AMA with Stella O'Malley, author of 'What Your Teen is Trying to Tell You'

[NicolaDMumsnet]

Hello

We’re pleased to announce an AMA with writer and psychotherapist Stella O'Malley in the wake of her new book What Your Teen is Trying to Tell
You. The thread is open for questions now and Stella will be returning to answer questions throughout the week.

What Your Teen is Trying to Tell You
'Drawing upon years of experience as a psychotherapist specialising in
counselling teenagers and offering useful case studies, in this book Stella gives tips on how to manage your adolescent’s feelings, ways to help them negotiate the often-bumpy path to adulthood and provides practical information on how to support them through mental health problems, eating disorders, alcohol and drug use and friendship challenges.

Stella O’Malley explores body confidence and coming to terms with emerging sexuality, sexual awakenings and approaches sexual orientation as well as looking at teens’ need to examine their identity and ask themselves ‘who am I, and who do I want to be?’ This book does not shy away from deep problems associated with the overuse of technology, how porn has changed; this is explored in one of the case studies. She also looks at the consequences of the ‘Disneyfied’ childhood and how on reaching puberty the wall of reality is frequently grim and difficult.

What Your Teen is Trying to Tell You will help parents to navigate the tricky teenage years and provide them with positive support so in the long-term their teenage children can be themselves.'

Please ask your questions from now - though the thread will be open until Stella has finished answering questions.

As always, please remember our guidelines - one question per user, follow-ups only if there’s time and most questions have been answered, and please keep it civil. Also if one topic is dominating a thread, mods might request that people don't continue to post what's effectively the same question or point.

Many thanks,

MNHQ.

Thank you, Stella. You were up late answering these!

I have another question (sorry!!) but this is prompted by your book!

I feel like we are living through an age where the role of the "expert" is increasingly undermined - see on Brexit "we've all had enough of experts" - Michael Gove. Or parents being encouraged not to trust what they're told by their GP but "do your own research" when we are wildly unqualified to do so. I remember once wading through a meta analysis of breastfeeding research linking to allergies and eczema and worrying about whether it had been peer reviewed - what was I even doing reading that stuff!? I have no background or expertise in interpreting scientific studies.

And yet simultaneously, we have the disempowerment of parents - something wrong with your kids? you have to get the experts in, you have to ask for advice, counselling, ask the school, child into therapy, you can't be trusted to make decisions for your own child. The most extreme example at the moment being the majority of schools in England saying they wouldn't inform parents of a child's social transition at school. I also heard a 17 year old trans person on one of the episodes of the JK Rowling witch trials podcast saying that her transition must have been the right thing to do because it was what the doctors were saying was right, even in the face of her parents and even her own qualms.

I guess the question is - as a therapist, how do you navigate this push me pull you situation? Do you ever tell parents their child doesn't need therapy? Is therapy even always helpful? (I don't think it's helped Prince Harry much, for example...)

Mostly wanted to say thank you for your podcasts they have been so helpful! And I've appreciated and followed some of your advice though my trans child is older. So a question that's maybe not so directly related to your book: is there a place to get clear factual and easily understood information about the health effects and health risks, short and long term, of different medical interventions such as puberty blockers, hormones, surgeries? Suitable for adolescents, parents, adults? There's a lot of wishful thinking around these interventions.

I have no question Stella, just another big thank you for your work with Sasha on the podcast and all the Genspect team. I wish I could come to the conference! You have some excellent speakers lined up.

Is there a resource you can recommend for talking to sons about porn?

I worry that I will land up rearing men like some of the scum bags I have met.

Thank you, Stella! You are so right. I need to focus on what I can save from all this. Not sure if I manage to give myself a real mental break when my daughter is going through her transgender phase. But I find your answer to my post and to the others' really calming and reassuring. Thanks again!

Hi @Acorn51 , It is often surprising for parents to hear that siblings coming out as trans is relatively common. There is usually a time lapse between the two coming out announcements. It is also often a surprise that the second child to identify as trans can be a good deal more trenchant in their identity - perhaps they have a lot more to prove as they are often told that they are simply copying their sibling.

As you have two children who identify as trans, you probably know quite a bit about the subject. If not, I think it is time for you to read extensively about this subject so you gain a deeper understanding of the many issues that couldbe facing your children. If you have already learned a lot about the subject it would be valuable for you to speak to both of them individually, at a time of your choosing and 'come out' with your own, well-informed perspective. This might entail explaining that you don't believe in gender identity theory but rather take a developmental view of gender (where a person develops gender-related distress as a consequence of a range of factors). You can explain that you are determined to remain supportive however you don't agree with the affirmative approach as it does not sit well with you. You might give specific examples of how you can support and why you dislike the affirmative approach.

Many families often find that the trans-identified children take all the attention of the family and so it is important that you ensure that both you and your third child receive as much respect and sensitivity as everyone else. Walking on eggshells is exhausting and is often the case in this context. This could be a long game and so I hope you get the time to spend time with your own friends and enjoying your own pursuits.

Hi @Hairlikeabewitchedhaystack , thank you for your kind words. Yes, there is a significant lack of therapists who are willing to work with gender-related distress. This has created a very difficult situation whereby the few therapists who are open to working with this are typically affirmative and so there is little opportunity for anyone to find a more depth-oriented approach.
I think the National Gender Service in Ireland are a reliable and well-informed. They do not follow WPATH and they do not follow the affirmative approach. Being in Ireland, the biggest risk to your child is that they lose patience with the waiting lists and instead buy hormones online. It would be helpful to your child if you explained that there are many snake-oil salesmen online and it is heavily not recommended to buy any drugs online.

Sorry @Hairlikeabewitchedhaystack I pressed send too soon!
Yes, it is well established that bad therapy is worse than no therapy and so I don't think seeking a therapist is the solution. I reckon you could benefit form seeing a therapist yourself more than sending your child to a therapist who might feel totally out of depth with this complex issue. If you see a good therapist then you will have support as you come to understand that your influence over your child is diminishing and that they might take decisions that you don't agree with at all. This can take some years so it is worth giving some time to yourself as you learn how to cope in a way that suits you best.

Hi @Zoeyclash extreme moodiness in a teenager can be really exhausting for the rest of the family - especially the parents who wonder, often with a deep sense of disappointment, what is so awful about the nice life they have tried so very hard to create for their kids.

Sometimes however, extreme moodiness can indicate something much darker is going on for a teen. Have you tried to figure out what is going on for them? In my new book, I give a step-by-step approach to first clarifying what could be causing the distress and then communicating the empathy, solidarity and lastly the depth that many troubled teenagers crave when they are lost in a negative spiral.

I'm not sure what your budget is like but if you have the cash and the time, it could be really valuable to begin going away with them so that you spend some time with them outside the home. This ideally would include some time in a car together, where you don't try to push the conversation, but instead acknowledge that they seem to be having a hard time and let them know you're willing to do whatever it takes that will help the situation.

Hi Stella, not sure if I'm too late but here goes, just in case. DS is just 15 and is basically a nice, generally friendly kid, prone to normal bouts of moodiness. The issue is that he seemed to enjoy lockdown too much - being at home, online- and this has continued into the present. He was also unfortunately dropped from his sports team couple of years ago, which was closely linked to his old friendship groups.

I can't get him to engage in ANY activities or hobbies. His school has an impressive range of extra curricular clubs etc but he refuses to try anything. Suggestions of activities to try result in a huge row every time. He hangs out with people at school from what I gather, but has no social life. He sees no-one but family at weekends and in the holidays. I know his old friends all meet up - I see them around together- but he's no longer part of that circle, is not invited out etc. I think he lacks a lot of confidence in his own abilities and also in his ability to "hold his own " in friendship groups.

He's tentatively started doing a hobby with his dad but I feel so sad for him re the lack of interaction with other kids, and also any sort of fulfilling hobby. He's happier playing on his xbox and watching YouTube (all mainly sports related, I do keep an eye on what he watches).

I'm far from a pushy parent but just want him to do something/ anything to get him off screens and out into the real world and engaging with people. I limit his screen time but he just reads in his room.

Any advice on how to approach this would be gratefully received.

Hello Stella

Do you think that social media - TikTok, Instagram, Snapchat- has had a negative effect on girls? Why do so many of them take selfies in their underwear whilst pouting? God I'm glad I was a teen in the last century!

Not too late! We're keeping this going over the long weekend. I'll answer a few more in the morning.

Thanks for this chat, Stella.

Do you have any advice on how to help an 18 year old manage their stress in the run up to A levels.

Hi @NotBadConsidering I agree with you. Body Dysmorphic Disorder is woefully unacknowledged and yet it is certainly a significant issue for many young people today.

Some girls focus on their breasts; both boys and girls focus on their body hair; bulking up is a complicated problem for many boys; the size of a belly or bum etc can become an obsession for many girls. It is easy to see why it can be difficult to discern whether it is anorexia, BDD or gender dysphoria and sometimes, in my clinical experience, it seems to be a mix of all three. As a psychotherapist, I seldom focus on the diagnosis and instead put my energy into the problems of living that can be associated with the particular challenges the individual is facing. Psychologists tend to focus on the diagnosis and the impact of the diagnosis. I fear chasing the 'right' diagnosis can lead to a series of false dawns that almost promise an answer to life and rarely delivers.

The failure to be satisfied and a harsh and extremely critical inner voice are typically evident in all three conditions. And yes, developing self-compassion and other-compassion is a key way to begin to recover from these very challenging issues. Self-acceptance and other-acceptance for our fallible selves are also important for recovery. I explore how to develop compassion and acceptance in my book What Your Teen is Trying to Tell You: https://www.amazon.co.uk/What-Your-Teen-Trying-Tell/dp/1800752547/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=&sr=

Essentially, this takes time. It's like throwing pebbles in a barrel. Bringing in a gentler voice, noting how destructive criticism can be, developing a more playful attitude to imperfections, takes a lot of time. Hurrying it doesn't work and so although progress is slow, the recovery can lead a person to develop some very healthy habits.

Hi @Xiaoxiong thank you for your kind words. Yes, I think you're on to something with this point. You reminded me of the book 'Battle Hymn of the Tiger Mother' by Amy Chua who also raised this issue.

There could be another impact as well though - if our western culture expects teens to be moody, grumpy, lazy etc then we will inevitably be less outraged when we see this behaviour and so more often allow bad behaviour. In many ways we have normalised terrible behaviour and it has not led to better mental health.

Teens who behave badly are often embarrassed and annoyed about their behaviour - and irritated that they were 'allowed' behave like that. Unfair and exasperating though that may be.

There is a great saying in AA, Al anon and other mental health groups and that is 'Take what you need and leave the rest.' I think your family could benefit if you chose to retain in your family values whatever you believe are the better aspects of Asian culture and mix it with whatever you think works better in western culture. This would mean that you read about both, critically examine both, and then over time decide how you want to raise your own kids.

I agree with you @Tradeup

Thank you @IWilloBeACervix , thats very nice of you xx

Hi @CodyRockall I think it's important to be extremely sensitive if a parent thinks their child is going throug a process of desistance. It can feel deeply exposing and vulnerable-making for the child as they have said they are definitively one thing and now believe that they got it wrong.

Myself and Sasha Ayad discuss desistance in episode 77 and episode 80 of our podcast Gender: A Wider lens (https://gender-a-wider-lens.captivate.fm/episode/77-desistance-pt-1-accepting-reality-now-vs-then and if you have a listen you will hear me describe how excruciating I found it to row back on my position.

I reckon it will be helpful if you proceed very slowly, yes, many parents avoid pronouns altogther - and perhaps fight for the right to make a mistake too. More than anything, it is probably best not to put pressure on a kid who could easily bolt the other way if you push too hard. I often think that we will never know how many detransitioners might have been helped to desist - or might have tried to desist and then reverted back into a trans identity when they felt vulnerable.

Lastly, be good to yourself. Many parents find the emotional tightrope of desistance particularly exhausting and the one step forward/ two steps backward non-linear process can be monstrously debilitating to a parent who is constantly watching for signs of hope. More than anything, and this is for everyone who is trying to help a 'stuck' child, the parent can help with expanding the child's existence, even while the child is trying to narrow their existence to their bedroom.

Haha @JarByTheDoor - ask her/him! You never know you might get a social prescription to do just that 😂

Have an inkling it may be something to do with the fact it's either holidays or therapy fees, not both

Oh my God @Xiaoxiong, you're singing my song! I'm in the middle of a research project and I have landed exactly at this point - parental authority has been significantly undermined at the very same time that parental responsibility has been increased. It's not fair and it's not working out for either parents or kids.

The dismissal of experts is another issue that I worry about too. However this has arguably happened as a result of too many Peters crying wolf. When so-called experts have proclaimed rubbish once too often, then we're left in a position that we can't quite trust what the 'expert' is saying. Hence you ending up wading through studies on breast-feeding. It's a mess and it seems to me that consumerism has negatively impacted education and science so that we can't rely on information any more.

I outline in my book What Your Teen is Trying to Tell You (https://www.amazon.co.uk/What-Your-Teen-Trying-Tell/dp/1800752547/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=&sr=) how and why I don't think all distressed teens need to go to therapy. Indeed I propose that when a parent first realises that their teen is distressed it can be helpful for the parent to lean in to the situation, ask clarifying questions, offer them solidarity and spend some time learning about the issue so that your responses are well-informed. Then, if the teen continues to be distressed, the parent might consider attending a therapist to help them help their child. Then, if that doesn't help, I recommend finding a good therapist - and this might take time - for your child to see. Bad therapy is a good deal worse than no therapy and so it is not recommended that a teen is sent off to any random therapist at the first sign of distress.

Hi @MumOfYoungTransAdult thank you for your kind words. A number of sites now offer some reliable of information about these subject. Stats for Gender https://statsforgender.org/ and the Society for Evidence-based Gender Medicine immediately spring to mind: https://www.segm.org/studies

Stats for Gender offer a collection of peer-reviewed studies on any given subject while SEGM analyse and disect important studies.

Thank you @FriendofJoanne

Hi @stealtheatingtunnocks Ritche Sadlier's book 'Let's Talk: About Relationships, Sex and Intimacy' is a could resource to give to teenage sons as Sadlier addresses the issues about porn in a practical and straight-talking manner: https://www.amazon.co.uk/Lets-Talk-About-Relationships-Intimacy/dp/0717191907/ref=tmm_hrd_swatch_0?_encoding=UTF8&qid=1680960498&sr=1-10
This is a really difficult subject and you may not have many opportunities to land your point so it is worth chatting with a trusted friend or relative before you bring it up with your teen so that you can be sure of exactly what you want to say. Good luck!