“Teenagers!” – with Dr. Michal Agus Fox, PsyD

Dr. N. Fox: Welcome to today’s episode of “Healthful Woman,” a podcast designed to explore topics in women’s health at all stages of life. I’m your host, Dr. Nathan Fox, an OB-GYN and maternal fetal medicine specialist practicing in New York City. At “Healthful Woman,” I speak with leaders in the field to help you learn more about women’s health, pregnancy, and wellness. All right, Dr. Michal Agus Fox, clinical psychologist, one of the senior psychologists at the Frisch High School in Paramus, New Jersey. Senior meaning not that you’re old and not that you take care of seniors, but it means you’re very experienced.

Dr. M. Fox: Yes. And old.

Dr. N. Fox: So this is…I’ve been wanting to do this podcast all year. You know, the last time, other than the podcast we just did about your kidney donation, the last time we spoke sort of from a podcast perspective and a clinical perspective was four years ago where at the time you are a school psychologist for preschool, lower school age children. And we were talking about, and you know, you’ve been doing it at the time for 17 years, 16 years, 18 years, somewhere, you know, in the high teens years. And we were using your expertise to give advice about all these little kids at home during COVID, like what to do, what are their fears, how to talk to them, all this stuff. And since then, a lot has happened to you professionally. And you’re in a totally different position now working with different kids. I wanted to talk about that, that transition, and then also talk about teenagers, because that’s who you’re working with now, which is such a development from a career perspective.

Dr. M. Fox: Maybe because I always said I would never work in high school or middle school.

Dr. N. Fox: Yeah, it’s like literally like I will not work with high school kids or middle school kids. Forget it.

Dr. M. Fox: I didn’t even interview in any job that required high school or especially middle school. I was like, nope, I’m not doing that. Thank you.

Dr. N. Fox: Little kids. That was…that’s who you worked. And you were like the little kid whisperer. I mean, and then you sort of said, I’m not doing this. What? So yeah, give the story.

Dr. M. Fox: I mean, I had worked at Ramaz for many, many years. Then I had worked at Manhattan Day School for three years. And I think I had amazing experiences at both schools. Wonderful jobs, wonderful parents, wonderful administrations. I met so many delightful kids and students and parents.

Dr. N. Fox: Which is crazy because now they’re adults. I mean, the kids like you, I mean, you’re like, oh, these high school grads were by kindergartners that I’ve talked to or this this one in college. I remember when like, you know, she couldn’t read, like, just it’s crazy.

Dr. M. Fox: It’s amazing. I feel like one of those old people. And also, I just want to mention I also had amazing colleagues that I worked with. So I it was the last time we spoke was COVID and COVID really put a challenge on everyone. It also challenged psychologists in schools. I think I just got burnt out from working in a school. I felt after 20 years of working in schools that I needed a change. And so I had decided that I was going to leave schools and open up a private practice and focus on younger kids and parenting help. And I did that. I opened up in the city. I had some clients in New Jersey. And it was my workday started at like 5 p.m. If you know me, that’s funny, because I am an early riser. So by the time my workday started, I was actually ready to go to sleep. I’m not exaggerating. So the hours were very hard for me. I tried to adjust to it, but I think I’m just an early person by nature. And that was very challenging for me.

Dr. N. Fox: But just for our listeners, may not get the reason the hours are late is because you’re working with kids after school.

Dr. M. Fox: Sorry. I thought it was obvious.

Dr. N. Fox: Well, yeah, I assume most people knew that but just to be clear.

Dr. M. Fox: Students get out, young children get out of school after school hours. And so there’s like a golden hour between 5 and 8, let’s say. And that’s a time when I personally get very tired. So it was very hard for my clock to switch.

Dr. N. Fox: Yeah. I think a lot of people don’t realize that because you think of most like medical type people, like dentists and doctors and this. They see people during daytime hours. And if you need to go, you leave school and you go. But for most psychologists, for children, that rarely happens. Usually they’re coming after school occasionally. Obviously, they do see kids during the day if they need to, maybe more crisis situation. But for typical, like weekly, every other week, whatever is therapy, you know, skills, you’re not leaving school for it because part of it is to get you through school.

Dr. M. Fox: Right. So my first… So I would see some parenting… I had some parenting jobs that I would do in the day, but most of it was in the afternoon. So that for me was a challenge. The second challenge I had was that I would tell clients they didn’t need me, that I didn’t think they needed a psychologist. So turning away clients is actually bad for business, I figure. I really…

Dr. N. Fox: You’re just honest. You can’t.

Dr. M. Fox: I’m very honest. I think a lot of it is more parenting work than actual one on one with children. And not all the parents want to put in the work. And I don’t say that in it may sound critical. I don’t mean it critically. It’s just a lot of work that we have to do as parents to raise children. And some parents often would like to drop off a child, check off. You know, I was that parent, too, so I can say that with a lot of compassion, you know, kind of check off like, oh, my kid’s at the reading teacher tutor, check, my kid’s at the psychologist, check. But a lot of it, especially I’m talking about with young children, is actually working with the parents. And I never gained that momentum to the way that I had wanted to. And so I found myself working with children a lot. And then I didn’t see the results I had wanted to see. And for me, I am somewhat of an impatient person, which is why I initially went into being at schools is because you can kind of come up with short term goals and solutions or plans and then to get, let’s say, the child through the school day. Whereas in therapy, it was much more of a long term process. And I found myself getting impatient with the work because I didn’t see the results that I personally would have liked to have seen. And so I didn’t find myself personally rewarded by the work I was doing.

Dr. N. Fox: And I’ve never asked you this before, actually, but I’m curious how much of it do you think also was you’re used to working in a team setting for 20 years, you know, that you have a reading specialist, you have a school principal, you have the kids, psychologists at home, like whatever it is. I mean, you’re all it’s very like team, team, team when you’re in a school setting. It’s very unusual that it’s one to one type of stuff. And this is a big shift.

Dr. M. Fox: Yeah. So, actually, people ask me all the time, because especially I have friends who have left schools and the adjustment after leaving a school and taking on a different type of job or going into a private practice is very lonely and alienating after working in a school system, which is so collaborative and lively and exciting and bouncing ideas off of people and working and collaborating with peers is… I missed it. And I know I have colleagues who are in the same boat and miss that also, the structure that’s given to you also with working in a school system, whereas when you get out, you have to create your own structure. And some…I think I am very much that person. I like when structure is given to me.

Dr. N. Fox: It’s funny. Like the children, actually.

Dr. M. Fox: Right. Exactly.

Dr. N. Fox: Yeah, it’s good. It’s good for children also, the structure. Ironic.

Dr. M. Fox: Exactly. And so, I found myself with a lot of free time and I am not someone who wants to clean my house. So I didn’t know what to do with the free time because I didn’t…all I knew to do was be a school psychologist. And I was really bored. And so this opportunity came up to work in a high school and I grabbed it because I was bored.

Dr. N. Fox: Yeah, it’s…it’s… I mean, you…to be…you’re humble. But to be fair, you could have had 1 of a 1000 jobs if you wanted just based on your experience, your skills and your reputation. I mean, you could have called any number of schools say, hey, I’m available. And they would say like, you’re in. So I’m curious why specifically this opportunity? Like, why Frisch and why a high school? Because that was a big shift also.

Dr. M. Fox: Right. The shift to high school was the biggest shift for me. I think I was ready for a change. I think when you do something for 21 years and I include the private practice in that 21 years because I was working in the same age group, it gets wrote and a little bit, even though every single situation, every single child and every single parent situation is different, there’s a lot of the themes that are the same. And I was ready for a challenge of something that I had never tried before. My youngest at that time was entering her senior year. I felt like I had raised three…you know, our youngest of four. So we had four children who had already went through or were continuing to go through their adolescent years. And I always felt that Frisch in specific was a school that was very much aligned with my own philosophy of students come first. And I always as our kids went through Frisch for high school, and I always felt as a parent that my kids were taken care of there, I’m talking about social emotionally. And because I have such hakarat hatov, I felt like this was an institution that I could be a part of and help contribute to that message of really helping kids through high school experience. And so I really…I thought Frisch was the right move for me at that time.

Dr. N. Fox: Yeah, I mean, it was…I mean, I remember when you were making this decision, definitely, there was a level of comfort that you sort of knew the school. You know, you knew the players, you knew the people, you knew the leadership like, you knew them, you trusted them like, it wasn’t an unknown in that sense. Obviously, the commute’s a lot better than coming into the city. That was…that’s delightful.

Dr. M. Fox: Yes. Crossing over the George Washington Bridge is not something I miss.

Dr. N. Fox: Yeah. And I’m curious. The fact, you mentioned that we, you know, we have four kids who sort of went through high school and our little one was going to be a senior. So basically, we’re on the tail end of teenagers. Is the fact that we had done that as parents and you had sort of learned from that experience, did that…was that part of the reason you felt like you could do it? Meaning, because I think that 10 years ago, not only did you not want to, you may have said, I don’t know if I can work with these kids in that sense.

Dr. M. Fox: Right. I definitely, have a lot of imposter syndrome in a lot of things that I do. And definitely, I felt in my own confidence that I wasn’t qualified to work with teenagers or I didn’t know what I was doing. And then I think raising our own kids and going through the joys, the ups and the downs of raising teenagers gave me a lot more confidence and experience. And just speaking to a lot of our kids’ friends and having regular conversations with them gave me more confidence that one, these kids are really interesting and they have a lot to say and they’re having a lot of interesting perspectives on everything. I found the age group very interesting and they gave me more confidence or two, gave me more confidence that, hey, you know what, I think I could do this.

Dr. N. Fox: Yeah, I mean, it’s…this is a question that comes up a lot when it comes to the met. I got this like, you know, I take care of pregnant women, but I’ve never been pregnant. Right? And so for some people, they feel like, well, you know, that’s why you should see like a female OBGYN because they get it. And others are like, well, you don’t need your oncologist to have had cancer to take care of you and you don’t need your geriatrician to be over 70 to take care of you. So there’s sort of both sides of that coin. And maybe it’s true in some circumstances and not others. So I’m curious in general, like, do you feel like in your experience in the world of psychology for children, people who, let’s say, have young children sort of have an advantage as psychologists for younger kids. And similarly, if you’ve had teenagers, are you at an advantage or is it really just person dependent?

Dr. M. Fox: I definitely think it’s person dependent. I’ve met a lot of fantastic practitioners and people I’ve collaborated with that don’t even have kids. So I think it’s very much a personal person by person for me personally, in order for me to have that confidence, I felt like I needed to go through those stages as a parent to help children, students, young adults and parents. I think having that perspective for me has only helped in my conversations with others.

Dr. N. Fox: Yeah. I mean, I happen to think that even if you did this 15 years ago, you would have been great at it then also. Yeah. But yeah, it’s, but you said it’s, it’s sometimes confidence also that you don’t, you know, you think it’s going to be something different, you know, but you sort of, you sort of know what happens with teens when they have come through in our family. So, you know, you’re sort of like in that world. How…general question, how has it been, your year working with teenagers?

Dr. M. Fox: So I am so happy. I love my job. I love working with teenagers more than I even thought I would. I think it is so different from working with the younger kids. My job is primarily, working with the students themselves, whereas with elementary school and early childhood, I would work much more in the classroom with the teachers to kind of get the environment to help the children or to work with parents on helping, let’s say the environment at home or helping with parenting and how to help kids. In high school, it is 95% working with students themselves and helping them problem solve or listen or whatever the…it might be. It’s really hands on, direct intervention with the students themselves.

Dr. N. Fox: Yeah. I mean, just from my perspective, you were…you always enjoyed your work like, it was, you know, you didn’t really complain about being a school psychologist. You loved what you did, but I’m not sure, you seem happier now just day to day than I can ever remember. I mean, you just, you’re just like, oh my God, like, these kids are great. This kid is great. This day was great. Like, it’s unbelievable. It’s so much fun. Like, it’s so cool.

Dr. M. Fox: I think also, though, being happy and work also has to do with where I am in life. My kids are older. I think having a full time job and raising four children at a younger age is hard. And you don’t really get a chance to breathe. You know, you go from, I would say by the time I got to work at 8 in the morning, I had already done a job of getting my kids dressed and up. And at certain points they would commute with me to the city. And so that in itself was exhausting. I don’t have that now. So I’m really able to appreciate the job for what it is. I think because of the different stage I am in life and raising our own kids also helps with that.

Dr. N. Fox: Yeah, I think that’s fair.

Dr. M. Fox: I think that’s a huge part of it.

Dr. N. Fox: Get to appreciate it more in a certain sense.

Dr. M. Fox: Yeah, it’s on both ends. I can give them more time. I’m not running out and focusing on my kid’s next doctor appointment or what I’m going to make for dinner that night, like, you know, which had preoccupied my life as a mom or, you know, how am I going to remember our stages of like getting our kids to after school activities or being responsible, having a babysitter that didn’t show up or, you know, whatever.

Dr. N. Fox: And your husband has to run out for a delivery and leave you with the four kids. Yeah.

Dr. M. Fox: The realities of raising children and having a full time job is incredibly rewarding and difficult at the same time. So, but I think there’s so many factors where I’m just finding the work I do so rewarding. The students I speak with are interesting. There’s a lot of hardships for these teenagers out there. And, you know, probably more than you and I have experienced, obviously, social media and everything kind of blasted in front of you, phones and all that as are…these are real issues. But I find just listening to kids, validating them and offering advice, but based on what they’re telling you is incredibly empowering. I love what I do. I, even on the most challenging days, not every day is amazing. There are some days where you just go home and cry and be grateful for what…some of the good that we have in life. Some of these kids experiences are really sad. It just…you go home and there’s a gratefulness that I appreciate that I didn’t necessarily factor into before I started working with high school kids.

Dr. N. Fox: Yeah. I think, you know, for our listeners who either have teenagers or will have teenagers or had teenagers or were teenagers, I think it’s, I wanted to sort of ask you, you know, now that you’re working with teens and like just sort of your insight, what are the things you’re seeing? What are the things you’re working with? Obviously not, you know, specifics for obvious reasons, but like what kind of issues are you seeing? Obviously, teens probably have the same issues across the world, but they may be more prevalent, certain ones might be more prevalent in some schools or some communities or some places than others. So what is it you’re seeing, let’s say a lot of that’s taking a lot of your time with the teenagers?

Dr. M. Fox: Right. So I was probably saying Jewish day school. Anxiety is obviously enormous. Can overtake kids, can just overtake somebody and, you know, just helping kids, kind of break down their anxiety and make a plan for them of let’s say, how are they going to finish their paper or whatever the anxiety is, sometimes it’s social anxiety, sometimes it’s work anxiety, academic work, learning, learning, you know, how to study for a test or, I mean, it’s everything and anything. So I would say anxiety is absolutely the number one, I would say, issue that I see the most.

Dr. N. Fox: Right. Now you’re, obviously, not their, like, treating psychologists. So what is your role? Like, so, you know, whatever, let, what are the numbers, at 25% of kids, whatever it is, some crazy number of kids, yeah, some crazy amount of kids have anxiety. It’s huge. And they come to you. And so what is it that…what’s your role in the school for kids with anxiety, as opposed to, let’s say someone that they have in their own lives, like a therapist, let’s say.

Dr. M. Fox: Right. So first of all, I’ve learned this year in working with teenagers that I have to ask sometimes the students, do you want me to listen or do you want me to help you make a solution? So that that’s very new for me because I’m really very into solutions and making plans and, you know, kind of making a list of, well, here’s what you do next. And that’s kind of my orientation, maybe somewhat of a behaviorist in that way, a cognitive behaviorist, but not everyone comes in wanting a solution. So I have some students where I say to them, I’m like, let me just be very clear. You want me to listen, right?

Dr. N. Fox: You’re just here to vent.

Dr. M. Fox: And they’re like, yes, just listen. And that has been a major shift for me. I know that sounds funny, but sometimes and getting to know the students and what they want out of our conversation is absolutely essential. So and that comes with developing rapport and trust and just a relationship. So I’ve learned, you know, I didn’t always get it right in the beginning of some of my conversations, but, you know, you get to know kids and what they want from you. So if it’s…if they’re venting, then I listen. Right?

Dr. N. Fox: Right. And you have, I mean, your office is like a train station. There’s…it’s not like a closed door appointment type of thing. There’s people, there’s traffic.

Dr. M. Fox: I love it. There’s traffic. It starts as early as right after prayers in the morning and sometimes…

Dr. N. Fox: Or during.

Dr. M. Fox: Or during. No, they didn’t hear that. Sometimes kids will come in individually and sometimes students will come in groups. It really depends. You know, I never know what the day is going to bring. Although, I don’t work on Wednesdays, which luckily was the day they gave science tests this year. So planning a job where you don’t work on days where they give physics, chem or bio test is actually brilliant, in my opinion.

Dr. N. Fox: Where’s the psychologist?

Dr. M. Fox: Not here.

Dr. N. Fox: There’s a physics test. We need a psychologist.

Dr. M. Fox: Right. It’s more like right after the test. A lot of a lot of kids missing classes from crying. Those are my favorite days because I’m not there. So, you know, it really I do tend to offer…I’m a problem solver by nature. I like for a kid to walk out of my office with something concrete. So, whether it’s even just to schedule them for like some of this almost executive functioning that gets in the way of their, you know, that they can’t make a plan for how to study for something. So really being concrete in that niche in let’s say it’s a learning thing. Right? Or making or giving them even just a study plan of what to do. Or sometimes I see a lot of social anxiety. So, a lot. And, you know, it could be so paralyzing for some of these students. And a lot of it is listening to them, hearing what they’re saying. Some of it is what they believe. So you can’t just tell them that’s not true. That’s actually my success with students is validating them, listening to them, and not giving them silly suggestions, but being real to what they’re coming to the table with and being real with a solution for them. And sometimes that might mean that they’re not going to have the best day. It doesn’t always mean that everything’s going to turn out amazing that day or the next day even. But sometimes it’s really just offering them an opportunity just to survive that day and just a place to go that they…I’m not trying to turn everything around into being so rosy and peppy positive, but a place where they can go and they are validated and heard. And I find that, you know, there’s…it’s a funny line of offering solutions, but then knowing like they’ve heard this all before. So stop it. Because now it’s almost like you’re blaming them for things that they’re not doing wrong. And it’s a fine line. That’s always been my personal pet peeve as a parent even is like enough. Our kids know, let’s stop being condescending to them. Like, they know the tools. We’ve given it to them. Sometimes kids are mean and we have to acknowledge that and offer our kids different solutions that don’t involve well, why don’t you text that student one on one and ask, you know, to go out one night? Like, that’s basic at this point. Like kids know to do that. I’m not talking about someone who let’s say is autistic or has real social, you know, I’m talking about our regular day-to-day kids. We need to stop being…offering, I would say simplistic solutions for kids because they know it already.

Dr. N. Fox: Right. And can you…because we’ve spoken about this a lot and you’re very passionate about it. Can you give maybe like, an example of like a situation where a kid comes to you with a certain issue problem ongoing, whatever it is, and what they’re used to hearing and what doesn’t seem to be helpful to them or what frustrates them? And maybe how you approach it, how you think that there might be sort of a different way that they seem to appreciate or respond to.

Dr. M. Fox: So I would say, you know, the typical thing we’ll do for us, you know, might be we’ll make new friends.

Dr. N. Fox: Right. There’s a kid, who’s like, I have no friends. Right?

Dr. M. Fox: Or they’re excluding me.

Dr. N. Fox: Right. I’m being excluded. I don’t have friends, which is obviously this is so, so common in high school. So many kids, the ones who don’t feel this are probably the exception, I would say.

Dr. M. Fox: Right. So I would say that, you know, it’s not so easy to just say to them make new friends. I think that is beyond demoralizing to say to a student at this point. They know that. Right. If they knew how to make friends, they wouldn’t be coming to me. How do I do this situation? Right. And I think what we do then is not intentionally, but we’re sending the message to these kids that it’s their fault that they are not successful socially. And then it only makes it worse. We are making our kids feel worse unintentionally. And it’s the message that they’re not hearing. Right. It’s not that you’re telling them like, you can’t make friends. You’re so bad at this. It’s try this. Try that. It doesn’t work. Like, it’s not so easy. I mean, sometimes it’s as simple as, well, why don’t you try joining a club? Right. And again, I think that is somewhat simplistic, but some kids don’t always think of it like that. And sitting down with them and finding club that’s of interest to them, hopefully, will have common interests. You know, other kids might have common interests. Right. And it could be a great way to find a friend. And I’m not talking about like the general clubs. I’m talking about more niche clubs.

So, for example, someone this year started their advisor art therapy club. Most kids aren’t going into an art therapy club. But if you find someone who’s interested in that and going to it weekly, if that’s something that interests you, that might be a student you never thought about meeting before. Or it’s not popular clubs that I’m talking about. I’m talking about the more nuanced clubs, not the ones that are competitive to get into because those kids aren’t always the nicest. I’m talking about the more open ended clubs where you don’t need to compete to try out, but where they’re just welcoming you for who they are. It exists. It’s just about being open to finding it.

Dr. N. Fox: You even helped start a club.

Dr. M. Fox: I started a club called the Board Game Club because there’s nothing that bothers me more than seeing students alone all day in a school day. And it’s noticeable. And so I walked…and it happens in every school. I’m not bashing remotely the school I’m in. And I walked in and I saw that there are the same kids that are alone all the time. You know, they’re at lunch, they’re sitting alone. During breaks, they’re alone. And I decided I’m going to start a Board Game Club in the middle of school day, like during lunch hours, where kids can just come and play games. And because it gives them something to do. Kids need something to do. It’s a purpose. It’s an idea. It’s an activity. And you don’t have to be friends with each other to come. And it’s been very successful. And all kids are welcome. And we’ve developed kind of this awesome rapport with each other.

Dr. N. Fox: It’s a motley crew.

Dr. M. Fox: It’s a motley crew.

Dr. N. Fox: I got to see it firsthand when I visited the school.

Dr. M. Fox: We’re loud. It’s in the middle school day.

Dr. N. Fox: It’s like…it’s sitting in the hallways. It’s kids playing, you know, Monopoly or whatever. Whatever they play. I have no idea. But they’re throwing dice and yelling at each other.

Dr. M. Fox: We’re playing every game. When I started working at the high school, I had to ask for supplies. That was almost like working in a kindergarten. I asked for like markers and board games and kids games. And they were like, what is happening here? Because I want my office to be a place where kids can do something. And a place that’s not…that’s, I would say, a place with no judgment. That’s really what it’s about.

Dr. N. Fox: Yeah. And they’re…it’s sort of, listen, obviously the idealized version of this, which isn’t typical. Kid goes, they go to board game, they meet another kid, their friends, their friends are like, fine. But even if that never happens, they’re not alone. They’re at lunch. They’re playing. Even they don’t know the kid. Their interaction.

Dr. M. Fox: On Mondays and Tuesdays, there’s a place that they can eat lunch that they’re not alone. And that’s what it’s about.

Dr. N. Fox: And just feel normal, whatever that means. They feel like they want to feel.

Dr. M. Fox: That they’re part of a community. Even if it doesn’t expand outside of that, 45 minutes of whatever it is, it’s just a place where a kid is accepted for who they are and not judged. And it’s such a passion of mine. And it’s something boys and girls, it’s this is not exclusive. It’s something that I will continue to reflect on and try to work passionately and try and help these kids.

Dr. N. Fox: Yeah. It’s when you were talking before, it’s so interesting. Something like struck me that I never made that connection before. Where you were saying that the messaging we give to kids by sort of being simplistic with them. We’re trying to be nice. We’re trying to be kind. We’re trying to be helpful. We’re trying to make their lives better. But we really don’t have the answer, obviously, because there is no answer. But when we do that, it can backfire because you can, again, not intentionally, but you can unintentionally give the message that since it’s not working for you, it must be your fault. That’s what they hear. Everyone keeps saying, well, go make new friends. And I’m like, I haven’t made new friends. It’s my fault. And when you’re saying it, I think it’s like, it’s literally the same thing I talk about every day with patients and pregnancy. It’s a totally different world. But it’s, like, the exact same thing like with miscarriage. It’s so common. Most people who are trying to build a family will have a miscarriage, just like most kids are going through high school are going to have social issues. And it’s very common. It’s very sad. But if I say to them something like, oh, you know, let’s try a different vitamin or, oh, rest more or, oh, maybe you should… By being simplistic and not just being honest with them, I’m giving them the message that they caused the miscarriage, which is not true. Whereas if I just say to them, to be honest, to say like, this really sucks. I’m sorry you’re going through this. It happens to a lot of people. There’s usually no reason for it that you have any control over. You know, and that’s it. Like, period. You know, like, hopefully, hopefully it’ll get better next time. Right? Which is a little blunt, but it’s honest. And that’s, but that’s…and so it’s sometimes hard to hear, but they’re getting the right message that this isn’t their fault. Like shit happens to people that has nothing to do with anything they can do or have control over. And it’s true with adults and it’s true with teenagers. I mean, you know, listen, we have our own kids and any of them went through times of social… It’s not wrong with our kids. Like, they’re fine. They’re great kids. But like kids go through this. It’s so common.

Dr. M. Fox: Kids go through this.

Dr. N. Fox: Yeah, it’s so common.

Dr. M. Fox: What I hear the most from the students is they appreciate my honesty and my…I’m real with them. I don’t, I don’t lie. I don’t send them stupid messages like it will get better soon. For some kids, high school is going to be quite painful.

Dr. N. Fox: Yeah, it won’t get better in high school. Potentially.

Dr. M. Fox: And I’m not necessarily going to pretend that it will get better after camp. I could offer them hope and I could offer some solutions or suggestions. But I am very real with kids and they really appreciate that. And I hear that over and over again. I’ve developed some trust and relationship with some of the hardest…with some kids who have been the hardest for faculty to breakthrough with them. And it’s just because I listen to them and I’m not trying to change them. I’m not trying to judge them. I’m just there. I’m listening for where they are at that point. And what do they need from me? It’s really what I aspire to help them in any way that I can. I think these students have so much to offer and not everyone fits in a box. And a lot of kids come with complex situations and they know they can come to me. They know I’ll help them or advocate for them.

Dr. N. Fox: Yeah, I mean, they’re much…you know, it’s one of the big shifts in the teenage years is they grow up as children and they sort of…they enter high school, then they sort of leave high school as adults. And there really is that transition where they’re not kids. I mean, they are kids because they’re young and they’re stupid and they do stupid things. And that’s normal. But they’re…they become much, much, more like adults are in terms of wanting their independence, wanting to think for themselves, wanting to be maybe sometimes wanting to be like everyone else and sometimes wanting to be different from everyone else, just like all of us are as adults. And it is a real frame shift to treat them as you should treat an adult. It’s just, it’s not as…you can’t always be directive, like do this, do this, do this. It just doesn’t…it doesn’t…they don’t respond to that and it doesn’t work.

Dr. M. Fox: Right. So it’s almost like I came in and I’m refreshing for them in a way. It’s just, it’s my personality. It’s how my approach to life. It’s just a different perspective. And I’m also very fast in decision making. So there have been times this year when I’ve had to make very quick decisions. Some of them are mental health based. And I’m decisive. I could make a decision. Sometimes that’s hard to do under pressure.

Dr. N. Fox: Yeah. That’s what comes with experience.

Dr. M. Fox: Experience, life experience, professional experience, confidence. That it helps.

Dr. N. Fox: Yeah. Obviously, this is something that would be much more prevalent in high school that younger students, how do you work with the kids with like drinking, drugs, like, substance abuse, which is obviously, it happens so…it’s so prevalent in high school to some degree, whether it’s not abuse, at least, certainly trying it and what not.

Dr. M. Fox: So the first thing I say to us, any student who walks into my room knows that the first thing I say to them always is what we talk about is confidential unless we’re talking about self-harm, any form of self-harm, harm to someone else, drinking and driving I put right in there if they’re of the age. And I’m very clear with them that if we’re talking about things that are very dangerous to them, I will tell their parents. It’s a very fine balance in adolescence of developing trust and also looking out for their safety.

So it’s something I’m working on in terms of the drinking and drug and substance abuse. I have kids who are very comfortable sharing with me their weekend experience. And it’s a judgment for me always to know what balance is that? What’s the balance of telling the parents or the administration needed? And what is the balance of, are you safe? Do you have, you know, because kids are experimenting. It’s everywhere. It’s out there and it’s understand the difference between, okay, but this is the student showing up high everywhere he goes/she goes, whatever, as opposed to experimenting once in a blue moon. Right? There’s a fine balance and it’s being able to recognize the difference and is it impacting their grades? It is impacting their functioning in daily life. So it’s my first year of working with this. It’s a huge shift from obviously from working with 5-year-olds where I did not have those type of issues. But for me, a lot of it is really the same way that I operate with every other mental health issue that walks into my office. Trust the relationship and establishing that relationship and knowing that I am there for them, but also that safety is my number one and they know it.

Dr. N. Fox: Right. When the fact that you tell them that at the beginning, do you think that that’s something that builds the trust? That they know the rules versus that you think it’s something that it has to be done, obviously. Or is this something you think that sort of pushes some kids away?

Dr. M. Fox: So, I think initially you don’t get that rapport that you may want. Initially, there’s definitely a hesitancy that comes with that. It’s not just drugs and alcohol, there’s self-harm, there’s suicidal ideation. It’s not just about the drinking…you know, drinking or drugs. But I think that as they see over time, the trust and the compassion and the empathy that I built with them allows for that trust to be had. And then eventually they may or may not open up to me.

Dr. N. Fox: For any of our listeners that maybe have teens or coming up on the years where they have teens, I was wondering if we could pick your brain for a few minutes. You know, just again, all of us are afraid of teenagers. They are a very odd kind of mammal and they’re unique and they sometimes are trouble, right? Either they’re true trouble or they’re experiencing difficulties and it’s hard to understand them. But is there anything maybe practical that people could know or could understand to help them working with teens? You know, either things that are common or things that should not be too alarming to them or sort of how to work with them. It’s kind of a vague question, but I’m just curious, if someone said to my kid’s turned 14 and I have three down the road, what would you like parents to know or think that they should know?

Dr. M. Fox: Sometimes when a 14 year old goes home and you say, how’s your day? And they say, fine. That’s enough. You don’t have to keep going with the questions. Some, it is our natural, it’s our nature, I guess, to want to know more as parents, to keep asking questions, to almost micromanage their lives. Don’t do that. You know, and it’s a fine line because you also want to make sure your child’s safe and okay and mentally okay. Like, you know, their emotional health is okay. So it’s not easy, but sometimes parents, it is our natural wanting to get involved, to know everything, to figure things out, to never let your kid experience any hardship. It’s normal. It’s okay for kids to have ups and downs and it’s okay for kids to sometimes try to figure that out themselves. And sometimes it’s successful and sometimes it’s not successful.

Part of what we want our kids to be able to do is to problem solve on their own. And that doesn’t mean we can blanket every fall they have. So whether it’s a kid getting an A on a test, to a kid not being successful in a social moment, whatever it is, sometimes our kids are not going to have the best days and not want to talk about it. And sometimes we have to realize not to push. So I would say that’s a huge part of the balancing act as parents that we have to be able to do.

Dr. N. Fox: Yeah, I think it’s, you know, the kids should know, the teens should know that they can talk to their parents, you know, that you’re there, you know, that they can bring up things that are difficult for them and you’re going to try to be there to help them or just be there for them. But that doesn’t mean that they want to at all times. And that’s fine.

Dr. M. Fox: So with that being said, also on the flip side, if a child brings up something that’s very uncomfortable for you, let’s say a child goes home and expresses suicidal ideation, you need to talk about that. That’s not the time to say we’re not talking about it. That actually is the exact time to say, okay, let’s handle this together. It is, you know, validate them and give them tremendous praise for opening up to you. And then that’s not the time to walk away. That’s the time to continue with that conversation. So it’s the fine balance also that sometimes these conversations are going to be very uncomfortable for you and being okay with that uncomfortable situation for both you and for the child. We call it get comfortable with being uncomfortable. That logic applies to a 2-year-old, to an 18-year-old, to even 50-year-old myself. Like, you know, sometimes parenting is going to be the most amazing moments and sometimes you’re going to have the hardest moments.

Dr. N. Fox: I remember advice that we got something like don’t get involved in the drama. You know, kids have drama, you know, different kinds of drama. And again, if it’s something that’s really concerning or dangerous, that’s their mental health. But if it’s just like, you know, this one said this about me and this one didn’t invite me and this one did this and that, like, it’s, you know, when the parents jump in and try to fix that, it just doesn’t work. We’d love to be able to fix it. You know, it may be easier to fix in a 3-year-old, may not be, but it’s for teens that they have to sort of with some guidance, they got to learn how to get through it because that’s, I mean, that’s life, you know, and like you said before, it’s not going to work. And so you’re patronizing them ultimately.

Dr. M. Fox: Right. Although what I would say is at times, and we’ve done this as parents and I’ve advised parents to do it is take your kid out if they don’t have plans that Saturday night, offer to go to the movies with them yourself. I mean, that may not be something you want to do or take them out for dinner, distract them. It could be as simple as just, and it’s not the solution, but sometimes just taking them out of that moment of whatever the hardship is and do something fun with them could be a fantastic plan in that moment that kind of takes away the pain of everything for a few hours or whatever it is. You know, it also goes back to what would you advise a parent to do if a child comes back to you in a hard situation or whatever it is?

Dr. N. Fox: Yeah. I mean, again, it’s not, it’s not the solution. It’s not the solution and it’s not the solution they’re looking for, but it’s better than just wallowing. You know, they’re doing something and they may have a good time, right? Especially if you have a good relationship with your kids.

Dr. M. Fox: And they may choose not to want to, but at least, you offered it. And it’s…there’s going to be so much joy also that comes with this and there’s going to be a lot of pain and it’s okay.

Dr. N. Fox: Yeah.

Dr. M. Fox: I don’t tell kids it’s going to get better next week, but I do believe that as kids get older, maybe out of high school, they can choose, they could choose a college, they could choose a path, whatever it is that they want to do. And that might be help with some learning issues so they can choose to study subjects that they’re interested in. They could choose different friends that are more comfortable for them. In high school, you’re kind of thrown in a situation where it’s, if you, if you fit in, Kol Hakavod, right? If you fit in, you’re awesome. Most kids don’t. And so, and it’s finding that journey as they get older, they will find something that works for them. That works better for them than high school did.

Dr. N. Fox: Yeah. I mean, high school definitely, your day, it’s still has a lot of that lower school in it that your day is sort of dictated to you, you know, this is your schedule. Obviously, you have more choices in high school typically, but you still got math. You’re going to have math, you’re going to have science, you’re going to have English, you’re going to have a sit in the classroom, you’re going to have desks, you’re going to have all these things.

Dr. M. Fox: And it’s going to be popular. There’s going to be different groups.

Dr. N. Fox: Yeah. There’s cool kids, there’s athletes, there’s smart kids. There’s clicks. That’s just how it is.

Dr. M. Fox: It’s like a 1980s movie.

Dr. N. Fox: Yeah, it’s true. And things typically, I agree, they typically are better in college. Not always, yeah.

Dr. M. Fox: Calmer.

Dr. N. Fox: It’s just, yeah, there’s less of that. There’s a little bit less of that drama and kids get to find their own way. Like if science is really hard for a kid, fine, they’ll do liberal arts, you know, they’ll be, they’ll read interesting things and write papers and, you know, plays or whatever it is, you know, or the flip side. It’s, I think one of the other things which we were talking about offline, which is, which might seem like a new idea for teens, but I know that you believe in little kids is that this idea to expect they’re all unique, they’re different from each other. Different kids need and want different things.

Dr. M. Fox: Right. So you have all these rules, right? Which is important. Don’t get me wrong, especially schools, you need rules. Like, I get that. And then the beauty of working in a school where kids come first is that sometimes those rules don’t apply for every child. And so being able to have the expertise to know when does that kid need an extension on a test, for example. When is the mental health issue really impacting that they can’t function? When can you push? When can’t you push? Right. So it’s…and every student, every child, every person is different and being able to individualize that for every student is essential. And so I feel very strongly that, you know, there are rules and then there are individual cases. And so being able to make those exceptions for those individuals or help them along in their process and their timeline, whatever it is, is you can’t, not every rule fits every kid.

Dr. N. Fox: Right. Some people have a very difficult time with that.

Dr. M. Fox: With what? With exceptions.

Dr. N. Fox: Yeah, with exceptions to rules because they start getting into, well, it’s not fair or it’s not consistent or how do you know? And so, you know, I think that people agree with you conceptually, but how does that work practically?

Dr. M. Fox: So, it’s really, I think that comes with experience on the job and knowing when is it really debilitating what that looks like and what’s the timeframe? Does it mean that it’s always going to be like that? So I have some kids who may start medication and they can’t get up in the morning. It’s a new medication. Maybe they’re in a depression state. They can’t get out of bed in the morning. And so it’s my job to be able to realize that this child for a specific amount of time is going to need that exemption to be able to come to school a little bit later in the morning. And I feel that I have the expertise to be able to give that. And I work in a school with administrators who also understand that mental health, there’s no timeline on mental health. And it’s also to be able to distinguish when can you push?

Dr. N. Fox: And when you say to the kid, get out of bed and show up at school.

Dr. M. Fox: And I’ve done that by the way, I do that more than people would realize.

Dr. N. Fox: Yeah, like enough.

Dr. M. Fox: Enough. It is now time that your rules are the same as everyone else’s rules. And giving that student notice and parents notice and what that expectation is and what that looks like. But also having the compassion to know what is a true mental health issue that needs that exception.

Dr. N. Fox: Yeah. And I think it’s interesting. You’re building trust with the students, with the kids, but you have to have the same trust with the administration because they have to know that, all right, she knows what she’s talking about. She knows this kid. This may not be how we would do it ourselves, but like, we trust that she knows what she’s doing.

Dr. M. Fox: And the teachers and working with individual teachers and making an exception for a student is also not a very high school… They also, rules are there for a reason. A due date is a due date. And I respect that 100%. But also working with teachers and administration together to help them understand that without going into details, confidentiality and keeping a student’s issues private is very important in high school and always, but helping understand that I have their…I’m fully supportive of the teacher and the administration, but at this point, this is what this student might need is something that goes along with trust and confidence and, and with a plan. This is where we’re at right now. I’m in touch with the psychiatrist or psychologist or both or whatever it is. This is what this student needs right now. And we’re going to work together on making a plan to help get the student back on track.

Dr. N. Fox: Right. And you’re saying that sometimes because of, you know, it’s obviously, individualized, but sometimes because of confidentiality, the teacher may just know, you’re not going to really know why, but this kid’s out for a week or whatever it is. And, you know, and that’s it.

Dr. M. Fox: And not to, we’ll say something like a child might have extended COVID. Yeah. Because it’s really not…it’s not fair for the student that people know it’s their own personal private issue. And oftentimes, actually I might know and the principal might know and that’s it. And that’s, you know, we’re there to protect the students. So when they come back or whatever it is, they feel supported and that everyone’s rallying around them without knowing their confidential situation.

Dr. N. Fox: How should parents…what do you think their roles should be in interacting with the school or with you about their kids? Because you’re saying before, like with the little kids, you’re with the parents all the time. You’re talking to them, you’re meeting with them, you’re back and forth with them. In high school, it’s very, very unusual.

Dr. M. Fox: Very different.

Dr. N. Fox: So for parents, how would they know, like, what is the right time they should be reaching out to the school or to you versus like back off and let them do their thing?

Dr. M. Fox: I think that if as a parent, you see your child struggling in a way that you have never seen before, right? If there’s something different going on, you reach out. You could reach out to the psychologist first if you don’t want to reach out to individual teachers and working together with the psychologist, you can make a plan. Is this something that we’re concerned about or is it something we’re not concerned about together? I would say call, err on calling, especially with the psychologist. There’s nothing wrong with calling the psychologist. If in some schools, their parents might be nervous to call the administration, whatever that is, but the mental health provider, whether it’s the school psychologist or the social worker or the whatever…

Dr. N. Fox: Whatever it might be, yeah.

Dr. M. Fox: They’re your partners. And I feel very strongly, just like I did in elementary school and high school also, you can work together. You can work together to make a plan. You could decide together, is this something to be concerned about or is this something not to be concerned about at the moment or to watch? Or I might go and observe a child, which is really not that frequent like it was in elementary school.

Dr. N. Fox: Where is Dr. Fox in our classroom today?

Dr. M. Fox: They all notice. She’s in the lunch room. I spent the first month of school just sitting in a lunch room and everyone’s like, you’re creeping the kids out. I was like, well, this is what I want to do. I need to see these kids.

Dr. N. Fox: I’m recruiting for the Board Game Club.

Dr. M. Fox: Exactly. I need to see who’s alone too. But I didn’t know the culture and the culture is not to have people watching them. And I respect that. But on the same note, how am I going to learn what the culture is without seeing it? And so I spent a lot of time observing in the beginning. A lot. And which was unusual. But funny.

Dr. N. Fox: Yeah. Well, for all of the listeners, we’re happy to report that your contract was renewed. Yeah. They want you back for that.

Dr. M. Fox: Yes. I will be back next year. And I, you know, and there are some parents that I’ve actually worked quite closely with this year and they can…I give them my cell phone number. They can call me at any hour of the day, night because you need someone who’s going to help you. Some parents, some kids need a team to support them. And I am part of that team and I love what I do. And I’m happy to help in any way that I can.

Dr. N. Fox: Amazing. Thanks for coming on the podcast again. This was terrific. Teens.

Dr. M. Fox: Love this. Love teens. Who knew? Now I’ll never work with middle school. Let’s see what happens with that.

Dr. N. Fox: All right. Good stuff.

Dr. M. Fox: Bye.

Man: Thank you for listening to the “Healthful Woman” podcast. To learn more about our podcast, please visit our website at www.healthfulwoman.com. That’s H-E-A-L-T-H-F-U-L-W-O-M-A-N.com. If you have any questions about this podcast or any other topic you would like us to address, please feel free to email us at hw@healthfulwoman.com. Have a great day.

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