Dr. Tim Thayne has Dr. Tim DiGiacomo and his two colleagues Rachel Morin and Brittany Little on the podcast this week. The discussion is centered around anxiety and how it develops and how you can reduce it. Anxiety isn't only genetic it can also be environmental in terms of modeling. In this episode, these four experts discuss skills to handle anxiety and to model techniques for your kids.
Dr. Tim Thayne has Dr. Tim DiGiacomo and his two colleagues Rachel Morin and Brittany Little on the podcast this week. The discussion is centered around anxiety and how it develops and how you can reduce it. Anxiety isn't only genetic it can also be environmental in terms of modeling. In this episode, these four experts discuss skills to handle anxiety and to model techniques for your kids.
Hi, everybody, thank you so much for joining the podcast today, I'm really excited because we have some special guests on the podcast. And if you're watching the video this, you get to see them. If not, I'll introduce them. But I'm grateful. So we've got we've got some of the clinical team from Mountain Valley treatment center. And their specialty is working with, with and you guys can help me with this. But working with children, adolescents, with OCD, with anxiety disorders, with challenges around those kinds of things. And even I heard just before the call some eating disorders as well. And so we've got Dr. Tim de Giacomo, who's the Clinical Director of mountain valley. And we're grateful for him being on the call here today, we've got Rachel Morin, who is Assistant Clinical Directors at right there at Mountain Valley, and another clinician Brittany Liddell is here. And so thank you so much for being on the this podcast, I have been a huge fan of mountain valley for a very long time. And I was always a fan, but then I had the opportunity to actually go and visit your campus and, and be there and kind of sit in on one of your groups that you had with with some of the students in your programs, your residents. And that was eye opening to me. And I started to really think a lot about some of the techniques I saw there actually tried to apply them a little bit in my own life, I started thinking of ways we could help some of the families and parents and teens that we're working with. And and so it's just fun for me to just to see the some of the processes that you all specialize in. So if you would, to maybe you could start out and just kind of maybe better introduce yourselves, and and your team here. And then we'll jump in and talk more about anxiety and what we can do.
Dr. Tim de Giacomo:Sure, sure. Glad to take it away. Tim, thank you for having us on here. And I think similarly, we've we've really appreciated having worked with, with your program Homeward Bound over the past several years. And we've also also found that our families are really benefited a lot from some of your wisdom and guidance. A lot of our families are still using your not by chance book. And frequently talking with parents who said, you know, I read this, this section and not by chance. And that's really true. And it really speaks to me. And I got to work on that. Or, you know, this guy definitely knows what he's talking about. So sometimes
Dr. Tim Thayne:you hit you hit the nerve, you know, when you write something and I always wondered if that would happen. It is fun when they'll they'll say something like, I was reading your book, and I thought you were reading the letters from my, my teen who's in treatment is like you are right there. You said exactly what he said. But it's just yours right patterns that you see over and over again. So glad glad it's been helpful.
Dr. Tim de Giacomo:Good, good. Good. Well, again, yeah, we appreciate being here today. And a mountain valley is is a program that really specializes in treatment of anxiety and OCD for adolescents, teens and young adults. So it just 13 to 20. And I've got some really great members of the clinical team here today. Rachel is our our Associate Clinical Director and Brittany Liddell, who was one of our expert, OCD clinicians. And I think it's a it's an interesting program. It's not very, it's definitely not like a hospital fields definitely got more of a boarding school field. We do a lot of work outdoors, primary therapy modalities or cognitive behavioral therapy and a lot of exposure therapy. And we also incorporate Acceptance and Commitment Therapy, DBT skills, medication management, so we really round it out so that our residents are getting the highest quality care that they can. And I'd say it's a pretty fun and interesting place to work with some really good people.
Dr. Tim Thayne:So that's, that's awesome. I want to get back out there again, because you're now in a in a new campus, I believe since the last time was there. You still have animals on campus.
Dr. Tim de Giacomo:I am looking at some steer and
Dr. Tim Thayne:my office Nice, nice. I've still got pictures of the pigs you had back then. Yeah, so yeah. I will have to get back out there again. Well, let's, let's jump into this topic here. I've had parents asked me if I felt like, not only were we going through a pandemic with COVID, but are we going through some kind of epidemic with mental health? And maybe particularly anxiety? And it sure seems like, everybody has a little more anxiety than they did before, or at least, the people I'm around and myself included, and maybe most because there's a lot of uncertainty around the environment we're in right now. So I think what we're going to talk about today could be applicable to anyone out there to some degree or another. And so as we get started here, with would would, would you comment on the question I've got here, of really around? How much of our anxiety that we feel are our children feel? Do you feel is environmental? And how much is that might be genetic? And do parents play a role in? And in that? The development of anxiety or the the reduction of anxiety in their children?
Dr. Tim de Giacomo:Maybe Rachel, Brittany, do you guys want to start with this, this is something that we definitely teach about in our webinars and, and in our ERP groups, to our residents.
Rachel Morin:Sure, I'll, I'll take this one. So definitely, parents can play a role in the development of anxiety, it is genetic. So if you have family members who have clinical anxiety or OCD, then the child may be more likely to have it as well. It also can be environmental in terms of modeling, and the things that we learn from our caregivers. And so if you tend to have parents who are pretty anxious about certain things, then that will rub off. And a lot of times kids will learn to be more hyper vigilant and more aware of their surroundings and concerned about the things that are going on around them. They may perceive danger where it isn't necessarily present, because of things that they've been told or just observing mom or dad or whoever the caregiver is react in certain ways to situations. So that is, as Tim said, something that we teach them and talk to families about while they're here as well. Hmm.
Dr. Tim Thayne:You know, just this week, it's kind of interesting. This ties into something that that I did this week, I was asked to be on a on a TV show here, k BYU TV show called family rules. And it was about it was about the topic of raising independent children. And and I told the story of, of my grandpa, he was kind of old school. He was, he was definitely not warm and fuzzy. But he but I knew he loved me, but he had his own way of doing it. And so every time we'd fall down, maybe hurt ourselves as little kids or something like that. It kind of laugh. And it just sort of say, Hey, come here, then I'll pick you up. And he was he was, every time that happened, I knew that was going to come out of his mouth. And even some pretty extreme situations. I got in with a horse one time, he did same thing kind of chuckled, I've got the wind knocked out of me. And I'm just laying there wondering, you know, can I get up and he's just laughing. He says, Hey, Tim, come here, and I'll pick you up. So he, he just kind of the kind of an example in my life of someone that did not, did not transmit that to me. It didn't make, you know, risky situations, you didn't make me feel like it was scary. Like I really needed to be able to do hard things and even maybe kind of risky, hard things sometimes. And so I got that from him. And that was that was countered to maybe some of the other influences I had at different times.
Dr. Tim de Giacomo:I wonder if there's something too about that. Or for your grandfather and others like that. There was a consistency in their response. And there's their presence as well. So you're getting the message of you can get up and you can cope with this and you You can deal with it. And also I'm here.
Dr. Tim Thayne:Yeah, you bring yourself over here and I'll hold you. I'll help you out a comfort. Yeah, if you need it. That's pretty fun to think about that any, any wasn't a therapist just, you know, old school cowboy.
Dr. Tim de Giacomo:And I think there's a difference, you know, we're talking about family responses to anxiety. And, you know, there's a genetic predisposition, as well as then the modeling. So if you fall off a horse, and you know, those around you, everybody looks in shock and awe and runs over immediately and makes a bigger deal out of it than maybe it needs to be. That sends a very different message than the one that you were talking about. I don't know much about horseback riding or what response you should or shouldn't have. But there's definitely a difference in and the ones that we're talking about.
Dr. Tim Thayne:Right? I've thought about that episode a lot. And, and I think the majority in me included, probably would have ran to them, oh, you okay, I'm so sorry, I wish maybe I shouldn't have had you do what I just had to do, you know, my fault. And that would have sent a pretty different message than the one I got, like, you're, you're strong enough to get up, you can do it.
Rachel Morin:And that's a big part of what we work with parents on while their children are here is how to reframe that message. So that the message that they're sending is you are strong, you are resilient, you are capable of handling the worst case scenario, should
Dr. Tim Thayne:it happen. That's awesome. And as you do that, what are some of the challenges parents have and really kind of embracing that? They might be able to get it cognitively. But what are some of the challenges for them to be able to actually send that message?
Brittany Liddell:What's the one of the biggest things that come up is like how to give validation as a parent. And to sort of hold this dialectic of validating that things are truly difficult. And I believe in you and you can get through it. So a lot of parents either hesitate to validate what's truly difficult, because they fear that if they validate, then they do have to send the message like you can't do this, or you need my help. Or on the other side of things, they feel like I'm being validating by coming over and saying, oh my gosh, that was so horrible. Let me help you. And so we do a lot of coaching around this balance of holding space for how challenging and difficult these things are, right? falling off a horse is scary and painful. And you got this, you got the distress tolerance, I got the distress tolerance, so really giving parents the language and the permission to do both at the same time.
Dr. Tim Thayne:That's great. Let's say a parent is struggling with anxiety themselves. And and they're becoming aware that this their own anxiety can have an effect on the way they parent and maybe transmit that to their their child. So they're becoming aware of that through education. Do you have any ideas for them of what they can do in the moment? When the anxiety is high? And there they could, they're, they're using? They're sort of aware, what could they do in the moment that would change maybe the outcome of some kind of episode or situation they're in.
Brittany Liddell:So the two things that I would say are number one, like potentially naming it, because parental modeling of having anxiety right now I'm going to use a distress tolerance skill would be useful for them. So there's
Dr. Tim Thayne:nothing wrong with telling your child Hey, on philosphy anxiety right here.
Brittany Liddell:Parental modeling is one of the strongest forces in a child's life. So if I model my problem solving or the skills that I want them to have, that's probably one of the best things I could do. So modeling it themselves. And using strategies to kind of down regulate themselves is useful, we tend to co regulate with the people we're around. So if something's getting escalated as a parent, if I just do what I need to do to down regulate myself, name it really kind of model that healthy coping. I've done something awesome for myself and for my kid.
Dr. Tim Thayne:Oh, that's awesome. You know what, what you've kind of done for me, as you talked about that, instead of it being a real negative. If I'm a parent, and I'm struggling with anxiety, instead of that being a real negative and me feeling guilty that maybe I've transmitted some of that to my child. I have an opportunity to maybe lead the way, you know, to be the one to kind of work on my own anxiety and kind of be transparent about what I'm feeling, what I'm doing, how I'm strategizing, what what kind of strategies I'm taking. So that takes a pause, though, doesn't it? Maybe, maybe that initial reaction, there might be that the old patterns could come back pretty quick. But what would you say about the pause? And and what what could they do? If they could just learn to maybe start with the pause?
Dr. Tim de Giacomo:I think if there's an awareness, and there's the pause, and I think there's actually, there's a lot that goes into that ahead of time. So Brittany was talking about awareness, talking about skills time down regulating, right. So it's not just like, all of a sudden, one day, you know, the parent is in the situation where they're able to say, Oh, I'm feeling anxious. Now, let me use the skills, right, there's got to be lead up to it. And so just like our residents are working on understanding skills and learning, how does anxiety actually operate, so learning things like anxiety maintenance cycle, learning how their thoughts and their feelings and their actions and physical sensations are all connected, right? We want parents to be doing that as well, so that they can get to that moment, when they're able to identify and be aware, I'm feeling anxious. Now, I'm going to pause now I'm going to do all of these things. So I think it's, it's easier said than done. And I think there's a lot that leads up to it, in order to really take advantage of when you're when you're identify whatever emotion you're feeling, whether it's anxiety or anger, whatever, that you're able to then take that as an opportunity to do something differently than maybe you've done in the past. Right. And in terms of the modeling piece than you were saying, I think there can be a stigma around. If I say I'm feeling anxious, so is that a bad thing? No, it's, it's a very good thing, especially if I can say I'm feeling anxious, and I'm still going to do what I gotta do. Like, I'm gonna lean into this situation, I'm not going to avoid it, I'm going to embrace it. And I'm going to figure it out. I think that sends a very powerful message to kids to others around you that, you know, you're capable, and you believe that those with you are capable, that they can deal with hard things.
Dr. Tim Thayne:I'm wondering, just hit me, I'm wondering if then becoming aware of all that and kind of leaning into it is like maybe one of the first levels of exposure work? Like they're, they're sort of exposing themselves to that emotion. Maybe more than just the realization itself helped me kind of work on that. i It's never, I've never thought about that. Is that true?
Dr. Tim de Giacomo:Rachel, you want to take that one.
Rachel Morin:So for sure. For a lot of people just identifying and recognizing or stating to others like I am feeling anxious can be a part of sitting with the distress of anxiety. For most of us and 10 mentioned the anxiety maintenance cycle, our natural reaction when we're feeling anxious is to fight flight or freeze. So for most of us, we want to avoid whatever is causing the anxiety at any cost. And so that's the main thing that we teach residents and their parents here is that, you know, the anxiety in and of itself isn't dangerous. And that's when we want to be able to recognize this is what I'm feeling and learn how to tolerate that distress by saying like, there's nothing that I really need to do about this.
Dr. Tim Thayne:I'm not going to numb out I'm not going to flee from the situation when I sit with it. And and realize that the end of that experience I'm, I'm okay.
Rachel Morin:I would also say that for a lot of our residents, when parents are doing this, they find it really validating to see like, because when they're learning about this, a lot of times they'll say, oh my gosh, my mom or dad has anxiety too. And they start to recognize it. And so in family sessions when mom or dad are able to say, you know, I did this exposure today or I was feeling really anxious and I did this or it's the resonance graduation and they know mom or dad has a fear of public speaking and they give a speech. That's really validating and really encouraging and motivating for the kids who are also working on their own anxiety to realize I'm not in it alone. And not only do Mom and Dad understand, but they're also doing this hard work.
Dr. Tim Thayne:Oh, that's awesome. I bet you see that quite a bit, don't you? We do.
Dr. Tim de Giacomo:I really liked I really liked seeing as well when when when residents and their families are getting together and we've we've discussed the idea of family accommodation, what is it that families are doing that that maintain the anxiety? And the residents are saying to the parents? No, don't do that for me, right? Like I, I'm going to do this, it's going to be hard, I might get upset. This is what I need from you. This is what I don't need from you. Right? It's really them. Taking the reins and, and go home, what?
Dr. Tim Thayne:What can you assess about a resident that gets to that point, where they add on the stages who changed? And you know, kind of what? What do you think that? What's that mean to you as a clinician when we see that happen?
Dr. Tim de Giacomo:Britney, you want to take that one?
Brittany Liddell:Yeah, I mean, at that point, it's pretty clear that they're either in preparation or action, potentially maintaining their changes at that point, and it signals a willingness to experience the emotion. And to Rachel's point, like, oftentimes, we're teaching folks to experience and tolerate their emotions, and teaching parents that all emotions are okay, I think we get into this cycle of thinking like, oh, my gosh, if someone's anxious, or they're sad, that's terrible, we need to change that. And that's not really accurate. We all feel those things at times. And the more we fear them, the more it becomes cyclical, but if we allow ourselves to experience it, and remind ourselves, that's a normal human experience, then we're able to move through think through things more effectively. So when kids are saying, like, let me experience my anxiety, it's okay, we're all gonna get through this, that signals to aspect, they're understanding that they're going to feel all the things at times, and that that's okay.
Dr. Tim Thayne:That's a moment moment in time where it seems that the resident, even though they might be just a young teenager, is now leading the way. And it does make me wonder what what the patterns you see from the family system, when one of the one of those you're working with will get to that point where they they start to recognize the family dynamic, and recognize that input from their parents, maybe over functioning for them is is getting in the way of their progress. What do you see happen on the parent side, when that happened, when when that takes place?
Dr. Tim de Giacomo:You know, goes send a little bit of this earlier when we were talking about before we started recording it, but I was thinking a lot of parents are really trying their best. Really, I think we really believe here that everybody's doing the best they can with what they've got. And so parents are really open to, to learning what we have to teach, but also then to have that self examination, and self exploration and figuring out once once we understand the way our family is working, what were each doing to either overcompensate or accommodate, what do we do differently, knowing that that's going to be kind of disruptive and challenging, right? And they don't always know where that's going to lead them other than it's going to be hard. But it's sort of the idea of I think a lot of our parents embrace this ideas for like, you know, choose you're hard, right? You want it to be hard, where you're accommodating, and your kid is stuck. And you as a family of soccer, you want to be hard where you're growing, and you're developing and it's more rewarding in that way. And yeah, so you know, our families really go for the ladder.
Dr. Tim Thayne:Oh, that's awesome. Yeah. Love that reframe. You know, it's gonna be hard either way. But choose your heart I wrote about this actually is in the book not by chance, but it's kind of a fun little story where this neighbor came over and my wife had been working on the shed and kind of fixing it up to be sort of uh, you know, food storage and different things that she was doing and, and she came and looked at what my wife had done. And she said, I can either she put her hands on her hips and she looked at all this because I can either be overwhelmed or inspired, I choose to be inspired. And so she she kind of similar to that there's kind of some choices that you can make with with what what we can what we get confronted with and so I guess maybe to kind of wrap this up and honestly this could go on and on because I love your knowledge. I love what you have to share. And you There's been times where I felt like wouldn't it be great, because I visited you guys that one time wouldn't be great just to come there let you guys work on me, you know, just, like, helped me deal with with some just things going on in my life. And I just seem fun to me like, like I could really get better at these things with with your health and exposure and things like that. But if there's there's one thing that you could share with parents, like if there's just one thing they could do on their hand if they've got an anxious child. And it might be three different One things for each one of you. What would you hope that they would do? And that's one of those things, it takes a little thought because you have to sift through all the things that that are great that you could do. It's kind of like that 8020 principle, right? If you boil it down if there's just and I do this with Homeward Bound, because we do a lot of different things. And I've asked our coaches a few times. Okay, if we could just do one thing. That's it well, too, okay. Just okay, too. I could, I couldn't just do one. What would they be? And that's a really great question. Because it, it brings it down to something fundamental, or key. And I'm wondering what that would be in your mind. And it might be three different things.
Rachel Morin:I'll go first before they steal what I'm going to say?
Dr. Tim Thayne:Yeah, good, good choice.
Rachel Morin:So I would say, to reduce accommodation. So as a parent, it's normal to try to save your child from these emotions that like Britney said, we usually consider as negative emotions. And so just to recognize your urge, as a parent to save your child, and start to kind of reframe that into like, you want them to grow, and it's okay for them to do this. And, and so to stop saving them from situations that they don't need saved from.
Dr. Tim Thayne:Awesome. Thank you. My, my son, I won't say which one. But as he became more we're more aware of our dynamic our relationship. One day, he said that, do you think we're in meshed? And my first response is no, what are you talking about? But the more I thought about it? Yeah, I think so. Because there was some accommodations going on that I was doing things he could have done for himself. Yeah, Brittany, yeah.
Brittany Liddell:So one of the things that we talked about is how parents are providing support. And to Rachel's point, like, support is not accommodating and enabling our child to kind of get around their anxiety, but support is really giving validation for how they feel. So I would encourage parents to really kind of practice those validation skills, and we want to send the message, I know that you can do this, I believe in you, I believe that you can tolerate these feelings. So oftentimes, I'll ask parents the question, like, Do you believe your child can tolerate their feelings? And so to really reflect on that, and dig into that, as a parent in my thinking are fragile? Am I afraid they can't do this? And so I think that self reflection as a parent, is a good idea.
Dr. Tim Thayne:Yeah, and that might even enable them to reduce accommodations. You guys, yes. To have a system? Some ideas? Yeah. Tim, what do you think?
Dr. Tim de Giacomo:Yeah, I, I would piggyback off of both what Rachel and Brittany are saying, I think so much of it comes down to family work and accommodation. And I've also seen families sort of communicate differently, again, by doing the work here, rather than a more honest, direct, you know, empathic and not judge non judgmental manner, in a way that's very supportive. And I think that's really key. Because then that that allows people are actually really open up about what is scaring them, what is creating a lot of difficult to hold emotion. And so as you're talking about it, as it becomes just becomes more known than you can actually work on on the problem. We've had a lot of kids, a lot of residents here who start to talk about things or disclose things that they hadn't talked about before, and realize that's really what's been holding them back. So again, once they make that known, then you can actually create a plan and actually work on it. And for a lot of people, you know, that, in and of itself is the exposure is just sort of sharing, just putting it out there. And, you know, sort of hoping that people are going to respond in a way that that's helpful for them, and allows them to continue doing this work. So
Dr. Tim Thayne:that's great, so good. I, I, hopefully, my grandpa is somewhere out there listening, because there was this other side, that would have been really good, like, you know, kind of what you were saying, Brittany, to acknowledge the feelings. And Sophia said, Tim, I know you're probably knocked the wind knocked out of you, and, and you're probably scared. And I'm sorry about that. But I know you can pick yourself up and, and come on over, that would have probably been a little better. But anyway, great, great stuff from all of you today. Again, I wish you all the best at Mountain Valley in what you're doing for so many people and families. And I, I love the fact that you do so much work with the parents, as well. And you understand this, the family system and influences and how we we create cultures inside our families and patterns that that can be a part of the problem without us even knowing it. And so how to undo that a little bit. And so I think this will be really helpful for the listeners of the podcast. I think we all could take something of what you've said today and apply it into our lives. And so thank you so much for being on the podcast and thank you all who are listening and watching today. For for being a part of it. If you have thoughts and questions, don't hesitate to reach out and share this with those people that you think this might be beneficial too. Thanks again, guys. And wish you all the best there mountain valley. Thanks. Thank you