Podcast: Mindfulness for Kids & Teens

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.

Hey, folks. So if you’re joining us for the first time, the 41st time, thanks for joining, I’m Jenn Kearney. I’m a digital communications manager for McLean Hospital. And today’s session is all about mindfulness for kids and teens.

The great thing about mindfulness is that it’s pretty subjective. So you can actually end up taking care of yourself in a multitude of ways. I know that we’ve got, mindfulness is kind of like that fun sexy term where everyone’s talking about it, but it’s still kind of vague.

And the nice thing about mindfulness for kids and teens is that it’s a lot of stuff that we can apply ourselves as adults. And I know that while I’m not a parent myself, I know I’m going to learn a ton of stuff that I can apply to my day to day throughout the session.

So without further ado, I’m going to introduce Lisa, and then we’re going to get started. So Dr. Coyne is a senior clinical consultant at the Child and Adolescent OCD Institute at McLean, otherwise known as OCDI Jr., co-author of a book, “Stop Avoiding Stuff” that I shamelessly plug every time because I love it.

Owner of three dogs. And she’s basically like having a cup of tea on a cold afternoon. She’s just someone that’s very comfortable, very easy to talk to. And I’m super excited to get this started with her.

So Lisa, I just have to pat myself on the back because I did your introduction from memory, so that was great. I’m jazzed with that. However, can we get started by talking just a little bit about what mindfulness is? Just because everybody talks about it, but nobody really gets that nitty gritty. So, can you just provide like that 30,000 foot overview?

Lisa: Sure, I can. And actually, we can start to practice right this minute ‘cause sometimes when we are trying to be mindful, there are distractions, which I will deal with right this minute, but mindfulness, just to boil it, I’m going to boil it down really, really simply ‘cause there’s many different traditions of mindfulness and there’s many different ways to approach it.

People talk about it differently. Some of the ideas are it is to calm you down, it is to focus. From the Buddhist tradition, it’s about finding sort of that space where you’re one with all things.

But our purposes today in thinking about it and how we use it, why is it important and how do we use it with children in adolescents, I want you to think about it as paying attention on purpose at will.

Now, a lot of things grow from that ability, but it is not an ability and it’s not a skill that we always know how to use or that we access frequently. And if you think about culture today, if you think about sort of our, the way we live, what we’re surrounded by, we’re surrounded by screens, we’re surrounded by really short little nuggets of texts.

We interact virtually, because we’re online quite a lot, because social media is designed the way it’s designed to keep our attention. Our attention has been shaped to require constant input, constant input.

And we’re in our heads a lot. We’re really, really in our heads a lot. And so we don’t really cultivate the ability to slow down and just simply check in with ourselves and notice, and drop into that observing space.

Jenn: How can we help our kids, especially during this time when they’ve been dealing with so many things that have just been curve balls, so they’re learning remotely, their classes have been canceled, classmates might’ve gotten sick. How do we help them ease their anxieties through mindfulness?

Lisa: And again, so some people think of it as an antidote for things. And I’m going to encourage you to not think about it like that. It is a skill that can help you learn. So when kids are anxious, the very first thing that we do when we feel anxious is it’s a signal.

It’s an emotional signal to our body to get up and go and get the heck out of here, that there’s a threat. And so we experienced physiological arousal where our heart rate starts to jump. We experience cognitive reactions where we’re starting to catastrophize about things, there’s danger.

Oh my goodness, what do I do, and an emotional reaction. So it’s got all those three parts. And the thing is when kids are experiencing anxiety, and stress, those reactions can be amplified. And they’re also overgeneralized where we don’t necessarily need to be anxious about things but our bodies do it anyway.

And so one way that people, the first thing that people do really, we just try and be less anxious, make it go away and sooth it and calm it. Sometimes that’s really counterproductive. Because it ingrains the idea that anxiety is something toxic and dangerous, and we’re really mistaking a signal our body’s giving us that may or may not be useful.

It may or may not be relevant in this situation. And so a better thing to do is to slow down and just let yourself notice it, stop treating it as toxic and dangerous. It might be uncomfortable, don’t get me wrong. None of us love to feel anxious. At least I don’t.

But it is something that’s information. Just like any other emotion. And it might be something we should pay attention to and it might not be. And so mindfulness in that context, the ability to slow down, check in with yourself, just notice like, what’s my body feeling? What’s my heart feeling? What am I thinking?

And just to explore those and retain them gives you just this little bit of pause when you can see if that quick avoidance response that we’re also geared to is useful or not.

And that’s at the heart of exposure based treatments really when you boil them down for anxiety ‘cause exposure is all about increasing your willingness to feel anxiety and not engaging in avoidance responses about it. And that may sound totally antithetical to everything we feel, and that’s okay. But that’s how evidence-based treatments for anxiety work.

Jenn: Do you have any advice for ways to apply mindfulness to your kids who just don’t listen? A parent today asked about the saying, I would love to end the constant nagging and power struggles in the home regarding uncooperative and sometimes obnoxious behaviors.

Lisa: Yeah, that’s a bigger question. And we all had that in our house too with my kids growing up. And paying attention on purpose is a really good skill to have.

And one of the things that you can do is, and again, there’s like, it’s hard for me to suggest not seeing the picture in my head of what’s going on.

But basically, I think I would make instead of nagging over and over again, I think I would make getting whatever it is that this is going to be a reward for this kiddo or what this kiddo wants, screen time, getting up from the table, what have you, contingent on slowing down, asking nicely.

And a really simple way. We don’t often think about this as mindfulness, but really, if we boil it down again to paying attention on purpose, if you have a kiddo coming at you with lots and lots of emotion and demanding and doing all of that, you can do, like, you can ask for, ask me nicely, which requires calming down, noticing the sound of one’s own voice, lowering your tone, and asking nicely in a polite, socially appropriate way.

And so what I used to do with my kiddos was I’d be like, if you’re going to talk to me inappropriately, you’re invisible, I don’t even hear you. But ask me nicely, and the answer might be yes. It might be no, but I will listen.

And so you want to shape that kind of self, it’s almost like self-regulation, so because kids are not often, especially if they’re impulsive and they’re sort of on that more active end, they’re not going to be very good at noticing your body is in space, noticing how the impact of their behaviors on others.

Are they nagging, are they bothering you, that that’s not going to be in their heads. And so getting them to slow down and notice is something that’s really, really helpful.

Jenn: Is there any way that we can steer older kids, and I would say older is between the ages of like eight and 12 away from having freak outs about small and seemingly controllable occurrences?

And one of the parents that wrote in and said, specifically, the iPad cover got scratched or they didn’t know an answer to a homework assignment and it’s just meltdown mode.

Lisa: Yeah, and like, I think I’d have to know a little bit more about that to say, but one of the things that we’ll often like, if I’m working with parents of anxious kids and kids that have some sort of inflexibility around needing things to be a certain way is I’ll actually work with the parents to become more mindful of their own responses to that.

Because I promise if kiddo is like, oh my gosh, my laptop, and we’re like, oh my gosh, your laptop, we mirror that, which we do ‘cause we’re human and we empathize. That’s just going to ramp it up.

And so a better way to model and be really mindful is you may be feeling very frustrated yourself, I would. But we don’t want to be dismissive of the kiddo. We want to be empathetic and we want to keep ourselves outwardly calm.

Even feel whatever you’re feeling, but you want to kind of keep it calm on the outside. So, wow, that looks really, I can see you’re really upset about that and just keeping it really calm and slowly solving the problem for the kiddo, but not treating their emergency as an emergency.

So like, do you remember that, you guys might’ve seen this, that bumper sticker, your lack of planning, a lack of planning on your part does not constitute an emergency on my part. Think about that.

And that obviously, this is not about planning, but you get the idea. So teaching kids that it is okay to experience emotions, whatever they are, and emotions are not emergencies necessarily.

Like one really important thing to notice too is that when little kids come to you with strong emotions, it is a signal for help. It is like mom and dad, come fix this. And so I think the empathy piece is really important. What not to do would be, again, be dismissive. Like that’s nothing to be anxious about.

Even though you can think that, and we all think that because they’re little kids and they get all excited about things that we’re like, oh my gosh, seriously. But honor the emotion they’re coming to you with and keep it calm if you can. I know you can handle that scratch on your iPad.

That’s really disappointing, I know. And with little guys, what you can do is you can use distraction. With kids who are older, you’ll want to do something a little bit different but kids that age, like it’s okay to kind of distract a little bit from that.

Jenn: I do love this next question because I am a proud auntie of toddlers. How can we apply mindfulness to toddlers?

Lisa: Oh, so much fun. That used to be my favorite. I used to teach this in Head Starts all over Boston. There is a great, oh my goodness, I’m not going to remember her name. Amy Saltzman is her name. And she is a psychologist and she has a website called the Still Quiet Place.

And she has a really wonderful CD that you can get for mindfulness for little guys, aged three to five and a little younger. And so one of the things that’s important to notice about little guys is that they’re already mindful, they’re so connected with what’s going on.

Have you ever watched little toddlers lost in play and just absolutely joyful, like learning how a new toy works or doing whatever, it’s so magical.

Jenn: Just being imaginative and coming up with this whole background story and people that aren’t there, yes.

Lisa: Playing house, oh my gosh. That used to be my favorite. Watching the little kids like negotiate, who’s going to be who and playing house in the Head Start too. So they’re already good at it, but they’re very active.

And so one of the things that’s really fun, one of my favorites actually is to have them do use mindful movement so that they can learn where their body is in space. ‘Cause that is not something that they’re necessarily good at.

And at that age, they’re not necessarily mindful of the effect of their behaviors on others. ‘Cause at this point, depending on where you are in toddlerhood into preschool, you’re talking about like parallel play.

Theory of mind, in general, the ability to notice that other people have different thoughts and feelings than we do doesn’t develop until around age four-ish. And they do have basic empathy before that, but really understanding people have different thoughts is different.

And you’ll notice that now that we’re talking about mindfulness in this age group, we’re really flexibly applying it to mindfulness of your body in space, mindfulness of what other people are noticing about you and the effects of your behavior on people.

That’s all that sort of mindful observation space. So we used to do one where we’d have them pretend they were seaweed in the ocean and their feet were the roots. So their feet couldn’t move, but their bodies could move.

And we would have them pretend to move like seaweed. And we would do in a really calm ocean kind of like, they can feel the wave, and they’re just noticing what this feels like. And then we would do like the ocean storm, which was of course, really fun, ‘cause then I’ll go, like if the waves are moving them around.

But that’s a good way to notice. Other fun things you can do with little guys, and these are listening games, Red Light, Green Light. That’s a great game. Teaching you mindfulness and awareness of your body in space.

How does your favorite animal move? Let’s pretend to move like our favorite animal, not this dog that keeps barking behind me. And so just incorporating games like that. Another fun thing actually, now that we’re mentioning the dogs is if there are therapy dogs or service dogs, like I would bring a dog, and there are plenty like Massachusetts, what’s it called?

Dog B.O.N.E.S. Massachusetts is a service that does, service dogs will come in and mindful touch of a dog. Just sitting and noticing what that dog is like. What does it feel like? What’s its fur like? Is it licking your hand, all of that stuff?

So there are lots of really fun ways, usually through five senses awareness or movement that you can work with mindfulness for little guys, but check out Amy Saltzman stuff. That’s really lovely. Yeah, exactly.

Jenn: I did want to ask you about how do we help kids who are having a hard time with changes in routine, especially if they’re unexpected changes.

It’s hard ‘cause you don’t want your kids to be upset and you also want to validate their feelings, but you don’t want it to be positive reinforcement every single time. So what can you do to help them understand that everything’s always going to be changing?

Lisa: Yeah, it’s hard. And so there’s two things I would suggest. One is where you can let them know what’s going to happen at a little bit in advance. Sometimes kids need more of that.

And so meeting them where they are is important and acknowledging that it’s hard when things change and sometimes they change. Again, how you guys model it as parents is going to be critical to your kids learning how to model it themselves.

So if you are very, very put out, showing those kinds of emotions, your kids are going to learn from that, that this is something that should be distressing. And so the other thing I would say is this, yeah, you’re right, we do not want our kids to feel sad, anxious, scared, stressed, but that’s part of life, and we can’t always protect them from those experiences.

And so one way to think about it is how do we become parents that teach our kids how to feel those things effectively and to still be effective, to manage them. Because that’s just part of life. You want your kids to have these experiences on purpose as opportunities to learn.

They’re little templates for things later like that. Oh my gosh. The schedule changed right now when your five is, oh my gosh, I didn’t get into the college of my choice, but maybe I got into my third choice.

It’s teaching flexibility when it’s needed. So I would say modeling for the kids that you are experiencing, oh, gosh, I didn’t like that either. And you know what, it’ll be okay. We’ll make it work. Modeling those kinds of responses are going to be I think really, really important.

Jenn: So this next question is basically your sweet spot of what you study and what you’re like super knowledgeable in. Are these ideas of mindfulness applicable and helpful to teens that have OCD?

Lisa: Yes, they are. It depends, and like anything, it depends on how you use them. I know plenty of kids who try to use mindfulness so that they don’t feel anxious or that they are not experiencing OCD.

That’s not an effective way to use it. Instead, so would you guys, I’m guessing that people know what the term like white knuckling means. White knuckling.

Jenn: Not sure, if you don’t mind elaborating.

Lisa: I will elaborate. So it means like, so just imagine for a second that you’re scared of rollercoasters and your friends are with you, you’re a teenager. You don’t want to go on this rollercoaster, but your friends pick you up, carry you, put you on there.

Just imagine, I know it’s not real, but they put you on the rollercoaster, and make you go. And imagine what that would be like being made to go. That’s hard. And you’d be like white knuckling hanging on to that thing, trying really hard to wait until that experience was over and closing your eyes and just defending yourself against it as much as you could right.

Now, contrast that with this, where you decide you’re scared of rollercoasters, just the same, and yet these friends are really, really important to you and you care about them. And this is an experience that they’re going to have together and you’re scared, and you also want to be a part of it.

So you choose and you choose to get on the rollercoaster yourself and you choose to kind of keep your eyes open and see what the experience is like. You get really curious and it’s scary, but it feels different than when you’re white knuckling it.

So we teach mindfulness, especially at OCDI and especially in exposure based treatments so that people are more willing to allow their experiences, so all emotions are information and you can’t get that information from those emotions unless you slow down and let them happen.

So for OCD, the gold standard treatment is exposure and response prevention, which means increasing your willingness to experience your fears and blocking any compensatory rituals, any other avoidance behaviors, and things like that.

And over time, what happens is you get increasingly flexible in your behavior when these kinds of scary thoughts and feelings pop up and you learn that they’re not really important information for you.

So even if they pop up in the future, they don’t really matter as much. It’s not that you’ll never ever have another anxious thought or feeling, for sure, we all do, but you’ll handle it. You’ll know, this is my OCD talking to me again.

And the very first step of doing really solid exposure based treatment is stepping back from what the OCD is telling you will happen and getting curious. And that curiosity, the seat of that observation is mindfulness. It’s that paying attention on purpose by choice to what’s going on so that you can learn from it.

Jenn: We had clinician write and asking, how can I introduce mindfulness to older kids and teens in my clinical practice who are experiencing a range of conditions, including anxiety, intrusive thoughts, depression, ADHD, and perfectionism.

Lisa: We can do it right now. Actually, this is how I always start. Unless it’s a very young child, we can do a really quick mindfulness exercise right now on the webinar. You can do it whether you’re watching or you’re listening.

So just take a moment, close your eyes. If you’re willing, if you’re not, you can look at your feet or the floor and just take a moment to notice what your body feels like sitting wherever you’re sitting.

And just take a moment to notice parts of your body that you don’t normally notice, like your ear lobe, the back of your hand, your knee. And now just take a moment to connect in with your breath.

Just see if you can notice it with curiosity like you’ve never noticed it before, like this is the first time. Just notice for a second that like through our whole day when we’re busy in our minds, our bodies has been taking care of us all the while just taking in in breaths and out breaths, just kind of let yourself marvel at that for a second.

Now, just let yourself take a couple of nice deep breaths. And when you’re ready, you can come back to the webinar with Jenn and I.

And so that little exercise, that short, that brief might be how I start. I don’t start by explaining it. I don’t start by extolling its virtues. I just show them. Because it doesn’t matter if they understand it. What matters is that they practice it.

And if they’re new to it, you want to start slow, you want to start with a short exercise just a few minutes and you can actually do this at the beginning of every session, if you like. And that actually becomes a cue for a certain kind of really mindful presence and awareness in session.

And there’s a little bit of data suggesting that it’s good for therapists too, especially if you’re having client after client all day. And it helps you sort of clear and center yourself for the next session when you’re in between.

Jenn: I do a similar meditation right before I go to bed. And that for me has become a signal that it’s time for me to start powering down and call it a night.

And I go through parts of my body, my feet, they’re shutting off, my legs, they’re shutting off, my fingers, they’re done moving around. And I worked through all of that awareness and it’s about five minutes and I’m usually asleep before I get to the top of my head.

Lisa: I love that.

Jenn: It works across the spectrum.

Lisa: It does, and it’s really nice because there’s like the Calm app, there’s Headspace. There’s like a lot of mindfulness apps that are really, really nice that are cool. Kids always have their phones with them these days.

So like it’s right there, you can listen to something. One of my favorites actually is when I’m anxious and I’m kind of having trouble sleeping or falling asleep just because of the busy-ness of whatever went on in my day.

I really like to listen to my ocean sounds. It’s just really nice. And not as a distraction, but I just really appreciate that kind of being in the ocean, like listening to the ocean as I’m drifting off to sleep.

Jenn: As somebody who has used, I’m on a 248-day streak, I think, with Headspace, but I listened to the ocean pier sounds every night, so 45 minutes of sleep and serenity. You’re preaching to the choir.

Lisa: That’s a healthy ritual. That’s a helpful ritual. So that might be something that’s nice. So I hope that helps, but I mean, there’s plenty of really wonderful resources out there to teach mindfulness in organizations, to the mindful schools organization, et cetera.

And I think it’s foundational to a lot of things just because it helps you, so it lets you, I love the way Amy Saltzman says it in one of her scripts for little kids, I think she says, it’s the place where you can go to make friends with your emotions where you’re always safe, because there’s still a quiet place. And I just love that.

And that’s really consistent with, I think, the more Buddhist models of it, where that sort of emptiness, that openness, that we experience sort of our oneness and all things are okay. it’s just a beautiful experience.

Jenn: And that’s something that’s so valuable to learn because that’s almost like when your critical voice in your head starts to get really strong and being able to kind of just blank slate and have much more better clear conscience. I think that’s huge.

Lisa: Yeah, it really is. That’s a great example for learning mindfulness is learning how to observe that critical voice and develop a different kind of relationship with it, that’s less of a have to, that’s more gives you a little bit of distance from it.

Mindfulness is the beginning of learning that defusion, that separation from that voice.

Jenn: Do you have any advice when teaching mindfulness to kids and young adults who have disabilities?

Lisa: I would use, so again, really short things and I would use movement-based ones. And I think I would just keep it very, very simple. So I’m very pragmatic when I’m working, so I try not to hold tons of assumptions for who can do what, but if I notice somebody struggling with what I’m teaching, I’ll make it smaller, and smaller, and more amenable.

I would advise this one thing, though. If you are working with kids who are anxious, don’t start with mindfulness of interoceptive cues. That can be very triggering. And we’re just actually publishing a paper on that very thing, a mindfulness based protocol for GAD in kids.

And that protocol we thought really carefully about like, what do we teach first and how do we think about this as a sequential development of skills that gets more and more sophisticated. And so with giving some choice about what do we want to do.

A mindfulness activity could be something like... My friend is back barking. Sorry, I apologize, guys. A mindfulness activity could be, I did this once with an anxious little guy, go to school. And by next week, I want you to tell me a hundred things that you’ve noticed about your classroom, that you didn’t notice before, big list.

And the goal was just to teach him how to pay attention to something, even if he’s anxious. And you know what, he came back with this list of a hundred things. And he was like, guess what? And some of them were like his peers and what the reactions to him. And it was really nice and he was super proud of himself.

So just giving choice, keeping it really simple and being really aware of like, it’s an easier skill to notice five things in the room around you for some kids than to notice like feelings in your body, things like that. So just keeping that in mind.

Jenn: As a parent, how can you practice and teach mindfulness or being calm if your kid is experiencing big emotions or even if you’re experiencing them yourself?

And the example that the parent wrote and said, my 12 year old daughter has been saying mean and hurtful things like, I hate you.

Lisa: Those are really hard, aren’t they? And I’m sure we’ve all been there. Trying to be mindful of the dog.

Jenn: Apparently, he’s also having big emotions

Lisa: Big emotions, yes. So, I want to make sure, so you can be mindful of big emotions and not calm. And when you’re first, so remember if we think about mindfulness as paying attention on purpose, the goal would be developing and cultivating this ability to observe our experience in a nonjudgmental way, a non-evaluative way, in a nonreactive way.

Mindfulness isn’t going to be armor against feeling hard things but it will help giving you the space to notice that and not react to them in a way that might not be helpful. It’s going to give you that ability to pause so you can be flexible.

And maybe that moment when there’s high emotion is not the time to respond, maybe it’s later. And so mindfulness, that kind of mindful awareness gives you just that split second to pause and choose. Do I want to say this thing or do I not want to say this thing?

And so for kids who are in those spaces, when they’re yelling, that’s not a great time to start teaching the mindfulness and you guys already know that, I don’t need to, I think, say that, but I think cultivating a way to be friend when you’re angry and notice, what are you doing when you’re angry? And is that behavior, that yelling, expressing that in that way, is that helpful?

And so that’s where the mindfulness comes in later to observe yourself in that, for the kid, to observe themselves in that situation and to observe, how did that work for you? Did that get you what you needed? And it might’ve felt good to express that anger, to vent, but did it help? Did it get you what you needed?

And teaching kids, and that’s a mindfulness skill. That stepping back into that observing space and taking a different perspective on yourself at a different time. And that takes time. That takes a lot of time, but that’s where I would go with mindfulness with that, I think.

Jenn: So I know I was a kid once, I hated chores, hated being told what to do, hated having the to-do list that my mom would leave for me when she left for work. How do we make mindfulness into our routine for kids without adding it to the chore list?

Lisa: I think it’s great. Honestly, I’m just thinking of creative ways to do this. So like in my house you know how I would do that. We all love to eat, go bigger but we might just like, before we eat, take a second and just notice all this awesome food on the table.

And just notice like the work that went into that, just notice like, do you remember the trip to the store? That’s mindfulness. Work it into daily activities that are fun. Talk about it in the context of sports. When athletes are mindful, they’re in the flow, there’s lots of data on that too.

Helping kids notice that, like when they’re playing music. When you’ve learned something and you’re just doing it fluidly, that’s wonderful. That’s mindfulness.

Like that’s really being in the moment and really attending to the music as it’s coming out or that hoop that you’re shooting right in that moment. Really cool. So pointing out where they are mindful already is another really good thing.

Jenn: Do you have any tips or advice to deal with kids that are acting out while they’re homeschooling, but they’ve got mental health conditions.

So a parent wrote in saying, I’ve got two boys under eight, one with ADHD and autism and one will act up and the other will follow or the other one will chime in because it just results in getting more attention. They also feel like resources are a little limited. So, what can they do?

Lisa: So I have been reading so many posts on exactly those kinds of situations from parents all over, who are really at their wits end because it is really hard to do what you’re doing, is really hard to be asked to do this and it’s been a marathon already.

And so, first of all, I just want to extend like just appreciation for the parents out there that are struggling and just give yourself a moment to just acknowledge, like this is really hard. And you may notice there’s a critic in your mind going, but I should be able to do this, or damn it, somebody should fix this.

And just notice that it may be a little while before help comes and before things are set alright. So what I would say is in these kinds of situations and we’ve written actually some work on this for parents for how to cope with this.

And we can even put, there’s a blog that I did, and there’s a little paper that we published for colleagues about some simple practices that parents can practice mindfulness practices that are not big, long things that you need to shoehorn into your day, but they’re more like tiny little breaks that you can take and do something kind for yourself.

And give yourself permission to say, you know what, I need five minutes and no one talk to me. And it’s okay also to change your expectations of what school engagement should look like in the pandemic.

And I know that there’s lots of stuff floating around out there about how damaging the pandemic is going to be to the kids. And there is data suggesting that kids are experiencing, almost one to two are experiencing higher levels of behavior problems.

That is a predictable response. And humans are flexible. We evolve and our behavior evolves and we adapt. And so, yes, this is hard, yes, this stinks. And yep, the kids are not going to be where they are supposed to be in school if they were in regular school situation, but they’re going to make up the time.

And there’s nothing that’s about this experience that’s going to change their brain’s ability and plasticity to adapt. It’s still going to be there. We just need to hang on until the end of it. And so I would think about practicing mindful breaks for parents in those situations, giving yourself permission to let things go to pick your battles.

It doesn’t have to be perfect, no such thing. There’s no pandemic. How to be a perfect pandemic parent. The day that manual gets written, jeez. It’s just not out there. So it is okay to feel like it’s hard. It is okay to feel overwhelmed. It is okay to feel whatever you’re feeling.

And even inside these words, inside that space, that’s mindfulness too, just checking in with yourself and saying, this really hurts, this is hard.

It’s okay to feel that, giving yourself permission, put on your own oxygen mask first before you take care of the kids and that will be probably the biggest and best thing you can do as a parent.

Jenn: I can’t help, but think of a few weeks ago in a therapy session of my own, where I was saying, I don’t feel like I have it together during this time.

My therapist said, there’s two types of people in the world. People who don’t have it together during this time and liars. We’re all in this together. And that is something super important.

Lisa: Exactly. And I think we’re all feeling it at this stage, it’s like, when’s the year anniversary of the pandemic? We should celebrate, Jenn.

Jenn: I have a month and a day until I was sent home and said, you’ll come back and spend 11 months.

Lisa: Oh my God.

Jenn: And even that kind of thought pattern is a lot of it has been spent especially if you’re listening live, we’re in the new year, a lot of people have said, oh, 2020 was so hard, 2020 was such a waste.

And I’ve been trying to flip the script at least for my own mental health about how have I grown and how have I actually flourished in 2020 in ways that I wouldn’t have expected and ways that I wouldn’t necessarily have been granted that space because of a pandemic.

Lisa: And I keep asking myself, like, what am I learning about myself in this? What am I learning about other people? What am I learning about friendships? What am I learning about? what’s surprising to me that I didn’t know? And that’s been interesting too.

Jenn: So we got a question from a clinician that’s working with kids and teens that have depression and anxiety, and they often find themselves contradicting when helping with challenging thoughts.

So there’s one route where it’s traditional CBT, like changing the content versus encouraging them to like sit in the thoughts and think of them differently, so mindfulness. Have you had experience reconciling or integrating the two different approaches? And if so, how?

Lisa: Oh my gosh, yes and yes. And it’s funny ‘cause like, and this is really fun. So I’m going to give a big shout out to my colleague in graduate school buddy, Jill Ehrenreich-May who is the current president of the Association for Cognitive Behavior Therapies.

And you guys may not know this, maybe you do, I’m the president of the Association of Contextual Behavioral Sciences, go figure. And we grew up together learning traditional CBT.

And I went into ACT and Jill went into CBT, and lo and behold, we have come back together and are now doing some projects together because we were realizing these are not irreconcilable differences at all.

For some kids, cognitive restructuring works really well and that’s what they want. And by all means, if that works great then you should do that. Because what it’s teaching you is, in a different way, you can think whatever and your mind is not always correct about things.

In the ACT way, acceptance and commitment therapy, which teaches mindfulness, it’s about observing, stepping back into this mindful space and observing thoughts and noticing, are they useful? Do they serve me or do they not serve me?

So through a different mechanism as some studies have shown there, some similar mechanisms across the two therapies and some different processes across the two therapies or types of therapy. It works.

And so as a therapist, I tend to be very, very pragmatic and I will do what works for my client. If someone feels like they need to police their thoughts and that they can’t live well unless they have the right thoughts, not depressed thoughts or not anxious thoughts, I have not found that to be helpful.

Similarly, with OCD, engaging with your thoughts, your obsessions to kind of talk yourself out of them is 100% unhelpful because it reifies those obsessions and it becomes a cognitive ritual. The function of that would be you’re engaging in a behavior to make those thoughts easier, better, smaller, whatever. That’s a ritual. And so we don’t do that.

So I think that you have to really notice what works for your client. One of the things that attracted me to acceptance and commitment therapy was the notion that we’re not ever just depressed and anxious, we’re depressed and anxious and then we have a story about what that means about us as humans, because we’re depressed and anxious, like I’m broken. Like I’ll never feel normal. I don’t fit in.

That’s the part where I take issue, where I want people to notice those stories and be able to step out of them, not to struggle with them, but to have the stories not matter. Lemon says hello, hello. This is the barker. So I just want everyone to see. But I hope that was helpful.

Jenn: As soon as she gets on camera, totally kind.

Lisa: Right, oh my God.

Jenn: All Lemon wanted was a little FaceTime, that’s all.

Lisa: Yeah, exactly. This is my little mindfulness buddy right here. So anyway, so yes, you can try and reconcile them. And so we think a lot about like, for example, emotion regulation like Jill is the founder of the Unified Protocol for Children in Adolescents that came out of David Barlow’s lab at BU, the center for anxiety and related disorders.

Stefan Hoffmann is someone who has been working with Steve Hayes. Stefan is another giant in the field. And Steve Hayes is of course the founder of ACT. And we’ve been coming together in looking at common processes that are transdiagnostic, that occur across disorders, and that underlie approaches.

And so we’re definitely looking to come back together. But I think the core issue is thinking about the function of behavior. That it’s not so much that the emotional experience is the issue. It’s what we do about it. What do we do when we’re feeling that way?

And how do we teach people how to be flexible and effective and not treat emotional experiences like they’re dangerous or bad, and teach them how to function that way. And it’s really fine, it’s really liberating once you learn those things and we’re all headed in the same direction.

Jenn: Do you have any particular tools or suggestions regarding mindfulness for kids who may have sensory processing disorders or challenges?

Lisa: That’s such a good question. And you know what, I want to, like, I’m digging in my head for an evidence-based answer and I just don’t have one, but my clinical instinct would be, obviously, you want to right size your mindfulness practice for kids with those.

You don’t want to like have the mindful of the thing that’s hard for them because that would be an exposure. So I think helping them notice and then gradually increasing their flexibility around the sensory experiences that are difficult, I think would be a good way to go.

So noticing and observing and like shorter is better building to longer and longer and longer. I would imagine that you could do sort of awareness training with those kind of sensations in the same way we work with misophonia, for example, gradually increasing the volume and gradually, misophonia is a disorder in which certain sounds are just intolerable for the listener.

It’s really tough. And so we do exposure with that, but it’s very, very gradual and it’s very, very repetitive. And I would think that mindfulness, you could use mindfulness in the sense almost of an exposure where some of those things, but I wouldn’t start with that if you want to kind of nail down just the practice of paying attention.

Jenn: Do you have any principals from ACT considering you are fluent in acceptance and commitment therapy? Any of them that you would suggest sharing with kids to make them more mindful and introduce them to better mental health practices without necessarily saying, hey, this is like a therapy practice.

Unfortunately, there’s still so much stigma around getting help for mental health that you almost want to make it a soft intro so that kids, if they ever need therapy, it’s better for them to be a little more accepting of it from the start.

Lisa: Yeah, and again, that’s why I never explain it. I just do it. So just the same way we did that little exercise earlier, we could do that.

Play mindfulness games, play awareness games about noticing, let’s notice your ankle. Let’s notice, see if you can find the part of your body that’s the least itchy? And you can come up with silly little games like that for younger kids that are fun.

But again, I don’t explain it. I just teach it. I just do it. I show it and I model it. And then I ask them, what was that like, what do you think? Do you want to do one like that next time? And sometimes kids like it and sometimes they don’t, but they will let you know.

So I would just start by teaching it, movement things, texture things are really fun. Sounds are fun. See who can tell the very smallest sound in the room. You want to see a quiet classroom do that.

I’m going to play the quiet game. You still have the quiet game as a mom of young kids. Mindful eating, oh my goodness. So many opportunities, chocolate, raisins, all of that stuff.

We used to do one actually with, what were they called, warheads. Those really, really spicy like whew, mindfulness of warheads.

Jenn: Those are really sour. There’s also like the cinnamon ones that I think they’re called fireballs. I don’t really know. I don’t like cinnamon stuff, but those are super hot.

Lisa: Yeah, exactly. So you can do, and Kelly Wilson, my mentor used to do it with Altoids Curiously Strong Mints, and just noticing, just teaching different ways.

And again, mindfulness isn’t a panacea and it’s not an antidote. It’s a practice. It’s a way of living and it teaches you. And it’s the foundation for developing a different kind of relationship to your thoughts, and your feelings, and your experiences.

When you start cultivating an awareness of this observer inside you of your experiences. And that is a sense of safety in the sense that then you can watch your thoughts and feelings shift, and change, and come and go, and notice the impermanence of them.

‘Cause like with little kids and with teenagers ironically, they tend to like, when they’re in the thick of a challenging, intense emotion, it feels forever, the biggest thing they’ve ever experienced and intolerable.

So teaching mindfulness helps give you an anchor to observe that and then notice it as it goes, shifts and passes.

Jenn: How can we start incorporating the thought or concept of impulse control to kids, ‘cause with everything at their fingertips, it’s so much easier for someone to be like, oh, I need that, I’m going to buy it right now?

Lisa: Yeah, that’s a hard one. And I think it’s going to depend on the ages of the kids, but one of the with younger kids games like Red Light, Green Light, Simon Says are great impulse control games.

With older kids, I think helping them as they get more skilled in mindfulness, being able to observe the feeling of urgency or urges, or just comfort around wanting something now and teaching them how to pause as a practice.

I think that those are really important and those are really foundational skills for being able to even attend in a classroom. Sometimes you got to wait, sometimes mom’s not going to stop the car if you got to go to the bathroom. You got to wait for another couple of miles, so you get to that next exit.

And taking the opportunity to be curious about uncomfortable experiences as well. I think that those are really helpful at teaching impulse control.

Jenn: We’ve got time for one more question. So can you explain a little bit of the science behind why small actions, especially when it comes to mindfulness end up being so impactful over the long run. I mean, the long and short of it would be like, why shouldn’t we try to build Rome in a day when it comes to mindfulness.

Lisa: And there’s some really lovely studies on the brains of long-term meditators versus shorter term meditators showing that that practice of repeated engagement in this leads to really significant changes in the brain, which I think is really, really important.

And it stands to reason, of course. The more you practice something, you’re going to change your brain. The more we practice an instrument. We don’t lose those pathways after a while.

So I think just even if you cultivate a very small practice of mindfulness, but you do it really consistently, try it, try it, sign up for the six-week mindfulness-based stress reduction course, see how you feel when you start, see how you feel when you’re done and see what it does in your life.

But yes, there’s lovely data and plenty of it suggesting that it actually does lead to brain changes when you meditate. And that’s another form of mindfulness.

Jenn: Well, I appreciate the positive reinforcement, but I mean, I don’t know about everybody who’s still listening, but I feel better already.

And this actually, this is right about the hour. So I’m going to take the opportunity to wrap up the session. Lisa, thank you so much. You can let Lemon back in.

Lisa: She’s outside being very mindful in the snow. So for those of you still with us, this is what’s happening. This is what all the barking was about.

Jenn: Well, I deeply appreciate you being able to juggle so many things yet stay so honed in on one topic at the same time. So thank you so much for joining me and thanks to everybody who joined.

This actually ends the session. Until next time, be nice to yourself, be nice to each other and wash your hands. Thank you. Have a good one.

Lisa: Bye, everybody, take care.

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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