Full Transcript for Why Insight Doesn't Equal Capacity in Gifted Teens with Emily Yi, LCSW | Teens Uncharted Ep. 68

like we're gonna get through this but it's gonna be a little intense. It's a little roller coaster ride. So yeah. Both and. I think I I love that 'cause I think that that is probably true for a lot of people with who they choose to work with and who they really feel the passion to work with in therapy. And I I think sometimes like it's a weird journey to think about like yourself as a younger human and being like now I'm here, right? Like I'm on the other side of this and like I can I can s I can share the hope. I can share all the things, I can share the struggles and like the trials and the growth and the experiences in like such a beautiful and profound way. As a therapist. Yeah. It's really exciting. It's like and part it's partially sad as you go through, you know, not quite forty yet, then I just have these moments where I'm like, Ooh, like it just hits you over and over again of like, ooh, I internalized that. Ooh, I internalized that. I made those choices. That wasn't you know, it was just it's just interesting as you figure it out. And my hope is to prevent as much trauma as possible. A lot of the I call you know, capital T traumas of near death experience, car accidents, things like that. that lowercase T trauma of just being misunderstood and mislabeled, lazy, manipulative, defiant, and a bully, you know, just mis titled and then internalizing that and then living that out for so long. The goal for me is to work with these teenagers and preteens and kids and help them stand on a strong foundation and avoid a lot of that lowercase T trauma or at least avoid it taking root and like living it, reliving it over and over again. I absolutely agree with you in terms of like prevention of trauma, right? And like giving them a narrative and helping them understand how those things like don't necessarily define them. And at the same time I talk a lot about how like once the neural pathway is built, it's a whole lot harder to like circumvent. And so we talk a lot about like how do we how do we like not build that bridge and how do we build other bridges, their neural system. So I totally agree with you. Yes. And it's sometimes hard because you're going a little bit against culture and the and parent systems. And I question myself sometimes of like, do I know what I'm talking about when I'm telling a parent? They weren't being rude. They were just saying The facts of that teacher, you know, a recent client that got in trouble for saying that was rude to an adult and lost her leadership role. And I'm understanding it through like neuroaffirming of okay. you do have to figure out who's a safe adult who you can talk to. But also she felt like that person was acting like a child. So she talked to them like a child. And that's so common in gifted neurodivergent spaces. And to for the adult then to be punitive instead of like coaching and teaching, because it's like a developmental delay really of That felt inappropriate and if you thought that was rude, there's a way to say it. You know, coaching through versus like you're bad for saying that to me with no explanation, no coaching, and just punit punitive movement. And so I feel like some it's it's just a tough space to navigate because we don't want to cripple our kids and be like, well, you can say whatever you want to anyone you want, and then they don't make it very far in life. We want to make it to where they have all of these opportunities. We just want to take away the shame and we want to make sure they're getting the teaching. Opportunities. But that's it's just very nuanced sometimes, and I I struggle through it. There's no path already built, you know. It's like we're kind of walking through mud. That's just like one small example of it. Yeah. I I love that you brought that up though, because I think that when we're talking about teens, one of like my biggest complaints is when we're talking about teens and teens in therapy, there are a lot of resources that kind of combine child and teen and teen and young adult. But I find that there's really a lack of kind of these like niche focuses of like how do we work with like these sorts of populations in a very specific and intentional way, which is one thing that I love so much about your course, which we'll talk about in a little bit. But I'm curious from your perspective how you find the work to be different working with kind of gifted and intense teens versus you're just kind of like maybe general category of teens. Yes. Let me see if I have okay. So one of the things in my course that we'll chat about but it one of the first intakes that I do I'll do it it's called color your life Okay, so each column is a year of their life. And this would be a pretty a good example of a gifted teen. And I don't have an example of a not gifted teen, but essentially all these colors are different emotions and they have they go all the way back to one year old. So they're remembering and articulating and analyzing their emotions really back to like seven years old, but even before that they can imagine like a complexity of emotion. And a teenager that I work with, if I do this assessment and they're not gifted and they're not Like they're just typical intelligence and they're maybe going through their parents are going through a divorce or they were in a tr a car accident or whatever. They'll just be like, happy, sad, happy, sad, mad. Happy, sad, mad, depressed. You know, like and it's just very concrete and simplified. so that's like an e a visual example of the difference in the clientele. It's like, we don't have enough time for them to say all the words and to the nuance and and really go into it when I'm working with gifted teenagers in an hour. But with a teenager in an hour that doesn't have the same high it's it's just an intensity level and it's like a speed. There's it's slower and it's more like simplified. And I don't I don't know that we should like n I'm I'm looking for the words.

but I would say I can definitely name what it looks like. It's hard to name what typical looks like. And I struggle with that. I struggle with this idea of is anybody typical? Do some of us do we all have intensities in different ways? So I might have a client that presents this way and often I'm like, gosh, was there like a language barrier? Like, what is the deal? Because I'm not getting to that complexity that I'm thirsty for and that I know is there and maybe art isn't their way. And so I'll go a different way. But it does come that the clients that I don't work well with because of my speed and my like need for intensity are often the clients that probably aren't appropriate for talk therapy. And it might be that I'm just like kind of saying you know, what's different about working with gifted kids. If we bring it back, I mean I showed you the v the visual of like there's an intensity level there. But then there's just this discrepancy, okay, of like they are A's high performer, whatever it looks like, highly verbal, but then completely resistant to brushing their teeth. Going back to your question of like what is typical, I I don't really know. That's why I think I I chose the word like general because I was like, How do you differentiate that? Particularly in the teen, because they just have so much going on. I'll tell you the the teenagers that end up with me. Okay, so like the parents that I know it's probably gonna be a good fit is when they're like, We've been and this is why it's like it's So hard because I don't want to say anything bad about anybody else. Whatever, I'm gonna say it. They'll say we've been to five other therapists and nothing's worked. We can just tell from the beginning the therapist isn't at the intensity, like the spark, the energy. And as soon as they meet, we know it's not gonna be a fit. The teen is bored and they feel like the therapist isn't really connecting with them. So when I hear that, I'm like, you're in the right place. Like you want a level of let's get in there and get messy that that I like to work at. And I and it analysis level of like we're really gonna get to the nitty gritty and the willingness to experience a little bit of discomfort because I like to be right on the edge of like where are we at and how do we get a little bit better constantly. Like there's not really a we're good. Okay, let's just coast here. That's really hard for me. Like COVID when we just did the same thing over and over again with my clients, if I benefited from it and I was able to like like stretch my flexibility to be present with people when there was no real growth besides just like enduring difficult times and but I love growth and so when I'm working with I would say that that's like those are the intake calls that people are like, we read your website and you're different. And the reason I'm different is because I'm willing to do whatever it takes to like keep your child engaged and to help them move forward. And

it's often it feels difficult to people who are just like, well I just do what's typical and people usually get better. But these clients don't. They need a little bit more of creative workarounds. I think of like brick walls in your brain. And we need instead of like trying to climb them and falling over and over again, like we need to get creative about how can we move around those a little bit, dig tunnels underneath. I am so glad you said that because I think that is often my my realm with like my high risk teens as well, where I'm like, I will do whatever is necessary to figure this out and to help them problem solve. And like I have a very creative brain. And so like to me that potential is like limitless. But when I talk to people who kind of do maybe more like standard therapy, they're just like that feels unethical or that feels like you shouldn't do that. And it's like, I'm not doing anything that's like unethical. I'm not doing anything that's illegal. Like I'm not breaking any of the standards of care that we have set. But It's this willingness, I think, for me, and it sounds like for you where you're like, I am willing to go to all of the steps to help you understand yourself, t for helping you understand your layers, for helping you understand what is life and how do you want to connect with it in this really deep nitty-gritty way. Yeah. And the clients that can tolerate that are the ones that are different. They can they sit with it, they'll they'll argue back, right? Like and there's a training communicate you know, of I am in your clubhouse, that is your brain. I am the guest and when you invite me into it and you ask my opinion I'll share it with you but you can argue with me I am not always right you know and like and there's this leveling with even a teenager or a preteen of you in this space I am not the authority right and I might have some answers some guidance but you get to decide and so but they have to be bought into that to go into this space of creativity because yeah it's not like I'm gonna tell you what to do and and I have all the answers and gonna fix it. It's like we're gonna create some tension and hopefully that's gonna be what's helps helps us get forward. I'm curious from your perspective, like when you're I know you're teaching your course and I'm I'll ask you more about your course in a minute, but what do you feel like your kind of traditionally trained therapist misses when we're working with like gifted youth? So I would say traditionally trained therapists would diagnose my clients with ODD and sometimes bipolar disorder but those two specific Specifically, I would say, and they're missing the fact that you can present this way without being, you know, psychotic. That you can, what's the better word? But diagnosable. There's a word. Words. but I would say, like, I get very simplistic responses, like, they're defiant, which is the description of what you see on the outside, but it's not what's going on underneath. And so that's not helpful. And it's actually, you know, it's It's like they're making this choice to be this way, which I tend to believe, and this is I think what traditional therapists we disagree, but my and that's where there's tension, and I always present it to my families like that. Like this is a controversial way of thinking that I'm presenting to you, right? So when you get in front of your school therap school counselor or teacher and you're like, well, my therapist, that just no, like you're taking a side, like research it yourself. But I'm saying if they could, they would. If they could get up and go to school. If they could clean their bathroom, they would. And the fact that they can't, there's this missing support. There's this missing piece. Whatever it is. And it it when I'm working with teenagers that maybe have been adopted and there's generations of trauma in their DNA. And they can do all these amazing things and there's this one random thing that they just can't do, you know, and we want to be so quick to say like bipolar disorder or and it's like, well, you know, there's just some support that that's needed. they it's not that they're being if we assume if they could they would then that gives us this space to say okay well what do they need in order to do this thing and and we can kind of just focus on one thing at a time and giving them the support they need instead of this like blanket well they're just disabled or and I don't want say that because people that are have employed sort of aren't disabled but they're just not able to function generally, you know So I would say that that's the traditional w route, which you know, to give it what it needs, it needs to be very general to cover a large population. It served its purpose up until now. And now we're in this more like trying to understand people 'Cause it seems like nobody is neurotypical, so now it's like, okay, well, maybe this way of thinking isn't really working. Or maybe it's working for the general population, or the person who is of typical intelligence, dealing with an anxiety or depression, and the traditional route is going to help them. But someone that is gifted is to being told, you know, just go for a walk, just take a deep breath, just think about what you're thinking about. And they can't even I need instead of just A to B, I need like the whole alphabet between A to B. What do you mean? Right? And that's like what DBT is, is how like let's break down the skills of managing my emotions like in a huge thick manual and I need to take it page by page because I need tutoring on this. And and when I'm ready for it Like when the right moment exists and I'm not in like fight or flight, you know, there's just so much nuance to how to really support someone. And that's really, I guess, where what I see in like these clients. And I would say that that's different from the traditional therapist that's like, what do you mean? I taught you how to do

it. Just do it. I don't know why you're getting stuck. And then the traditional therapist might also move into like, well, let's try ketamine assisted therapy. Maybe that will help you get unstuck. Or let's try these other therapies, which that's another route. out of possibly getting there, but there's also just this piece of like Let's just sit with that and go a little bit deeper there and be curious about what else is it that you might need or what's going on in that moment. I just keep saying I love that because I'm just like, yes, like when you talk about the fact that so many of your kids, so many of your teenagers come potentially with a diagnosis of bipolar and ODD. Like I have I've been thinking so profoundly lately about the diagnostic criteria we have for different things. And when we're talking about teens and and children, so many of the things that We are diagnosing on are things that the outsider is observing, and it's a whole lot less of what their internal experiences are. And like that's one of my issues with like the ODD diagnosis, is because I feel like we're focusing on these behaviors and not the internal experience of the person, right? And like if we're then thinking about behavior being communication, right? Like, what is this behavior communicating outside of the societal expectations of respect and being, you know, not really. and doing the things you need to do, right? They're a whole lot deeper than that. Yeah. And how how often do we know as the frontline providers that this is often a systemic problem or a family systems problem or, you know, just something a trauma a child who's been adopted at birth, we have no idea where their what their genes, you know, contain. And and so we're trying to find a way to describe it quickly and simply and really putting the problem on the child instead of the family in the system. So which is very difficult and something that I grapple with a lot as a teen therapist is how much of this is this teenager and how much and sure, here we are, and this is what makes it different from child child therapy is we've kind of you know, to your point of like setting the mold, some things are set at this point. And we're not doing necessarily the same, you know, if a child is presenting with what a traditional therapist might describe as RED, then we're not doing the same bonding you know, therapy that we might do at a younger age at this point, it might be we're looking more about how can they live independently? How can they sustain themselves? Because they're just fighting everything that you try and there being a terror in their home. How can we give them the space that will allow them to be safe? And and that's a different approach and that's very narrow affirming versus like we're gonna punish them for not like fitting the mold, but we there's no going back and it's not their fault. And so how do we address that? And so we might look at that in so many different presentations of like here we are, now we're fourteen. And so we can keep being mad about what happened in the past or we can just like help this person in front of us be as successful as possible. And it's a different situation with teens than it is children. Yeah. Yeah. I And you're not quite adults. It's it's sketchy. It's a little bit tough. It is okay. It is so it is so sketchy because you're working with People who teenagers who are starting to differentiate themselves from family understand autonomy a little bit more, know that they can make their own personal decisions about different things, have the capacity or the ability to kind of like maybe like keep secrets or like not disclose because they understand like maybe what they're doing and and who they want to tell about it. while at the same time they're still needing to be supervised by adults and guided by adults, right? So it's this really And the adult can go to jail for their behavior. Right. That's the hardest. I wish that sometimes I'm like, oof, how do we emancipate this kid so that they go to jail for their own behavior? Because that's what's best for them. Like we need to give and that's where I'm like, I'm totally sketchy. It's like, but they need if they're gonna keep making these choices, and I'm very big into like responsibility and freedom. If you're responsible, you get more freedom. If you're not responsible, you get less freedom. And for the relationship, which I'm so I I put the relationship first. First. for their relationship with their parent, they need to have a separate legal standing so that they can make these autonomous decisions and have the own the responsibility beyond them. So that the parent and them can have a relationship. And I think that that's that neurodivergent like asynchronous development when we know they're not gonna make the right decision, but they don't and they are so stubborn about it. And it's like, okay, how do we create an environment Where you can say, I love you, and I don't agree with your choices, but if you're gonna make that choice, you get that consequence, and that's yours, and separate them from and a lot of times it's like with these kids that are 16, and so with gifted development, like what I see often, what's different? Here's some nuggets. Okay, they're coming. Just take it some time. So Eric Erickson's theory of development says, you know, with these different ages you develop in in your personality and in your ability to be a p a person. And Dabrowski's theory of development, which is where a lot of the gifted education comes from, says you pretty much there as an adult, all the development that Eric Erickson talks about by eight years old. And then from there you're just having we he calls it positive disintegration. But essentially you're disintegr everything's falling apart. and then you're coming back together, falling apart, coming back together. Whereas Eric Ericksons would say, okay, you get to about 45, where you're kind of an adult,

you're functioning on your own, and then you have positive disintegration, midlife crisis of like, what's the point of all of this? Let me just like you know, do whatever. But then you come back together. wait, maybe I should get back together with my spouse and like, you know, there is a reason. And so that positive disintegration happens one time. And so you have these gifted kids where it's like I'm eight. What's the meaning of life? What's the point, you know, of being popular, like I don't care, I'm just gonna do my thing, positive disintegration, okay, maybe if people like me I can get more power and control, but then what's the point of that? Positive disintegration, well maybe it's just about, you know, the good of the world. And they go through that the rest of their life, it never stops. But when we start seeing the suicidal ideation and and questions about death, and I just want to disappear and What's the point? And they're totally not motivated by like social standing, and they're not really into like honoring you because you're above me. They're like, that means nothing to me. So we have our 16-year-olds who are gifted, they've been through positive disintegration, they're still under their parents legally, and they're like, I can live by myself. I don't mind being poor if that means I don't have to have anybody in control over me. And when you're in control over me, I get dysregulated, you don't understand me. You tell me no. I don't care if somebody rapes me. I don't care. Let it happen. They're like very like And and if I am about the relationship between the child and parent, I really think that's gonna what's gonna help them in the long run as a child, maybe of adoption at birth, and like this trust is very I'm not gonna say hopeless, because I believe in over time, but just a long time, not just eighteen years. Like when that child is forty-five, you know, then there's this like, okay, you have been there for me my whole life. You know, maybe I can love, you know, let you love me. So that's those are examples of just like where it gets sketchy and it gets where you're really taking a risk trying to negotiate and thinking outside of the box and you're not just using all the traditional ways of handling things. for the sake and good of of the client. And with hope. That I guess that's part that disr differentiates us from like the traditional realm too is like a lot of times in the traditional way of thinking, it's just like, okay, borderline personality disorder, no hope. RAD, no hope. Bipolar, no hope. You know, it's just like all the hope goes out the window and then we're left with people that are like, but I wanna live and I think I can live and I think you've misunderstood what the situation is here. So that's where we meet them and we're like, all right, well how are we gonna navigate this? Well and it's it's knowing too that and this is one thing I I love talking with parents about is like your teen is never gonna live life the way you would have lived life, right? Or the way that you did live life. And like you may have had hopes and dreams for your kid which is so normal. But like your teen is gonna grow up and make their own decisions and make their own choices about what they want to see for themselves. And like I think it's hard for parents to like kind of like connect or or combine like their hopes and dreams for their teen and also their teen's choices, knowing that like I I've definitely had the the teen who's like, I literally don't care if I'm poor living on the street as long as like I get to make my own choices. Yeah. Yes. And another sketchy thing is suggesting to the parents to lower their standard. Like, I know they could go to Harvard. I know. But also they can't go to Harvard. You know? Like what if they just went to community college and we're happy? Could we all be on board with that and like really grappling with that and that's like you know what was what we were raised in, our generation was like you have so much potential. If you would apply yourself, the best thing for you is to reach the highest point of your potential. And what I'm coming back with is just because you can doesn't mean you should. Like probably the best thing for you is to accept, even though you can see it in your mind, you know, like the perfectionism and you can see what your life could look like, but you're you have to see the other part of that of like, and I'll be nonverbal by four PM every day. Like is that a life? You know? Is that what we want for for somebody who's neurodivergent and doesn't have a hard time managing their aspirations? So yeah, we're working with the parent on lowering their expectation. We're working with the child on is that a life to be like so poor that you have like open wounds and you know, or should we maybe come home by eleven o'clock? Like and but we're just being flexible and that's one of the tools in the course is it's called a flexibility. map and it uses the ideas from EMDR of the answer, but our response to stress, our way of handling things. So if the child's way of handling things is fighting, and that's what they always do, is they always come into the room and fight. And so I would say to them, you're so good at articulating and like advocating for yourself and you're so convincing, like all these things. And you've overdeveloped that to where when it's when it's like not time to fight, you don't really know what to do. You're not very good at just l going with the flow or letting people give you a compliment or accepting, you know, good y and sitting with it. And so I want to stretch your flexibility so that you can fight and you can be at peace. And depending on the situation you can make a choice. It's a choice instead of just like an automated like this is what I'm doing. So the flexibility map, it's like goes through all these different capacities and these different continuums and helps you identify with the client

like where they are on the continuum and then come up with little experiments that you do in session to help, you know, like if there's somebody who's not a fighter, help them say no. Help them speak up for themselves and feel what that feels like in their body. And if there's somebody who's not a rester, help them rest in session and notice Like how crazy does their brain go when we're just like being quiet for a whole minute and just being on the edge, on the cusp of what they can do and taking them a step further. Okay. So tell us tell us a little bit more about your course. I'm assuming like all of your knowledge, all of the all the teens you've worked with that you've kind of seen come into your office, I'm imagining part of that was like the root of like I need to create this course. So really it was I can't see any more clients and I can't refer them to anyone because nobody gets it. So Yeah. I wanted to and then the the business mind of like I can't see any more clients and I can't grow beyond this point if I'm not doing something else, like somehow. And so there's that portion of it too of like let me start investing in something that can scale besides just like my time. And I don't want to have a group practice, like I struggle with organizations. Organization and tasks, and so I don't necessarily want to like be over other people's organization and tasks because I struggle with it, then I become like very like controlling and perfectionistic, and then I put that on other people. So I'm like, let how else can we scale besides that? And so that's where the idea came from. But it was like, okay, do I sell to my clientele, which is these families? Like, okay, I can't get you in. Here's a course to help you understand where you're at, or and then I was like, how about I make a course first for therapists. I get some people through it, and then I can make a course for parents, and I can say, and if you need a therapist, here's people who's take who've taken my course, who understand the complexities here and who un who are willing to be creative with your teenager, and who are invested in themselves. So all of those things I felt like let me just get a little referral list going. so that's kind of how it was born. Okay. Okay. I I mean I love it. So tell us tell us about your course. So there's four modules, understanding giftedness, working with parents. So I'm curious about how that, you know, lines up with yours. doing intake session or like how do we do assessments with a teenager if you're not doing traditional therapy of just like answer these rapid fire questions and then growing their capacity and really stretching their flexibility. Because flexibility is a term that's popular in the gifted world of being inflexible, being very black and white and rigid in how they think and how they live. And so we wanted that's part of becoming more healthy is like, how do we get more flexible? Because then you'll have more opportunities, all the things. And I have interns. They're postgraduate. They're working here in the office. A friend has a group practice here in the office that has like 20 therapists in it. So I get to supervise interns, but I'm not like their task supervisor, which is really fun. And they're like Can you record sessions? You know, can I sit in with you? Which I love having I have therapists just sit in and and shadow me all the time just to see how slow it's such a slow pace of working with these teens in the not that they don't get better quickly, but like the time, the If you let them, they'll talk a hundred miles an hour just like you're letting me talk right now. But when I like when we slow it down is when we're able to really make progress. So I want them to see how quiet I am so much of the session and how focused I am on them. It's just, you know, and that's true for all therapists, I'm sure. We go home and tell our people in our lives, like, I completely like morph into them. I wrap my little I use the term octopus arms of like sensors around them. And try to feel what they're feeling. And it's a full body, mind, soul experience for a whole hour. And watching like having therapists that are baby therapists come in, and that's really what I want them to see from it, is each hour I just merge, I try to feel and I try to like name and provide all of that for the client and that's something that's hard to teach. It's something that I think needs to be kind of witnessed. So I in this course record myself, I don't have a client in the room, but I record myself as if I'm talking to the parents, as if I'm talking to the client. And then I talk to the therapist and like describe and explain everything. I provide a script. I provide like we just to the same point of if you're a therapist that's interested in this population you're probably intense and I don't wanna it is not complicated but also there like it's it's simple but then there's just different ways of looking at it from all the different parts of the cube and so I provide all of that instead of you sitting in my office and like feeling it. I try to give you as much of that as possible. I love that. It it sounds like such an amazing course. And like I I think that when I think about my work with teens, I'm like, well teens are easy. There's this vibe where I was like, it's not easy, but it is complicated. And I think that like there are so many different lenses you can take, but I think having our own flexibility and our ability to kind of see and like I love your your idea of like the octopus because I'm just like that is such a nice like visual for I f I feel like what therapy should be like really for everybody. I think it's hard for us. As very I don't know, finding a therapist that you feel like does that for you is to is tough. As somebody who gives that. It's like, okay, I want my turn. Massage therapy is my favorite. Like literally, like I need I need like four octopus Yes. So the course There's

like the flexibility map and then another one is the over excitabilities assessment. And that's just a guide that helps therapists understand because often we're educating parents and to the point of like working with teens love it. Like I remember what it's like to be a teenager. I have fun with them, like we laugh so much. Working with parents is when you really need to be on your game. And it takes time to figure out how do I teach? How do I move at a pace that they can accept? How do we hold their emotions? How do I get the balls together to invite them into my office and not know what they're gonna say and if they're gonna be mad at me, you know, for loving on their kid instead of shaming their kid, you know, really working against the grain. And so again, like I love when parents are like, We've been to five therapists, they're not connecting. I really just want a place for them to have a relationship with an adult. And like, done like we're on the same team. But when this is their first experience with therapy and the parent is more traditional thinking, that is a challenge of how do I I have to win the parent before I can, you know, really have the permission to work with their child in this way. And so because it's their child. And so that's that and that takes a lot of skill. And that's really when I'm working with the interns I'm constantly like Gently pushing them. Like, have you met with the mom yet? Have you met with the dad yet? The one that's estranged, that's an alcoholic, that's terrible and crazy, and we've totally like cut them off and just assumed we're not gonna reach out to them, they're not involved. It's like we need the full picture, we need the vibe check of where this kid came from, you know, and like where their neurodiversities and idiosyncrasies. If the mom is that off her rocker, like this child is half of them genetically, and we need to know what that looks like and why are we avoiding it really? It's 'cause you're scared, you know, it's like don't be scared. I know that they're scared. And so I try to like gently like empower them. Yeah. I mean it it's like it's terrifying and I think when you work with teens, you kind of go through this growth process of like the the parent work and like understanding your connection to them and your connection to the teen and like how you're like navigating any sort of triangulation and like the dynamics between them. It's funny, I actually I love the parent work because I just think that it's like when you look at the research and the indicators for the prognosis, so much of it obviously you're gonna do things and you're gonna improve the prognosis if you're working with the teen if the teen is in therapy but that prognosis is actually doubled the outcomes are doubled if you're working with the parents as well and so like for me I'm like Yes, it can be really scary and at the same time I think it's something that you're not gonna learn from a book. You have to jump in and you

have to like experience that and figure it out and and understand what you're seeing and feeling in real time when you're working with that damn dynamic in front of you. and sure, like obviously there's teams that don't like that, but I think You know, in my course I talk about kind of like the differences between like a clinical consultation and like disclosure, right? Because like those are actually kind of different things. And like we do a lot of parent coaching. We do a lot of like skills-based stuff with parents because nobody hands you a manual and says, here you go, here's how to like parent your teenager and here's you know how to like think about things. we do that a lot for child and and like infants. but for some reason around a certain age, everyone is like, I don't know, man, they're a teenager. Go figure it out. Right. And I think just you're making me think of a lot of my clients do want to set like a really strong boundary because they feel like and this goes back to like systems, families, they feel like the parent takes over their whole life. It's always about the parent. And so they come into therapy and they're like, I don't want that the I want this to be my space and it becomes that battle of like control. And I'm just thinking in my mind, again, this like creative way around that, right? Is creating a YouTube channel or having resources for the parent that you're like, okay, well, in order to build rapport with this client, we're gonna meet four times without the parent. But I want the parent to watch these videos or this training, you know, having a resource that you don't just leave them high and dry and out to to dry. That's just like a creative way around that. But as much as we can, we want to avoid That it's so hard. And sometimes the ones the ones that are so resistant to being in with the parent need you to build trust with them first. And so all that to say, like you're like, it's not hard, but it is complicated. There's just it is art, it is your clinical judgment all the time. And sometimes we mess up. And I think that that's okay too. Like you you don't have a manual for this child in front of you of how they're gonna respond. I was working with a family in like kind of moving into family therapy and then the mom was very emotionally dysregulated and I should have seen it of like, this isn't safe for the client, this isn't, you know, helpful and the neck and the client's like, I'm not coming back. I'm like, Okay I hope you do, but I understand because that was that wasn't safe and that was on me. And so we're constant I'm constantly learning and I think that being willing I think that's another traditional therapy versus like this work is being willing to fail in order to learn and pushing the limit and like figuring out 'cause if you're following a a C B T proven this helps so many you know, a certain percentage of people, if you just follow this, you won't make a mistake and you'll help people. Do no harm, right? And so that's but when we then call people hopeless and we don't take the risk, that's where that's I guess the with the seas that we're swimming in is we're taking a little bit of risk. We've given them the autonomy to stop coming at any point. You know, it will not hurt my feelings. And the parents, I meet with them and I'm like, it does not need to be forced for her to come here. I made a mistake. I pushed that boundary. Please leave the door open. But also, those are I think not every therapist is willing to swim in those seas and to kind of process and deal with all of that. So it is it's not hard, but it is complicated and there are risks and there is failure. And I hope that navigating that failure with the teenager and essentially taking accountability for making a mistake as an adult is too part of like the therapeutic process of like I'm not perfect. And ap I apologize to my teenagers that I work with, you know, or the adults that I work with all the time. Like, that was, you know, inappropriate or not helpful and and that and I'm glad you said something and that we can work through this. I'm not going anywhere. I'm not quitting on you. we will work through conflict if if you keep coming back. So I it's not easy. I I wouldn't say it's easy. It's not it's I mean, I think I think there's so much joy and there's so much like awesome stuff that happens when you're working with teens. And I think there is this like hidden complexity. There is this like how do you navigate those situations? Cause they're not five. You know, they're seventeen and they're a a budding young adult and they're headed in like this different direction. But I think I think so much about therapy sometimes is about being a space for healing and being a space for that voice to be seen. And like I apologize to my clients if I mess up too. I'm just like I'm so sorry, right? Like, and I I allow them that opportunity for like me to be accountable and for me to kind of own the decision I made. But I also think that's the hard part that's maybe missing in grad school is because you don't develop that clinical decision-making skill in grad school, right? Like you develop that at your first job, you develop that with your supervisor, you develop that as you go, and you develop that when you're taking courses like yours. So like when you have someone who's gifted in front of you and you've taken your course, you understand. whole lot more where some of those risks are and what to look out for and how to manage some of that and how you feel about that too. Right. I think the part too of inviting the client in and getting their permission to take risks together. Like, okay, do we want to try some things? It might not work. And that's okay. Like we don't know what's gonna work. We're gonna try some things and some of it might not work. Some of it might make you feel worse, but we're gonna go so slow. That like to the point of the family session. There was no yelling, there

was no nothing like that. But it just was across the line, just enough that she decided, I'm not coming back. And I fully am like, that was I see that. And then being able to follow up with the parents of like that was the line. And going forward to the next therapy, we need to honor that with the therapist and within yourself and with her. And so I still feel like we pushed it to the edge and then we found what the edge was. It's not just, she's crazy and can't handle conflict. We have a little bit more of an understanding. But yes, you are not encouraged and probably wisely showed you're not encouraged to find the line, find the edge of what's like help helpful in grad school, it's opposite. It's like find what's worked in the past and just do that. You know, and but then we do have this whole population of people that that's not helpful for. So if you're ready to help Those people, then these trainings and this kind of support and not worrying alone, like working in collaboration with other professionals. When you're in this part of the work, when you're helping that these kind of populations, you do you want to have a lot of people around you to where you because yeah, we can't do it by ourselves. Like we need a whole team, that client needs a whole team, and that's something that I encourage parents too. Of and I think this is true for every teenager, but I say it to them about gifted teenagers in their kit teen. That are neurodivergent is you could be the perfect parent and they would still need more help beyond you. They need more than just the two of you. They're both of y'all's intensities stacked on top of each other, and neither one of you can really get there. We need like a team. So having them in therapy is super helpful. Having healthy coaches that are speaking into their life, appropriate teen teachers that are in their life, spiritual support. Like, what is it as a team, and in all these ways we're creating this web for them. And so you're not failing by bringing them to therapy. You're building a team that that they need because they're a special needs person. They are very needy. And it's more than what you can give. And so just like affirming that for these parents of this is the right track to have them in a supportive environment and have somebody outside of you that they can confide in and work through things with. I agree and I I think like every teen should have access to therapy or should be in therapy because I think it's just such a healthy, beautiful space to kind of figure out how all of these things are meshing together. But I I love your message, right? Like parents aren't failing just because their kid is in therapy, right? They're acknowledging and noticing that their kid needs something and we are never gonna fail if we are able to meet our kids' needs. I wanted to bring something up that's a little bit spicy because you've planted some seeds in my mind. about in the social media post about kids that aren't willing to do things. Something about like defiance and not Yeah. It was a story. It was like a story for asking people like what questions they had. And I thought of a client a case that I've had where and this happens a lot and it's the the PDA. Demand avoidance. That was what it was asking about. And I was like, this might be kind of a little bit outside. It's a little bit outside of really what I work with. It's more of an autism, what do we want to call that? There's a word for it. characteristic or part of the profile. pervasive demand for autonomy. Yes. I call it something else. Yeah. Pervasive demand for autonomy. Okay. I like those words better than the words that I always use. And so when I'm that is a good description of a lot of the clients that I work with. of they're not getting up in the morning, they're constantly hiding vapes in their room, their grades are terrible. They won't come home when they're supposed to. And if I ask them to do anything with the family, like they make everybody miserable. But when they're alone with me, we have this great relationship. And like we can connect on certain things. And they love to go to the grocery store and they love to cook and they love to take care of the animals. And like there's this side of them that's so precious. But when it comes to rules and structure, take a sho get up, take a shower, get dressed, get ready, let's get to school on time, they're in bed, curled up, crying because they can't do it. Then that when we are connected and cooking together, they're like, I want to do it. I know it's what I'm supposed to do, but when it comes time, I just can't. And if I don't have weed with me all the time, then I for sure can't. Right? So it's like they're self-med medicating and recognizing that as a therapist who I'm like willing to kind of be sketchy and meet I'm like let's meet them where they are. Let's just all freedoms, you know, we're not restricting freedom right now. We're talking about what are the responsibilities we want them to have, what are the freedoms they want to have. And then how do we even though they're sixteen, they need a sticker chart essentially of what are the r routine that we have for them and can they check it off each so they need all this support And they need the motivator of if you get it done, you get this thing. And potentially we let go of some of the autonomy of the vape. We're not gonna like hunt down the vapes in their room. We're gonna just let them have that. Because we're focusing on getting up and getting a shower, eating lunch, like and that's that's sketchy of you know, do we prioritize and so for for some families it's hard for them, especially like in the Christian community. and areas of faith to let go of queer identity and sexuality. It's like we're gonna focus on eating and sleeping and not feeling suicidal. And we're not gonna focus on that part of identity that doesn't fit in y'all's bubble, but it's all you can think about. And so

and those are just hard shifts of like we're prioritizing their needs and we're letting go of what everyone around you is saying, but that's the problem. It's the substance use, it's the sexuality It's the friend group and when it comes to demand avoidance, it's like, what are you willing to let go of in order to have a relationship with your child? And sometimes it's the thing that everybody around you thinks that's crazy. And then we step in as therapists and we're like, but we want them to not be suicide. We want them to be alive. When they're if they're not alive, they really can't change anything about their life. And so help like supporting the parent in reducing all of the like anxiety around them that they're doing a bad job. By supporting their child. That's stuff that we that I deal with in this population. And it's another example of it gets overwhelming very quickly when you're trying to meet this child where they are and the parents are focusing on something that is not relevant to like life or death right now. I talk a lot about that in my harm reduction training because I feel like at the end of the day, if we're looking at all of the skills someone can use, like death is the worst one to me because it's irreversible. So to me, anything that is above Death in terms of coping. Cool. Right. Like let's figure out how to kind of like navigate those other pieces. And so when you're talking about, you know, like suicidality, like a vape isn't really necessarily impacting someone's like suicidality, but lack of sleep, lack of like sustenance, right, lack of like control over their own lives, like those things can absolutely kind of like perseverate like SI, right? So I and I think it is a hard shift for parents to be like, Well, what do you mean we shouldn't focus on the vape? Right. And it's like how is Let them do whatever they want to do. That is the that is the parent that's the hardest question to sit with. It's like you feel so guilty letting go of that. And two things can be true of like I feel guilty and I feel loving. And it's like it's hard to navigate alone. And I think that that's where we all I think we all bring our own stuff too. I bring a lot of I notice this in groups of people. I can it depends. Like I I'm very like merciful and I'm very like fighting for the underdog. And once I'm there, then I'm about justice, right? But like I think we all just need to be a part of a team, like all holding on to the little parachute to pull that tension. And and that's definitely one of the things that and I so I appreciate that when parents are like, well, what kind of parent would I be if I did that? I'm not giving up on my kid till they're eighteen, like I'm gonna do this, this and this. And I'm like, I that conviction in your heart is so admirable. And I'm giving you some other information to consider, you know, and I'm not taking that away from you, but we're gonna just both hold on. To this parachute together and and let's get some other people on our team. And you don't necessarily have to go against the convictions in your heart for your child. It's your child. I always feel a little bit of like, oof, am I I don't want to push through somebody's convictions. I want to give them the the right to determine things. And who am I to know? I'm just another human on the world with you. But but I also really believe in what I'm saying. So it's like it's just a tough working with parents is tough. And when you feel like the kid is on the line. then I get a little feisty. Like, okay, do you want them to be alive or not? Like, I get a little crazy, but have to check myself I just I think that's just like you're pointing out the reality though. Right. And like there are certain realities that we would like never want to be true. And I think when we have that lens and we have the scope of like this could be the outcome unless we like hard shift into a different space, like I think that is just being practical and rational with the data we have, with the kids hang in front of us, with the family we know. I I say the same thing and I'm like it maybe is a controversial thing to say to parents, but I do think like at the end of the day I want them alive. Yeah. It's like we won't regret taking them seriously. We might regret not. And like we might regret holding our guns versus like providing some space to figure this out a little bit. So that's not necessarily what I specialize in to the point of like harm reduction and and high risk, but it does come up in this population quite a bit. And I am very like mindful of at what point am I looking. looking for resources outside of outpatient therapy here in my own little bubble. Again, like I don't have the wraparound services. I don't have all of the things. I do what I can and then I try to be ready to to refer them to like skills group training and just knowing what's available to these families. Well, and now you've created a training, maybe the training, for therapists who want to get really good at working with this population and just grow the skill set, right? So instead of like extending out and building more breadth, now we're building depth. I personally can't wait to take it. So I'm gonna drop the link for everything on all your resources below too. So people can reach out to you if they want to take it. but count me in at some point. Okay. Yay. Yes. And I'm gonna do a a live webinar this in, I think November 2nd. I'll get you the information for that. But it's gonna be just like a like come into my office, be a part of an intake session, essentially, like for an hour, talking through some of it without going into super detail, but also just like for therapists who are interested, especially baby therapists, of like how do you do it a little bit differently? How do you kind Of be creative with things and how do you use humor? Just how do you work with teens? Maybe somebody that's like dipping their toe in the water of what am I allowed to say, you know, and so just kind of giving a little behind the scenes of that, and then that'll be and I'll share a little bit about the course there too. I love it. Okay, we'll put all that information in the podcast too, and I can I'm happy to post about it as well to get like the word out for it. Because I think I think this course could be so helpful and so great for so many folks, and I'm so excited you created it. Yeah, thank you. Yeah, it's been a it's like Like a baby, and I have to now we're in the toddler stage and I'm over it, but we're gonna keep pushing through. I feel that. Okay. All right. Well, Emily, I can't thank you enough for being on the show today. I have learned so much. I'm really appreciative for all of the things you got to share. Again, I'm gonna link everything below for folks, but I can't wait to hear more feedback on your course and I'll be at your webinar. So come hang out with me. Thanks, Jeremy. All right. I'll talk to you later. All right, sounds good. All right, guys, we are signing off for today, but thank you so much. Link for everything for Emily is in the bio.