problem in the eye? Is this actually a moment where, you know, I need to approach this situation, you know, after I kind of use a little distress tolerance.

How do I approach it? How do I ask for help? This is all, like, wise minded kind of strategies that we’re using. And as parents, you’re using your wise mind, you’re constantly thinking wise mind. What do I want best for my child long term? That’s your parental wise mind.

And that’s really important to keep in mind every time you’re interacting, you know, with your kid. What’s happening right now, in this moment, this is the only thing I need to respond to, but also big picture.

What do I want to kind of see big picture for my kid and how do I help support and cheerlead them?

Jenn: One of the things that we have talked about a little bit is that it takes a village to raise a kid, right? So sometimes that village actually looks like a blended family, where one parent’s biological, one isn’t.

Can you talk a little bit about introducing coping methods if it’s a blended family and/or are there are different parenting strategies between whatever parents are in the environment?

An example from a listener was that one parent would take a conversational approach with the kid, but the other tends to use more discipline.

Maggie: Hmm, yeah. So this is really tricky, this is really tricky. So we’ll say in, kind of, in our programs, is that you can have very different styles, as long as you have a united front on how you’re responding to some of these kind of target behaviors.

And so I think what would be helpful in this moment, is to think through, what’s the behavior that you’re both, kind of, really worried about here, and what I’d kind of suggest to just parents in that moment is, be able to accurately express, what are your specific fears about this behavior?

Because oftentimes we get really angry about behaviors and we kind of really want to problem solve it. And we try to with our conversational style, or we try to with, like, discipline stuff.

But I would say for both parents in that moment is have, just between you two, have a conversation about, like, what are your fears if you don’t intervene, what will happen to this kid?

And try to better understand where you’re both coming from, because my guess is that you both actually have a similar goal. It’s just the way in which you’re intervening is different. You kind of have different ideas about how to intervene.

But what we’ll say is that your parental wise mind, if you can get on the same page about, like, “Oh, this is actually what I really want for my kid. And this is actually some of my fears.” Then you can have a little bit more of an open conversation with each other about how you’re going to go into it as a team.

Because what’s challenging is that if one person comes in it with this way, and one person comes in the other, you’re inadvertently undermining each one of your strategies here. You know, you’re both kind of spinning your wheels, and that’s not helpful.

And I’m sure it kind of contributes to your own burnout and stress, you know, within the relationship as well. And that’s not helpful for the kid because, remember, if we’re thinking about kind of that co-regulation, creating, like, a consistent expectation, and that the environment’s not unpredictable, that’s what’s going to help your kids.

So I would say there’s probably more, kind of, conversation behind the scenes about how to respond.

Jenn: One of the things I do want to address are some of the unhealthy coping mechanisms that you might, a kid may actually lean toward. Do you have advice about helping young people when coping is leaning more toward self-harm or suicidal thoughts?

Maggie: Yeah, yeah. So, I’ve lots to say, of course, I have lots to say about this. So, again, I think these are very worrisome and scary behaviors, and dialectically, you want to think in the short term, how are these coping strategies helping with whatever emotions?

What is this kid trying to solve with these kind of behaviors here? And in terms of, kind of, helping to motivate the kid to target it, is that kind of the question, Jenn, like, how do you kind of talk to your kid about?

So I have multiple ways about this. So one way you could go about this is you could say, you know, let’s just try to understand, like, what is this doing for you in the short term? And what other problems is it causing you in the long term?

You could actually have the kid do a pros and cons. It’s a little bit more of a clinical approach, but you could, I have lots of resources too for parents, but you could have the kid do pros and cons of self-harming.

Like, what does it do for them, you know? And what are the consequences that has also played a role? And what would be the pros and cons of, like, maybe using one of those distress tolerance skills?

And by having that conversation, you kind of see, you know, you hear some of the kids’ worries, that like “I’m worried it’s not going to work as effectively,” or “I’m worried that, you know, if I don’t act on, you know, self-harming behavior, you know, this is what’s going to happen.

I’m going to explode more,” or you know, “I’m going to have,” you know. So by having this kind of conversation, you kind of get a better sense of like, what your kid is really struggling with in this moment.

I’ll say one of the pieces that we like to think about is wise mind. We’ll kind of say that, unhealthy coping skills will say, you know, it’s looking like it’s emotion mind, you know. What would it be like to do wise mind?

And we kind of do, like, two different strategies here. So one strategy to kind of think of them, like, what are my values and my self-respect, is we think through, like, so this is a little bit, this will be a little jarring, okay?

But I feel confident that I want to share it here. And this is coming from a supervisor like ten years ago, okay, who shared this with me, and I love it so much, is we have kids think through like, do you know any other kids or younger kids specifically, that you know of?

And we had the kid think through like, “Oh yeah, I, you know, I have a cousin,” or something like that, “who’s seven.” And we’ll say, “You know, your seven year old cousin, you know, when they’re struggling with, you know, sadness or, you know, loneliness, would you actually have them do what you do to cope with it?”

And it’s a little bit, kind of, jarring, but then the kids will say “No, oh my god, no, I would never have my kid do that.” And this is not to shame the kid, to shame the adolescent. This is by no means, that’s not what you’re trying to do here.

But what you’re trying to do is put the behavior in perspective. And the take home message would be, if you wouldn’t coach a younger kid to do your coping behavior, chances are, it’s not consistent with your wise mind, okay, if you wouldn’t teach the younger generation that.

And so if you just think about that for a moment, it definitely does put it in perspective. And then the kid usually says, “Well, I know, but I just don’t know what to do.” And then that’s when we think, okay, well, great. So now we know it’s not in your wise mind, but you want to figure out how to get to your wise mind about this.

So what skills can we put in place? How can we help? You know, what is it that, again, this goes back to, like, what are you trying to solve with the self-harm and what can we do instead that will help you cope with it?

Because, remember, it’s not enough just to stop the behavior, you have to have an alternative skill to replace it with. And so that would be one way, is to think about, like, younger generation.

The second way you could think about it is, and this isn’t with self-harm. This is, like, really with any behavior, just to kind of help a kid identify what their values are.

Even think, you know, like in five, ten years from now, if somebody interviews you or they interview all your friends and family, anybody who’s important to you, how would you want them to describe how you treated others, how you responded to stressors in your life?

How did you, kind of, man-, you know, you had a lot of things that, you know, really, a lot of obstacles you encountered in your life, how would you want them to describe your resilience? What is it that you did?

You know, so you try to, like, put it in perspective of, like, and what you’re trying to do is kind of, like, saying like, “How do you ideally want to live your life? And what behaviors are you doing right now that are inconsistent with how you ideally want to live your life?”

And then let’s go after that. And again, this is all about, like, motivation, collaboration, because without that motivation, collaboration, it’s really hard.

It’s really, your kind of, like, trying to force the behavior change and what you think is best, which is, you know, is really, you know, what you think is best is really, you know, best.

But you got to have your kid on board here, so these would just be kind of, like, two ways, you know, I’d be curious too, you know, if there’s any feedback on that.

Jenn: Do you think that those would be similar methods that you can use for controlling anger? Or are there any methods for coping with anger that you’d also recommend too?

Maggie: Yeah, oh, I love this question here. Sure, you could absolutely do that. Like, you know, if you think about those two examples, you know, would you tell, like, a little kid to, like, yell and, like, say, you know, lash out at their friends? No, okay?

Well, chances are you don’t want to be a person who lashes out, or you don’t want to be a person, or whatever it is that you do when angry. If you, you know, destroy property or you lash out.

Chances are, you don’t want to be that person, okay? But what I’m also hearing is that this is, like, it almost feels reactive and automatic, you know? And so let’s see if we can kind of try to slow this down for you.

And what I’d probably try to go after is, you know, does this person, again, if we go back to mindful awareness, does this person have a mindful awareness of what it is that really, you know, what are the factors that set them off?

Like, you know, so what are the precipitating factors? What are the, you know, you can say trigger, you know, whatever words you want to use, cues, triggers, you know, whatever, prompting events? Do they have a good sense of that, okay?

So, do they have a sense of that? And then second, do they know what to do instead of lashing out or whatever, I’m just hypothetically, or destroying property. So it may be self-soothing.

They may need to actually do a skill that kind of matches the intensity of their anger, okay? Because rule of thumb is that the skill’s got to match the intensity because if not, you know, if, like, I’m angry ten out of ten, coloring in a book isn’t necessarily going to calm me.

I mean, it may for some, but you know, for others, it won’t, you know, and so maybe for that, you know, if I’m so angry, I got to, like, get that energy out.

I got to go, you know, ten times up the flight of stairs, you know, nearby me, or I need to dunk my head in some cold water, you know, like, I need to kind of, like, kind of reset my nervous system.

There is a skill called opposite action here, and which is basically like doing the opposite of lashing out. And it could be just getting some space from the person and it means you’re not spending the whole time thinking about why you’re so angry when you’re getting space, you may be using some of those distress tolerance skills.

It can also be, you know, can I think about this, you know, can I think about how the other person is feeling in this moment. Or it’s even harder, but it’s doable, you can do it, is can I actually say something kind to this person in the moment, if my goal is to reduce my anger.

My other piece would be, you know, anger is usually a secondary emotion, and I’d probably ask, what’s the primary emotion that’s motivating this? Like, is there sadness or fear actually at play here?

Because, oftentimes, just responding to anger, I think that’s important just to like, kind of get control over behaviors that are maybe, like, that feel really destructive in the moment. But if you’re really wanting to kind of practice emotion regulation, you got to go a little bit, you know, the iceberg metaphor always comes to mind, is like, what’s underneath the anger?

Usually there’s something else there. Is there a loss? Do I feel really hurt and disappointed about something or how I was treated? And if that’s the case, I’m going to need to do a little bit more problem solving, you know, I need to do a little bit more asserting or advocating what I need from that person.

Or maybe I need to ask for help about like, how do I go about this because I feel so hurt. That’s ultimately going to help reduce the anger. If you can, kind of, go to a little bit more of the primary emotions there. Does that answer the question, Jenn?

Jenn: Definitely. Any tips for parents and kids for coping with a situation like financial difficulties?

Somebody wrote in saying that, for example, the adolescent is blaming the parent for not having the money to give them what they need.

Maggie: Okay, like, need like clothes or like video games or?

Jenn: Yeah.

Maggie: Or, like we’re saying, okay. So I think that would be, for a parent, whoever answered that, that is so hard to hear. And I’m sure in this moment there is, I’m sure maybe some frustration about that.

And so I think my initial response to that would be, again, adopting your nonjudgmental, curious stance and kind of validation here and kind of lean into it, of like, what is it that that kid is actually really upset about here, and if they don’t have these specific items like clothes you know, or video games, I mean, whatever it is, I’d be really curious like, what the feared outcome here is if you don’t have it, and is it social rejection?

Is it that they feel like, I don’t know, like they don’t feel confident enough. I would try to get to, like, the root of, like, what it is because it’s not really about, I mean, it’s about money, but it’s, like, something else is there.

I would try to get really curious about that. That may help you have some compassion for the moment. You may still not be able to give them what they want, but some compassion and kind of thinking dialectically, where are they coming from about it?

And then hopefully maybe kind of have a better understanding by doing that, better understanding where your kid’s coming from. It doesn’t mean you have to agree with it. Validation is not about agreement.

It could kind of level the playing field for the kid to be able to hear like, you could say, like, “No, I hear you. And the painful reality is that we don’t have these resources to give you. And I know that’s so disappointing and you don’t like that and that doesn’t feel good, and that’s the reality here.”

But I think I would try to go after, like, what is it that the kid is experiencing, versus, I mean, because I could see a gut response to be like, “You’re not appreciating,” you know, I’m not saying this parent is doing this, but you know, I think parents could resonate.

Like, “You’re not appreciating like what I’m already giving you,” and you know, and again, I don’t think it’s really- I would try to see what the kid’s experiencing from their point of view. What was the other question, Jenn? Was there another one before I- oh.

Jenn: Nope, no other, I have a couple more for you, but nothing piggybacking off of that question.

Maggie: Yeah.

Jenn: I feel like one of my parents wrote this in from 15 years ago but, how can I get my teenager to be nicer to their younger sibling?

Maggie: Oh, so, okay, again, I would, in this moment, for behavior change, do you have a sense as to like, you know, for the parent who wrote this in, is, of course you probably have a family value of being kind to others.

And that’s something that you hope to, and I bet as a parent who wrote this in, you’re trying to model and reinforce that to your kid. And so it probably does not feel good to you as a parent who sees maybe your kid being hurtful or harmful to your other kid here.

So again, I would go after, I would go after the, do you know what it is that really bothers, you know, your kid about, you know, the older one against the younger one, do you kind of know where your kid’s coming from here?

And I would probably say as a family expectation, you know, the expectation, you don’t have to, you know, like your kid in this, you know, like so and so, your younger sister in this moment and you’re allowed to feel whatever you feel.

And the expectation though, is that, you know, you’re not going to say something harmful or call names or something. That’s the expectation in the family, okay? Again, I’m not saying that you can’t be angry with them.

I’m not saying that you even have to like them, but there is, like, this baseline expectation that you’re going to do this. And again, I would try to be like, do you know what you could do instead of lashing out?

So if you’re really upset, can we think about ways that you can do this separately? It’s super hard. But I think as a parent, you, in your wise mind, I think that seems a little bit more of, like, a family culture, that’s not something that’s acceptable for your family.

There’s going to be an urge to kind of want to punish, you know, the older, you know, or I’m not saying this is for all parents, but sometimes there is like trying to get control of it, to be like, “You can’t do this and we’re going to stop.”

I would really try to go after it in a more collaborative way first and try to understand, like, what is it that you’re, you know, help me understand.

Like, you know, “I know younger siblings are annoying, but I feel like I’m missing something here, and I want to know what I’m missing, and I can’t solve this if I don’t know what I’m missing. So fill me in because I feel like I only have a few pieces of the puzzle here.”

Jenn: At what point should I reach out to my child’s care team if I don’t think that they’re coping well with a life change, big emotion, or something else that’s coming up for them?

Maggie: Yeah, and by care team, we’re probably talking like school staff, but also maybe a potential outpatient kind of?

Jenn: You know, pediatrician, mental health specialists, depending on who is part of their care team per se.

Maggie: Yeah, so depending on the kid’s age, regardless of the kid’s age, I’d probably do the same thing. So, first, I’d ask myself, what is my parental wise mind? What do I hope is achieved by reaching out? What’s my goal here?

Is my goal something that I want the care team to do? Do I want the care team to, like, assess it? Do I want the care team to see if they see the same behaviors? I would try to get really clear, what is my wise mind goal here?

And then I’d probably kind of just be mindful. Do I have any parental emotion mind kind of showing up here as well? I trust your judgment. You know, if you feel like something’s off, I trust that.

I think though, you just want to be mindful of like, what ultimately do you feel like will happen if you talk to them, and what do you hope will happen?

And then the second piece, consistent with your parental wise mind of raising an autonomous, independent, resilient kid is, I would actually try to talk to your kid first, before talking to the care team.

And that’s usually something that we usually will coach parents to do is, is say like, “You know, I’m noticing,” if we start from the beginning of this webinar, “I’m noticing this,” kind of non-judgmentally describe the behavior and you know, “I’m wondering if you’re feeling, you know, really stressed and anxious or overwhelmed or hopeless?

Is it hot, cold, Marco Polo? Am I getting close? Am I totally missing the boat here? Fill me in, help me understand, because I think I’m missing something here, because without that I kind of want to talk to everyone else because I don’t know what else to do here. What is it?”

And, again, trying to get, because you’re going to find your parental wise mind, the more information you have, it’s kind of easier for you to then figure out, “Okay, yeah, you know what? My kid is struggling, and they think they’re struggling.

Okay, so I want to talk to your care team about this. How do you think would be the best way we could talk to your care team about it?” And consult with your kid on what would be helpful.

Because then you’re reinforcing your kid advocating and problem solving themselves with your support, depending on the age, scaffolding, you’re going to do a lot more support with them.

But as they get older, you know, you’re going to be really wanting to, kind of, trust their judgment and help them kind of, you know, cheerlead, you know, what they feel like is best for them as well, so.

Jenn: Maggie, this was amazing. I cannot thank you enough. You clearly have so much knowledge and have so much more that you could share. I wish we had more than an hour, but I’m still grateful for the hour that you gave me.

So thank you so much for sharing all of these valuable tips about coping for kids, adolescents, and even adults. And if you are tuning in as a member of the audience, this is actually the end of the session.

So, like I say every time, be nice to one another, but most importantly be nice to yourself. So Maggie, thank you so much again, and have a great day everyone, take care.

Maggie: Yeah, thank you. Alright, bye-bye.

Jenn: Thanks for tuning in to Mindful Things! Please subscribe to us and rate us on iTunes, Spotify, or wherever you listen to podcasts.

Don’t forget, mental health is everyone’s responsibility. If you or a loved one are in crisis, the Samaritans are available 24 hours a day at 877.870.4673. Again, that’s 877.870.4673.

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The McLean Hospital podcast Mindful Things is intended to provide general information and to help listeners learn about mental health, educational opportunities, and research initiatives. This podcast is not an attempt to practice medicine or to provide specific medical advice.

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