December 3, 2025 • 55 mins
Feeling overwhelmed by holiday stress? 🎄 Dr. Ashley Zucker shares tips for teens & families on managing pressure, emotions, and social media. Tune in for supportive advice and real talk on "The Hope Table"! #MentalHealth #Holidays #Podcast
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Episode Transcript
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Erin Brinker (00:00):
Hey, welcome everyone to a brand new podcast
(00:09):
called The Hope table. Our firstguest I'm super excited about is
Dr Ashley Zucker. You're goingto hear another introduction
that was recorded when we didthis interview a couple of weeks
ago, well before Thanksgiving, Ithink you're going to enjoy it.
(00:47):
Let's get started.
Welcome to thehope table. I'm Erin Brinker,
and I'm thrilled to be sittingdown again with Dr Ashley
Zucker. She is a board certifiedpsychiatrist focused on
children, adults andadolescents, and today we're
going to talk a lot about tweensand teens and the holidays and
(01:10):
applying for college and all ofthose things that are stressors.
She's worked with KaiserPermanente here in Southern
California. Dr Ashley Zucker,welcome back to the show.
Dr. Ashley Zucker (01:20):
Thank you so much for having me back.
Erin Brinker (01:22):
So so let's talk about this. It's November and
the holidays. It seems like wewere just dealing with 105
degree weather, and now we'rewe're focused. Halloween is
behind us. So let's talk aboutthe life of a teen during this
time, especially seniors in highschool, kind of what is their
life like, and how do they keepeverything straight?
Dr. Ashley Zucker (01:47):
Yeah, you know, you got to feel for those
teens, especially in highschool, it's just such a
challenging time. And I thinkwhether you're a senior or a
freshman, you know, it's areally difficult time of year,
because it's really when yourclasses have ramped up. So
things are a little bit moreintense. You know, heading into
the holiday seasons. You mightbe heading into midterms or
(02:08):
final exams even kind of,depending on what you know the
status of your classes is. Andthen, of course, for you know,
our seniors who are applying tocolleges or considering what
they're going to do aftergraduation, that just adds, you
know, an additional layer ofstress. And I know for myself, I
have a sophomore, and so she'sworrying about prepping for
(02:30):
driver's ed, for having a childthat drives. But yeah, so
there's a lot of things comingat everybody
Erin Brinker (02:41):
as soon as the time where you can toss with the
keys and say, Can you run to thegrocery store? I'm out of milk?
Dr. Ashley Zucker (02:46):
Yeah, I can't wait,
Erin Brinker (02:49):
you know. And I brought up seniors, just because
I think about the senior yearwhen all of the applications are
due. And so for their colleges,and if they didn't take the SAT,
or they need to retake the S, A,T. They do that in the fall, and
their classes are still most ofthem are still taking the AP
classes or the honors classes orthe, you know, all of them that
(03:15):
International Baccalaureate IBclasses, trying to get
everything in so they can getinto that good college. And it's
stressful all the differentcolleges, all the different
applications, you got to writeessays for all of them and still
do well in your classes. Theymay be playing sports or in a
play. You know, we put a lot onour kids. We really do.
Dr. Ashley Zucker (03:33):
We really do.
And there's only so many hoursin the day. So, you know, I
think making sure that we helpthem with their time management
is one kind of strategy, but Ithink it's also trying to take
away as much of the pressure aspossible, easier said than done.
But you know, if they're, youknow, mostly on top of their
stuff, just kind of steppingback and letting them kind of
(03:53):
guide themselves can be helpful.
But of course, some kids arejust going to need a more hands
on approach and maybe some more,you know, specific help with
that, that time management, butyou got to also make sure
they've got time to just be ateenager too. Yeah. So that's
probably the most importantpart.
Erin Brinker (04:12):
You know, I think about my teen years, and it's a
time when every emotion is felt.
To use a very old reference atan 11 and go watch Spinal Tap if
you've not seen it, buteverything is feel like
everything is turned up to 11when the the it's supposed to
stop at 10, and you feeleverything so intensely. So how
do you how do you help yourteens? And that's not unique to
(04:32):
seniors, that's starting atpuberty. How do you help them
navigate that?
Dr. Ashley Zucker (04:39):
Yeah, I mean, I think it's really important to
recognize that, just like yousaid, you know, teenagers are
naturally kind of moreemotional. They feel things very
acutely. You know, they don'tknow anything else, and so
what's happening for them now isthe biggest thing ever, and it's
also a time in life where you'rereally in this kind of stage of
moving away from. Family beingsort of your primary connection
(05:02):
to more of your peers and yoursocial connections. And
sometimes there's a big bit of atug and pull between those two.
And so that can also, you know,raise emotions as well. But I
think the number one thing thatI would say is that we have to
recognize for ourselves and forour kids that emotions are okay.
I think too often we're sort ofafraid of them, or we sort of
(05:24):
label emotions as bad. And Ilike to say there's no bad
emotions. It's just what you dowith your emotions. And so, you
know, letting our kids sort offreely express that, but making
sure they have, you know,positive outlets for it, and
also just hearing them. Youknow, it's not that we have to
say anything or give them anyadvice, because they don't want
(05:44):
to hear it.
They're not going to take itanyway, exactly, right, exactly.
But just hearing them, hearingthem out, or just recognizing,
hey, it sounds like you'rehaving a rough day. Can I do
anything for you? You know,those types of just very general
kind of soft approaches. I thinkcan, can be really helpful. But
again, number one thing, noemotion is bad. It's just what
(06:05):
we do with them.
You know, I, I,
Erin Brinker (06:10):
I love that the no emotions are bad because we, you
know, especially at that age,don't have any control over how
we feel. We have control overhow we act, although teenagers
don't, yet they haven't learnedthat skill. But what we as
adults have control over, how wereact, but not what we are
feeling. And when you havereally big feelings all the
(06:31):
time, it's overwhelming. I mean,you really need time and space
and a way to unplug that'sconstructive,
Dr. Ashley Zucker (06:38):
yeah, for sure. And I think just what you
said in terms of, you know,teens don't always have that
full control, so they may betrying to do the right thing
with their emotions, but theyjust, you know, don't have the
full frontal, low development,right? Exactly. And I think
that's where our role as adultscomes in to really role model
for our kids, right? We haveemotions too. It's not just when
(07:01):
you're a teen, and I think it'sgood to show your kids that you
do have emotions too, and kindof show them the best ways to
handle them. And also know that,you know, as adults, we don't
always handle them the right wayeither, and that's okay. So you
know, showing your kids it'sokay to mess up and say maybe,
oh, I shouldn't have gotten soupset about that, or so angry
(07:22):
about that, or I shouldn't haveyelled about that. I wish I had
done X, Y or Z. And so reallyshowing them, you know, it's
okay to have emotions, okay toreact, it's okay to react wrong,
but you got to catch it,recognize it. I think that's
where we can do the most, youknow, benefit for our kids.
Erin Brinker (07:39):
So I'm thinking about, they say that depression
is and I don't know this istrue. So you're going to
disabuse me of this if it's notthat depression is anger turned
inward, and that if that iscompounded, then it becomes
overwhelming. So we havesituational depression, that
something, maybe a friend movedaway, or somebody passed away,
God forbid, or something youbroke broke up with a boyfriend,
or whatever you know as ateenager. But then there's the
(08:01):
more pervasive depression. Canyou talk about depression,
especially starting in in middleschool, so puberty, through the
teen years? Yeah.
Dr. Ashley Zucker (08:11):
I mean, I certainly think that the the
anger, turn inward, can be acomponent of depression. I don't
think it's the end all be all.
But you know, depression canactually look a lot of different
ways, and it can also look verydifferently for, you know, for
kids and for teenagers. And sowhen we think of depression,
often, we think of people whoare sad down, sort of, you know,
slow moving or and that can bethe case for sure. But one thing
(08:32):
that we actually see morefrequently in in kids and teens
is that they are way moreirritable. And now I say that,
and you probably laugh, becausewhat teen isn't irritable, but
it really gets to, you know,these sort of excessive levels
where it's just like, you know,everything is bothering them,
not just you, but everything.
(08:55):
And you do start to see thatmaybe they're just changing
their typical behaviors in a waythat just doesn't seem like it's
not just, oh, I don't want tohang out with mom and dad. It's
more, I don't want to hang outwith anybody. I don't want to
engage in the world. So thatkind of social withdrawal,
right? Because we know for forteens, it's that key time in
life to really be social, and soif there's a huge avoidance of
(09:18):
that, or just not wanting to doit anymore, especially if they
were social before. Those aresome of the big things that that
we want to kind of watch for.
But I'd also say, you know, toyour point, there can definitely
be things that cause depression,so situational depression, like
you mentioned, but sometimesthere's no specific trigger. So
I hear a lot in my office fromparents like I don't know why
(09:39):
they're depressed? There'snothing for them to be depressed
about, and that's becausedepression is, you know, a
chemical problem in your brain,and doesn't necessarily be
caused by something that'shappening outside or around us.
And so sometimes that can behard to fully understand, but I
think it's important torecognize, especially in kids,
in a.
Erin Brinker (10:00):
Adolescence, you know, I remember with my own
children, who are now adults. Iremember they had this, a life
that was so separate from me andby design, because I would ask
questions I'd want to get toknow their friends. And there
was a, you know, I mean, Icertainly knew who their friends
were, but I there was a wallthat, that they had, that their
(10:20):
life, their inner life, and alsotheir their outer life that was
focused on school and friends.
And that's scary for a parent,because you know you you don't
know exactly what's happening.
You try to do your best and andso there's these things going on
that you can't protect yourchild from, and there's also the
other side that you don't wantto protect them from everything,
(10:41):
because they had to learn how tonavigate. And so, you know, how
do you help families throughthat?
Dr. Ashley Zucker (10:47):
Yeah, I mean, every family is different, too,
so it's hard to say there's oneright way to do all of it. You
know, I think, like you said,you want to give your kids their
space. You want to allow them tomake mistakes. I think sometimes
we're really bad at that, atletting our kids fail, yeah, we
want to protect them fromeverything, right? So I would
(11:08):
say that's one thing is, youknow, this is a time in life
where they can fail at somethingthat's not going to have massive
consequences. Obviously, somethings they fail at could but
where there's that space to, youknow, if they don't do great on
a test. It's not the end of theworld. It's one test, right? And
maybe they kind of need toexperience that, or you just
have to let them experiencethat. So I certainly think
(11:29):
that's one piece of it. I alsothink when you reference, like,
the social stuff, I think just,you know, staying engaged and
staying interested, and thatdoesn't mean you have to know
every single thing, or pry orkind of be like, tell me
everything that anyone saidtoday to you, but you know,
like, I don't know, right? Fine,I don't know, right? Yeah, but
(11:53):
you know, remembering theirfriends names, or just like, oh,
you told me about so and so lastweek. Is everything okay? Or
what's the latest, you know, andmaybe they want to share, maybe
they don't, but the fact thatthey know that you were
listening the first time wherethey were talking about
somebody, I think it means a lotto them that you care about who
their friends are and kind ofwhat they're up to. But it
(12:14):
doesn't have to be like agossipy kind of thing. It's
just, you know, like, Oh, Iremember your friend Sally. You
haven't talked about herrecently. How's she doing
something like that?
Erin Brinker (12:26):
Oh, see, that's good. That's good. I remember,
yeah. And for my son, it waseasier because he would come
home, and my son's on thespectrum, and he would come home
and sit down and do a braindump, everything that he would
want to start the beginning ofthe day and tell me everything,
and my daughter was theopposite. So it's kind of, how
(12:46):
do you how do you navigate that,right? And, you know, everybody
does the best they can and tryto keep that communication open,
and a lot of it. So I know thatwith little kids, it's when
you're when you're talking abouthow their world is shaped.
You're really talking about theparents more than the kids. And
as they get older, they becomemuch more separate as the
supposed as they're supposed to.
But I suspect that when you'rewhen you're dealing with teens,
(13:09):
you're also really have to dealwith their parents. Is that
true? Yeah.
Dr. Ashley Zucker (13:14):
I mean, it's definitely true of all, all
ages, but yeah, it's this, youknow, in in my office,
certainly, it's about reallymaking sure that I'm
understanding where the the teenis out at, sorry, but also
getting their parents kind of onthe same page. So it, you know,
it depends on the situation, butoften it's just kind of helping
(13:34):
their parents sort of understandwhere their kid is struggling,
or potentially why they'restruggling, or just being that
sort of safe space where, youknow, I've definitely been in my
office and had, you know, momand teen yelling at each other,
and I just have to guide themthrough that conversation.
That's a fun part of my job. Oh,my goodness.
Erin Brinker (13:59):
And you know, your hope is that they get all of
that out, they kind of clean outall the noise, and they they
vomit their emotions all overeverywhere, and then they clean
themselves up and they go homeand they're fine, or they're
better, maybe not fun, butthey're better. Yeah.
Dr. Ashley Zucker (14:14):
So I would say, I think the more positive
experiences when you can kind ofput something kind of on their
minds, or sort of plant theseed, so to speak, and then sort
of leave that for them to gohome and talk about. And so a
lot of that is usually around,kind of like what the treatment
plan might be. But I really lovekind of giving that ownership
back to them as a team, toreally decide what they feel is
(14:37):
is best, unless, you know,there's certain circumstances
where you may have to be alittle bit more kind of
directive of that guidance. ButI love the idea of just having
them leave the room with aconversation that I've asked
them to have
Erin Brinker (14:51):
something to think about, something to chew on, so
how much of what you see is.
Maybe mom or dad had significanttrauma in their life. They're
trying to break those chains,those cycles, those negative
patterns, and I just don't knowhow. And they, they're they,
they visit that on theirchildren, because that's how
(15:13):
they're wired, because that'swhat they grew up with. And then
how do you overcome that, thattrauma, while trying to prevent
the trauma, trauma in thedaughter or the son. You know
what I'm trying to ask? It'slike, the intergenerational
stuff,
Dr. Ashley Zucker (15:28):
yeah, well, there's a saying in child
psychiatry that 90% of the time,if you treat the parent, you
don't need to treat the child.
And what that really means isthat we have to make sure that
parents are also getting thehelp that that they need. And so
sometimes that is reallyadvocating for the parent to
also get their own therapy, or,you know, see their own
(15:51):
psychiatrist, and because it'smuch easier to identify that
somebody else needs help, orwhat I can do for somebody else,
right?
Everything that's wrong withthem,
exactly, exactly. Yeah, so. AndI mean, therapy can help
everybody, right? There's no onethat therapy couldn't help. But
(16:12):
I think sometimes when you'rereally seeing some of those
patterns play out, or just notnecessarily even a pattern. But
you know, if I see parents thatare just really struggling with
how to navigate their you know,through life with their child,
then that's often where I'mlike, You really need to make
sure you have your own supportand your own help. It's not just
about getting your child thehelp, but it's also making sure
(16:33):
you've got a safe place, a safeperson to talk to that's not a
friend, not a family member,that you can really process this
with. So, you know, I thinkthat's a huge part of it is just
making sure that parents alsohave the supports in place for
themselves, and that we're notjust solely focused on the
child. Because sometimes thatcan make all the difference.
Erin Brinker (16:56):
I have to think, yeah, I'm sure it does. I mean,
you can't give what you don'thave, and you can't pour from an
empty cup. And so if there'snothing filling up, mom and dad
or primary caregiver, whomeverit is or whoever it is, how can
they give what they what theybut they've never seen, or what
they don't have, or what they'venever dealt with and and, yeah,
that's important. So it's reallyabout treating the whole family.
(17:20):
And maybe you're seeing thechild. Are you seeing the child
and the parent together? Andthen the parent getting support
elsewhere is also important too.
So that's a good point. So let'stalk about expectations. So
unmet expectations in any familydynamic is a lot, is a lot of
where the friction points are,where you expect somebody to
behave a certain way or do acertain thing, or get the
(17:42):
certain grades or get thecertain promotions, or, you
know, this is not only withkids, but with adults, and they
don't, and that's where thingsstart to rub right? So what kind
of expectation setting and doyou have those conversations
when you when you're treatingyour patients?
Dr. Ashley Zucker (17:58):
Yeah, I think it's, I mean, it's a really
tricky one, because especiallywith our kids, right, we put a
lot of expectations on the do.
So that one's reallychallenging, but we also have to
understand what's possible, andmaybe some things are not. And
so in a certain space, some ofthat is about like us as parents
or as adults, kind ofaddressing, or sometimes even
(18:22):
grieving the loss of what ourexpectations were for our
children. And that sounds reallynegative, and it sounds really
hard, and it is, but sometimesit's their reality, right? You
know your your kid doesn't andit can be something like your
kid doesn't love the sport youwanted them to excel at. It
doesn't have to be somethinghuge and tragic, but sometimes
(18:44):
that's still a loss for you as aparent. And so I think it's one,
understanding that parents maybe grieving something through
the process, but two, alsohelping them to recognize the
things that are the strengths oftheir child, what their child is
good at, but also just beingrealistic too, right? So maybe,
if it's about grades, right,maybe your kids are performing
(19:08):
as well in school as you'd likethem to, you know, kind of
trying to figure out, Is thereanything that I could be helping
with? Are there any additionalsupports they could do? Are you
connecting with the school, withtheir teachers, to see if their
teachers are recognizingsomething in particular. And so
just kind of, again, it's thatcheck in with your kids, and
(19:28):
it's not the like helicopterhave to know everything about
you, but just like, Hey, I sawyou. Know you didn't do so great
on that last math test. Wasthere anything in particular,
that made that one harder thanusual, or, you know, things like
that, where you're just sort ofshowing that you're concerned
and you care and not thatyou're, you know, punishing
(19:48):
them. Or like, Well, that wasterrible. Why didn't you do
better at that? You know, thatdoesn't feel very good.
Erin Brinker (19:57):
What's wrong with you idiot? Right? Oh, probably
not the most constructive way toapproach it, exactly. So there
was a movie that came out latesummer, early fall, actually,
not that long ago, called thesenior. And it's about this,
this guy, this football player.
He was, he's in his late 50s atthe in the movie, but when he
(20:18):
was in college, he was afootball player. And through
that, you're getting flashback.
Flashbacks of how he wasparented very, very harshly. And
he he had gotten into fights,which his father encouraged. He
had gotten into fights when hewas a senior in college and
gotten himself bounced out ofschool, kicked out of school,
and kicked out of the footballteam, off the football team in
West Texas. And he's going backto a reunion. He hasn't seen
(20:41):
everybody in 30 years, or 40years, whatever it was, and they
all joked that he had anotheryear of eligibility, and he
thought, Well, I wonder if Icould go play. And he did. He
went and tried out for his team,and he ended up playing as a 57
year old on a college footballteam in Texas. It's a true
(21:01):
story, and through that, you sawthis dynamic, both with his
father and not meeting hisfather's expectations. His
father's very, like I said, veryharsh. But also, his son wasn't
a football player at all. He wasthis creative guy, and how they
kind of are starting to figureit out. I don't want to give too
much, but if you haven't seenthe senior. It's an excellent
(21:21):
movie and and does expectationscolliding? Every family deals
with that at some level. I knowour family, did you know?
Because you think your kid, I'mgoing to do these things with my
kid. I'm going to have a boy,I'm going to we're going to do
these things together. I'm goingto have a girl. She's going to
like the things I like. Well,not necessarily. She's a wholly
different person.
Dr. Ashley Zucker (21:42):
Yeah, yeah.
Sometimes it's also I recognizethis with my own kids. I'm like,
I want them to like something Ididn't like and they don't like
it either.
Erin Brinker (21:51):
I want you to be able to paint because I can't
draw a straight line.
Dr. Ashley Zucker (21:57):
I'm like, Well, I guess you are my kid. So
Erin Brinker (22:02):
that's funny, yeah, my daughter, when she was
really little, she really wantedto play the violin. I'm like,
Okay, you have to commit to itfor one year. One year she was
six, we bought her a littleviolin. She hated it. She hated
everything about it. We made herstick to it, because that was
the deal. And, you know, she hadlessons once a week. It wasn't
that bad, but, but then she,after that year, she's like, I'm
(22:24):
done, I'm out, you know? And wason to the other thing. And I so,
I love stringed instruments. Ican listen to string instruments
all day long. And I thought thatwould be so exciting. But no,
that was not for her, exactly.
So let's talk about, you know,the holidays and and
expectations of the holidays andall the different family
(22:44):
dynamics and family stresses andkind of how to take care of
everybody during that window oftime.
Dr. Ashley Zucker (22:54):
Yeah, I mean, I think that last part that you
said is probably the first thingI would pick up on, which is,
how do we take care of everybodyat that time? It's not our job
to take care of everybody atthat time.
Okay, well, I would say thatgreat.
(23:14):
I you know, I think it'sunderstanding where, where
you're at, what you have togive, what you need, right?
Because everybody around youtrying to give to but also
recognizing that we have to berealistic, right? You're not
going to be able to doeverything for everybody, and
you may have to pick and choose.
You know, what you can and can'tdo. You know, be realistic about
the amount of time you have whatyou can offer.
(23:40):
Yes, right,exactly, right. But know that
it's, you know what? I'm just sobusy right now, I just don't
have time to help out with Xevent. But you know, I'd love to
be first on the list for nextyear, something like that,
right? So I guess that would bemy number one advice for the
(24:00):
holidays, is just recognize yourown limits. And yeah, that it's
not your responsibility to takecare of everybody. You have to
take care of yourself first, andthen what you have, you give,
you know, and what you don'thave you don't have, you don't
that's okay,
Erin Brinker (24:19):
yeah, you know it reminds me of I know women, many
women like this have been somein my family where they putting
on the perfect spread with thePerfectly Decorated home, and
everything has to be perfect,and the food is delicious and
the home is beautiful, but Butthe person who wants that
perfection is exhausted andcranky and yelling at everybody
(24:39):
and nobody wants to be aroundthem, right? So maybe, maybe put
on a few fewer decorations andget takeout, and everybody will
enjoy themselves
Dr. Ashley Zucker (24:49):
exactly.
There you go.
Or if you you're not thatperson, right? That's setting
everything up and makingeverything perfect. It's saying,
What can I do for you? Right?
Can I do the dishes? Can I cleanup for you? Or maybe, can I
bring X dish so you don't haveto worry about all of it, right?
Because, you know, whatever yourrole is, where can you kind of
lean in in a realistic way andmaybe take some pressure off of
(25:13):
somebody else too? But again,we've all got our own pressure,
so we've got to find that
Erin Brinker (25:19):
balance we do, we do and give each other space to
be human, yep. So, so what aresome trends that you're seeing
in in your office, with peoplecoming in, or that you've read
about, things that are happeningin the interpersonal space and
the mental health space? BecauseI know it's been, it's been
(25:40):
changing a lot over the years.
Dr. Ashley Zucker (25:43):
Oh, that's hard to say. I mean, some of it
doesn't change at all, right?
It's just the social dynamics ofbeing a teenager. It might play
out a little bit differently,but I think those things are
still there, certainly, youknow, things like people being
challenged with bullying. That'sstill a very common I think what
that looks like might be alittle bit different with, you
know, like social media andstuff like that, but the the
(26:05):
impact that it has has alwaysbeen there. So I think some of
those patterns are very much thesame. I think about, you know,
for teens, and this is part ofwhy I really love working with
teens, is, is that time of lifewhere you're just trying to
figure out who you are, andthat's really challenging to
navigate, and you're trying tofigure out who you are for
(26:26):
yourself, but also trying tomanage, I guess, those
expectations of your parent andthat maybe you're not who they
think you are, who they thinkyou should be, those are
Definitely some, somechallenges. I think, you know,
school performance, that's a bigone that we see for sure. You
know, I think the world is avery, very stressful place. So
(26:48):
certainly you see some of that,you know, play out and in what I
see in in my office. But, youknow, I think also, it's not
like there was ever a time wherelife or the world wasn't
stressful. It's just what itlooks like changes. So I try to
keep that perspective as aswell.
Erin Brinker (27:08):
You know, it used to be that all of the scary
stuff would be on the nightlynews from at six and 10. Now
it's in the palm of your hand,24/7 and so, you know, and and
the rage bait. It's reallysomething because I, you know,
will be on x, and I don't reallypost very much, but you know,
the stuff that people post, youknow, this horrible thing has
(27:30):
happened, but you don't care,nobody's going to comment. I
mean, so everything ismanipulated to make people feel
bad, and that is a reallytwisted way of existing. But it
seems to be how, how somemarketing is done in this era.
It seems to be how news is toldin this era. And that has to
have an impact on teenagers. I'man I'm a full grown adult, and
(27:50):
it bothers me. And so for them,I have to imagine, it's
overwhelming.
Dr. Ashley Zucker (27:57):
Yeah, no, absolutely, you're absolutely
right. I think what's so, youknow, difficult with, I guess I
would say social media inparticular. Are these like
algorithms that, you know, getget created that we don't
necessarily have control over,and so we get fed stuff that we
weren't necessarily looking for,that they think will grab our
(28:17):
attention and keep us kind ofwrapped in and unfortunately,
there's a lot of stuff that'svery negative that is utilized
in that kind of manner. Butthat's also not to say that,
like all social media is bad,or, you know, all you know, news
or entertainment is bad, I thinkit's about one moderation. But
to, you know, really trying tofind the things that actually
(28:40):
bring you joy. There's a lot ofreally great stuff on the
internet and on social media,and so if you can really try to
manipulate your own algorithm
Erin Brinker (28:49):
exactly, be intentional about it, yeah,
because one one afternoon ofdoom, scrolling could wreck your
whole algorithm.
Dr. Ashley Zucker (28:59):
Absolutely, absolutely, yeah, it's also, you
know, like, I think of don'tfollow things that don't make
you feel good, right? Or maybeyou follow like, one, I don't
know, I don't want to say onemedia source, because then
you're only getting one mediasource. But maybe only follow
one negative thing and the restare positive. Or for every like,
(29:20):
one media outlet you follow, youfollow 10 funny dog video people
you know exactly.
Erin Brinker (29:28):
If you're if your feet is full of baby goats and
cats and dogs, you're probablygoing to be just fine, right?
Exactly. So I did see, there's anew trend that I saw yesterday
on Tiktok that that what theycall raw dogging life, or raw
dogging boredom. And so they'lljust sit there with nothing, and
they'll time themselves justkind of sitting there. And I
(29:50):
thought, you know, it was thosein between spaces where real
creativity happens, right? Sothat's where, you know, it's out
of boredom that great. And.
Novels are written. It is out ofboredom that beautiful music is
written, because people are leftto just think. And I think that
if, if that trend really catcheson, what a beautiful thing. If
we're if we're consuming 24/7,then we don't have any time to
(30:13):
create, and we don't have anycapacity to create. And I worry
that our brains will lose theability to create. I don't know
what your what your opinion isabout that, but that's my
theory.
Dr. Ashley Zucker (30:26):
Well, I think the the irony of social media
trending, not doing anything isgreat. Yeah, I think, I mean, if
you think even about yourself,right? If you're kind of sitting
there for even a second. Well,one you've got like, your to do
list going through your head,right? But what's like? The
(30:47):
first thing you do like, youpick up your phone, you scroll
through social media, or you dosomething or right? You're like,
you don't even let yourself bebored. So how are our kids
supposed to know how to navigatethat, you know? So I do think
it's important that we all kindof, you know, have those moments
where we really turn things off,put them away, put them aside,
(31:09):
and really try to engage in thenon electronic world around us,
so to speak, and go for a longand, yeah, exactly, go for A
walk, do some coloring, youknow, I don't know, dig in your
backyard Exactly.
Erin Brinker (31:26):
Pick up, pick up that guitar that's been
collecting dust
Dr. Ashley Zucker (31:29):
in the corner. Yep, yep, exactly. So
let's
Erin Brinker (31:33):
talk about the, you know, what? What the How
bright, how people's brains areare have changed with the advent
of social media. And so, youknow, I know that all of this
impacts how brain wiring, right?
And I'm not a neuroscientist.
Don't pretend to be, don't evenplay one on TV. But I, I know
that it has an impact,especially for young people. And
(31:54):
are you seeing that, that howpeople think is different, how
how they approach life isdifferent, how, you know,
they're just all of it isdifferent because of the advent
of of this ubiquitous devicethat we've been holding in our
hands since 2007
Dr. Ashley Zucker (32:13):
I think the the most common thing that I see
is that it's really impacted ourattention span. And I see that
even my myself, you know, it'slike you're just sort of
constantly seeing somethingdifferent or right? It's all
these, like, short, you know,32nd videos, or whatever it
might be. And so it's just a lotof information always coming at
(32:35):
us in short bursts. And so Ifeel like our brains just sort
of get used to that pattern, asopposed to more extended periods
of, you know, focus andattention. And so there's
definitely a trend, not justwith with kids, but certainly
with adults, of, you know,complaining about concentration
(32:55):
and focus issues. And I have tothink that some of it is just
also that the way we're workingwith the world right now is not
helping us, you know, build nosustained attention. It's not,
yeah, I think that's probably, Imean, I can't say like that.
We're definitely seeing thisthrough X, Y and Z, you know,
(33:19):
study or things like that, but Iknow that there is some evidence
that does suggest that there issome change in just duration of
attention span over the lastseveral years to decades, where
we're seeing that people arejust sort of, I don't know that.
It's not the ability to focus,but that's just not our pattern,
or we're sort of craving that,like constant flow of change and
(33:42):
information, because that's whatwe're used to.
Erin Brinker (33:45):
I wonder what that does to our capacity to do hard
things. And I think about, youknow, people to get and I'll use
doctors as an example.
Obviously, you know thisexample, well, the classes that
you have to take to get into theundergraduate program are all
the hardest classes. And thenyou get into the undergraduate
program, you're taking organicchemistry and chemistry and
(34:06):
biology, etc, etc, etc, andthat's hard. And then you go
into medical school, and thenyou have an internship, and et
cetera, and on and on. All ofthat takes concentration. It
takes discipline, and it takesthe ability to work through
something that's really hard,and are we? Are we hijacking or
our kids? Are maybe not we, butyeah, we, as a culture,
(34:27):
hijacking our kids brains sothat they don't have the
capacity to do that.
Dr. Ashley Zucker (34:35):
I hope we're not but, I mean, I think it's
yes and no, right? I think thereare some things where it just
sort of depends on the likeamount of time that you're
spending on social media or evenon things like video games, and
so it's sometimes about likequality, not quantity type of
(34:57):
thing, right? So again, I don'tlike to say that all. Social
media is bad, or all videogaming is bad. I think there's
actually some skills that youcan can build through utilizing
those things that might actuallyhelp throughout, even if you're
taking those hard classes or,you know, trying to really apply
yourself. But it's also thatability to really know when you
(35:17):
need to turn it off that Ithink, is, like that key piece
that we have to hold on to,like, how do you really say I'm
gonna go do this or play thisgame for an hour and then I'm
gonna stop? I think that'sthe hard part. Yes, yeah, yeah.
I think we have to focus on andthat will help us to make sure
(35:39):
that we can do hard things. Butyou know, it's also, I think,
like we were talking aboutbefore, taking that time to
maybe be bored have nothing todo, or maybe taking the time to
make sure you do focus onsomething for a long period of
time, and like reading a book,for example, right?
Erin Brinker (35:58):
You know, I think of there are, there are, there
are faith communities. Andspecifically, I'm thinking about
the Jewish community that theythey turn off their devices.
They turn off everything onFriday night to Saturday night.
And it's just about family. It'sabout connection. It is about
just getting back to what'simportant. And wow, what a great
example I you know, creatingthat kind of a tradition in your
(36:20):
family, whether you call it aSabbath or not. I think is
really wonderful, yeah?
Dr. Ashley Zucker (36:25):
And I think that that may sound like a
really lofty goal for a lot ofpeople, so I think of like, can
you have, you know, one meal aday where there's no phones at
the table? That might be whereyou start, right?
Erin Brinker (36:38):
That's true.
That's true. Yeah? So, well,yeah, so, so what kind of, you
know, we're talking about, aboutsetting boundaries and, and, you
know, we exist in this veryconnected world, so you have to
be connected if you want to toexist and engage in this world.
So how do you set thoseboundaries and, and if you
didn't do it when they werefour, can you still? Can you it?
(36:59):
Has you? Have you lost thewindow at 11 or 14?
Dr. Ashley Zucker (37:04):
Well, no, you've never lost the window.
But I think for many things,it's, I guess, well, what I will
say also, and I say this toparents of like newborns too,
especially when they asked aboutthings like sleep training, just
as an example, right? It's likeyou're going to have to put in
the work at some point. Do youwant to put in the work now? Or
(37:26):
do you want to put in the worklater? So I don't think you're
ever like beyond the point of noreturn. I do think it happens a
little bit faster the earlieryou sort of set those
boundaries, those expectations,but I can't say it's easy at any
time, you know. So I think it isimportant.
Erin Brinker (37:47):
It's about doing it yourself, too. I mean, when
they're really little, you'renot really disciplining them,
you're disciplining yourself,which is really so sorry.
Dr. Ashley Zucker (37:56):
I didn't mean to interrupt.
No, no, no, that's so true,though. But yeah. I mean, I
think, you know, you see it playout, like with teens and stuff
around, like the cell phone,right? So they don't sleep
because they're up all night ontheir phone. Okay, we'll take it
away. But I can't, they getreally upset. It's like, okay,
well, you're gonna have totorture yourself and them. So,
(38:18):
yes,
Erin Brinker (38:19):
yes, yeah, because you want them to grow up to be
fully functional, fullydeveloped adults. And sometimes
that job is terrible. A lot oftimes when, especially when
they're teens, and they'rethey're, you're, you're, you're
embarrassing them by existing,and you're making rules that
they don't like, but theysecretly do like because they
(38:41):
need the boundaries. It's justthey're pushing back against
them. You know, they get past 25and they recognize that that,
Oh, Mom and Dad weren't stupid.
Oh, right for this, parents whodon't know when your child hits
about 11, they're gonna thinkyou're an idiot, and it's okay.
It's normal.
Dr. Ashley Zucker (38:57):
What do you know, Mom,
Erin Brinker (39:00):
what do you know exactly? Exactly? I actually
have to tell you story. I was ata family event, and there was an
uncle there, and we're standingaround a a bonfire, or it was in
a it was in a container. But myI said something to my daughter,
I remember what we were talkingabout, and I gave her some
(39:21):
advice, she goes, No, Mom,that's not right. And this uncle
who was standing there gave herthe same advice, like, not three
minutes later, oh, that's reallygreat. I think I'm going to do
that really.
Dr. Ashley Zucker (39:33):
That's actually my role. A lot of the
time, parents will come in andbe like, can you talk to them
about this, because they won'tlisten to me.
Erin Brinker (39:44):
Oh, that makes sense. That makes sense. So, so
let's switch gears a little bitand talk about, you know, mental
health is, is has been on thefront of people's minds for the
last few years. People aretalking about it. They're being
open about it. People make.
Videos about their diagnoses,whatever those diagnoses are.
And a lot of people think theywant to go into the mental
(40:04):
health field, whether as apsychologist or psychiatrist or
some other kind of practitioner.
What would you what advice wouldyou give to a young person who's
considering that?
Dr. Ashley Zucker (40:16):
Ooh, well, I think the first thing I would
like say is that there's just somany ways to get into it. It can
look so many different ways tobecome somebody in mental
health, right? So like you said,there's just a lot of options
about what that could could looklike. So I think it's about sort
of exploring and evenunderstanding all of the spaces
(40:39):
in which, you know mental healththings exist. So I think the
things we think of the most aretherapists, psychologists,
psychiatrists. But there's a lotof other opportunities out there
too. I think there are somepeople that really, really love
the concept, but then when theykind of get that sort of actual
(40:59):
involvement in mental health,it's something that they feel is
too much for them. So that'salways one thing that I think
about, too, is it's good to, youknow, try to get some experience
wherever you can, although Iwill also say sometimes getting
experience in mental health isreally difficult because of the
sensitivity of it. It's not likeyou can just go shadow or do
these types of things. But ifthere's, you know, if you're in
(41:22):
in high school and there's likea peer support club or something
like that, I think those are theways to, you know, kind of get
involved and sort of see, do Ilike actually doing that? But I
think, I guess, I think back towhen I was in medical school, I
had a really good friend who wasincredibly caring,
compassionate, very sensitive,and when she did her rotations
(41:44):
in psychiatry, she just couldn'thandle it. She was like, this is
just so hard. I can't live likethis, right? And so for her, it
was recognizing that like, eventhough, in theory, that really
sounds like it fits with her andher personality, it just wasn't
something that she could reallynavigate through, and so
recognizing that too. So that'swhere the experiences is
(42:05):
helpful. Unfortunately, you dohave to be able to separate a
little bit some of the reallydifficult stuff you have to deal
with in mental health, and makesure that you're not carrying
the weight of all of that all ofthe time. And so that's just not
for everybody. But again, that'swhy I think it's so important to
recognize that there are otherways to be involved in mental
(42:26):
health that might look a littledifferent than just sort of
those traditional, you know,methodologies. But I think the
biggest thing I would say isthat, you know, being in some
type of peer support, type ofprogram, no matter what age you
are is probably the best thingthat we can do, also not just
for our own like experiences orinterest, but to help one
(42:47):
another, because we'll neverhave enough therapists. We'll
never have enough psychiatristsfor everything that everybody
needs. And so where can wereally fill in those gaps with
just each one of us having alittle bit of a better
understanding of how to supportone another. To me, that's like
the best opportunity we have.
Erin Brinker (43:05):
So you might get in and I I'm one of those where
I really wanted to be in mentalhealth. I really did. And
several times over the course ofour marriage, I've been married
for 31 years, my husband's like,Erin, you would take everything
home. Every single patient wouldbe on your mind all the time. It
would eat you alive. It's like,okay, so what can I do? I can be
(43:26):
a mentor. I can be a coach. Ican be I can volunteer to work
with youth, and all of thosethings I do, and I love them.
And he was right. And you haveto understand where your
boundaries are and your capacityto create boundaries. And if you
can't do that in a healthy way,then that that job will kill
you.
Dr. Ashley Zucker (43:45):
Yeah, no, definitely. Opinion,
yeah, no. And I think you knowit's it goes each way, right? So
I think about like, I love beinga psychiatrist. I love working
with kids. I love working withadolescents. But if you asked me
to be a teacher in high school,elementary school, kindergarten,
no way. I don't know howteachers do it. I give them so
(44:10):
much credit, but you know, andso it's just finding your space,
right? I love kids, but I cannotbe their teacher,
Erin Brinker (44:17):
right, right? We all have our gifts, yes, yes,
that's that's very, very true.
So for those of the for thosepeople thinking maybe they're
they're heading into medicalschool, and they're considering
psychiatry as a specialty, and Iknow that you kind of are asking
yourself, what do I want to doall the way through? I would
imagine, you know what? Howwould you tell them to? How
(44:40):
would you have them order theirtheir learning in a way that
favors psychiatry?
Dr. Ashley Zucker (44:49):
Ooh, that's really difficult. I mean, when
you're in medical school,certainly you're getting
exposure to, like, all of thedifferent specialties. And I
think that's critical, no matterwhat you do, right part of the
like. Joy of medicine, to me isthat we know so many things
about other things outside ofour specialty, but then we do
get to kind of focus in onsomething in particular. So I
(45:11):
would say, first of all, don'toverlook the other things that
are outside of psychiatry,because they will make you a
better psychiatrist in the longrun. So that would definitely be
one, next one piece of it. Andthen I think it's about the
variety, like the, you know,especially, I always, one of the
things I love about psychiatryis that it's one of the, you
know, kind of under developedspecialties. And so there's so
(45:35):
many new things, like constantlycoming out. And so there's so
many ways to look at it. And youcan say, you know, whether
you're in the outpatient spaceor you're in the more acute
space, inpatient, the emergencyroom. But there's also all of
these emerging technologieswithin psychiatry which are
really, really exciting to beinvolved in. And so again,
(45:55):
there's just so much variety,and making sure you kind of get
a little bit of all of that tosort of see, you know, what
excites you or maybe you don'tlike it. That's okay too.
Erin Brinker (46:05):
Yeah, you know, yes, because you may get in
there like, oh, I don't likethis at all. I didn't think I'd
be doing this much instatistics, yeah, if you will,
Dr. Ashley Zucker (46:15):
exactly, exactly, well. But I'm really
grateful for a lot of the thingsthat I learned and did outside
of psychiatry, and I reallystill utilize those today. So
that's why I always think it's,you know, you don't want to get
so lost in the weeds of onething that you forget to, you
know, learn the other thingsaround you.
Erin Brinker (46:34):
Well, that's excellent. That's excellent. So
what are some things going on inKaiser Permanente surrounding
psychiatry, psychiatry andpsychology and and what are,
what? What's on the horizon forKaiser?
Dr. Ashley Zucker (46:46):
Oh, boy, that's like, where do you start?
I mean, there's so many piecesagain. I think one of the one, I
guess, a place to start is whereyou start, right? So one thing
that I, you know, truly believein, and I know has always been a
huge focus for KaiserPermanente, is really in that
(47:07):
preventative space, right? Sohow do we keep you healthy? How
do we prevent you from, youknow, actually needing more
intensive care? That's our goal,right? We want to help you be,
you know, be the best you can beearly on. And so I think it's
about that, like earlyidentification, early
intervention. So there'sdefinitely been a large focus on
(47:29):
on that. So the earlyidentification and that you know
is taking place when you seeyour primary care doctor or your
pediatrician, right? They'reScreening for Mental Health
concerns. But there's also somany offerings that are
available that you know, youdon't have to come into
psychiatry or addiction medicineto access a lot of those
resources and services. So youknow, whether it's the
(47:51):
utilization of we have certainapps that we like to to offer to
partner with, but one resourcewhich is really great and
actually available for non KPmembers too, is that we have a
lot of mental health webinarsthat are available through the
website that kind of go over avariety of topics. Some of them
(48:12):
are actually teen specific,like, there's some parenting
ones, so I'll plug those.
There's some about like anxietyand work stress and and it,
there's just a ton of them thatare really there. So it's also a
great place, or a great resourcefor people who are, one, just
kind of looking for that sort offirst step. But two, I've
(48:32):
actually used those a lot withmy own patients who are very
hesitant about like, gettingmore into therapy. It's sort of
dipping your toe in the water ina more safe series, because
it's, yeah, it is. It's like, Idon't know what that's going to
be like, or that feels verypersonal or invasive. And so
that's a very safe space to kindof enter and start to learn some
of the you know, skills andstrategies and ways of managing,
(48:55):
you know, your mental healththat I think are really, really
important. So I think thatupfront focus is huge, but we
also have to have the fullspectrum of care, right? So yes,
we want to keep you healthy, butthat doesn't work for everybody,
right, right? And there are somethings you just can't avoid.
Your genetics are just going totake over. And so making sure
(49:16):
that we have kind of all ofthose layers of care throughout
and so again, having a, youknow, robust psychiatry
department where you can get theindividual therapy, the group
therapy, the medicationmanagement, kind of all of those
components. And then if itescalates beyond that, like, how
do we make sure that we connectour, you know, our patients, our
(49:37):
members, to those services, andreally try to track them
throughout that, you know, kindof continuum of care is what we
call it. So, you know, if, for,you know, whatever reason,
unfortunately, one of ourpatients ends up in the
hospital, making sure that wehave them come, you know,
directly back into the system,so that we can make sure that
they have all the resources thatwe need. So I. Think that kind
(49:58):
of care management throughouthas been just a really, you
know, strong component of whatKaiser is able to do with our
integrated system. But I thinkalso what people don't always
think of is we kind of touchedon it a tiny bit, is like all
the kind of innovations that arehappening within psychiatry and
so really, you know, the focuson incorporating those and
(50:21):
making sure we have thoseaccessible to our patients, you
know, has been something that'simportant to us. So it used to
be, you basically hadmedications or ECT, right? And
ECT is the stuff movies are madeof, literally. And ECT is
actually a wonderful treatment.
I've seen some really amazingthings happen with ect. So I
(50:43):
don't want to give it a bad rapat all, but there are a lot of
things that people, I think aremore comfortable with, like TMS,
which uses magnets instead ofelectricity, and so being able
to offer those services. Yeah,yeah. So that's a relatively new
one, I guess in the last, Idon't know, decade or so, so not
like yesterday, new but, butyeah, it's been kind of the the
(51:06):
sort of replacement for ECT, ormaybe the first step before,
kind of getting to ect. So feelsless kind of scary to people.
Erin Brinker (51:15):
So I know that, you know, if you if you grew up,
and we'll just say lots offamilies have lots of trauma
that's been around for a longtime, and unpacking that in an
hour, and then having to pack itall in and go on with your life
for the week until you can comeback, that's a little scary. And
you know, people need to haveways to connect beyond that that
(51:39):
that one appointment, becauseyou need support. Once you start
unpacking, maybe that wound,well, it's open now, and and how
do you deal with that in aconstructive way? And do you see
that kind of happen in your inyour treatment?
Dr. Ashley Zucker (51:53):
Yeah, I mean, I think that's part of the
process of therapy too. Is likeyou don't want to make or you
want to make sure that somebodydoesn't leave your office like
an open wound bleeding out intothe universe. So you want to try
to get them to a better placebefore they exit. But I think
it's also about really, youknow, empowering people with the
skills and the strategies tomanage how they're feeling. And
(52:16):
so you know that that sort ofold perspective of you go into
the psychiatrist or thetherapist, and you lie on the
couch and you pour your heartout, and then you walk out the
door, you can still do that, butyou know, a lot of the focus
over the years has really beenon, how do we make sure that
we're equipping you with how tonavigate and manage what comes
(52:37):
up next, right? Because we'renot going to stop you from ever
being sad or ever being anxiousever again, but really equipping
people with the skills and thestrategies to do that. So I
think that's one big piece thatI always like to think about, is
like, what's something I cankind of give you to take home
and use, and then it's alsobeing able to utilize some of
the great technologies that wehave, like apps, right? So that,
(53:00):
you know, maybe you don't have atherapy appointment, or you
don't have access to somebody inthe moment and you're having a
panic attack, for example, canyou pull up some resources on
your phone that you can use? Youknow, are there other
strategies? Or, you know,there's even, like, those apps
that you can you can text with arobot or AI. And I know that's a
whole nother Hot Topic typicallydesigned for it. So I'll say
(53:26):
that very adamantly, they arecreated to help and program to
help with mental health, asopposed to some of the more
generic ones, which we've heardsome terrible, you know, news
stories about, but also thingswhere we like we have some
programming or some apps thatyou can use, that you can
actually do, like live textingwith a like a coach, right? So
they may not be a like atherapist level professional,
(53:48):
but they have enough of thatkind of education and training
to kind of guide you throughthat moment until you can get to
that next appointment, you know.
So I think those are some of thegreat things that we can kind of
incorporate into our practice.
Well.
Erin Brinker (54:02):
Dr Ashley Zucker, as always, this has been a great
conversation. This time has goneby so quickly. How can people
learn more about KaiserPermanente, the mental health
services at Kaiser Permanente,and make an appointment with a
clinician? Yeah.
Dr. Ashley Zucker (54:16):
I mean, the best place to go is kp.org, and
you can see all of it there. Alot of our mental health
resources are available right onthat kind of home screen, but
you can also search for, youknow, just mental health, and
you'll be able to find all ofthose resources, how to make an
appointment, access to some ofthose webinars, like I was
talking about. But another greatthing that I always remind
(54:37):
people of is you can alwaysstart with your primary care
doctor, a lot of them, really,really can start you off in
treatment, and if they need to,then they can, you know, send
you on to psychiatry. But theyoften have access to a lot of
resources, and you know, knowhow to start that treatment
process and take care of youtoo. So it doesn't have to be in
(54:58):
psychiatry. It can be with yourprimary. Care doctor as well,
wonderful.
Erin Brinker (55:02):
Well. Thank you very, very much. Happy Holidays,
and I hope to have you on againnext year.
Dr. Ashley Zucker (55:08):
Yeah. Thank you so much for having me back.
Erin Brinker (55:13):
Thank you so much for joining us today. I'm Erin
Brinker, this has been the hopetable, and you can listen to
this on terrestrial radio inInland Southern California on X
95.7 Sunday mornings at 9amthat's X 95.7 in Inland Southern
California and wherever youdownload and listen to your
(55:34):
favorite podcast, Apple Spotify,etc, again. Thank you so much
for joining me. You've beenlistening to the hope table.
Have a great week. You.
Hey, welcome everyone to a brand new podcast
(00:09):
called The Hope table. Our firstguest I'm super excited about is
Dr Ashley Zucker. You're goingto hear another introduction
that was recorded when we didthis interview a couple of weeks
ago, well before Thanksgiving, Ithink you're going to enjoy it.
(00:47):
Let's get started.
Welcome to thehope table. I'm Erin Brinker,
and I'm thrilled to be sittingdown again with Dr Ashley
Zucker. She is a board certifiedpsychiatrist focused on
children, adults andadolescents, and today we're
going to talk a lot about tweensand teens and the holidays and
(01:10):
applying for college and all ofthose things that are stressors.
She's worked with KaiserPermanente here in Southern
California. Dr Ashley Zucker,welcome back to the show.
Dr. Ashley Zucker (01:20):
Thank you so much for having me back.
Erin Brinker (01:22):
So so let's talk about this. It's November and
the holidays. It seems like wewere just dealing with 105
degree weather, and now we'rewe're focused. Halloween is
behind us. So let's talk aboutthe life of a teen during this
time, especially seniors in highschool, kind of what is their
life like, and how do they keepeverything straight?
Dr. Ashley Zucker (01:47):
Yeah, you know, you got to feel for those
teens, especially in highschool, it's just such a
challenging time. And I thinkwhether you're a senior or a
freshman, you know, it's areally difficult time of year,
because it's really when yourclasses have ramped up. So
things are a little bit moreintense. You know, heading into
the holiday seasons. You mightbe heading into midterms or
(02:08):
final exams even kind of,depending on what you know the
status of your classes is. Andthen, of course, for you know,
our seniors who are applying tocolleges or considering what
they're going to do aftergraduation, that just adds, you
know, an additional layer ofstress. And I know for myself, I
have a sophomore, and so she'sworrying about prepping for
(02:30):
driver's ed, for having a childthat drives. But yeah, so
there's a lot of things comingat everybody
Erin Brinker (02:41):
as soon as the time where you can toss with the
keys and say, Can you run to thegrocery store? I'm out of milk?
Dr. Ashley Zucker (02:46):
Yeah, I can't wait,
Erin Brinker (02:49):
you know. And I brought up seniors, just because
I think about the senior yearwhen all of the applications are
due. And so for their colleges,and if they didn't take the SAT,
or they need to retake the S, A,T. They do that in the fall, and
their classes are still most ofthem are still taking the AP
classes or the honors classes orthe, you know, all of them that
(03:15):
International Baccalaureate IBclasses, trying to get
everything in so they can getinto that good college. And it's
stressful all the differentcolleges, all the different
applications, you got to writeessays for all of them and still
do well in your classes. Theymay be playing sports or in a
play. You know, we put a lot onour kids. We really do.
Dr. Ashley Zucker (03:33):
We really do.
And there's only so many hoursin the day. So, you know, I
think making sure that we helpthem with their time management
is one kind of strategy, but Ithink it's also trying to take
away as much of the pressure aspossible, easier said than done.
But you know, if they're, youknow, mostly on top of their
stuff, just kind of steppingback and letting them kind of
(03:53):
guide themselves can be helpful.
But of course, some kids arejust going to need a more hands
on approach and maybe some more,you know, specific help with
that, that time management, butyou got to also make sure
they've got time to just be ateenager too. Yeah. So that's
probably the most importantpart.
Erin Brinker (04:12):
You know, I think about my teen years, and it's a
time when every emotion is felt.
To use a very old reference atan 11 and go watch Spinal Tap if
you've not seen it, buteverything is feel like
everything is turned up to 11when the the it's supposed to
stop at 10, and you feeleverything so intensely. So how
do you how do you help yourteens? And that's not unique to
(04:32):
seniors, that's starting atpuberty. How do you help them
navigate that?
Dr. Ashley Zucker (04:39):
Yeah, I mean, I think it's really important to
recognize that, just like yousaid, you know, teenagers are
naturally kind of moreemotional. They feel things very
acutely. You know, they don'tknow anything else, and so
what's happening for them now isthe biggest thing ever, and it's
also a time in life where you'rereally in this kind of stage of
moving away from. Family beingsort of your primary connection
(05:02):
to more of your peers and yoursocial connections. And
sometimes there's a big bit of atug and pull between those two.
And so that can also, you know,raise emotions as well. But I
think the number one thing thatI would say is that we have to
recognize for ourselves and forour kids that emotions are okay.
I think too often we're sort ofafraid of them, or we sort of
(05:24):
label emotions as bad. And Ilike to say there's no bad
emotions. It's just what you dowith your emotions. And so, you
know, letting our kids sort offreely express that, but making
sure they have, you know,positive outlets for it, and
also just hearing them. Youknow, it's not that we have to
say anything or give them anyadvice, because they don't want
(05:44):
to hear it.
They're not going to take itanyway, exactly, right, exactly.
But just hearing them, hearingthem out, or just recognizing,
hey, it sounds like you'rehaving a rough day. Can I do
anything for you? You know,those types of just very general
kind of soft approaches. I thinkcan, can be really helpful. But
again, number one thing, noemotion is bad. It's just what
(06:05):
we do with them.
You know, I, I,
Erin Brinker (06:10):
I love that the no emotions are bad because we, you
know, especially at that age,don't have any control over how
we feel. We have control overhow we act, although teenagers
don't, yet they haven't learnedthat skill. But what we as
adults have control over, how wereact, but not what we are
feeling. And when you havereally big feelings all the
(06:31):
time, it's overwhelming. I mean,you really need time and space
and a way to unplug that'sconstructive,
Dr. Ashley Zucker (06:38):
yeah, for sure. And I think just what you
said in terms of, you know,teens don't always have that
full control, so they may betrying to do the right thing
with their emotions, but theyjust, you know, don't have the
full frontal, low development,right? Exactly. And I think
that's where our role as adultscomes in to really role model
for our kids, right? We haveemotions too. It's not just when
(07:01):
you're a teen, and I think it'sgood to show your kids that you
do have emotions too, and kindof show them the best ways to
handle them. And also know that,you know, as adults, we don't
always handle them the right wayeither, and that's okay. So you
know, showing your kids it'sokay to mess up and say maybe,
oh, I shouldn't have gotten soupset about that, or so angry
(07:22):
about that, or I shouldn't haveyelled about that. I wish I had
done X, Y or Z. And so reallyshowing them, you know, it's
okay to have emotions, okay toreact, it's okay to react wrong,
but you got to catch it,recognize it. I think that's
where we can do the most, youknow, benefit for our kids.
Erin Brinker (07:39):
So I'm thinking about, they say that depression
is and I don't know this istrue. So you're going to
disabuse me of this if it's notthat depression is anger turned
inward, and that if that iscompounded, then it becomes
overwhelming. So we havesituational depression, that
something, maybe a friend movedaway, or somebody passed away,
God forbid, or something youbroke broke up with a boyfriend,
or whatever you know as ateenager. But then there's the
(08:01):
more pervasive depression. Canyou talk about depression,
especially starting in in middleschool, so puberty, through the
teen years? Yeah.
Dr. Ashley Zucker (08:11):
I mean, I certainly think that the the
anger, turn inward, can be acomponent of depression. I don't
think it's the end all be all.
But you know, depression canactually look a lot of different
ways, and it can also look verydifferently for, you know, for
kids and for teenagers. And sowhen we think of depression,
often, we think of people whoare sad down, sort of, you know,
slow moving or and that can bethe case for sure. But one thing
(08:32):
that we actually see morefrequently in in kids and teens
is that they are way moreirritable. And now I say that,
and you probably laugh, becausewhat teen isn't irritable, but
it really gets to, you know,these sort of excessive levels
where it's just like, you know,everything is bothering them,
not just you, but everything.
(08:55):
And you do start to see thatmaybe they're just changing
their typical behaviors in a waythat just doesn't seem like it's
not just, oh, I don't want tohang out with mom and dad. It's
more, I don't want to hang outwith anybody. I don't want to
engage in the world. So thatkind of social withdrawal,
right? Because we know for forteens, it's that key time in
life to really be social, and soif there's a huge avoidance of
(09:18):
that, or just not wanting to doit anymore, especially if they
were social before. Those aresome of the big things that that
we want to kind of watch for.
But I'd also say, you know, toyour point, there can definitely
be things that cause depression,so situational depression, like
you mentioned, but sometimesthere's no specific trigger. So
I hear a lot in my office fromparents like I don't know why
(09:39):
they're depressed? There'snothing for them to be depressed
about, and that's becausedepression is, you know, a
chemical problem in your brain,and doesn't necessarily be
caused by something that'shappening outside or around us.
And so sometimes that can behard to fully understand, but I
think it's important torecognize, especially in kids,
in a.
Erin Brinker (10:00):
Adolescence, you know, I remember with my own
children, who are now adults. Iremember they had this, a life
that was so separate from me andby design, because I would ask
questions I'd want to get toknow their friends. And there
was a, you know, I mean, Icertainly knew who their friends
were, but I there was a wallthat, that they had, that their
(10:20):
life, their inner life, and alsotheir their outer life that was
focused on school and friends.
And that's scary for a parent,because you know you you don't
know exactly what's happening.
You try to do your best and andso there's these things going on
that you can't protect yourchild from, and there's also the
other side that you don't wantto protect them from everything,
(10:41):
because they had to learn how tonavigate. And so, you know, how
do you help families throughthat?
Dr. Ashley Zucker (10:47):
Yeah, I mean, every family is different, too,
so it's hard to say there's oneright way to do all of it. You
know, I think, like you said,you want to give your kids their
space. You want to allow them tomake mistakes. I think sometimes
we're really bad at that, atletting our kids fail, yeah, we
want to protect them fromeverything, right? So I would
(11:08):
say that's one thing is, youknow, this is a time in life
where they can fail at somethingthat's not going to have massive
consequences. Obviously, somethings they fail at could but
where there's that space to, youknow, if they don't do great on
a test. It's not the end of theworld. It's one test, right? And
maybe they kind of need toexperience that, or you just
have to let them experiencethat. So I certainly think
(11:29):
that's one piece of it. I alsothink when you reference, like,
the social stuff, I think just,you know, staying engaged and
staying interested, and thatdoesn't mean you have to know
every single thing, or pry orkind of be like, tell me
everything that anyone saidtoday to you, but you know,
like, I don't know, right? Fine,I don't know, right? Yeah, but
(11:53):
you know, remembering theirfriends names, or just like, oh,
you told me about so and so lastweek. Is everything okay? Or
what's the latest, you know, andmaybe they want to share, maybe
they don't, but the fact thatthey know that you were
listening the first time wherethey were talking about
somebody, I think it means a lotto them that you care about who
their friends are and kind ofwhat they're up to. But it
(12:14):
doesn't have to be like agossipy kind of thing. It's
just, you know, like, Oh, Iremember your friend Sally. You
haven't talked about herrecently. How's she doing
something like that?
Erin Brinker (12:26):
Oh, see, that's good. That's good. I remember,
yeah. And for my son, it waseasier because he would come
home, and my son's on thespectrum, and he would come home
and sit down and do a braindump, everything that he would
want to start the beginning ofthe day and tell me everything,
and my daughter was theopposite. So it's kind of, how
(12:46):
do you how do you navigate that,right? And, you know, everybody
does the best they can and tryto keep that communication open,
and a lot of it. So I know thatwith little kids, it's when
you're when you're talking abouthow their world is shaped.
You're really talking about theparents more than the kids. And
as they get older, they becomemuch more separate as the
supposed as they're supposed to.
But I suspect that when you'rewhen you're dealing with teens,
(13:09):
you're also really have to dealwith their parents. Is that
true? Yeah.
Dr. Ashley Zucker (13:14):
I mean, it's definitely true of all, all
ages, but yeah, it's this, youknow, in in my office,
certainly, it's about reallymaking sure that I'm
understanding where the the teenis out at, sorry, but also
getting their parents kind of onthe same page. So it, you know,
it depends on the situation, butoften it's just kind of helping
(13:34):
their parents sort of understandwhere their kid is struggling,
or potentially why they'restruggling, or just being that
sort of safe space where, youknow, I've definitely been in my
office and had, you know, momand teen yelling at each other,
and I just have to guide themthrough that conversation.
That's a fun part of my job. Oh,my goodness.
Erin Brinker (13:59):
And you know, your hope is that they get all of
that out, they kind of clean outall the noise, and they they
vomit their emotions all overeverywhere, and then they clean
themselves up and they go homeand they're fine, or they're
better, maybe not fun, butthey're better. Yeah.
Dr. Ashley Zucker (14:14):
So I would say, I think the more positive
experiences when you can kind ofput something kind of on their
minds, or sort of plant theseed, so to speak, and then sort
of leave that for them to gohome and talk about. And so a
lot of that is usually around,kind of like what the treatment
plan might be. But I really lovekind of giving that ownership
back to them as a team, toreally decide what they feel is
(14:37):
is best, unless, you know,there's certain circumstances
where you may have to be alittle bit more kind of
directive of that guidance. ButI love the idea of just having
them leave the room with aconversation that I've asked
them to have
Erin Brinker (14:51):
something to think about, something to chew on, so
how much of what you see is.
Maybe mom or dad had significanttrauma in their life. They're
trying to break those chains,those cycles, those negative
patterns, and I just don't knowhow. And they, they're they,
they visit that on theirchildren, because that's how
(15:13):
they're wired, because that'swhat they grew up with. And then
how do you overcome that, thattrauma, while trying to prevent
the trauma, trauma in thedaughter or the son. You know
what I'm trying to ask? It'slike, the intergenerational
stuff,
Dr. Ashley Zucker (15:28):
yeah, well, there's a saying in child
psychiatry that 90% of the time,if you treat the parent, you
don't need to treat the child.
And what that really means isthat we have to make sure that
parents are also getting thehelp that that they need. And so
sometimes that is reallyadvocating for the parent to
also get their own therapy, or,you know, see their own
(15:51):
psychiatrist, and because it'smuch easier to identify that
somebody else needs help, orwhat I can do for somebody else,
right?
Everything that's wrong withthem,
exactly, exactly. Yeah, so. AndI mean, therapy can help
everybody, right? There's no onethat therapy couldn't help. But
(16:12):
I think sometimes when you'rereally seeing some of those
patterns play out, or just notnecessarily even a pattern. But
you know, if I see parents thatare just really struggling with
how to navigate their you know,through life with their child,
then that's often where I'mlike, You really need to make
sure you have your own supportand your own help. It's not just
about getting your child thehelp, but it's also making sure
(16:33):
you've got a safe place, a safeperson to talk to that's not a
friend, not a family member,that you can really process this
with. So, you know, I thinkthat's a huge part of it is just
making sure that parents alsohave the supports in place for
themselves, and that we're notjust solely focused on the
child. Because sometimes thatcan make all the difference.
Erin Brinker (16:56):
I have to think, yeah, I'm sure it does. I mean,
you can't give what you don'thave, and you can't pour from an
empty cup. And so if there'snothing filling up, mom and dad
or primary caregiver, whomeverit is or whoever it is, how can
they give what they what theybut they've never seen, or what
they don't have, or what they'venever dealt with and and, yeah,
that's important. So it's reallyabout treating the whole family.
(17:20):
And maybe you're seeing thechild. Are you seeing the child
and the parent together? Andthen the parent getting support
elsewhere is also important too.
So that's a good point. So let'stalk about expectations. So
unmet expectations in any familydynamic is a lot, is a lot of
where the friction points are,where you expect somebody to
behave a certain way or do acertain thing, or get the
(17:42):
certain grades or get thecertain promotions, or, you
know, this is not only withkids, but with adults, and they
don't, and that's where thingsstart to rub right? So what kind
of expectation setting and doyou have those conversations
when you when you're treatingyour patients?
Dr. Ashley Zucker (17:58):
Yeah, I think it's, I mean, it's a really
tricky one, because especiallywith our kids, right, we put a
lot of expectations on the do.
So that one's reallychallenging, but we also have to
understand what's possible, andmaybe some things are not. And
so in a certain space, some ofthat is about like us as parents
or as adults, kind ofaddressing, or sometimes even
(18:22):
grieving the loss of what ourexpectations were for our
children. And that sounds reallynegative, and it sounds really
hard, and it is, but sometimesit's their reality, right? You
know your your kid doesn't andit can be something like your
kid doesn't love the sport youwanted them to excel at. It
doesn't have to be somethinghuge and tragic, but sometimes
(18:44):
that's still a loss for you as aparent. And so I think it's one,
understanding that parents maybe grieving something through
the process, but two, alsohelping them to recognize the
things that are the strengths oftheir child, what their child is
good at, but also just beingrealistic too, right? So maybe,
if it's about grades, right,maybe your kids are performing
(19:08):
as well in school as you'd likethem to, you know, kind of
trying to figure out, Is thereanything that I could be helping
with? Are there any additionalsupports they could do? Are you
connecting with the school, withtheir teachers, to see if their
teachers are recognizingsomething in particular. And so
just kind of, again, it's thatcheck in with your kids, and
(19:28):
it's not the like helicopterhave to know everything about
you, but just like, Hey, I sawyou. Know you didn't do so great
on that last math test. Wasthere anything in particular,
that made that one harder thanusual, or, you know, things like
that, where you're just sort ofshowing that you're concerned
and you care and not thatyou're, you know, punishing
(19:48):
them. Or like, Well, that wasterrible. Why didn't you do
better at that? You know, thatdoesn't feel very good.
Erin Brinker (19:57):
What's wrong with you idiot? Right? Oh, probably
not the most constructive way toapproach it, exactly. So there
was a movie that came out latesummer, early fall, actually,
not that long ago, called thesenior. And it's about this,
this guy, this football player.
He was, he's in his late 50s atthe in the movie, but when he
(20:18):
was in college, he was afootball player. And through
that, you're getting flashback.
Flashbacks of how he wasparented very, very harshly. And
he he had gotten into fights,which his father encouraged. He
had gotten into fights when hewas a senior in college and
gotten himself bounced out ofschool, kicked out of school,
and kicked out of the footballteam, off the football team in
West Texas. And he's going backto a reunion. He hasn't seen
(20:41):
everybody in 30 years, or 40years, whatever it was, and they
all joked that he had anotheryear of eligibility, and he
thought, Well, I wonder if Icould go play. And he did. He
went and tried out for his team,and he ended up playing as a 57
year old on a college footballteam in Texas. It's a true
(21:01):
story, and through that, you sawthis dynamic, both with his
father and not meeting hisfather's expectations. His
father's very, like I said, veryharsh. But also, his son wasn't
a football player at all. He wasthis creative guy, and how they
kind of are starting to figureit out. I don't want to give too
much, but if you haven't seenthe senior. It's an excellent
(21:21):
movie and and does expectationscolliding? Every family deals
with that at some level. I knowour family, did you know?
Because you think your kid, I'mgoing to do these things with my
kid. I'm going to have a boy,I'm going to we're going to do
these things together. I'm goingto have a girl. She's going to
like the things I like. Well,not necessarily. She's a wholly
different person.
Dr. Ashley Zucker (21:42):
Yeah, yeah.
Sometimes it's also I recognizethis with my own kids. I'm like,
I want them to like something Ididn't like and they don't like
it either.
Erin Brinker (21:51):
I want you to be able to paint because I can't
draw a straight line.
Dr. Ashley Zucker (21:57):
I'm like, Well, I guess you are my kid. So
Erin Brinker (22:02):
that's funny, yeah, my daughter, when she was
really little, she really wantedto play the violin. I'm like,
Okay, you have to commit to itfor one year. One year she was
six, we bought her a littleviolin. She hated it. She hated
everything about it. We made herstick to it, because that was
the deal. And, you know, she hadlessons once a week. It wasn't
that bad, but, but then she,after that year, she's like, I'm
(22:24):
done, I'm out, you know? And wason to the other thing. And I so,
I love stringed instruments. Ican listen to string instruments
all day long. And I thought thatwould be so exciting. But no,
that was not for her, exactly.
So let's talk about, you know,the holidays and and
expectations of the holidays andall the different family
(22:44):
dynamics and family stresses andkind of how to take care of
everybody during that window oftime.
Dr. Ashley Zucker (22:54):
Yeah, I mean, I think that last part that you
said is probably the first thingI would pick up on, which is,
how do we take care of everybodyat that time? It's not our job
to take care of everybody atthat time.
Okay, well, I would say thatgreat.
(23:14):
I you know, I think it'sunderstanding where, where
you're at, what you have togive, what you need, right?
Because everybody around youtrying to give to but also
recognizing that we have to berealistic, right? You're not
going to be able to doeverything for everybody, and
you may have to pick and choose.
You know, what you can and can'tdo. You know, be realistic about
the amount of time you have whatyou can offer.
(23:40):
Yes, right,exactly, right. But know that
it's, you know what? I'm just sobusy right now, I just don't
have time to help out with Xevent. But you know, I'd love to
be first on the list for nextyear, something like that,
right? So I guess that would bemy number one advice for the
(24:00):
holidays, is just recognize yourown limits. And yeah, that it's
not your responsibility to takecare of everybody. You have to
take care of yourself first, andthen what you have, you give,
you know, and what you don'thave you don't have, you don't
that's okay,
Erin Brinker (24:19):
yeah, you know it reminds me of I know women, many
women like this have been somein my family where they putting
on the perfect spread with thePerfectly Decorated home, and
everything has to be perfect,and the food is delicious and
the home is beautiful, but Butthe person who wants that
perfection is exhausted andcranky and yelling at everybody
(24:39):
and nobody wants to be aroundthem, right? So maybe, maybe put
on a few fewer decorations andget takeout, and everybody will
enjoy themselves
Dr. Ashley Zucker (24:49):
exactly.
There you go.
Or if you you're not thatperson, right? That's setting
everything up and makingeverything perfect. It's saying,
What can I do for you? Right?
Can I do the dishes? Can I cleanup for you? Or maybe, can I
bring X dish so you don't haveto worry about all of it, right?
Because, you know, whatever yourrole is, where can you kind of
lean in in a realistic way andmaybe take some pressure off of
(25:13):
somebody else too? But again,we've all got our own pressure,
so we've got to find that
Erin Brinker (25:19):
balance we do, we do and give each other space to
be human, yep. So, so what aresome trends that you're seeing
in in your office, with peoplecoming in, or that you've read
about, things that are happeningin the interpersonal space and
the mental health space? BecauseI know it's been, it's been
(25:40):
changing a lot over the years.
Dr. Ashley Zucker (25:43):
Oh, that's hard to say. I mean, some of it
doesn't change at all, right?
It's just the social dynamics ofbeing a teenager. It might play
out a little bit differently,but I think those things are
still there, certainly, youknow, things like people being
challenged with bullying. That'sstill a very common I think what
that looks like might be alittle bit different with, you
know, like social media andstuff like that, but the the
(26:05):
impact that it has has alwaysbeen there. So I think some of
those patterns are very much thesame. I think about, you know,
for teens, and this is part ofwhy I really love working with
teens, is, is that time of lifewhere you're just trying to
figure out who you are, andthat's really challenging to
navigate, and you're trying tofigure out who you are for
(26:26):
yourself, but also trying tomanage, I guess, those
expectations of your parent andthat maybe you're not who they
think you are, who they thinkyou should be, those are
Definitely some, somechallenges. I think, you know,
school performance, that's a bigone that we see for sure. You
know, I think the world is avery, very stressful place. So
(26:48):
certainly you see some of that,you know, play out and in what I
see in in my office. But, youknow, I think also, it's not
like there was ever a time wherelife or the world wasn't
stressful. It's just what itlooks like changes. So I try to
keep that perspective as aswell.
Erin Brinker (27:08):
You know, it used to be that all of the scary
stuff would be on the nightlynews from at six and 10. Now
it's in the palm of your hand,24/7 and so, you know, and and
the rage bait. It's reallysomething because I, you know,
will be on x, and I don't reallypost very much, but you know,
the stuff that people post, youknow, this horrible thing has
(27:30):
happened, but you don't care,nobody's going to comment. I
mean, so everything ismanipulated to make people feel
bad, and that is a reallytwisted way of existing. But it
seems to be how, how somemarketing is done in this era.
It seems to be how news is toldin this era. And that has to
have an impact on teenagers. I'man I'm a full grown adult, and
(27:50):
it bothers me. And so for them,I have to imagine, it's
overwhelming.
Dr. Ashley Zucker (27:57):
Yeah, no, absolutely, you're absolutely
right. I think what's so, youknow, difficult with, I guess I
would say social media inparticular. Are these like
algorithms that, you know, getget created that we don't
necessarily have control over,and so we get fed stuff that we
weren't necessarily looking for,that they think will grab our
(28:17):
attention and keep us kind ofwrapped in and unfortunately,
there's a lot of stuff that'svery negative that is utilized
in that kind of manner. Butthat's also not to say that,
like all social media is bad,or, you know, all you know, news
or entertainment is bad, I thinkit's about one moderation. But
to, you know, really trying tofind the things that actually
(28:40):
bring you joy. There's a lot ofreally great stuff on the
internet and on social media,and so if you can really try to
manipulate your own algorithm
Erin Brinker (28:49):
exactly, be intentional about it, yeah,
because one one afternoon ofdoom, scrolling could wreck your
whole algorithm.
Dr. Ashley Zucker (28:59):
Absolutely, absolutely, yeah, it's also, you
know, like, I think of don'tfollow things that don't make
you feel good, right? Or maybeyou follow like, one, I don't
know, I don't want to say onemedia source, because then
you're only getting one mediasource. But maybe only follow
one negative thing and the restare positive. Or for every like,
(29:20):
one media outlet you follow, youfollow 10 funny dog video people
you know exactly.
Erin Brinker (29:28):
If you're if your feet is full of baby goats and
cats and dogs, you're probablygoing to be just fine, right?
Exactly. So I did see, there's anew trend that I saw yesterday
on Tiktok that that what theycall raw dogging life, or raw
dogging boredom. And so they'lljust sit there with nothing, and
they'll time themselves justkind of sitting there. And I
(29:50):
thought, you know, it was thosein between spaces where real
creativity happens, right? Sothat's where, you know, it's out
of boredom that great. And.
Novels are written. It is out ofboredom that beautiful music is
written, because people are leftto just think. And I think that
if, if that trend really catcheson, what a beautiful thing. If
we're if we're consuming 24/7,then we don't have any time to
(30:13):
create, and we don't have anycapacity to create. And I worry
that our brains will lose theability to create. I don't know
what your what your opinion isabout that, but that's my
theory.
Dr. Ashley Zucker (30:26):
Well, I think the the irony of social media
trending, not doing anything isgreat. Yeah, I think, I mean, if
you think even about yourself,right? If you're kind of sitting
there for even a second. Well,one you've got like, your to do
list going through your head,right? But what's like? The
(30:47):
first thing you do like, youpick up your phone, you scroll
through social media, or you dosomething or right? You're like,
you don't even let yourself bebored. So how are our kids
supposed to know how to navigatethat, you know? So I do think
it's important that we all kindof, you know, have those moments
where we really turn things off,put them away, put them aside,
(31:09):
and really try to engage in thenon electronic world around us,
so to speak, and go for a longand, yeah, exactly, go for A
walk, do some coloring, youknow, I don't know, dig in your
backyard Exactly.
Erin Brinker (31:26):
Pick up, pick up that guitar that's been
collecting dust
Dr. Ashley Zucker (31:29):
in the corner. Yep, yep, exactly. So
let's
Erin Brinker (31:33):
talk about the, you know, what? What the How
bright, how people's brains areare have changed with the advent
of social media. And so, youknow, I know that all of this
impacts how brain wiring, right?
And I'm not a neuroscientist.
Don't pretend to be, don't evenplay one on TV. But I, I know
that it has an impact,especially for young people. And
(31:54):
are you seeing that, that howpeople think is different, how
how they approach life isdifferent, how, you know,
they're just all of it isdifferent because of the advent
of of this ubiquitous devicethat we've been holding in our
hands since 2007
Dr. Ashley Zucker (32:13):
I think the the most common thing that I see
is that it's really impacted ourattention span. And I see that
even my myself, you know, it'slike you're just sort of
constantly seeing somethingdifferent or right? It's all
these, like, short, you know,32nd videos, or whatever it
might be. And so it's just a lotof information always coming at
(32:35):
us in short bursts. And so Ifeel like our brains just sort
of get used to that pattern, asopposed to more extended periods
of, you know, focus andattention. And so there's
definitely a trend, not justwith with kids, but certainly
with adults, of, you know,complaining about concentration
(32:55):
and focus issues. And I have tothink that some of it is just
also that the way we're workingwith the world right now is not
helping us, you know, build nosustained attention. It's not,
yeah, I think that's probably, Imean, I can't say like that.
We're definitely seeing thisthrough X, Y and Z, you know,
(33:19):
study or things like that, but Iknow that there is some evidence
that does suggest that there issome change in just duration of
attention span over the lastseveral years to decades, where
we're seeing that people arejust sort of, I don't know that.
It's not the ability to focus,but that's just not our pattern,
or we're sort of craving that,like constant flow of change and
(33:42):
information, because that's whatwe're used to.
Erin Brinker (33:45):
I wonder what that does to our capacity to do hard
things. And I think about, youknow, people to get and I'll use
doctors as an example.
Obviously, you know thisexample, well, the classes that
you have to take to get into theundergraduate program are all
the hardest classes. And thenyou get into the undergraduate
program, you're taking organicchemistry and chemistry and
(34:06):
biology, etc, etc, etc, andthat's hard. And then you go
into medical school, and thenyou have an internship, and et
cetera, and on and on. All ofthat takes concentration. It
takes discipline, and it takesthe ability to work through
something that's really hard,and are we? Are we hijacking or
our kids? Are maybe not we, butyeah, we, as a culture,
(34:27):
hijacking our kids brains sothat they don't have the
capacity to do that.
Dr. Ashley Zucker (34:35):
I hope we're not but, I mean, I think it's
yes and no, right? I think thereare some things where it just
sort of depends on the likeamount of time that you're
spending on social media or evenon things like video games, and
so it's sometimes about likequality, not quantity type of
(34:57):
thing, right? So again, I don'tlike to say that all. Social
media is bad, or all videogaming is bad. I think there's
actually some skills that youcan can build through utilizing
those things that might actuallyhelp throughout, even if you're
taking those hard classes or,you know, trying to really apply
yourself. But it's also thatability to really know when you
(35:17):
need to turn it off that Ithink, is, like that key piece
that we have to hold on to,like, how do you really say I'm
gonna go do this or play thisgame for an hour and then I'm
gonna stop? I think that'sthe hard part. Yes, yeah, yeah.
I think we have to focus on andthat will help us to make sure
(35:39):
that we can do hard things. Butyou know, it's also, I think,
like we were talking aboutbefore, taking that time to
maybe be bored have nothing todo, or maybe taking the time to
make sure you do focus onsomething for a long period of
time, and like reading a book,for example, right?
Erin Brinker (35:58):
You know, I think of there are, there are, there
are faith communities. Andspecifically, I'm thinking about
the Jewish community that theythey turn off their devices.
They turn off everything onFriday night to Saturday night.
And it's just about family. It'sabout connection. It is about
just getting back to what'simportant. And wow, what a great
example I you know, creatingthat kind of a tradition in your
(36:20):
family, whether you call it aSabbath or not. I think is
really wonderful, yeah?
Dr. Ashley Zucker (36:25):
And I think that that may sound like a
really lofty goal for a lot ofpeople, so I think of like, can
you have, you know, one meal aday where there's no phones at
the table? That might be whereyou start, right?
Erin Brinker (36:38):
That's true.
That's true. Yeah? So, well,yeah, so, so what kind of, you
know, we're talking about, aboutsetting boundaries and, and, you
know, we exist in this veryconnected world, so you have to
be connected if you want to toexist and engage in this world.
So how do you set thoseboundaries and, and if you
didn't do it when they werefour, can you still? Can you it?
(36:59):
Has you? Have you lost thewindow at 11 or 14?
Dr. Ashley Zucker (37:04):
Well, no, you've never lost the window.
But I think for many things,it's, I guess, well, what I will
say also, and I say this toparents of like newborns too,
especially when they asked aboutthings like sleep training, just
as an example, right? It's likeyou're going to have to put in
the work at some point. Do youwant to put in the work now? Or
(37:26):
do you want to put in the worklater? So I don't think you're
ever like beyond the point of noreturn. I do think it happens a
little bit faster the earlieryou sort of set those
boundaries, those expectations,but I can't say it's easy at any
time, you know. So I think it isimportant.
Erin Brinker (37:47):
It's about doing it yourself, too. I mean, when
they're really little, you'renot really disciplining them,
you're disciplining yourself,which is really so sorry.
Dr. Ashley Zucker (37:56):
I didn't mean to interrupt.
No, no, no, that's so true,though. But yeah. I mean, I
think, you know, you see it playout, like with teens and stuff
around, like the cell phone,right? So they don't sleep
because they're up all night ontheir phone. Okay, we'll take it
away. But I can't, they getreally upset. It's like, okay,
well, you're gonna have totorture yourself and them. So,
(38:18):
yes,
Erin Brinker (38:19):
yes, yeah, because you want them to grow up to be
fully functional, fullydeveloped adults. And sometimes
that job is terrible. A lot oftimes when, especially when
they're teens, and they'rethey're, you're, you're, you're
embarrassing them by existing,and you're making rules that
they don't like, but theysecretly do like because they
(38:41):
need the boundaries. It's justthey're pushing back against
them. You know, they get past 25and they recognize that that,
Oh, Mom and Dad weren't stupid.
Oh, right for this, parents whodon't know when your child hits
about 11, they're gonna thinkyou're an idiot, and it's okay.
It's normal.
Dr. Ashley Zucker (38:57):
What do you know, Mom,
Erin Brinker (39:00):
what do you know exactly? Exactly? I actually
have to tell you story. I was ata family event, and there was an
uncle there, and we're standingaround a a bonfire, or it was in
a it was in a container. But myI said something to my daughter,
I remember what we were talkingabout, and I gave her some
(39:21):
advice, she goes, No, Mom,that's not right. And this uncle
who was standing there gave herthe same advice, like, not three
minutes later, oh, that's reallygreat. I think I'm going to do
that really.
Dr. Ashley Zucker (39:33):
That's actually my role. A lot of the
time, parents will come in andbe like, can you talk to them
about this, because they won'tlisten to me.
Erin Brinker (39:44):
Oh, that makes sense. That makes sense. So, so
let's switch gears a little bitand talk about, you know, mental
health is, is has been on thefront of people's minds for the
last few years. People aretalking about it. They're being
open about it. People make.
Videos about their diagnoses,whatever those diagnoses are.
And a lot of people think theywant to go into the mental
(40:04):
health field, whether as apsychologist or psychiatrist or
some other kind of practitioner.
What would you what advice wouldyou give to a young person who's
considering that?
Dr. Ashley Zucker (40:16):
Ooh, well, I think the first thing I would
like say is that there's just somany ways to get into it. It can
look so many different ways tobecome somebody in mental
health, right? So like you said,there's just a lot of options
about what that could could looklike. So I think it's about sort
of exploring and evenunderstanding all of the spaces
(40:39):
in which, you know mental healththings exist. So I think the
things we think of the most aretherapists, psychologists,
psychiatrists. But there's a lotof other opportunities out there
too. I think there are somepeople that really, really love
the concept, but then when theykind of get that sort of actual
(40:59):
involvement in mental health,it's something that they feel is
too much for them. So that'salways one thing that I think
about, too, is it's good to, youknow, try to get some experience
wherever you can, although Iwill also say sometimes getting
experience in mental health isreally difficult because of the
sensitivity of it. It's not likeyou can just go shadow or do
these types of things. But ifthere's, you know, if you're in
(41:22):
in high school and there's likea peer support club or something
like that, I think those are theways to, you know, kind of get
involved and sort of see, do Ilike actually doing that? But I
think, I guess, I think back towhen I was in medical school, I
had a really good friend who wasincredibly caring,
compassionate, very sensitive,and when she did her rotations
(41:44):
in psychiatry, she just couldn'thandle it. She was like, this is
just so hard. I can't live likethis, right? And so for her, it
was recognizing that like, eventhough, in theory, that really
sounds like it fits with her andher personality, it just wasn't
something that she could reallynavigate through, and so
recognizing that too. So that'swhere the experiences is
(42:05):
helpful. Unfortunately, you dohave to be able to separate a
little bit some of the reallydifficult stuff you have to deal
with in mental health, and makesure that you're not carrying
the weight of all of that all ofthe time. And so that's just not
for everybody. But again, that'swhy I think it's so important to
recognize that there are otherways to be involved in mental
(42:26):
health that might look a littledifferent than just sort of
those traditional, you know,methodologies. But I think the
biggest thing I would say isthat, you know, being in some
type of peer support, type ofprogram, no matter what age you
are is probably the best thingthat we can do, also not just
for our own like experiences orinterest, but to help one
(42:47):
another, because we'll neverhave enough therapists. We'll
never have enough psychiatristsfor everything that everybody
needs. And so where can wereally fill in those gaps with
just each one of us having alittle bit of a better
understanding of how to supportone another. To me, that's like
the best opportunity we have.
Erin Brinker (43:05):
So you might get in and I I'm one of those where
I really wanted to be in mentalhealth. I really did. And
several times over the course ofour marriage, I've been married
for 31 years, my husband's like,Erin, you would take everything
home. Every single patient wouldbe on your mind all the time. It
would eat you alive. It's like,okay, so what can I do? I can be
(43:26):
a mentor. I can be a coach. Ican be I can volunteer to work
with youth, and all of thosethings I do, and I love them.
And he was right. And you haveto understand where your
boundaries are and your capacityto create boundaries. And if you
can't do that in a healthy way,then that that job will kill
you.
Dr. Ashley Zucker (43:45):
Yeah, no, definitely. Opinion,
yeah, no. And I think you knowit's it goes each way, right? So
I think about like, I love beinga psychiatrist. I love working
with kids. I love working withadolescents. But if you asked me
to be a teacher in high school,elementary school, kindergarten,
no way. I don't know howteachers do it. I give them so
(44:10):
much credit, but you know, andso it's just finding your space,
right? I love kids, but I cannotbe their teacher,
Erin Brinker (44:17):
right, right? We all have our gifts, yes, yes,
that's that's very, very true.
So for those of the for thosepeople thinking maybe they're
they're heading into medicalschool, and they're considering
psychiatry as a specialty, and Iknow that you kind of are asking
yourself, what do I want to doall the way through? I would
imagine, you know what? Howwould you tell them to? How
(44:40):
would you have them order theirtheir learning in a way that
favors psychiatry?
Dr. Ashley Zucker (44:49):
Ooh, that's really difficult. I mean, when
you're in medical school,certainly you're getting
exposure to, like, all of thedifferent specialties. And I
think that's critical, no matterwhat you do, right part of the
like. Joy of medicine, to me isthat we know so many things
about other things outside ofour specialty, but then we do
get to kind of focus in onsomething in particular. So I
(45:11):
would say, first of all, don'toverlook the other things that
are outside of psychiatry,because they will make you a
better psychiatrist in the longrun. So that would definitely be
one, next one piece of it. Andthen I think it's about the
variety, like the, you know,especially, I always, one of the
things I love about psychiatryis that it's one of the, you
know, kind of under developedspecialties. And so there's so
(45:35):
many new things, like constantlycoming out. And so there's so
many ways to look at it. And youcan say, you know, whether
you're in the outpatient spaceor you're in the more acute
space, inpatient, the emergencyroom. But there's also all of
these emerging technologieswithin psychiatry which are
really, really exciting to beinvolved in. And so again,
(45:55):
there's just so much variety,and making sure you kind of get
a little bit of all of that tosort of see, you know, what
excites you or maybe you don'tlike it. That's okay too.
Erin Brinker (46:05):
Yeah, you know, yes, because you may get in
there like, oh, I don't likethis at all. I didn't think I'd
be doing this much instatistics, yeah, if you will,
Dr. Ashley Zucker (46:15):
exactly, exactly, well. But I'm really
grateful for a lot of the thingsthat I learned and did outside
of psychiatry, and I reallystill utilize those today. So
that's why I always think it's,you know, you don't want to get
so lost in the weeds of onething that you forget to, you
know, learn the other thingsaround you.
Erin Brinker (46:34):
Well, that's excellent. That's excellent. So
what are some things going on inKaiser Permanente surrounding
psychiatry, psychiatry andpsychology and and what are,
what? What's on the horizon forKaiser?
Dr. Ashley Zucker (46:46):
Oh, boy, that's like, where do you start?
I mean, there's so many piecesagain. I think one of the one, I
guess, a place to start is whereyou start, right? So one thing
that I, you know, truly believein, and I know has always been a
huge focus for KaiserPermanente, is really in that
(47:07):
preventative space, right? Sohow do we keep you healthy? How
do we prevent you from, youknow, actually needing more
intensive care? That's our goal,right? We want to help you be,
you know, be the best you can beearly on. And so I think it's
about that, like earlyidentification, early
intervention. So there'sdefinitely been a large focus on
(47:29):
on that. So the earlyidentification and that you know
is taking place when you seeyour primary care doctor or your
pediatrician, right? They'reScreening for Mental Health
concerns. But there's also somany offerings that are
available that you know, youdon't have to come into
psychiatry or addiction medicineto access a lot of those
resources and services. So youknow, whether it's the
(47:51):
utilization of we have certainapps that we like to to offer to
partner with, but one resourcewhich is really great and
actually available for non KPmembers too, is that we have a
lot of mental health webinarsthat are available through the
website that kind of go over avariety of topics. Some of them
(48:12):
are actually teen specific,like, there's some parenting
ones, so I'll plug those.
There's some about like anxietyand work stress and and it,
there's just a ton of them thatare really there. So it's also a
great place, or a great resourcefor people who are, one, just
kind of looking for that sort offirst step. But two, I've
(48:32):
actually used those a lot withmy own patients who are very
hesitant about like, gettingmore into therapy. It's sort of
dipping your toe in the water ina more safe series, because
it's, yeah, it is. It's like, Idon't know what that's going to
be like, or that feels verypersonal or invasive. And so
that's a very safe space to kindof enter and start to learn some
of the you know, skills andstrategies and ways of managing,
(48:55):
you know, your mental healththat I think are really, really
important. So I think thatupfront focus is huge, but we
also have to have the fullspectrum of care, right? So yes,
we want to keep you healthy, butthat doesn't work for everybody,
right, right? And there are somethings you just can't avoid.
Your genetics are just going totake over. And so making sure
(49:16):
that we have kind of all ofthose layers of care throughout
and so again, having a, youknow, robust psychiatry
department where you can get theindividual therapy, the group
therapy, the medicationmanagement, kind of all of those
components. And then if itescalates beyond that, like, how
do we make sure that we connectour, you know, our patients, our
(49:37):
members, to those services, andreally try to track them
throughout that, you know, kindof continuum of care is what we
call it. So, you know, if, for,you know, whatever reason,
unfortunately, one of ourpatients ends up in the
hospital, making sure that wehave them come, you know,
directly back into the system,so that we can make sure that
they have all the resources thatwe need. So I. Think that kind
(49:58):
of care management throughouthas been just a really, you
know, strong component of whatKaiser is able to do with our
integrated system. But I thinkalso what people don't always
think of is we kind of touchedon it a tiny bit, is like all
the kind of innovations that arehappening within psychiatry and
so really, you know, the focuson incorporating those and
(50:21):
making sure we have thoseaccessible to our patients, you
know, has been something that'simportant to us. So it used to
be, you basically hadmedications or ECT, right? And
ECT is the stuff movies are madeof, literally. And ECT is
actually a wonderful treatment.
I've seen some really amazingthings happen with ect. So I
(50:43):
don't want to give it a bad rapat all, but there are a lot of
things that people, I think aremore comfortable with, like TMS,
which uses magnets instead ofelectricity, and so being able
to offer those services. Yeah,yeah. So that's a relatively new
one, I guess in the last, Idon't know, decade or so, so not
like yesterday, new but, butyeah, it's been kind of the the
(51:06):
sort of replacement for ECT, ormaybe the first step before,
kind of getting to ect. So feelsless kind of scary to people.
Erin Brinker (51:15):
So I know that, you know, if you if you grew up,
and we'll just say lots offamilies have lots of trauma
that's been around for a longtime, and unpacking that in an
hour, and then having to pack itall in and go on with your life
for the week until you can comeback, that's a little scary. And
you know, people need to haveways to connect beyond that that
(51:39):
that one appointment, becauseyou need support. Once you start
unpacking, maybe that wound,well, it's open now, and and how
do you deal with that in aconstructive way? And do you see
that kind of happen in your inyour treatment?
Dr. Ashley Zucker (51:53):
Yeah, I mean, I think that's part of the
process of therapy too. Is likeyou don't want to make or you
want to make sure that somebodydoesn't leave your office like
an open wound bleeding out intothe universe. So you want to try
to get them to a better placebefore they exit. But I think
it's also about really, youknow, empowering people with the
skills and the strategies tomanage how they're feeling. And
(52:16):
so you know that that sort ofold perspective of you go into
the psychiatrist or thetherapist, and you lie on the
couch and you pour your heartout, and then you walk out the
door, you can still do that, butyou know, a lot of the focus
over the years has really beenon, how do we make sure that
we're equipping you with how tonavigate and manage what comes
(52:37):
up next, right? Because we'renot going to stop you from ever
being sad or ever being anxiousever again, but really equipping
people with the skills and thestrategies to do that. So I
think that's one big piece thatI always like to think about, is
like, what's something I cankind of give you to take home
and use, and then it's alsobeing able to utilize some of
the great technologies that wehave, like apps, right? So that,
(53:00):
you know, maybe you don't have atherapy appointment, or you
don't have access to somebody inthe moment and you're having a
panic attack, for example, canyou pull up some resources on
your phone that you can use? Youknow, are there other
strategies? Or, you know,there's even, like, those apps
that you can you can text with arobot or AI. And I know that's a
whole nother Hot Topic typicallydesigned for it. So I'll say
(53:26):
that very adamantly, they arecreated to help and program to
help with mental health, asopposed to some of the more
generic ones, which we've heardsome terrible, you know, news
stories about, but also thingswhere we like we have some
programming or some apps thatyou can use, that you can
actually do, like live textingwith a like a coach, right? So
they may not be a like atherapist level professional,
(53:48):
but they have enough of thatkind of education and training
to kind of guide you throughthat moment until you can get to
that next appointment, you know.
So I think those are some of thegreat things that we can kind of
incorporate into our practice.
Well.
Erin Brinker (54:02):
Dr Ashley Zucker, as always, this has been a great
conversation. This time has goneby so quickly. How can people
learn more about KaiserPermanente, the mental health
services at Kaiser Permanente,and make an appointment with a
clinician? Yeah.
Dr. Ashley Zucker (54:16):
I mean, the best place to go is kp.org, and
you can see all of it there. Alot of our mental health
resources are available right onthat kind of home screen, but
you can also search for, youknow, just mental health, and
you'll be able to find all ofthose resources, how to make an
appointment, access to some ofthose webinars, like I was
talking about. But another greatthing that I always remind
(54:37):
people of is you can alwaysstart with your primary care
doctor, a lot of them, really,really can start you off in
treatment, and if they need to,then they can, you know, send
you on to psychiatry. But theyoften have access to a lot of
resources, and you know, knowhow to start that treatment
process and take care of youtoo. So it doesn't have to be in
(54:58):
psychiatry. It can be with yourprimary. Care doctor as well,
wonderful.
Erin Brinker (55:02):
Well. Thank you very, very much. Happy Holidays,
and I hope to have you on againnext year.
Dr. Ashley Zucker (55:08):
Yeah. Thank you so much for having me back.
Erin Brinker (55:13):
Thank you so much for joining us today. I'm Erin
Brinker, this has been the hopetable, and you can listen to
this on terrestrial radio inInland Southern California on X
95.7 Sunday mornings at 9amthat's X 95.7 in Inland Southern
California and wherever youdownload and listen to your
(55:34):
favorite podcast, Apple Spotify,etc, again. Thank you so much
for joining me. You've beenlistening to the hope table.
Have a great week. You.
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