Talking To Teens: Expert Tips for Parenting Teenagers

Andy:
So talk to me a little bit about what inspired you to write this book? The book is decoding boys, new science behind the subtle art of raising sons. And this is not your first book, you've been writing about issues in this constellation for a long time. But now specifically you felt that it was time for a book on boys. Why is that?

Cara:
Well, I think you probably have to go back through my own personal trajectory to get to where I landed. So I'm a pediatrician and I was in practice for many years and when I transitioned out of the practice of clinical medicine, I ended up moving into writing. At first I wrote parenting books but in 2011, I ended up joining forces with American girl, the doll company, but also the relatively unknown publisher behind the cult classic book, the care and keeping a view, which is a body book for girls, walking them through what's going to happen to their body as they go through puberty. I've spent the last 10 years working with them and I had the opportunity to update the original book and then we've written four more in the series.

Cara:
From day one, I said to American girl, what about boys? My editor over there, who is a mom of a son said, "I know, right." But we're American girl, so that's what about boys. But she and I had this five year, I wouldn't call it a battle because everyone was on ourselves, but a five-year path to convincing everyone at the company that the process of growing up and transforming both in your body and your brain and your social world and your emotional life, it's very not gendered, right? I mean, parts are parts and probably about 20%, I would say if the puberty process is gender specific, but the vast majority is experientially the same. It doesn't matter what your gender and so they gave in. About four years ago, I published a book called Guy Stuff, which was the care and keeping a view for boys. It was right in time for my own son to head into puberty. My daughter is two years older, when she saw that book come out she was thrilled because her life was a mix of pride and humiliation when your mom writes puberty books.

Andy:
Right, it's not going to have a bunch of stories about me in it, yay.

Cara:
The books came and she opened the box and she was so ecstatic, she flipped through one of the books and she said, "Ry, come here. I want to read with you because now it's your turn." Of course it opened to what was called the erection section. She was like, "Oh my God." But anyways, so I wrote guy stuff and I was out on the road talking to families about guy stuff and publicizing guy stuff. What became very clear to me, and at this point, my son was about eight or nine, maybe a little older and what became clear to me is that parents were having a vastly different experience raising their boys than they were raising their girls.

Cara:
I've known this from practice, but it really as someone who was out on the road, talking to parents about a book written for their boys, what parents were begging me for was a conversation about conversation. They didn't know how to talk to their boys and there's been a very palpable difference in the past 20 or 30 years in how we talk to girls about their bodies. Girls have gotten all this language and all this voice, and they talk about periods and they talk about boobs and everyone's totally good with it. In fact, parents expect their daughters to talk to them and if their daughters don't talk to them, the parents sort of insist on it. But there's no corollary for boys and parents were sort of begging me to talk about that and I had a boy who was heading into puberty. So it was personally very interesting to me and it was professionally very interesting and so I took on the challenge of writing a book, trying to understand why boys go quiet when they go into puberty and what we as parents can do to help them through it. Because language, as it turns out, is one of the single greatest resources that we have to keep ourselves safe and healthy.

Andy:
You talk in this book about how a lot of boys go quiet when they hit the puberty years, or there's at least a phase that's a silent phase. They're just not saying that much and that it is a phase and they'll go through it and they'll come out of it on the other end. But you also write that we as parents don't necessarily have to accept their silence and you're right, if we fully accept our son silence and don't insist on keeping a conversational thread alive, trust me when I say will face a much steeper climb when a heavyweight topic rears its head. What do you mean by not accepting their silence? Why do you say that?

Cara:
Yeah. Well, let me start by saying, there's always a parent who's listening who says, "Well, my son talks to me, he's totally verbal and we share everything." So none of this applies and I would argue that almost all boys go quiet to some degree.

Cara:
The most talkative ones, maybe the volume comes down just a little, they still talk, but it down a little. There are also a lot of girls that go quiet.

Andy:
Hm, interesting.

Cara:
So again, speaking to the point of not gendering, but my feeling about quiet at this point is that, as parents we are so conditioned to expect our boys to shut their doors and to shut us out, at least for some period of time that when they do it, what we say is, "Oh, that's just puberty."

Andy:
“Going through that phase,” yup.

Cara:
Right? So I'm just going to ride this, I'm going to respect my son, I'm going to give him his privacy and when he emerges out the other side, then I'll reconnect with him and it's all going to be okay. When I talked to the boys, the boys don't want to be behind those doors all the time. Don't get me wrong. Sometimes they really want to be behind those doors.That's why you show it knocks, it's a very important piece of parenting advice.

Andy:
For sure.

Cara:
But the reality is that most boys actually like being engaged by their parents and they take their parent's silence, not as respect, but as disinterest.

Cara:
It becomes a barrier to communication between parents and kids, that's a barrier you don't want to have to overcome if you don't need to. Because there are big ticket items down the road, whether it's conversations around sex or drugs or friendships or stress and anxiety or... I could give you a list of a hundred things. You want to have a relationship with any and all of your children where they can come to you and talk to you, if the modeling is, "It's okay when you shut the door, I'm just going to leave you be indefinitely."

Andy:
Right.

Cara:
That shuts down that conversational thread and boys will often tell me they then try to find that somewhere else. One thing that parents are somewhat aware of as their kids become teenagers, is they're talking to their friends.

Andy:
Totally.

Cara:
They're just not talking to you, and so what's that? Some of that is normal developmentally. That's what adolescents should do. But some of it is learned because they're responding to the behavior that you're putting in their direction.

Andy:
Yeah, and it's not necessarily realistic to think that they're not going to resist these kinds of conversations. People don't like to do things that are awkward and not fun and so this is not necessarily something that your kids are just going to love and say, "Oh, thank you so much for bringing this up. This is great. Really appreciate it." But they're going to learn if you don't that all they have to do is put up a little resistance and you'll leave them alone, you won't press the issue and they'll learn that they can get out of stuff and how to not engage with you about things that they don't want to talk about and so...

Cara:
Yeah. Do not expect a gold star from your kid when you reach out, they're not giving you that. But on the other hand, you are absolutely right that over time, it may take five or 10 tries on any given conversation, but over time, if you are a little bit relentless, kind but relentless, they will eventually realize that you really care and they'll start opening up. Some of them, just a little, and some of them a lot.

Andy:
Isn't that what you want from your parents? That they just never gave up on you and even when you were kind of an asshole, they just kept at it.

Cara:
100%.Right. Frankly, for your parent to be so honest with you, that they can say, "Here's where I've behaved badly as your parent. Here's where you're behaving like a little jerk as my kid." I mean how do you say that in a loving way? Only honestly, and openly, if you have a dialogue. If your whole dynamic with your kid is lecturing them and it's a one-way street, it doesn't work out very well when you're saying something that you think is loving and protective. They don't take it that way. So the back and forth, so the first step is how do you talk to them? The second bigger step is, how do you listen? How do you talk with them instead of just one direction?

Andy:
So one of the big questions I think with regard to adolescence and puberty in general is when do you need to start talking about it? When is the point of no return that it's too late now? When does all this stuff even start? There's this folk wisdom that it's a lot earlier in girls, girls start this process a lot earlier and go through the growth spurt and the boys are later on. So maybe you're good, you can wait until your boys are maybe a little older until you see maybe the hair start a little bit, the voice starts to break, the shoulders start to broaden and the smell, you start to smell them and then you're like, "Okay, now it's time to have the talk."

Cara:
So let me break those apart and answer them all, because they're really good questions. The first is if you have a kid in your life, if you're a parent, grandparent, trusted adult who has a kid in their life who is 15 and you're not talking to them, start talking to them. If you have a kid who's 12, start talking to them. If you have a kid who's seven, start talking to them. If you have a kid who's four, start talking to them. I mean, you're going to talk to a four year old about really different things than you're going to talk to a 15 year old about that but the idea of keeping open lines of communication is as important when they're little as it is when they're older. If you haven't started, you're never too late. Let me just emphasize that a hundred times because that's the biggest worry I get in response to telling parents to talk to their kids. "Well, I've never done that. Did I miss the boat?" Nope. You did not miss the boat. If your kid is 25 and you still haven't done it, you go, "I probably should have done this a little while ago, but you know what? I'm just trying to be a great parent. So here we go." But start the conversations now.

Cara:
Puberty, and when puberty begins and all that, it's a really big topic that I'll boil down to a few sentences here. I write a lot about it in the book, but the take home message is that it's a lot earlier now than it ever used to be the average age for girls in the United States to begin showing signs of puberty is between age eight and nine, and depending upon ethnicity, black girls in this country, if they are starting to develop breasts at age seven, seven and a half, that is considered normal. Boys, the onset of puberty is actually almost just as early. It is between nine and 10, depending upon what your ethnicity is. It didn't used to be that way.

Cara:
This timeline has marched backwards by a couple of years over the last 30 or 40 year chunk. No, I don't know why. A whole other kettle of fish, probably everything in our environment, what we eat, what we drink, what we breathe. There are a lot of really smart people working on that. But it's important to realize a couple of things about the earlier onset of puberty, one is that it's like taffy. So it's starting earlier, but it's not going any faster. In fact, it's probably going slower because those landmark moments of puberty, particularly girls getting their first period, those moments have not really budged at all. So girls are still getting their first period around 12, 12 and a half, but now they're developing breasts, instead of two or three years before they get their period. It's four or five years.

Cara:
So this whole run-up to these milestones of puberty is much slower, which is an interesting fact. The other thing, and I think equally interesting is most parents of boys have no clue that their boys are in it.

Cara:
That's because boy puberty is dictated largely by testosterone. Testosterone is just a hormone. It tells your body to grow and change so that you go from boy to man. Testosterone is manufactured in the testicles. Those are the testosterone factories.

Cara:
In order to get enough testosterone on board to go through full-fledged puberty, you got to get the factory up and running and it takes a little while. So the first several months, or even a couple of years of puberty in a boy might just be testicular growth. You don't see anything else. You don't see any broadening of the shoulders. So you don't hear the voice change, hair is a whole different issue, it's a little bit of a red herring because hair growth, is actually not a marker of puberty. It just happens to happen at the same time.

Andy:
Interesting.

Cara:
Which is very complicated for people, me too. It's really throws you, but boy puberty happens way before we notice it. When I speak to audiences, I always have a parent in the crowd who's got a nudist who's running around their house and they're like, "Oh, I knew what my kid was in puberty." But for every one nudist, they're like 99 completely private boys who shut the door and won't let you see them. What I say to those parents is, "That's fine. You do not need to know when they go into puberty. I am a pediatrician. I write about all this stuff and even I didn't look when my son was starting to go through puberty and trust me, I was tempted to understand it. That's very scarring." So if you've got a private kid, your pediatrician can look, they can do an exam and they can tell you when your son is tipping into puberty, but it is happening a lot earlier than you think.

Cara:
There's significance to that because the hormones don't just circle through the bloodstream below the neck, they go up into the brain and they circulate around the brain and they impact the way kids think and feel. That, when you start paying attention, you go, "Oh yeah, I see puberty in the snarkiness, in the mood swings." All that kind of stuff, and now you start to give yourself permission to recognize that your kid is on a new drug and that drug is testosterone for boys. It is estrogen and progesterone for girls and those are powerful.

Andy:
What about using those to induce puberty in late bloomers, or can you supplement with some of those hormones you're talking about when you have a kid who is getting into later teens and they haven't really started this process yet?

Cara:
Yeah. I write a lot about late bloomers because we talk so much about what's happening earlier and earlier, but the kids who are on the later end, that's hard. It's socially really hard. Everyone around you has grown in height and all their features have changed and they look more adult and here you are, and you just look like a young child and your brain is aging. What you want to do is chronologically appropriate, but you don't look the part. That's very hard. The definition of late bloomer for a boy is a boy whose testicles have not started growing by 14, and so what I say to parents who's 12 and 13 year old boys, seventh and eighth grade, they look young. The other kids seem to be changing, those kids aren't. I say to them, "Take your son to the pediatrician and have the pediatrician examine him because if his testicles are starting to grow, you're good."

Andy:
Okay, yeah.

Cara:
He's on the later end. If by 14, the testicles haven't started to grow at all, then sometimes you do need medical intervention. You need a little dose of testosterone to jumpstart the machinery and it can be enormous. There are endocrinologists, hormone doctors for kids who will sometimes recommend testosterone younger than 14. I think that's totally appropriate when that happens, because if you think about it, go back to your eighth grade self for a second. So not the most fun year and now imagine being the only one, pretty much who has nothing going on physically. That's pretty late to wait and if the kid is starting to have some distress about it when he's 12 or 13, it's fine to take them earlier and if someone deems it appropriate to start thinking about treating him a little bit earlier, or to prove that, "Hey, no, everything's working. It's just taking its time and we don't need to medically treat it." It's very reassuring for a boy.

Andy:
Because wow, that seems like really detrimental to your just self-concept and your idea of who you are in the world, that to be going through such a formative phase of your life and feeling like you're an outsider or not having the same experience as everybody else.

Cara:
Yeah. I write a lot about the show Big Mouth, which is very interesting show. I really like Big Mouth. I always say it's wrapped in incredibly inappropriate set of premises and the storylines are crazy and the language and the this and that, but at the end of the day, it's a story of an early bloomer and a late bloomer and everything they put in that show is medically accurate, everything. Every theme that they deal with and they talk a lot about what it is to be a late bloomer It makes boys who they are when they're men in many ways who have gone through the process, it definitely impacts the person they become.

Andy:
It changes you forever, yeah.

Cara:
But it's hard. It's really an interesting path. You talk to late blooming guys as adults and there's a large community online who talks about the experience. It's pretty interesting to read. The reason I point out late blooming boys especially, is that girls tend to go through puberty earlier than boys. So the last of the last schools are done before the last group of boys can even begin.

Andy:
Yeah, if you're the last boy in your class to go through puberty, you are just out there on your own.

Cara:
It's hard, yeah. This is what I always say, okay, being the first to go through puberty, oh my God, that's so hard. Being the last to go through puberty that's so hard and being in the middle, well, that's so hard because it's puberty.

Andy:
You have it a really interesting section in here on brain changes that occurring and one thing that I marked was the limbic system versus the prefrontal cortex and specifically the differences in myelination and how myelination starts in the center of the brain and kind of works its way out. So during the teenager years you have this situation where, and I love this line, you say, "That means if two messages are sent simultaneously, one to the limbic system and one of the prefrontal cortex, then in the tween or teen brain, the message going to the limbic system will arrive much faster, 3000 times faster." That is a lot faster.

Cara:
It explains everything, the decisions we make in middle and high school and college, right?

Andy:
So when you're trying to figure out what to do next, your emotions kick in 3000 times faster than your logic basically.

Cara:
Yeah, basically.

Andy:
So then we have the parents say, "What were you thinking? What was going through your head when you made this decision?" "I don't know, that didn't happen until 3000 times after the impulse to do the thing occurred."

Cara:
That's right. Whenever I teach kids about that, they're so happy they go home and they're like, "It wasn't my fault, it was my brain." But that wasn't the point of writing that I actually wrote that chapter so that kids in middle and high school could read it and understand what was happening in their brain so that they could actually then start using tools to be able to think and make smart choices. So when you think about how fast a message is sent to the emotional part of the brain, and you compare it with how fast a message is sent to the rational part of the brain, how do you then get your brain to think rationally? You just give it time.

Andy:
Yeah, slow down.

Cara:
3000 sounds really high, right? But if you count to 10, you're good. If you are thinking about doing something really dumb, and then you count to 10, your prefrontal cortex now has the chance to go, "That is so dumb. Don't do it." That's all we need kids to do.

Andy:
Something really interesting in here is you said that as a pediatrician, you would often ask teenagers about what conversations they've had with their parents about these topics. They pretty much universally say, "Nope, haven't talked about really any of this. Sex, nope. Body changes, no, not really, haven't no." But then when you ask the parents the same question, about a hundred percent of them say, "Oh yeah, of course, you know, we've talked about this stuff a lot." I thought this was fascinating because the lab that I worked in before this doing psychology research we studied alcohol use and we found the exact same thing with parents when we survey the teenagers and ask them, "What have your parents told you about alcohol use? What are their expectations with regard to how much you're going to drink in college?" All of these things.

Andy:
The kids are like, "No, I haven't really talked about it. Their expectations are that I'm going to probably drink a lot. You know, they know it's college and et cetera." Then when we talked to the parents, they're like, "Oh no, I've really clearly communicated. We've talked about this a lot. They know they're not supposed to do it." So I think there's just this disconnect in general with a lot of the communication between parents and teenagers, where we think that we're coming across to them, we think that we've communicated things to them, but they haven't really received it in the same way or it didn't affect them as much as it affected us or something.

Cara:
Yeah, so there are a few things here. I mean, one is, we used to call the talk, the talk. It was supposed to be the talk about sex. Well, the talk about anything doesn't work, it's like when your child was a baby, sometimes you had to try a new food 10 times before they would accept it. So that's how I think about every conversation about everything important, sex, drugs, rock and roll. I don't care what it is. You as a parent have to have it eight, 10, 12 times before it sinks in. Kids know that, it's not that they didn't hear it, but sometimes these conversations are horrifying. Sometimes these conversations are so PG compared to what they're getting from other mediums. They are so far beyond what you think you're shining a light on.

Andy:
Yeah, right.

Cara:
Which is why it's important to listen and figure out where they are. But repetition is also critical, really cues your kid that something matters to you. So if you've got a kid who's going off to college and do you think you've done a great job, having the talk about all the safety things and the drugs and the alcohol, it might be a good idea to have that conversation like 20 more times, or maybe have your kid tell you what you think.

Andy:
What have you understood about what I've told you?

Cara:
That's right.

Andy:
What do you think my expectations are?

Cara:
That's right, and by the way, that is their prefrontal cortex talking. They are telling you using their rational brain, what they know you want to hear and then he go to the party and it's not their prefrontal cortex that is working. It is their limbic system and is the emotional center and so the part that told you, what you wanted to hear is not in charge until they're close to 30. That is a really important conversation to have with them. "Thank you for telling me exactly what you think I want to hear. Now, let's talk about what you do in real life, because I want you to be protected."