Importance of Positive Memories in Relationships
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It's important to build up in your interpersonal bank account good feelings and good memories even though we all have bad ones and tough ones.
Introduction to 'Doorknob Comments'
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Thank you for joining us on Doorknob Comments, a podcast that we created to discuss all things involving mental health. We take the view that psychiatry is not just about the absence of illness, but rather the positive qualities, presence of health and strong relationships and all the wonderful things that make life worth living.
Meet Dr. Farah White and Dr. Grant Brenner
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I'm Dr. Farah White. And I'm Dr. Grant Brenner. We are delighted to have a very special guest, psychiatrist, psychoanalyst, author,
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and writer Dr. Harvey White with us. Dr. White is a founding member of the American Family Therapy Academy, has been in practice on the Upper East Side of Manhattan for many years. He has a lot of accomplishments. I think his greatest accomplishment is teaching people
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how to love and be loved. Thank you for joining us. Dr. Farah White, is there anything else you'd like to say about Dr. Harvey White? No, I think that's it. Right. Does something else come to mind? I feel like maybe the apple doesn't fall far from the tree.
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I would agree with that. And I'm very happy to be here. It's a very interesting subject, which ripples out into so many other areas.
Impact of COVID on Family Dynamics
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So I'm delighted to be here. And we can talk about this COVID and the strategies people have used or discovered or been invited to deal with it. You know, some people have either returned home
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after many years of living independently to sort of quarantine with families. And some people have had a lot less contact with their families because they're trying to stay away to sort of protect. Yeah. Exactly right. So you have
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too much closeness and too much distance and not enough predictability about when it will end or ameliorate or reshape itself. With this COVID, you have people more indoors and inside, less outside, more eating and drinking and less exercising.
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Those are all risk factors that undermine resilience. Exactly right. I'm working from home though today I'm in my office but I've been working from home a fair amount and I learned something interesting. There are these two small human beings that live in my apartment with us. I'm told are my children
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So I'm wondering, that's a little joke, a very little joke apparently, but what are the upsides for family? Thank you, that's very kind of you. I think you were saying that Dr. Toffler mentioned that some families are thriving. Obviously not everyone is so lucky, but what did you want to say there?
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There can be opportunities for close contact and close conversations. One of the other things we have more of and less of, there is more indoor activity and more time for rumination and regrets, I find in many of my patients.
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and less time for talking and singing. But one of the things that people have discovered is taking advantage of the opportunity for close, connective conversations with people in the family who were busy with other things going in and out of the family. A family that is hunkered down, as we say, is a family that is
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in a closed space that can be useful as a way to share intimate conversations that are not usually indulged in. People talk about what's to do, what did we do, and what could we do, rather than what the purpose of all of this family
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togetherness and play and what the family means in more open terms. So there's opportunity for creating shared meaning. Exactly right. Meaningful conversation, purposeful conversations, family mythologies, family stories. I've encountered a number of families
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that have discovered things about their children or about their parents and grandparents that were unknown. People can review a family history consisting mostly, as we know in family therapy, of coming and going and work on communications. You know the old, the Chinese word for disaster is opportunity and crisis. Crisis and danger is the same symbols.
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So situations like this tend to push systems one way or the other, meaning a family can either kind of like further isolate and worsen their historical problems, or they can take the opportunity to get to know each other better.
Opportunity for Family Resilience and History Sharing
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What I wanted to ask is whether you think the trauma element helps people to discuss, say, parents talking about their own history of adversity, which they might not otherwise have shared with their kids,
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You know, and having a meaningful conversation versus, you know, watching, say, a lot of television together. Absolutely right. Families that do take great pains to limit screen time and distraction time.
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to get into these conversations and discover things about the family history which were traumatic. You're quite right. This is a time of crisis, but it is a time when one can turn crisis into opportunity rather than danger and shutdown and the more families
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get into their history of previous epidemics, previous trials and tribulations, ups and downs, economically, socially, romantically, the more you hear histories
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about previous generations, the more resilience, the more options people have in growth. And maybe not so different in some ways, though they didn't have Zoom in 1918, did they? Yeah, I was actually just going to say how you think having Zoom and texting and social media, all of these things sort of allow us to stay not fully connected, but like somewhat connected
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to work, friends and families that are not together have been relying on it. But do you think that it changes the dynamics?
Role of Digital Platforms During Isolation
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And what do you think about people who are getting together online instead of?
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in person, do they lose something? All of the high tech togetherness is a boom. It's a strategy. It ameliorates the isolation and the sense of danger that people have. I think it's a wonderful thing to have.
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One that I've heard of for many people who were in London during the war is this is like the blitz. You run for cover, you don't know when it's coming, and you don't know when it's going to stop. And it takes people away suddenly like an assault. And many people, I included, have had shocking immediate losses. I have had a friend who
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was out for dinner one night and three or four days, three days later, he was on a ventilator. And two days after that, he was gone and people die alone. People die without connections, except with essential workers. It's a horrendous, inhumane thing. It is. To try to visit and come to visit somebody in need and have to say hello and goodbye and how are you doing on an iPad.
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That's a huge problem for people. And it's very sad. It's similar in a lot of ways to a lot of other traumatic disaster situations. And yet it's a chronic disaster that we don't understand that well. We're not very familiar with. And pandemics like this
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According to the data this big, they only come along every 50 or 100 years. Now, I'm kind of reminded of the Great Depression also. Again, it makes me think of my father who grew up during the Great Depression. One thing I do when I'm confronted with very difficult things is I tend to rely on humor quite a bit. So I did want to point out one thing about
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The Spanish flu pandemic in 1918 is that they didn't have to worry about a slow internet connection. So, envious. Correct, yes. Other worries supplant old worries. Every problem brings with it new problems in its solution. The overflow into economics is something that is very important to families.
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an existential, demoralizing condition that makes being short of funds even worse. It's a real danger. I mean, there's a real risk and we may be facing a sort of a secondary disaster wave of evictions, right? Exactly
Economic Challenges and Family Resilience
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right. There's not a lot of support from the government. Food, clothing and shelter. Well, one of the things that seems to have happened from the government based on
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What do you mean the overflow meaning?
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What did happen during the Great Depression, giving bank holidays, Keynesian economics opened the door to flexibility in the creation of money, in the creation of credit, and the securing of our financial institutions.
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and having learned from the Great Depression and the New Deal that followed it. We have some of the payroll protection plans. That's good, but I want to just break it down on a more micro level for people who might be listening and wondering how unemployment or
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the slow family business or whatever else, parents, you know, whose kids see them worrying and not working, kids who are fresh out of college and not able
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to find a job because there are none. Are there ways that either we can support each other or the family can support each other? A resilient family always is a buffer to the kinds of stresses that will follow on when the rules change so unpredictably and dramatically. Families are there.
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Families, as Robert Frost said, are the place where when you have to go there, they have to take you in. Families provide a kind of a backup. Families which are caring supply each other with food, clothing and shelter or do whatever they can to get it from a system which is struggling to supply food.
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and shelter. The community is exactly right. And that brings up what this means for patients with mental illness who are suffering more than people who do not have mental illness. One of the things Dr. Loeffler pointed out is that frequently patients with mental illness who are used to being
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in the community-serviced system, they have a feeling they're less overwhelmed than people who have never needed such services. There's a sense of not being as isolated. That's exactly what you understand now, yeah. What was that, Farrah? No, I was just saying that I think that's something
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Because now collectively we're just all feeling so anxious about this, so concerned about contagion and contact, it's touching on a lot of things that I think people have felt alone with for a good deal of time and that there's something very unusual about an anxious person who's suffered.
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and maybe been the only one in her family to have to manage these feelings and now has a lot of company with it. Yes, now the field is leveled out. Now you know what life has been like for me and there can be a role reversal. Patients who have chronic illnesses or OCD or anxiety or other kinds of major mental illnesses, they're used to being in the system.
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and they can guide and parent family members who are overwhelmed as if assaulted. In case listeners don't know, right, like Dr. White is your father, right? And my first thought was kind of like, okay, Dr. White, senior, do you think people are not as tough as we used to be? There's a feeling nowadays that people are sort of more vulnerable because things have been relatively good.
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I had another thought though, yeah, and I wanted to ask you about how to tap into the wisdom that people who have had issues hold, as you were saying, that someone who's struggled with an anxiety disorder for years has a lot to offer someone who is blindsided. One of the things family therapy focuses on as a primary entree
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into the psychological and emotional and even physical processes consists of communication. Families can sharpen and make more specific and make more loving their kinds of communication with each other. And hearing about the travails of people who have had a rougher time, the importance of
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good and healthy communications could not be, I couldn't emphasize anything more firmly. That doesn't come easy to everyone. I think there's another piece of it, which is that people who have struggled or have had challenges that they've needed to overcome are often just much more compassionate.
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you know, when someone else is suffering, it's almost like they can intuit what someone else's needs might be, what they wish someone would ask them. And, you know, I think that that those particular family members, I sort of disagree, Grant, that people are less resilient. I think people are dealing with much more at a much earlier age, like the latency period has just been shrinking.
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Really? Well, I don't mean to disagree, but I wasn't saying I believe that was true. No, no, no. I understand. I think it's a common perception. What is your definition of resilience, right? So some people are kind of tough and stoic, and they don't communicate, and they think that's the best way to go. And then other people, as you're saying, are perceptive and empathic, and they kind of know the right thing to say without needing to learn it, right?
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But in what ways do you think people are more resilient now than they used to be in, say, the great generation? I think there's a great evolution. The challenges are different. The resiliencies are different. Community resources are different from what they were in the past. I don't know if people are tougher. Families have travails. Every human being has stresses.
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Some people who are more more the CDC report said that pointed out that this COVID and the adaptations to the COVID are toughest on young adults and minorities and people who are essential workers.
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and especially unpaid caretakers. I think there's a great variability. The more people are able to talk to each other and get history and get in touch with what goes into good communications.
Improving Family Communication
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It's like marital therapy. It's important to build up in your interpersonal bank account, good feelings and good memories, even though we all have bad ones and tough ones.
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Now could be a time where we connect with family members, you know, give support get support, feel for each other and and help the sort of build up, you know that bank of good feelings. It's almost like a second chance.
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to be in the same house together and relate to people differently than we might have growing up. You could repair some developmental experiences. I've certainly heard of a number of families where the young adult children are at home and it gives them a chance to work through some issues and do things better, almost like a second chance. I've had a lot of families experience that. People who were thrown together
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But they eventually make a human system that adapts to whatever is coming from the outside, which is extremely stressful.
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It is a tsunami of things and strategies to deal with it that are social and physical and economic. Spiritual, existential. I sometimes think it's helpful for people to have very concrete feedback during times like this because one thing we understand about stress and chronic stress is even worse.
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is that it reduces cognitive capacity. And so I like to think about something like sometimes I'll call this communication hygiene, just simple guidelines for people to talk with each other. Do you have a couple of pearls of wisdom you would share about how families should actually conduct themselves? Should they bicker and interrupt each other a lot? Do you recommend that? And make a lot of ad hominem attacks or? It's interesting.
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Grant that you bring that up because just today, this morning, I was thinking about how growing up, you know, we have some practical jokers in the family. And your family. Yeah, we were not allowed to put each other down. So you would say no put downs. Is that one of the rules, one of the communication rules
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We like to tease. What's the difference between teasing and bullying? And can we have a good time with it? What's the difference between playful teasing and hostile teasing? Yeah. The effect on the listener, there are rules of good communication. There is a book called Your Family is Good for You, the title of which has been under some very reasonable
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question, a book that I wrote, but there is a chapter on communication. One of the things that Farah, you mentioned, is no put downs, sticking with the issues rather than being in a family courtroom attacking each other's characterology.
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or who somebody is or what their intent is, but sticking with the effect rather than the intent of communication to define whether it's useful or not. Don't say never and don't say always is a very good guideline and being able
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to listen as well as to get clear what one wants to say and what one wants to accomplish. There is another point about good communication that relates to people with serious mental illness and that is
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to limit expressed emotion and people who have a major psychiatric illness, if they live in a household where emotion is very limited and never overwhelming or powerful or hostile, they are hospitalized much less frequently and have relapses
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much less frequently than those who are much more measured and rational in their conversation. The idea of taking turns speaking and listening kind of mutual effect is what came to mind. And there are two things I tell my kids, which I think are awful, but you can tell me if I'm a terrible parent or not. One of them is it's not who starts the fight, it's who stops it.
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And the other thing I like to say is that it's only play if both people agree that it's play. Those are two wonderful guidelines. And I wanted to ask you a question. So, OK, there's an analyst named Beyond who talked about group process quite a lot. We won't go down that rabbit hole right now because it's very didactic. I love his work. And he says sort of like a group has two basic modes. One is the basic assumption mode where where the group is like off.
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the rails. They're not doing what they're supposed to be doing. They're not doing the work that they're there to do. If it's a therapy group, they're not doing therapy. They're fighting about how come Joe was late last week and it ruined the group. And then the other group is called the working group. And the working group is in a mode where they're focused on the task at hand. And they're of one mind about that. What would you say the primary tasks are for families during COVID, say? I would say they're the same as
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they are before, during, and after COVID, and that is to be there for emotional and physical support for each other, for maintenance. Families are there for us to go, for a recharge to go. When you have to go there, they have to take you in to get support, physical,
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and emotional support to get a sense of what is and should be the task at hand. Yeah, I think that, you know, in a family, everybody should have, let's say, an outlined, I don't know, role. For example, the kids go to school, the parents go to work, or one parent works, and one parent stays home. One of the kids is the couple's therapist, right?
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I think just that, you know, the family is only doing as well. It's sort of like a team is only as strong as its weakest player. The family is only doing as well as the person who's sort of the least functional. What can we do to make
00:24:09
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Zoom just doesn't do it for her or him. They're also afraid to go outside and meet up with friends in person or something of that nature. What's the kind of situation you're actually seeing now? Yeah, the things that I see are people becoming either overly engaged in like online life.
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every family function at its top overall level?
00:24:29
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uh for example you know want to play games non-stop because it's their only interaction or you know and they're otherwise very very isolated too isolated and so i do think that it's the role of other people in the family to say you've
Balancing Online and Offline Activities for Kids
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been sitting at your computer for the past 10 hours it's time to come sit down for a meal with us
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We restructure their daytime activities to give advice. Families are most crucial to people who are very, very young and just enter into this life and the elderly and they are sporadically
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are necessary for those in young adulthood or middle age who can come and go for reasons of physical caretaking. But there are times like in adolescence when kids will get involved maladaptively in things outside the family, drugs, hypersensitivity, dysfunction, they will need to
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navigate some kind of community, extra familial community input, but it is best if it incorporates the family and the family's history with various community resources. I think that it's especially important for parents to be aware that you're right, young children,
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are more in need of the family. But I do think that adolescents, especially with the freedom that they have from their computers, like they can go anywhere, they can see anything, they can talk to anyone. And they're just by nature, impulsive, a little bit labile. And so I think that we really need to sort of rein that in. What does labile mean?
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means that their mood really vacillates quite quickly. One minute they're happy and you're the best parent ever and the other minute they're, well, I guess this isn't just teenagers, but this really could be any child. And I think that the internet is just too vast and wide and dangerous and that
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It presents a unique challenge. The internet creates kinds of addictive urges that substances also provide. A quote unquote dopamine hit. A dopamine hit. And it's designed to be rewarding. Exactly right. People have to watch for themselves. We're all a family is like a vessel and we all have to watch each other for getting too close to the edge or
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for being swept overboard and influencers and alcohol is still the biggest of all of our problems with addiction, alcohol and food. The internet is designed to create the same dopamine pulse
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that to drag people back to it over and over and over, having a baseline expectation from other family members can serve to modulate that. Yeah, I saw some study we talked about where families that have healthy behavioral control, but not too much psychological control, the kids tend to grow up healthier in the presence of support.
00:27:58
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So you give the kids clear guidelines, but you don't get in their heads and be like, you know, you're wasting your time on your phone and you just say, well, you have half an hour to play and now we'll do something together. It's probably good for parents to do things together with their kids and encourage creativity as well.
00:28:15
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The other thing, which is a bit of a blessing, is that under the right circumstances, you know, what you were talking about, extra familial relationships or, you know, chums, friends. We have, for example, our kids in our local group, they all know that there's this one internet space they can go to and meet up with their friends. It's like a virtual playground. And just like playgrounds in New York, like you're not allowed to hang out there if you're a lone adult.
00:28:43
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And so the kids know they can go meet up there so it's safe from, you know, free from predatory interactions, and the friends who are vetted in the local group can all hang out. So I'm curious, it's like a chat room, but you know video. I'm trying not to say zoom because we're not receiving any royalties from zoom.
00:29:03
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Essentially, it's a Zoom room that the local parents have set up that their kids can go to anytime and they can message each other and kind of meet there. And like I said, it's a little bit like running to the neighborhood playground and it's a safe space. Yeah, but are people watching it and is there oversight, parental oversight there?
00:29:23
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Not too much and not too little, in other words. Not turning upon the age of the kids. No, I think it's a good point. I think that kind of venue is one that is a growth experience and kids learn teamwork and they learn who is what, whom can be counted on to be helpful versus hurtful, competitive.
00:29:52
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Everything I needed to learn, everything I ever needed to know, I learned in kindergarten. I think it was Robert Flogum's book. And there is truth to that. Depending upon the age and the venue, the seven-year-old kids can't do what 17-year-old kids can do. Different levels of autonomy and oversight. You don't want to be a helicopter parent either. Being overprotective probably isn't useful.
00:30:16
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No, but I do think that, you know, especially because we have these mobile devices that can be paid pretty easily, but that are very powerful. I sort of have a policy that I don't want screens.
00:30:29
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in rooms with closed doors. Do you have parental control software? I know that's something some parents use. It's a funny balance between sort of spying on your kids and making sure they're safe. I just have a sort of open door policy, which means I mean, I guess I can't look at Snapchat, but I can look at a lot of other things if I need to having no, no expectation.
00:30:54
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of privacy when it comes to internet stuff. I have absolutely respect boundaries, physical boundaries within the house. If they want to be in their rooms alone, that's one thing. But if they want to be alone in their rooms with a phone, it's just not okay with me. It depends on the age of the kid and what might come across. Telephone.
00:31:16
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Anything and everything comes across people's minds without any wiring whatsoever and that can't be legislated or helicopter. You can't. Not yet anywhere. You can make someone feel guilty about it or not.
00:31:31
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Or not. Yes. You can try to induce guilt or shame. Accountability. I don't know which is worse. We can have a long dialogue about that. It doesn't accomplish as much as rational decision making between a knowledgeable, authoritative person on one hand and the other.
00:31:56
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who is dealing with a particular impulse. Yes, the authoritative parenting is supposed to be the best, not authoritarian, not permissive, not neglectful, not indulgent, but authoritative. I can't help but wonder how old were you when you were allowed to get a phone, Dr. Farah White? I didn't have one till college.
00:32:15
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I wish I'd had a little more regulation in my own household growing up. I was allowed to do almost whatever I wanted, though one of the main things was that it was always important that I get good grades. That was one of the overarching rules of my household. I didn't have to study, but I did have to get reasonably good report cards.
00:32:37
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But now they say to value the effort rather than the product. I don't know how true that is. I mean, maybe the product is meeting kids where they are and having them do their best is important. But I think it's important to value the effort more than to impose a character, a logical value. You are so great. You are a bad kid. You are a wonderful kid. All of those things are a little bit hollow.
00:33:07
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And it's much better to value how long they worked on it, what they got out in particular that was surprising. The processing kid's schoolwork is as important as the
00:33:22
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as the final product, that is true. Some kids are more rebellious temperamentally, I think. Yes. And how do you deal with a kid who's more rebellious and kind of very talented and in some ways unruly, especially during a time when we're really stuck together? Too much closeness can lead to heightened impulsivity.
00:33:45
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It depends what goes into that unruliness. Kids need to exercise their bodies, their minds, their ideas about the past and the future.
00:33:57
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They need to have particular interests. And depending upon if a kid is inherently or conditionally unruly, you have to create spaces just like that space for get-togethers, where they all get together on a Zoom or something like it. One has to create some appropriate and useful release activities.
00:34:25
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for kids who are unwilling. You're hitting on something that is particularly difficult because very impulsive kids find this lockdown much more difficult than kids that can enjoy things or enjoy being together.
00:34:44
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Games are a good release and activity that is safe and knowable and can counteract what is the primary trauma of this lockdown, which is its unknowability. It's going to get assaulted and how long is these crazes going to last.
00:35:07
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Are there any games you recommend to families in particular that you like?
Family Bonding Through Games
00:35:11
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I had a whole bunch. I don't have them right in front of me. Well, I know you're a very big advocate for, well, parcheesi, chess. What I love is that there are some, so parcheesi and chess, you know, those are more like
00:35:25
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thinking, strategy, there are games that are more physical. Cranium is one of them, and they have games where the kids can really get up and move. They have video games. Even charades, right? Oh, yes. They're charades. That's a wonderful game. Risk, life, all of these games. But you're talking about how to get exercise, right? I see the kids doing PE over their Zoom school. Yes.
00:35:52
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You know, it requires a different skill set. You really have to have some flexibility. I mean, cognitively. Yeah, but I think grabbing things like that are safe to use indoors, hula hoops are great. All of that can only help. And I know now every time I come to your house, there's toys on the floor and floor time. So I think that's for me and your mother. Kids have to come to themselves.
00:36:21
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Play a lot of cards. Yeah. Cards are good also. One of the important things about this COVID that we shouldn't fail to mention is the importance, even though sometimes it's a bit constrained, the importance of having some kind of schedule and activities.
Creating Routines to Cope with Changes
00:36:41
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Routines. Routines, schedules that you stick to, even though it's in a different time and place. Predictability.
00:36:50
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It's hard to initiate it, but once done, physical, walking outside, activities inside, going to this spot in the house. And this can be in very small apartments or it can be in larger apartments, but this place is for that. This place is for that. Those routines and the fungibility of time and space
00:37:19
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which you have when everybody is in school.
00:37:22
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seven hours a day that does not exist now, but it's important to impose that to provide it provided, especially for kids who are younger than 1314. It gives them some predictability. Sorry, go ahead. Oh, I was just going to say, I mean, I know we're actually wrapping up now, but I do think I mean, even with this project now, Grant and I have a weekly meeting. It's a set time.
00:37:51
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Yes. Yeah. I am so, so grateful to you for joining us today. Thank you. And for everything. I heard a lot of things and a lot of things are buzzing in my brain too. All right. I've got both of you. All right. It's a wonderful idea. Everyone be well and take care of yourselves and one another. Exactly. Take care. Take care.
00:38:21
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One disclaimer, this podcast is for general informational purposes only and does not constitute the practice of psychiatry or any type of medicine. It's not a substitute for professional and individual treatment services and no doctor patient relationship is formed. If you feel that you may be in crisis, please don't delay in securing mental health treatment.