Lisa Damour

Kate Bowler: This is Everything Happens, and I’m Kate Bowler. We used to be afraid of teenagers, but now we’re afraid for them. Anxiety, depression, social media, school pressures, loneliness. It’s easy to feel overwhelmed about what it means to raise or support a teenager today. But my guest has spent decades helping us understand what’s actually happening in the emotional lives of teenagers and what they really need from the adults who care for them. Before you think, oh, maybe this episode is not for me, you are wrong, she said respectfully. It takes a village, which means that none of us are exempt from learning about how to care for and support the teenagers in our lives. Also, all of the advice that she gives is wonderful advice for just being a person. So, three cheers. So if you ever wanted to be a loving, steady presence in a teenager’s life without making things weird, this one’s for you. Today, I’m speaking with Dr. Lisa Damour. Lisa is the author of three New York Times bestsellers, including Untangled, Under Pressure, and The Emotional Lives of Teenagers. She hosts the Ask Lisa podcast, which is one of my very favorite shows. She tackles really hard questions with ease and action. And, fun fact, she was a consultant on Pixar’s Inside Out 2. So basically everyone wants her advice on how to understand teenagers. Here she is. Lisa, we really never have guests back a second time, but I have decided that the Everything Happens podcast is now just a Lisa Damour tribute album and you should come back every week. Especially after I heard you give this incredible lecture at Duke a few months ago, and it made me want everyone to hear what you have to say. You make managing fear and anxiety around teens’ mental health feel so much less scary, so much more accessible. So thank you so much for being my official co-host until the end of time with me today.

Lisa Damour: I’m deeply honored. This is the best thing that has happened to me professionally in ages. Let’s do it. Let’s do it.

Kate: Okay, I want to start with the big trope that we see reflected in the media and in conversations, and it always goes like the teens are not okay. So I wondered if we could crack that open a little bit today and start with maybe how the pandemic might have exacerbated an issue that perhaps already existed.

Lisa: I am so glad we’re starting here. Okay, so and I don’t want in any way minimize, we are in a very particular and painful moment with adolescents and there is an adolescent mental health crisis and we need to tackle it, you know with everything we’ve got. But we’ve gone from being frightened of teenagers to being frightened for teenagers. Okay, I think we should be frightened for teenagers. I think there is a lot on the table here right now. I also want us to be cautious of stereotypes, whatever they are. So here’s the benefit of us being frightened for teenagers right now, and there is a real benefit. We are suddenly taking very seriously adolescent mental health in a way I’ve never seen in the 30 years I’ve been in this business. We’re looking at resources that can be pointed in that direction. I am very very invested in trying to grow the community of clinicians who specialize in teenagers. There’s not a lot of us. So the all hands on deck about adolescent mental health is extremely useful. Where I worry is that it also means we’re seeing all of these headlines about what to worry about with teenagers. And we’re seen a lot headlines, and this is where it goes awry, that are equating psychological distress with a mental health concern. Those are not the same thing. You can be emotional without being fragile. Lots of people are, we do it all the time. So Kate, here’s my biggest worry. Here’s my biggest worry. In the overdue, extremely necessary attention to the mental health needs of teenagers, I worry that we are confusing the question for families about when they should worry about their kid. Because if you have a teenager who is developing according to plan, there will be a lot of meltdowns. There will be a lot of bad days. There will be lot of disruption. There will a lot a worry. And my concern right now is that these sweet families who’ve never had a teenager before, who are looking at headline after headline after headline about the adolescent mental health crisis, are looking that, looking at their kid in a fetal position on the kitchen floor and thinking.

Kate: Oh man. I broke them. They’re broken. That’s it.

Lisa: Yeah. My kid is in crisis. Now, in all likelihood, the kid had a terrible, terrible day and will recover on their own or with loving support from their family. So we have to do two things at once. We have to two things at once, we have get really serious about making sure that the kids who need clinical care get what they need. And we want to keep as few kids from needing it possible. And we have to get really serious about… What is typical and expectable in adolescent development and having been in this business for a long time, it is spicy, it is disruptive, it hard by its nature. And so I think the more guidance we can give people about what to expect and when to worry, that’s more most helpful.

Kate: I like that so much because I mean, I usually spend most of my intellectual effort trying to figure out that space between everything is possible and nothing is possible. And what I love about this argument is you’re really being so intense about this narrow window of both opportunity and very specific historical sociological formation we’ve got right now. You have this really funny phrase that I started thinking about where like, how do we think about just like basic mental health and all the things they need in this really routine, sustainable way. Imagine swapping out the words mental health with the words dental health. How do you think about the dental health of teenagers? What are some of the basic, basic ways that you think about this?

Lisa: Well, so, okay, so you know, the adolescent mental health crisis is a public health problem. It is a public health problem and what’s great is we know how to think about public health problems and we need to bring that thinking to teenagers. So when we think about public health problems, you think in terms of primary, secondary, and tertiary intervention. So using dental health models, which I find very helpful, primary prevention is what we give everybody to try to keep them healthy. So in dental terms, this is fluoride in the water, right? Like just reduce cavities everywhere by having fluoride in the water. Okay, so then the first question is what is primary prevention for teenagers? What is the psychological fluoride in the water for teenagers, and we know some things. Okay, so boring, so not sexy, a good night’s sleep. Sleep and mental health are extremely tightly correlated. And when teenagers are not sleeping, their mental health degrades very quickly. This is true for all of us. I think teenagers can be very vulnerable to this. I think some of the worry about the phones is probably a sleep worry, that kids have their phones in their rooms and it’s keeping them up and that that’s leading to mental health concerns. So sleep is a huge thing. A huge thing we can do.

Kate: And Lisa, how much sleep are we talking about?

Lisa: It’s a lot more than people think. It’s lot more. So here are averages, right? So high schoolers are supposed to get between eight and 10 hours of sleep. So an average of nine hours of sleep which is so wildly higher–

Kate: How is that even possible?

Lisa: Well, it’s often not. It’s often not.

Kate: So did we just imagine at some point that they’re supposed to get seven and we all locked that in?

Lisa: We just sort of decided this or we came to this agreement but it’s not actually biologically what they needed and deserve. So teenagers really are usually sleep-deprived and so that’s a factor. One thing, the data are very clear, delayed school start times work. We know this. I mean and this is what’s so interesting to me, like we have studies that tell us these things and when schools delay start times we see mental health improve in teenagers we see it all happen. So we know what matters and we know what makes a difference. And I think it’s important that we just start from that primary prevention approach of like, generically, how do we keep fewer kids from having mental health concerns? And things like getting a good night’s sleep, going to school later if they can. The other key factor is strong relationships with caring adults. This is critical for teenagers.

Kate: I want to hear all about this, because I’ve heard you say that kids are saved by theater teachers, that this is not a small thing for there to be somebody influential that’s pitching in, or just consistently having a helpful and strong opinion.

Lisa: It’s huge. And here’s the thing, Kate, that I think we have to work against is that people feel like teenagers don’t like adults or don’t want adults in their business. And there’s some truth to the not wanting adults in your business, right? But we have reconcile that with this really clear finding that the single most powerful force for adolescent mental health is strong relationships with caring adults. So here’s what teenagers don’t like. They don’t always like adults with an agenda. And often adults have an agenda when it comes to a teenager. And they really don’t like, and they can detect at a thousand yards, adults who don’t like teenagers or who think less of them. You know that, right? You know, that they can just tell someone who’s got their stereotypes locked and loaded and is coming their way. If, however, you are an adult, loves and respects teenagers and finds them inherently interesting, they can smell that too.

Kate: I mean, our culture doesn’t have a lot of intergenerational opportunities left. We don’t do a lot of things where there’s an old person and a young person and the same thing, but a lot people in this community have like a church situation or community situation where there is a lot opportunities to mix it up. If you’re, if they’re one of these people and they’re not totally sure how to get somebody, maybe they have an acquaintance, a teenage acquaintance to open up, what are some of your, how do you talk to teenagers, Lisa?

Lisa: No, this is great. First, you have to adopt the stance of like, these are the most interesting human beings in the world. Like you have believe that. I believe that. And you have to embody and hold that feeling. And then I think you go to them and say like, what do you have going on that’s really interesting to you right now? Something like that, like, no angle, no agenda, no, I’m asking you this because there’s a gotcha at the end, just like what’s like the most interesting thing you got going right now, or what do you find most compelling right now? Just to like get into their world and let them drive. We should not underestimate our ability to help teenagers out who are not actually our kids. And I’ll tell you a story, like I may choke up in telling you this, but it was like, this is such a good example. I was at a school a couple of months ago and I was actually talking with a faculty about the extraordinary power they have to be there for teenagers in unique ways. And one of the faculty members came up to me afterwards and he got a little choked up telling me this. And he said, you know, my high school situation, my family, it was not good. It was really not good, like my situation in my home. And he says, there was one teacher I could talk to about it. And what that teacher said to me was, your situation probably will not change. You will over time get better at dealing with the situation. And the guy said to me, that saved me in high school. And I think what he was saying is, this guy took the broad view, did not give me platitudes, and also invested me with capacity, right? Like, you will develop capacity to manage the situation. You know, the guy who was telling me the story was probably in his mid-50s. And so I think that… If each of us can go back and be like, what was something an adult did for me when I was a teenager and how do I replicate that?

Kate: That’s such good advice. That’s such good advice because I do think it’s very funny, I mean, just as a historian, I know we’ve like mythologized youth and we started really, really doing that in the late 50s and by the 70s it was just religion that America’s a cult of youth and that whatever is young is the coolest and therefore obscure and don’t even try because you’re going to feel dumb and there’ll be all these words you don’t know. Like it does, it creates all these social barriers that are. When you think of like a person in front of you, it really abstracts who they really are.

Lisa: Right, that they’re so different from us. You know, and it’s something else, Kate, you said about like they have words that we don’t know and they can be, they can feel like across a distance from us, the other thing I will tell you about teenagers, they want adults to act like adults. They actually don’t like it when adults, I mean, if you want to make your teenager cringe and this is like my favorite thing to do, is like start using their slang, right? It makes them bananas. Whereas I promise you, if you stop the teenager on the street and say, which would you take? A straight shooting adult who acts entirely like an adult or an adult who’s trying to be cool and speak on your level, they’re like, oh my gosh, all day long, give me the straight shooting slash boring adult who acts like an adults over someone who’s trying to be on my level.

Kate: Totally! I’ll never forget this old man in my church who I loved. He was the custodian. He never said much to me, and then one day he turned to me, he’s like, I heard you’re going to be going to Russia on a trip. I’ve looked up an exhibit at a local museum you might be interested in. And I was like, you are officially the coolest person I know, Ferd. Like, it was utterly over-serious in a way that I really appreciated.

Lisa: But taking you seriosuly. You’re going to Russia. You might want to go check out this exhibit, right? I mean, that’s all that matters for teenagers is to be taken seriously. I really mean, that take them seriously and the rest solves itself.

Kate: We’re going to be right back after a break to hear from our sponsors. Don’t go anywhere. You were describing the idea of creating a sort of relationship map between adults and kids in their care in order to figure out who might not have the trusted people or the resource we imagine. There’s a lot of people in our community who are maybe educators or work with youth in some way. And how do they do this? And why is it such a great way of figuring out who’s being cared for?

Lisa: Okay, I’m obsessed with this. Okay, so going back for a minute to our dental health models. So secondary prevention, if we go on the dental health model, it is who is not brushing or eating lots of candy, right? Like who’s at high risk for a cavity or a problem? And so if we switch that over to mental health models for teenagers, who’s a high risk or mental health concerns? Like they’re not there yet, but we wanna prevent them. So there are a couple things we can do. One is this relationship mapping, and the people who do this best, it’s a group called Making Caring Common at Harvard run by Rick Weisbord, who’s a dear colleague. And here’s what they do, they do this in schools, but you could do this in all sorts of organizations. They go to the school, and they give the adults in the school a roster of all the kids in the schools. And they basically say put a dot next to the name of every kid that you’re connected to. And then they go to kids, and they gave them a roster of all of the adults. And then they say, put a dot next to the name of all the adults you feel connected to. And then, they put it all together. It’s so smart. And you get two pieces of information from this, at least. One is, you find out kids who, like no adult, puts the dot next that kid’s name. Like, red alert. The other is, you find if the kid feels connected to the adult who thinks they’re connected to that kid.

Kate: Do you like me too?

Lisa: Because if the adult’s like, oh yeah, we’re best friends, and the kid’s like I don’t even know that person’s name, right, like then you’ve got a problem. Now, I am saying adults in the building. I’m not saying teachers.

Kate: I see.

Lisa: I’m thinking about your custodian. I am thinking about the person at the front desk at some schools. Kids, it’s all a chemistry problem. And kids need to find the adult with whom they have the right chemistry. And so when I’m working with a school, I am so glad when, if I’m presenting, the faculty and the staff are there. Because in terms of who actually is doing the good work with kids, sometimes it’s the teachers, and often it is the crossing guard. So that’s one model where we can catch kids who may not yet be on our radar, but if they are not connected to an adult or cruising for trouble, like we just know it. Like it’s like internal trouble or external trouble, like it’s not what we want to see.

Kate: Even just you describing that, like, people in my life that just went un-witnessed, you know, like they just, it’s not like they wanted to be that bad. There just wasn’t anybody that was going to ask.

Lisa: That’s what I worry about the most, but imagine a kid who doesn’t have that. Picture a teenager with no meaningful connection to a caring adult at home or outside the home. Intuitively, we know that is not good, not good. And that’s where people are saved by their theater teacher, saved by a neighbor, saved by someone in their church who sees them, reaches out, says, what are you liking these days? How are you? Like, really.

Kate: That’s really good. I have many things I really like about you, comma, Lisa, comma. But one of them is that you have the opposite reflex of most of the parenting advice that I hear. Because one bit of advice I hear a lot is like, look, like when you see a teenager going through something, just treat them really delicately, like just back off and they’ll come to it on their own and you’re like, look you, I have seen you ask more from people and I just want I want to hear you talk about why asking more from teenagers is also like a good way of creating durable connections.

Lisa: Okay, it goes to something I threw out earlier and I want to come back to, and I think you and I should have a t-shirt that we’re gonna make. Because I think about this, that says emotional does not equal fragile, right? I think that that is a place, especially with these super duper scary headlines about teenagers, then we see them getting emotional, we can make the assumption that means they’re fragile, which then puts us in this position of like, back off, don’t, you know, rock the boat with them. Okay, if we uncouple those, if we say you can be very, very emotional without being fragile, that changes how we approach teenagers. Because we can be like, what is going on? You are clearly really upset. You are really clearly upset. Like I see it and I’m interested and I am curious. As soon as you’re talking to them, you’re already saying, this is in the realm of what can be managed. We can talk right about it. We can go right at it. I think about a dear colleague of mine, we were in a supervision group together and like the scariest things in our lives, the things that we’re most frightened of, she would say, you know, honestly, the best thing is just turn and face them. Turn and face them. And so I think that that’s the instinct I always have around these things is that if we treat kids as fragile, they feel more fragile. If we say like these are some big feelings, like, help me understand them more. That is the, let’s just turn and face it, I’m right next to you while we turn and we face it. And the fact that we are turning and facing it, we’re already saying, it can’t be that bad. You know, this is in the realm of me.

Kate: Yes. It’s not so bad, we can’t do something about this. Man, I really, really have seen so many, I mean, I’m just thinking of people who are now adults whose parents treated some kind of emotional episode as being too big to handle. And like as the friend you heard all about it and you thought like, oh man, this is like a big deal, but it’s, but somebody just needs to get in there with them. And yet their parents just like backed up. And then they thought, oh my gosh, there’s something really wrong with me.

Lisa: This is really bad, right? This is really bad. One thing I have been thinking about so much and you’re a mom. I think about that moment when your kid’s in pain and your kids in pain in front of you and I’m a mom and I think about how every cell in our body just wants the pain to stop. So in those moments when we do come up against adults who are trying to shut it down or trying to reassure very quickly or not doing what, just being a steady presence, being curious about what’s happening, I also have so much empathy for the adult in that moment who is like, you are in pain, I want nothing more in the whole world than for it to stop. How fast can we get there? How fast we can get there. And I think that that sometimes when, to use finger quotes, when we’re misstepping, it comes from like that incredibly loving and I would even say like almost evolutionarily driven place of my progeny is in pain how do I make it stop.

Kate: That makes sense, either by pretending it’s not happening or by bubble wrapping or by making it easier.

Lisa: Or intervening right away. I mean, like, it all, like I have to tell you, there’s so little I’ve ever seen in parenting that I couldn’t understand.

Kate: We’re going to take a quick break to tell you about the sponsors of this show. We’ll be right back. One of the surprising parts of current research you describe is that talking about depression and anxiety might actually not help in the way that we imagine. And I want you to describe that.

Lisa: So one of the secondary interventions that’s out there, and this is like, it’s really murky, really fast, is doing a lot of education for kids about depression and anxiety at school. This can go really well, this can sometimes not go so well. And we have some early data that sometimes talking about, what I would say like pathology, talking about pathology a lot, we have early data showing that it can actually leave kids feeling worse.

Kate: How many of you feel horrible right now?

Lisa: And so, we don’t know exactly why or what or how. And I do think it’s actually important to talk with kids about diagnoses and when you’ve crossed the line from sadness to depression, when you cross the lines from nerves to anxiety. But what we don’t want to do, and I think that this may be, who knows what accounts for this, is I worry sometimes that maybe kids are like, okay, so that’s depression. If I think I have it or my friend has it, now what are we supposed to do? That we want to make sure that there’s a clear, here’s why we’ve taught you this, here’s what we want you to do, and it’s not on you to fix it. So I’m a big fan, when we do any form of school-based, population-wide education, I’m big fan, I actually do think we should talk about pathology. I think we should say to kids, here are the things you wanna be looking for in yourselves and your friends. And it’s things like, you know, self-harm. You don’t have to go into details about that, kids know what that is. Substance misuse, worrisome weekend behavior, eating disordered behavior. Mood concerns, either depression, of course, and suicidality, if we’re gonna think about, you know, you wanna run down for kids, like here are the things that we really worry about. That has to quickly be followed with, if you detect this in yourself or others, here’s how you get that information to an adult, and that information needs to go to an adult.

Kate: Okay, and just to review it one more time, like things to that are concerning that they should say, depression?

Lisa: I actually think there’s five things–

Kate: Tell me–

Lisa: That we should say to teenagers. if you are aware of this in yourself or a friend, let an adult know. So depression/suicidality, eating disordered behavior, I call it sort of out-of-control behavior on the weekends and when I’m talking to teenagers about this I will say we know you guys go to parties. I’m taking about teenagers who scare other teenagers and they all are like bingo. You know, so kids who are just really pushing the limits. Self-harm. Actually the other one, the fifth one is relationship violence. Kids, even in adolescence, will find themselves in relationships that are unsafe. Romances. I think it’s really important to be clear like these five things, you are not responsible for trying to fix or care for these things. These should come to an adult. Now you’ll notice anxiety isn’t there. Of course, if kids want help with anxiety, we will help them. For me, these are the big safety issues, right? These are the safety issues.

Kate: I like hearing them put in a different category because it creates this like there’s a threshold and if you cross this threshold then there’s a process and the process is this information has to go to a trusted someone that is not you it is a trusted adult I like that that feels nice and clear.

Lisa: It’s clear and it makes tons of sense to teenagers. And when I say to them, I say, look, and this is not because you’re teenagers and we’re adults. It’s because once it crosses this threshold, it actually has to go to somebody with specialized training. So it’s not just adults, it’s particular adults and the adults can help get that there. I think it’s so important that kids learn about feelings and learn about emotions and know what to worry about. My ideal is we really focus heavily on coping. We normalize distress. We say, look, you’re gonna have good and bad days. That is a done deal. What matters is how you cope with them.

Kate: I just want to repeat you back to you, which you repeat to me, and now I’m going to repeat it back to you. Your definition of mental health is not being happy all the time, it is having the appropriate emotion in the appropriate circumstance.

Lisa: And managing it well. That is where the rubber hits the road. It’s the managing it well, so you can get bad news and go get hammered to deal with it, or you can bad news, call a friend, have a good cry, go for a run. You know, it’s, does it bring relief and cause trouble? Does it bring a relief and do no harm, right? Like that that’s the great divide. And the fun thing, Kate, you would love this so much. If you get teenagers talking about how they really cope, really, really cope. It is not usually what adults picture. You know, we picture like mindfulness practices. I don’t usually hear about that from teenagers. The thing I’m hearing, this is so delightful to me, a lot of high school junior and senior girls are currently watching Barbie Dreamhouse, Barbie and Her Friends Dreamhouse the cartoon. They love it. It helps them feel better. And these are like women who could run a corporation, but they’re like, when I really need to take the edge off, Barbie and Friend’s Dreamhouse. It’s just so soothing. So soothing, familiar. They know where it’s going. It’s pink. It takes them back to a time that was easier. It’s like the cutest. And I’ve had 17-year-old boys say to me, oh, I go reread my Captain Underpants books. Yeah, I mean, these are, you know, guys who are like shaving, right? And so I think being open to how teenagers cope is really fun.

Kate: I like that so much. It lets people be like, just sort of mush inside that is trying to find their own sweet little way.

Lisa: No, it’s so the key here is the big stuff has to go to adults and teenagers need to know what it is, and they’re relieved to hear it. They don’t want to be responsible for each other’s very scary things.

Kate: Oh my gosh. Because it’s so true. We all remember that feeling where we found something out that was too heavy to carry and we didn’t know what to do.

Lisa: I will say, and I’m skidding over this and I want to sort of take a minute, the question of teenagers feeling comfortable telling adults what they know is a big one. They worry a lot that if I tell you that my friend’s being out of control or that my, you know, they worry a a lot that their friend will get busted or in trouble or they’ll be disloyal, like they’re very, very loyal to one another. And one thing I have found that can sometimes help get over the hump with that, I will say to teenagers, why don’t you tell me the entire situation, not tell me the kid. And I will tell you what I think we should do. And then you can decide if you want to tell me who you’re talking about.

Kate: Oh, I like that.

Lisa: And that is enough, usually, for the adult to take a beat and be like, okay, well, in that situation, what I would probably do is I’d call the school, let them know this information, or we need to get that information to that child’s family. You know, here’s 14 ways we could try to do that. But you can play it all out in the hypothetical, and then the teenager can be like yes, no, maybe yes. Okay, here is the name of the kid I’m worried about.

Kate: Mm-hmm.

Lisa: So that little adjustment can go very, very far.

Kate: That makes sense. Everyone is the most worried about social media. The words social media are entirely equated in people’s minds with like the breaking of the adolescent mind. Why are you less worried about social media than if I used a crazy voice right now?

Lisa: So we do worry about social media and we do know that there are definitely conditions where it is bad for adolescent mental health. I’m going to tell you exactly what those conditions are. One is when it is crowding out all the stuff that is good for child development. So social media should not interfere with sleep, physical activity, in-person time with friends, studying in a focused way, helping out. So we call it kind of like the displacement theory. Like if you’re spending eight hours on your phone, it’s coming at the cost of things that are nourishing to development. So that’s a grounds for concern. The other grounds for concerned, and these are both facts driven by the algorithm, is that social media has really toxic garbagey stuff that your kid will see. Like there’s just no question about it. Unfortunately, the algorithms will throw in that stuff whether or not your kid’s looking for it. The problem with the algorithm in teenagers is that teenagers are vulnerable to norm shifts. More than kids are, more than adults are, teenagers, if they think that it is what everyone’s doing, they themselves will do it. If you see one hate post and then you see a thousand hate posts, it doesn’t seem so strange anymore. And in fact, it may start to feel okay or even interesting. If you see image after image after image of ultra fit, ultra thin bodies, that just starts to feel like what bodies look like and it can change behavior and we know it does. Okay, so that’s when I worry. When it’s either crowding out what kids should be doing instead or when they get online and they’re taken to places we don’t want any kid to go and their norms start to shift. So we need to put guardrails around that, right? Kids shouldn’t be online that much and to the degree that they’re gonna get on social media, I’m like 14 at the youngest, because 14 is when skepticism really comes on board, the older the better, because we need kids, they’re going to see this stuff, we need them to withstand it, okay. And it’s a little murky how you do this, but in terms of like how much of the variance of adolescent mental health problems are explained by social media when we look at the whole population of teenagers, it’s not the majority by any measure. There are many, many other things that are huge factors in adolescent mental health. Sleep, back to that. Achievement pressures in many communities. Worries about guns. The number of kids who talk to me about being scared at school when they hear a door slam. Worries about political polarization, worries about the climate, worries about what’s ahead for them. And so, we want to do two things here. We want to talk really precisely about problematic social media and minimizing it. And we don’t want to talk about social media to the exclusion of talking about all of these other things that we know are a really important factor for teenagers.

Kate: That makes me feel so much less worried because I think we all do feel like we’ve got good common sense about how long is too long or how to describe how social pressure feels and have a conversation about that. Those feel like very doable things.

Lisa: Those are and there’s a couple more things to say that just by way of like trying to be helpful around the social media stuff. One is I think it’s important to uncouple phones and social media. You can give a kid a phone without giving them social media and this is something I’ve done as a mom. Because they do need to be able to text often with their friends to stay connected. They also like just messing around on their phones, right? So you can set up a phone with no browser no social media apps and no capacity to add any of these things without adult permission, and that can go a long way. So the things that matter are rules that make sense to kids and a strong relationship with an adult. So if you say, here’s why I don’t want you on social media yet, you’re gonna see some really yucky garbage and I need you to be old enough to have a really good judgment about this and I’m gonna wait till you’re 14 or older at least and I really trust your judgment before we enter those waters. Rules that make sense to kids, like that really helps. Or your phone’s not going in your room because it’ll mess with your sleep and your sleep is so critical, right? Like those kinds of things. I don’t want to lose sight of tertiary intervention. Okay, so back to dental. This is a cavity, right. You now have a kid with a cavity. So the goal is to fix the cavity and keep new cavities from coming. So tertiary interventions are the kids who need clinical care, who are depressed, who are anxious, who are suffering and in need of care. So there’s a couple of things we need to really do. First is recognize that we’ve never had the workforce we need for teenagers and we need to bump up that workforce. And that’s something I’m thinking a lot about, like how do we train more clinicians who are good at this? We also have never had the workforce of clinicians of color that we need. And that is, I think, an area that needs triple, quadruple extra support because we know clinically it matters to be able to talk to somebody who comes from your own community. And so that’s, you know, when we think about workforce, that’s the thing that we need to think very, very, seriously about. The other thing that can do, and this gets to big policy questions, we can protect Telehealth. Telehealth was a game changer for teenagers. Because nobody has to drive them to the appointment.

Kate: Oh, that’s really smart.

Lisa: Logistically, it works really well. And I’ll tell you, Kate, it’s also very interesting to care for a teenager in their bedroom.

Kate: Because you can see their life.

Lisa: They’re cat walks by, tell me about that. They’re sort of a funny ease to them. So telehealth was, you know, suddenly became a thing in the pandemic. Licensing for it, licensing across states for it became a things. What now is likely to be fragile is ongoing insurance coverage for it. So if we’re thinking about tertiary care for teenagers, for everybody, but for teenagers especially who may not be able to get themselves to appointments, protecting telehealth is actually a really big deal.

Kate: Youre the most practical friend I have. I like it. It makes me want to go out and protest about policies about telehealth.

Lisa: There is like, you know, domains of like, how do we think about teenagers and what they need? They need Barbie Dreamhouse. They need late starts. They need adults who are interested in them.

Kate: They need your big smiley face. Lisa, I love personally telling you my problems, but I love hearing you describe how very manageable it can be if we walk into each other’s worlds in this deliberate and practical way. It’s so loving and I absolutely adore you. Thank you so much for doing this with me.

Lisa: Oh, Kate, I’m so excited about our new podcast together.

Kate: Me too, it’s happening right now.

Lisa: Thank you so much for having me. It is like such an honor and a pleasure.

Kate: I’m so glad I got a chance to talk to Lisa again, the patron saint of teenagers. Every time I talk with her, I come away feeling like I got a little wiser and I feel a little more peaceful. She has a way of making me feel well-equipped to handle difficult topics. And my son’s not even a teenager yet. So here are my four takeaways from today’s conversation. 1) Everyone could use a little more sleep. Feeling overwhelmed? Extra weepy? Try to get in bed a little bit earlier tonight. 2) Emotional does not mean fragile. Having an emotional response does not mean that what is happening can’t be addressed head on. 3) Mental health does not mean being happy all the time. Let us liberate ourselves from that concern. It just means having the appropriate response at the appropriate time. And four, teenagers need a steady loving presence. And hey, that could be you. Maybe it’s time to volunteer at your church or become a casa or join the Boys and Girls Club or ask the teenagers you already know what they’re really into right now. And then, listen. They are the most interesting people in the world. And if you missed out on our first conversation, oh my gosh, you’re going to love it, go back and listen. I will link it in our show notes. And I’ll also include a bunch of other free resources we’ve pulled together for working with teenagers. Blessings, episodes, book racks, even a free small group curriculum to use with some friends or in your church. And I am serious about wanting Lisa back on the podcast regularly. I want to hear from you. What questions do you have for her? Or what were some of your big takeaways from this conversation? Find me @katecbowler or leave us a voicemail at 919-322-8731 and let me know. And also just because I love any excuse to read a blessing for the people doing this hard and holy work, I wanna end this episode the way I ended our first one with a little prayer for anyone trying to love a teenager and live to tell the tale. Here is a blessing for parenting teenagers. Bless you who love a teenager, you whose worries about them keeps you up at night, wondering if you’re gonna do it right, if they’re gonna be okay. If you overreacted or under-reacted, if you’re gonna make it through tomorrow without losing it, or how you’re going to have to have that hard conversation without them shutting down or shutting you out. Bless you in this hard, beautiful work. In those moments of big feelings, may you remember to take a beat and offer a, if I was in your shoes, I’d feel the same way. Even when you’re tempted to give them advice or solve their problem for them. Or to offer about how maybe they could have avoided the problem in the first place. Bless you in your restraint. May you know when to intervene and when to stay that steady calm presence that will offer them the grounding to grow and change their mind and make mistakes. May you have the patience to affirm their normal, sometimes very big feelings, and may your constant love relieve their fears and yours. May laughter and joy fill your home, fueling even the hardest moments and most difficult conversations. And bless all of you who wish you could have gotten this kind of parenting. And bless you who want to do it differently, even when it’s imperfect. Bless you, my dears. A big thank you to our funding partners, Lily Endowment, the Duke Endowment and Duke Divinity School, and to the team behind everything happening at Everything Happens, Jess Richie, Harriet Putman, Keith Weston, Baiz Hoen, Gwen Heginbotham, Brenda Thompson, Iris Greene, Hailie Durrett, Anne Herring, Hope Anderson, Kristen Balzer, Elia Zario, Catherine Smith, and Megan Crunkleton. Thank you. This is Everything Happens with me, Kate Bowler.