Thursday, October 7—Paula Rauch, M.D., joined the Winsor community virtually to share insights on the active role caring adults can play in helping children face challenges, anxiety, and uncertainty with agency in order to achieve security and resilience. Dr. Rauch is the founding director of the Marjorie E. Korff Parenting At a Challenging Time (PACT) program, and a consultation child psychiatrist specializing in the impact of medical illness on families and on the emotional health and well-being of children.
Drawing on decades of experience, Dr. Rauch offered parents/guardians guidance rooted in an understanding of the process of natural adolescent development. “Think about development as being a climb up a steep hill, and every child has their own unique backpack,” she said. In order to understand each child’s challenges and strengths, the caring adults in their lives have to do the work of unpacking the backpack. Particularly at this time in our country’s history, “the number of family stressors is just enormous.” Taken in combination, external factors, including global, national, and local events; internal factors, including temperament and environment; and the role media plays in daily life can become overwhelming.
Acknowledging from the outset, “It’s a myth that telling a teen what to do will work,” she suggests, “As hard as it is, we need to step back and be consultants.” To help parents face the challenge, she offered some essential advice:
Model behavior. How parents and adults react to what’s going on in the world, in our country, and in their communities; how they handle relationships and stresses at work and at home; and how they model what it means to live a meaningful life all set the example. Children and teens are always watching, and they will largely model the behavior they see.
Experience challenges, not trauma. “The age-old adage is not true. Everything you live through does not make you stronger.” Trauma is the experience of adversity without connection, and it leads children and teens to feel isolated, helpless, and over the long-term, afraid for the future. Adults can help children and teens avoid trauma, and experience challenges that help them build skills and confidence by providing a source of connection, and support. When enabled to discuss and take action to drive change, children and teens move forward feeling stronger and more competent.
Apply a growth mindset to growing up. We have come to expect children to stumble along the way in their academic growth. They can, and should, be given the same opportunity to fumble and build new skills in their lives. “Think about it as if they are writing their autobiography all the time, and continually editing it,” she said, adding, “You want to be a co-author, writing the narrative along with them, helping them examine what they are seeing and experiencing.” And she cautioned, “You don’t want Alexa to be the co-author!” When teens direct all their questions to technology, the adults in their lives don’t hear what they are thinking and worrying about, which limits their ability to help.
Know the difference between knowing and processing. Particularly with teens today, they are consuming media all the time. It isn’t uncommon for them to know about something before the adults in their lives do. But “knowing about something isn’t the same as processing it and making sense of it. So don’t be fooled.” Oftentimes, they are frightened or confused by what they have seen, and they need your help to process and understand it.
Agree to worry with, rather than about. “Teens are moody, messy, self absorbed, and idealistic, dedicated, and compassionate.” To help them better cope, let them know that they are expected to be all those things, accepted for being that way, and that as a family, you are all in it together for the long haul. If they share their concerns and struggles with you, you can listen, be a sounding board, and worry with them. But if they don’t communicate, you are more likely to worry about them, and persist with questions and concerns (which they typically find very annoying.)
Show Don’t Tell. Tone and facial expression are “the music” behind the words you say, and kids are more likely to pick up on the tone than they are the words. ”If you can calm yourself enough so the words come from a place of calm and curiosity rather than anger or an agenda, you are much more likely to be successful.” And when it comes to commenting on their actions, “underscore what you want to see more of, not always what disappoints you. Help them recognize what they are doing right…If you catch them in small acts of kindness and consideration and tell them you appreciate it, that’s the gold standard.” At the end of the day, “memory disproportionately retains the negative,” so “you want to disproportionately share the positive.”
Communicate. Communicate. Communicate. Children and teens want to understand the why behind the things you do personally, and as a family, and they want to be part of the conversation, particularly when things get difficult and action plans are made. They are far more likely to feel secure, and to succeed, when they understand and have a stake in the desired outcomes, and have the opportunity to take action and exert some control on the outcome.
In closing, Dr. Rauch reminded parents/guardians to avoid the pitfall of telling their child they just want them to be happy as an ultimate goal, as it’s not possible, or achievable to be happy all the time—a fact emotional teens know all too well. Rather, teens grow more confident and secure when they set goals that are doable and achievable, and believe that there is no such thing as perfection as they work to achieve them. And above all else, no matter what happens, “home needs to feel like the safest place to go when a teen messes up.”
Dr. Rauch has practiced at the MGH since 1982 and is an Associate Professor of Psychiatry at Harvard Medical School. She is the inaugural incumbent of the Timothy Christopher Davidson Chair of Psychiatry at the MGH.
Dr. Rauch has been honored with numerous clinical and teaching awards, including the Kenneth B. Schwartz Compassionate Caregiver of the Year Award and the Simon Wile Leadership in Consultation Award from the American Academy of Child and Adolescent Psychiatry. She co-authored the book Raising an Emotionally Healthy Child When a Parent Is Sick along with many chapters and journal articles.
Dr. Rauch graduated from Amherst College and the University of Cincinnati College of Medicine. She completed her Psychiatry Residency at The Massachusetts General Hospital and her Child Psychiatry Fellowship at Cambridge Hospital. She is board certified in adult and in child and adolescent psychiatry. She serves on the Science Advisory Board for the Military Child Education Coalition and as consultant to the PBS cartoon, Arthur. She is a trustee emerita at Amherst College.