Psychiatry & Psychotherapy Podcast - Inpatient Child and Adolescent Suicidality, "Culture of death", "13 Reasons Why" with Dr. Britt

Episode Date: February 6, 2018

In this episode I will be interviewing William Britt, PhD level clinical psychologist, an expert in cognitive behavioral therapy, object relations therapy, EMDR and a board certified neuropsychologist. He runs cognitive rehabilitation groups and neuropsychological assessments, and supervises neuropsychological fellows and interns. He also works closely with the psychiatric residents teaching about suicide.   In this episode, Dr. William Britt explores his experiences running an inpatient psychiatric group for 5 to 13 year olds who are being treated for violence or attempted suicide, using uses a method based on Irving Yalom's inpatient group psychotherapy technique. We discuss how the trend of teen suicide has increased over the years and the typical causes of depression. We also cover common bullying tactics and how cyber bullying has changed society.  We then discuss how to use the group's support to help each other move away from being suicidal. We explore how the Netflix TV series "Thirteen Reasons Why" has influenced young minds and the new terms the patients are using. In the end, Dr. Britt and Dr. Puder answers how we adapt and recover from trauma, and how we find meaning and value within stress.   By listening to this episode, you can earn 0.75 Psychiatry CME Credits. Link to blog. Link to YouTube video. Join David on Instagram: dr.davidpuder Twitter: @DavidPuder Facebook: DrDavidPuder CV of Dr. Britt

Welcome to the Psychiatry and Psychotherapy Podcast, the podcast to help you in your journey towards becoming a wise, empathic, genuine, and connected mental health professional. I'm your host, Dr. David Puter, a psychiatrist who splits his time practicing psychopharmacology, individual and group psychotherapy, medical director of a day treatment program, medical education research, and teaching, residents, and medical students. So in this episode, I will be interviewing Dr. William Britt, PhD-level clinical psychologist, a colleague and friend of mine, an expert in cognitive behavioral therapy, object relations therapy, and EMDR, and a board-certified neuropsychologist.

I work closely with Dr. Britt at the University Outpatient Center that I work at, and I really enjoy referring patients to him because he does a marvelous job, and the patients get better quickly, and they really connect with him well, and they really appreciate the work that he does for them. He also works closely with psychiatric residents and teaches them about suicide in a series of classes. Dr. Britt and I are going to have a discussion about some groups he has been running for a child psychiatric hospital for the last 30 years. Children are brought either by their parents or they have tried to commit suicide and are brought in, or they're put on a hold and then brought to a psychiatric hospital. In this episode, he's going to be talking about

the type of group he runs, how the population has changed over time, how bowling has changed over time, cyberbullying and how social media plays into it, and how he helps them move out of suicidal thoughts and cognitive errors into a place of a less desire to kill themselves. We're also going to talk about some cultural pieces like 13 reasons why, the new Netflix TV show, and how that has been sort of brought up in the groups and a broader sort of context of things that have been helpful to bring meaning and purpose to these young kids' lives. All right, here we go. All right, so I'm here with Dr. Britt. So Dr. Britt, just to start out, tell me a little bit about this group that you've been running in an inpatient psychiatric hospital for children. Okay, the group started

when the hospital was created in 1989. There was another psychologist that helped me run it, and we had two sessions a week. And the purpose, it was just called the feelings group, was to help the kids start talking about their feelings and sharing it in a group situation. And at that point, it was mainly males in the hospital, very few females and they were in there for behavioral problems.

When you started running it. And how many years have you been running this? Well, let's see. 89, getting close to, you know, 2019. So what would that be? Almost 30. Almost 30 years. So you've been running a weekly group.

And how old are these kids? The oldest would be 13. because it's the child group and youngest sometimes we can get down to five or six. Okay, so and how many people are usually in this group? It's limited to 10, and so usually we'll have 10. Okay. And so you're focusing on emotions and feelings. Right.

And how do you sort of bring that out of them? Well, we use a group method based upon herbialums in patient group psychotherapy. Okay. And the model is that you have one chance to see these kids because the next week they'll be gone. Okay. So we do what's called a go-around and we find out why they've come to the hospital. And that shapes the direction of the group. So if most of them are there for behavioral problems, then we'll discuss more about anger and what types of things get you angry.

What have you done that got others angry? And then what coping skills do you have? And then we'll talk about some coping skills that they can use. That used to be primarily the thing that we dealt with. But then more and more in the past five to ten years, the issues are not so much anger. They're suicide. So you've been seeing a shift from anger to suicide. That's right.

And a shift in the gender, because it used to be just about all males, maybe one or two females. And then over the years, it has completely shifted to the opposite. Now most are 10, 12, 13-year-old females and a few males. And now the other shift has been, it used to be the males were in for behavior problems, but now almost the whole group at times will be suicide, males and females. So what used to be the behavioral problems that these males would have the first like 20 years you were running this group? Well, they would obviously be out of control in the sense of family. They would be punching walls, breaking windows, running away, getting into fights maybe at school.

Then it began to move towards, in the later years, actually assaulting teachers, either stabbing them with pencils or something, depending on how young they are, up to picking up a chair and hitting a teacher. So, wait, when you first started, that was not something you would ever hear? That was not something you'd ever hear. Oh. Wow. And so that started maybe 15, 20 years ago, you started hearing more stories about aggression towards teachers? Or what would you say?

I would say in the last maybe five. In the last five? Five, seven years, yeah. Okay. Before that, you didn't have that level. I didn't usually hear aggression to teachers. It was against maybe parents, obviously other kids. kids, but not against teachers, but then that began to creep in.

How do you make sense of that, or do you? Well, it just seems to be a change in our cultural norms. It seems to be a change in our society's views of teachers, of authority, things like that. that's coming all the way down to the kids. Wow. So, and you said the suicide has become a lot more common. Like, what are we talking about? Are they just suicidal, like suicidal thoughts?

Well, that's the way it began. The transition was as we, in the past, let's say, 10 years, it began to shift over from behavioral problems to suicidal ideation. And then more and more, it became not just ideation, but actual attempts. And so now it would probably be, not only are they having suicidal ideation, but for most of them,

they're in because they've made an attempt. And how are they usually trying to kill themselves? And do they really want to end their life, these like 10 to 13-year-olds? Well, we try to tease that out. Okay. You know, 13 and below, yeah. We try to tease out oftentimes,

it used to be for fairly good reasons. maybe I want to escape something or whatever now. It's because my life sucks. My life is horrible. Or there's too much drama in my home. Or I got mad at my mom or dad. So the reasons have become much more superficial. But the problem is the action can still,

the self-harm action. can still lead to death. Now, when you say superficial, what does that exactly mean? Well, the trigger seems to be much milder than it used to be. You can understand somebody who is depressed. They're having just life seems to be going nowhere. They don't seem to be having any goals. relationships are bad.

Maybe there's physical sexual abuse, things like that. But superficial, and this is especially with the younger kids, would be my mom wouldn't let me go visit my friend, so I tried to jump out of the car. So sometimes it's impulsive,

but sometimes it's also just I'm mad at my dad or I'm mad at my mom or something like that happened. And so they're either threatening suicide or they've actually made an attempt. Now, obviously, for the older ones, there's probably something that builds that's going on like depression, and it builds up to a superficial type of trigger. But for younger kids, the sad thing, the tragic thing, is it often can be just something very slight because they don't understand death.

they don't understand the consequences of their actions. Do you think that maybe you're just not seeing the full picture when it seems superficial? Like maybe there's other things going on? Because you're just meeting these kids fairly briefly. Right. Briefly. Yeah. I'm sure there's probably other things going on.

But the change in the past two or three years has been that they used to articulate fairly plausible reasons why somebody might want to kill themselves. And they still do. But there's a little bit of a shift in this sort of... But there's a shift in that it's almost for any little reason that... And I'm sure there are other things going on. Obviously, they're probably depressed or have a lot of anxiety or there are other types of things. but the trigger, the triggers have become very superficial types of triggers for such a drastic action.

My mom wouldn't let me go see my friend, so I jumped out of the car in the middle of traffic. Wow. What do you hear from them in terms of bullying? Has bullying changed at all as time has progressed? Yes, bullying. When we first started the group in the late 80s, you almost never heard of that. And then it began to become a factor maybe 10 years or so ago. And it seems to have worsened with social media because now you can have cyberbullying.

And the bullies seem to have gotten very skilled at really, hurting people deeply, if I might make a quote from, that's a fairly common, the bullies will tell, especially girls, you're worthless, you're a slut, no one cares about you, everyone hates you, the world would be better off if you were dead. Why don't you just do it as it's a favor and kill yourself? And it's almost sound scripted as if somewhere the bullies have gotten together and figured out this script because you hear, now that these are kids from throughout, our region. They're different kids every week, but that common theme that the bullies use, I hear

over and over again. They're getting text with this? Could be. They're being told this at school. Like in person? In person. Okay. Or it could be they're being told this through text, through other social media that they

might be using. And the sad thing is with bullies is they tend to have a group of friends they find the people who are the most vulnerable they isolate them they find them when they're in an isolated situation and then they attack

and then if the victim tries to tell the teachers the bully and their friends come and say oh no it was that person who attacked us and so often the victim of the bully actually gets punished because they're the ones who have the friends who will back them up. When you hear this stuff and the kids are hearing it from each other,

are they surprised that the other kids have also been bullied in a similar way? Well, I think that's part of the healing part of the group. I think sometimes they do feel like they're the only ones, because oftentimes they seem very isolated in their school. I'll say, well, what about your friends? Well, I don't have any friends. Or, you know, they have very few friends. And so to hear other people, other kids, say,

I've experienced the same thing, is often somewhat healing because now they feel like they're not the only people in the world, the only kids in the world who are experiencing this, that there are other ones. So part of the healing is, is hearing that common, the common story and having sort of the empathy for each other. Right.

And the common suffering. Yes. What do they say about, what else do they say to each other that is healing? Well, the first thing I ask in the group, once I find out that the majority of the group are dealing with suicide, I say, tell me some good reasons why you should kill yourself. And so then we, you know, they raise their hand and they'll give a reason like my life is horrible. No one likes me. I don't have any friends. It's just not worth living anymore.

And so then we'll take that one and we'll say, what to the rest of you think? And some will say, I agree and others say, no. And I say, oh, no, why not? And it may be, well, we were all put here for a purpose and we need to find our purpose in life. Or you need to, you know, not let the bully's words hurt you. You need to just go ahead with your life. Or somebody will say, well, they'll say think about your future. So they're really queuing into like each other.

there's meaning and purpose. Yeah, they are. And that's what kind of can help them pull out of the hole that they're in. Sometimes. Yes. Sometimes. The other thing that they will say is, well, if I did it, my family, you know, would really be sad.

And so then I pushed that a little bit. Well, how sad would they be? Well, they'd be really pretty sad. Like devastated, yeah, like devastated. And then I say, well, how long? oh I don't know maybe a few days or a few weeks and I say well would it just be a few days or weeks because most of the research shows they're devastated for their life

yeah that probably would be and so they're able to tie into and then I bring up something that they rarely mention I say do you think they'd feel guilty yeah I guess they would because they would think they should have done something to help and then somebody else might say well, I don't know how my family would feel. And I say, well, wouldn't it be important to find out how they would feel before you would do something so drastic as to end your life?

Maybe. Or I might say, well, is there anybody else in your family besides immediate family? Are there any friends? Are there any pets? Sometimes the last straw is, well, at least there's a pet that would care and that would feel bad. And so we're looking for anything that can kind of give them some reason to live. Have you ever had a kid who, after doing that, they still feel stuck like, no, I think everyone else would be better off without me.

Yes. And what I usually do is I take a risk if I think it's going to work. And I say, because they'll say, you know, no one cares about me. I don't have any friends. No one would care if I would die? I'd say, well, would anybody in here care? And boy, the hands to shoot up. And you start hearing all these kids who are in there for suicide.

Please don't do it. And they, you know, you're wonderful. You're so kind. You're so friendly. You're all of these attributes. And you just hear from one kid after another. We want you to live. We would be so sad.

So they really offer immediate. support. Every time you do that. Every time you do that. And how do the kids respond when they get that support from their fellow sort of peers that are also in there for suicidal thoughts and intent? Oftentimes they tear up. Yeah. They've just never experienced peers saying things like that. Or sadly for some, when they've gone to parents, the parents will either give a no support or they report some of their family members say, well, why don't you do that? That would be good. Why don't you kill yourself?

And I think when parents say that kind of thing, often it's a reflexive sort of like, I don't know what the hell to do with this sort of thing, you know? Yeah, I would agree. What advice would you give to parents? Like, let's say a parent of a suicidal kid was listening to this. How could they be helpful? helpful to their son or daughter? Well, I think the first thing to do is recognize that this is a genuine cry for help.

And so they need to listen. Most of the kids will complain when you ask about parents. Well, they won't hear me out. They won't listen to what I'm going through or whatever. And my take on suicide, and I think research is bearing it out, is it's kind of the royal road to take you down to what's really bothering them. So if you can listen and try to find out what is it that would drive you to suicide, then at least you can get some idea of what's going on.

But more than that, the child feels listened to. They feel like you do care. And let them know how devastating it would be. It's amazing the number of kids who say, I don't know how my family would feel. What do you think keeps a parent from listening, from understanding? Well, some of these kids are fairly depressed. Some of them are probably behavior problems,

and they've probably done things that have exasperated the parents. sometimes it's the kids aren't even with parents. They're with aunts, uncles, maybe even just a non-family member who's taking care of them or grandparents. So either it may be I'm doing you a favor by taking care of you. Why are you causing me all this hassle? Or just maybe a fear of not. even wanting to go there, not even wanting to ask about this. I think what I've seen is there's a lot of fear.

And the parents really don't have a box to put suicide in or to understand suicide or to understand depression. And so it seems so different or foreign or, you know, like they don't even want to really engage it or they don't know how to engage it or they're fearful of engaging it. I think so. And then when the child says, mom, I'm feeling suicidal, it's like mom sometimes often freaks out to the level even beyond the child. And if mom is hyper aroused and sort of, you know, incredibly fearful, then it's very hard to listen to what is really going on or knowing how to help. Because I think the parents often get super aroused not knowing what to do.

It's like they want to have some quick action to solve this and they don't know what. what that is. Right, because, you know, if kids are talking about doing something like this, there are probably lots of layers of things that are happening, and it's overwhelming for the parents. So it does make it difficult, and especially if you don't know the steps to take. And so either it's dismissed or, you know, the parent just doesn't want to engage or they're too busy or lots of these types of things. Yeah.

So your advice to parents would be to slow down, see if you can get them to talk about it. Right. Let them know you're concerned. You're taking this seriously. Certainly try to seek and get some professional help for this. But the key thing is letting them. know how much you do care. Because sometimes the kids will say, yeah, I think my parents probably would be pretty

sad, but either that's not the impression they give me or because of, they will admit, because of my depression or how I perceive things, I find it hard to believe that they really would care. I see that a lot. Like sometimes the kids are even like early, you know, adults. it's like they'll hear one negative, slightly negative comment from an adult or from someone and they hear maybe, you know, five or ten positive comments, but they cling on to that sort of negative comment.

Have you ever seen that? Yeah, that's just depressive genetic thinking. It's the negative aspects of depression where you see, you look at everything through a lens of negativity and you latch on to the, the negative types of things and rarely hear the positive. That's why I think, as I mentioned earlier, it's so overwhelming to these kids when I asked the other kids, would you care if this person died? When they get all of this, what we used to call strength bombardment, it was just being

bombarded with all these positive things and they're almost overwhelmed because they're not hearing anything negative. But the key thing is to let the kids know how devastating this would be for a parent and try to listen and find out as much as you can in terms of what's going on and realize, especially if they've not mentioned this before, this may be a change for them. They may have moved deeper. into either depression or to some times it's anxiety, but they've made a shift, a change in that

now they're contemplating something that could have drastic effects. So I know we talked about 13 reasons why, the Netflix TV show that came out. And have they brought this up in the group therapy before, this particular TV show? Yes. So my approach is because oftentimes the complaint I get as we're talking about reasons to kill yourself, well, you adults don't understand how hard it is for us as kids. And so I say, well, help me understand. And so a couple of weeks ago, several of the adolescents said, okay, our culture is one of death. Music glorifies suicide and cutting. We've got this program out, 13 reasons why, that seems to say suicide is the answer to our problems. And now this is a new thought that's emerging or a new thing I've heard that I haven't heard before. So it may be isolated, but a couple of kids said, you know, now kids at school, even the popular ones,

thinks it's cool to be mentally ill, to be depressed, to cut themselves. And that just makes it worse for us because we're really suffering. And then they're coming along trying to be acting like they're depressed or whatever. I hope that's an isolated type of thing. But you've heard that. These are, I see just just one time. One time. Okay.

But these kids tend to be the canaries in the mine because they're the most. vulnerable to cultural change. And so when you start hearing enough of this from a broad range of kids over time, you begin to realize this is the direction the culture is going because they're the ones that pick up on it the quickest. Wow. So specifically with the 13 reasons why a couple kids have brought this up or just one or two? Yeah. Yeah. It's a trend. It's a trend. And it's one of the reasons they give as to why we're in a culture of death. They actually use that term. We're in a culture of death. And, you know, even in the media, we have this TV series, 13 reasons why, telling us that basically suicides the answer. Now, since we started planning on having this

conversation, I asked you to see if you could watch a little bit of it. Did you get a chance to watch any of it. Yeah, I was able to watch the first episode and I hope to continue. And what I noticed that the kids are right, that adults don't often recognize. What was new for you as an adult? The fact that kids no longer have privacy, because if they take a harmless picture, but it's somewhat compromising, they think it's private, and then somehow it can get on the social media, whether they're showing other kids and they grab the phone and put it out there, or it just begins to, somehow it gets on to social media, and what they thought was private is no longer private.

And so then everybody in the school or whatever gets, finds out about this, and then you begin to see the ostracism that occurs. it's almost as if it's so much easier to gossip. Exactly. It's so much easier to spread falsehood and then how do you correct false narratives that get out about you? Right. And that can be really, really hard. It is.

And in this, 13 reasons why, I mean, it seemed to be legitimate. But if you've got a bully who's making up things about you that never happened, putting it out on social media. and the kids don't seem to have the discernment to realize, hey, this is a, quote, enemy of this child. This is a bully who's bullying this other kid. They'll believe it. And then the child becomes more shamed, more embarrassed, more ostracized. And it's hard for parents to realize for kids at this age when peer support and peer culture is so important to be shamed and embarrassed in front of all of your friends is just it's enough to drive somebody. to want to kill themselves because they can't think beyond it.

They get locked in to death is the only solution. I have some school teachers who are my patients, and they talk about their kids with the phones, and they'll be on their phones during class. And when the teacher asks for their phone, they'll say, you know, F no, and they'll put it in their pocket. And that to me was like that level of disrespect was fairly mind-blowing. Yeah.

They also said that the principal has told the teachers they can't take away the phones anymore because one of the phones, I guess, dropped in the process and they had to replace it, which was expensive. So it's taken away some of the power from the teachers. Yeah. And then the teachers don't always know what's going on because they don't. have access. The kids have access to phones. They're sending message to each other, but they're not letting the teachers know. So again, it robs the teachers of the ability to monitor what's

going on. The other thing I heard was that there's this, there's one app in particular where you can drop a picture, and anyone in the geographic region around you can see the picture, but no one knows where it came from, and no one, so people can see it for a time, but they don't know where it came from or you know like so you can anonymously put up things which could be really harmful and really bowling and no one would know you know that that who put it up there so there's no personal responsibility yeah and i think that's what they mean when they say you adults don't understand because we don't even know that that's for most of us that that's even available yeah what about um do they ever mention using phones at night

not specifically, it's usually just broadly social media. But the interesting thing is they do recognize, and some of them, one of them last week even used the term, because I talk about suicide as an ambivalence, because sometimes there's a stronger wish to live, sometimes a stronger wish to die. And one patient used the term, Jesus becomes blind when that suicide drive is so strong.

You don't think about what will happen to your family. You don't think about the fact that you might be leading younger brothers and sisters or cousins into your footsteps. You've opened the door for this time. type of thing. In fact, I use a little funnel as a concrete illustration, and I tell them most of the time we look through the narrow end of the funnel and we look out. And we see our pain and our hurt and maybe the desire to end our life. But we also see what it'll do to our parents. We see it eliminates our future. We see what it, the door it might open for younger brothers and sisters. But when we really get suicidal, the funnel turns, we're looking. through the wide end and it narrows down and always see his death. And that's what the kid was talking about, this blind, blindness that takes over where the only thing you can think about, he says it blinds your thoughts. You're not even thinking about anything, but let's end this with death.

And I say, when that happens, you've got to flip that funnel back around and start looking at all the other consequences that will occur if you take this action. So that's another important thing to mention to kids is that this is fleeting. They all know that it's fleeting. It's not going to last very long. They're going to go back and forth between the wish to live, wish to die, and you want to not have them take a catastrophic action when the wish to die is stronger than the wish to live. So let's say someone was listening to this.

And they were thinking, how do I help this population? You know, in what way could I, you know, help them? What would you say are some of your thoughts on what you've learned in this process that is most helpful? Well, I think the key thing in terms of influencing them has to come from their peers. They already don't think that adults understand. And so one of the powerful things about the group is that the group begins challenging their thoughts, challenging their reasons for wanting to die. And it causes them to really have to think. So I think in terms of what adults can do, it would probably be either working with a school or church or.

organization or some other group where you can get a group of kids together and actually talk about some of these things. And these kids are very articulate at this age. And they can talk to each other. And if you guide it correctly, you can help them come to some conclusions and maybe some ways of helping each other. In fact, one girl about a year ago, one patient said, when I was being being bullied, I went around and found out the other kids who were being bullied. And I said, let's form what I called an anti-bullying club. And so they would get together. They would eat lunch together.

They would meet each other after class and stick together so that when the bullies came and tried to do something, they were witnesses. And they would go en masse to the teacher and say, this person was bullying this other person. and that way action occurred. So it's mobilizing the kids to help themselves is going to have the most power because they're at the age when they're most likely to listen to each other and least likely to listen to adults.

Wow. This has been a really deep discussion. And one thing that struck me was how when they're talking to each other, they're trying to like infer like think about you know there's something that you've been put on this world to do you have some purpose you have some meaning even if you don't really know what it is yet right um that's a common theme because they recognize some of them will say hey we're just kids we don't even know we know we have a purpose but we might not even know what it is yet so there's a recognition that if they can hang on until adulthood they're going to have more control

they're going to begin to learn what their purpose is. And there's also, in addition, many of them have beliefs in God. They believe that he doesn't want them to die. And so oftentimes they'll bring those in as well. That can be very helpful you've seen. That can be very helpful, yeah. It's interesting, I was studying this, and I'll probably in a future podcast go into this in more detail.

but I was looking at like, why has the suicide rate gone up in the last, you know, 10, 15 years? And in this one, you know, social media study where they linked it, you know, there's a slight increased risk of depression and suicidality and high utilizes of social media. They also saw that spirituality had decreased in the people who had higher risk and that was a trend that it had been decreasing. and also the sleep deprivation from social media. And there's also some links with the difficulty of finding a good provider. Yeah. Because there's a kind of a lack of the necessary amount of mental health professionals and in a lot of regions of the U.S.

Right. Yeah, it seems like those are, when you put them together, are very plausible reasons. And it's interesting, almost all the kids will have some view of God or whatever. So one of the things I often ask when they say, and another reason that we haven't talked about for some kids, we talked about opening the door. Oftentimes, family members, even some like grandparents,

that they never knew, but they know that they committed suicide or they died and they want reunion, they want to join them. And so I'll say, well, do you think God wants you to die, to kill yourself? I've not had one say yes. They all kind of look and say, well, no, probably not. So even though they may not even come from a religious home or whatever, there's almost a unanimous view that really God doesn't want me to do this, whether or not. they believe in him or not. What about, like, do a lot of these kids have therapists that they've really connected with or are connecting with at the time that they're in there?

And is that something that they've said is meaningful or would keep them from doing it? I would say a minority. Most of them don't have a therapist. Most of them don't bring up treatment, either therapy, medication, anything as a reason to live. it's like we're just stuck here we've got to sort this out the best we can by ourselves they just don't seem to have those resources now there are some who do

and they will talk about you know my therapist recognized I was becoming suicidal or my therapist is somebody I can that will help me but most of them don't seem to have that resource um one thing that I walked away with when I watched 13 reasons why is sort of the internal versus external locus of control. And I found that the main character who ends up killing herself has a very kind of external locus of control.

It's always, you know, everyone else is doing these things to me, which were horrible. I mean, there was a lot of bad things that happened to her. But how do you sort of increase the internal locus of control, meaning like I have the ability to change my situation? my mental health, you know, like I'm not going to be influenced all the time by everything that's going on around me in my environment. How do we shift someone to more of like that internal? Like I have the power to create some of my own meanings and purposes. Well, I think it takes building internal resources. One thing that can be helpful is to have them think back through previous difficult times and how did they get through that? What types

of internal resources did they use? What did they call on within themselves to get through previous difficult times? Or you can build in resources from people that they admire. It might be religious figures or people in their family or heroes or it could even be fictional heroes. How would that person handle something you were going through so that they can kind of model, you know, how would this person handle it? And then you can even have what are called symbolic resources, which might be animals like an eagle or a lion or some type of, again, symbolic type of representation. you know, how can you call on the strength of a lion or the strength of an eagle and think about, okay, how can I use that symbolism to help me get through? Yeah. So those are some of the internal types of research.

There is kind of like the hero archetype in all of us, or the warrior, the person, the overcomer. Right. And so it's like getting, I like how you said, like find difficult things that. they've been through and how do they overcome it. And that really is like tying into the meaningful parts of themselves that if strengthened and if they're reminded about continually, it creates a victor narrative, you know, and not such an external look as these things are happening to me and I have no power. No, I think bad things are happening in you, but you have the choice to, and you have historically found a way through it.

it. And that's meaningful. And I think you mentioned earlier about how parents can help. I think that can be very powerful. Parents should reflect on their lives and think about even back to when they were that age. When I went through a crisis, what did I do? What did I summon? What types of internal, external strengths did I summon to help me? And that way you teach the kid that the child,

that there are ways of summoning the internal strength that they have to get through things. So again, it's that letting them know that you've been through more difficulties, obviously, because of age than they have, and that that's a way that they can utilize too. Remember how I did it. Remember how your grandfather did it. remember that can often be meaningful. I've even heard kids say, well, my grandfather fought in a war and he had some really difficult times. And so I think about, okay, if he got through, maybe I can. Right, right. When I think of overcoming things, I think of stress, recovery, adaptation.

And to build psychological strength, stresses are going to happen. And, you know, not also stresses are bad. Actually, stresses can be very good. And there has to be recovery. And then as we recovery from a particular stress, we can actually be stronger. And this works both physically and psychologically. And so one of my sort of thoughts is how do we see life as a series of stresses that we can recover and adapt and get stronger from? And how do we help kind of, the youth in that way, you know, see some of these stresses that they've been and see how they've, you know, adapted and recovered and, you know, kind of bring this idea of, you know, that you could be victorious, that you could be strong, that you could find meaning and value. And sometimes I think

overcoming those stresses, you have to find the meaning and value in the stress or in the sort of obstacle as a part of the psychological recovery? Any of that kind of ring? I think so. I think it gets back to family sharing, you know, how has the family gotten through some difficult times? What has the family done? Calling on their spiritual heritage, religious beliefs, or whatever, that God can give the power to get through these things. He's concerned. He loves you. He cares about you. Oftentimes, the thing that's actually keeping the final thing that's keeping a child or an

adolescent from committing suicide is that belief in God that he doesn't want me to do this. So all of these various things can be helpful. But we've got to remember the age we're talking about 13 and down, they don't know about all of this stuff. So that's why we have to spend time with them and not only listen, but talk about our own struggles and not be afraid of doing that and how that you as a parent, a grandparent, an aunt and uncle friend, how have you gotten through things and to help them realize they have had experiences that they can call on as well? Where would you say over-disclosing would be?

kind of part of that, if you were a parent, like over disclosing as in you're sharing maybe a little bit too much for this person to handle. Do you ever see that as well? Because I want to be hesitant to... Yeah. Well, I think if you can, go back in your memory to when you were around the same age, those can be the most powerful types of things. You know, when I was around your age, this happened, and this is how I dealt with. it. So it may take some thinking back. Okay. Or just kind of leaving out details sometimes. You don't have to go into details because you want the emphasis not to be so much, I think, on what the

circumstances were or the stress, but what you did to cope. Yeah. Sometimes I hear kids, they'll say after the family member talked about something like that, they'll say like, oh, but they have no idea what I've been going through. It's so different. You know, they immediately went into advice. And I'm not saying that that couldn't be helpful in a certain context, but I think that there is a starting place of empathy for the child in their suffering before the parent jumps to their own sort of experience. Right, I would totally agree. I guess I'm thinking more of this in terms of this would be a regular dialogue.

Before you even hear that a child is having struggles, be open to sharing how when you were this age you had this because you know they're going to have struggles. But then when they do come to you with a struggle, you want to make sure you listen, understand, maybe repeat back so you're saying this, so that the child really feels that you understand. Okay. That's the key thing. And then if you've been talking to them all along about that, you can say, remember,

we've talked before about some things that can be helpful. And then you can tie in what you've been talking about. I think my hesitancy is if a child comes to you and says, I'm suffering in this way. And you immediately go to your own story. I think the child often doesn't feel heard in their story. And then they're not going to listen. Yeah.

So they've got to feel like you hear them first, and you really want to try to do as much as you can to get them to open up and talk about what's really going on. So you know the level of help they might need. All right. Dr. Britt, thank you so much for joining me in a dialogue about this, and we'll leave it there for today. I'll likely have Dr. Britt back in the future.

Thank you so much. Thank you. Thank you so much for joining us in this discussion, and I hope it's been as helpful for you as it has been for me and thinking through what's happening in our culture and the shifts and how we can help this next generation overcome their mental health difficulties. If this episode has been helpful for you and you know someone who might value some of the insights or be interested in it, please share it and I would be much appreciative of you getting the word out and if you have any questions, any thoughts, throw them up on one

of my social media posts that relate to this episode. All right, until next time.