Dr Jane Gilmour Welcome to “Inside the Teen  Brain.” This ACAMH series will leave you   inspired by best practice and armed with tips  to transform your work. I’m Dr Jane Gilmour,   and I have a special interest in the teenage  brain. From puberty to about the age of 25,   the brain is in a unique state, with core drives,  including identity, novelty, risk, peers, respect,   autonomy and intense emotions. In each episode,  we explore one of these developmental drives   and answer three big questions, “What’s the  background, so what, and now what [pause]?” So, to our first big question, “What does the  literature tell us?” Adolescence is a time of   heartfelt goals according to Dahl and indeed,  numerous imaging, self-report and observational   studies illustrate it’s a period of unique  emotional sensitivity and intensity. It’s   perhaps perplexing that young people would  evolve to be emotionally charged precisely   when their world is in flux. Surely they’ll feel  overwhelmed? Well, it’s certainly true for some,   75% of all mental health disorder emerge by the  age of 25, but for most, it might be considered   a perfect storm, if we consider the utility of  emotion. Among other functions, emotions are a   crucible for learning, they grab attention and  imprint experience with magnificent efficiency. Emotion ensures lessons learned in adolescence  stick, particularly those learned by association.   In convincing, but not peer-reviewed,  cross-sectional data, Stephens-Davidowitz   showed that the odds are our favourite song  is one released in the year we turned 13 or   14. The emotional brain confirms they really  don’t write them like they used to. Emotional   regulation is the modulation of experience and  expression. Positive regulation methods might   include cognitive re-appraisal, for example, and  can be a protective factor against mental health   conditions, but there are complications for the  developing brain. Nook described a “dip” in the   ability to describe emotions in teens relative  to younger children, and this is likely because   teens to be – begin to experience several emotions  simultaneously, an effect that might be considered   analogous to a proficient automatic car driver  switching quite suddenly to using manual gears. Further data support an emotional regulation skill  decline in early teens. Zimmerman, Blakemore and   other groups report distinct developmental,  hormonal, gender and emotion specific patterns   associated with various regulation approaches. As  discussed in other episodes, the pull of the peer   group is mighty. It’s likely that peers invite  such emotional reactivity in young people because   they offer crucial learning experiences for  future social inclusion. Groups at the University   of Virginia and elsewhere offer robust evidence  that social learning is top of the teenage brain   agenda, with all its nuance and unpredictability.  For example, Blakemore’s data shows social reward   is the ultimate reinforcer, and peer exclusion  the most aversive during teenage years. Individual differences in the experience  of peer rejection may offer clues to   understanding the development of mental  health conditions. Part of this picture   may be that mentalising increases post-puberty,  inviting adolescents to contemplate what others   think of them, a developmental process  that, of course, coincides with intense   self-referencing emotions, such as shame.  It’s a heady mix indeed, but as Rilke said,   “No feeling is final.” So, let’s get  right to the heart of the matter [pause]. So, now we turn to our second question  and ask, “So what?” What – how do we apply   these data? To guide us on the social  and emotional tour of the teenager,   I’m delighted to introduce Dr Eileen  Kennedy-Moore, Author, Psychologist,   mum of four, based in Princeton, USA. Her numerous  academic books and articles cover themes including   emotion, mood and coping strategies. She  produces wonderful material for families,   including the popular podcast about friendship,  and the Growing Friendships blog, which has   over five million views. Her extensive range of  book titles for parents includes “The Unwritten   Rules of Friendship Simple Strategies  to Help Your Child Make Friends.” So,   it’s a very warm and heartfelt welcome to our  series, Eileen, and many thanks for joining us. Dr Eileen Kennedy-Moore Thank you, Jane,   I’m delighted to be here. Dr Jane Gilmour Well, let’s crack on,   ‘cause there’s a lot to get through and a lot  of content to discuss. So, I’m going to dive in   with my first question, and I want to think  about emotional regulation. So, as we know,   adaptive emotional regulation is very likely a  mental health project – protector, so can you   describe some techniques that you’ve used in your  practice to help teenagers manage their emotions? Dr Eileen Kennedy-Moore Well, I think we want  to start first with, what are some themes that I   commonly bring up with – about emotions for teens  in my practice? And usually when clients come in,   it’s because they feel bad and they want to  stop feeling bad, but our job, as Psychologists,   is to expand their understanding of emotions,  of themselves, of their relationships. So,   one theme that I often cover is that emotions  are, kind of like, smells. So, think about that,   they can be pleasant or unpleasant, mild or  intense, but they’re not just things to be   gotten rid of, they’re a source of information  about ourselves and our relationships and our   environment. We want to use that information.  And then I’m a Cognitive Behavioural Therapist,   so another thing that I really focus on  is that wrapping our feelings up in words   is really important, and seeing the connections  between the thoughts that trigger our feelings,   their interpretation of what’s going on,  is very useful. That’s one of the fastest   ways you can regulate your emotions, is think  about the situation differently. So that’s… Dr Jane Gilmour And it really speaks well  to the, you know, the cognitive behavioural   framework really speaks well to the – you  know, Matt Lieberman’s affect labelling,   doesn’t it? The idea of contextualising how  we feel using words to make sense of our   emotion and our, you know, consequent  feeling, so I think that’s beautiful. Dr Eileen Kennedy-Moore Exactly. Dr Jane Gilmour I interrupted  you, Eileen, keep going. Dr Eileen Kennedy-Moore No, please, but I  mean, also, if you think about James Gross   has written a lot about emotion regulation,  and he talks about it as a whole series,   and usually people focus on the  end, punching pillows. Oh my gosh,   there’s no empirical evidence whatsoever that  punching pillows does a lick of good. In fact,   it tends to rehearse and intensity negative  feelings when we’re acting out on it. But if   we start way earlier in the sequence,  with the environment or the thoughts,   then it’s easier, it’s way easier than dealing  with it after we’re already ana – aroused. So,   I’m going to – I’m a Clinician, so I’m going  to try to squeeze in as many practical ideas… Dr Jane Gilmour Yes. Dr Eileen Kennedy-Moore …as we can do. Dr Jane Gilmour Yes, yes. Dr Eileen Kennedy-Moore So, one thing that I’ve  used with kids as young as four, all the way up to   my teenagers, is what I call ‘feeling cards’. So,  I’ll take some index cards and I cut them in half,   just ‘cause they’re a nice size, and then I will  work with the teen to name as many emotions as   we can think of. And I, in my mind, have – am  stacking the deck a little bit with the ones that   I think that they need, but we do the whole range.  We do positive ones, we do the angry family,   we do the sad family, we do the anxious family, we  do the self-conscious emotions, like jealousy or   pride or guilt or shame. And then I have the teen  sort the cards to describe how they’re feeling   right now, and they sort ‘em into three piles,  yes, no, maybe a little bit. So, “How are you   feeling right now?” You – and it turns it into  a recognition task, rather than something that   they have to pull out of themselves. So, they can  decide, am I feeling discouraged right now? Yes,   no, maybe a little bit. And then after they do  that, I will have them go through the yes pile   and say, “So, what is making you feel discouraged  today?” And then they can talk through this. This is also a really useful technique to share  with parents, because what do parents do? They   usually leap in to fix things, but let’s just  slow it down and acknowledge the feelings. The   other thing is it shows two important themes for  teens. One is that we rarely have just one feeling   at a time. Our feelings are almost always a  constellation of a whole bunch of different   things, and I’m using the word ‘feelings’  generically to describe all emotional experience.   But – and the other theme is that they change. So,  if you do the feeling cards now, and you do it two   hours or two days later, you’ll probably get a  different constellation, and then if they don’t   have that many in the yes pile, I’ll go through  the maybe a little bit pile, then that’s good too. Dr Jane Gilmour But there’s so much about that’s  really – is very affirming. It also, I’m noticing,   of course, it includes the whole range of emotion,  the – both the socially acceptable and the less   socially acceptable. You know, for example,  jealousy’s written down there on a card, and   that somehow gives a young person permission to  recognise that that’s a feeling that we all feel. Dr Eileen Kennedy-Moore Exactly. Dr Jane Gilmour So, I think that’s a wonderful  exercise, and that is a practical one. It’s also   somehow dis – it allows the emotional intensity  to be drained away. So, I think it’s a… Dr Eileen Kennedy-Moore Exactly. Dr Jane Gilmour …wonderful idea, and the idea  that you can do this through developmentally,   from young kids to teenagers, means that  that emotional literacy can develop. You   can do that over and over and over  again, even as a family, as you say. Dr Eileen Kennedy-Moore  Right, and it makes it easy. Dr Jane Gilmour Hmmm hmm. Dr Eileen Kennedy-Moore ‘Cause how many times do  you have a teenager sitting there, and you’ll ask   ‘em, “How are you feeling about that?” “I don’t  know.” Or, “So, how are you?” “I don’t know.” You   know, those teenagers who are not going to talk  to you, this makes it easy, it’s a segue in, and   then the l – talking about, “So, what is making  you feel jealous?” Then we can talk through it. Dr Jane Gilmour Yeah. Dr Eileen Kennedy-Moore So, a third theme  that I have in my work is the interpersonal   context of emotion. So, if we – and this is  something that I think CBT has really neglected,   but it’s something that I find so interesting.  My very first book was for mental health   professionals, and it was called “Expressing  Emotion Myths, Realities and Therapeutic   Strategies,” and it talks about how expression  is the link between internal experience and the   outside world. And it is deeply connected to who  we are, how we feel, how we connect with others,   so this is so important. Our teenagers tend to  have binary thinking about emotions. Either I let   it all out, or I hold it all in, and, of course,  there are many, many options in between those. So, if we think about the interpersonal  context, where do our big emotions come   up? Usually it’s related to somebody else  important in our lives. So, we don’t just   have anger in the abstract, “Yeah, I’m angry  at her because of what she did yesterday,   and that’s so unfair,” and how I express those  feelings, how I communicate those feelings,   is going to have a big impact on my relationships.  So, that can be really, really powerful. Dr Jane Gilmour Well, that really – I mean,   that’s wonderful, and I think you’re right  to highlight the CBT neglect, somewhat,   of the contextual and the interpersonal issues. I  think it’s a really important one to highlight. I   was going to ask about your academic writing  on emotion, and you’ve raised it already,   because I wondered how much you described  the theoretical aspects and I – you know,   specifically you talked about “expression versus  experience.” How much do you make that explicit   with the young people you work with, or is  it implicit in the work that you’re doing? Dr Eileen Kennedy-Moore Both, both. So, sometimes  I’ll do what I call a ‘feelings story’. So,   I’ll just draw a circle, and I like to draw with  kids, because I just think it sticks in their   head better than all of our adult yammering. So, I  talk about – what starts out is there’s an event,   and as soon as that event happens, we  people are meaning making creatures,   so we start thinking about, well, what does this  mean about our relationship? What does it mean   for me? And those thoughts trigger feelings,  and now, we crossed the line between the inner   experience towards the outer absorbable part,  the expression. And so, our feelings are going   to trigger or make more likely, or make us want  to do certain actions, but we have a choice about   that. And then our actions are going to tre –  trigger reactions from the other person. Now,   the beauty – which could be another event  setting the whole cycle in motion and again. But the beauty of laying out the cycle is that  every single one of those points is a point of   intervention. So, with the event we might want  to change the situation. With the thoughts, well,   we got a lot we can work with there. For instance,  research tells us that kids and adults who are   prone to anger tend to assume that they did it  out of deliberate meanness, but usually they   didn’t. So, sometimes I’ll have – I’ll talk with  kids about what are some other reasons why they   might have done it? Let’s see how many we can come  up, and maybe they di – maybe they were annoyed,   may – or maybe they didn’t get enough sleep last  night, and maybe they were annoyed with their mom,   and they just happen to say something to you.  Maybe they didn’t realise. When we come up with   lots of maybes, it makes the deliberate  meanness explanation seem less likely. Dr Jane Gilmour And that re-appraisal is  such a positive emotional regulation skill. Dr Eileen Kennedy-Moore Exactly, and  it’s way the heck upstream, with... Dr Jane Gilmour Yeah. Dr Eileen Kennedy-Moore Yeah. Dr Jane Gilmour So, it’s about getting it  in, and I like the way – and I, you know,   I would agree, we’ve actually had a couple of  other episodes thinking about the power of drawing   and visual expression as well. Dr Eileen Kennedy-Moore Yes. Dr Jane Gilmour And so that’s a very powerful  description, because you can see, you know,   as you say, what’s upstream and where your  intervention and your emotional regulation   is more likely to be effective, way  upstream, as you say. And it shows   that cascade of context effects and, you  know, when things are burning brightly,   it’s harder to bring in some of your  coping strategies. So, I think that’s… Dr Eileen Kennedy-Moore Right. Dr Jane Gilmour …a wonderful  piece of information. Dr Eileen Kennedy-Moore Yeah, and keep  working around with the – once the emotions   start coming up, we can harness our capacity  to feel more than one thing at the same time. Dr Jane Gilmour Hmmm. Dr Eileen Kennedy-Moore So, “You’re nervous  about this. Are you a little bit excited too?   Can you pay attention to those feelings?”  “You’re mad at her. Can you find a little   bit of compassion too?” And it’s not that  the one erases the other, but it softens it. Dr Jane Gilmour Hmmm hmm. Dr Eileen Kennedy-Moore So, that can  be very useful too. And, of course,   in terms of behaviour, we’ve got a lot of control  over that, we can make a lot of choices about how   we communicate with other people, and we can  anticipate how they’re going to do that. Yeah,   so, so many options, rather than  just hold it in or blast them. Dr Jane Gilmour Yeah. So, you’re really  unpacking it and unfurling. You know,   it’s as if you are lifting the hood of a car  or, you know, unpacking a recipe, you know… Dr Eileen Kennedy-Moore Yeah. Dr Jane Gilmour …putting things into steps, so  you can see how the outcome might be. You know,   we might roll back the film and look  at what happened at the beginning of   that scene. That’s great, and it’s a really  – and I can feel your creativity in the way   that you’re describing it, because that is  half the battle, isn’t it, about getting… Dr Eileen Kennedy-Moore Exactly. Dr Jane Gilmour …the young person engaged in the   idea that there is a way to look at  this differently, or to, you know,   manage your emotion or manage your behaviour,  manage the context in a different way? So… Dr Eileen Kennedy-Moore Yeah. Dr Jane Gilmour …I think that’s wonderful. Dr Eileen Kennedy-Moore Yeah, it – and really   it’s about the engagement, because you  can have the most beautiful techniques,   but if you don’t have a connection with that  kid, you’re not going to get anywhere. So that… Dr Jane Gilmour Yeah. Dr Eileen Kennedy-Moore …that is really an  important part, and sometimes we can use that   connection. So, I had a client once, a teenage  girl, and she was ripping herself apart about, “My   this is too big and my that is too small,” and I’m  listening and I’m listening. And then, I knew her   pretty well, so I could use the relationship, and  I said to her, “Do you think I should quit my job,   stop seeing clients, stop writing books  and articles and podcasts and so forth,   and just spend eight hours a day working on my  abs? I’m sure they would look a lot better than   they do now if I devoted a full day, all of my  time, to working on my abs. What do you think?”   And fortunately she laughed, and I said, “How do  you know that I’m not going to do that?” And the   answer is because it’s not my values. You know,  like, I try to exercise, I try to be healthy,   but I’m not going to devote my life to my  abs, ‘cause I just don’t care that much. Dr Jane Gilmour Yeah. Dr Eileen Kennedy-Moore So, the context of the  – harnessing teenagers’ values, this is such   a wonderful stage, because they’re beginning  to be able to think at a more abstract level,   and being able to pull in your  values, “Who do you want to be?” Dr Jane Gilmour Hmmm hmm. Dr Eileen Kennedy-Moore So, I’ll tell you another  strategy that I use pretty often. Psychologists   sometimes talk about ‘egosyntonic moments’, and  this is a terrible name, and I haven’t come up   with a better one, but when you describe it to  kids, it’s those moments when you – when we say,   “This is who I am or who I want to be.” And I  tell kids, “Pay attention to when those happen,   write ‘em in your phone, keep a  little running notes about that,   because those are breadcrumbs, sort of, guiding  you to the direction that you want to go.” Dr Jane Gilmour But you say so – you know,  you use such evocative cases to show this,   and actually, we had another episode where  we talked to a young person who described   her experience in Child and Adolescent Mental  Health Services, and the thing that mattered   most to her and to her peers, was that the  Clinician cared about what she was up to,   what mattered to her, and that was  the leverage on which the rest of the   technical stuff could happen. There is nothing  without the foundation of the relationship. Dr Eileen Kennedy-Moore Absolutely. Dr Jane Gilmour So, I think it’s really – you  know, I think it’s a terribly important point,   no matter what our clinical issue,  no matter what technique we’re using,   we will get nowhere unless we’ve got  a connection. And allowing the young   people to say, you know, “Whoever I am,  whatever that moment is, that breadcrumb,   is worth something to me, I’m listening  to that, and I’m interested in that,” I   think is very powerful. I think that’s  wonderful stuff, that’s great, Eileen. Dr Eileen Kennedy-Moore Yeah. Dr Jane Gilmour I wanted to move – and you  really touched on it a little bit, you know,   we know that emotions and the social world are  very tightly entwined in the teenage years,   and we know that the experiences with  peers contribute to the success of future   relationships and mental health status, both now  and in the future. So, if we had a situation,   clinically speaking, where there’s a teenager  who’s being persistently excluded by their peer   group, how would you support them? What  techniques have you found successful? Dr Eileen Kennedy-Moore Well, first of all,  I have to say, I believe this so deeply, when   we think about the epidemic of loneliness among  adults and the mental health crisis among teens,   and the general divisiveness in our world,  it has never been more important to teach   young people to build strong and caring  relationships. Like, this is urgent. Dr Jane Gilmour Hmmm. Dr Eileen Kennedy-Moore So, I’ve done – most of  my work about friendship has been – my writings   about friendships has been with younger kids,  but the number one reaction that I get from   parents to this is, “This applies to adults.”  It’s, like, “Yes,” you know, it’s not, like,   we learned at age nine and then we’re done. Even  as adults in new situations and new relationships,   we’re continuing to learn about getting along  with other people. So, one thing that’s really   important to understand is that social skills  are not about doing one thing. They’re about   being able to flexibly adjust our behaviour  to fit the situation, to fit us, to fit the   relationship, and we don’t all have to become  a bounding into the room, life of the party,   extrovert. There is definitely room in the  world for a quieter way of interacting. Broadly speaking, when we’re thinking about any  problem, but especially a social skills issue,   we want to think – we have three options. We can  change the environment, we can change the person,   or we can change the match between the environment  and the person. The last one is usually the   easiest. So, when a kid is feeling rejected at  school, for example, I would be thinking hard   with that teenager about what is it that they like  to do that they could do with other kids? And that   could be the basis of a genuine connection. Kids  make friends by doing things, doing fun things   together, so what can we do to help this kid  find their people? And sometimes I need to pull   the parents in, to prod a little bit, because  it’s uncomfortable, it’s scary, especially when   you’ve faced rejection before. And I will full-on  acknowledge that, that this is raw courage. “What   you’re doing right now, by showing up for the  robotics club, that’s the same as me jumping out   of an airplane with a parachute, you know, this is  really, really scary, and I know you can do it.” Now, some – in terms of changing the person,  we might be able to teach particular skills,   so in one of my books I talk about five essential  social skills, so “reaching out to make friends,   stepping back to keep friends, blending in to  join friends, speaking up to share with friends,   and letting go to accept friends.” We need all of  those, and if you’re thinking about clients now,   you can probably go, “Hmmm, that one, that one,  that one,” and they’re different. You know,   some kids, for example, need to recognise stop  signals. So, I’ll make a list with them, okay,   “How do you know somebody wants you to stop?”  “Quit it,” “Cut it out,” “You’re being annoying,”   or sometimes it’s non-verbal, huh. When you hear  one of those, or see one of those, you need to   stop, because otherwise, you’re signalling to  the other person, I don’t care how you feel. Now stopping is hard for some people, so we  have to give them particular strategies to stop.   Sometimes it’s physical, like sit on your hands,  or, you know, pretend your tongue is stuck to the   roof of your mouth. Another thing to do is to say  a statement, like, “Okay, I’ll stop now.” Like,   it’s a little bit unusual, but at least you’re  signalling to the other person, “I heard you,   I’m working on it,” and it gives them that  extra two to three seconds to, kind of,   rein things in. But this is part of our big cycle  of noticing how the other people are reacting,   as opposed to just what I’m feeling. This is so  important and it’s so hard. Theory of mind starts   around age four, and we are more empathic at 29  than we were at 19, and probably at 39 than we   were at 29. So, it’s something that we have to  constantly be working on, and we can do that.  But with other kids, we might be helping  them to make their way into a situation,   and here a good formula is match the emotional  tone of the group, or you can say, “Watch,   then blend.” So, you’re not sure what you – to  do, watch what the other kids are doing, and then   slide into the action without interrupting. And  when – with teens, it’s usually a conversation,   so listen first, hear what everybody’s saying,  pick up on, what is the emotional tone? So,   if everybody is complaining the history  test and our kid comes in and says, “Well,   I thought it was easy,” woah, you know, that’s,  like, the melody’s going on, la-la-la-la-la,   and, eek, you know, there’s a sour note, so we  don’t want to do that. Now, she doesn’t have to   lie and say – and pretend she’s stupid. That –  you know, deceit isn’t a path towards closeness,   but she could say, “Yeah, I can’t believe there  were four short answers,” or, “Yeah, I can’t   believe we had to do that on the same week that we  had to do the math test,” or something like that. Dr Jane Gilmour So, it’s the fine  art of blending into the peer group,   which, of course, is absolutely  fundamental to the teenager and… Dr Eileen Kennedy-Moore Yes. Dr Jane Gilmour …their brain, and staying  authentic, staying true to who you are. Dr Eileen Kennedy-Moore Exactly. Dr Jane Gilmour And that – you know, and I think  the importance of these social experiences is that   they are so nuanced and they are unpredictable,  and, you know, if it were a maths equation,   you know, the social learning experience  probably would be a few months, not 15 years. Dr Eileen Kennedy-Moore Right. Dr Jane Gilmour So, I think that’s really  – you know, because it’s an evolving and   iterative experience in terms of how we develop  these social skills, I love the way that you   have these practical ideas that a teenager could  use to try out, come back and maybe, you know,   review, “How did it go? What went well? What was  easy about that, what was difficult?” Because… Dr Eileen Kennedy-Moore Exactly. Dr Jane Gilmour …you know, often it’s –  although teenagers are thinking more abstractly,   they need some concrete skills too,  and some concrete action to take to   start the integration into peer groups, so  it’s beautifully described. I wonder if you   could – so – ‘cause one of the things that  I really was struck by as you were talking   is the idea of the experience or the perception  of our peer group. And there’s some interesting   emerging data showing that our perception of  peer rejection, particularly as a teenager,   might offer some clues to mental health  difficulties. And I know you’ve spoken in   the past about the difference between ‘meanness’  and ‘bullying’. Could you say a little bit about   that and how we might support a teenager to  understand the difference between the two?   Because that perception might make a difference  to how they experience their social world. Dr Eileen Kennedy-Moore Exactly, and this  is fundamental with social anxiety. So,   Researchers have a very specific definition  of bullying, it involves “deliberate meanness,   targeting a specific person,” usually repeatedly  over time, although sometimes one especially   horrible action can count. But the most important  part is that there is a power difference between   the kid doing the bullying and the kid being  targeted. This power difference is what makes   it im – difficult or impossible for the kid  being targeted to handle it on their own. So,   it’s either the kid doing the bullying is bigger,  stronger, more socially powerful, or it’s a group   of kids picking on one kid, and then that’s  bullying. If there is no power difference, it’s   not bullying, it’s just a conflict. So, that is  something that kids need to be able to learn how   to handle, with support and guidance, of course,  with people – from adults who care about them. Dr Jane Gilmour Or even perceive,  ‘cause I think there’s a difference… Dr Eileen Kennedy-Moore Right. Dr Jane Gilmour …in the perception   of that, and say, “Well, that  kid’s mean, maybe I don’t get   along with them,” to – as compared to,  “I’ve been bullied,” because that’s… Dr Eileen Kennedy-Moore Exactly, bullying –  if – we really want to be careful about over   using the B word, because it’s saying to kids,  “You’re a victim, you ca – you are fragile,   you can’t handle it if anyone is even slightly  mean to you,” and that is not something that – a   message that is empowering for kids, it’s a  dead end. Basically we’re saying, “There’s no   hope here,” so – or, you know, “The adults have to  fix it.” Sometimes that’s true, and absolutely, we   need to step in in those cases of true bullying,  but on the other cases, we need to guide the kid. I had a middle schooler come in once and tell  me, “I was bullied today,” and I said, “Oh,   what happened?” And he said, “This kid, he told  me, “Quit making that annoying noise.”” Like,   no, that is not bullying. And I had another girl  who was on the bus with a friend and the friend   started sitting with somebody else, and she was  deeply hurt, so she decided to write her friend a   letter, listing all the mean things the friend  had ever done, base – it was a take her down,   kind of, letter, ‘cause she felt that  the friend was bullying her. And then the   friend promptly accused her of bullying her  with this long letter, and no, this was not   bullying on either side. This was just a clumsy  effort to deal with a friendship rough spot,   and it was poignant on both sides and it was  something that we could deal with. You know… Dr Jane Gilmour Yeah. Dr Eileen Kennedy-Moore …there  were many paths forward other than,   you know, labelling either one of them as a bully. Dr Jane Gilmour And I know you do lots of  work with middle schoolers, and there’s,   you know, a huge amount of resources that  the ACAMH audience can go and look at,   and I’m sure learn from, and although our focus  is on the teenage years here, we know that,   of course, prevention is better than cure. So,  if you’re thinking about the middle schoolers,   so those kids in middle school, we’d call  them, you know, late primary school in the UK,   what do you recommend? And we’ve touched on some  of them, but maybe you could add a little to that,   what would you recommend to young people and their  families in terms of preparation for adolescence,   so they’re fostering good mental health  when things are more vulnerable, they’re   fostering positive peer relationships when peers  matter so much? What’s your prevention strategy? Dr Eileen Kennedy-Moore So, we  really want to make space and   make time for their friendships. If you  think about it, the teen years are about   stepping out and discovering who they are  outside of the immediate family. And what’s   interesting is, the research shows that the  importance of parents does not decrease as   kids move into adolescence, but the importance  of peers sky rockets. And if you imagine it,   there’s an antelope alone on The Savanna, that  is bad, you know, that is very dangerous, so,   of course, as they’re moving away from the family  of origin, they want to be in the herd. And that’s   okay, that’s developmentally appropriate, so –  ‘cause sometimes I hear parents saying, “Well,   I want my kid to be a leader.” Well, you know,  let ‘em join first and they’ll find their way. It’s really the middle school years that  the kids are focused on being exactly the   same as everybody else, and once they get into  high school, it’s more – they understand that   they can have different groups and they can  have – their friends can have more than one   friend and it expands a little bit. The young  adolescents spend a lot of time pondering,   “Am I really lazy or am I really hardworking?” And  by the time they get to 17, they know, I’m both,   you know, we all are. So, we want to respect  that they are – the developmental progression of   things. Parents often tell kids, “You shouldn’t  care what other people think.” Well, that’s not   possible, it’s just not, they need to care what  other people think, and we all do, right? But   we can help them think about, “Whose opinion  matters to you?” And let’s try to think that. So, one of the main things that I think gets in  the way of kids making friends is what I call   the “magnet myth of friendship.” So, this is the  belief that I have to be so amazing and wonderful   that I draw friends to me the way a magnet  attracts metal. This is a myth, it does not   work with that – like that. Your peers do not want  to be the metal, and if you’re looking for that,   “Wow, she’s amazing” reaction, you are not looking  for friends, you are looking for fans and sorry… Dr Jane Gilmour Yeah… Dr Eileen Kennedy-Moore  …that’s not going to happen. Dr Jane Gilmour …I love that, yeah, very nice. Dr Eileen Kennedy-Moore So, the magnet myth can  keep kids holding back. It’s this, like, “Oh, I’m   not amazing, I can’t possibly reach out.” Doesn’t  matter, or they can reach out in not so good ways   by bragging or showing off and trying to impress  everybody, which does not work. So, friendship is   fundamentally a relationship between equals. If  we think of two overlapping circles, and, yes,   I draw those all the time, “This is you, this is  the other kid,” that overlap in the middle, that   is the common ground. That is where friendships  begin. So, if you’re talking about something   that’s true only of you, that’s irrelevant to  building the friendship. So, “What do you have   in common?” Especially, “What do you like to do  with other kids? And let’s find a way to do that.” Another thing is the single best way that  kids can deepen their friendships is with   those one-in-on – one-on-one get togethers, so  – but a lot of times they hold back and they’re,   like, “Well, I don’t know them that well.”  It’s, like, that’s backwards. You know,   if you’ve had fun with them once, good  enough, invite ‘em over. Even if they say no,   it’s a compliment, ‘cause you’re saying,  “Hey, I like you enough to spend you – spend   time with you outside of where we have  to spend together,” so get ‘em over. Dr Jane Gilmour And I think that’s  a really interesting point about the   idea of these one-to-one friendships, so  that’s where the nuance and the, sort of,   fine tuning happens. And we know that obviously,  in middle childhood, kids tolerate adults being   around more and they are more likely to follow  their lead explicitly. Though as you say,   in teenage years, you know, parents continue  to have really important roles to play. So,   there’s an opportunity there, there’s a  window of opportunity to teach and perhaps get   slightly, in a developmentally appropriate way,  involved in terms of modelling good behaviour,   you know, perhaps being around at a play date  or whatever. You know, so parents have a little   chance before kids get into in indep – more  independent social world, where things – you   know, they just have to, you know, fly solo  without a parent, but they’ve been – you know,   all the good stuff that parents have taught them  are baked in through those middle school years. Dr Eileen Kennedy-Moore Yeah, so there is a… Dr Jane Gilmour And I think it’s really nice. Dr Eileen Kennedy-Moore Yeah, there  is a special opportunity there,   but we can still do it in the teen years. Dr Jane Gilmour Yes, yes. Dr Eileen Kennedy-Moore  Because parents control access… Dr Jane Gilmour Yeah. Dr Eileen Kennedy-Moore …and opportunity. And  you can also say – you know, give ‘em a choice,   “You have to do an activity, you can do this  one or this one, you pick.” So, of course,   with teenagers, we always want to give them – even  with younger kids, we want to give them choices,   so they have a sense of autonomy. We can also  ask good questions to help teens think things   through. So, for instance, one – and this is  harnessing their new ability to think beyond   the present moment, right? So, one – two questions  that I often ask kids are, “What is the reaction   that you’re hoping for from that other person?”  and “What kind of communication is most likely   to get that reaction?” And they usually have not  thought about that. You know, it’s just, “I’m mad,   therefore” – you know, or, “I’m shy, therefore” –  and, you know, that’s the end of the conversation.   But we can guide them in really thinking this  through, and then they are imagining the other   person’s perspective not as a, “Do they like me?”  but as a, “What are they like as a human being?” Dr Jane Gilmour Hmmm. You describe… Dr Eileen Kennedy-Moore The best… Dr Jane Gilmour …so – I mean,  apologies for interrupting, Eileen… Dr Eileen Kennedy-Moore Yes, please. Dr Jane Gilmour …you describe  so beautifully the – you know,   a consultative model. Just ask  the question and the teenager   is likely to give you the answer that  you would love to lecture, as it were. Dr Eileen Kennedy-Moore Exactly. Dr Jane Gilmour You’ve turned  it around, so the teenager… Dr Eileen Kennedy-Moore Yeah. Dr Jane Gilmour …is answering their  own question, developing their own,   you know, their own reflection, which  is far more powerful, so it’s a very… Dr Eileen Kennedy-Moore Yeah. Dr Jane Gilmour That’s a very effective  strategy. Eileen, we could talk all day,   but I think we should turn to our final  question, which is, “And now what?” So,   perhaps with Clinicians in mind, can you offer  one practical tip which would improve the service   we offer our young people? Perhaps something  that could be slipped into current practice   without too much cost or organisation. Dr Eileen Kennedy-Moore Okay, so I’m   going to do two. Dr Jane Gilmour Okay, go for it. Dr Eileen Kennedy-Moore Because I’m cheating. Dr Jane Gilmour I would – yes… Dr Eileen Kennedy-Moore I’ve got one for parents. Dr Jane Gilmour …I think  you’ve got so much to tell us. Dr Eileen Kennedy-Moore One  for parents, and one for kids. Dr Jane Gilmour Yeah. Dr Eileen Kennedy-Moore So, for parents, as  Clinicians, it is incredibly helpful if we can   teach them to empathise with their kids. So, I  give ‘em specific scripts of – so the basic one   is, “You’re feeling blank because blank,” or  another one is, “It’s hard for you when,” “It   bothers you when,” “You wish.” And I say to the  pa – and, you know, if you’ve got a prickly teen,   you can add, “It sounds like” or, “It seems  like,” but usually just saying it. And then I   have ‘em written out, and then I say, “Circle the  word “you” in all of these. Notice that there is   no word “I,” it’s all about “you.”” And this  is a dippy intervention, but some of us have   made a career out of it, because wrapping  those feelings up in words is so powerful. And so, I had a mom who the teenager came home  spitting nails about something the Teacher had   done, I don’t remember what, and the mom told me  afterwards, it was, like, “For once I remembered   that thing about the reflection.” And so she  said, “You’re feeling mad because the Teacher   did” whatever, and the kid said, “Yeah, and she  always does this thing.” “It’s hard for you when   she always does this thing.” And she goes, “Yeah,  and it’s so not fair.” “It really bothers you when   she does that.” And the kid says, “Yeah, and  she should be doing the other thing,” and the   mom said, “You wish she would” whatever, and the  kid said, “Yeah.” And you see this softening. So,   I tell the parents, “Wait for problem solving  until you see the softening in their face or in   their body,” and they’re not going to say, “Why,  yes, mother, what an insightful observation,” but   you will see that softening, you’ll get  that grunt of acknowledgement. And then,   and only then, you ask, “So, what do you think  you might do?” And the girl said, “I guess I’ll   go talk to the Teacher,” and she stormed off.  And the mom was, like, “Huh, it worked.” So… Dr Jane Gilmour Fantastic. Dr Eileen Kennedy-Moore …reflecting their  feelings, asking rather than telling,   is really powerful. The second tip for kids, and  this is not – oh gosh, I’ve got two things I want   to tell you about kids. Okay, so I’m going to  talk fast. So, the first thing is for peers,   and this is something I call a ‘soft criticism’,  it is probably the best thing I’ve ever invented,   ‘cause it works, and it works for teens  and it works for us as adults with spouses   or co-workers or whoever. So, the normal  response to criticism is to defend, “Well,   it’s not my fault, and you do it too, and  they do it worse,” this is human nature. So,   the soft criticism is designed to  get around that normal defensiveness. And the step one is we give an excuse. The excuse  says that we know they’re a good person with good   intentions, even when they mess up. So, instead  of barraging a friend who did something wrong,   ‘cause they’re going to do something wrong,  we can start with the soft criticism,   we give an excuse, “I know you didn’t  mean to, you probably didn’t realise.   I get that you were trying to” whatever,  and this is good for parents with kids,   as well. So, the excuse puts us on the same  side, rather than against them, and practically,   if we give an excuse, they don’t have to come  up with one and we can just skip that part. So, the second step is that we describe  the problem, and here our formula is,   when you bad behaviour, bad outcome. So, “When you  tell people things that I told you in confidence,   it really upsets me. You know, I want to be in  charge of” who knows what. So – and then the third   step is probably the most important, which is  about focusing on moving forward, ‘cause whatever   happened happened, you know, we can’t undo that.  We can only move forward. So, with a parent,   they might ask the kid, “What can we do to  prevent this?” or, “What could you do instead?”   Or with a kid to a peer, you might ask,  “From now on, could you please?” and   we’ll move forward in that way. And this  is much better than blasting somebody. Okay, so – and then the last thing that I want  to tell us is a formula that I use with kids,   with parents, and I call it “the angry adult  formula.” So, usually, when adults are mad,   they, you know, do the whole thing about,  “You always do this, and you never do that,   and if you keep on like this, you’re going to  end up like that.” So, I tell kids, “You have the   power to calm down an angry adult, but only if you  use the formula exactly as I teach it to you. So,   when the ge – adult does the whole big thing,  your job is to find a kernel of truth that you can   agree with, and then you say the words, “You’re  right.” You’re not agreeing with everything,   just that tiny kernel of truth.”  So, step one is, “You’re right.” Step two is you have to show them that you get  their point, right? So, you say, “I should have   blank,” and step three, ‘cause you want to pull  it into action, right, the words are only so good,   then you say, “I’ll do it now,” or if you really  can’t do it now, you say, “from now on.” So,   “You’re right, I should have, I’ll do it now.” And  I’ll drill them on it, “Say it again three times,   close your eyes, you’re right, I should have, I’ll  do it now.” And I tell them, “I had a teenager who   this saved her job.” So, what happened was the  kid – the boss would call her and say, “I need   you there at 4 o’clock on Thursday,” or whatever,  until one week, he didn’t call her until he called   her yelling at her, and said, “You’re supposed to  be here and, you know, I can’t have employees who   don’t take this responsibility seriously,  and if you don’t want this job,” etc. Now,   the kid could have said, “Well, you didn’t  call me,” but that would not have gone well.   So, instead, she remembered the formula, and  she said, “You’re right, I should have checked   the online schedule. I’ll do that from one  now. Would you like me to come in now?” Boom. Dr Jane Gilmour Oh, okay. Dr Eileen Kennedy-Moore And I’ll drill kids  on this, so I’ll say, “Okay, I’m your mom,   you be you. Here’s the formula, you ready?”  “Okay, honestly, Pete, how many times do I   have to tell you, don’t leave your shoes in  the middle of the walkway, I’m not your maid,   you know, and anybody could trip on this.” And  the kids are, like, “Oh, my mom said that.” Dr Jane Gilmour It’s time for the formula. Dr Eileen Kennedy-Moore Right? “You’re right, I  should have put my shoes in the basket, I’ll go… Dr Jane Gilmour Yeah. Dr Eileen Kennedy-Moore …do  it now.” Boom, it’s done. Dr Jane Gilmour Beautiful. Dr Eileen Kennedy-Moore It’s done. Dr Jane Gilmour I think that’s so… Dr Eileen Kennedy-Moore And it’s not giving in,   it’s communicating effectively and  resolving a conflict. Look at you go. Dr Jane Gilmour And watching, I’m sure,  the success, which is so reinforcing to   a young person, you know, particularly when  they’re managing something as difficult as   your first boss or similar, I think that’s  brilliant. I suspect if we had more time,   Eileen, we could get more and more fantastic  stuff, but unfortunately, we had to come to   the end of this episode. So, all that’s left  on my agenda is to thank you, Dr Kennedy-Moore,   for sharing some of your absolutely  superb experience with the ACAMH audience. Dr Eileen Kennedy-Moore My pleasure.