Join Dr. Pete & Dr. Norna Jules for another Mental Health Awareness conversation as they discuss how Covid impacted today's youth. Dr. Jules offers insight into the uptick of social anxiety & social disorders and how to identify issues when problems present. Therapy isn't one size fits all and Dr. Jules shares her unique approach with years of expertise and knowledge on the subject.
Dr. Norna Jules is a licensed Clinical Psychologist passionate about advocating for individuals and families through life's transitions. Dr. Jules focuses on neurodevelopmental disorders and she is specifically interested in how teens have been impacted by Covid, social media and other external factors.
Please click on the link below to learn more about Dr. Jules:
https://dr-norna-jules.com/about/
https://mhanational.org/mental-health-month/
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:17):
Welcome back to On Air with Dr Pete.
I hope you've been having agreat week, and we are here for
May Mental Health AwarenessMonth and I have a very special
guest for you today.
But, as you know, it was notthat long ago.
We had things like COVID andall this stuff was getting in
the way about the issues ofanxiety and depression and the
devastating effects that it'shad, especially with our little
(00:37):
humans, and more research iscoming available, and I've been
curious to see how this hasimpacted, and so that's why I
brought on this guest today.
This is Dr Norna Jules.
Dr Jules is also a formerstudent, so this is really cool
full circle.
We're going to talk about thata little bit.
She is a clinical psychologistpassionate about advocating for
(00:59):
individuals and families intheir life's transitions.
Dr Jules focuses onneurodevelopmental disorders,
and she is specificallyinterested in how teens have
been impacted by COVID, socialmedia and external factors, so
we are going to learn all aboutthat today.
Welcome to the show.
Speaker 2 (01:14):
Hi, thank you so much .
What a warm welcome it's been.
Speaker 1 (01:18):
Oh, my goodness, I'm so glad that you reached out.
And so what was it like in myclass and you could be honest?
It's okay this.
Speaker 2 (01:25):
we like to keep it real here you know, the most
real thing I can say is yourclass was the first time I was
introduced to cognitivebehavioral therapy.
I had no idea what it was and myperspective on therapy was so
different yeah before coming toyour and at the time you didn't
call it that, but what I feltyour style was was more
(01:48):
assimilative, so thatintegrative CBT who's the person
, in addition to the cognition,behaviors, thoughts and it just
drew me in and ever since thenand I don't think I've told you
this ever since then I decided Ithink this is the type of
therapy I want to do.
Wow, so a lot of the work I dois attributed to that CBT class.
Speaker 1 (02:11):
Well, and it's funny because your peers I remember.
One of the things that theysaid is that I was the first
person to tell them that gradschool is traumatic.
That was one of their memories.
Speaker 2 (02:22):
That is so funny.
Speaker 1 (02:33):
Yeah, yeah, memories.
Yeah, yeah, I don't rememberthat, but I'm sure maybe I don't
know I forget who it was, but Iremember that group because I
think was that right beforecovid, was that like 2017?
No, 18 or 19, what wait when?
Was that 18 19 19 yes, it waslike right before covid probably
right before covid.
Yes, it was all before covidyeah, so give people a
background as to like what youwere doing as you got there.
(02:54):
Like who is dr norna jules?
Speaker 2 (02:57):
dr norna jules.
Yeah, um, I am the youngest of10 and so I think that informs a
lot of my therapeutic style.
Speaker 1 (03:08):
You give a new name to the baby.
Speaker 2 (03:10):
I give a what.
Speaker 1 (03:11):
You give new name to the baby the baby of the family.
Speaker 2 (03:14):
Oh, what do you mean?
Like?
Speaker 1 (03:16):
the last born.
So you said you're the last of10, or one of 10?
.
So I'm the last of three.
That's like nothing compared toyou.
You have a trophy for being thebaby of three that's like
nothing compared to you.
Like you give you you, like youhave a trophy for being the
baby of the family oh yes,setting a whole new standard,
absolutely.
Speaker 2 (03:32):
But it's interesting because that has shifted a lot,
because I'm the first doctor ofmy family yeah, so there's
almost like a paradigm shift.
But when it's Thanksgiving andChristmas, I am the baby, baby.
So that will always be the case, but as far as it always
informing my therapeutic style.
(03:53):
Just from a young age, I had tolearn how to advocate for
myself Sharing the bathroom,getting the hand-me-downs.
I don't want to wear this.
But, it really translated tofriendships and professional
relationships and, of course,I'm sure, as you know, my
education as well.
So when it comes to therapy, Isee it as an opportunity not
(04:16):
only to work with the person'sintra psyche but to also help
them advocate across systems.
And that's a big part of thework that I do and parents say
it all the time when they workwith me in my private practice
also in the hospital publicsector is I feel like I know
(04:38):
more about who I am as a personin the world, not just in the
inside, because of who we aretogether.
So when you think about DrNarnia Jules, I hope you think
psychologist, but also advocateand just someone who is very
passionate about, I guess,helping people see that advocate
within themselves.
Speaker 1 (04:59):
Well, and you've said that it's like not a one size
fits all, which I love, and soyou gave me a little shout out
of sort of forming yourcognitive behavioral therapy
approach, and so give us moreabout your philosophy.
Like that it's not a one sizefits all.
Speaker 2 (05:13):
It's not structured and concretized for the sake of
not facility but to facilitatetreatment, to get to the core
(05:39):
symptoms that are acrossexperiences.
So when we think aboutdepression, anxiety, trauma,
what are things that we seeacross?
People diagnosed with thisthing.
But, as we know, there's a lotthat informs how people's
symptoms manifest and that iswhat's individualized.
So, once we get a hold of thosesymptoms, what is coming up
(06:00):
from their past, what is comingup from their childhood that is
going to get in the way ofmaintenance?
Yes, and that is going to impactpreventative measures.
So that is a big part of thenot one size fits all,
especially when it comes tochildren.
Because when we work withadults, there's a lot in the
past that we have to siftthrough, but when we're working
(06:22):
with children, adolescents,adolescents and adults, we're in
it.
So there's a lot of the familydynamics that's still in
development and theinterpersonal dynamics that's
still in development and I sayyou cannot work with children
and expect a one-size-fits-all,it's just impossible.
Speaker 1 (06:38):
Ever and so more importantly than ever.
So you also specialize inneurodevelopmental, which some
listeners may not understand.
So neurodevelopmental is lotsof different diagnoses that are
biologically based and today,most recently with some of the
sociopolitical challenges,there's a lot of discussion
around the high rates of autismjust in the last 24 hours, so
(07:02):
hopefully we can air this soonso this stays relevant.
But my sense is it won't changethat much.
But yes hopefully, but like whatare your views of these
findings?
You know, in terms of likeunderstanding, how much work
you've done aroundneurodevelopmental disorders is
specifically autism.
Speaker 2 (07:20):
Yes, so how much time do we have?
I'm going to start with thefact that the prevalence, which
is the monitoring network thattracks the diagnostic rates and
prevalence of autism withinspecific states in the country.
(07:53):
So, it's not across every stateand of course there's research
across the spectrum ofpsychology and medical research
and such that might look atother states, but the most
referred to one is the ADDMstats.
I actually had a didactic withthe researcher who runs the ADDM
(08:15):
stats while I was a fellow in aneurodevelopmental fellowship
and he did explain the methodsby which they collect the data
and how they all communicateacross states and how they
determine what states areinvolved and what states aren't.
And consistently, californiaand New Jersey, as we know, are
head to head when it comes tothe diagnostic.
Speaker 1 (08:35):
Always yeah.
Speaker 2 (08:37):
And what a lot of people don't know is that those
rates are actually looking atfour year olds, eight
eight-year-olds and, just in2018, 16-year-olds.
Speaker 1 (08:47):
Okay.
Speaker 2 (08:47):
So when we think about the diagnostic rate
increasing of autism, in thecountry.
People usually think across thecountry, like every state, and
they usually include adults,which is a lot less monitored
and a lot less reliable when wecome to the statistics.
So when we see that increase inprevalence.
It's usually talking aboutchildren.
Speaker 1 (09:09):
Well, that's why we need people like you out here
educating, because these ratesand these numbers are scary
without that context, yes.
So what about the misdiagnosisof autism and ADHD?
What are your thoughts on that?
Speaker 2 (09:22):
Well, my thoughts are that there's a lot of
intersection between ADHD andautism, and when we think about
misdiagnosis, it's usuallybecause of gender Girls more
likely getting a diagnosis ofADHD first because of some of
the symptoms that are easier tocatch.
And I'm doing bunny ears whenwe think about some of the
(09:45):
intersection between autism andADHD.
And it's also because ofintellectual disability, and I
won't get too deep into that,but a lot of the times if
somebody is used to seeingautism a certain way, they might
not diagnose it unless there issome clear impairment in
cognitive functioning which, aswe know and as the research is
(10:09):
increasing, that is notnecessary for an autism
diagnosis.
So I think with the ADHD, anautism misdiagnosis, a lot of it
comes down to gender, cognitivefunctioning and of course, as
we are increasing our knowledgeand what ADHD looks like and
what ASD looks like, we'refinding that it's just kind of
(10:33):
one lump but it's hard to kindof parse apart to tease it out
say that their labels don't havemeaning, because they do, but
depending on the context, somepeople might not know how to
differentiate between the two.
Speaker 1 (10:53):
So well, I, I love learning from you.
I mean, this is, uh, becausethat was actually really
interesting for me to hear,because, oh, the adhd always
think about boys because boysare always like over diagnosed,
but to hear that girls aremisdiagnosed because of the
autism presentation, that isreally really curious to me.
Speaker 2 (11:11):
So, uh, that was a thank you sure, yeah, a lot of
that just comes with the idea ofwhat do these things look like?
Yeah and it always comes downto how they manifest, and, and
so, as we are seeing more girlsget diagnosed with autism in
later stages, we're starting tounderstand.
(11:32):
Oh, what we used to attributeto inattention, for example,
might be more consistent with asocial communication deficit or
difference, and so, asdefinitions change, I think
we'll see some of the diagnosticrates change.
Speaker 1 (11:48):
I love that and I love that you also said that,
because I mean, I teach a lotabout like it's not the category
or lumping people into acategory.
I just use it to inform thetreatment, you know, and that's
why you need the diagnosis,because autism ADHD would be
treated very differently.
Are we still with that?
Speaker 2 (12:05):
I think so.
Speaker 1 (12:06):
Yeah.
Speaker 2 (12:07):
Yes, and at the same time, it depends on what the
person is coming in to treatmentfor, which comes back to the
original comment of it's not onesize fit all.
We're not treating a diagnosisper se, but we're treating what
that person is coming in for.
So if somebody with ADHD islike I really need to understand
(12:28):
why I can't interact withpeople or my partner or whatever
the way I'd like to, maybe wewould take more of an
interpersonal socialcommunication stance, even if we
don't have that ASD label.
Speaker 1 (12:40):
Yeah, Cause there's all the social stigma around
certain diagnoses, and so it.
Yeah, I love that you have tokind of work with what they come
with now because of thepopulation you work with.
What are you seeing with colike post COVID?
I know lots of stuff written onthis right now, but I don't
(13:08):
know that we know yet enough, um, but okay I do see it.
Speaker 2 (13:13):
Even in the short amount of time that has passed
between covid and now we're in,I feel safely we can say
post-COVID.
Speaker 1 (13:21):
Hopefully yes.
Speaker 2 (13:24):
Parents are concerned about their children's ability
to interact with other people.
Speaker 1 (13:31):
Yeah.
Speaker 2 (13:32):
And some of the main things that we see in
neurodevelopmental differencesis that impact on social
communication.
Yeah, and so when we thinkabout social communication
succinctly nonverbal and verbalmeans of communicating and how
that impacts the way youinteract with other people.
So it's not just eye contactand it's not just verbal
(13:54):
language, but it's also bodymovements, it's also euphemisms
and idioms and sarcasm.
So there's a lot that goes intointeracting in person that
children learn, and we do nottalk enough about the fact that
there was a time span of threeyears where children, who were
(14:18):
in the most developmentallycrucial time of their life.
Speaker 1 (14:21):
when it comes to engaging, what kind of age group
would you say there, just forlisteners?
Speaker 2 (14:26):
I would say early school age, years when we really
start to push them out into theworld, when they're starting to
learn how to use some of thosethings they pick up from their
family with other people andrealizing oh, this is useful.
Speaker 1 (14:41):
Like five, six, seven , eight-ish.
Speaker 2 (14:43):
Yeah, yeah.
Yes, keep me sustained Dr isuseful Like five, six, seven,
eight-ish.
Yeah, yeah, yes, keep mesustained Dr D.
You know, like that five toeight-year range yeah.
Speaker 1 (14:50):
That was more for me, because I'm terrible with ages.
Speaker 2 (14:55):
Yes, you get the white beard.
Oh yeah, Once you get the whitebeard, you're not concerned
about other people?
Speaker 1 (15:01):
That's exactly right.
But my nieces were that ageduring that time so I was always
mindful of that for my brother,of like how hard it was for
them and just observing that.
So you know you really buildresilience and I know you talk a
lot about strengths andresilience with your clients.
So how do you kind of fosterthat in the clients that you
work with, trying to identifytheir strengths and then build
resilience?
Speaker 2 (15:23):
I start with the family, their strengths, and
then build resilience.
I start with the family, andthat's where we have to start
when we're thinking about thatage range where the impact on
their social communication hasleaked into all other systems in
their lives.
I start with the mostaccessible system that is the
most forgiving, hopefully.
Speaker 1 (15:41):
Hopefully.
Speaker 2 (15:43):
And that is the family.
And so with this age range sonow the five to eights would be
somewhere between what 13 to 16ish um, we're working with the
family, finding out what isgoing on in the home when it
comes to some of thoseinterpersonal challenges that
(16:03):
they're experiencing, whatthey're seeing at home, before
we even talk about what'shappening at school or in the
teams or in the social clubs,because that's where we can
intervene first.
And if I'm working with thechild individually or the
adolescent individually, thenit's mostly about building, like
you said, that resilience andincreasing their exposure to, in
(16:27):
a forgiving way, common themesthat a lot of these children
didn't have this access to ingentle ways, like they usually
do when they're introduced intograde school and then they get
into middle school, where thingsget really intense.
A lot of them were just throwninto middle school and so
rejection from peers issomething that they weren't
(16:49):
gradually introduced to.
Speaker 1 (16:51):
Kids are terrible.
Speaker 2 (16:53):
Awful, but I love them At the same time.
We all went through this, yeahwe did.
Speaker 1 (16:59):
Yeah, that's such a tough time.
I was walking out of thegrocery store yesterday and my
family was.
There's a bunch of adolescentsaround and as we, after we got
past them, my family was like oh, your favorite group of kids,
you know, like that age group isjust so uncomfortable and it's
like they're just it's such asuch a hard time.
It really is.
(17:19):
So shout out to parents thathave those adolescents at home.
It is not easy.
Speaker 2 (17:24):
No, it's not easy and you also reflect.
A lot of parents reflect onwhat it was like for them.
So, just what you're goingthrough like this was terrible.
There's a lot of anticipatoryanxiety too that comes into this
life change or this transition.
Speaker 1 (17:41):
So it almost comes from the parents, from their own
anticipatory anxiety.
Is what you're saying?
Absolutely Wow.
Speaker 2 (17:45):
Absolutely, wow, absolutely.
Speaker 1 (17:47):
You know, I was like such an awkward adolescent,
which is really really funny.
I was really really awkward.
Speaker 2 (17:54):
Really.
Speaker 1 (17:56):
How was your adolescence?
Speaker 2 (17:59):
Wait, oh no, that just I'm mindful right now
actually.
Speaker 1 (18:04):
Oh, glasses like weird clothing, totally
uncomfortable.
Speaker 2 (18:09):
Oh really.
Speaker 1 (18:10):
Oh yeah.
Speaker 2 (18:11):
No.
Speaker 1 (18:13):
Like bullied but like sort of the cool group you know
was like in and out you know.
Speaker 2 (18:19):
Oh, you were the one that they secretly talked about.
Speaker 1 (18:21):
Yeah, totally yeah.
Speaker 2 (18:23):
Get out and look totally.
Speaker 1 (18:24):
Yeah, get out.
Speaker 2 (18:25):
And look at us.
Speaker 1 (18:29):
If you're watching on YouTube, you would have just
seen the sparkle out of DrNorn's eye.
That was really.
That was good.
So you also.
I know your school.
You have a real family andassistance approach.
Was there someone that reallyinfluenced that in you and your
training, either during schoolor after?
Speaker 2 (18:51):
um, I think it mostly was just my upbringing okay,
you can say no, I just yeah yeah, yeah, but you know, we had
some big hitters well, that'swhy I was.
Speaker 1 (19:03):
I wasn't was curious.
Ok, I was curious, yeah.
Speaker 2 (19:05):
So with Dr Boyd Franklin, of course, having
taken a few of her courses,although I was never directly
supervised, just her.
Speaker 1 (19:14):
She retired right after you got there.
Yeah, yeah, yeah.
So, yeah, but it's influencethere, it's still.
It's still there.
A lot of advocacy is a part ofyour work as well, which you've
mentioned already.
I wonder how do you make timefor that?
You have all these differentroles that you're doing and
people that you're working withand families.
(19:35):
How do you make time for thatwork?
Speaker 2 (19:37):
I had more time in grad school um, but wherever I
can in my professional life,I'll do it just one by one
individual each family.
That's how I get it out.
So, and like dr boy franklinused to say, brick by brick
right, that's how houses arebuilt.
So a lot of my satisfaction andadvocacy comes through just
(19:59):
seeing a family get an IEP putin place or seeing a child's
scores on the you know Beck'syouth below clinical levels.
That is where a lot of mydesires and are satisfied.
Speaker 1 (20:14):
Yeah, it's a lot of work with these, dealing with
the school districts and theIEPs and why, has everything got
to be so difficult?
Speaker 2 (20:22):
Um well, this, based on how things are going, we
don't know if it's going to getmuch easier.
So I'm telling a lot of myfamily is hold fast, especially
if you need those things inplace buckle up, buckle up, but
we got people like Dr Julesthere for you.
(20:56):
Buckle up, buckle up, but we,you actually have a lot of great
things about you, even if thesocial communication isn't
perfect.
Let's think about those placeswhere you can engage openly and
freely Maybe it's dance, maybeit's music, maybe it's art,
maybe it's basketball, whateverand see those strengths.
And then, once we get to thoseplaces where we need to start
(21:19):
changing things up, let's thinkabout how to transpose those
strengths, so strength-basedperspectives, and also with
parents, giving them a break andletting them know that there's
a lot of environmental thingsthat play a role in why we, why
we are where we are, and sonormalizing a lot of those
(21:39):
challenges and referring to thefact that everyone is having
their own version of what it isyou're experiencing right now.
So, what I'm going to fallbacks,normalizing and strength based
perspective.
Speaker 1 (21:53):
We're all going through something.
Speaker 2 (21:55):
Yeah.
Speaker 1 (21:56):
We're all going through something.
Yeah, we're all going throughsomething.
But you know, sometimes what'simportant is just to give that
some space, name it, and then Ilove that you talk about like
that you know dance or or findsomething, and it made me think
of like the it gets bettercampaign, which I know I think
is, I think is specific to lgbtq, but I could really be applied
to this group, right, yeah, yes,like, think about it gets
(22:18):
better, because the adolescentsare.
So you know we're joking, causewe can uh that they're awful.
Speaker 2 (22:23):
I'm saying that those are my words Um to be clear,
that's all me, uh, but.
Speaker 1 (22:31):
But it's.
It's the bullying, it's the,it's the hormones,
developmentally, like all thestuff that we know is supposed
to happen.
Like, if I'm working withcollege-age students, I know
that you're supposed to blackout every so often when you
drink.
You know I don't want you to,nor do your parents, and
developmentally these types ofthings will happen.
Speaker 2 (22:47):
Yes, they will they will.
Speaker 1 (22:50):
Bullying will happen Like we can't do.
You know, like I don't want itto happen, I don't.
I'd love an abstinent approachto it, but it's just not
realistic, right.
Speaker 2 (23:00):
It's not realistic, and that's where a lot of this
gentle exposure to theseconcepts or these families comes
in.
Because they come in and they'relike I don't like the fact that
my daughter is not in the coolgroup and I'm like, well, you
know, your daughter also is, hasa lot of great strengths.
Where does she fit in?
Let's talk about that for asecond, and then we can talk
(23:22):
about the fact that everyonegets bullied, and maybe the
reason why you're so afraid isbecause you were bullied.
So okay, it happens.
And look at you now, Um and soa lot of that is just.
Speaker 1 (23:32):
Let's pass by, let's pass by it of that is just let's
pass by, let's pass by it.
That is uh, yeah, that is deep,because it's it is really all
families, it's the thing.
I hear you saying so again.
So I was asked about yourinfluence.
But a lot of times people willdrop off their teen and say go
fix them and it's like no mom,dad, parent, whatever you are,
come in here, let me talk to youfor a second yeah, absolutely,
(23:57):
absolutely it's, it's the wholesystem, like people pick up on
it, the kids pick up on it andso, um, how do you see the
future?
so we're talking, you know we'vetalked about a lot so far.
We've talked about theneurodevelopmental piece, the
diagnosing, uh, these challengesof this.
You know, uh, justdevelopmental of the stage.
So where do you see mentalhealth services going for this
group?
Speaker 2 (24:27):
I see it becoming more.
I don't want to sound like abroken record here, but more
family-oriented.
My understanding is a lot ofintervention misses the family
piece and it doesn't have to befamily therapy, it doesn't have
to be hardcore parent management, training, all those those
things have their place, butinvolving the parents and
holding them up and showing themyou can do this too.
(24:50):
It's not me, it's actually youdoing the work, it's actually
you encouraging the progress,empowers them and is actually
one of the best measures ofsuccess for maintaining that
progress is parent involvementwhen we see our children and
adolescents.
So I'm hoping, as we moveforward in the field and there's
(25:13):
a lot of anxiety and depressionmanuals for teens that are
starting to see and incorporateparent sessions and parent-based
supports, cause we we're we'rerealizing that the family is a
big place to intervene upon andI'm hoping that's where we'll
see some more changes, getempowering parents more.
Speaker 1 (25:32):
I love that.
Yeah, you really.
It's so beautiful to see youtoday and shine like this and
you have to.
You have to go to the YouTubeto see Dr Jules' little sparkle
every time she gives these gemsand these jewels.
And I really admire thisholistic approach and this
conversation is going to be veryhelpful for a lot of people
(25:53):
struggling.
So where can listeners find youto learn more about the work
that you're doing?
Speaker 2 (25:58):
So I actually got my website up and running just for
this.
I was like I need to have thisready, but so it's Dr period.
Dr underscore nornajulescom.
Wow, I'm hoping that's right.
Speaker 1 (26:18):
Well, we're going to put it in the show notes anyway.
Speaker 2 (26:21):
Okay, great, and my Instagram, Facebook, linkedin is
Fruitful Minds.
Speaker 1 (26:29):
One word Fruitful Minds, so be sure to check out
Dr Narnajules.
Thank you so much for beinghere no-transcript.
(27:02):
They are misunderstood.
So anyway, listeners, thank youfor tuning in.
You are the reason that we arehere to give you this messages,
and so I'm truly passionateabout helping others.
That's what this podcast isabout, so you know.
You can find everything atofficial Dr Pete dot com.
Thank you all again for beinghere.
Please like, follow and shareanywhere you listen to podcasts
or socials.
(27:23):
We will be back next week withmore for May mental health.
Until then, spread a littlekindness and stay well, thank
(27:49):
you.
Welcome back to On Air with Dr Pete.
I hope you've been having agreat week, and we are here for
May Mental Health AwarenessMonth and I have a very special
guest for you today.
But, as you know, it was notthat long ago.
We had things like COVID andall this stuff was getting in
the way about the issues ofanxiety and depression and the
devastating effects that it'shad, especially with our little
(00:37):
humans, and more research iscoming available, and I've been
curious to see how this hasimpacted, and so that's why I
brought on this guest today.
This is Dr Norna Jules.
Dr Jules is also a formerstudent, so this is really cool
full circle.
We're going to talk about thata little bit.
She is a clinical psychologistpassionate about advocating for
(00:59):
individuals and families intheir life's transitions.
Dr Jules focuses onneurodevelopmental disorders,
and she is specificallyinterested in how teens have
been impacted by COVID, socialmedia and external factors, so
we are going to learn all aboutthat today.
Welcome to the show.
Speaker 2 (01:14):
Hi, thank you so much .
What a warm welcome it's been.
Speaker 1 (01:18):
Oh, my goodness, I'm so glad that you reached out.
And so what was it like in myclass and you could be honest?
It's okay this.
Speaker 2 (01:25):
we like to keep it real here you know, the most
real thing I can say is yourclass was the first time I was
introduced to cognitivebehavioral therapy.
I had no idea what it was and myperspective on therapy was so
different yeah before coming toyour and at the time you didn't
call it that, but what I feltyour style was was more
(01:48):
assimilative, so thatintegrative CBT who's the person
, in addition to the cognition,behaviors, thoughts and it just
drew me in and ever since thenand I don't think I've told you
this ever since then I decided Ithink this is the type of
therapy I want to do.
Wow, so a lot of the work I dois attributed to that CBT class.
Speaker 1 (02:11):
Well, and it's funny because your peers I remember.
One of the things that theysaid is that I was the first
person to tell them that gradschool is traumatic.
That was one of their memories.
Speaker 2 (02:22):
That is so funny.
Speaker 1 (02:33):
Yeah, yeah, memories.
Yeah, yeah, I don't rememberthat, but I'm sure maybe I don't
know I forget who it was, but Iremember that group because I
think was that right beforecovid, was that like 2017?
No, 18 or 19, what wait when?
Was that 18 19 19 yes, it waslike right before covid probably
right before covid.
Yes, it was all before covidyeah, so give people a
background as to like what youwere doing as you got there.
(02:54):
Like who is dr norna jules?
Speaker 2 (02:57):
dr norna jules.
Yeah, um, I am the youngest of10 and so I think that informs a
lot of my therapeutic style.
Speaker 1 (03:08):
You give a new name to the baby.
Speaker 2 (03:10):
I give a what.
Speaker 1 (03:11):
You give new name to the baby the baby of the family.
Speaker 2 (03:14):
Oh, what do you mean?
Like?
Speaker 1 (03:16):
the last born.
So you said you're the last of10, or one of 10?
.
So I'm the last of three.
That's like nothing compared toyou.
You have a trophy for being thebaby of three that's like
nothing compared to you.
Like you give you you, like youhave a trophy for being the
baby of the family oh yes,setting a whole new standard,
absolutely.
Speaker 2 (03:32):
But it's interesting because that has shifted a lot,
because I'm the first doctor ofmy family yeah, so there's
almost like a paradigm shift.
But when it's Thanksgiving andChristmas, I am the baby, baby.
So that will always be the case, but as far as it always
informing my therapeutic style.
(03:53):
Just from a young age, I had tolearn how to advocate for
myself Sharing the bathroom,getting the hand-me-downs.
I don't want to wear this.
But, it really translated tofriendships and professional
relationships and, of course,I'm sure, as you know, my
education as well.
So when it comes to therapy, Isee it as an opportunity not
(04:16):
only to work with the person'sintra psyche but to also help
them advocate across systems.
And that's a big part of thework that I do and parents say
it all the time when they workwith me in my private practice
also in the hospital publicsector is I feel like I know
(04:38):
more about who I am as a personin the world, not just in the
inside, because of who we aretogether.
So when you think about DrNarnia Jules, I hope you think
psychologist, but also advocateand just someone who is very
passionate about, I guess,helping people see that advocate
within themselves.
Speaker 1 (04:59):
Well, and you've said that it's like not a one size
fits all, which I love, and soyou gave me a little shout out
of sort of forming yourcognitive behavioral therapy
approach, and so give us moreabout your philosophy.
Like that it's not a one sizefits all.
Speaker 2 (05:13):
It's not structured and concretized for the sake of
not facility but to facilitatetreatment, to get to the core
(05:39):
symptoms that are acrossexperiences.
So when we think aboutdepression, anxiety, trauma,
what are things that we seeacross?
People diagnosed with thisthing.
But, as we know, there's a lotthat informs how people's
symptoms manifest and that iswhat's individualized.
So, once we get a hold of thosesymptoms, what is coming up
(06:00):
from their past, what is comingup from their childhood that is
going to get in the way ofmaintenance?
Yes, and that is going to impactpreventative measures.
So that is a big part of thenot one size fits all,
especially when it comes tochildren.
Because when we work withadults, there's a lot in the
past that we have to siftthrough, but when we're working
(06:22):
with children, adolescents,adolescents and adults, we're in
it.
So there's a lot of the familydynamics that's still in
development and theinterpersonal dynamics that's
still in development and I sayyou cannot work with children
and expect a one-size-fits-all,it's just impossible.
Speaker 1 (06:38):
Ever and so more importantly than ever.
So you also specialize inneurodevelopmental, which some
listeners may not understand.
So neurodevelopmental is lotsof different diagnoses that are
biologically based and today,most recently with some of the
sociopolitical challenges,there's a lot of discussion
around the high rates of autismjust in the last 24 hours, so
(07:02):
hopefully we can air this soonso this stays relevant.
But my sense is it won't changethat much.
But yes hopefully, but like whatare your views of these
findings?
You know, in terms of likeunderstanding, how much work
you've done aroundneurodevelopmental disorders is
specifically autism.
Speaker 2 (07:20):
Yes, so how much time do we have?
I'm going to start with thefact that the prevalence, which
is the monitoring network thattracks the diagnostic rates and
prevalence of autism withinspecific states in the country.
(07:53):
So, it's not across every stateand of course there's research
across the spectrum ofpsychology and medical research
and such that might look atother states, but the most
referred to one is the ADDMstats.
I actually had a didactic withthe researcher who runs the ADDM
(08:15):
stats while I was a fellow in aneurodevelopmental fellowship
and he did explain the methodsby which they collect the data
and how they all communicateacross states and how they
determine what states areinvolved and what states aren't.
And consistently, californiaand New Jersey, as we know, are
head to head when it comes tothe diagnostic.
Speaker 1 (08:35):
Always yeah.
Speaker 2 (08:37):
And what a lot of people don't know is that those
rates are actually looking atfour year olds, eight
eight-year-olds and, just in2018, 16-year-olds.
Speaker 1 (08:47):
Okay.
Speaker 2 (08:47):
So when we think about the diagnostic rate
increasing of autism, in thecountry.
People usually think across thecountry, like every state, and
they usually include adults,which is a lot less monitored
and a lot less reliable when wecome to the statistics.
So when we see that increase inprevalence.
It's usually talking aboutchildren.
Speaker 1 (09:09):
Well, that's why we need people like you out here
educating, because these ratesand these numbers are scary
without that context, yes.
So what about the misdiagnosisof autism and ADHD?
What are your thoughts on that?
Speaker 2 (09:22):
Well, my thoughts are that there's a lot of
intersection between ADHD andautism, and when we think about
misdiagnosis, it's usuallybecause of gender Girls more
likely getting a diagnosis ofADHD first because of some of
the symptoms that are easier tocatch.
And I'm doing bunny ears whenwe think about some of the
(09:45):
intersection between autism andADHD.
And it's also because ofintellectual disability, and I
won't get too deep into that,but a lot of the times if
somebody is used to seeingautism a certain way, they might
not diagnose it unless there issome clear impairment in
cognitive functioning which, aswe know and as the research is
(10:09):
increasing, that is notnecessary for an autism
diagnosis.
So I think with the ADHD, anautism misdiagnosis, a lot of it
comes down to gender, cognitivefunctioning and of course, as
we are increasing our knowledgeand what ADHD looks like and
what ASD looks like, we'refinding that it's just kind of
(10:33):
one lump but it's hard to kindof parse apart to tease it out
say that their labels don't havemeaning, because they do, but
depending on the context, somepeople might not know how to
differentiate between the two.
Speaker 1 (10:53):
So well, I, I love learning from you.
I mean, this is, uh, becausethat was actually really
interesting for me to hear,because, oh, the adhd always
think about boys because boysare always like over diagnosed,
but to hear that girls aremisdiagnosed because of the
autism presentation, that isreally really curious to me.
Speaker 2 (11:11):
So, uh, that was a thank you sure, yeah, a lot of
that just comes with the idea ofwhat do these things look like?
Yeah and it always comes downto how they manifest, and, and
so, as we are seeing more girlsget diagnosed with autism in
later stages, we're starting tounderstand.
(11:32):
Oh, what we used to attributeto inattention, for example,
might be more consistent with asocial communication deficit or
difference, and so, asdefinitions change, I think
we'll see some of the diagnosticrates change.
Speaker 1 (11:48):
I love that and I love that you also said that,
because I mean, I teach a lotabout like it's not the category
or lumping people into acategory.
I just use it to inform thetreatment, you know, and that's
why you need the diagnosis,because autism ADHD would be
treated very differently.
Are we still with that?
Speaker 2 (12:05):
I think so.
Speaker 1 (12:06):
Yeah.
Speaker 2 (12:07):
Yes, and at the same time, it depends on what the
person is coming in to treatmentfor, which comes back to the
original comment of it's not onesize fit all.
We're not treating a diagnosisper se, but we're treating what
that person is coming in for.
So if somebody with ADHD islike I really need to understand
(12:28):
why I can't interact withpeople or my partner or whatever
the way I'd like to, maybe wewould take more of an
interpersonal socialcommunication stance, even if we
don't have that ASD label.
Speaker 1 (12:40):
Yeah, Cause there's all the social stigma around
certain diagnoses, and so it.
Yeah, I love that you have tokind of work with what they come
with now because of thepopulation you work with.
What are you seeing with colike post COVID?
I know lots of stuff written onthis right now, but I don't
(13:08):
know that we know yet enough, um, but okay I do see it.
Speaker 2 (13:13):
Even in the short amount of time that has passed
between covid and now we're in,I feel safely we can say
post-COVID.
Speaker 1 (13:21):
Hopefully yes.
Speaker 2 (13:24):
Parents are concerned about their children's ability
to interact with other people.
Speaker 1 (13:31):
Yeah.
Speaker 2 (13:32):
And some of the main things that we see in
neurodevelopmental differencesis that impact on social
communication.
Yeah, and so when we thinkabout social communication
succinctly nonverbal and verbalmeans of communicating and how
that impacts the way youinteract with other people.
So it's not just eye contactand it's not just verbal
(13:54):
language, but it's also bodymovements, it's also euphemisms
and idioms and sarcasm.
So there's a lot that goes intointeracting in person that
children learn, and we do nottalk enough about the fact that
there was a time span of threeyears where children, who were
(14:18):
in the most developmentallycrucial time of their life.
Speaker 1 (14:21):
when it comes to engaging, what kind of age group
would you say there, just forlisteners?
Speaker 2 (14:26):
I would say early school age, years when we really
start to push them out into theworld, when they're starting to
learn how to use some of thosethings they pick up from their
family with other people andrealizing oh, this is useful.
Speaker 1 (14:41):
Like five, six, seven , eight-ish.
Speaker 2 (14:43):
Yeah, yeah.
Yes, keep me sustained Dr isuseful Like five, six, seven,
eight-ish.
Yeah, yeah, yes, keep mesustained Dr D.
You know, like that five toeight-year range yeah.
Speaker 1 (14:50):
That was more for me, because I'm terrible with ages.
Speaker 2 (14:55):
Yes, you get the white beard.
Oh yeah, Once you get the whitebeard, you're not concerned
about other people?
Speaker 1 (15:01):
That's exactly right.
But my nieces were that ageduring that time so I was always
mindful of that for my brother,of like how hard it was for
them and just observing that.
So you know you really buildresilience and I know you talk a
lot about strengths andresilience with your clients.
So how do you kind of fosterthat in the clients that you
work with, trying to identifytheir strengths and then build
resilience?
Speaker 2 (15:23):
I start with the family, their strengths, and
then build resilience.
I start with the family, andthat's where we have to start
when we're thinking about thatage range where the impact on
their social communication hasleaked into all other systems in
their lives.
I start with the mostaccessible system that is the
most forgiving, hopefully.
Speaker 1 (15:41):
Hopefully.
Speaker 2 (15:43):
And that is the family.
And so with this age range sonow the five to eights would be
somewhere between what 13 to 16ish um, we're working with the
family, finding out what isgoing on in the home when it
comes to some of thoseinterpersonal challenges that
(16:03):
they're experiencing, whatthey're seeing at home, before
we even talk about what'shappening at school or in the
teams or in the social clubs,because that's where we can
intervene first.
And if I'm working with thechild individually or the
adolescent individually, thenit's mostly about building, like
you said, that resilience andincreasing their exposure to, in
(16:27):
a forgiving way, common themesthat a lot of these children
didn't have this access to ingentle ways, like they usually
do when they're introduced intograde school and then they get
into middle school, where thingsget really intense.
A lot of them were just throwninto middle school and so
rejection from peers issomething that they weren't
(16:49):
gradually introduced to.
Speaker 1 (16:51):
Kids are terrible.
Speaker 2 (16:53):
Awful, but I love them At the same time.
We all went through this, yeahwe did.
Speaker 1 (16:59):
Yeah, that's such a tough time.
I was walking out of thegrocery store yesterday and my
family was.
There's a bunch of adolescentsaround and as we, after we got
past them, my family was like oh, your favorite group of kids,
you know, like that age group isjust so uncomfortable and it's
like they're just it's such asuch a hard time.
It really is.
(17:19):
So shout out to parents thathave those adolescents at home.
It is not easy.
Speaker 2 (17:24):
No, it's not easy and you also reflect.
A lot of parents reflect onwhat it was like for them.
So, just what you're goingthrough like this was terrible.
There's a lot of anticipatoryanxiety too that comes into this
life change or this transition.
Speaker 1 (17:41):
So it almost comes from the parents, from their own
anticipatory anxiety.
Is what you're saying?
Absolutely Wow.
Speaker 2 (17:45):
Absolutely, wow, absolutely.
Speaker 1 (17:47):
You know, I was like such an awkward adolescent,
which is really really funny.
I was really really awkward.
Speaker 2 (17:54):
Really.
Speaker 1 (17:56):
How was your adolescence?
Speaker 2 (17:59):
Wait, oh no, that just I'm mindful right now
actually.
Speaker 1 (18:04):
Oh, glasses like weird clothing, totally
uncomfortable.
Speaker 2 (18:09):
Oh really.
Speaker 1 (18:10):
Oh yeah.
Speaker 2 (18:11):
No.
Speaker 1 (18:13):
Like bullied but like sort of the cool group you know
was like in and out you know.
Speaker 2 (18:19):
Oh, you were the one that they secretly talked about.
Speaker 1 (18:21):
Yeah, totally yeah.
Speaker 2 (18:23):
Get out and look totally.
Speaker 1 (18:24):
Yeah, get out.
Speaker 2 (18:25):
And look at us.
Speaker 1 (18:29):
If you're watching on YouTube, you would have just
seen the sparkle out of DrNorn's eye.
That was really.
That was good.
So you also.
I know your school.
You have a real family andassistance approach.
Was there someone that reallyinfluenced that in you and your
training, either during schoolor after?
Speaker 2 (18:51):
um, I think it mostly was just my upbringing okay,
you can say no, I just yeah yeah, yeah, but you know, we had
some big hitters well, that'swhy I was.
Speaker 1 (19:03):
I wasn't was curious.
Ok, I was curious, yeah.
Speaker 2 (19:05):
So with Dr Boyd Franklin, of course, having
taken a few of her courses,although I was never directly
supervised, just her.
Speaker 1 (19:14):
She retired right after you got there.
Yeah, yeah, yeah.
So, yeah, but it's influencethere, it's still.
It's still there.
A lot of advocacy is a part ofyour work as well, which you've
mentioned already.
I wonder how do you make timefor that?
You have all these differentroles that you're doing and
people that you're working withand families.
(19:35):
How do you make time for thatwork?
Speaker 2 (19:37):
I had more time in grad school um, but wherever I
can in my professional life,I'll do it just one by one
individual each family.
That's how I get it out.
So, and like dr boy franklinused to say, brick by brick
right, that's how houses arebuilt.
So a lot of my satisfaction andadvocacy comes through just
(19:59):
seeing a family get an IEP putin place or seeing a child's
scores on the you know Beck'syouth below clinical levels.
That is where a lot of mydesires and are satisfied.
Speaker 1 (20:14):
Yeah, it's a lot of work with these, dealing with
the school districts and theIEPs and why, has everything got
to be so difficult?
Speaker 2 (20:22):
Um well, this, based on how things are going, we
don't know if it's going to getmuch easier.
So I'm telling a lot of myfamily is hold fast, especially
if you need those things inplace buckle up, buckle up, but
we got people like Dr Julesthere for you.
(20:56):
Buckle up, buckle up, but we,you actually have a lot of great
things about you, even if thesocial communication isn't
perfect.
Let's think about those placeswhere you can engage openly and
freely Maybe it's dance, maybeit's music, maybe it's art,
maybe it's basketball, whateverand see those strengths.
And then, once we get to thoseplaces where we need to start
(21:19):
changing things up, let's thinkabout how to transpose those
strengths, so strength-basedperspectives, and also with
parents, giving them a break andletting them know that there's
a lot of environmental thingsthat play a role in why we, why
we are where we are, and sonormalizing a lot of those
(21:39):
challenges and referring to thefact that everyone is having
their own version of what it isyou're experiencing right now.
So, what I'm going to fallbacks,normalizing and strength based
perspective.
Speaker 1 (21:53):
We're all going through something.
Speaker 2 (21:55):
Yeah.
Speaker 1 (21:56):
We're all going through something.
Yeah, we're all going throughsomething.
But you know, sometimes what'simportant is just to give that
some space, name it, and then Ilove that you talk about like
that you know dance or or findsomething, and it made me think
of like the it gets bettercampaign, which I know I think
is, I think is specific to lgbtq, but I could really be applied
to this group, right, yeah, yes,like, think about it gets
(22:18):
better, because the adolescentsare.
So you know we're joking, causewe can uh that they're awful.
Speaker 2 (22:23):
I'm saying that those are my words Um to be clear,
that's all me, uh, but.
Speaker 1 (22:31):
But it's.
It's the bullying, it's the,it's the hormones,
developmentally, like all thestuff that we know is supposed
to happen.
Like, if I'm working withcollege-age students, I know
that you're supposed to blackout every so often when you
drink.
You know I don't want you to,nor do your parents, and
developmentally these types ofthings will happen.
Speaker 2 (22:47):
Yes, they will they will.
Speaker 1 (22:50):
Bullying will happen Like we can't do.
You know, like I don't want itto happen, I don't.
I'd love an abstinent approachto it, but it's just not
realistic, right.
Speaker 2 (23:00):
It's not realistic, and that's where a lot of this
gentle exposure to theseconcepts or these families comes
in.
Because they come in and they'relike I don't like the fact that
my daughter is not in the coolgroup and I'm like, well, you
know, your daughter also is, hasa lot of great strengths.
Where does she fit in?
Let's talk about that for asecond, and then we can talk
(23:22):
about the fact that everyonegets bullied, and maybe the
reason why you're so afraid isbecause you were bullied.
So okay, it happens.
And look at you now, Um and soa lot of that is just.
Speaker 1 (23:32):
Let's pass by, let's pass by it of that is just let's
pass by, let's pass by it.
That is uh, yeah, that is deep,because it's it is really all
families, it's the thing.
I hear you saying so again.
So I was asked about yourinfluence.
But a lot of times people willdrop off their teen and say go
fix them and it's like no mom,dad, parent, whatever you are,
come in here, let me talk to youfor a second yeah, absolutely,
(23:57):
absolutely it's, it's the wholesystem, like people pick up on
it, the kids pick up on it andso, um, how do you see the
future?
so we're talking, you know we'vetalked about a lot so far.
We've talked about theneurodevelopmental piece, the
diagnosing, uh, these challengesof this.
You know, uh, justdevelopmental of the stage.
So where do you see mentalhealth services going for this
group?
Speaker 2 (24:27):
I see it becoming more.
I don't want to sound like abroken record here, but more
family-oriented.
My understanding is a lot ofintervention misses the family
piece and it doesn't have to befamily therapy, it doesn't have
to be hardcore parent management, training, all those those
things have their place, butinvolving the parents and
holding them up and showing themyou can do this too.
(24:50):
It's not me, it's actually youdoing the work, it's actually
you encouraging the progress,empowers them and is actually
one of the best measures ofsuccess for maintaining that
progress is parent involvementwhen we see our children and
adolescents.
So I'm hoping, as we moveforward in the field and there's
(25:13):
a lot of anxiety and depressionmanuals for teens that are
starting to see and incorporateparent sessions and parent-based
supports, cause we we're we'rerealizing that the family is a
big place to intervene upon andI'm hoping that's where we'll
see some more changes, getempowering parents more.
Speaker 1 (25:32):
I love that.
Yeah, you really.
It's so beautiful to see youtoday and shine like this and
you have to.
You have to go to the YouTubeto see Dr Jules' little sparkle
every time she gives these gemsand these jewels.
And I really admire thisholistic approach and this
conversation is going to be veryhelpful for a lot of people
(25:53):
struggling.
So where can listeners find youto learn more about the work
that you're doing?
Speaker 2 (25:58):
So I actually got my website up and running just for
this.
I was like I need to have thisready, but so it's Dr period.
Dr underscore nornajulescom.
Wow, I'm hoping that's right.
Speaker 1 (26:18):
Well, we're going to put it in the show notes anyway.
Speaker 2 (26:21):
Okay, great, and my Instagram, Facebook, linkedin is
Fruitful Minds.
Speaker 1 (26:29):
One word Fruitful Minds, so be sure to check out
Dr Narnajules.
Thank you so much for beinghere no-transcript.
(27:02):
They are misunderstood.
So anyway, listeners, thank youfor tuning in.
You are the reason that we arehere to give you this messages,
and so I'm truly passionateabout helping others.
That's what this podcast isabout, so you know.
You can find everything atofficial Dr Pete dot com.
Thank you all again for beinghere.
Please like, follow and shareanywhere you listen to podcasts
or socials.
(27:23):
We will be back next week withmore for May mental health.
Until then, spread a littlekindness and stay well, thank
(27:49):
you.
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