Don't Avoid the Issue: Helping Your Anxious Child Thrive with SPACE therapist Robin Isman, LICSW

In this episode, therapist Robin Isman talks about how to help children with anxiety using SPACE therapy, which stands for Supportive Parenting for Anxious Childhood Emotions. She discusses the role of avoidance in making anxiety worse.
Robyn Isman, LICSW, is a licensed therapist, parent coach, and leading expert in childhood anxiety. With over a decade of clinical experience, Robyn is the founder of Parenting the Anxious Child, where she specializes in helping families move from overprotection to empowerment.
She is a certified provider of SPACE (Supportive Parenting for Anxious Childhood Emotions), an evidence-based treatment developed at Yale that focuses on changing parental response to effectively treat anxiety and OCD in children. Through her coaching programs and online community, Robyn teaches parents how to break the cycle of over-accommodation and build lasting resilience in their children.
A mother of three based in the Greater Boston area, Robyn blends her professional expertise with personal insight to provide practical, compassionate strategies for the modern parent. You can find her resources at TheAnxiousChild.com or join her community on Instagram @parentingtheanxiouschild.
https://www.theanxiouschild.com/
https://www.theanxiouschild.com/podcast


Please note that while I am a pediatrician, I am not your child's pediatrician. This podcast is for informational purposes only and does not constitute medical advice. For any medical concerns or decisions, please reach out to your child’s health care professional.
Cover art by Charlotte Feldman

Transcript

0:11

Welcome to Kids Matter. I'm Dr. Elisa Minkin. As a pediatrician, mom and grandma, I understand how challenging it can be to help our kids grow into their best selves. We are so much more powerful together. Here I will be sharing the knowledge and wisdom of a wide range of people who understand and care deeply about children. I'm hoping for your input as well because kids really do matter. They are our future.

Alisa Minkin 0:40

Welcome back to the Kids Matter podcast. I'm really honored and really excited to have a really special guest today, Robin Eisman. Robin Eisman is a licensed therapist, parent coach, and leading expert in childhood anxiety. With over a decade of clinical experience, Robin is the founder of Parenting the Anxious Child, where she specializes in helping families move from overprotection to empowerment. Oh, how much do I love that? Is a certified provider of SPACE, Supportive Parenting for Anxious Childhood Emotions, an evidence-based treatment developed at Yale, Dr. Eli Lebowitz, that focuses on changing parental response to effectively treat anxiety and obsessive compulsive disorder in children. Through her coaching programs and online community, Robin teaches parents how to break the cycle of over-accommodation and build lasting resilience in their children. A mother of three based in the greater Boston area, Robin blends her professional expertise with personal insight to provide practical, compassionate strategies for the modern parent. You can find her resources at theanxiouschild.com or join the community on Instagram at Parenting the Anxious Child, and she is also the host of the awesome Do Less Parenting podcast. Links will be in the bio. So thank you so much for joining me today. I'm really excited. I literally hunted you down as the person I needed to interview to follow up my interview with a child psychiatrist on childhood anxiety, and I'm gonna ask the listeners to please listen to that one first, because we are not going to repeat that information. The child psychiatrist has one lens. We talk about the basics of anxiety, and we talk about medication there. We will not be talking about medication here. We will be talking about a specific therapeutic approach and adjacent topics including, I'm gonna tell people up front just so you don't leave us too soon, pathological demand avoidance. We're here for that

Robyn 2:40

We are.

Alisa Minkin 2:41

too. So thank you so, so much for joining me. I, I wanna start with the role of parents in childhood anxiety, because we alluded to that, that you're a SPACE therapist, and we are not blaming. I always have to say this. We're not blaming. We're not shaming. But I actually called my, my talk with the child psychiatrist Our Anxious Generation to reflect that anxiety is basically everywhere And that includes in parents as well. So I want you to start with the role of parents in childhood anxiety, please.

Robyn 3:11

that is a very easy segue for me. I, actually, the way Eli Lebowitz explains this when you do the SPACE training, so SPACE stands for Supportive Parenting of

Alisa Minkin 3:20

And it definitely has been proven to decrease childhood anxiety by working with parents.

Robyn 3:28

the

Alisa Minkin 3:28

And the way he talks about it in the training is that anxiety is interrelational. So we think of anxiety as living between the parent and the child. We don't think of anxiety as the child has anxiety

Robyn 3:44

the

Alisa Minkin 3:44

or the parent has anxiety. We actually--

Robyn 3:47

two

Alisa Minkin 3:47

While those two things could be true,

Robyn 3:49

we actually are

Alisa Minkin 3:50

actually are treating an anxiety

Robyn 3:52

that is

Alisa Minkin 3:53

is being impacted between them interrelationally. Yes. So we know that the child has anxiety. That's why typically the parents are seeking support. But we don't teach parents how to teach their child anxiety.

Robyn 4:06

use the

Alisa Minkin 4:07

use the parent

Robyn 4:08

for

Alisa Minkin 4:08

a tool for change, as the conduit for change because there is so much evidence that shows there is a direct impact on parenting

Robyn 4:17

and then how

Alisa Minkin 4:18

and how your child is able to regulate and decrease anxiety.

Robyn 4:22

moods are impacted.

Alisa Minkin 4:24

impact, I mean, we have

Robyn 4:25

for

Alisa Minkin 4:26

our biological reasons that

Robyn 4:27

on our

Alisa Minkin 4:27

can impact other children, so why wouldn't that be true with anxiety? I love that so much, And I will say that it doesn't matter whether the parent has an anxiety disorder, whether the child has an anxiety disorder. What you're focusing on is bringing the two together in a healthy way, right?

Robyn 4:45

So according

Alisa Minkin 4:47

because

Robyn 4:50

in the clinical trial had an anxiety disorder. They had a diagnosis,

Alisa Minkin 4:54

that's just science. You have to do that. Anecdotally, when we treat people in therapy there or in coaching or through

Robyn 5:03

space,

Alisa Minkin 5:03

light space,

Robyn 5:04

really realize

Alisa Minkin 5:06

realize you can

Robyn 5:07

with

Alisa Minkin 5:07

this with

Robyn 5:08

do

Alisa Minkin 5:08

people who do not have official diagnoses. We don't have to put them on a regimen to see progress. Sometimes you have a child who presents

Robyn 5:16

hesitant to

Alisa Minkin 5:17

hesitant to try new things.

Robyn 5:18

they're

Alisa Minkin 5:19

they're nervous about talking to people. Some people might call that social anxiety, but they might not

Robyn 5:24

a

Alisa Minkin 5:24

fit the diagnosis for social anxiety. But

Robyn 5:27

support

Alisa Minkin 5:28

support them in that same way.

Robyn 5:30

thing with

Alisa Minkin 5:30

Same thing with phobias. You know, we might have a kid who has a phobia of something and say we have to go through a process of getting a diagnosis. We can still

Robyn 5:37

out

Alisa Minkin 5:38

figure out as the parent how to support them in that way by not

Robyn 5:41

overly

Alisa Minkin 5:42

overly accommodating them and overly protecting them,

Robyn 5:45

supporting them

Alisa Minkin 5:46

them emotionally. And that's the

Robyn 5:51

them and demand

Alisa Minkin 5:53

beauty of space. We don't just overly push them and demand things of our kids,

Robyn 5:57

in

Alisa Minkin 5:57

but we do believe in them

Robyn 5:58

believe their emotions, we believe their experiences, but we also believe in them, and that's the crux of what we're doing.

Alisa Minkin 6:06

So we believe their emotions, we believe their experiences, but we also believe in them. And that's kind of the crux of what we're doing. That's a really good explanation, and I want you to get more granular and tell me-- Let's start with... I'll give you a story, okay? Because I read a story in a magazine, and it bothered me so much I wrote a letter to the editor. And

Robyn 6:15

God,

Alisa Minkin 6:15

the story,

Robyn 6:16

that.

Alisa Minkin 6:17

the story was, there was a-- It was a made-up story. It was a fictional story in a parenting magazine, and it was that the parent was upset because the school was going on a trip to a water park, and didn't they know that their child had a phobia of water developed nine months ago when they saw an accident happen at the water? And the child was rocking in the corner, not going to school, and the mother was yelling at the school staff.

Robyn 6:39

Oh. Oh, okay. Yeah, we

Alisa Minkin 6:42

wanna know what you would say. What I would say is basically what you say, which is, "Why is this parent not getting support Manage their anxiety?" So it's still...

Robyn 6:49

So the first thing that I would say is, and I know you would do this also, is full of compassion. So I've worked with so many parents that the root of an anxiety or a phobia is

Alisa Minkin 7:01

You

Robyn 7:05

losses. You could have

Alisa Minkin 7:08

know, you have a child who presents with very severe separation anxiety because they lost one of their parents.

Robyn 7:13

And

Alisa Minkin 7:13

so of course that is...

Robyn 7:16

Feelings and

Alisa Minkin 7:17

Feelings and emotions are always valid, but,

Robyn 7:19

is, we'd say

Alisa Minkin 7:19

you know, it's, it's

Robyn 7:20

of course,

Alisa Minkin 7:21

like of course there's a deeper fear that has arose from losing one of their

Robyn 7:25

or if

Alisa Minkin 7:26

Or if they're having such a bad...

Robyn 7:29

with people who have been in car

Alisa Minkin 7:30

It's harmful. It's,

Robyn 7:31

could obviously

Alisa Minkin 7:31

it's obviously you want

Robyn 7:33

If you could have medical trauma, and

Alisa Minkin 7:35

trauma. And so then you develop because first

Robyn 7:39

avoidance,

Alisa Minkin 7:40

a way to...

Robyn 7:41

first of all, you

Alisa Minkin 7:42

first of all, you start with complete validation and compassion of like, of course we got here from,

Robyn 7:48

came by

Alisa Minkin 7:49

we came by this reasonably, you know? Validate. You're validating.

Robyn 7:54

But I just wanna really emphasize that at no point do we dismiss the anxiety or the experience, and I really actually think that's so important because people think that we

Alisa Minkin 8:05

Now we are swinging the pendulum of like

Robyn 8:08

of

Alisa Minkin 8:08

expectations of our kids and believing in our kids to the point where we're dismissing their experience. But I could spend

Robyn 8:14

time,

Alisa Minkin 8:15

so much time. I hope you can hear my voice. Like it

Robyn 8:17

much

Alisa Minkin 8:17

so much time validating the experiences and truly

Robyn 8:20

them.

Alisa Minkin 8:21

believing them. When my children say how they feel, I say, "Oh, wow. That is so silly to think of that." So we, you know, we really have to believe them. So with a situation like this, with this story about a child experiencing water trauma and then being expected to go to school on a virtual field trip, of course that is a completely valid and necessary.

Robyn 8:41

Now,

Alisa Minkin 8:42

And I argue that the more concrete and physical and the root of the anxiety is,

Robyn 8:49

actually think it's

Alisa Minkin 8:50

I actually think it's

Robyn 8:51

important

Alisa Minkin 8:52

It's that we do the work of not

Robyn 8:54

accommodating the child,

Alisa Minkin 8:56

the child because

Robyn 8:57

that brain

Alisa Minkin 8:58

brain is so

Robyn 9:00

there

Alisa Minkin 9:00

sure there is a danger

Robyn 9:02

we

Alisa Minkin 9:02

that we have to work even harder to convince it.

Robyn 9:06

the word

Alisa Minkin 9:06

I don't love the word convince, but we have to har-work even harder to model that we can

Robyn 9:11

do

Alisa Minkin 9:12

still do things even while we have this fear.

Robyn 9:15

And

Alisa Minkin 9:15

And

Robyn 9:16

and it will

Alisa Minkin 9:17

And it will go to that place of avoidance even easier than someone that maybe didn't have that trauma. So it's even more important that we practice these skills and that

Robyn 9:28

child

Alisa Minkin 9:28

we work toward developing them. So we believe you that this is so scary, and we believe in you,

Robyn 9:33

ability

Alisa Minkin 9:34

ability to work toward overcoming this fear.

Robyn 9:37

we

Alisa Minkin 9:37

Because if we don't do that part, avoidance is the only option.

Robyn 9:41

often say

Alisa Minkin 9:41

What I often say to people is the opposite of doing this work is never going anywhere.

Robyn 9:46

And it starts

Alisa Minkin 9:47

it starts slowly. Okay, don't go on one field trip.

Robyn 9:50

Who

Alisa Minkin 9:51

That is

Robyn 9:51

care if

Alisa Minkin 9:51

able to play. My kid was four. There were so many things my kids do

Robyn 9:55

that

Alisa Minkin 9:56

that I don't actually care that they do.

Robyn 9:59

but what's my

Alisa Minkin 10:00

But what's my driving,

Robyn 10:01

conviction is

Alisa Minkin 10:03

is

Robyn 10:03

don't not do

Alisa Minkin 10:05

not do it

Robyn 10:05

anxiety or your

Alisa Minkin 10:07

or your fear or your hesitation.

Robyn 10:09

J- I don't,

Alisa Minkin 10:10

I don't want them to have to make choices like it would be activities they would

Robyn 10:14

play around,

Alisa Minkin 10:15

play around. They, they go to school. They fear going even like besides the physical part of it. I

Robyn 10:20

the

Alisa Minkin 10:21

even learned a lot. It's like, oh, my mom sees kids running Playing. Like, I love that. Oh my.

Robyn 10:26

But, sorry.

Alisa Minkin 10:26

My eyes are bugging out. And

Robyn 10:28

I know.

Alisa Minkin 10:29

Like, we need

Robyn 10:34

our kids to

Alisa Minkin 10:34

to get our kids to do

Robyn 10:35

what I

Alisa Minkin 10:36

a lot. Right. To play and, and feel

Robyn 10:38

about,

Alisa Minkin 10:38

some trust.

Robyn 10:39

passionate about this

Alisa Minkin 10:39

I'm so passionate about this work and that what I want to trust them is not their stuff.

Robyn 10:43

what

Alisa Minkin 10:43

So

Robyn 10:44

of is,

Alisa Minkin 10:44

I think of it like, yeah, it starts with a field trip, but

Robyn 10:47

what happens at

Alisa Minkin 10:47

what happens at the summer camp? I mean, summer camp typically involves water.

Robyn 10:51

not

Alisa Minkin 10:51

we start not doing a camp anymore. And then

Robyn 10:53

when

Alisa Minkin 10:53

happens when they grow up and their

Robyn 10:55

pool

Alisa Minkin 10:55

has a pool party or like there are so many places where water is gonna come up because typically

Robyn 11:00

don't always

Alisa Minkin 11:01

don't always stay around one thing. So walking past cars can be dangerous. Being looking down the street can be dangerous.

Robyn 11:09

There's so many

Alisa Minkin 11:10

There's so many ways our brains can make sense of a, of a safe scene as a dangerous one.

Robyn 11:15

I know I,

Alisa Minkin 11:15

To go back to avoidance, we went a little weird here, but just to go to, to go back to what I said, I start with compassion and always validation. And I parallel the experience that I want the parent to do with the child with the parent. So I'm validating, but I'm also believing in them that we can support the child. And then what we do is

Robyn 11:31

out

Alisa Minkin 11:31

we figure out where we can decrease the accommodation but still support them. So, you know, if it's a very recent trauma, we're not saying, "We're sorry, you're going on the field trip." Right. But we might

Robyn 11:41

he- they go to

Alisa Minkin 11:42

"Can they come to

Robyn 11:42

Can they

Alisa Minkin 11:43

part of it? Can they

Robyn 11:44

Can

Alisa Minkin 11:45

Even if they go but not

Robyn 11:47

in

Alisa Minkin 11:47

Participate in a ride. If they go, maybe if I drive them. Like

Robyn 11:51

ways

Alisa Minkin 11:52

ways to

Robyn 11:53

wor- to

Alisa Minkin 11:54

work to send the message to the child very explicitly,

Robyn 11:57

on this

Alisa Minkin 11:58

you have this fear, so that the fear or the trauma isn't controlling your life, and the anxiety isn't controlling your life." And that's the goal. And to be angry at the school is a really missed opportunity

Robyn 12:10

it's

Alisa Minkin 12:10

because it's saying, "How could you cause my kid?" That's not...

Robyn 12:14

like when people go down

Alisa Minkin 12:15

Like, without the sort of stuff because that is not realistic because

Robyn 12:17

someone who

Alisa Minkin 12:18

meet someone who can't

Robyn 12:19

them. It's actually

Alisa Minkin 12:20

them, and actually just not good for them. It's not good to learn

Robyn 12:24

after you've

Alisa Minkin 12:25

after you've experienced a traumatic thing, the only way to be okay is to avoid

Robyn 12:30

the trig- the

Alisa Minkin 12:31

the tra- the traumas and the triggers because life is just-

Robyn 12:35

full of them.

Alisa Minkin 12:37

Yeah. So I wanna say a couple things. I, I love everything you're saying, but I wanna say a couple things. First of all, first of all, the mother wanted the trip to be canceled for everyone. Not only did she want her child

Robyn 12:48

Oh.

Alisa Minkin 12:49

have to face this, she wanted everyone to get a better reward because it was, the trip was supposed to be a reward. And people wrote in saying, "Oh, it's not fair. We have to accommodate everyone." The mother said, "What if my child were in a wheelchair?" I don't know what you wanna say to that, but I don't think it's the same thing.

Robyn 13:08

I think that what happens is we go too far with adv- obviously I'm a huge advocate for mental health, and I'm a huge ad-

Alisa Minkin 13:15

I can't say that

Robyn 13:16

life

Alisa Minkin 13:16

like my whole thing is this.

Robyn 13:18

I think that

Alisa Minkin 13:19

think that even if a child

Robyn 13:22

or when a child is in

Alisa Minkin 13:23

when a child's in a wheelchair, though, like I don't

Robyn 13:25

if

Alisa Minkin 13:26

know when that is reality that I'm gonna do in your class when I go to something.

Robyn 13:30

that I

Alisa Minkin 13:31

Like I, I mean, it's not that I don't agree that it should be treated

Robyn 13:33

as a

Alisa Minkin 13:34

as a true

Robyn 13:36

I don't want to say the

Alisa Minkin 13:36

I

Robyn 13:36

disability, but a true

Alisa Minkin 13:38

but a true need.

Robyn 13:39

it's

Alisa Minkin 13:39

It's not, it's not that I go down the road saying this fear is not a true need.

Robyn 13:43

if you,

Alisa Minkin 13:43

I,

Robyn 13:43

we

Alisa Minkin 13:44

if you, if we wanna say, you know, it could be as serious

Robyn 13:48

prohibitive to

Alisa Minkin 13:49

as it is to have a physical disability.

Robyn 13:53

can be, it truly can be.

Alisa Minkin 13:54

It can truly,

Robyn 13:55

agoraphobic

Alisa Minkin 13:56

or

Robyn 13:56

their

Alisa Minkin 13:56

physically, or not leaving your house. People are truly... Their days

Robyn 14:01

completely

Alisa Minkin 14:02

are completely destroyed. And so it, there is a reality to

Robyn 14:06

even with

Alisa Minkin 14:07

And even

Robyn 14:07

we have to

Alisa Minkin 14:08

the work you have to work with is, okay,

Robyn 14:10

How do we

Alisa Minkin 14:10

good about we owe this child

Robyn 14:12

in, by

Alisa Minkin 14:13

in scheduling the experience? And I would hope many people would do that even for someone with a physical disability. Like, okay, so what, what reward does that child need?

Robyn 14:21

the

Alisa Minkin 14:21

I also think the reward thing has a little bit of bias because I want people with a child who struggle with anxiety to feel rewarded. Right. So that's a little sad because then,

Robyn 14:29

what

Alisa Minkin 14:29

know,

Robyn 14:29

their reward?

Alisa Minkin 14:30

a reward? But

Robyn 14:31

way,

Alisa Minkin 14:32

way,

Robyn 14:32

want

Alisa Minkin 14:33

we don't want people... Somebody needs to be the responsible candidate for something. That's the biggest thing.

Robyn 14:37

wanna

Alisa Minkin 14:37

We don't wanna blame the world for this That makes sense. Yes. So, you know, there's many solutions to that particular dilemma, but I just wanna say the other thing I wanted to say is that that child might not be capable of attending that trip in any shape or form. And when we talk about scaffolding, we're not asking a child to go beyond their current abilities.

Robyn 14:59

Yeah. Do you

Alisa Minkin 15:01

So...

Robyn 15:01

want me to respond to that?

Alisa Minkin 15:03

Yeah, I wanna know how you stretch that.

Robyn 15:04

Yeah. W- I would work with the parent on is this what we work on, like this exact field trip, or do we say

Alisa Minkin 15:12

We say something more like, "Okay, well, how can we make this day special for him? Not at the field trip, but

Robyn 15:18

continue to

Alisa Minkin 15:19

continue to work on building tolerance to these fears."

Robyn 15:23

it's

Alisa Minkin 15:23

So sometimes it's not about going on that specific field trip.

Robyn 15:25

soon. We

Alisa Minkin 15:26

too soon. We haven't had a chance to work on it. Maybe it's too big for whatever reason.

Robyn 15:30

so we

Alisa Minkin 15:31

And so we say, "Okay,

Robyn 15:31

gonna,

Alisa Minkin 15:32

one we're gonna, you know,

Robyn 15:33

say

Alisa Minkin 15:33

we're just gonna say bye." Like, it's not, it's not helpful. It's gonna make them upset and, and

Robyn 15:38

like I said,

Alisa Minkin 15:38

leave, like I said,

Robyn 15:39

because they're

Alisa Minkin 15:39

sad because they're not getting

Robyn 15:41

So okay, what

Alisa Minkin 15:41

to go. So I would walk in and feel over predictive.

Robyn 15:43

to

Alisa Minkin 15:44

The goal is for the children, one, will feel over predictive. And I would be educating the parent on how avoidance is going to make a child more at more-- Avoidance. Avoidance breeds avoidance, and so it breeds anxiety.

Robyn 15:59

So

Alisa Minkin 16:00

So

Robyn 16:00

we

Alisa Minkin 16:01

while we might not get to go on the field trip, we--

Robyn 16:03

reframing the approach

Alisa Minkin 16:06

overall. This comes up a lot with schools with,

Robyn 16:10

drills

Alisa Minkin 16:10

drills.

Robyn 16:11

And I have

Alisa Minkin 16:11

That-- And I have this really visceral reaction to schools who

Robyn 16:15

parents a

Alisa Minkin 16:16

major anxiety heads up about a fire drill

Robyn 16:18

that

Alisa Minkin 16:19

because, and this is an example of something where to

Robyn 16:21

the

Alisa Minkin 16:21

understand the concept, and I,

Robyn 16:23

with families

Alisa Minkin 16:24

I have worked with families where they have kids that have 504

Robyn 16:26

drills. So you

Alisa Minkin 16:26

for anxiety, and so we have to sit down and tell them about the fire

Robyn 16:31

it's just

Alisa Minkin 16:31

And it's just such a slippery slope. Like, and sometimes there really is a fire

Robyn 16:36

not a

Alisa Minkin 16:36

that is not a drill, or maybe it's not a tripped system or something. Like, it's not always planned. And,

Robyn 16:42

so that's an example.

Alisa Minkin 16:42

so that's the example. You pick me up, and they'll be like, "Okay, well, how do I make it respond to a permanent thing that feels really minor?" But then what we're not do- helping our kids learn is

Robyn 16:52

tolerate

Alisa Minkin 16:53

to tolerate uncertainty. Ah. Obviously, working with ki- kids,

Robyn 16:57

kids

Alisa Minkin 16:57

parents and kids and schools on

Robyn 16:59

like to sit

Alisa Minkin 17:00

what is it like to sit somewhere when you don't know there's about to be a fire drill? What is that feeling in your body? How do we manage that feeling? Because that is gonna happen in a lot of settings. And, and we can solve the fire drill problem pretty easily,

Robyn 17:14

solve the

Alisa Minkin 17:15

solve the feeling of the uncertainty

Robyn 17:18

is

Alisa Minkin 17:18

because that is gonna exist somewhere else. And we can't call every single person who they're coming in contact with and say, "Let me know if there's gonna be a sudden loud noise." That, that's not something we can do. And when we model that we're requesting they be safe accommodate and tell us when there's gonna be a fire drill so the kid can stay home or they can prepare, whatever it is, like, so that they can prepare. But we model that. We are saying, "Yes, that uncertainty is really

Robyn 17:42

you, and

Alisa Minkin 17:43

for you,

Robyn 17:44

solve

Alisa Minkin 17:44

I'm gonna solve

Robyn 17:45

so

Alisa Minkin 17:45

for that

Robyn 17:46

to

Alisa Minkin 17:46

so you don't have to experience it because it's so dangerous to you." And it's not dangerous. Danger is different than extreme discomfort.

Robyn 17:55

saying...

Alisa Minkin 17:55

am not saying people respond to my...

Robyn 17:58

sometimes

Alisa Minkin 17:59

Sometimes saying like, "It is painful for the kid. It is." And I truly agree and believe that. Like, I do believe I have a kid with some sensory sensitivities. I, I

Robyn 18:09

It is

Alisa Minkin 18:09

understand it is not something I take lightly,

Robyn 18:12

they

Alisa Minkin 18:12

and they will not die from it.

Robyn 18:14

I

Alisa Minkin 18:14

And I really want to help them build tolerance in whatever they way they can

Robyn 18:19

they

Alisa Minkin 18:20

so that they understand the difference between danger and extreme discomfort. These are different things, and I think it's important for kids, a kid to understand they are different. It's really, really important, and I think there's a balance between accommodating needs, like accommodating sensory needs, and you can't fix the world to accommodate your child. And so learning how to deal at the same time, two things can be true at the same time. We're not minimizing any of your child's needs

Robyn 18:49

No.

Alisa Minkin 18:50

we're trying to help them function, and that's a really... Yeah.

Robyn 18:53

Sorry I know, I feel too passionate. It's hard for me to wait. I...

Alisa Minkin 18:58

Me too.

Robyn 18:58

Also both cultures I'm from are very verbose.

Alisa Minkin 19:02

Italian and Jewish?

Robyn 19:03

yeah,

Alisa Minkin 19:04

know, it's

Robyn 19:07

I was gonna

Alisa Minkin 19:07

funny

Robyn 19:10

this line of

Alisa Minkin 19:11

how doing the narrative of they just have to stay in their bubble and they're gonna go out in the world and we have to be accommodating all of them because they actually want the driven motivation or whatever it is for it to be that it's actually not good for your kid. It's not that I actually... Like sure, they actually could set up a life

Robyn 19:28

is pretty

Alisa Minkin 19:28

is pretty accommodating. They could, especially now,

Robyn 19:31

remotely,

Alisa Minkin 19:32

they

Robyn 19:33

your

Alisa Minkin 19:33

could keep your camera off in a lot of the jobs. You can have your headphones in. You can

Robyn 19:38

so

Alisa Minkin 19:38

be super... I guess speaking of an introvert, I know it's very hard, but you can even be

Robyn 19:43

comfortable

Alisa Minkin 19:44

comfortable, like, by yourself.

Robyn 19:45

and

Alisa Minkin 19:46

And you will miss out on a lot of things by not building your tolerance. And so I actually want parents to know that we're not just allowing now

Robyn 19:56

it's,

Alisa Minkin 19:57

it's like, "Well, you're gonna throw them in the deep end in five years or whatever, 10 years." I actually want them to know that this is just how the brain works. The brain kicked them out in tolerance.

Robyn 20:07

I

Alisa Minkin 20:08

And sometimes we won't be able to give that gift to your children. I don't want you to

Robyn 20:12

them all

Alisa Minkin 20:13

make them build this. Now some people say,

Robyn 20:14

kids

Alisa Minkin 20:15

"Well,

Robyn 20:15

all the

Alisa Minkin 20:15

do that. It's all the same. We're trying to get them all to be neurotypical."

Robyn 20:18

not true.

Alisa Minkin 20:19

That's not true. No. You can do both.

Robyn 20:21

them

Alisa Minkin 20:21

I want them to know I am giving you the right to

Robyn 20:25

doing

Alisa Minkin 20:25

of doing things that I want to do

Robyn 20:27

That's all. That's it. If I could summarize my goal, it would be I am capable with the right tools to do what I wanna do, to try what I wanna try. That's it.

Alisa Minkin 20:36

That's all-- That's, that's if I could summarize what goals they would be. Body image, going to the grade school, continue to go when I do group work, right? But I'm not sure- I'm gonna, I'm gonna tell... I love that. I'm gonna tell another story. There's a movie called Thelma. Highly recommended. The actress, I think, is June Squibb. I think she just got an award for the first time or a, a, a nomination for award at 96. She's really amazing. And the grandson in the movie is a failure to launch, like 20-something guy, and at one point he just throws up his hands and goes, "I can't do it. I can't do math." It is so terrible for self-esteem for kids to not have that competence, and having the competence is where, right, they're gonna feel better about themselves and function better. So obvious, but I think th-the acceptance and the tolerance of your tolerating your child's discomfort and skill deficits is the only way to get there, right?

Robyn 21:22

Yeah, and I think that it's tolerating... because I'm on social media And

Alisa Minkin 21:26

And I'm writing this all the time about like, just pushing my brain, like the word like tolerance and capability and capacity and both with all the words.

Robyn 21:36

really

Alisa Minkin 21:37

And I really think about these words and I think, "What does this mean?"

Robyn 21:40

I

Alisa Minkin 21:40

And I just thought, I think parents get lost thinking

Robyn 21:45

If I

Alisa Minkin 21:46

if I try to teach them to tolerate more, I'm dismissing their experience

Robyn 21:52

that

Alisa Minkin 21:52

and that their pain isn't as real, and I need to validate that pain and therefore not cause them more pain.

Robyn 21:59

But

Alisa Minkin 22:00

But

Robyn 22:01

pain, I don't love the

Alisa Minkin 22:02

I don't love

Robyn 22:03

word

Alisa Minkin 22:03

the word pain, but pain/discomfort is often the pathway to growth. You know, I'm not trying to cause pain. I don't love that, but the discomfort is,

Robyn 22:12

we don't

Alisa Minkin 22:12

you know, improving the comfort. We survive, we maybe

Robyn 22:18

con- pe- some

Alisa Minkin 22:19

become something even more than I think we could have ever when

Robyn 22:22

so

Alisa Minkin 22:23

comfortable. So comfort may be in some way limiting our daily, when there's conflict,

Robyn 22:28

there's

Alisa Minkin 22:28

when there's discomfort, when we push each other, you know? So it,

Robyn 22:32

it, there's this

Alisa Minkin 22:33

there's this feeling I think in a lot of parents that if you are pursuing things that

Robyn 22:39

are

Alisa Minkin 22:40

are threatening to your child,

Robyn 22:42

use these

Alisa Minkin 22:42

we use these big words like threatening, danger, pain,

Robyn 22:46

it has

Alisa Minkin 22:47

and it has led us to be just like, "Okay, we should just be comfortable." And

Robyn 22:51

really

Alisa Minkin 22:52

it really does lead, lead to a decrease in confidence, a decrease in confidence because we-- They are looking to us to believe in them, and if we are saying, you know, "Put in your brain like

Robyn 23:03

fully

Alisa Minkin 23:03

fully believe that you are just unable to do this. I mean,

Robyn 23:09

just

Alisa Minkin 23:09

so we're just gonna,

Robyn 23:11

take

Alisa Minkin 23:11

know, take a break from all of these things." Yeah,

Robyn 23:14

they

Alisa Minkin 23:15

they believe us. Like they believe us because We're their,

Robyn 23:18

North

Alisa Minkin 23:19

their North Star, you know? Absolutely, and I can't wait to talk about PDA anymore. That's a great segue into what is called pathological demand avoidance. I don't know if you wanna first just define what it is. You know, I'm not an expert on PDA, pathological demand avoidance.

Robyn 23:37

spent,

Alisa Minkin 23:37

spent, you know, years studying it. I,

Robyn 23:40

I,

Alisa Minkin 23:40

you know, I think it's important that

Robyn 23:42

America,

Alisa Minkin 23:42

in, America, so my-- this is, I'm in Massachusetts, so it's not recognized in the, in the DSM. We

Robyn 23:47

therapists, if,

Alisa Minkin 23:48

therapists

Robyn 23:48

parent,

Alisa Minkin 23:49

parent,

Robyn 23:50

in the

Alisa Minkin 23:50

people in the parent world

Robyn 23:52

we know

Alisa Minkin 23:52

we know about it very deeply because we have had many people come to us, and I think maybe because I've talked to so many people about this, is that so once somebody starts, once people start coming to you with descriptions of their kids using

Robyn 24:06

labels you should do

Alisa Minkin 24:07

you, you should do your due diligence and get education around that thing.

Robyn 24:12

I do

Alisa Minkin 24:12

So I do not dismiss it. I don't say, "Oh, that's not a diagnosis" or anything like that. I don't frame

Robyn 24:17

I

Alisa Minkin 24:17

it for that many people, but these people, I believe their experiences. So it is... There's two ways people describe it,

Robyn 24:23

demand

Alisa Minkin 24:24

demand avoidance or persistent drive for autonomy.

Robyn 24:26

It's described as

Alisa Minkin 24:28

as a nervous system disability,

Robyn 24:31

really

Alisa Minkin 24:32

really just illuminates that the d- the nervous system's drive for autonomy will trump any other

Robyn 24:44

demand, even if

Alisa Minkin 24:45

even if that demand is a basic need or a survival need. So meaning that drive for autonomy

Robyn 24:51

over

Alisa Minkin 24:52

over eating, it will win over going to the bathroom, win over showering, going to school,

Robyn 24:59

listening to your par-

Alisa Minkin 25:00

listening to your parent, whatever. And it's like, and, and, and the

Robyn 25:02

for

Alisa Minkin 25:02

drive for autonomy is uber,

Robyn 25:04

of

Alisa Minkin 25:05

you know, of survival.

Robyn 25:06

And so when you

Alisa Minkin 25:07

when you have a kid who fits the description of PDA,

Robyn 25:11

are

Alisa Minkin 25:11

are,

Robyn 25:12

thinking

Alisa Minkin 25:12

are thinking about

Robyn 25:13

how

Alisa Minkin 25:14

how to support them in a way where you understand that that need for autonomy is pervasive,

Robyn 25:21

you

Alisa Minkin 25:22

and you can't just create sort of,

Robyn 25:24

behavior

Alisa Minkin 25:25

a behavior plan or something like that because that survival need for autonomy is going to be what wins out in the end, so you're gonna end up just kind of shutting down. They have,

Robyn 25:34

in the

Alisa Minkin 25:34

in the PDA world, they call it burnout.

Robyn 25:37

it

Alisa Minkin 25:37

So we call it burnout.

Robyn 25:39

So that's

Alisa Minkin 25:39

so that's like my best way to describe the experience without confusing it too much with my- Own take? I want your own take. Don't be afraid.

Robyn 25:47

you my take.

Alisa Minkin 25:48

Okay.

Robyn 25:49

me this was not gonna be a provocative podcast.

Alisa Minkin 25:52

Not intentionally, but, but the-- I'm sorry, the reason I'm saying that... Okay, I'm a pediatrician. I'm also not an expert in, in PDA. However, the way I see it is a lot of people are self-diagnosing themselves or their kids on social media, They do not necessarily have... All of these people do not necessarily have a persistent drive for autonomy but they do... are very demand-avoidant. And I think there's a big difference between the way it was originally described Of kids that are getting labeled as such, 'cause they're tough kids. And I, I'm just gonna say, I-- this is my notes. This is my... And y- I'm gonna... I wanna hear what you think about this. It is because we don't have an evidence base for it, I think we have to really have honest conversations. We can't just have consensus and say, "Okay, consensus is... should not be confused with evidence." So... Wait, I'm not gonna give you a turn to talk, but one...

Robyn 26:44

Oh, no,

Alisa Minkin 26:44

I want... Yeah. Yeah, yeah. Okay. So I, I don't think that PDA is avoidance from anxiety, I have to make that clear, necessarily. I think that PDA kids are, I think, 100% on the neurodivergent spectrum. They may have ADHD, autism, or both. I don't know if there are any that are meeting that who don't. I've heard that it's considered to be a profile on the autism spectrum. Again, we don't know, and certainly the kids who are getting self-diagnosed or diagnosed by their parents as PDA who are demand-avoidant can certainly be just have ADHD, I think, or some other neurodivergence. Okay. So I don't think they just have anxiety, or they may not have anxiety, but I think probably most of them do. And so I think the avoidance anxiety cycle that you described before is, is relevant. However, I think that anxiety can come from skill deficits, and I think in these kids, the reason they're so hot under the collar, right, they react, you know, the way they do, is because I think they tend to have a lot of other skill deficits, and each kid will be different. You've seen one kid on the spectrum, you've seen one kid on the spectrum. So it could be self-regulation, frustration tolerance, too much screen use so they don't wanna get off. Like I think you see a lot of PDA behaviors with kids who are on screens a lot, 'cause screens are, are, are... And I don't believe they're regulating, okay? But they are definitely very, very dopamine inducing. Planning, all kinds of skills, social skills, and then I think you see this PDA behavioral pattern. That, that's how I look at it,

Robyn 28:08

Right.

Alisa Minkin 28:10

skills. You can't just keep talking about how dysregulated they are, you know, and how demand-avoidant they are. So your turn.

Robyn 28:16

Yeah. So I, So okay, so I'm certified in SPACE, supportive parenting of anxious childhood emotion. I'm also trained in parent management training, which is more of a behavioral approach. I actually didn't even send you that in my bio because I don't real- I do use it, but I SPACE is just my niche. But the, what I, the reason I just said this is because there is so much evidence that

Alisa Minkin 28:40

So then, you know, instead of authoritative, very clear, when we

Robyn 28:43

we

Alisa Minkin 28:43

think authoritative, we mean

Robyn 28:44

compassion plus

Alisa Minkin 28:46

plus boundaries. We mean,

Robyn 28:49

validation plus

Alisa Minkin 28:51

plus boundaries. So we're not-- We're basically authoritarian is where, you know, the dominance and kind of punishments, things like that. And then the way it's even

Robyn 29:03

parenting

Alisa Minkin 29:04

parenting is where I've just let everything happen, permission given, you can do whatever you want basically. But there is so much evidence that shows that the gold standard of parenting is authority.

Robyn 29:15

to

Alisa Minkin 29:15

We need to, we have compassion and validation for our children and we have to have these expectations. So

Robyn 29:22

scares

Alisa Minkin 29:23

scares me about, about the

Robyn 29:25

media.

Alisa Minkin 29:26

of social media, someone being

Robyn 29:27

the problem

Alisa Minkin 29:28

the problem is not that they don't believe PD exists.

Robyn 29:31

is a

Alisa Minkin 29:31

It is a diagnosis in other countries and the profile of it 100% exists.

Robyn 29:35

see

Alisa Minkin 29:36

I have seen people,

Robyn 29:37

talk to

Alisa Minkin 29:37

I've coached them, I validate the experience with them. But emotionally, I don't

Robyn 29:42

have

Alisa Minkin 29:43

if they simply don't

Robyn 29:44

label out but just the

Alisa Minkin 29:46

it or just don't know. Even if it's been this profile that have been successfully treated

Robyn 29:51

other

Alisa Minkin 29:51

whether the severe management training is effective for parents with children with profiles that are similar to PD profiles.

Robyn 30:01

had

Alisa Minkin 30:02

had great success. CBT is 92% effective with ages two to 15.

Robyn 30:07

it's,

Alisa Minkin 30:07

So it's--

Robyn 30:08

have

Alisa Minkin 30:08

We have evidence-based programs with space and it's specifically about anxiety. So like you said, with demand avoidance, you have to kind of think about where is that

Robyn 30:16

is

Alisa Minkin 30:16

coming from?

Robyn 30:17

sensory

Alisa Minkin 30:17

Is it because of sensory base?

Robyn 30:18

it a biological

Alisa Minkin 30:19

it, is it a biological thing? What is going on? You know, is it a skill deficit? What- whatever it is.

Robyn 30:24

but

Alisa Minkin 30:25

but

Robyn 30:25

that

Alisa Minkin 30:25

know that when we

Robyn 30:27

but also

Alisa Minkin 30:27

but also continue to have expectations, that is a proven strategy to support kids

Robyn 30:32

moments, through hard

Alisa Minkin 30:33

are, resistant to learn things. And the scary part about social media is, one, can

Robyn 30:38

to someone

Alisa Minkin 30:39

talk to someone who truly believes that PD doesn't exist but understands it perfectly. It is rare. It is not--

Robyn 30:47

media,

Alisa Minkin 30:47

on social media, it is not rare. It is

Robyn 30:50

everywhere. It is not

Alisa Minkin 30:52

It

Robyn 30:52

it

Alisa Minkin 30:53

not rare, it is everywhere. It, it is--

Robyn 30:55

are

Alisa Minkin 30:56

People are just lonely people looking for themselves. Like,

Robyn 31:00

I, it's

Alisa Minkin 31:00

I, I--

Robyn 31:00

so

Alisa Minkin 31:01

It's just, it's so hard.

Robyn 31:02

It's so hard to talk

Alisa Minkin 31:02

It's so hard to talk about something I'm really passionate and emotional because it has been really difficult to watch people with

Robyn 31:08

kids

Alisa Minkin 31:09

kids do not fall into that most likely and maybe have ADHD,

Robyn 31:14

severe

Alisa Minkin 31:15

s- severe anxiety, a phobia, OCD. OCD is so stealth. OCD

Robyn 31:22

a kid who have O-

Alisa Minkin 31:22

can- Mm-hmm. Kids have OCD, and the OCD can make a truly different day of their lives,

Robyn 31:28

look

Alisa Minkin 31:28

it will look like they're demand avoided.

Robyn 31:30

don't

Alisa Minkin 31:30

if you don't know to look for that and you're not believing evidence-based strategies, you can

Robyn 31:37

You

Alisa Minkin 31:37

miss it

Robyn 31:37

miss

Alisa Minkin 31:38

will miss what's happening, and you will think my kid is a...

Robyn 31:40

will...

Alisa Minkin 31:41

then you will... So then the, the challenge is, is that the current narrative on social media is to decrease demands, lower, lower demands.

Robyn 31:50

demands, I do

Alisa Minkin 31:50

Demands, I do believe that the people doing it accurately are scaffolding demands, but a lot of the narrative on social media is

Robyn 31:56

kid be

Alisa Minkin 31:56

let your kid be on screens as long as they need. Regulate them. Bring them whatever food they want. There's, you know, just do what they

Robyn 32:04

basically,

Alisa Minkin 32:05

basically, because that will reconnect you. And then once you're reconnected, their nervous system is safe,

Robyn 32:11

you

Alisa Minkin 32:11

and so then you can continue to build expectations.

Robyn 32:14

take a

Alisa Minkin 32:14

If you take a kid who is anxious, who has OCD who has ADHD,

Robyn 32:21

put

Alisa Minkin 32:21

and you put them on screens, or first of all, you give them

Robyn 32:24

of

Alisa Minkin 32:24

this level of avoidance, the accessibility to this level of avoidance, you are making these diagnoses worse.

Robyn 32:31

that

Alisa Minkin 32:31

And so that is very scary to people who, like me, follow evidence-based strategies to see anxiety go down and see OCD go down and see how families can come out of these dark places. And then, but if they go down, went down this road,

Robyn 32:47

just get

Alisa Minkin 32:48

it would just get smaller and darker.

Robyn 32:50

so that is scary.

Alisa Minkin 32:52

is scary. And then,

Robyn 32:53

the

Alisa Minkin 32:54

and then also the point about you would be missing it, and then they have to touch on screens. The screens themselves

Robyn 33:01

The

Alisa Minkin 33:02

can be the root

Robyn 33:03

a lot

Alisa Minkin 33:04

of a lot of the issues. And I don't

Robyn 33:06

that

Alisa Minkin 33:06

give them

Robyn 33:07

I know

Alisa Minkin 33:07

the credit to people in the world that I'm in and the area that, you know, this is something we talk about, this is something we learn about, this is something we have freedom. I mean, this is like my whole life is this.

Robyn 33:16

if

Alisa Minkin 33:16

But if you take a kid who

Robyn 33:17

with ADHD and you think,

Alisa Minkin 33:19

you think,

Robyn 33:20

they

Alisa Minkin 33:20

"Oh, they are demand avoided," and you say, "Well, I'm gonna, I'm gonna just, you know, meet them where they are, give them access." I mean, I have a child like this,

Robyn 33:28

if

Alisa Minkin 33:28

and if I would just gave him access this way,

Robyn 33:31

ADHD would get

Alisa Minkin 33:33

would get so much worse. He would--

Robyn 33:35

the

Alisa Minkin 33:36

He is-- The way his dopamine receptors would develop would be so horrible to him,

Robyn 33:41

his

Alisa Minkin 33:41

and his demand avoidance would only get worse. And you can see it in day-to-day. Like, you see how, like, they're calm, and then when you take the screen, people will say screens are regulating because they're calm in them.

Robyn 33:52

that's not

Alisa Minkin 33:52

And regulating, that's distraction. That's-- And being calm and being regulated are not the same thing.

Robyn 34:00

is being able to

Alisa Minkin 34:01

Being regulated is being able to actually be dysregulated and to be able to

Robyn 34:04

tools

Alisa Minkin 34:05

tools to be able to, like, You know,

Robyn 34:08

to keep using the

Alisa Minkin 34:08

make it

Robyn 34:09

but

Alisa Minkin 34:09

the day properly. But it, it's not actually about

Robyn 34:12

regulated. It's

Alisa Minkin 34:12

regulated. It's about being distracted. It's about being calmer, and it's about being easier.

Robyn 34:17

It's a

Alisa Minkin 34:17

It's, it's a very difficult thing because I understand it, and I also...

Robyn 34:20

just to insert

Alisa Minkin 34:21

Just to insert my passion again. Yes, please.

Robyn 34:24

is that

Alisa Minkin 34:24

I was gonna do that for you, but...

Robyn 34:25

I understand. I tried really, I,

Alisa Minkin 34:28

Yeah.

Robyn 34:28

I try really hard. It's hard when I get on this 'cause there... is,

Alisa Minkin 34:31

whatever What

Robyn 34:33

this

Alisa Minkin 34:33

it

Robyn 34:33

good

Alisa Minkin 34:34

to be

Robyn 34:34

for people,

Alisa Minkin 34:35

and

Robyn 34:36

you learn

Alisa Minkin 34:37

when you have children, demand, anxiety, and fear,

Robyn 34:42

have the

Alisa Minkin 34:42

you have to be a rookie in yourself to make a change.

Robyn 34:45

control

Alisa Minkin 34:46

be changed

Robyn 34:47

that

Alisa Minkin 34:47

and

Robyn 34:47

a huge

Alisa Minkin 34:48

have a huge impact on them.

Robyn 34:49

be

Alisa Minkin 34:50

I want that to be bad news, but it

Robyn 34:51

is good

Alisa Minkin 34:52

is good news that we actually can

Robyn 34:55

we

Alisa Minkin 34:55

control our kids and make

Robyn 34:56

but we

Alisa Minkin 34:56

a difference. We can control ourselves. So,

Robyn 34:59

and I wanna have the

Alisa Minkin 35:00

and I really have the compassion because again, in my own lived experience and also,

Robyn 35:04

just from knowing

Alisa Minkin 35:05

just really with so many different families, some have resentments and feelings. We can support them in a way that helps with the doubts a little bit,

Robyn 35:15

it

Alisa Minkin 35:15

but it is

Robyn 35:16

exhausting

Alisa Minkin 35:18

so exhausting and hard.

Robyn 35:19

so

Alisa Minkin 35:20

so good when your kid

Robyn 35:22

calmer, and when

Alisa Minkin 35:24

and when you can sit next to them and not get a fight,

Robyn 35:27

you can

Alisa Minkin 35:28

and you can feel like for five minutes they're enjoying themselves.

Robyn 35:31

I

Alisa Minkin 35:32

And so I understand how this happens, and I really, really, really, I certainly get

Robyn 35:37

It's, and

Alisa Minkin 35:38

It, it's, and it's, and it's painful. Like these parents are--

Robyn 35:40

even

Alisa Minkin 35:41

It's not even like this is their problem. I mean, it's, it's painful to see our kids in a bad place. I mean, it is

Robyn 35:47

on a screen,

Alisa Minkin 35:47

us, for me,

Robyn 35:48

food that

Alisa Minkin 35:49

eating definitely as good. We're not, we're not going outside for days.

Robyn 35:53

I

Alisa Minkin 35:53

You know, I don't think this is fun for anyone, and that's why I just want, I want to have so much compassion. I just want people to know there's another way, and that the social me- the social media narrative doesn't have to carry.

Robyn 36:04

of it, and we

Alisa Minkin 36:05

And we can actually find a lot of these evidence-based groups that have been around for a really long

Robyn 36:11

to, to

Alisa Minkin 36:12

time to change. So I'm gonna bring it up. To me, it's the elephant in the room, and that's access, okay? It's access. Access. And, and the problem is I looked you up on space parent p- approved space parenting. You're like one of ten in the country, okay?

Robyn 36:28

There's

Alisa Minkin 36:28

Of people who at least took...

Robyn 36:29

there's a ton of trained people. There's not a lot of certified people. Yeah.

Alisa Minkin 36:33

I see. I see. Well, where do you find the list of the trained people?

Robyn 36:35

SPACE, onspacetreatment., oh gosh. I'll

Alisa Minkin 36:39

I went there. I only saw ten names, including yours, but... Okay, my, my point is that...

Robyn 36:42

trained versus certification, there's different lists. Go ahead.

Alisa Minkin 36:46

I wonder if they're available in universities at like a, a, you know, lower cost.

Robyn 36:51

so I will say I'll give a pitch for this for sure. There's a lot of centers, I know in Massachusetts, I would have to look at other states to know,

Alisa Minkin 36:58

Right.

Robyn 37:00

communi- we have,

Alisa Minkin 37:01

Because the agencies that they'll have space trained providers

Robyn 37:08

run

Alisa Minkin 37:08

and neighborhood groups that they have-- I mean, it's,

Robyn 37:10

it's

Alisa Minkin 37:11

of course it's, you know, it's a niche, so there'll be a wait list most of the way in.

Robyn 37:14

also

Alisa Minkin 37:15

There's also some space providers that take insurance. Like it's impossible that no one provides access. Access is so many people. Access is

Robyn 37:22

actually

Alisa Minkin 37:22

Actually finding that hole and also in knowing about it. Think about like how many people have gone through something like this and still see

Robyn 37:28

maybe doing the

Alisa Minkin 37:29

maybe doing the research that means like basically doing identity research or resources to do the research and, you know, doing the teaching or being somewhere physically. And also the investment of working full-time. So if you ask me, I'm like, "Well, we're gonna have to see if we can start the day." Well, that's an access issue. Not everybody can go on Zoom to work every day. They have to still- It's really seductive. The, the, the PDA narrative is really seductive because it feels good in the short term. You see your kid happy, you get peace, they get peace, but it's not the long-term solution.

Robyn 37:59

do wanna add that you actually... i, just because I know a lot of these parents is, I don't even wanna say that they see their kid happy. Sometimes they're happy, but also s- it's continues to be painful, but like you're saying, it is relief. It is short-term relief of fighting the system and working so hard and all of that. But a lot of parents, while that's happening, they're working so hard. It's not that it's easy, it's just, it just feels "Oh, okay, this is something I can do,"

Alisa Minkin 38:26

fighting the system and working somewhere and all of that. But a lot of people don't know that it's happening. They're working so hard. It's not that it's easy, it's just, it just feels like, "Oh, maybe this is something I can do." I'm really glad you said that. I'm gonna link to there is a a group of podcasters called The Refrigerator Moms, and they did an episode on pathological demand avoidance, and I'm linking to what they call The Refrigerator Papers, 'cause when they do an episode, they have a longer article based, all evidence-based with research behind it, and I, I thought it was phenomenal. One of the things they said is that two bad choices. That's the hardest thing. It is so hard. You don't have good choices, and you're trying the best you can, and we wanna come at this with incredible compassion, but it's, it's not, it's not as, it's not as sexy, all right, what we're talking about. It's hard work. It's hard work for the parents. It's hard work for the kids. And I just wanna say that it's okay to try the best you can and not be perfect at it,

Robyn 39:09

Totally.

Alisa Minkin 39:10

right? One step forward, two steps back.

Robyn 39:12

And it's also okay to say, I don't even... Like I was saying about the Lord of the Flies thing, like I, I don't know that I'll never, take a break from mainstream schooling. I don't know if my kid will always do

Alisa Minkin 39:25

everything straight

Robyn 39:26

It's

Alisa Minkin 39:27

up. Now, I'm not saying anything.

Robyn 39:28

it one

Alisa Minkin 39:29

But I think it's important about this narrative of the only way to regulate my child is to, you know,

Robyn 39:36

them complete

Alisa Minkin 39:38

them

Robyn 39:39

removal

Alisa Minkin 39:40

complete

Robyn 39:40

of, their

Alisa Minkin 39:41

their stressors, and that's the way that I have to support them. That's the only way that this nervous system piece can,

Robyn 39:48

go, can move

Alisa Minkin 39:49

go,

Robyn 39:49

And

Alisa Minkin 39:50

get over and heal and all of that. And I think that that is a slippery slope.

Robyn 39:56

what it

Alisa Minkin 39:56

really what it is. I think that if you come at it with love,

Robyn 39:58

placement that I'm

Alisa Minkin 39:59

placement that I'm in right now isn't working, okay, we're gonna take a break, then I need a therapist. We talk about it. Right. Yeah, you can. Yeah.

Robyn 40:09

this wonderful Calm

Alisa Minkin 40:10

Plus connect me to him, please. Plus connect me to him, please.

Robyn 40:13

who's also just started the PDA Parenting Podcast, Kirk he talks

Alisa Minkin 40:17

He talks about the

Robyn 40:17

child

Alisa Minkin 40:18

biggest general approach is

Robyn 40:19

like

Alisa Minkin 40:20

it's not like he doesn't want a perfect

Robyn 40:21

here

Alisa Minkin 40:22

We're not

Robyn 40:22

there's

Alisa Minkin 40:22

to say there's one way. That's not what it is. It's

Robyn 40:26

slope

Alisa Minkin 40:26

sake

Robyn 40:27

be-

Alisa Minkin 40:27

of

Robyn 40:27

believing

Alisa Minkin 40:28

believing that the only way to the other side is

Robyn 40:31

all

Alisa Minkin 40:32

the whole of this, of the demands from your child is the

Robyn 40:36

gonna

Alisa Minkin 40:37

only way that they're going to be able to regulate or eat.

Robyn 40:39

it's just,

Alisa Minkin 40:40

Like it's just too extreme. Is it

Robyn 40:43

of

Alisa Minkin 40:43

a subset of people? Yes. But the idea that it has generalized in this way,

Robyn 40:48

is

Alisa Minkin 40:48

that is what is scary.

Robyn 40:50

self-diagnosis.

Alisa Minkin 40:51

says, well, it is really hard to go back and forth. I think what they say, so I don't have the answer to that.

Robyn 40:57

they

Alisa Minkin 40:57

But when they say like,

Robyn 40:58

have

Alisa Minkin 40:58

well, you don't have lived experience and

Robyn 41:00

evidence

Alisa Minkin 41:01

no evidence that shows that for me,

Robyn 41:03

no

Alisa Minkin 41:03

there's no evidence

Robyn 41:03

that

Alisa Minkin 41:04

that shows that. Right.

Robyn 41:05

on either

Alisa Minkin 41:06

But either side, like you said, we

Robyn 41:07

studies, so we

Alisa Minkin 41:08

studies. We have to talk about it. We have to talk about the alternatives and provide options. We have to have conversations about it. We absolutely do. I think that's a really, really important point. And I want to say about schools, we mentioned authoritarian. Many schools are authoritarian and that will make these kids worse. And you're the parent. Take them out then, you know, or find a better placement for sure. That's not the same thing as avoidance. I don't think we have to... We're going to backlash. We're going from authoritarian to permissive, bopping right over to that authoritative.

Robyn 41:37

Exactly.

Alisa Minkin 41:37

we had schools that were, you know, using more responsive parenting, teaching type approaches because responsive, true responsive parenting is authoritative parenting, right? The problem is what's become mocked as gentle parenting is not that way. It

Robyn 41:54

words,

Alisa Minkin 41:54

was

Robyn 41:59

and for getting out there and all that, it is a very difficult space to watch. It's hard with

Alisa Minkin 42:03

like work

Robyn 42:08

programs.

Alisa Minkin 42:09

programs. Like I

Robyn 42:10

media, and

Alisa Minkin 42:10

and I was selling

Robyn 42:12

evidence-based programs.

Alisa Minkin 42:13

programs. Like I was selling only evidence-based programs. I don't make up my own programs. I don't want to. And I'm not saying everybody who does is wrong.

Robyn 42:21

think

Alisa Minkin 42:21

Like I think that there are some wonderful people out there creating wonderful

Robyn 42:25

on

Alisa Minkin 42:25

things based on evidence. So like I get it. But I

Robyn 42:28

tell people,

Alisa Minkin 42:28

just wanted to be like, hey, these programs exist. Like

Robyn 42:31

them with

Alisa Minkin 42:31

do we look for things that don't exist? Yeah. So I'm gonna just add another note of compassion here. And that I think the problem with responsive parenting as it's portrayed and the reason we get the mockery of gentle parenting is because it's not realistic. Idealistic, it's not realistic, and it's creating this intensive parenting culture for which we get backlash. And I don't blame any parent of a neurodivergent kid. Anyone. I am one of those. That I could go to you and say, "I can't do this."

Robyn 42:57

Yeah,

Alisa Minkin 42:58

There's theory and reality. And I think trying to get your brain out of the idea of perfect parenting, which is a total myth even for a typical kid and how much more so for a neurodivergent kid and say, "Let me figure out the best that I can do. And we'll have good days and we'll have bad days. It's okay."

Robyn 43:14

Yeah, totally. Totally. I agree. It's... All of this, I know, I hope people who are... I hope too many people didn't,

Alisa Minkin 43:20

drop that. We, we freaked them

Robyn 43:22

during the

Alisa Minkin 43:22

out.

Robyn 43:22

But I really, all of my work comes from a place of compassion towards

Alisa Minkin 43:26

Right.

Robyn 43:26

It's not at

Alisa Minkin 43:27

And

Robyn 43:28

understand,

Alisa Minkin 43:29

understand. I mean, there's a dark space where you say to parents, people accommodate their kids out of love and compassion and out of

Robyn 43:36

Because w- I,

Alisa Minkin 43:37

Because

Robyn 43:37

slides is

Alisa Minkin 43:38

of my slogans is like, people accommodate their kids out of-- because you're a good parent.

Robyn 43:42

accommodate their

Alisa Minkin 43:42

accommodate their kids because it comes from a place of love

Robyn 43:45

compassion,

Alisa Minkin 43:46

and passion and survival, biological need to protect your kids. Like, this is,

Robyn 43:51

you

Alisa Minkin 43:51

this is... We are driven to do this.

Robyn 43:54

just have

Alisa Minkin 43:54

We just have learned a lot about how, you know, to

Robyn 43:58

the

Alisa Minkin 43:59

discover. And so when we

Robyn 44:02

protect, that's when we

Alisa Minkin 44:03

that's when we kind of steal their,

Robyn 44:05

their, growth.

Alisa Minkin 44:06

their growth. We Kind of say like, "No, no, no, it's okay." It goes back to when we talked about how

Robyn 44:11

the older

Alisa Minkin 44:12

people with our kids

Robyn 44:13

love

Alisa Minkin 44:13

that have a love to use

Robyn 44:14

is the

Alisa Minkin 44:15

as a coach is

Robyn 44:15

we're just

Alisa Minkin 44:15

a hard source because it might be they're the

Robyn 44:19

children that

Alisa Minkin 44:20

children

Robyn 44:20

with,

Alisa Minkin 44:21

we were

Robyn 44:21

with

Alisa Minkin 44:21

with the, the parents of the little children. It's

Robyn 44:25

did we accidentally steal

Alisa Minkin 44:27

and we steal their opportunities for By kind of trying to help protect them. And that came from a place of love, and that doesn't mean it was protective.

Robyn 44:37

it's

Alisa Minkin 44:37

But based on that opinion, there's very small space

Robyn 44:40

that are

Alisa Minkin 44:41

of some people perhaps trying to-

Robyn 44:42

their kid. I've

Alisa Minkin 44:43

Oh. I've

Robyn 44:44

really had that come up. For me, it's always out of

Alisa Minkin 44:47

been there. I never believe that. It, it is fear for me. Yeah. And I, I don't believe it's ever too late, although I think earlier is always better. And I wanna say also, we want to talk just a minute about appropriate scaffolding as opposed to inappropriate. And I think what that-- the difference is, is to get to the just right challenge. We're not asking parents to ask kids to do what they can't do. How do you know the difference? What's appropriate scaffolding? Maybe I would keep

Robyn 45:23

you might have a kid who, there's so many examples.

Alisa Minkin 45:26

many examples. One could be a sen- a sensory piece. It's like, well, here's a good place to think about this.

Robyn 45:30

you could have a

Alisa Minkin 45:31

And you would have a kid who really doesn't like, but not doesn't like, feels sharply

Robyn 45:35

noises,

Alisa Minkin 45:36

This is... And so an accommodation for them could be

Robyn 45:40

or something to

Alisa Minkin 45:41

or something to dull. But, but blind, but maybe something that would be similar.

Robyn 45:47

wouldn't

Alisa Minkin 45:48

Right. But now that that could

Robyn 45:49

all.

Alisa Minkin 45:49

of me,

Robyn 45:50

it

Alisa Minkin 45:50

they may have engaged harder. They

Robyn 45:53

sitting.

Alisa Minkin 45:53

in their city. They think it's city, so to the job where they Could have appropriate you know, sensory accommodation. But that really Doesn't put the sensory, you know, kids who

Robyn 46:02

fabrics.

Alisa Minkin 46:02

pair of earrings.

Robyn 46:03

That doesn't bother me.

Alisa Minkin 46:04

that doesn't bother me. I'm like, "Okay,

Robyn 46:06

not to be able to

Alisa Minkin 46:07

well, we want them not to be something that

Robyn 46:08

That's...

Alisa Minkin 46:09

helps."

Robyn 46:09

This

Alisa Minkin 46:09

That's me. This is a lot of Talk because

Robyn 46:11

need?

Alisa Minkin 46:13

up. The same thing with everybody who

Robyn 46:15

mutism

Alisa Minkin 46:15

has selective mutism or social anxiety. And you can talk about a non-selectively speaking for their employee. Write

Robyn 46:22

they can

Alisa Minkin 46:22

down if they are-- if they get free, you might

Robyn 46:24

So

Alisa Minkin 46:25

write down what they should say. So that's their accommodation

Robyn 46:28

but

Alisa Minkin 46:28

sense.

Robyn 46:29

for someone

Alisa Minkin 46:29

But you're doing it for someone who maybe feel they can't think. You're trying to help them through it. Let's get them speaking.

Robyn 46:35

me, the

Alisa Minkin 46:35

And so they have to like to be an appropriate accommodation of giving them something to say. So they have to close it once they're free to do the non-selectively speaking or

Robyn 46:44

task.

Alisa Minkin 46:45

But because

Robyn 46:46

anxiety, it

Alisa Minkin 46:46

with social anxiety might be like you're

Robyn 46:48

one of the

Alisa Minkin 46:49

saying one of the things you're ordering at a restaurant, you're ordering one thing, but they're ordering something like that. So it's like, what is the need

Robyn 46:57

and what is the

Alisa Minkin 46:58

and what is the anxiety

Robyn 46:59

do we

Alisa Minkin 46:59

do we

Robyn 47:00

that apart?

Alisa Minkin 47:01

bring that to light? And it might be on a ladder, like a hierarchical ladder,

Robyn 47:05

Totally.

Alisa Minkin 47:06

would be different, right?

Robyn 47:08

And I think about it as... I guess the question I would always ask is this helping your kid access something, or is this helping your kid avoid something? So if an accommodation is

Alisa Minkin 47:17

an accommodation is something that access

Robyn 47:19

making their

Alisa Minkin 47:20

something so that their heart's bigger and an accommodation is helping them believe something that is going to make their heart small.

Robyn 47:27

that,

Alisa Minkin 47:27

And that,

Robyn 47:28

a good

Alisa Minkin 47:28

that to me is a good barometer

Robyn 47:30

is this accommodation

Alisa Minkin 47:31

accommodation appropriate? That may be very difficult because your kid may have a good day or a bad day. On one day, they may be able to do something and another day not. And it's really hard to know. So just to be compassionate again for parents, it's okay to be getting it wrong. That's how you learn, right?

Robyn 47:47

It's all trial and

Alisa Minkin 47:48

There's,

Robyn 47:48

It's that's

Alisa Minkin 47:49

yeah. And tolerating your own uncertainty, right?

Robyn 47:56

is a crystal ball to tell them that it'll be okay.

Alisa Minkin 48:00

Right. I can fix this.

Robyn 48:02

Yeah.

Alisa Minkin 48:03

You can't, you can't always. And being able to accept your child where they're at and tolerate where they're at and then help them move forward, I think is the goal. And I promised you we'd be done in time, so I'm gonna let you go. But I want to thank you so, so much for doing this with me.

Robyn 48:15

It was

Alisa Minkin 48:16

Thank you, Robin.

Robyn 48:17

glad. It was. I'm so glad. Thank you.

48:21

Thank you for listening to Kids Matter. Raising Healthy, happy Children Takes a village, and I'm grateful you are part of ours. If today's conversation resonated with you, please share this episode with another parent, grandparent, teacher, or anyone who cares about kids. Together we can build a supportive community our children deserve. I'd love to hear from you. Share your thoughts, questions, or suggestions for future topics at Kids Matter podcast@gmail.com. With no explanation for your voice truly matters. Until next time, keep advocating for the children in your life because kids really do matter. They are our future. I'm Dr. Elisa Minkin and this has been Kids Matter. Please note that while I am a pediatrician, I am not your child's ped. This podcast is for informational purposes only and does not constitute medical. For any medical concerns or decisions. Reach out to your child's healthcare professional.