The clinical psychologist Lisa Damour published her latest best-selling book, “The Emotional Lives of Teenagers,” in February, a week after the Centers for Disease Control and Prevention issued an alarming report on the mental health of adolescents. In the C.D.C.’s survey, three in five teen-age girls reported having felt “persistently sad and hopeless” in the past year, thirty per cent reported that they had seriously considered suicide, and thirteen per cent said that they had attempted suicide. All of these marked significant increases over previous years, and girls also reported increased exposure to sexual violence. Among L.G.B.T.Q.+ kids, the numbers were even worse: two-thirds reported feeling persistent sadness, forty-five per cent had thoughts of suicide, and twenty-two per cent had attempted suicide. Hypotheses about the causes of this apparent mental-health calamity centered on the overuse of social media, the lingering psychological damage wrought by the pandemic, and, for queer kids, an increasingly malignant political climate.
To make sense of the C.D.C.’s shocking numbers, many media outlets turned to Damour, who explores young people’s inner worlds in her popular “Ask Lisa” podcast, in her books (her first two, “Untangled” and “Under Pressure,” homed in on teen-age girls), and in her private psychotherapy practice, in Shaker Heights, Ohio. Damour is herself the mother of two daughters, ages twelve and nineteen, and, although she does not discount the evidence of a post-pandemic surge in anxiety and despair among American teen-agers, she wants to recalibrate the terms of the conversation. “Mental health is not about feeling good or calm or relaxed,” she told me when we spoke on Zoom in May, days after the U.S. Surgeon General issued an advisory about the ill effects of social media on tweens and teens. “It’s about having feelings that fit the circumstances you’re in and then managing those feelings well, even if those feelings are negative or unpleasant.” She went on, “The adolescent mental-health crisis doesn’t end when all teen-agers feel good. It ends when teen-agers have the support they deserve and are able to cope effectively with the distress that they will invariably face.” Our conversation has been condensed and edited.
In “The Emotional Lives of Teenagers,” you take what we often think of as problems to be solved and you reframe them as facts of life—adversity that you just have to deal with, bad feelings that you can’t necessarily extinguish. You write about the value of being comfortable with discomfort and seeing emotions as tools and as data. Why do you think that that kind of work is harder now for your patients—and perhaps for their parents—than it was in the past?
There are combined forces at work here. One may be the commercialization of wellness. There’s marketing that can suggest that an emotional Zen exists, and with the right products or practices we can get ourselves there. That’s not true, but it’s very alluring as an idea, and it has contributed to a rising discomfort with emotional distress.
There’s also the reality of what we’ve all been through. The pandemic hit families in so many different ways. It left us pretty raw and eager to find a place that feels easy. I entirely understand that desire. Unfortunately, development has always been a bumpy road. The pandemic may have had us in a ditch for a couple of years. Now we’re back on the bumpy road that is typical adolescent development, but maybe we’re feeling those bumps in a different way, having been through so much.
Yeah, we’re exhausted and dirty to start with because we had to climb out of the ditch. “The Emotional Lives of Teenagers” was published within a week of a C.D.C. report that revealed troubling data about teen-agers—teen-age girls and L.G.B.T.Q.+ kids in particular. Then the Surgeon General issued an advisory about teen-agers and social media, which pinpoints moments in adolescent brain development when kids are especially vulnerable to negative effects of social media: between ages eleven and thirteen for girls, ages fourteen and fifteen for boys. Do those numbers track with what you’ve observed with patients in your practice?
It’s certainly a particularly vulnerable time for kids for negative influences. A lot of the disparity between girls and boys is driven by the neurological development that is jump-started by puberty, and girls enter puberty as a group earlier than boys do. So that’s why you see those age disparities.
What’s hard about the tweens to the early teens is that kids are often still quite concrete in their thinking. Regardless of how intelligent they are, they’re not always able to stand back from ideas and consider them from a wide range of perspectives. That comes along later in adolescent development. Older teens, as a function of having more fully developed brains, are able to be more skeptical about what they’re exposed to online, to consider what might be the motivation for any given post, as opposed to taking it at face value, as a younger teen is neurologically inclined to do.
The advisory from the Surgeon General seems to suggest that it’s not necessarily Snapchat or Instagram or TikTok in and of themselves that is the problem but, rather, some kids are spending two or three hours a day, or more, on them. Is part of your role as a psychologist to try to get kids to manage how much of their precious brain-developmental time they’re giving to tech companies?
The advisory highlights two things that we really need to focus on. One is harmful content, which we don’t want kids exposed to. The other is problematic use, which is spending so much time online that it disrupts the activities that are essential for healthy development, such as sleep, physical activity, time spent in person with friends, time spent helping around the house or in one’s community. When parents are trying to sort through these recommendations, one thing that they can do is not necessarily to think of themselves as being against technology—that’s probably a losing battle—but being for our kids and teen-agers spending essential time doing the things that will help them grow and thrive.
The other day, I was talking to a friend who said that he has accepted that he cannot persuade his teen-age daughter to spend less time on TikTok—he has given up doing it, even though he feels that it is harming her. What would you say to him?
My first question is whether she takes technology into her room and whether it’s there with her overnight. I will categorize this as a fight worth having with teen-agers. I have long recommended that technology not be allowed in anybody’s bedroom—parents or kids, ideally never, but certainly not when they’re supposed to be sleeping. If a teen-ager has enjoyed having technology in their room, they’re not usually agreeable to having it removed. So a parent can say, “We’re taking it out of our own bedroom because we know it is bad for our physical and mental health to have it in there. And if we take it out of our bedroom, and we leave it in your bedroom, it’s like we got in the car and we put on our seat belts, but we’re not putting on yours.”
Whatever else you can say about technology and how any of us use it, the more it disrupts sleep, the more likely it will be to contribute to mental-health concerns.
So does she spend three hours a day on TikTok in the living room?
The next way to tackle it might be to think in terms of the reality that it’s good for kids to be busy—not too busy, but busy. So another question that I would ask is: What is she doing after school? Does she have an abundance of free time that couldn’t be better spent? Now, I think the part that is hard for parents is that a lot of us, myself included, watched ungodly amounts of television—
Ungodly. Criminal. The amount of MTV I watched at that age—ridiculous.
And this is where we get down to the question of harmful content, and the question of what side of TikTok this kid is on. There are no simple and perfect answers here. But if this dad could get to a place where he says, “Actually, she’s watching two hours a day of goofy dance videos,” then we have to search our own hearts about whether this is better or worse than all of the “Gilligan’s Island” I watched as a kid.
The challenge is that the algorithms are going to feed your kids all sorts of stuff. They are designed to see what it takes to get a kid to be unable to walk away. And that can involve exposing them to harmful content or deeply upsetting content. I am a hundred per cent behind the idea that it needs to be regulated by somebody other than parents.
In “Emotional Lives” and in one of your earlier books, “Untangled,” you write about how teen-agers, particularly girls, need to hand off their “emotional trash.” In this metaphor, the parents—most likely the mother—serve as the girls’ emotional-garbage collectors. I wondered if this, in particular, is a place where parents have to get comfortable with discomfort—their daughter coming to them because they’re the safe place to throw her trash.
By and large, our teen-agers are incredibly well behaved for the duration of the school day. They spend all day, nearly every day, with a whole bunch of peers and adults whom they did not choose, shuttling from room to room, doing things that they may or may not have chosen for themselves, and actually being quite gracious, patient, and polite through the whole thing. Usually, the way they make that bargain work is, in the course of the day, they catalogue all of the injustices and indignities to which they feel they’ve been subjected, and save them up to tell us all about them.
I do hear from teen-agers that this is part of what helps them to be their better selves. Upon telling, the teen-ager feels tremendous relief; the trash is gone—they’ve disposed of it. They are ready and willing to go back to school the next day to see what comes. So long as the parent doesn’t feel like it is their job to prevent their child from coming home with emotional garbage in the first place, and the parent doesn’t carry the garbage around too much themselves, this can be a pretty elegant system.
But sometimes the emotional garbage isn’t, you know, “I had the silliest fight with my friend today,” or “This teacher is getting on my nerves.” Sometimes the emotional garbage is all of the feelings roiling inside that she can’t take out on her friend or her teacher, and instead they translate into hurtful words, yelling, arguing, these really awful fights which kids have with their parents. That’s the stinky, runny garbage that breaks the bag.
So we need to remember that teen-agers’ emotions are very powerful, and teen-agers can be very impulsive. Much of the time, when a teen-ager says something that is harsh or cruel, they regret it as soon as the words are out of their mouth. There’s enormous value in making that assumption, as the adult on the receiving end, and in being prepared to say something like “I’m going to pretend I did not hear that.” Or “I don’t think that came out the way you meant it.” Or “That is not like you—what is going on?”
It’s enormously useful to work with the understanding that all teen-agers have two sides. They have the side that can be mean and impulsive and immature and unpleasant and self-centered. And they have the side that is decent and kind and philosophical and broadminded. The side that you speak to will tend to be the side that’s going to show up for the conversation. One of the hardest moments in raising teen-agers is when they’re showing you the first side and you have to speak to the second. But I can tell you that it tends to work. And seeing it work makes it easier to repeat.
In your books, you don’t spend a ton of space on bullying. You also write that a lot of what we may call bullying is really just conflict between peers. I wanted to ask you about that specifically in the context of L.G.B.T.Q.+ kids. In the C.D.C. report, one in four queer high-school students said that they’d been cyberbullied, and close to a quarter said that they’d been bullied at school in the past year—and the survey was conducted in the fall of 2021, so a lot of those kids hadn’t necessarily even been in school all that much. I wondered if you could talk about how we should approach the question of bullying with L.G.B.T.Q.+ kids at a moment when we know that their mental health is very fragile.
I am hearing from L.G.B.T.Q.+ kids and their parents that this is a very scary time to be a sexual or gender minority. There’s a lot of concern about the ways in which the discourse around these topics can influence how teen-agers treat one another. We do make a distinction between bullying and garden-variety conflict—the kids who just don’t get along with one another, which is to be expected, whereas bullying is about a power dynamic. We define bullying as when a person is on the receiving end of mistreatment and is unable to defend themselves because of the power dynamic that’s in place. This is a really complex time in the country around questions of power and questions of what it means to be a marginalized youth.
It’s taboo to admit it, but bullying is a pleasure-seeking behavior for a lot of kids, right? They get a thrill out of it, a dopamine rush. It’s hard to talk somebody out of that.
Right—it’s a power trip.
What has to be done? What’s the intervention?
When we look at the science of bullying, in terms of intervention, bystanders actually have power. It is imperative that all of us say to our children, “If you are ever present when one kid bullies another, you must do at least one of three things. You must tell the kid who’s bullying to cut it out, you must take the child who is on the receiving end under your wing, and/or you must go tell an adult what just happened.” It’s not realistic to give them only the option of standing up to the bully in that moment. There are other things they can do that make a material difference.
So it’s not necessarily an intervention on the bully or the bullied; it’s an intervention on the people standing on the sidelines.
Yeah, absolutely, and making it very clear to every one of our children that it is not acceptable to stand by passively.
Is bullying a topic that comes up a lot with your patients?
It’s come up quite a bit more post-pandemic. Kids came back into their peer groups with rusty, if not completely undeveloped, social skills that have occasionally taken the form of extraordinary meanness.
Is there anything that your patients or their parents tend to want from therapy that they just can’t get?
I mean, right now you can’t even get an appointment.
And you can’t get insurance to cover it, either.
Which is obviously a huge problem.
The teens whom I care for often wish their parents would change. And often they’re not wrong when they are detailing their parents’ limitations. My work in those moments is to help the teen-ager try to give feedback to the parent in a way that may succeed, if the limitations are real, and also to help the teen-ager come to terms with the fact that there are aspects of their parents’ personalities that were in place long before that teen-ager was born and that are going to be in place long after that teen-ager leaves home, that parents by their nature are imperfect, and to try to not take personally what we perceive to be their shortcomings.
Clinically, my work so often is in helping that teen-ager redirect their energy away from trying to change an adult, who may not want to change or need to change, and toward advocating for their own best interests and, increasingly, taking over the work of caring for themselves and making thoughtful choices.
You’re a person who grew up to be an expert on teen-agers. What kind of teen-ager were you?
I grew up in Denver, where I went to a public high school. I played sports, I swam, I skied in the winter, and I spent a huge amount of time with my friends, and I had wonderful, wonderful friends. I loved being a teen-ager. It was a time in my life when the world really opened up. I worked as a bus girl in a restaurant until I had enough money to buy myself a car—a nine-hundred-dollar diesel Volkswagen Rabbit, a 1979 car, in 1986. Having that car, and the freedom that came with it, made me feel like the world went from being in black-and-white to color. I have incredibly vivid and joyful memories of driving in that car, listening to music, hanging out in the afternoons.
Do you think that today’s teen-agers have less access to that kind of freedom and that kind of ecstatic togetherness?
I think they get it in more fleeting ways. Their lives are often quite a bit busier and more demanding than ours were when we were teen-agers. We had a huge amount of time after school that we spent together, huge freedom on the weekends, lots of time for leisure. There’s no way that some teen-agers could spend that kind of time hanging out with their friends and meet the academic demands that are placed upon them.
What led you to the work that you do?
Part of it is just because I like teen-agers. I enjoy being around their entirely unique energy. They are direct to the point of seeming, at times, rude to adults. They’re clear-sighted in their ability to assess character. They’re very funny. They are delightful in how they can be utterly childlike—you know, having a competition with their friends to see how many Goldfish crackers they can stuff in their mouths, and then, a moment later, asking profound and impossible-to-answer questions about the nature of equity in the world or how the mind works. For me, the mix of all this is incredibly compelling.
Do you ever see your teen-age self in your patients?
I don’t know that I do. But I do remember feeling as a teen-ager that my friends were so interesting and that we all had so much going on. Part of why I enjoy my work with teen-agers, and why I can be effective with them, is that teen-agers can quickly sense who credits them as being interesting and complex, and who stereotypes them as being merely provocative or impulsive.
They have that intuition.
They can smell it at a thousand yards. ♦
