How Can We Challenge Perfectionism and Cultivate Resilience in Teens

This is my part two conversation with Dr. Amy Young.

Ever felt the relentless pressure of perfectionism? Or perhaps witnessed a teenager grappling with it? Well, you're not alone. Today, we're unmasking the enigma that is perfectionism with our insightful guest, Dr. Amy Young. We dissect how it stealthily permeates different arenas of a teenager's life, morphing into late-night cramming sessions or even procrastination. Dr. Young, with her expertise, helps us decode the telltale signs, and distinguish between a pursuit of excellence versus a dangerous inclination towards perfection.

Dr. Young also helps us navigate the less-charted territories of teen compulsions and body-focused repetitive behaviors. We shed light on the physical and mental compulsions that teenagers may manifest, and the potentially addictive cycle of hair-pulling and skin-picking. You'll get to understand the biological precursors to these conditions and Amy will introduce you to effective strategies to reduce these behaviors.

The conversation then veers towards differentiating these behaviors from self-harm and we illuminate the importance of education in this realm. Hear how open, non-judgmental conversations can empower teens to advocate for themselves. As we approach the end of our dialogue, we emphasize the cruciality of repairing relationships post-mistakes. So, tune in, as we challenge the concept of perfection, and instead, embrace the invaluable lessons that come from embracing our imperfections.

Bio:
Dr. Amy Young is the Founder and Director of the CBT Center for Anxiety & OCD and has been working in the behavioral health field since 1995. She completed her Postdoctoral Fellowship training under nationally recognized OCD expert, Dr. Jonathan Grayson, and anxiety expert, Dr. Linda Welsh. She holds Doctoral and Masters degrees from Philadelphia College of Osteopathic Medicine, a Clinical Psychology program specializing in Cognitive Behavioral Therapy.

 Dr. Young treats all types of anxiety, OCD and Obsessive-Compulsive related conditions in children, teens and adults. Dr. Young utilizes a variety of CBT interventions, including Exposure and Response Prevention, among other evidence-based treatment.

Transcript

Speaker 1: 0:01

Hi, amy, thank you so much for joining me again in this part two of our compulsive obsessive disorders. We talked in episode one a lot about mental compulsions. We talked quite a bit about OCD related kind of issues and struggles that teens come up with. In this episode I really would love to focus on compulsive obsessive related conditions that we had talked about briefly offline. So if we could start with kind of what is perfectionism? Because in my mind a lot of perfectionism comes from anxiety, perhaps If you could kind of talk to that and maybe I can have some follow up questions, then Great.

Speaker 2: 1:05

I'd be happy to.

Speaker 2: 1:06

Yeah, so you know, a lot of times when we're seeing individuals with perfectionism in our practice, it's because some of the kinds of thinking that they're having, associated feelings and actions, are causing a lot of difficulty in their life. It's causing a lot of disruption. Oftentimes, when we think of perfectionism, we think of things that are very valued, you know, striving, getting things done, achieving, succeeding. However, there can be this other piece to perfectionism, in that sometimes it's pursuit of the illusion of something perfect, to the exclusion of being able to get something done, or letting it be good enough to the exclusion of our well-being, to the exclusion of our relationship with other people. And so oftentimes, what we're trying to do is differentiate between things like striving for excellence versus striving for perfectionism, or letting good be good enough, and making decisions about how we want to show up in this world based on our values, versus the achievement of something that's more maybe ego driven or built on a habit and getting in the way of relationships and maybe even getting in the way of getting things done.

Speaker 1: 2:42

And that's such an important point, right, because a lot of times, we all in some ways try to focus on having this, quote unquote perfect relationship. Now, what that means to each one of us is perhaps different, right, when it comes to teens and their relationships, what shows up in terms of perfectionism and I do definitely understand achieving excellence what does that mean when it comes to relationships, especially amongst teens?

Speaker 2: 3:25

Yeah.

Speaker 2: 3:26

So there's lots of ways that it can show up.

Speaker 2: 3:28

With teens, we say, perfectionism can be somewhat trans diagnostic in that it is a tendency that can occur with OCD, it could occur with health anxiety, it could occur with sports performance, academic performance, relationships.

Speaker 2: 3:50

So lots of different ways that it can show up and oftentimes what we're trying to help our teenagers that we work with and their parents differentiate is this idea of good enough, of not losing sight of the ultimate goal, what it is that we're trying to achieve, being aware of some of the tendencies of perfectionism, one of the most insidious ones being this idea that my worth is contingent upon some performance, how many people like me, what I look like, what my grades are, how I did well in some kind of athletic competition. That my worth is contingent upon that and it can have a very compulsive feel to it, because with perfectionism oftentimes we keep moving the finishing line. So we achieve something and then sometimes we'll externalize it and personify it. We'll call it Mr Perfect. We'll say now I want more, now I want you to achieve a little bit more. And so we really want to shed some light on those tendencies, build some insight, some motivation around that, and then we take action.

Speaker 1: 5:05

That's so interesting again right like moving the finishing finish line. When it comes to teens, I'm wondering if kind of is it so? In my mind it's kind of related to self and the other, so, for example, looking for that perfect partner and then looking for yourself as being perfect in the relationship. Are there any signs in terms of mental compulsions perhaps, or obsessive behaviors that you see in teens when it comes to that?

Speaker 2: 5:45

Definitely so. What you'll see is what oftentimes can feel, on one hand, like an excessive amount of time, energy and emotion spent on a pursuit or an activity, again to the point where maybe the initial goal and the activity is lost. So, for example, teens that are staying up really late at night to finish their homework or to study for a test, taking copious notes, maybe reading a chapter, rereading it again, rereading the page, getting to turn assignments in late because they don't feel like they're good enough or they're done. You can also see the other side of it, too, which sometimes is lesser known as a sign, and that might be even procrastination of starting things or finishing things. You can see this with, maybe, the way a teenager keeps their room. You know it might be a mess, and sometimes teens and parents are really surprised that that could be a sign of perfectionism.

Speaker 2: 6:52

So what happens on this other side? This other sign that we can see, is an avoidance or an under responding, waiting for the perfect time to feel ready to study, waiting for the perfect mindset, waiting for the perfect amount of time to clean one's room or to get it just right, and because that perfect time never comes, the person keeps putting it off and putting it off and generally may only do it until there's some kind of consequence. Maybe there's a deadline where they're getting in trouble because their room is a mess. So you can see a typical over responding, overdoing things, staying up late, spending excessive time, even on the way they present themselves, you know, with clothing, trying to get it just right, changing outfits, maybe missing the bus, maybe even, you know, choosing not to spend time with friends in a way that other teens might, because they want to stay at home and do their homework. But you could also see the other side, the avoidance and the under responding as well, procrastination. Those can be signs.

Speaker 1: 7:58

And I had really not thought about procrastination as part of sort of the perfectionist mindset. So thank you for kind of talking to that, because we really don't think of procrastination as perfectionism. We really think of it as okay, that's part of teens being quote unquote lazy right. You mentioned something earlier about health anxiety. Could you talk a little bit about what that looks like when it comes to perfectionism?

Speaker 2: 8:34

Sure, yeah. So it could just be perfectionism about our health and it can manifest in a whole host of ways. Just right, sensations worrying about our health. Do we have cancer? Is there something wrong with my body and the way that it looks, the way that it functions? We could have a hypersensitivity to sounds, so there could be perfectionism in things like mysophonia or tinnitus, where we have sensations that we're experiencing, maybe distress around sounds, and we can get quite perfectionistic about it, wanting the sound to come through clearly or wanting to avoid sounds that are uncomfortable. Really, anything that's about the health, maybe the way that our body or even our cognitive functioning is being experienced. Am I thinking clearly? Am I forgetting things that we could have perfectionism about that, wanting to get it just right or wanting to know that it's going to be okay?

Speaker 1: 9:48

And so there is a constant worrying around that Is that what?

Speaker 2: 9:53

There's a constant yeah, so we can again kind of going back to part one. We had talked about different kinds of compulsions. We have both physical compulsions, overt things that we can see. So body scans, checking, maybe googling things. You know, scanning one's body, how does it feel touching certain areas? Does it feel like my appendix is okay? Is my appendix gonna burst? You know, my eyes feel a little weird. There's like sort of a blurriness. Is everything okay? Kind of checking those things out, asking to go to the doctors. And then we can also have more covert compulsions, mental compulsions, rethinking things, scanning things. Even if a teen were to go see a doctor about something health related like I worry that my appendix may burst, and they saw the doctor and the doctor said everything is fine, they may mentally review that. Did the doctor seem qualified? Did they seem like they knew what they were talking about? Did they really understand the extent of my concerns? Did they hear all the symptoms? So mentally reviewing that can also be a compulsion.

Speaker 1: 11:06

Wow. So there's a lot of what sort of a lot of energy goes into understanding, sort of yourself in that sense, how my body kind of is functioning, but also questioning if other people around us are able to assess that Correct. Yeah, wow, shifting gears a little bit here with kind of. The other piece to obsessive, compulsive, related conditions is body focused repetitive behaviors. What are some of the repetitive behaviors that you see in your practice?

Speaker 2: 11:53

Yeah. So there's a variety of what we call BFRBs or body repetitive behaviors, body focused repetitive behaviors, some really common ones that we see in teens. One is hair pulling or trick or telemania. Another is skin picking or exhortation. Sometimes we can work with teens who engage in nail biting. Generally it would be to the point where it might be causing some physical discomfort again, really causing distress and getting in the way of their life cuticle biting. Sometimes we'll even work with younger children with thumb sucking. So it's really any behavior that is body focused and repetitive in nature. The two most common that we tend to work with are hair pulling and skin picking.

Speaker 1: 12:46

Can you explain a little bit more in terms of what each of these conditions look like and whether there are signs earlier on in the developmental stages that parents can kind of see or tap into Sure?

Speaker 2: 13:07

Yeah, so you know the most common signs that we'll see and then I'll work backwards. The most common signs that you would see would be a teenager, a child, who is engaging and repetitively pulling their hair out from different spots. It could be near the forehead, near the ears, you know the nape of the neck, the crown of the head, generally focusing in on a certain area. You may see that they do it during times of stress or agitation. You can see it during times of boredom, you know when there's downtime, they may do it consciously that they're aware of it, and sometimes unconsciously. Studying for homework, you know and writing with their right hand and you know pulling with their. You know their left, for example. It can be on the head, it can be eyebrows, it can be eye lashes, it could be in the groin area, which might be a harder sign for parents to pick up on because it's private, but it could be any area on our body that we have hair, the most common being eyebrows, eyelashes and the head in our head of hair. Same goes for skin picking. You may see, you know, marks on your teen or child's face that they've been picking. You may see increases in that during adolescence, when there's acne can be really common. Sometimes we'll see it with younger kids with, you know, scabs. Maybe they've skinned a knee or they had a bug bite an itchy bug bite and just repeatedly picking at the scab to the point where it really has difficulty healing In terms of precursors that you might see. You know children who maybe get frustrated a little bit more easily or have a harder time coping with stress on their own. Sometimes precursor can be a person who has a little bit of a just right. They can also have some perfectionism, wanting to get things just right. It does run in families. You know. It's not necessarily something that families talk a lot about, but it can run in families. So it is somewhat neurologically and biologically based, essentially having an urge to pick or pull, and then when the teenager does pick or pull, it satiates that urge. It feels good to pick or pull, it feels as if you're kind of getting something, and so there's a very reinforcing cycle going on there where they're more likely to do that, and so when we're engaging in treatment, we're targeting what are the emotions that may, you know, start that off. What are the areas from their body that they're picking or pulling? So we're going to target those areas. We'll talk about some stress management. We will talk about habit reversal, training.

Speaker 2: 16:14

So what else can we do with our hands? What can we do with our skin? Are there areas, ways that we could use what we call blockers, so blockers for our hair, blockers for our skin? It might be things like Vaseline on our eyelashes or eyebrows, hats, bandanas, tape and band-aids on our fingertips that we use to pull from and having access to fidgets, things that we can do that give the body some of that sensory information, some of that sensory input, and we want to have access to those fidgets in all the places that we may pick or pool. There are other strategies, like dimming lights.

Speaker 2: 16:54

If we do a lot of picking in the bathroom, we might just have a nightlight on. We might not turn the lights on when we go in. We might make it a race when we go into the bathroom. We might even cover up mirrors, and we may. If there are certain activities that lead to more picking or pooling, we may encourage the teenager to do those things around other people to help with some accountability. So, for example, if there's a lot of pooling, that happens when they're doing their homework alone in their room and they're not aware of it. We might ask them to do that maybe downstairs at the kitchen table, because they might be less likely to do that. We'll also use some stimuli like jingle bracelets. So if there's some unconscious pooling or picking, that goes on, because then that helps to wake the body up a little bit.

Speaker 1: 17:47

Okay, okay, so there are so many different kinds of treatments for different kinds of behaviors. Could you talk a little bit to sort of some of the factors that maybe? Perhaps you mentioned genetic, biological factors. Someone in the family probably has had it, has it, and these are difficult conversations to have. So I guess my question is a little bit multi layered Is there a stigma to sort of pooling, picking, and what are some of the conversations that may happen to be able to get help?

Speaker 2: 18:39

Absolutely so. There definitely can be stigma associated with it and because of that there can be a lot of movement towards self advocacy. Self compassion is another adjunct treatment that can be very helpful. You may find somebody who's had ongoing long term difficulty with hair pulling, for example, that really decides that they just want to keep their hair shorter Because it gives them a sense of control, you know, with it, and there is a big advocacy movement on I believe it's wwwbfrborg. There's a big advocacy movement to help with some of the shame and stigma associated around that. They have some wonderful videos on there. They have a YouTube channel that contains a lot of self advocacy and self compassion as part of the treatment due to the stigma and the shame.

Speaker 2: 19:48

I'd also want to take this opportunity to clarify that BFRBs are not the same as self harm. Sometimes parents might think that they are. Is this self injurious and self injurious behavior or self harm? And it's not. They have very different roots. Although stress may contribute to both, there's a very strong genetic component with a BFRB and it's it's generally not by and large, the teenagers interest to hurt themselves. In fact, they would like to not engage in the BFRB, but really struggle in knowing how to do that.

Speaker 1: 20:26

I believe you asked another question about precursors and yes, and I actually sort of now have multiple questions, but but thank you for kind of explaining that and I think one of the important sort of points that you brought up was the difference between self harm and BFRBs. And for parents who don't sort of understand the difference, could you elaborate a little bit on that, because to a to a person who is not aware that there is a difference, they might, it might, seem similar, because I have had, you know, parents talk about their kids, teens who are picking, using, you know, different sort of, sometimes instruments, things like that, and that definitely seems like self harm.

Speaker 2: 21:29

Yeah, so it can. Yeah, so with a BFRB, if a teenager were to get pretty into it, there could be some behaviors that they're engaging in that certainly are harmful. You know, particularly when it comes to skin picking, if they're using instruments, tweezers and other kinds of things to try to get a blemish out, they certainly could inflict harm. It's just that the motive of the behavior is very different. So the motive, say, for skin picking, for example, you know, would be to get rid of the blemish or the imperfection, what feels like it shouldn't be there, removing that from their body, whereas with self it injurious behavior or something that intentionally is meant to create, to create some self harm. The motive of that is very different and even that can be sort of multimodal, you know, in its function.

Speaker 2: 22:30

It could be to punish oneself, it could be to purposely create physical harm.

Speaker 2: 22:36

It could be as a way to regulate affect, to feel a physical sensation in exchange for a very confusing emotional sensation, to make it very poignant and just draw one's attention to that area, to help with focus.

Speaker 2: 22:54

Even so, it's important to understand the motive, because the outcome may look similar but really, you know, the motive behind it is really important to understand, there are other things that can help in terms of differentiation. Generally speaking, if there is some harm that's done to the body that involves hair or skin, particularly on the face or other areas where there may be blemishes, like the chest or the back, or like a scab on the leg from a bug bite, those would be much more indicative of a BFRB, whereas if someone is using some kind of implementation scissors or a knife, something to scratch themselves with or harm themselves or cut themselves, generally that may occur on the arms or the legs, the belly, maybe more private areas. So, while it's not 100% true each time, generally speaking, skin picking has a lot more to do with, like the chest and the face, whereas self-injurious behaviors would tend to involve other parts of the body.

Speaker 1: 24:09

Yeah, and as I'm thinking about the difference as well, and is a lot of time self harm I don't know whether it's consciously or unconsciously, but sort of a hidden thing, right, like there is a lot more, I would say, shame and stigma attached to that, because it sort of comes across as you have a choice and to your point of intention right, the intention is different. The intention is kind of. Therefore, there is a choice in many ways, it would seem, and with BFRBs, as you mentioned, with sort of the genetic component, biologically sort of it, again it seems more out of control, even the urge, and so it has a different sort of connotation. Is that? I know I'm putting it?

Speaker 2: 25:14

quite simplistically. But no, no, it's true, and I think it's an interesting point of discussion. You know, with both of them we do have a choice and there is an urge, you know that really occurs with both. I think I would just say that a lot of the differentiating criteria would have to do with the motive and I do think that in general, you know and I'm thinking about cases right now trying to sort of make a decision about this I would say in general that when it comes to self injurious behaviors, there probably is more shame associated with that, there's more stigma, you know, associated with that.

Speaker 2: 26:04

The other interesting thing is that oftentimes with BFRBs, the person is inclined to pick or pull areas that can't be hidden. So it's interesting because when we talk about shame, we will say secrecy promotes shame, so shame cannot exist in the light. So, in general, anything that we are able to cover up or hide, whether it's our emotions or our thoughts or something physical, the decision, the action to keep something hidden will actually encourage and strengthen the shame around that. So in some ways, some BFRBs can't be hidden, you know, if you bite your nails or your cuticles or pick your pick at your face or your hair, although I've had many, many clients make attempts, certainly, to camouflage that with makeup or styling their hair in a certain way.

Speaker 2: 26:57

So there are attempts, but in some ways one could argue that the ability to completely hide what has happened as a result of that urge is just not as possible as the ability to hide what's happened as a result of a self-injurious urge. You could wear long sleeves or pants or cover your belly up. So yeah, I think it's. I think it's, you know, I think it's an interesting question and potentially somewhat debatable. If you have clients who represent self-injury and those who represent BFRB, I think both would say that there's a lot of stigma and shame with both.

Speaker 1: 27:34

And again, not to sort of have any kind of comparison right In terms of shame and stigma, because you're right, like shame is shame, stigma is stigma and it's really personal and individual and how we take that. So I totally understand that sort of point of view. I think I was kind of also wondering more in terms of choice, whether you know it is a. So here's what I'm thinking and I'll just say it like a lot of self-harm also comes from a lot of perhaps trauma and you know, some sort of pain. I would assume that then sort of gets translated into a self-harm behavior. And I'm also wondering whether BFRBs have that sort of basis right, and if it's genetic, if it's biological, then it's also to a degree in my mind, is kind of very much rooted in sort of I don't have that much of a choice, I mean in terms of treatment, I understand. So I think that's where my kind of question was coming from and I know there's a lot of research and a lot of debate around all of this.

Speaker 2: 29:02

Yeah. So and I can only speak, you know, from my experience, a lot of times the clients that you know that will see the teenagers that we'll see, because we tend to work with a very anxious population with a lot of perfectionism and wanting to get things right. You know, for some of the clients that we work with who have self-injurious behaviors, there may not have been any trauma that happened for them. It's really the trauma in some ways, if you will or not, trauma, at least how we typically think of it. The trauma, you know, in some ways, is more their experience of their own mind and their own expectations. So expecting themselves to get perfect, you know, a straight A is expecting themselves to have a perfect appearance, or expecting themselves to be the perfect child or the perfect friend. And then when we can't achieve that goal, because it's not possible and again because with perfectionism we're moving the finishing line, then there is this internalization of that, so an internalized punishing of oneself that could, you know, could present as cutting or burning or slapping oneself or banging one's head because they feel like they haven't met the expectation. So certainly some people with self-injurious behaviors have certainly absolutely experienced typical trauma, and some of the clients that we may see may not have experienced it. It's more their you know, their own personal experience.

Speaker 2: 30:39

What's interesting about BFRB is in shame is, despite the fact that it can be very biologically based, it's not often something, as you see, with a lot of mental health. It's not something that's often talked about in families, and so it's only through a process of discovery and years that they may come to learn that maybe their mom had, you know, difficulties with the BFRB, or you know that their grandmother did, you know, was a person who engaged in skit picking. And it's not, you know, it's not a clear one-to-one genetic you know process. So I think, I think because I still think, because there's a lot of misinformation and lack of understanding about mental health in general that there's a lot of self-blame for many of the clients that I work with, and it's tricky because, you know, safer teens there may be an expectation that their parents have of them will just stop it, just don't do it, and if it were only that easy, they of course would do that.

Speaker 2: 31:48

So then that really adds to a lot of shame around it, and then it can become this vicious cycle where the more pressure that they feel to just stop it and it's really a coping mechanism, right in some ways, to deal with stress.

Speaker 2: 32:02

To deal with stress, but the more that they feel pressure to stop it and they don't know how, then the more stress that they feel and then the more that they may engage in the behavior because it's a, in a way, it's a coping mechanism for the stress that has a biological underpinning, a predisposition, so it becomes kind of this vicious cycle.

Speaker 2: 32:21

So part of the strategy as a psychologist is also educating people teens and their parents on the extent to which we will have control over it and also shaping that behavior. So keeping the expectations reasonable and working toward you know an end goal and also educating them that oftentimes with BFRBs you know what might be really important is having a big motivator. So like a prom coming up and we want our hair or our skin to look a certain way. Or if someone's just started medical school and they really want to present a certain way, you know as a med student they don't want to have their skin picked or I don't know, somebody has a big dance coming up or they're starting high school. Sometimes those life events can be very instrumental in helping with the motivation to get more control over it.

Speaker 1: 33:19

Yeah, thank you so much for clarifying that and I do understand it's so complicated and we don't know everything about a lot of these mental health issues. But to have that kind of clarification and distinction between two different sort of, you know, struggles that teens go through can be helpful for parents to understand how they can approach their children. So, in your practice, how do you educate parents in terms of understanding okay, this is a BFRB, and how can they talk to their teenagers about that without feeling that they're inflicting more judgment or shame or stigma around that?

Speaker 2: 34:13

Sure. So as a cognitive behavioral therapist, what we call psycho education is a really important part of the cognitive behavioral model. There's no tricks up the psychologist's sleeve. You know. We want our teens and our parents to know everything that we know about it. It's a very transparent kind of therapy. So when we're providing information about BFRBs I would direct them to you know bfrborg? I would have them look at videos for homework.

Speaker 2: 34:46

I would explain some of the genetic roots of it. I would say it's nobody's fault. You know, sometimes parents will want to know did we do something wrong? You know, was there some kind of trauma that they experienced and sharing with them that? It's very genetic. It's habit begets habit. It's a, you know, a coping mechanism for stress and boredom and oftentimes for a lot of individuals with BFRBs again, a sensation that might be painful for another person actually feels, if not pleasurable, at least relieve stress. So when they pull a hair it feels stress relieving to do that, versus for someone else it might be painful and that might inhibit them from doing it again. So the way the brain is registering that sensory information is different.

Speaker 2: 35:39

We will utilize a very collaborative approach, asking the teenager how do you want your parents to be involved in this. Do you want them to offer you a fidget, do you not, you know? Do you want them to offer you some gloves or band-aids or tape to use as blockers, or a hat, or a bandana, or a little, you know, jar of aceline? Do you want their assistance with that or do you want to do this on your own? How can we help, how can we communicate and really encouraging parents to approach it non-judgmentally, understanding that while there is an element of control that the teenager will have, that it's difficult and that it's going to take time to extinguish that behavior. So we're oftentimes, when treating a BFRB, be working from a very systems-oriented place, spending some time with the teenager, working on strategies, understanding you know what might be their triggers, their situations, and then being able to relay that to the parents so that we're you know, all of us are working together as a team.

Speaker 1: 36:48

Yeah, yeah, that's. I mean. Psychoeducation for parents is such an important thing, especially when it comes to mental health. We struggle, we struggle to understand our own mental health. We struggle to understand our teens, especially teenagers, because there's so much going on. How can teens advocate for themselves when it comes to perfectionism or BFRBs? Since it's so, you know, sometimes it's misunderstood, sometimes it's stigmatized.

Speaker 2: 37:30

Yeah, I think to you know so many answers, I'm like where to start. I you know it's interesting because you know, having been in the field almost 30 years, you're finding, I think, in general although it has a long way to go I'm seeing teens be able to advocate for themselves more than they had been. I think we are prioritizing mental health in school systems. Teens are much more aware of mental health being a thing. They will talk with their friends about their mental health. They'll talk about going to therapy very openly and what's worked for them. They will sometimes recommend their therapist, you know, to one of their friends because they're able to talk more openly. So I think there's a conversation that's more open about it than it had been.

Speaker 2: 38:23

I also think teens have access to all kinds of information on the internet and through social media. So sometimes, you know, I'm finding that teens are aware that there may be a mental health component going on a BFRB or perfectionism or something else, even before their parents are, because something pops up in their you know, their TikTok feed, but, I think, sharing it with their parents in whatever way that they can. So, whether it's a conversation that occurs at the dinner table or, you know in a private car ride, or whether it's for teens to send their parents an article or a TikTok link you know that they saw or whether it is writing their parents a note or sending them a text, you know, in whatever way they can communicate, you know what's going on. You know, if a text to their parents that I think I'm, you know, struggling with a BFRB or I think I'm having difficulty with skin picking, is a way, a low key way, to communicate that and that's a lot easier than a face-to-face conversation, you know, then that's great.

Speaker 2: 39:39

And same goes for parents, you know, to just begin to have conversations. Don't be afraid to ask. I do think kids are more and more primed to have open conversations about these things than they ever have been. I think there are huge advocacy movements going on everywhere and in particular, I would say additionally, in response to the pandemic and increasing mental health needs, but in whatever way possible and for teens to not give up on their parents. Sometimes very well-intentioned parents may brush off some of those things and you know, you know say I think it's nothing like, let's see how this goes. You know, I don't really think it's a problem. I would encourage teens, and two with parents, vice versa, to continue to have those conversations. You know, just to bring them up until whatever party feels heard.

Speaker 1: 40:40

Yeah, that is such an important message Because, as parents, we feel inadequate a lot of times right to do and we want to do the right thing, we want to be there for our children, we want to be supportive, we want to be available, and yet at times we make mistakes, right. So I love that advice, I love that you know give your parents a chance, give your teens a chance and keep having those conversations.

Speaker 2: 41:13

Thank you, if I could also, can I just add one little quick point yes absolutely, you know, just a global strategy, as if there has been a rupture, you know, in a relationship we haven't on either side, you know, shown up as our best self, one of the most important things that we can do is just to repair, you know. So we always have that opportunity, you know, in any relationship, truly to circle back around and to readdress something, to apologize, to come back to it. It's a beautiful intervention and some experts would even argue that it's better to have made some mistakes in our relationship and not shown up as our best self on either side and then to repair it. Then it would be to have never had any mistakes in the relationship at all. It's really important. You know, we're human, we're going to mess up sometimes. It's okay On either end. We just have to show up good enough and then to be able to come back and repair is just. It's such an important and beautiful intervention.

Speaker 1: 42:22

Yeah, and going back to where we started with perfectionism, right, like we cannot be perfect parents and we cannot expect our children to be perfect. So, yes, absolutely, you know, trying to do the best that we can. Thank you so much, amy, for talking to me again on this important topic and really clarifying some of the things that you know, as parents, we struggle with, and so thank you again and I hope we can talk again soon.

Speaker 2: 42:57

My pleasure. Thank you so much for having me.