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Hello and welcome to teenagers untangled, the audio hug for parents going through the teenage years. I'm Rachel Richards trained parenting coach and mother of two teenagers and two bonus daughters. Since I launched the podcast back in December 2021, I've found that some of our episodes have been immensely popular, gaining more than double the downloads of others, one of the most popular looked at how to support teenagers with anxiety. So I thought you might appreciate hearing from someone who spends her life actually treating anxiety, senior clinical psychologist, Renee Mill, I genuinely loved our conversation because she touched on so many of the important things I've learned whilst researching for this podcast, how what matters is our beliefs about an event rather than the event itself, how we can support our teens in a way that genuinely helps them, and how important it is to be authentic and honest with our teens about our own values. She started out by explaining what anxiety can feel like for a sufferer,
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people find anxiety, very debilitating, just the symptoms are very, very uncomfortable. So you can have, you know, a lot of negative thoughts and the rumination they don't stop, which interferes with people's ability to sleep, but also just being comfortable in themselves. So you know, I've dealt with top CEOs, but they're sitting in a meeting and they're having the imposter syndrome, and they're becoming anxious that they're going to get caught out. And nobody knows, but they're very distressed internally. And then you get all the physiological responses that are awful. People don't like it, their heart races, they, their muscles can tingle, often they have their feet go numb, they sweat. They have a lot of headaches and tension, irritable bowel, they're all kinds of things. There's a whole gamut.
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It's not just one more, but it's they can be very, very distressing. So it's not as many people will come in and go, I'm having what they call it, they call it an anxiety attack. And we're not talking about a panic attack. They're just aware of it. But actually, a lot of doctors send people to me. So I'll have gastroenterologist who will say to people with irritable bowel, or even Crohn's or colitis, it'll help you to go and manage your stress. We're not saying it's the cause. But it definitely exacerbates what's going on. So it's very related to our body.
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That's so interesting, because it does it kind of recruits the fight or flight sides of our sort of endocrine systems, isn't it?
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Right. And my, the symptoms you're talking about my daughter experienced, actually, when she was public speaking, and we tried desperately to, to manage it by using different techniques like breathing, and all those sorts of things. And actually, what we found in the end was that the best way to help her was to get her doing public speaking in an environment where she didn't feel stressed because she didn't know anybody. And she was also given all the techniques right from ground zero, so she wasn't expected to know anything. So sometimes it's about environment, isn't it?
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Well,
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we call that exposure. It's a very well known behavioral tool where you expose people and we call a graded exposure. So you start off in an environment of people where you feel safe, and in a way where you can't get it wrong. And then you slowly increase it, it's actually a well known anxiety treatment is exposure paths. So one of the best ways of overcoming those kinds of fears is by actually just doing it, but integrated way.
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Right? So we've got you here, you know, all about anxiety. So what's the difference between feeling anxious and actually having anxiety? How would you be able to stop that said, let's say I'm a parent, how would I be able to spot either that I'm struggling with anxiety or that my teen isn't, is as gone tipped over, they got stuck?
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That's a difficult question to answer.
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Because I have a medical background originally did occupational therapy or at a medical school with doctors. I also come from a background of not getting too stuck into labeling. So if you feel anxious. And a big way of treating anxiety is to acknowledge the feeling and to find ways of managing and living with it as opposed to go, I'm suffering from anxiety, I've got a diagnosis and a syndrome because that label can be self limiting. But I'm not minimizing what people go through. But that's often what I end up working with people is they start saying I am an anxious person, and then they don't really change because that they now have it as part of their identity. So if you have a feeling of anxiety, and it's affecting your daily life, you're not being the person you want to be, or achieving the goals you want to achieve, then you can always benefit from good psychological therapy. So I want to say this. I'm originally analytically trained, so I'm not dissing or criticizing anybody who does counseling I do a lot of counseling myself. But that's what I've found over the years was before CBT came in, I was doing analytic work that talking about your problems going deep did not help anxiety and did not hear that help the symptoms. So people would come to me and go, I really understand where my trauma comes from a wifey like this, but I'm still having heart palpitations. So when CBT came along, I had because I was originally an occupational therapist, and I saw the value of behavioral tools like exposure will help your daughter much more than understanding why she had it, that might be nice at another time. But sometimes you need if you've got performance anxiety, or teenagers at school, they need to do well. There are good CBT tools that help you manage anxiety. So anytime you feel blocked or stuck, or not being the person you want to be, get that help. Because the second thing I want to stress is, if you don't know how anxiety works, is it becomes entrenched in your brain. So if you think about a circuit, when you get anxious, you actually form a neural circuit, or describe it like a child's railway trick. So the heavy and principals is neurons that fire together wire together. So what happens is the sort of network gets in every time you're anxious, it literally gets thicker, that railway track gets thicker. What then happens is you go you know, I'm feeling anxious, I'm going to go and go for counseling, or go for one or two sessions. And some therapists will say go and just do breathing, because it's not really helping. And the reason it's not helping is because you haven't unwired, that trick. So you need to unwire it with enough practice and repetition of new behaviors.
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And then the old wiring gets undone and you have new wiring.
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So that's why a lot of people feel it didn't help me, I went for a do breathing or I did a bit of this, but nothing changed. Because the longer you've had anxiety, the more entrenched it becomes. And then what I often have is people say to me, I don't know why I'm anxious, my life has never been better. But if we trace back, they've been anxious for so many years, that it's entrenched in their brain now, that's the default.
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Wow, I just that's so important. I absolutely love what you're saying. Because, of course, also with teenagers, they've got such neuroplastic brains that that's going to be even more pronounced presumably that this rewiring will happen. And with the people I know who had children, for example, who've had eating disorders, or any of these issues, getting in really, really quickly, early on, makes such a difference to their recovery. That's right. Yes. So you have a model that you tend to use, I think called the EVO model, would you explain how that works? Sure.
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So it is a form of CBT. Although I've added on a few things, I just want to explain what CBT is cognitive behavioral therapy. So it's sort of the gold standard of treating anxiety and depression, it's a very well known psychological treatment.
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And Put very simply, if we call it the A ABC model, that you have an activating event, anything can happen. We say that events are all neutral, then you have a belief about the event.
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And then there's a consequence.
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So that's what the ABC stands for. So my airflow model of tease that out into explaining what happens and what sets of anxiety. So something happens, you you have an exam coming up, you then have a belief about the exam, I'm not good enough, or I'm not going to do well or I'm never going to do the career I want or my mom's going to hate me or I'm going to be cut off from the inheritance, whatever settle for you. So that the ease the event the B is the first B of EB. And then from that belief follows behavior. So if you believe that something's going to happen, you will then behave in a particular way you'll withdraw or you'll become perfectionistic. So you can have behaviors, then the F stands for feelings, you'll have certain feelings of failure or disappointment, or fear. The L is your limbic system, then fires that tells you you know, you start having all the physiological symptoms. So that belief leads to changes in your behaviors and all the things I've just mentioned your feelings and the limbic system.
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And then the O stands for an outcome depending on what the belief is, you'll have a certain outcome, and then we want to achieve a win win. So the example I give in my manual actually, is I did sharks, but then my publisher thought that wasn't a good idea because we've had a few shark attacks in Australia. And even though statistically, if you you know, measure it out it and I'm not minimizing again, it's not that many but it's so dramatic. So I actually while I was deciding what to do, I happened to me watching the news. And in far north Queensland, there was this massive Python over three meters long that was found in this woman trainers house and I thought, Oh, how fortuitous. And she was totally like flatlock Oh, I knew it was in the in the ceiling. And I was just didn't bother me. But now that it's in the roadmap, actually called the snake catcher. And then the guy came on to TV, and he said, this was the second biggest monster I've ever seen. He was so excited. So when people said me, everybody's scared of snakes, I go, Well, Trina wasn't and he was excited. The snake is the event. So if you have a positive belief that this is exciting, I love these big monsters, then your behavior will even are my gestures are exciting, I'll feel happy, my limbic system is calm.
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But if I believe I'm going to be eaten, then the opposite happens, I'll withdraw and my heart will start beating and I have fear. So working with the belief is a core part of CBT.
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And that changes everything else. Sometimes working with a behavior, which is what exposure is, sometimes we we don't need to work with a believer doesn't matter why you have performance anxiety, if you just expose yourself gradually. Or if you're scared of snakes, actually, exposure is also a graded exposure, where that in itself will habituate the brain. So that's the ED fro model. And one of the reasons I chose that name is because it's fluid just like the sea ebbs and flows. People often feel used the word neuroplastic. People often feel stuck. This is how I am I was born this way it runs in my family, I'm hardwired. But actually you can move in and out once I said once I've learned the method very quickly. So once you know what it is, you can make yourself anxious very quickly by changing your thought. And you can undo it by changing your thought.
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Interesting, yes. Because that's another thing we talk about a lot in the podcast, this tendency to believe that you are rather than you. So for example, I am. I'm stupid rather than I've just made a mistake. It's that kind of mindset, isn't it that can make a big difference. And you know, what you were saying there reminded me of when I was a young girl, and I was in South Africa. And we had these dramatic thunderstorms that were kind of scary. But one thing my parents said was, which was really smart, was we all got behind the glass doors and the behind the sofa, and sat there and watched it like it was a show. And that way of approaching it meant that ever since then, I just thought they were amazing, and something to watch. So it can be as simple as just how do we receive this as being either scary or, or exciting. So let's write it these are, this is a fascinating model. And it sounds it makes so much intuitive sense. If one of the things we're going to be doing in one of our next episodes is talking about introducing your school, your teenager to their new school, because a lot of teenagers are going from their junior school where it's a quite a safe environment to being in a senior school, they're usually much bigger, the emphasis is very much more on exams, and they're sort of expected to grow up really quickly, meet new friends, and also perform. And so how can we as parents, help our kids a prepare to move to a new school, and be perhaps cope when they come up against you know, really anxiety inducing scenarios.
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So the most, and this is tough. The most important thing we can do is what I call be a calm container is as parents, we need to work on our own stress and anxiety. So we need to be cognizant of a we anxious for our children, often we're anxious for them. And often we thinking about what could go wrong. And so even if we don't tell them in words, they'll pick it up from us. So the first thing is we need to check in with what are we telling ourselves, and we need to actually find a way that we comfortable for them to move to the next level. And I have to say that my kids are grown now.
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But I was surprised myself how each life event and each milestone made me question myself. It affects us when our children grow up and they move to the next milestone. And we have our own anxieties about how they're gonna do so that's the first thing. And then the second thing is to tune into the child.
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If the child is not anxious, be very careful not to make them anxious by asking them all these questions. Sometimes we project our own anxiety onto them and they actually Okay, so we have to also have a little bit of thinking about what is Who is this child? How does this child tick? What does this child need?
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There's not a cookie cutter answer but if There is some anxiety, certainly in teenage years. I'm all for what we call collaborative parenting. So I would go, Look, I've noticed you're anxious and nervous, you're not sleeping, what do you think would help you, you know, talk about a death and be part of the solution. And it's less about giving advice. But as I say, being the calm couldn't contain and helping them finding solutions, of course you guide them. But what we have to be careful of is that, as I say, our messaging because just like I was saying earlier about the repetition, it's not a one soft.
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So if we're very anxious, and then we think today, I'm just going to say the right thing, it doesn't really help. We have to over and over. And we talk about this with teenagers, we have to be consistent in our values, or the way we see the world. And even if they rebel against it, normally, by age 25, when the sort of the the mature brain kicks in, they got off, Mom was quite smart. After all, she learned a lot in the last 10 years, didn't she? They spend if you haven't actually given them values or beliefs, a way of thinking about it, then nothing's going to kick in when they turned 25.
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Yes, I love that. Because we again, we've talked about that, where, you know, we shouldn't shy away from being really clear about what our values and beliefs are, but also listening to what they say.
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And that kind of listening until they feel understood knowing that it's not all about us. And that's really hard when you're a parent because you feel like you know, you feel like you know what's right for them. And if they just did this, it will be okay. I've even had some I've even had professional practitioners message me saying, Oh, God, I forget to do this stuff when I'm at home because we we all become scared, scared parents, don't we?
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Yes.
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So and often we think we saying the right thing. And kids know, when we're not being authentic, you know, so often parents will say, All I want is for you to try hard. But really, we want them to excel. And it's actually important to be authentic, you know, to find a way where we can be authentic, because that causes anxiety when children know mom's not telling the truth is she's trying to protect me.
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How it causes anxiety is very subtle. It's like, Does mom think I can't cope that she's hiding it from me. So finding a way that we can be authentic without burdening our kids.
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These are all important things.
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I love that because there's some cognitive dissonance there. And that's confusing. And that seems to kind of get there. They'll notice it, but they won't know why. Yes, and eating. So we you know, we also have lots of parents listening. It's not just about helping them. It's about helping parents. So what kind of top tips can you give, like that parent, they've just said goodbye to, we've got one parent whose daughter whose son has just been given a full bursary to go to a private school because he's so great at sports, which is absolutely thrilling.
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But he's 13. And he's going to be a full boarder. And she, she's beside herself. It's really, it's exciting. But at the same time, she's not quite sure how to deal with these, these feelings. So as a parent, you know, how can we center ourselves and, and not let that anxiety start to take over?
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That's right, I'll go back to the airflow model and what how I work with people. So I have divided I have it's a four step process. So the is the event.
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Step two is where you validate what you feel. So it's okay to say I'm having separation from my child, or I want him to Excel or anxious how they get their safety, whatever is going on, you have to, and I have it on a worksheet. So there's lots of emotions that people don't even know they're here. But those people do sound glared, and sad and angry. So they're all kinds of things. And then at some point, we really we got, okay, I have a choice, and what tools can I use to center myself and I have, I have 27 tools, they might be more. And we know with coping with anxiety, and stress, you need a repertoire, not one thing works every time. And so you might go, I'm going to solution, I'm going to speak to other mothers who have been through the same thing and find out how to do this better, or I'm going to practice meditation, or I'm going to whatever I need to do, I'm going to do and so you then choose a tool or more than one tool. And then step four is what I call the self motivation. And that is where one notices our growth, we don't notice outcome we notice our growth. And that keeps us motivated to keep doing it. So it's the self awareness. This is what I'm going through, then being proactive in choosing tools to manage our own anxiety.
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But as I'm saying there isn't just one in the moment and also what we needed their time.
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Yes to go to such great point and you've mentioned a list is that in one of your books or because in
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my book anxiety free drug free, I have my worksheet. And what that book is is, so you need to do a worksheet a day for 90 days to rewire the brain. And that's what I do that's unique. None of my tools are, you know, earth shattering that you've never heard of, it's the system of doing a worksheet each day, the event, what I feel making a choice to use a tool. That's how you rewire your brain. That's how you undo that railway track and develop a new one, which is a common one. And that's a mistake that I feel a lot of people have made, as I say, they go for therapy, or they never really changed their brains. As soon as something happens, they go back to their own own anxiety. So it's the practice and repetition, 90 days isn't long. It's not like seven years of psychoanalysis. But it's the consistency of thinking a different way. And that's as mothers or parents, we need to do, we need to realize that change happens all the time. And we need to be aware of what we telling ourselves and finding our own value so we can find an inner consistency of what's important to us. What kind of appearance do we want to be?
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What kind of home Do we want to create? How do we want to be around our children? How will we cope if they don't excel? How will we cope if they choose a lifestyle? We don't lie? These are all things that are going to impact us.
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Yes. And we did an episode on New Year's resolutions and trying to change and it was so fascinating, because I basically the end of it, or the real way to do it is micro steps. And we have to remind ourselves every day, we you know, we sort of say to our kids, oh, you know, you need to do this. And then two days later, you say they just haven't changed anything? Why are they going to change that readily? It takes time for people to build new habits. And I think we rely on habits a lot, don't we we're not, you know, we can consciously think that we always get back to our own habits. So it makes so much sense to have to sort of re drill the way that we think, to form new habits.
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And the step before that is to think about because often resolutions don't work because of what you're saying they're too big.
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And whether it be this new person in a man. But the second thing is to actually be in touch with what's important for us and Santas. Be very honest. Because we choose things that we're not ready for, because there's not stuff really what's important to us.
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Oh, I love that. Yes, yes, it will return on any else
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is doing or what we think is the right thing. But really, that's not for free really thinking or feeling.
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And then I've said to my kids, you know, when my kids not tidy in their room, I've actually had to stand there and say, Is it that it's not actually that important to you, because if it isn't, then you're never going to get them to want to do it. It's just not you know, you we can push it on them. But and the emotion thing is very interesting to me, because one of the things that I read about when I was trying to understand self harm was that a lot of people who end up in this cycle of self harm, are struggling to identify the emotions that they're feeling.
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And then they're using this as a technique to manage it. And I think we can't underestimate the power of being able to help both ourselves because I think we need to have that emotional awareness. Kind of first to help our kids be able to identify like, what is it I'm what is this signal I'm getting? What am I feeling? Um, does it is it important?
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Well, as a psychologist, we say every feeling is important.
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Everywhere. Of course, you don't minimize anything. Yes, what you do about that feeling is is you have a choice. But it's acknowledging those feelings.
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And from a very young age, the you know, you might have parents of younger children, it's never too young to have a big, I have vocabulary, feelings, vocabulary, use lots of different words. And even if you get it wrong, your kids will correct you. So let's say your teenager comes home and they didn't get in the cricket team and you go, Well, I think if you must feel rejected, and they go, No, I don't I feel hatred, doesn't matter that they're corrected you, but you've given them a word, and that helps them to find their own words. So we're not always going to get it right. But we try to understand and we're using a vocabulary to articulating feelings are very important. And that's absolutely right. People who are very anxious, chronically stressed, and of course, to have trauma, they are cut off from their feelings. And we do a gradual exposure to help people safely start getting in touch with feelings, because that is us, as you say, our safety switch.
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That's when we know we need to use our feelings to know when to run from that snake and when not to.
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And is that vocabulary list also in that same book?
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No, I don't think it is, but I can send that to you.
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Oh, I would love that because honestly, that's one of the things I
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have in my parenting book actually.
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Sorry to interrupt you. It actually might be in my parenting book.
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Let's put links to both because actually, I think that's critically important particularly With young men, and the reason I say that is everything I'm hearing is that the emotion that young men are told is okay is anger.
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And very often they're not given a vocabulary for explaining precisely what it is they're thinking, feeling, you know, girls talk more because it's more socially acceptable to talk about your feelings and thoughts. And we need to be able to give our sons dot you know, explicit ways of expressing how they really genuinely feeling so they don't go from here to just anger.
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Right?
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And you know, anger is, is anxiety, fight or flight. So very often when I deal with Assa, treat anger, but I know it's coming off in this anxiety, right? So they don't know how to deal with something, and so they lash out, whereas often, the opposite is we withdraw or we freeze. But anger actually is a form of anxiety as well, where we have to try and feel safe,
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is there anything you would like to be able to say to parents or teens, that might help them through this sort of stress and the anxiety that they may be experiencing?
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I think I, when I started off saying, I really want to get rid of the labels and the stigma, and to really know that we all have anxiety, it's part of our nervous system, and to learn to talk about it, and to not be afraid to ask for help. And help doesn't, you know, even that word is not really the right word, but it's to actually learn how to be emotionally intelligent. I mean, it's another way of putting it, how do I manage my emotions, what happens when I'm flooded, you know, I just saw my last patient now it's the end of the day here for me, you know, he's about to lose his house, he bought a house and he can't afford the mortgage, our interest rates have gone up and he was sobbing, you know, grown man, father of four, sobbing in the chair, you know, but he knows he can manage it on his own, and it's appropriate, he's feeling what he's feeling. And you know, he can learn to manage it. So it's normal in life to have feelings come and go. And as normal, as often the someone would say, there's like a piano, you know, you've got high chords and low chords, and you'll sometimes feel that. And when you starting to feel distress, really seeking treatment, early learning methods, learning habits, learning my worksheet very early on, it's a tool for laugh, I use the worksheets myself to this day, when something happens, I whip it out, even if I'm not anxious, as such, I know I need to emotionally regulate. And so you The earlier you catch it, the less so to take away the stigma and to go, I'm really going through a rough time. Let me learn. There's so many strategies out there. And as I was saying, you know, with psychology, there are techniques that we use that are evidence based. So a lot of people, a lot of the men I work with, they don't want psychobabble and they don't want softly, softly and they don't want counseling and I go to nothing like that. You'll love it. It's strategic, it's planned. It's a manual, it's a book, you can have it on your iPad, and then I feel okay. But the truth is, there's a lot to be said about that. It's not something there's a place for counseling. But actually, these treatments are very, very focused and very, very helpful.
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Right. And getting rid of that sense that which we get a lot of on social media that we that everything's going to be good that we can be happy all the time. And there's this, this is insane level of positivity. And as soon as you feel bad, there's something broken or wrong about you. This is normal. It's just a cycle of
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death, we talked about the tyranny of happiness. You know, it's a, it's a word that has caused.
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That's why I like the ACT model as well. They talk about you can't be happy all the time. But you can live a fulfilling life every day. So even if you're feeling sad, but you are doing your best to be a good mom, and you're living by that value. You that's a fulfilling day. Love every day.
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On that note, that is exactly what I want to end on. Because that's the message is that we can do this.
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We're not going to get it right all the time. And, you know, there's support out there and techniques that we can use. So this is absolutely fascinating.
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Thank you so much for now, I'll put all the links to your books and things on the podcast notes.
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And yes, thank you so much for being with us.
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It's a pleasure.
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That was Renee mill, senior clinical psychologist, if you want to contact her all of her details are in the link to this podcast.
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And there's more information on our website www.teenagersuntangled.com dot com. If you liked this interview or any of our other podcasts, please share it and hit the Follow button so you don't miss any. You could message us at teenagers on tangled@gmail.com.
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And if you leave a voice message on the website telling us which is your favorite episode and why I'll feature you on the podcast.
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We're back next week with Suzy and we'll be talking about how to support your teenager when there's a serious illness in the family. That's HIPAA. Now my fellow untangle is Be kind to yourself. You're a great parent
