Ep 21: The Perfect Storm: Parenting through Puberty & Perimenopause with Kianna Carter, LICSW

When moms and teens face life’s big transitions together, emotions can run high—and communication often breaks down. Puberty and menopause create overlapping waves of change that can leave both feeling overwhelmed, misunderstood, or isolated. Without the right tools, these challenges risk driving a wedge between mothers and their kids, creating resentment, burnout, and emotional distance.

But what if there was a way to navigate these turbulent times with compassion, clarity, and connection?

In this episode, I’m joined by Kianna Carter, LICSW, a community mental health expert who works closely with adolescents and women across generations. Kianna dives into how setting loving boundaries, practicing self-compassion, and using intentional check-ins can prevent emotional burnout and build stronger family bonds—especially when life feels like a “perfect storm” of change.

Resources & How to Connect with Kianna Carter, LICSW

Mindful Therapy Group

Kids Mental Health Pierce County 

Kids Mental Health Washington

Psychology Today

Connect with me:

TikTok

Instagram

Eastside Menopause & Metabolism

Audio Stamps

00:40 – Kianna’s journey from community mental health to supporting both adolescents and women across generations.

03:10 – Menopause and puberty: a clash of identities and emotions.

04:45 – How ‘do it all’ culture fuels shame in menopause.

06:27 – Perimenopause triggers past trauma; self-compassion aids healing.

08:57 – Spotting nervous system overwhelm and using somatic tools.

16:43 – Setting firm, loving boundaries with teens.

19:33 – Modeling emotional regulation as a parent.

23:08 – Teen red flags signaling need for support.

26:35 – Talking to kids about struggles without burdening them.

29:23 – Boundary tools to prevent burnout for moms and teens.

33:10 – Self-compassion helps moms model kindness and reduce shame.

Thanks for listening. Find more info about Reset Recharge on the website or Instagram.

Transcript

Dr. Komal Patil-Sisodia 0:01

Welcome to the Reset Recharge podcast with your host, Dr. Komal Batia, a board certified endocrinologist, internist, and obesity medicine specialist. This podcast is focused on empowering women's health and aims to help you reset your understanding of your metabolic health. And recharge the conversations you are having with your healthcare providers. While I am a physician, this podcast is purely for educational purposes. No individualized medical advice is being given on this podcast. If you do find information that is helpful, please discuss it with your healthcare provider at your next visit. Hi everyone. Welcome back to Reset Recharge. I'm excited to introduce our special guest for today, Kiana Carter, who is a licensed, independent clinical social worker with over a decade's worth of experience in behavioral health. She specializes in adolescent and young adult mental health and is currently the Youth Engagement Services program clinical manager. That is a mouthful. At Mary Bridge Children's Hospital in Tacoma, Washington. She also has a private practice therapist and I've known Kiana for a few years now on a personal level as well as professional. And I'm really excited to have her here today to talk about how we navigate. Menopause while our kids are going through puberty, and this is a time where hormones are all over the place. They're colliding with each other within ourselves. And it can be really hard when you are a woman who's going through perimenopause and menopause and then also trying to parent a child who is going through similar changes, but you really don't necessarily have. An even playing field or even an understanding of what the other person is going through. So Kiana is here to help us demystify that. So thank you for joining us.

Kianna Carter 1:50

Yeah, thank you so much for having me. I'm excited to be here. And I think that this is a really important topic to dive into.

Dr. Komal Patil-Sisodia 1:58

Yeah. How can you share a little bit about your clinical background and what led you to focus on both adolescent and women's mental health?

Kianna Carter 2:05

Yeah, so most of my clinical background up until I went into medical social work was rooted in community mental health. And so a little bit of like context for people who are not familiar with community mental health, you don't necessarily have the opportunity to, tailor what types of clients you're getting. It just is who, whoever walks into the clinic. So I really had an opportunity to diversify who I was seeing when I was working at that clinic. And for me, young women and adolescents were the clients that stuck out and like really resonated and aligned with my clinical focus. So I had the opportunity to be able to work with young women. Adolescents. And then that was what led my transition over to Mary Bridge Children's Hospital to continue working with adolescents in the ER experiencing behavioral health crisis.

Dr. Komal Patil-Sisodia 2:52

And that's like the most extreme example of what you see. And so you have this nice. Spectrum of care that you're providing. You see people who are in crisis, but then you're also doing the day-to-day health maintenance. And the nice thing is we see that you're working across generations here. So what kinds of emotional or relational patterns are you seeing when mothers are in perimenopause and their kids are entering puberty?

Kianna Carter 3:18

Yeah, I mean, it really is a perfect storm, right? Yep. In the worst way possible. We notice a lot of overlap. Like both individuals are having increased mood swings, like increased irritability, heightened sensitivity. They're shifting like sense of identity. We have moms who are transitioning into another period in their life, and we also have our adolescents who. They're being flooded with hormones and they're, it's developmentally appropriate, right? They're trying to figure out who they are in the context of the world, and they want autonomy and they're pulling away from their caregivers, and that in turn is hurting caregivers feelings sometimes. So it really is this unfortunate, perfect storm that needs a lot of compassion and I think demystifying around how to navigate it in a way that. Keeps the sanity intact within households. So it's quite, it's quite a storm to watch. Yeah.

Dr. Komal Patil-Sisodia 4:11

Well we are very lucky we have people like you doing that work. You know that I have a 13-year-old son who is just about, into the puberty and I am in that perimenopausal age range. So this is a great importance to me to hear this topic out. I'm sure there's a lot of other moms and parents out there who are trying to navigate the same thing,. I loved that you pointed out that, each life stage is different and somebody is growing into their next life stage, no matter what age they're at. So we have that, that's happening physiologically. And there's a mental emotional impact of that. How do cultural expectations influence how women experience this dual? Role of caregiver and then self navigator through these hormonal shifts. Right. Because we haven't talked about perimenopause and menopause and the impact on women. This seems like a tough crossroads for people to be able to navigate.

Kianna Carter 5:02

No, absolutely. I think that that's a great point. It's challenging, right? When we think about the dual roles that mothers carry and there are some cultural considerations to take in. To account, I think a huge piece is feeling like we have to do it all and then that like residual shame comes forward when it feels more challenging. Yeah. And so demystifying and really challenging that stigma and shame around that is huge, right? Like we name it. Yeah. And we're able to move forward because it's normal. Like we have to normalize this in order for things to shift because we can't always do it all. And it. It shouldn't be that expectation, but I think culturally we're bumping up against that, that regardless of what you're going through, you have to still be it all. And that is just not sustainable. And that's where we see like the storm come through, right? Where it's like we're seeing an erosion and people's just. Basic wellness and ability to navigate

Dr. Komal Patil-Sisodia 5:58

Yeah.

Kianna Carter 5:59

Is a very normal part of the lifespan. It makes it more challenging, right? It doesn't have to be hard. So I think the work of de-stigmatizing this and normalizing it is a really huge step in helping moms transition a little bit more seamlessly.

Dr. Komal Patil-Sisodia 6:14

That's great. And yeah, it's I think more women are finding community in that as well. Yes. Yeah, absolutely. We're trying to talk about our experiences, whereas before it was like very siloed. It was a very siloed experience. So you've described your work as trauma informed when women are going through perimenopause, how might past trauma be reactivated for them, especially when they're parenting teens? Because I look at my. Son and I see what he's going through and it brings back things that maybe I went through at the same time, and obviously we're different gender identities and what females, cisgendered females go through is different than what cisgendered males go through. And then the whole spectrum in between. So how do you see that as a big or a component of how to navigate this?

Kianna Carter 6:59

Yeah, I mean I think that that's a huge piece, right? Like trauma, I always like to say is not something that is just healed once and then dissipates, right? Yeah. It's something that we live with lifelong and it's not just in our conscious mind of healing. Like trauma lives in our nervous system. It lives in our bodies, and so when our bodies are having these significant hormonal changes coupled with some environmental stuff, like we're watching our kids go through. Puberty and like the natural, like progression of challenging moments in life. Again, it's a perfect storm where it's like these residual pieces of trauma are coming up for us. It's not again, I sound like a broken record, but I think normalizing that is huge too because it's not a reflection of regression. This is this, it's a normal part, right? Like trauma breaks in our system and it heals. But it's still a festering wound. And so that is going to come up and being compassionate with yourself and being curious about why that's coming up rather than going into a place of shame. And yeah, making it feel like it's a moral or values based like transgression on you is, it's not helpful. It more so is about like, how can I regulate? And like being curious about that part of yourself that's coming up. What can I do to support my nervous system as these things are coming up in real time and being able to wield that knowledge of knowing that we're having hormonal shifts and there's a lot of different pieces moving. But I think the biggest like piece is not shaming yourself in that process. It's not a reflection of your lack of healing or. Like willingness to change and grow. This is a normal part of the lifespan.

Dr. Komal Patil-Sisodia 8:39

So interesting. It's so much easier to show compassion to others than to yourself, right?

Kianna Carter 8:44

1000%.

Dr. Komal Patil-Sisodia 8:46

Yeah, I know I've been in that position before where I'm listening to people's stories all day and. I can extend that compassion. So I can see how that translates over to personal relationships as well outside of work. So what are some common themes that you hear from women who feel emotionally overwhelmed or disconnected from their kids during this time? What are some common stories you're hearing?

Kianna Carter 9:08

Common things that I oftentimes hear right, is just like that really short fuse that's coupled with this sense of shame or that it's something that's like very personalized to them, right? And some type of failing on their part. And that's just, it's not the case, right? Yeah. Like we, we all have different coping mechanisms that regulate us at varying capacities, and so. I think it is huge to recognize that this is a harder chapter in our lives and we have to treat it as such. We are not on the same playing field that we have been historically. And so the tools that have served us and maybe regulated us in the past are not what they currently are current within this like capacity. Yeah. And so I think a huge thing that I notice is just like the clashing of my child is not listening. They are pulling away like very normal developmental cues, right? And it, it's taken pretty personally. And so there's that hypersensitivity and not understanding like where our adolescent is coming from. And so I do think it is important for caregivers and parents. Not parents, moms and children, to be able to sit down and have these open and compassionate conversations with one another about we're both going through things and so how do we navigate this in a way that's compassionate and understanding and how do we like make this household sustainable

Dr. Komal Patil-Sisodia 10:31

initial inability to show that grace to each other and to ourselves is so hard. So how do you help moms recognize when their nervous system is dysregulated? Because we're in such a. Busy world where we have work, we have family, we have our self-care that we're trying to do, right? Because that's everywhere. Take care of yourself. And it's so to see out of that haze of busy to even know that your nervous system might be dysregulated. I was talking to my husband after I saw my doctor last week and she said, oh, have you ever considered that you might have anxiety? And I said, no, I'm just stressed. And I came home and I told Hersh, I was like, you know, maybe I have anxiety. And Hirsh goes, maybe, and you know, my husband, he does not have a filter about that, but I was like, wow, you kept that in for 20 years. We've been together for 20 years. He was like, I was just waiting for you to come to that conclusion. So

Kianna Carter 11:21

patient. He is

Dr. Komal Patil-Sisodia 11:22

right. So patient. So we'll keep him. So, I'd love to hear how you help moms recognize that when their nervous systems are dysregulated, because case in point, it took me 20 years and somebody saying it to me for it to be even a possibility of my mind.

Kianna Carter 11:40

Yeah. Like even on your radar,

Dr. Komal Patil-Sisodia 11:41

exactly.

Kianna Carter 11:43

It's challenging, right? I think to your point, like we have so many like stimuli in our day-to-day life that it is challenging to be able to like really slow down and recognize and tease apart. Is this stress or is there like something more chronic and reoccurring and deeper happening? And I mean there's no easy way around like identifying some of those nervous system triggers. But there, there's some strategies, right? Like we have to. Slow down, which is really counterintuitive, particularly in our current like cultural like landscape. But it's important, right? Because I think sometimes like we get into this space where we are acclimated to a dysregulated nervous system, and that's just what we operate with that baseline. And so slowing down and really listening to your body. Somatic therapy is huge, and I love it as it relates to how trauma impacts our bodies and being able to slow down because our nervous system and our conscious mind they do not really converse, right? Like they are speaking two different languages and our nervous system doesn't understand logic. It is able to talk to us through like physiological symptoms, so like slowing down and notice. Saying are you experiencing rapid heart rate when like interfacing with certain stressors? Are you noticing increased, like irritability? Are you noticing yourself, like experiencing muscle tension? Like these are things that we have to clue into, and sometimes they're so nuanced and necessarily easily identifiable that if we're not looking for them, we're not gonna find them. And so there's a level of like mindfulness coupled with that, like somatic experiencing. That helps kind of tease that out. But I do think it is important that like those body scanning experiences happen because the body is going to let you know what's happening. You just have to be looking for it and listening. Wow.

Dr. Komal Patil-Sisodia 13:31

So that's very interesting because I didn't actually learn about that until very recently in my life. Yeah. And it. Something that I've been trying to do and to your point, it can be very hard to sit in that discomfort. It's very uncomfortable to be in that position where you are trying to pin things to what's. What you're feeling in your body how do you help people get past, I guess that dis that initial discomfort of doing it? I think over time, hopefully it gets a little easier. Right. But initially it sounds like it can be very, or I've experienced that it can be very hard to start.

Kianna Carter 14:05

Yeah, no, it can be incredibly challenging and I think the hardest part to sit with is that a level of discomfort and wading through that is to be expected, right? Like we're getting in tune with something that is maybe not necessarily serving us and might be connected to a more core wound that we're experiencing. And so we do have to get familiar and uncomfortable with that. We've lived beside it for a really long time. Yeah. A lot of us carry around that trauma. But to actually look it in the face and have to interface with it is a different beast of itself. And so I always like to, when I'm setting the stage of like, how do we go about this? Like incorporate some coping mechanisms. So it's like you're not going up against this empty handed, right? So like being able to, one, notice that you're getting dysregulated, whether that's like a physiological response, rapid heart rate, muscle function, increased like. Body temp and being able to do some like somatic experience type tools. There's a therapeutic modality called EMDR, and so they really focus on bilateral stimulation. So activating both parts of your brain and really being able to tell your body and your nervous system like you were safe. Because logically we know that, but your nervous system doesn't. Yeah. And so butterfly tapping is a huge one where people sit and they tap. For a consecutive period of time. And so just some like really simplistic and create somatic tools to be able to get a sense of what it's like to experience an a regulated nervous system.

Dr. Komal Patil-Sisodia 15:36

Yeah, that's So Kiana, for our listeners who may not know what e MDR is, can you tell us what that stands for?

Kianna Carter 15:42

Yeah, so it is eye movement desensitization and reprocessing therapy. Okay. Okay. This modality is used very heavily with folks who have experienced post-traumatic stress disorder and just any real experiences with trauma, and it really is rooted in being able to regulate the nervous system. So it looks a lot different than like traditional psychotherapy and talk therapy. It really is targeting your nervous system and trying to help regulate it.

Dr. Komal Patil-Sisodia 16:10

That's really neat. I, that was one acronym that I had not heard of, so I'll definitely be looking that up and I'll pick your brain for resources for that we might be able to post. So far we've talked about talk therapy, we've talked about somatic techniques, we've talked about EMDR, and I wanna make sure I have that linked for all of our listeners. Shifting gears a little bit, we've talked about. The moms or the parents or the guardians in this situation who are trying to get their own nervous system regulated. So when we are looking at parenting through puberty, with your background in adolescent mental health, how do you advise parents to hold boundaries while staying emotionally in tune with their kids? Because the thing is I think nowadays we. And maybe this is not everybody, but there's almost this push to be more of a friend to your kid than a parent to your kid. And I think this is probably one of those critical junctures where they really need you to stay in that parent role. And that can be very hard because of all of these other competing things around you.

Kianna Carter 17:07

Yeah, no, you are absolutely right. It's, I think it's just challenging at baseline to set boundaries with our adolescents, and then we throw in perimenopause and it's just a whole other just layer of stuff.

Dr. Komal Patil-Sisodia 17:20

Yeah,

Kianna Carter 17:20

I think again, right to be a little bit of a broken record, like we have to take care of ourselves and know our limitations and recognize like when we have hit those points as caregivers and as mothers, right? And knowing like when do I need to step away and then come back when I feel a little bit more regulated. Yeah. There's. Or like missteps around, need to step away and gather yourself or to regulate before returning parenting adolescence is hard. It's just, it's hard at baseline even when you have the easiest kids. Yeah. Like it's still difficult. They're dealing with a ton of different things and it's, I think we can all look back at adolescence and like kind of cringe at moments. We all have those standout moments. But I do think to your point, like there is definitely this cultural phenomenon of wanting to be like friends with our kids. Yeah. And it's not that we can't like have that empathetic and like connected sense of, being connected with our kids, but we can also be firm. Firm does not mean punitive. Like we can lead with love and compassion around a boundary and. Still set it. Like an example might be, I had a teen client, I don't know, maybe a year ago when we were doing some family therapy. Yeah. And I was working around like some boundary setting around curfews. Like an older teen. We talked about like validation, right? I understand that you're frustrated that you can't go to this party, but we had agreed upon the fact that. Your curfew is 10 and the party doesn't start till 11. And so it feels pretty clear. Yeah. Like we can validate that that's frustrating and we can validate that FOMO is a thing right now. That's, but the boundaries still exists. And that's important, right? Because you're leading with love and not like compromising those boundaries. You're holding a child to an expectation and we're not wavering on that. Is it challenging to watch them like stomp off and slam their door and maybe whisper something a little not so kind on the way back. Absolutely. Yeah. But I think that's the piece of being intentional as a caregiver about like your own, like wellness, right? And making sure that like you're taking care of yourself. Also validating and recognizing like this is, yeah, it is a challenging time period to be a parent and setting boundaries.

Dr. Komal Patil-Sisodia 19:32

That is a great piece of advice. Do you have any tips on how parents might model that? Like emotional regulation or keeping their emotions in check and, so that they and their teens can maybe do that together? They and their adolescent kids can do that together, and maybe I don't know what that looks like.

Kianna Carter 19:49

Yeah, I mean I've been reactive

Dr. Komal Patil-Sisodia 19:51

in those moments. Not my proudest moment, but I can admit it.

Kianna Carter 19:56

Humans, I only parents and family sessions or like one-on-ones that like we, there are going to be moments that we slip, right? Yeah. And I think the real work, like in those moments when we slip is like, how do we own that? And how do we like make this That's so true. Perhaps like a teachable moment, like knowing when to apologize because you're modeling behaviors that. You want to instill in your adolescent, like being able to own up when maybe you've made a misstep or done something that you're not super proud of. Yeah. And being able to model that as a parent. Even in those moments when you're like, I shouldn't have snapped on you and like I was super reactive. That's huge. But to your point, like your earlier question, co-regulation is huge and I think that sometimes that is also how we navigate that storm is like. Being able to model that behavior so that eventually our adolescent can absorb some of that. So like the example, I love a quick Take five. I love when a conversation is just not heading in a productive direction. And modeling that as a parent and like being able to stop the conversation and saying I need to take five. And then let's resume this conversation. I just need a minute. Yeah. To just pull back together. I wanna finish it. It's really important to me that we get to the bottom of this. Yeah, let's take five and come back together. Because that opens the opportunity too, that maybe like our kids can utilize that too. And it's not a practice of avoidance, it's a practice of understanding when a conversation is becoming unproductive and when we're reaching a place of dysregulation and having that awareness and knowing that we need to stabilize. But come back to the conversation and talk. Yeah, so I think that that's a huge one. I think too when we're thinking about like just regulation and whatever coping mechanisms we're working with, it's nice to bring our kids into the fold. Like if you are doing box breathing or you're doing like body scans, teach them, maybe do it with them. Such a great idea might like woo woo in the moment. Yeah, and I always tell my team clients like. I hear you, right? Yeah. Like I, it's a little, out there, but. Just, just go with it and like you can be a little silly with it, but sometimes bringing'em into the fold of that practice can be helpful too, because not only are you getting an opportunity to practice that tool, you're teaching it to them and have giving them an opportunity to learn a tool that they can use out in the world at home, or whatever the case is. So co-regulation can be super helpful and I think beneficial in just like opening the door of being compassionate to one another.

Dr. Komal Patil-Sisodia 22:25

Yeah.

Kianna Carter 22:26

Issues.

Dr. Komal Patil-Sisodia 22:26

It's really cool. Rose started elementary school here. When I went to the first parent teacher night, they talked about how it was a social emotional learning school. Mm-hmm. And I had never heard about that. And so they were telling us this technique about how they were teaching kids to identify their feelings starting in Kinder Garden and associate them with a color and then go do an activity if they were feeling any color other than green, to kind of help them get back to their baseline. And this sounds almost like. In parallel with that for both to do together. Right. I wish I'd had that tool when I was a kid and growing up. I feel like I'd be such a more functional adult, but we grew up with what we grew up with, so. Yeah, here we are. We talked a lot about, these hormonal shifts and things like that, and there that seems to be typical for being a teen, but what are some signs that a teen may need more support or intervention? What are things that we can distinguish? Like yes, there's going to be emotional ups and downs, there's gonna be things where we can't connect, but what are some signs that parents can look for that. They may need to do something more for their kid.

Kianna Carter 23:29

Yeah, so I think that this is a great topic because it is incredibly hard to differentiate and tease out, right? Like what is like a pretty typical developmental sign that you know you're going through. Versus when have we entered the realm of you may need some additional supports and it's a bit more exacerbated. So we know like at baseline, like our exploring and want autonomy, they want independence. They are sometimes a little bit more irritable. Their sleep patterns might change. All these different pieces that things that we really wanna be mindful of. Is that these are temporary and situational and it's not something that's going to happen over like a long term like span. Yeah. And it's also not going to erode at like their like daily like functioning capacity. Yeah. So things that we wanna start to pay attention to and things that I have noticed just in the span of working with adolescents that. Are always red flags as a clinician in my book is drop in academic performance. If you've historically been a pretty, yeah, be a student and you are declining like at a significant rate, that's a red flag. Like what's happened in there. It doesn't sound like there's ever been any educational challenges. It's what's going on with that. Okay. I think another piece is like social isolation more so than that independence and like pulling away and like, mom, I don't go to the mall with you today. Yeah. It's. It is concurrent and it's over a long span of time, and it's usually followed with apathetic mood. Like just presenting pretty like depressive, right? Like pretty flat. There's just a disconnect, loss of motivation. Maybe they're not engaging in activities that they used to enjoy. Yeah. Dropped out of all of their sports or like extracurriculars. These are things that we really wanna pay attention to. And those are always like red flags to me as a clinician that like you have like pretty significantly gone off of your baseline. And what do we do about that? Other things to pay attention to, which I think are more normalized, like red flags and more so things that are universally like caught suicidal ideation, self-injurious behaviors. Those are the easy things to spot. It's harder to be able to tease more of those earlier signs, but again, like I always tell parents like, you need to trust your gut and you know your child. You know your child better than I do, right? Yeah. Like you. That is your child. And so if you are getting a feeling that something fills amiss, it never hurts to seek like professional help, right? If it's really rooted in developmental, stages of change like that will be what it's gonna be. But I always err on the side of caution because. Sometimes certain adolescents can mask things really well and we don't want near misses to happen, so Makes sense.

Dr. Komal Patil-Sisodia 26:17

Yeah. So it sounds almost like, there is always gonna be some degree of separation as teens pull away from their parents and siblings, but if we see it in all other aspects of life, that's really kind of big red flag that things are probably not going well right now.

Kianna Carter 26:34

Yes.

Dr. Komal Patil-Sisodia 26:35

And I think the other thing is that teens take a lot of, while trying to get this autonomy, it feels like they may also feel a lot of responsibility for what's happening in their worlds. And so how can moms. Talk to their kids without About what they're going through. About what's happening in their lives without making the kids feel responsible or overwhelmed. Because I think in that quest to be quote unquote friendlier with our kids, we might tend to. Overshare or talk about things that they may feel responsible for or burdened by.

Kianna Carter 27:09

Yeah, no, absolutely. I, it's a hard conversation to have. And again, yeah, I think it has to be tailored specific to the youth, right? I think. That parents have to be very intentional about like addressing these conversations in an age appropriate way, but also taking into account that like your child may need more like a nuanced approach, right? Yeah. And so I always go at it from the space of let's start with like more higher level, just context of I just want you to be informed about this and like just come at it from a lens of this is explaining some of my behavior and I want you to have this context and I want us to be, if you have questions for me and coming at it from a place of curiosity. Yeah. And opening up the space where it is transparent, but also pretty directly reaffirming that this is not your responsibility to hold. Yeah, and I am, and I can manage it, but I want you to have this context as well, so you don't think that there's just this major shift and we can even talk about the different like stages of life that we're on, right? Like I'm going through my own hormonal changes and so are you and

Dr. Komal Patil-Sisodia 28:16

yeah.

Kianna Carter 28:17

I have like a humor moment of like we're, on different ends of the spectrum, but kind of experiencing similar things. Yeah. So I really do think it is important to tailor it based upon what you think that your adolescent has the capacity to really be able to process and go from there and be open and willing to answer questions for them when it's relevant and like appropriate.

Dr. Komal Patil-Sisodia 28:39

Those are some great tips. I know moms who are listening in will definitely feel like they are walking away with some tools there. I, it's so hard to talk to kids sometimes. Oh my gosh.

Kianna Carter 28:50

It's so, it's so challenging.

Dr. Komal Patil-Sisodia 28:52

It's so challenging. We had, it was a Ro Rose said something snarky to me last week. Yeah. Or a few months ago. I can't even remember when. And I called him and I said, Hey, you know, that wasn't very kind. And he looks at me, he goes, my bad, my bad. I'm going through puberty. I'm like, you know, you're so real for that. But also don't tell your endocrinologist mom. It's your hormones.

Kianna Carter 29:14

He's hilarious.

Dr. Komal Patil-Sisodia 29:16

Oh, he's a character. So now to shift a little bit to tools and strategies and things like that. What kind of self check-ins or boundary tools do you recommend for both moms and kids to use to help prevent resentment and emotional burnout when they're going through these changes? Yeah. Again, I think that it varies individualized to the parent and the child, so there's a whole culmination, right? I love a good weekly check-in. I think that being very intentional about like just getting a temp check with one another is huge. And this could be mom and adolescent. It can be a whole family check in. Like, how you doing? Like really how are you doing? Right. Yeah. Like how has the week been? And it's a little bit, it's a bit of a deeper dive than like when they're walking through the door after a long day at school. How was school good? Yeah. Let's ask, what did you do? I don't remember.

Kianna Carter 30:11

I don't remember. Okay. Cool. Go do your homework. Yeah. This is a little bit more intentional. Yeah. And that it's a great practice to really be able to hold space for one another. Yeah. And really do like intentional check-ins. And there are tons of resources and books around just like open-ended questions. Like what was one thing you were really proud of this week? Yeah. What was something that was really emotionally taxing for you or challenging that you faced? This week and how did you work through it? Are you still working through it? Is there anything that I can do to be of support? Yeah, so just diving a little bit deeper. Yeah. And normalizing that within like the framework of your family I think is huge because it fosters, right? Yeah. Like these ongoing conversations so that when you do have to have the hard conversations or we do have to kind of check in about. You're a little bit more irritable. So am I. Yeah. Like these aren't left field conversations. These are things that feel normal for our family structure because we're already having them. Yeah. So I'm really big on like being proactive and like implementing those not in the hard moments and just having it be more regulatory. I love that. Yeah. It's a, it fo fosters a safe space. Something similar to that because we have some kids who are just like, uh, like I'm not really gonna engage verbally with that. And so I've had over the past few years check-in journals, so maybe it's a big Okay. And it almost is like the sisterhood of the traveling journal. And mom writes an entry, dad writes an entry about their week and it can be like cultivated around like an open-ended question or it can just be like, this is what I'm checking in about this week, or this is maybe some things I want you guys to know. Yeah. And sometimes. Easier to express where we're coming through. Yeah. By written word. So that is something that I think is helpful for youth who maybe aren't as big of talkers and maybe express themselves a little bit more in depth via writing. That's oftentimes a really good intervention. I think like communication strategies is really huge too. Yeah. And being very clear about like how we wanna communicate with one another. Yeah. And sometimes I think it's so nuanced sometimes in families where it's like, yeah, you snapped at me, that hurt my feelings, and we're moving on. But sometimes it can be helpful to have some of those like recalibrating conversations where we're getting clear about like, how do we show up in this space with one another? And what are hard boundaries for us and where do we know when the line has been crossed? And being able to kind of set some of that context with one another. And also like it's not meant to be punitive, invite the adolescent into the conversation or some things that I say or how do I say them That like makes you feel some type of way, share those things with me so we can. So they have ownership of it, but they can also hear what you're saying too, and it's like this mutual accountability piece. So I think that that's huge is having conversations around how do we communicate with one another in a respectful and compassionate way.

Dr. Komal Patil-Sisodia 32:58

That's great, because we're not always our best selves and sometimes you don't hear your tone when you're speaking to somebody else. So that feels almost like the permission to hold a mirror up to the other person and say, I love that. So, moving along those same lines. And we talked earlier about shame and guilt. How do you guide women who feel shame when they lose it in the moment or they're not being the parent that they want to be in this season? Like how do you help them show compassion to themselves?

Kianna Carter 33:28

Yeah. Yeah. I mean, it's the age old, you know? Yeah. Um, it is so easy to exert compassion to others, but when it comes to ourselves, like any minor, in discretion feels unforgivable. And I think self-compassion is. An ongoing practice that like we have to be very intentional with, and it takes looking in the mirror and recognizing like I'm an imperfect human and these things are going to come up. And right now it may be a little bit more exacerbated because of like this. Error in life that I'm currently going through. So how do I show that piece of my self-compassion? Because my rule of thumb is always like shame is never going to move us in the direction of anything productive. It is going to exacerbate things and it doesn't really leave a lot of room for growth. It just leaves us in this festering place. And so when we can identify like shape is not really productive and how can I show up and be compassionate to myself? Yeah. That's where some of the work happens. And I think too, like to my point earlier, like having those like reunification conversations, if you don't feel good about something that you've done or said, or maybe like in the heightened sense of like reactivity we own up to that and we. Try and do better next time. But it is also an opportunity to be able to model that for our children and recognize like sometimes we're gonna do things that we are not proud of and like how do we come back from that and how can we do better next time? Yeah. Like should I have walked away five minutes? Before,

Dr. Komal Patil-Sisodia 35:04

yeah. Could I

Kianna Carter 35:05

have done some box breathing? Like what could we have done? And really kind of come at it from a lens of like, how, like how can I do better next time? So it's hard though. I think self-compassion is something that continues to be studied and there's no one like avenue of like really getting it down pat. It is a practice that you have to do again and again and again, and it never feels like profoundly easier.

Dr. Komal Patil-Sisodia 35:33

Kiana, I just wanted to thank you so much for making time, to be on the podcast. As we kind of wind down the episode, I have a few questions to close with, and the first one is, what's the one thing that you want every mother. To know who's feeling like she's unraveling and everything's kind of falling apart while her kid is too. What do you want her to know?

Kianna Carter 35:53

I think the takeaway for me is that I want them to know that this moment in time is not a reflection of who you are as a caregiver as a whole. And that just because you are having these small moments does not mean that like it wipes away everything that you are as a parent and everything that you've poured into your family. And so if I could give one piece of advice, and I know it's challenging, it would be to try and lead with compassion for yourself. And of course it's challenging, but I also think about as a mother myself, and I think about like how I navigate the world and how I show up. I'm always, always kind of thinking about. What is my son gonna absorb from this? And will this make him a more compassionate human being? And as mothers, oftentimes we're quite selfless in that sense. And so if you have to come at it from that direction Sure. Of like me showing self-compassion for myself is also me modeling that for my child. And so they can grow up and be a more whole human that can. Navigate that a little bit more seamlessly. And so if I can kind of break this, you know, I wouldn't even call it a generational curse. I would call it like a much larger curse that we're interfacing with. Yeah, passion. But if I can start to model that, even if it's hard, my child has a better opportunity to do that more seamlessly because I did the hard thing.

Dr. Komal Patil-Sisodia 37:13

That is a beautiful statement. So I hope a lot of women walk away with that, that sense of hope and positivity. And in the work that you do with adolescents and families or adolescents and their mothers in particular what hope do you find in that?

Kianna Carter 37:28

Yeah, I find a lot of hope. I know we talk a lot about like the red flags and like really the trenches of everything, but I see. Of hope, particularly in the work that I do with adolescents and within family therapy with their moms who are experiencing perimenopause. Like there's light at the end of the tunnel.

Dr. Komal Patil-Sisodia 37:46

Yeah.

Kianna Carter 37:47

It really is an opportunity to cultivate compassion with one another and recognize that we can go through hard moments within our lifespan, but we can do it together and we can lead with love and compassion and it just takes us both showing up, right? And so. I'm, a little bit more optimistic in that sense. And I do see like tons of work being done and I think just having a sense of community and de-stigmatizing these stages of life is huge.

Dr. Komal Patil-Sisodia 38:18

Thank you for the work that you do. I know our community is better for it. And as are all of your patients, and thank you so much for sharing your knowledge with us today. Where can people connect with your work? Are.

Kianna Carter 38:30

Yeah, so for my private practice I'm currently seeing adolescents, so they are always welcome to go over to Mindful Therapy Group and they can just put in my name into the search provider. And from there our admin team works with getting them connected to me. In terms of my work with Mary Bridge Children's Hospital. So we specifically serve youth in Pierce County. School age. So really I think our youngest that we've accepted is like six and so they can usually reach us through the Kids Mental Health Pierce County website. We have a very kind of basic formal drop form that they can go to and fill out for inquiry of services, but that is specific to Pierce County Youth, although we do have an extension. Have extended the model out to Kids Mental Health Washington. So different regions of Washington also have our program models in place. So I encourage folks to check out Kids Mental Health Washington as well, because it is attached to Mary Bridge Children's Hospital, and it's a great coalition that is very community based around adolescent behavioral health and caregiver support. Yeah.

Dr. Komal Patil-Sisodia 39:33

That's wonderful. And then are there any go-to resources you'd recommend for moms?

Kianna Carter 39:37

I think it's gonna be specific to their regions. I'm really big on like caregiver support groups, so I always recommend folks to look at psychology Today. I don't know. Oh, that's a

Dr. Komal Patil-Sisodia 39:49

great resource,

Kianna Carter 39:50

but you can filter through and look specifically for groups in your area and dependent upon like insurance coverage or whatever the case is, you can kind of that. But typically there are lots of support groups in your region, so that's always a really good resource to use for caregiver support groups.

Dr. Komal Patil-Sisodia 40:07

Fantastic. Thank you again, and like I said before, I appreciate all of your time and knowledge that you've dropped with us. We will link all of the resources as well as a way to connect with Kiana in the show notes for the episode. Thanks everyone, and I'll see you on the next episode.