depression

Another parenting principle: It's not just what you say that matters, but HOW you say it.

When providing parent coaching, I often find that many parents already know what to say when their children are upset or distressed. Many of them provide thoughtful emotion coaching (i.e., helping their child identify the emotion they feel or giving words to what their child is feeling), and many also express appropriate empathy (i.e., "You must be so upset about that - I’m so sorry you’re sad!”). Some praise when they see their children respond to difficult emotions in a positive and effective manner (this makes me especially happy to see!).

While I definitely focus on the content of a message, I also spend a lot of time helping parents evaluate how they talk to their children. When I say how, I mean specifically the tone, feel, and emotional delivery of what they are saying.

It’s important, especially for little ones, that the intensity of or emotion in your voice matches what they are feeling. Can you imagine if you were seriously upset about something and were talking to a friend about it who responded in a totally flat and blase voice “Oh, I’m so sorry. That’s so terrible.” The content would be totally spot on, but the emotional intensity and meaning behind it would leave you feeling totally unsatisfied, if not dismissed. It’s the same for children - when they are upset, it’s important that you match their intensity and tenor, as this helps them feel heard and validated.

It can be difficult doing this when your child is upset about something that feels unreasonable (some parents tell me they feel like their kids’ requests are outright insane). I’m not asking you to agree to their demands, I’m asking you to acknowledge and agree to how upset or distressed they are when they don’t get what they want. Validating their emotions doesn’t mean you have to agree to what they want. This can be hard for parents, as many have asked, “Well, if I say that it’s okay for her to feel upset, doesn’t that mean I need to give into what she wants?”

Not necessarily. As adults, we often encounter disappointments. The important thing isn’t that we can always change circumstances to be in our favor, it’s that we learn to deal with feelings of sadness, disappointment, anger, etc. that arise as a result of these trials and tribulations. By holding the line and validating our children’s emotions, we are starting to teach the early lessons of facing the realities of life while being able to manage difficult emotions.

I’ve run into the effects of incongruence between message and delivery with kids who tell me that their parents don’t “get” that they are sad, anxious, or upset despite the fact that the parents saying all the right things. Sometimes it’s just a matter of parents tweaking how they speak to their kids - lowering their pitch, softening their tone, slowing their speech, adding a bit of sadness - for kids to really feel heard and understood.

I recently came across a research study by Weinstein and colleagues (2019) in the journal Developmental Psychology, titled Listen to your mother: Motivating tones of voice predict adolescents’ reactions to mothers. As I discussed above, tone matters early in childhood when validating and emotion coaching, but it also continues to matter in adolescence, and in positive interactions. In this study, mothers of teens provided motivational instructions (e.g., “Do well in the play) in a variety of tones - supportive, neutral, and controlling. Unsurprisingly, the teens who had mothers provide the instructions in a supportive voice tended to report having more positive emotions, more closeness with their mothers, and were also more engaged than the teens whose mothers used a controlling voice.

Taken together, this study (and many before it) tells us that it’s not just how parents talk when dealing with difficult situations that matters, but also how they express provide encouragement and support that matters. Parents sometimes ask me how they will know they get it right - I ask them to practice with me in session (role playing helps A LOT!), and to practice with each other and give each other feedback. I’ve had parents come back to tell me that it not only helps how they relate to their kids, but how they relate to each other - that doesn’t surprise me. At the core, all people, children and adults alike, want to feel like our emotions are reasonable, acceptable, and understandable. Having that message delivered in a way that resonates goes a long way to help achieve that.




Photo credit: https://www.flickr.com/photos/ruthanddave/

Teens and Suicide

During my residency and post-doctoral fellowship, a significant part of my training involved treating suicidal teens and kids. Like many mental illnesses, suicidality does not discriminate -I treated patients from all ethnicities, socioeconomic backgrounds, and genders and some who were elementary school-aged. The scariest part for me was that there was nothing consistent across all of those cases that could have predicted who, when, or why, or how. The article below resonated with me and is a thoughtful discussion of what suicidality looks like in youth today:

Article: I treat teens who attempted suicide. Here’s what they told me.




Photo credit: https://www.flickr.com/photos/ruthanddave/