Episode 33: Mental Health – Social Anxiety in Teens – Dr. Tracy Ballardo

[00:00:01.810] - Jill Stowell

Think about your high school self. I'll bet you can remember some times when you felt really vulnerable. If you're the parent of an adolescent or teen, your child probably feels that way, too. Today we're going to be talking about social anxiety in adolescents and teens, understanding it, and some practical tips for parents. This is LD expert Live.

 

[00:00:39.450] - Jill Stowell

The other day, I watched a special on David Foster, one of the greatest music producers of all time. He told a story about a time when Celine Dion and Andrea Bocelli were going to sing together at the Grammys. Andrea Bocelli's plane was late and he wasn't going to make rehearsal. So David Foster called a music teacher that he knew, and he asked if he had any students who sounded like Andrea Bocelli.

 

[00:01:10.090] - Jill Stowell

He got the number of a 17 year old boy, and he called him up and said that he wanted him to come sing in Bocelli's place for the rehearsal. Now, this boy is talking to the biggest name in the music industry for discovering talent and making careers. The boy is thinking, "I don't have the range for that song. I'm not going to embarrass myself like that." And he tells David Foster I can't make it. I have school and homework.

 

[00:01:41.850] - Jill Stowell

Well, luckily, David Foster is a pretty forceful guy, and he said, you get yourself down to the Shrine Auditorium this afternoon, you're singing. The boy who almost gave up the opportunity of a lifetime because he was afraid of being embarrassed was 17 year old Josh Groban. Insecurity and social anxiety kind of go along with the territory of being a teenager.

 

[00:02:12.630] - Jill Stowell

Welcome to LD Expert Live, your place for answers and solutions for learning disabilities, dyslexia, and attention challenges. Our guest today is Dr. Tracy Ballardo. Dr. Ballardo is a licensed psychologist in Pasadena, California, who provides therapy to children, teens, college students, and young adults.

 

[00:02:37.610] - Jill Stowell

She specializes in treating eating disorders and also treats mood and anxiety disorders, trauma and grief that often co-occur with eating disorders. Dr. Ballardo is passionate about assisting individuals with building coping skills to increase emotional regulation and decrease symptoms of depression and/or anxiety that might be contributing to academic stress, social anxiety, poor self esteem, and conflict in relationships. Welcome, Dr. Ballardo.

 

[00:03:19.110] - Dr. Ballardo

Thank you for having me.

 

[00:03:21.690] - Jill Stowell

I am so excited to have Dr. Ballardo with us. She is a lot of fun to talk to and has such relevant information for us. I know when we talk to you said you use play therapy to help young people decrease depression, anxiety, and behavioral issues. I would love for you to share a little bit about what that looks like when we're talking about adolescents and teens.

 

[00:03:50.850] - Dr. Ballardo

Most definitely. So if we look at play therapy, it really is designed to help the school age child or even younger children. In my experience, I have the most experience working with school age children that might look like puppets or paint or anything to really get them involved using play to express themselves emotionally.

 

[00:04:12.870] - Dr. Ballardo

We view play therapy as basically being the emotion of children and so translating that to older children such as teens and adolescents, that looks like using creative art measures such as music or art therapy in addition to poetry, creative writing to really express themselves so that we're doing more than just talking.

 

[00:04:34.770] - Dr. Ballardo

In my experience, if you just ask a teen to talk about how they're feeling or talk about school, you're not going to get as far as you do when you're asking them to really express themselves through things that they really enjoy to do, which might be music. We can spend minutes talking about their favorite song or even expressing themselves by creating a story or writing about their feelings.

 

[00:04:59.350] - Jill Stowell

Well, it is definitely needed are kind of notorious for you ask them something and you kind of get a little bit of a grunt. So coming alongside them where they really are is fabulous. Parents we talk to are, of course, concerned about their child's academic skills, but they are equally concerned about their kids having friends and feeling good about themselves.

 

[00:05:34.370] - Jill Stowell

What I'd like to do today is talk a little bit about the teenage brain and the risk factors for social anxiety, the egocentricity of teens, and then give some practical tips for parents, especially right now during the pandemic when kids don't get to physically be with their friends. So let's start with the teenage brain. What should we be expecting from our teenagers?

 

[00:06:05.030] - Dr. Ballardo

Such a great question and such an important piece to open up with this topic. So when we look at the teenage brain, we really are seeing that the brain truly is under construction.

 

[00:06:15.010] - Dr. Ballardo

So in any brain, regardless of the age, we all have what we call prefrontal cortex, which is the front of the brain which houses our executive functioning. So some research is actually nicknamed as the boss of the brain, so to speak. So the prefrontal cortex is there and designed to help us with planning, with decision making, with controlling our impulses, or at least managing our impulses, and most importantly, regulating our emotions.

 

[00:06:42.430] - Dr. Ballardo

So with this being the last part of the brain to develop, we really do expect teens to struggle with managing their feelings. With figuring out how to plan beginning to end of what their day or what their week might look like. Being able to really kind of navigate really big, complex feelings while they're also pressured to take that math test or score really high on whatever other extracurricular activity that they're doing.

 

[00:07:10.720] - Dr. Ballardo

So the prefrontal cortex really helps us master and control all of these things, but it's not fully developed until about age 25 or so. To expect our teenager to kind of have it all, to manage our emotions, to figure out that the person across the room isn't necessarily laughing at them, maybe they heard a really good joke. The prefrontal cortex is still trying to really develop and figure that out all for them.

 

[00:07:38.310] - Dr. Ballardo

So clearly I'm really personifying the brain. But what we're seeing in the teenage brain is the prefrontal cortex still needing some time to develop and manage things that the other parts of the brain may be a little bit more equipped or a little bit more sensitive to.

 

[00:07:53.520] - Dr. Ballardo

So what I mean by that is there's this whole other part of the brain called the limbic system which is where our emotions are managed, in particular the amygdala. The amygdala is part of the limbic system that helps really regulate kind of that fight or flight response that we can get when we're nervous or we feel scared or we feel attacked.

 

[00:08:14.100] - Dr. Ballardo

So during adolescence, the limbic system is more or less fully developed. But the boss of the brain that executive manager the prefrontal cortex is not fully developed. So it doesn't have the best skills at managing the limbic system, which is what manages our emotions.

 

[00:08:31.690] - Dr. Ballardo

And so you put that together and you have that classic prototypical teenager that might feel moody or scared or anxious and is really having a hard time regulating those emotions and even being able to plan and control impulses or figure out the way of the day and figure out what they're wanting to do.

 

[00:08:52.440] - Dr. Ballardo

So in other words, the limbic system is kind of taking over while the prefrontal cortex is still under construction, like I said earlier.

 

[00:09:01.730] - Jill Stowell

Wow, that is really interesting. Our teenagers look so grown up that we expect them to act grown up. And that's really interesting to know that the emotional part of the brain is developed but the executive function part, the boss has many years to go in development and so things can get out of balance there.

 

[00:09:35.870] - Dr. Ballardo

Most definitely.

 

[00:09:37.490] - Jill Stowell

And our teenagers, I think one of the things that's really tough for them is they do at that point in their life, they get this hyper awareness of their own challenges and compare themselves.

 

[00:09:58.710] - Dr. Ballardo

Yeah. And I think one important thing to keep in mind for parents is that you know that right. You know that you don't want your 15 year old or 16 year old to maybe jump in a car and get their license right away and just carry on their merry way.

 

[00:10:11.380] - Dr. Ballardo

And insurance companies know this too, and they use this science. And that's exactly why insurance rates are so much higher for someone driving under the age of 25. It's expected, unfortunately, that you're going to stumble and bumble along the road and sometimes get into car accidents and probably get into more car accidents than an older experienced driver.

 

[00:10:32.880] - Dr. Ballardo

And that's because the brain not only has more life skills to kind of pull from, but it truly is fully developing. And so I just wanted to kind of really emphasize that for our parents that know this to some degree, it's common sense and we now have the science to back that up.

 

[00:10:49.650] - Jill Stowell

Wow. I always knew that insurance costs for driving go down after 25 years and I knew about executive function too, but I never quite put together that they were actually using science to make that decision.

 

[00:11:08.910] - Dr. Ballardo

Right.

 

[00:11:09.700] - Jill Stowell

So what kinds of things would cause kids to be at higher risk for social anxiety? I mean, I can see that just this whole emotional factor going on at that age and the expectations that a lot of people have for them because they look so grown up could cause anxiety, period. But what puts kids at higher risk for that?

 

[00:11:41.670] - Dr. Ballardo

That's such a great question and I think there's different kind of perspectives we can take with that. I tend to explain my thoughts about that using what psychologists call the biopsychosocial model.

 

[00:11:54.390] - Dr. Ballardo

So it's a long, fancy word for discussing basically that there are biological factors at play, which I did introduce was talking about the brain. There are psychological factors and there are also environmental or social factors playing a role.

 

[00:12:09.150] - Dr. Ballardo

Since we really just dived into the biological section already, I want to go now and talk about the psychological factors. A moment ago I talked about the limbic system and the prefrontal cortex and basically we can picture this giant caution tape on the brain, the front part of the brain that's really under construction, trying to figure it all out.

 

[00:12:30.510] - Dr. Ballardo

And then we can kind of look at what's happening psychologically. From a developmental lens, not only is a teenage brain under construction and really equipped at learning and just being so fluid with picking up new skills, in fact, it's the best time for a teenager, for any of us rather to learn a second, third language, to figure out algebra, to study geometry and all of these really abstract pieces that impact our cognitive functioning.

 

[00:13:00.090] - Dr. Ballardo

We also know at an emotional level, the teenage brain is still developmentally trying to really navigate this social and emotional world. So cognitively, your teenager might, as Jill mentioned, look and kind of act growing up to some degree. We also see these experiences that might make them a little bit more or maybe a lot more at risk for social anxiety.

 

[00:13:24.610] - Dr. Ballardo

So, in terms of the psychological factors, we can look at studies and theories involving developmental psychology and one traditional researcher is Piaget. And Piaget had to say that during teenage years we see what we call egocentricity. And again, this is a big fancy word. What that means is teenagers really have a hard time taking perspectives of others.

 

[00:13:52.180] - Dr. Ballardo

And so you may have heard stereotypes or maybe have even kind of fed into your own stereotype of your teenager really just thinking that the world revolves around them. There is some research that kind of points to that in a way that is much more teen-centered with looking at what is it about that development, what is it about this growing brain that actually makes it difficult for them to take perspectives of others.

 

[00:14:17.040] - Dr. Ballardo

Egocentricity is this difficulty figuring out what that other person across the room is thinking, managing arguments with you as mom or dad at home, figuring out why their brother is so upset at them. They have a really hard time figuring out what other people are thinking and feeling as it relates to their own really big emotions, right?

 

[00:14:40.380] - Dr. Ballardo

Remember we talked about how the amygdala and the limbic system are kind of in almost full control while the prefrontal cortex is still trying to manage what's happening in the brain. And so when you think about egocentricity and you think about teens having a difficult time taking the perspectives of others, it doesn't necessarily mean that you have a selfish kiddo or that this kid is just going to grow up and be completely self-centered and not know how to share or not know how to take other people's thoughts and feelings into consideration.

 

[00:15:13.430] - Dr. Ballardo

In fact, Piaget would say it's developmentally appropriate for your teenager to struggle with figuring out the thoughts and feelings of others. So, in other words, taking perspective, right? And so Piaget went on further, and he gave some other really sophisticated definitions to talk about egocentricity.

 

[00:15:35.040] - Dr. Ballardo

From that we have things like imaginary audience. And so Piaget talk about imaginary audience being when your team is literally kind of thinking that all eyes are on them, giving them either positive attention or negative attention.

 

[00:15:52.650] - Dr. Ballardo

In the event of looking at social anxiety, as you can imagine, that might look like negative attention or perceived judgment, perceived scrutiny, regardless of your teen having that experience, or regardless of them truly being judged in that very moment by those people.

 

[00:16:11.170] - Dr. Ballardo

And so going back to this definition, imaginary audience really is what it sounds like. So it's that teenager waking up with a giant pimple on the forehead telling you, I'm not going to school. This is ridiculous. Everyone's going to laugh at me.

 

[00:16:25.250] - Dr. Ballardo

Now, they may tell you that in a really overt way, or you may, as mom or dad, really be keen and intuitive to thinking, okay, that's probably what's going on today. The last time they wanted to miss school, it was related to some sort of fear of being embarrassed. Or maybe they did get embarrassed. And this is now resulting in, guess what? I have this pimple. I'm not going to school looking like this.

 

[00:16:47.030] - Dr. Ballardo

So going back to this idea of egocentricity, how that might play out is your teenager thinking, "Everyone's going to see this giant pimple and they're going to laugh at me." With helping your team take perspective and challenge that.

 

[00:17:00.840] - Dr. Ballardo

That might look like as a parent maybe using some humor or offering this new thought. This new perspective. In other words, what would happen if everyone else is looking at their own pimples. Chances are they're not staring at you and looking at that specific pimple. May they notice it? Possibly. But are they going to really judge you and scrutinize you, or are they judging their own selves? Right.

 

[00:17:24.660] - Dr. Ballardo

If teens are with peers, chances are they all developmentally are going through egocentricity as well. So across the board, we can see now that teens may have some level of risk that's higher for social anxiety compared to college students or maybe even compared to younger kids that aren't thinking about themselves in this sort of spotlight sort of way. So that's one thing I definitely would want parents to know.

 

[00:17:52.290] - Jill Stowell

Yeah. It just is a particularly vulnerable age, I think. My husband used to be a band director, and I always noticed that 15 year old boys, I mean, my heart just, oh, my gosh, I could just see how they were trying to be so grown up and how vulnerable they were at that age.

 

[00:18:20.010] - Jill Stowell

And I can see that younger kids might not feel that as much. And certainly then as they get into their late teens and 20s, they're starting to get more secure and confident. But boy, those main teen years can be tough.

 

[00:18:42.930] - Jill Stowell

Dr. Ballardo is accepting new telehealth clients from anywhere in California, so be sure and grab a screenshot of her contact information when we put it up here. Or you can check it out on our Facebook or Instagram page.

 

[00:19:01.470] - Jill Stowell

So, Dr. Ballardo, thank you so much for helping us understand our teens better and for all the practical suggestions that you slipped in along the way. What last thoughts do you have for parents and teachers?

 

[00:19:17.970] - Dr. Ballardo

I just wanted to thank you as well for giving me the opportunity to be on the show today. I think these times are tough for all of us, and I think just as parents and as teachers, just give yourself a moment rather to have self care and to even just reflect back on your own teen self. Right.

 

[00:19:38.690] - Dr. Ballardo

Sometimes you're going to butt heads with your teen, and it could be that your inner 16 year old is having a fight with your 16 year old, who chronologically is 16, right.

 

[00:19:47.950] - Dr. Ballardo

So I think thinking about these things and going through the show thinking about yourself and these strategies will be helpful not only for you to connect to your child, but connecting to self compassion might help you really parent in ways that might give you a new perspective. Today a big theme has been perspective taking. That would be one takeaway I want parents and teachers to have.

 

[00:00:00.910] - Maddie

Stephanie expresses that it frustrated her that teenagers are expected to act like adults, but yet sometimes get treated like children. And my 16 year old self wanted to give that an Amen there, so I could definitely see how that would be frustrating.

 

[00:00:19.610] - Maddie

And then we've got actually a question here, so this one's a little bit long, I'll take it down in a second. Autism Resources Mom, she expresses that her son is on the spectrum. He's about 23, but developmentally more like 17 or 18. And unfortunately it's really sad, but he did have kind of a bad experience with the teacher in high school who sounded like he might have lashed out a little bit, a little bit unpredictable. And even to this day, he'll sometimes still bring up his name when he's angry or anxious. And so she's kind of wondering maybe some advice on how to deal with that. Any thoughts?

 

[00:01:00.710] - Dr. Ballardo

Yeah, it's such a great question. And there's part of me that almost wishes I can do trainings or talks like this specifically just for teachers and more power to me because I can. I think that's definitely inspiration.

 

[00:01:14.870] - Dr. Ballardo

I wish that there's something we can do for your son and peers alike, teens alike, to help them see that teachers aren't perfect and that adults sometimes can have a really tough time tapping into what it's like or what it was like for them to be a teenager.

 

[00:01:34.280] - Dr. Ballardo

And to remember that we all go through this and that this is really normal to feel embarrassed sometimes. And teachers were able to really kind of just take a step back and remember that they have a teen that might not be yelling at them because they're trying to be oppositional, but they might be yelling back at the teacher.

 

[00:01:54.510] - Dr. Ballardo

For example, I have no idea what happened in this classroom, but they might be yelling or giving that teacher what feels like a tough time for the teacher, when in fact it could be related absolutely to social anxiety.

 

[00:02:07.440] - Dr. Ballardo

So it could be your teens way of defending against his fear. And sometimes it doesn't always look like a timid child that's shy to raise their hands. Sometimes it looks like a teen opposing that teacher. And so that thought came to mind regardless of how your teen may or may not present with social anxiety.

 

[00:02:25.140] - Dr. Ballardo

Because I think teachers sometimes feel threatened when teens are being oppositional in different shapes and forms and sometimes that's rooted in different things. But I think what gets overlooked sometimes is that actually being a mask for social anxiety. And so I would really want to help your son kind of look at identifying that and maybe even identifying the triggers.

 

[00:02:50.730] - Dr. Ballardo

Did that teacher maybe ever call on him or call on him in the classroom that led to him feeling really kind of scared and felt like he didn't really know the answers. And that felt really scary because other peers were there?

 

[00:03:04.680] - Dr. Ballardo

Did it ever feel different in a different classroom? Did he have a different experience to a teacher that maybe approached him one-on-one? So really helping your teen build a sense of mastery, even if it's on the inside of, like, you know what? You're right. Mr. So and So treated me this way, but Mrs. So and So didn't. That might help them externalize what's going on.

 

[00:03:24.920] - Dr. Ballardo

So what I mean by that is take a moment to kind of step outside what's going on for them and realize that they're not this bad kiddo and that this one relationship with one teacher doesn't mean that all teachers treated them this way, and that might help them realize that maybe there's something bigger outside of me. So, in other words, we're helping them take perspective.

 

[00:03:47.330] - Jill Stowell

You know, I think that is so important. I have run into so many adults who kind of look back at one incident in their usually high school years, and it has kind of shaped their life because they held onto it. And so for the student being guided in taking a step back and getting a bigger perspective and not internalizing that as, no teachers will like me, I'm not good, because our words are powerful.

 

[00:04:35.040] - Jill Stowell

So that's the other piece of what I was thinking was, as teachers, teachers have so much to do and so many different personalities and so many stressors on them, but if they can first and foremost kind of look at those kids and kind of remember sitting in those seats themselves and recognize that, boy, what I'm seeing there may not be exactly what it looks like.

 

[00:05:10.420] - Jill Stowell

We work with kids who struggle with learning, and sometimes they're really good at putting up a wall, because that's a defense for them against all the struggles that they've had. And it isn't defiance, and it isn't a bad kid. It's a heartbroken kid back there that's just trying cover up.

 

[00:05:38.050] - Maddie

Yeah, I know. That's a good point. I think the biggest thing that I've learned, aside from just, like, how to do my job, but working here at the Stowell Center is, like, what you see is like, if there's a behavior or something, it's not about the behavior. It's almost always a mask for something else. So, yes, that definitely resonates with me, and I'm sure a lot of these parents here for sure. So thank you for that.

 

[00:06:04.950] - Maddie

We've got a question from Carla. She says, what can you do to motivate a child with controlled ADHD and social anxiety to participate in sports or school activities? Any advice for Carla?

 

[00:06:21.930] - Dr. Ballardo

Great question. I know our topic isn't specifically on ADHD today, and I want to give that its own divided attention that it well deserves. So just kind of assuming that there might as a parent, I'm imagining you're thinking your wheels are turning, hearing this conversation of social anxiety, that maybe there are some things at play for your child here.

 

[00:06:45.510] - Dr. Ballardo

I think coming at this approach of motivation really being best when it's coming from your child can be tough as a parent because you're wanting to push them maybe past that comfort of what may be social anxiety.

 

[00:06:59.370] - Dr. Ballardo

I definitely was thinking about things related to recommendations for someone that might be struggling with social anxiety and specifically preparing for thinking about online learning now more than ever with the pandemic and most kids really having to plug into this new form of learning.

 

[00:07:16.230] - Dr. Ballardo

I know I've worked with children that may struggle sometimes with this idea of it being online and social anxiety looking really different. And so I've really found it creatively challenging to find ways to help them basically graduate towards working closer and closer to that fear of, in this case, learning online.

 

[00:07:41.400] - Dr. Ballardo

So thinking about I'll give you some examples and then go back to this idea of sports and how can we kind of plug them into something that may not particularly feel comfortable for them. Thinking of this idea of online learning and plugging into this new skill despite the fear.

 

[00:07:56.610] - Dr. Ballardo

The goal is going to be to help the child get closer and closer to comfort, to doing this thing of online learning, which might involve putting a camera on, which might involve listening and speaking or even typing in the responses during a live Zoom class or another online platform, right?

 

[00:08:14.860] - Dr. Ballardo

I would never recommend, okay, well, just tell your child, do it anyway, and today's Monday and you just got to get it done, right? The child's probably going to bury themselves into a bedroom, barricade the bedroom and say goodbye.

 

[00:08:27.630] - Dr. Ballardo

Being a little dramatic here, but we see kids protect themselves in this way of really avoiding whatever it is that you're asking them to do. And in the case of any anxiety, specifically social anxiety, the main sort of coping strategy that we all face, whether we're a kid or an adult, is avoidance, right?

 

[00:08:46.090] - Dr. Ballardo

What I would recommend is getting them closer and closer and closer to that desired behavior. Which in your case would be joining a sports team. Going back to that idea of online learning. Instead of asking them to just do it anyway Monday morning and plug into Zoom. I would ask them to maybe consider doing things that might be kind of related. But a little easier. Right?

 

[00:09:08.580] - Dr. Ballardo

So it could be that this summer they're plugging into a virtual online library membership book club rather, right? And so they're attending and participating something that might be similar, but there's no grade involved, so they don't have to worry about being scrutinized for their performance or their achievement. They can choose to not put the camera on. They can choose to just listen, they can choose to type in their responses if that platform has that capacity.

 

[00:09:38.700] - Dr. Ballardo

What you see here is me really giving that child option. And I really recommend that parents do that regardless of what the desired goal is. So in that case, the desired goal is to get them closer and closer to feeling comfortable to learn online.

 

[00:09:53.760] - Dr. Ballardo

Through that process, you might realize they're not so worried about online learning, they're worried about that camera. And so you can help them get closer and closer to getting comfortable using the camera in ways that hopefully are less threatening.

 

[00:10:05.810] - Dr. Ballardo

So I would recommend a similar thing if the goal is for you to help your child feel more comfortable playing sports on a sports team and you genuinely think that they want to play, they enjoy that playful spirit, they enjoy the movement of the game, but they're just afraid of joining a team.

 

[00:10:24.000] - Dr. Ballardo

If you feel like there's something bigger happening socially that's getting in the way. I would recommend something as simple as playing ball in the backyard with your kid and maybe if there are siblings or anyone else in the house slowly but surely joining more people into that sport or that play so that they can get more comfortable and then doing something a little bit further in terms of a social outlet.

 

[00:10:48.390] - Dr. Ballardo

Maybe for some reason it's less threatening to join the YMCA and do sports there versus do it with their school where their peers know them and they remember them from third and fourth grade.

 

[00:10:59.630] - Dr. Ballardo

So getting to know your child and know the triggers will be important, which is going to be so individual, but also doing what therapists call graduated exposure, which is basically what I just described, getting closer and closer, inching our way closer to the desired goal versus just throwing them in and opening up the floodgates and expecting them to swim right. They're going to feel really scared and probably oppose that goal or that behavior even more.

 

[00:11:29.250] - Maddie

That's practical advice. Thank you. That's awesome.

 

[00:11:33.750] - Jill Stowell

And really recognizing that we don't exactly know what it is behind that fear. You mentioned playing sports with kids who have known them through since third or fourth grade. You know, I mean, the issue with sports could be that they feel like they don't understand the rules well enough.

 

[00:11:59.560] - Jill Stowell

Or it could be that they feel like they don't have the skills good enough, they don't catch well enough. Or it could be that they're embarrassed in front of certain kids who used to make fun of them way back. And so that gradual exposure kind of helps you also figure out what is really going on here that's getting in the way.

 

[00:12:26.240] - Dr. Ballardo

Most definitely.

 

[00:12:27.810] - Maddie

And then we do have another question. Stephanie, she says another kid with great self awareness. She says her 14 year old has trouble with motivation, but they want some advice on how to get their motivation back. So any tips for that?

 

[00:12:45.340] - Dr. Ballardo

Oh my gosh. Again, I could feel my heart growing hearing that to have a child say I'm struggling with motivation how adult is that, right? So that's such a perfect contextual example of what we were talking about with this brain under construction, right?

 

[00:13:00.120] - Dr. Ballardo

The prefrontal cortex has this thought, this really complex, causative, abstract thought. I'm struggling with motivation and your child is probably feeling really overwhelmed with this feeling because I imagine, like most of us, it doesn't feel good, right? It doesn't feel good to not feel motivated.

 

[00:13:16.660] - Dr. Ballardo

So I think doing what I just did there was acknowledging the feeling, right? Acknowledging that it's normal, acknowledging that it doesn't feel good to not have motivation and to take it a further step, I think, as a parent and really self disclose to your child that there's times where you don't feel motivated at times too. And it doesn't feel good.

 

[00:13:39.350] - Dr. Ballardo

I mentioned the biosychosocial model earlier. Going into social or cultural or environmental factors. Everyone knows at this point the pandemic is really negatively impacting our motivation or can I should say. Can negatively impact our motivation in more ways than one.

 

[00:13:58.730] - Dr. Ballardo

And it's certainly impacting our day to day. Regardless of what age you are, you could be a newborn baby and your schedule is completely different because mom and dad's schedules are completely different during this pandemic, right?

 

[00:14:10.900] - Dr. Ballardo

So first and foremost, I think just really normalizing, that motivation being high or low is really normal. And it's really normal to have that reaction during a really abnormal circumstance. Whether it's a natural disaster or pandemic or some sort of other trauma or stressor, it's really normal.

 

[00:14:31.870] - Dr. Ballardo

And I think as parents, it's important to kind of adjust our expectations, right? It's not going to be possibly the summer where your child has a ton of AHA moments and feels extremely motivated to get up, make their bed every single day, do online learning if they're plugged into a summer class or read five books, right? It may just not be their summer for that.

 

[00:14:57.180] - Dr. Ballardo

So I think for one, acknowledging the feeling. Two, self disclosing that you feel that way from time to time, and three, adjusting your expectations, right? We don't want necessarily our kids to think that they're off the hook because things are tough and they're just going to lay in bed all day.

 

[00:15:11.990] - Dr. Ballardo

We still want to give them some sort of structure and expectation and helping them realize that when we don't feel motivated, it's tough to still feel productive or take care of ourselves and play and have fun. But it's important sometimes to do it as if. I'm quoting that as if. Right?

 

[00:15:32.050] - Dr. Ballardo

So allowing yourself or maybe even pushing yourself sometimes to do things as if. So that might involve modeling as a parent. You know what, son or daughter, talking very formally, I don't know your children's name, but sometimes I don't always feel so motivated to do this too. You know what, can we maybe do it together? Would that help? And basically again, you're doing that exposure right there.

 

[00:15:55.900] - Dr. Ballardo

Again, you're graduating them in closer and closer to that thing that they don't really feel motivated to do. Or maybe there's days where you just have a plan day where there's nothing going on, and maybe they need that and maybe you need that as well.

 

[00:16:08.600] - Dr. Ballardo

So I think really being creative, flexible, having structure, but also being mindful of motivation, being lower and higher some days more than others, is completely normal. And letting your kid know that too can give them a lot of power to feel like, okay, maybe there's something else wrong with me. Maybe I'm actually having a normal reaction to this really abnormal circumstance.

 

[00:16:32.010] - Jill Stowell

And that is so freeing to have that. I love that you're talking about validating where they are as opposed to coming in with all this advice. You're validating where they are and saying, hey, you know what, I think this is normal and I kind of feel it too.

 

[00:16:58.170] - Jill Stowell

And I liked what you said about "as if" so were you saying it's kind of like sometimes we just have to get up and do something. And so it's like, yeah, I don't really want to do this, but I'm going to go after this as if I were motivated. Is that kind of what you were talking about when you said as if?

 

[00:17:23.600] - Dr. Ballardo

I certainly would say so jill and I agree. I think we don't want to treat this as a formula. So to speak. But I think when we're really just wanting to acknowledge our children and that might feel newer for some parents. That might be related to how you were parented or just related to your own kind of parenting style. I think it's really important to acknowledge the feelings and really just push yourself to really just try to make it a connection moment and then helping them after you're connecting to the feeling and you're selfdisposing and you're addressing and providing empathy to your child. I think at that point your child is really able to hear you and feels connected. So then you're able to go into that as if, like you said, doing it not just because we have to get it done, but doing it because sometimes doing things for ourselves is an act of self care. And then that might make us feel better, which in turn might eventually turn into having more motivation. So it's not a perfect science, of course, but I think that acknowledging and then helping your child do the as if, like you said, really in essence helps them build life skills, that's going to help bridge that child, that's not quite totally a child just yet, but isn't quite totally an adult.

 

[00:18:40.790] - Dr. Ballardo

Right. That's truly the definition of an adolescent. So I think you definitely hit the nail on the head there.

 

[00:18:47.330] - Jill Stowell

Yeah. And thinking of it in terms of making a connection, my kids are grown now, but I remember as the parent of teenagers, the most precious thing was making connections with my teens because there can be some rocky roads there between parents and teens.

 

[00:19:10.890] - Maddie

One more question from Ron Kay. I'll bring it down in a second. But she brings up that she's heard that girls can often be worse bullies, she says, now than ever before. I don't know if that's due to just technology or whatever, but she says one parent confessed that she would not have been able to make it through middle or high school in this generation. Okay, so, yes, I'm sure it's technology related. Any tips on that? Like that technology, cyberbullying?

 

[00:19:41.070] - Dr. Ballardo

Sure, yeah. Speaking of females in particular, this does go back to that biopsychosocial model. When we're looking at social or cultural factors, we always want to be looking at, at least for professionals in the field, what that may look like is looking at gender norms, cultural norms, things that really impact how we see ourselves as an individual from that culture or gender, as well as how others see us. Right. So in the case of teen girls, or I should say females in general, looking at the research, we actually know that females are more susceptible to social anxiety. And when I look at that data, as a psychologist, I think about this biopsychosocial model. And when I teach this to undergrads, when I'm teaching developmental psychology, I really challenge them to use this model to think more about what's happening in terms of gender stereotypes and expectations versus the female brain being fundamentally different than the male brain. There may be differences, but what we're seeing in terms of the statistics is it's more about gender norms at play, right? So we expect as teachers or as parents, girls to behave and for boys to be unruly at times or be a little bit more aggressive and might get in trouble in the classroom.

 

[00:21:01.440] - Dr. Ballardo

But they're boys. We even have this stereotype or this phrase, boys will be boys. Right? And so where does that fall into play with girls and stereotypes and social anxiety? We may not expect them to be as assertive or we may push them. We may want our girls to use their voice. But as teachers, that can be viewed as them being a little bit more oppositional when they have thoughts or feelings to share. I think that, of course, these are stereotypes and these are gender norms that we may not always realize are happening. But I think just noticing that and acknowledging that and trying to see if maybe that might come into play, even if in a hidden or covert way as a parent is really important. Looking at raising our teen girls in particular, so helping them build skills, helping them build social skills so that they are celebrated for having thoughts, feelings, and opinions may help them on different spectrums of social anxiety and how that's manifested. So for some people with social anxiety, it may look like shyness. It may look like being really timid and being afraid to raise your hand.

 

[00:22:10.970] - Dr. Ballardo

We may know that child. We may recognize, oh, I know you, you're social anxiety, right? Again, I'm personifying here, but we may not necessarily know that kid. That's the bully, that's the queen bee that's really behind the Mean Girls sort of thing going on at school, or in this case, cyberbullying, right? So that can be incredibly scary. But I would say as a parent, if you believe that your child is a victim or maybe even a victim of bullying or the one being the bully, I think it's important to really look at taking a step back and thinking, is there something else at play? Were they ever feeling fearful behind the bully? What's behind that mask? Like Joe mentioned earlier, if we're looking at these as defenses, I think it's really important to look at that and to also look at how every animal kingdom, every kingdom, including being human, there's alphas and there are people that are going to be more dominant in groups and that helps us survive. We need leaders, right? And animal kingdoms really survive by this as well. And so I think really even just helping your child learn that this again, taking a step back, helping them externalize, that this is not something wrong with them, whether they're being bullied or maybe are falling suit to a queen, being in their group that's also bullying other girls and they're doing the same thing.

 

[00:23:34.860] - Dr. Ballardo

I think helping them again with this thing of perspective taking, helping them realize how would it feel if you are the other one being bullied in this way? I think children sometimes can take a step back and realize, oh, now that you put it that way, that big B word bully. I don't want to be a bully, but how do I not do that, right? So I think there's a number of things we can do. It's a really complex, serious issue with cyberbullying. There's really sophisticated ways to really get in there and it should be really insidious. And that's something that I think needs a bigger discussion and more time. However, one thing I would do to start out is if you notice again your child is either a victim or the one bullying, I would have them do a quote unquote homework assignment and watch Mean Girls or watch Breakfast Club or watch 16 Candles or any of these movies. Looking at group dynamics, specifically teen social dynamics, to help them realize something made in the 80s well before they were born, is well beyond them. Right? So these things are going to repeat because we're looking at it to be atypical and related to what's happening developmentally, but something we can work through together, right?

 

[00:24:44.790] - Dr. Ballardo

We don't have to end up saying bullying is normal, stuck it up. No, we want them to realize that this is a challenge and it's a developmental challenge. So as parents, we can take a step back and realize this is something that I need to step in as the boss of the brain while their boss of the brain continues to develop and grow. Right. Going back to that comment about the prefrontal cortex.

 

[00:25:07.270] - Jill Stowell

Wow, awesome. So many important things there. And I wrote down three words that I just think are good to keep in mind, to just notice where our teams are, what they're feeling, acknowledge, and then what you were just talking about, about educating. I mean, as soon as we can educate them and give them a bigger picture, it opens up the possibility for some different responses. So that was great stuff.

 

[00:25:46.570] - Maddie

Thank you so much. Oh, sorry, Jill.

 

[00:25:48.640] - Jill Stowell

Go ahead. When you were talking about girls, it made me think about actually a student who is 16. She is a really sweet girl, but hasn't really had friends, hasn't been very successful with having friends. So she's very lonely right now and she does have a few people that she would like to connect with, but she kind of feels like, well.

 

[00:26:31.230] - Dr. Ballardo

I.

 

[00:26:31.630] - Jill Stowell

Can'T see them in person and they're probably really busy and I don't want to bother them. I know they're burdened right now. I don't want to burden them anymore by texting them. And so we've got this teenager who's really lonely and she wants to reach out, but she's kind of sabotaging that for herself, I think. Do you have any thoughts about guiding her?

 

[00:27:00.570] - Dr. Ballardo

Yeah, I think that's a great question. And I'm thinking about this summer and thinking summer with social anxiety, especially if it's a team that's transitioning to a new school or starting their freshman year. It's tough, right? It's tough thinking about how do I keep connections, how do I make new friends or keep old friends. Right. It can be incredibly difficult. And I think helping our teams realize that it's almost like muscle memory to some degree of staying connected, especially during the summer. If you use the metaphor of trying to work out a muscle in the gym, you can't just do it for 5 hours on a Friday and expect results. Right. So I really want to help kids kind of understand and learn that social skills or feeling a little bit more social tolerance is really important as well. And so it doesn't have to be that you're having them meet face to face every day. And I know with our current limitations, that would be unrealistic expectation. Right. So I think really starting small and again, going to this idea of graduation towards exposure. So graduated exposure it could be calling a friend, which I think most teams these days don't feel so comfortable doing.

 

[00:28:19.170] - Dr. Ballardo

Telephones have kind of gone out the window. Telephones are cameras and apps and internet.

 

[00:28:24.180] - Maddie

Right.

 

[00:28:24.380] - Dr. Ballardo

That's what that means. 15. But we also can use those apps too, so I know there's a fun one that I was introduced to recently called Marco Polo, and it has camera features that you could do funny helium type voices. Your voice sounds super loud, and it can be a way to just kind of be an ice breaker and still do something that's social and fun that just goes to one friend. So it could be a way to kind of break the ice. You could even text message through that too. There's different ways to kind of break through social anxiety, which hopefully will help them feel a little less lonely and might even help them realize, oh, my friends also think she's feeling lonely. I thought it was just me. So I think really helping them find ways that work for them, whether maybe they do feel more comfortable talking on the phone, great. They can call grandma, they can call their friend, they can practice social skills without it necessarily being up here. And then also helping them kind of plug into maybe apps or something that might be a little bit more up their alley could be helpful.

 

[00:29:24.630] - Maddie

All right, thank you so much. I know a lot of people in the comments are loving the idea about watching the movies, so thank you for that. That's a great idea.

 

[00:29:33.410] - Dr. Ballardo

Sure.

 

[00:29:34.890] - Maddie

We got another question here. Christy, she says she's a mom. It sounds like her kid is going into their freshman year. No, I'm a mom of a rising freshman, so her senior year, of course, due to covet, was ruined. Okay. So it sounds like she's dealing with a lot of mood swings due to this whole unpredictable situation, and her anxiety is through the roof, as she says. I got her a journal. Any other suggestions to kind of help her through that?

 

[00:30:09.030] - Dr. Ballardo

Yeah, I think journaling is great. I also am thinking about Telehealth, the online therapy. So there are a lot of therapists that are connecting by means of video appointments. That could be an option as well. Really kind of getting them out of their head. Doing some of these other activities that we've mentioned I think can be super helpful. Whether it's playing with clay. Doing something with movement. Blowing bubbles. Just as a matter of helping them breathe. Can help with anxiety and can be a fun. Playful way to go about that. As well as maybe even watching some of these movies to kind of plug in and see. Asking them questions about it to kind of see. Okay. Is there some social anxiety at play. Or is this anxiety a little bit more general. Kind of helping assess that. At least for yourself. But you can maybe use some of these other strategies mentioned today to help your child. I think could be really helpful too.

 

[00:31:04.210] - Maddie

Okay, that's awesome. I like the blowing bubbles one. I was, like, trying to get them to take a deep breath and they like, just sit there. That's a great idea. Perfect.

 

[00:31:17.230] - Jill Stowell

I know that you are working completely remotely right. Now, right?

 

[00:31:22.530] - Dr. Ballardo

Correct.

 

[00:31:23.590] - Jill Stowell

And so how is that working in a therapy as you're doing your therapies with?

 

[00:31:31.660] - Dr. Ballardo

You know, I'm having a lot of fun. I'm working with school age kiddos. I'm working with teens, young adults and adults. So you can see my little let me move my head out of the way. My little bee right there, that's actually a puppet. It's my little mascot. So I use the bee to represent Dr. B, and I have metaphors and therapy around bees and animals and whatnot. So I'm having a lot of fun. My kids, my teens, my adults are really blowing me away. I've been really impressed at not only how easy it's been for most of my clients to kind of buckle into this online world, but just how flexible people have been and really seeing that there's just so much you get out of online therapy. That really flew me away. I've done some trainings on it, but to do it because I have to do it because this pandemic is completely different than being a participant in continuing education related to the benefits of online therapy. So now to actively be the provider of online therapy, I'm just really grateful and really impressed as to how resilient these kids are and older clients of really just plugging in and doing the work from afar, I'm just really grateful and really happy with the outcome.

 

[00:32:51.130] - Jill Stowell

One of the interesting things we found when we went to remote sessions was that it was really fun to relate to kids in their own space, then being able to share a little bit about their lives in that way. Oh, that's my dog over there, or, oh, this is my favorite whatever that they kind of brought in to share. So it's been fun on both sides for us as we've worked remotely as well.

 

[00:33:27.970] - Maddie

Yeah, definitely. And along with what you said, Doctor Biarto, it's impressive to see how resilient these kids actually can be and go along with these changes. I mean, not to say that it's easy, but it's still pretty impressive to see what they're capable of. We have time for one more question, so we'll put up this question here from Stephanie. I mean, I can totally relate to this from just, like, my past, but she says that her 14 year old kind of feels like they're putting on a mask depending on who they're around. Yeah, I keep putting on a mass depending on who I'm around. Almost all my friends know me differently. So do you have any advice on that? Kind of like that shape shifting personality type?

 

[00:34:09.060] - Dr. Ballardo

Yeah, I'm very glad you clarified because I'm so out of sorts right now. It's funny that I was thinking math like a shield. What am I talking about here? Wow. But yes, going back to the fingertips, math, that's such a big part of therapy, and it's such a big piece of working with a team. It is such a time. It's such a season for putting on masks because they're trying to figure out all these spotlights, right, going back to these imaginary audiences, they may have thousands of different audiences that they feel like they have to perform for, right? So I think the teenage years is such a rich time for exploring one's identity. And I think really just at a basic level, helping your kiddo kind of identify what they like, whether it's their favorite color or realizing, oh, your favorite music was this, and now you're saying, your favorite band is this today? Really naming it for them and helping them realize the shapes and the shifts that are going on, I think will help translate into them noticing and identifying that mask for themselves eventually. So it is abstract, as I just mentioned in my goofy, silly moment.

 

[00:35:22.650] - Dr. Ballardo

Right. It's really abstract to think about these masks. And so your team may not necessarily relate to it in that way. It sounds like a lot of you are some really powerful parents. I'm hearing a lot of questions of your kiddos actually really grasping these abstract thoughts. So if they are able to use that metaphor, I would say more power to you definitely using that mask in your language with them. But if they're not quite there yet, I think even just acknowledging, as I said earlier, helping them kind of figure out what their wants and likes, dislikes are their needs, and helping them recognize if those things are shifting moment to moment because we expect that developmentally, it goes right into what's happening in terms of identity. And again, that brain being under construction, all these wonderful rich things happening during adolescence.

 

[00:36:11.410] - Jill Stowell

And it sounded almost like that 14 year old that she was asking about was aware, but worried a little bit that, oh, I'm doing this, that's probably a bad thing. That education of that's kind of what happens in teenage you're figuring out who you are. And so then together, as you said, kind of identifying what do I really like of all these things that I've sort of tried out or shifted to what do I actually really like? And it's okay to kind of be in that process, but it's definitely okay to decide who they are all on their own.

 

[00:37:01.730] - Dr. Ballardo

Most definitely.

 

[00:37:03.130] - Maddie

And then we do have a question about kind of like virtual therapy. In your opinion, do you feel like it's genuinely helpful for the client, or how do you feel like it compares to in person?

 

[00:37:19.570] - Dr. Ballardo

Yeah. So being a California based therapist, being a local native to California and La in my clinical training, I never thought I would be doing this, to be perfectly honest with you. I mentioned the context of where I live because of the resources in it. Being an urban area, it's much different than a rural setting where you might be the one psychologist for the town, and it might be more convenient for your clients to plug in virtually. And so I say that to share that there are therapists and other professionals across the world where this is really normal and this is a normal means to reaching individuals, whether it's outreach because of a natural disaster and you're not able to reach your clients or because it makes more sense than driving 2 hours with no traffic to go and see your therapist. And so I say that also to share that I've received training from folks that do this for a living, pandemic or not, this is where they plug in in terms of their work. And one thing that I've really been able to see it's super beneficial is Jill commented on having the context of seeing the child in their natural habitat, so to speak.

 

[00:38:38.750] - Dr. Ballardo

I've seen people I'm also a teacher, and so I've seen students, college students seem really comfortable, like having their pet on their lap or maybe in the background. And that's been really cool to see. And then also just having that convenience factor, right? If the parents not having to worry about drop off or pick up as well as the therapist, I actually am able to see their emotional expression much closer than if I was sitting in a therapy room that might be a couch, 5ft away, 6ft away, something of that sort, right. The point is, I am much closer and so I'm able to pick up on emotional cues, which is a big piece of therapy. So I actually have noticed it to be quite beneficial for a number of people.

 

[00:39:21.590] - Maddie

That's awesome. I would have even thought about that. But that's so true.

 

[00:39:24.440] - Dr. Ballardo

You're like, right?

 

[00:39:25.050] - Maddie

It up in their face. It's.