Ep. 33 – Dr. Dzung Vo – The Mindful Teen
- The delicate dance of the parent-teen relationship.
- Dealing with stress as the root to most mental and physical health concerns.
- Kindness and compassion (for self and others) through mindful practice.
In this episode of Family360, pediatrician and adolescent specialist, Dr. Dzung Vo, describes ‘stress’ as a root cause of mental and physical health during teen years.
“Adolescence is a time when our kids need us the most,” says Dr. Vo, yet, while we try to help them manage stress, it can feel like they resist our care. In this interview, Dr. Vo explains the delicate dance between parents and teens; how we can take the lead without stepping on their toes. He also shares from his impactful book The Mindful Teen (impactful for all ages!) with principles and practices that welcome stress to fuel our resilience rather than rule our reality.
Dr. Dzung VoDr. Dzung Vo works in the specialized field of adolescent medicine. He’s a professor at the University of British Columbia, and a pediatrician at BC Children’s Hospital, where his medical practice promotes restoration and resilience in young people, helping them thrive in the face of stress and adversity.
To address the growing needs of teen’s who struggle with chronic stress, chronic pain, depression and anxiety, Dr. Vo wrote The Mindful Teen that has been endorsed by mindfulness leaders such as Tich Nhat Hanh and Jon Kabat-Zinn.
Website: Dr. Dzung Vo
Facebook: Dr. Dzung Vo
Twitter: Dr. Dzung Vo
Instagram: Dr. Dzung Vo
LinkedIn: Dr. Dzung Vo
Transcript: Dr. Dzung Vo – The Mindful Teen
Rachel Cram – Welcome Dr. Dzung Vo, to this conversation,
Dr. Dzung Vo – It’s a pleasure to be here.
Rachel Cram – We’re so glad to have you at the studio. I’ve spent the last weeks immersed in your work and your book The Mindful Teen, and as a parent of teens myself I’m so eager to jump into today’s conversation, but as in introduction, would you mind giving a little bit of description? What is it that you do?
Dr. Dzung Vo – I’m an adolescent medicine physician. And what that means is I’m a pediatrician and I specialize in the teen years with teens who face all kinds of health problems including mental health issues, and how are all of these things fitting together into the context of their family, their social situation and how can I help them to be resilient to reach their full potential and to thrive into adulthood. So that’s really what Adolescent Medicine is about.
Rachel Cram – Do you get people asking you, “Why teenagers?” because I think a lot of people are kind of intimidated or fearful of those years.
Dr. Dzung Vo – All the time. It’s true that many adults are nervous around teenagers and I think that’s really unfortunate because I really love teens. I find it such an enjoyable population to work with. I think it’s a tremendous opportunity. Teens, they’re really figuring out, Who am I? And they’re also figuring out How can I handle stress? How can I handle these strong emotions that I’m experiencing right now?
And they’re tremendously creative, they’re tremendously honest. And if we can really connect with teenagers and help guide them in a positive direction then they can really develop lifelong habits and skills that will help them to be healthy, help them to cope with stress and help them to be contributing adults in society.
So I really see it as a fantastic opportunity but it’s also a tremendous amount of fun because teenagers, they really tell me what’s on their mind. They have a really great what I call a B.S. meter where it’s just about being authentic with them, being real with them, being human with them. They don’t care how many degrees I have or what the certificates are on your wall or the letters behind your name. They care, are you really being real with them. And for me that’s a real gift, a real privilege that I can just be honest, authentic and human. You know of course bringing in my professional skills and my knowledge and all of those things but also connecting with them on a human level. I think it’s tremendously rewarding and a lot of fun.
Rachel Cram – Well, I’m sure that’s a big part of why you are so good at what you do. I like to start conversations with a question about your background to learn more of you. And I’m going to change the question a bit because of your work with teens. I’m wondering, Dzung, is there a story or experience from your teen years that has shaped the person that you are today?
Dr. Dzung Vo – Yeah I’d like to share about two really important people who influenced me during my adolescence. So the first person was my father and he was a Buddhist from Vietnam, our family is from Vietnam, and so he introduced me to a Zen master named Thich Nhat Hanh. And when I was a teenager he would talk about him and he would introduce me to meditation and chanting and things like that. And to be perfectly honest I wasn’t really into it. In fact just like many teenagers I rebelled. I pushed back against it. I thought it was kind of boring. But when I look back now, I saw that that was a really important experience because it really planted those seeds. And later in my life, I was much more ready to embrace them and to explore my own path.
The second person was my high school guidance counselor. His name was Roger Messier. And I went to high school in North Carolina in a boarding school. And Roger also was a meditation practitioner. He didn’t talk about it too much but he more showed it. And I remember thinking, “You know, whatever it is that he’s doing to have that quality of presence, that calmness, I want to learn about that. I want to check that out.” So those were two really important people in my life as a teenager.
Rachel Cram – Well, as adults, we can wonder what exactly are kids picking up from us and you don’t always know for sure. So, what a legacy these mentors offered you Dzung.
So with your experience of mindfulness you started from Buddhism and your teacher but I know from your book you don’t see that it has to be rooted in a religious practice although it certainly can be. Can you describe your understanding around that a little bit more?
Dr. Dzung Vo – Yeah. So for me personally I was introduced through the Buddhist practice and some of the most influential people who brought mindfulness into western medicine, into Western healthcare, I’m thinking about people like John Kabot Zinn from the University of Massachusetts who developed mindfulness based stress reduction. He was very much influenced by Buddhism, by people like Thich Nhat Hanh. And what he did was he translated it for a Western audience and for a specific application in health care for people who were dealing with very difficult health conditions. And he made it something that was universal that anyone could approach.
The way that we teach it certainly does have historical influences in Buddhism and I think it’s important to honor and acknowledge those roots. But at the same time you don’t need to be a Buddhist to practice mindfulness. It’s really something that we find in every wisdom tradition throughout the world. They may not use the word mindfulness or the word meditation but there are things like that in every wisdom tradition.
And practicing mindfulness doesn’t ask us to believe anything. It doesn’t ask us to not believe anything. What it’s really about is paying attention, very carefully and with a lot of love to your own present moment experience. And I think that’s something that we can all do regardless of our religion.
Rachel Cram – You know it’s so interesting, when Roy and I reflected back on season one, we realized that pretty much every guest we interviewed, talked about the importance of being present as one of the key focuses of their practice. And I think this is just something we’re just realizing in our lives that we need to have that as a focus.
Dr. Dzung Vo – And that’s what mindfulness is about. We all know how to do it but we can learn and strengthen that capacity especially in hard times. And so it turns out that traditions from the east like Buddhism and yoga have developed these really meticulous and effective ways to train ourselves to be more present. And regardless of religion, we can take advantage of the wisdom and experience of thousands of years and apply it to our modern life in 2020.
Rachel Cram – Mm hmm. Well what I love about your book is that it is filled with practices that are very accessible, easy to understand and we’re going to get into that. But you open your book, your beginning line, you say, “Being a teenager can be really stressful.” And you work with teens who experience intense stress. You say depression, anxiety, chronic pain, difficulty sleeping, problems functioning at home and at school. Dzung, is there any one constant root or cause to that stress in teen years.
Dr. Dzung Vo – All of the problems you mentioned are really manifestations of how teens get overwhelmed by stress and it’s different for every teenager. But some of the common causes are school stress, stress in the family, stress in the community. Many of the teens I work with also experience things like discrimination, racism, homophobia. There is multigenerational stress as well, so these are legacies of historical events, for example residential schools in indigenous youth.
So those are the sources of stress and stress brings up strong emotions and uncomfortable emotions. And teens can manage it in a negative way or an unhealthy way, things like substance use, disordered eating, fighting, unsafe sex. And they’re actually quite understandable responses to stress because when someone’s feeling anxious it’s quite understandable to think why they would get high or get drunk in order to feel better for a moment. Unfortunately that just leads to more consequences, that lead to more stress and that can get in a vicious cycle of negative coping and negative stress.
When those negative coping mechanisms become a pattern. That’s when we see things like anxiety, depression, substance use disorders, eating disorders. So what they all have in common is that their unhealthy responses to stress. So, what I want to help young people do is develop positive coping mechanisms.
Rachel Cram – At what point in a teen’s life would a parent step in to approach somebody like you? What would be the warning signs that would let them know that they needed to have intervention?
Dr. Dzung Vo – I think the biggest thing is for parents to really know their teenager and that’s not always easy because teenagers often don’t share a lot with their parents. But I think if parents can show, that they will love their teenager no matter what, unconditionally, without judgment, hopefully the teenager will be able to share with their parent when they’re having a hard time.
The parent can also see it in the way that teenagers are functioning, the way that teenagers are living their lives, especially when there’s a dramatic or unusual change. So a teenager for example who used to love school or used to love sports, or used to love hanging out with their friends and then this year all of a sudden they’re not doing those things. And those are things that I think a parent can ask about, can be curious about, can say, “You know, I’ve noticed these things. Is there something going on? We’re here for you. We love you. We want to help you.”
Musical Interlude #1
Rachel Cram – Often during those years your child that at one time was so communicative and so engaged with you makes a shift into answering with grunts or monosyllabic answers. It can be hard to get a response when you’re trying to figure out what’s going on in their life. But that doesn’t necessarily mean that they are in a place of danger when they’re responding like that. But you can wonder and I guess even worry.
Dr. Dzung Vo – It’s really important for teenagers to learn how to connect with other people their age and learn how to develop relationships with people their age. And so especially in the early to mid adolescent years, so thirteen to sixteen, that seems to be their intensive focus. But I think it’s useful for adults to remember there’s a really good reason for that, because these are the people who they’re going to develop personal relationships with, romantic relationships with, professional relationships and the only way they know how to develop these relationships and communicate with each other is by doing it.
And so that’s a good reason why adolescents are focused on that. They’re learning how to do that. They’re experimenting. They’re growing and it’s a very important skill for them. And also at the same time they need to start to learn how to do things independently and not rely on their parents for everything. And so that’s also why teenagers seem to be turning away from their parents during this age.
It’s important for them to learn how to do things on their own. You know, take the bus, start to drive, start to do activities on their own, take some independence. And so for parents it can seem like the teenagers are turning away but I think it’s important for parents to remember that parents are still the most important people in teens lives, even if it doesn’t look like it, even if the teenager is not saying it. The fact that the parent is there, fully present with the teenager, with unconditional love, without judging the teenager, that is super important. And when the teenager needs them, then the parent will be there for them even if it doesn’t look like it every single day.
Rachel Cram – I think you can be worried that you’ve lost your child forever.
Dr. Dzung Vo – Well there’s no doubt that the teenage years are a time of great change. And the child that the teenager used to be when they were eight or nine or ten is not the same person that they’re going to be when they’re fifteen or twenty or thirty. So it’s difficult for a parent to go through that change. And there may even be a grieving process of the child that we used to know but they need to become a different person. They can’t stay at that same childlike state their whole life. And certainly that time of transition can be challenging. It can be turbulent. It can be difficult but it’s a really important part of growth that parents can help support their teenagers through. And at the same time I think parents can recognize that it’s hard for them too and they can practice some self compassion with that.They may be missing the child who they used to know. They may be worried, like you said, and it’s very normal and natural for parents to worry about their teenagers and in fact parents should worry about their teenagers. That’s their job is to keep teenagers safe. And the teenagers job is to push against those boundaries and to figure out how to do things on their own and to figure out what they can do safely and where those boundaries are. And sometimes that involves making mistakes and the way that teenagers learn is through experience and they can’t learn and grow if everything’s perfect. If they don’t take risks. If they don’t make mistakes. So that’s why actually risk taking is an important part of adolescent growth and development. If they never take risks they will never grow. They need to be able to take some risks. They need to be able to make mistakes. They need those mistakes to be forgiven and to be seen as learning opportunities for them to be able to grow.
And then parents, what they need to do is to set limits when the risk taking and the mistakes are life threatening or dangerous. And that’s always a dance between the teenager and their parents. And so that’s really one of the challenges of parenting a teenager and also of being a teenager.
Rachel Cram – I like that analogy of it being a dance because you are still together in it. And I think even myself as a parent, you can let yourself start thinking that you’ve been pushed out of your child’s life. And I think when you think that way it’s very sad. But when you think of it as a dance, that you’re reading your child’s cues and moving in and out in a way that really supports that individuation process, then that changes everything.
Dr. Dzung Vo – Yeah absolutely. I think that parents still have a tremendously important role to play, maybe even more important than at earlier parts of their life. But it just looks different.
Rachel Cram – Yeah. Are there things that you can be doing in even your preschoolers life to set them up for teen years and that dance? Helping you move together into that dance?
Dr. Dzung Vo – Yeah absolutely. Parents can role model and create a family culture of growth mindset, which means encouraging even younger children to take risks, to not be perfect. So for example, sign up for a class that they may be scared of, or go to the birthday party that they may be scared off because all of those things are risky for kids but it can be done in a safe way. And kids need to try new things in order to grow. So that’s one thing. The second thing is role modeling the way that we respond to mistakes. So even in elementary school or on the sports field or a social event, when there’s a mistake, how can we help a young person acknowledge, “Yes, this is hard but mistakes are part of life. How can we grow from it? What can we learn from it rather than beating ourselves up?”
Can the parents, instead of judging or blaming the young child, can they help them to see it as a growth opportunity? Can they help them to see it as a learning opportunity? So I think those are things that can really set the stage for a healthy adolescence.
Rachel Cram – That’s helpful. Thank you. If we can just continue with this dance analogy for a bit longer, I have a question. If a parent is really struggling to let go, as many parents do, does that affect the dance?
Dr. Dzung Vo – Yeah absolutely, because parents are learning how to trust teenagers and teenagers are learning how to trust themselves. And if they don’t have an opportunity to try new things, to try things independently, the teenagers will never gain the confidence that they can do it. And so when they become adults they’re really going to struggle. So for example, if a teenager is going to university and their parents have taken care of all of their problems, maybe if they’ve ever had a challenge with a teacher in high school and they get to university and they’ve never had the experience of solving those problems on their own then they’re going to have a really hard time when they’re in university or even beyond because they haven’t had the chance to develop those skills.
For teenagers they have to really earn the trust of their parents too. They have to demonstrate that they can handle the responsibility. And I think one of the great advances that we’ve seen in the last 10 or 20 years is things like graduated driver’s licenses where teenagers have to demonstrate responsibility and then they’re given more trust.
So it’s not a free pass. It’s not a blank check. There’s responsibilities on both sides. So it’s a gradual process. And some days or some weeks there’s two steps forward one step back. When a teenager makes mistakes or when a parent makes a mistake. But over time what we want to see is that dance develop so that way the teenager is more independent, not completely independent, they’re always going to be interdependent with their parents. And we hope that they’re going to have a lifelong relationship with their parents but they’re going to be more able to do things on their own and the parents are going to trust them more. And the only way to do that is to do it.
Musical Interlude #2
Rachel Cram – If I can just jump back a little bit you talked about the need for unconditional love and I think that most parents would say that they fully desire to give that but we all have our blind spots. How do you live before them so that they will believe that you do love them unconditionally?
Dr. Dzung Vo – One of the things I really learned is that what we as adults do matters way more than what we say to teenagers. And so when we’re talking about unconditional love, if parents can show unconditional love, that’s much more important than saying it. And how do parents show it? Number one they can demonstrate unconditional love for themselves, self compassion. This is an important part of mindfulness. So when a parent makes a mistake can they talk about it with their child? Can they say, “You know, I made a mistake, either in the family or outside the family but it’s OK I’m gonna learn from this and I still love myself and I’m not going to beat myself up.” And can they role model that process of growth mindset and self compassion to their child.
Secondly, when their child makes a mistake, can they do the same thing? Can they say, “You know, I know this was a mistake, it wasn’t what you meant. And can we learn from this? And I still love you. I will love you no matter what.” And more than just saying that, can they demonstrate that through their actions? They’re not there to punish their child. They’re not there to make their child suffer more, but they’re there to help their child to grow from that experience.
And then the third is really just finding opportunities that are not so formal. So it’s not like, let’s sit down across from each other and you tell me what’s happening in your life. But it’s often in the midst of informal activities, where sometimes teenagers will share a little bits with their parents. Often when the parents don’t expect it actually, and they’re not going to necessarily give a long speech about, “I’m going to tell you everything about what’s going on in my life and all of my deepest feelings,” but they might say, “Yeah, I had a argument with my best friend last week and you know I’ve been really down about it.”
And that might be the end of the conversation but at least it gives a glimpse into the life of the teenager in a way that the teenager feels safe.
Rachel Cram – I often find that driving back and forth to my kids sporting activities, that’s kind of a key reason that I keep them in sports I think. It’s the drive to the games, it’s the drive to the practices, these little conversations come up.
Dr. Dzung Vo – Yeah, or maybe it’s cooking in the kitchen, maybe it’s spending time outdoors. There’s all different ways but it’s often not, “Let’s sit down and have a chat. Let’s sit down and have a talk. And we’ve got 30 minutes for this.” That’s not going to be a time where many teenagers are comfortable.
Rachel Cram – Yeah, saying, let’s sit down and have a conversation and dig into your life. Not an invitation for a great response.
Dr. Dzung Vo – Yeah. I mean it depends on the teenager. There are some teenagers that are totally fine with that but some teenagers are not.
And then lastly I would say one of the things that I’ve seen allow kids to open up is just saying in moments that are not in crisis, “I’ll be here for you no matter what. Even if things are hard, you can call me anytime day or night. If you’re out somewhere and you’re worried about your safety. Just call me. I won’t judge you. I won’t punish you.” And then really following through with that.
Rachel Cram – I love that focus on unconditional love. So important. Thank you!
Now, if it’s ok with you Dzung, I’d love to jump into some of the demonstrations and mindful practices that you offer. And I’m wondering, can you explain the hand model of the brain that you share in the book? Because I think sometimes knowing what’s happening inside of us, particularly in our brains, gives us a real patience for what seems to be coming out in our mouths and in our actions.
Dr. Dzung Vo – Absolutely. So I share this hand model of the brain with teenagers and parents. It’s a very concrete way of understanding what’s happening in the brain when we’re stressed out.
Rachel Cram – Okay I’ll do it with you too. And we’ll show a visual on family360 facebook and instagram site too if that’s ok?
Dr. Dzung Vo – Yeah. So we can hold our hands up.
Rachel Cram – Okay. So sort of like you’re saying STOP.
Dr. Dzung Vo – Like you’re saying stop. So your palm is facing forward. And then I want you to put your thumb into the middle of your palm.
Rachel Cram – Okay. Kind of like you’re tucking it in. Okay.
Dr. Dzung Vo – You’re talking in your thumb. So this is the middle part of our brain. Sometimes we call this the lizard brain because it’s a very similar part of our brain to what lizards have.
Rachel Cram – So the thumb is that lizard part?
Dr. Dzung Vo – The thumb and it’s in the very center, the base of our brain. Scientists will call it the limbic areas. And this is the part of the brain where we experience strong emotions. When we have stress, we go into fight, flight or freeze mode, this part of the brain is activated and its job is to protect us from danger. And so lizards are very good at that. Their brains get activated when there is danger. Humans are the same way.
And our brains are really designed to respond to danger in our environment that would have been life threatening for our ancestors, like you know wild animals or something.
Rachel Cram – Okay okay. So that thumb is the lizard part of your brain and it’s tucked right in the middle of your palm
Dr. Dzung Vo – In the middle, that’s right. Now why don’t we curl our fingers over. It’s almost like you’re making a fist but with your thumb still tucked in your fingers. And so these knuckles right in the front, this represents the prefrontal cortex, or we can just call it the human brain because it’s the part of our brain that gives us the capacity to think clearly, to make a wise decision, to regulate our emotions, to really see what’s going on.
And we can see that the fingers are touching the thumb. And what this represents is the many many connections of nerves between the human brain and the lizard brain because the human’s brain job is to regulate the lizard brain; is to say to the lizard brain, “Hey, this is not actually a tiger attacking us. This is a stressful situation but it’s not life threatening. So you can stand down.” The lizard brain can calm down.
So this is the regulation of emotions.
Rachel Cram – Those four fingers regulate your emotions.
Dr. Dzung Vo – Those four fingers.Yeah. So the lizard brain wants to get excited but the human brain is saying calm down. This is not a life threatening situation. So that’s how we’re operating when we’re well regulated.
Rachel Cram – OK. So if it was a life threatening situation?
Dr. Dzung Vo – In a real life threatening situation we want that lizard brain to be activated because we want to fight, run or hide. If we were actually being attacked by a tiger or by something else that was threatening our life, then that lizard brain activation would help us to survive; would help us to run faster or to fight back to survive. So it’s a really important part of our brain and it’s built into us as our survival mechanism. And every animal has this.
But most of the things that affect us nowadays are not acute life threatening situations. So that’s where the human brain comes in is to be able to tell what’s the difference. And to be able to regulate that lizard brain.
Now what can happen, imagine if you’re a teenager and maybe you woke up late that morning. Your alarm clock didn’t go off. You miss breakfast, you were late to school and then a teacher criticizes you and gets on your case. Your brain is going to respond just as if you’re being attacked by a tiger.
So the blood is going to go to this lizard brain which is the little thumb part right in the middle of your hand and your lizard brain is going get activated and it’s actually going to overwhelm your human brain. And what’s gonna happen is that you’re going to flip your lid, you’re going to lose your mind. So you can visualize that by lifting your fingers up and pointing up right.
Rachel Cram – And you call that, “You flip your lid. You lose your mind.”
Dr. Dzung Vo – You flip your lid, you lose your mind. So the human brain is no longer covering the lizard brain. The human brain is no longer in touch and the lizard brain has taken over. And when we’re in that state, we’re in fight, flight or freeze mode, we’re more likely to do something that isn’t helpful or more likely to say something, to yell, to hurt something, to you know punch a locker or to get into a fight that doesn’t really solve the situation. And that’s a very human thing to do and I’m sure all of us have done that at some point in our lives. So that’s a very human thing. It’s not just a teenage thing.
Rachel Cram – So when we do that. When we respond, even as a parent, when you respond with an angry outburst that really was not warranted, in those cases have we flipped our lid?
Dr. Dzung Vo – Absolutely. Parents can flip their lid. Adults can flip their lid. Teenagers can flip their lid.
Rachel Cram – So if you are looking at your brain at that point, it would be like these four fingers are up and your lizard brain is active.
Dr. Dzung Vo – Absolutely. So that’s the bad news. But here’s the good news. The human brain is still there. It hasn’t gone anywhere. And all we have to do is recognize what’s happening. “Oh my goodness. I’ve flipped my lid, my lizard brain’s really active.” And teenagers can tell me this. They can say, “You know, I got in an argument with my mom the other day and I flipped my lid.” They really can recognize this. And then we can take a step back, we can practice a healthy coping mechanism, whether it’s mindfulness or anything else and we can actually bring our human brain back online.
So if you have your hand up, what you can do is you can bring your fingers back over covering that thumb. And what this represents is that the human brain is getting reactivated and it is
regulating the lizard brain again. It’s calming down that stress response.
And when the human brain is fully activated, then it can help us to make a better decision. It can help us to see what’s really happening and to act in a way that actually helps the situation rather than making it worse.
Musical Interlude #3
Rachel Cram – So we can all do this kind of brain regulation, teenagers and adults.
Dr. Dzung Vo – Yeah, teenagers and adults. Now here’s the difference between the teenage brain and the adult brain, is that the teenager’s human brain is still growing. It’s still in development. And what we know from neuroscience is that that part of the brain does not fully develop until the early to mid 20s. So later than we used to think. But the lizard brain, the limbic areas, are actually fairly fully developed and fairly mature by early adolescence.
So during the adolescent years there’s a bit of an imbalance between those two different parts of the brain. So teenagers, number one, are more vulnerable to flipping their lid. But number two, it’s actually more important for them to practice when they do flip their lid to bring their human brain back online. Because the more they do that the stronger those connections go. And that’s actually how they develop emotional regulation, is by practicing regulating themselves over and over and over and building those connections between these two different parts of the brain.
Rachel Cram – Well, no wonder those years are so stressful, because you look like someone who’s fully formed but you’re being controlled by a lizard brain, and in the midst of trying to form who you are. No wonder the question of “who am I” is such a struggle, you almost can’t even answer it during those years.
Dr. Dzung Vo – That’s right. So the important thing is asking the question because the adolescent brain is exquisitely sensitive to life experience and so they need to try on different identities. They need to be able to make mistakes and learn from those and be forgiven for their mistakes as well.
Rachel Cram – Well I think this is often what parents can be very annoyed by; is the trying on of different identities, like why do you have to dress like everybody else? They can say, or, why are you needing to follow these people on Instagram. But that’s kind of what they’re doing isn’t it? Is practicing identities.
Dr. Dzung Vo – Yes they’re practicing, they’re learning and growing through experience. It’s not something that an adult can just tell them, “This is who you are.” But they actually have to try it and learn for themselves.
Rachel Cram – Yeah, I remember some of my kids, they’ll pick up certain words or certain phrases and all of a sudden start using them again and again and it could be so annoying because you can think, “This isn’t you.” But that’s part of who they’re trying to become I think is what you’re saying.
Dr. Dzung Vo – And it’s when I say it’s actually a wonderful thing too because I think adolescence should have the right to reinvent themselves because when they try on an identity that doesn’t really suit them they always learn something from it. They learn about themselves, they learn about their values, they learn about their peers and their friends. And they should have the right to try something different, to begin anew. And actually I think adults can learn from that because what it really shows is an open mindedness. And sometimes as adults we get a little bit stuck in our identities. We think we know who we are. But actually that closes us off to who we could be. And adolescents really have that adventurousness and that open mindedness that I think adults could learn from as well.
Rachel Cram – That’s a good point. I’m going to take that to heart. So Dzung, perhaps even connected to that open mindedness and our need to practice bringing our human brains back on line, in your book, you introduce some really interesting mindful practices, and I’d love to explore some of those with you. You say, “Mindful practice can actually rewire our brain.”
Dr. Dzung Vo – Yeah, so what we know about mindfulness practice in adults, there have been studies looking at the brain development and showing that even eight weeks of mindfulness practice can change the brain in ways that can be seen on an MRI scan, that can change the way that the brain looks anatomically. We have not had those studies in teenagers, so I can’t say for sure that mindfulness practice would cause changes in the brain of an adolescent. My hypothesis would be that it would actually stimulate more changes in the brain because the adolescent brain is so exquisitely sensitive to experience and is growing so rapidly. I would think that through repeated experiences like mindfulness practice, which is a repeated experience that’s done every day, ideally, that we would see changes in the adolescent brain but we haven’t had research to prove that yet.
Rachel Cram – I appreciate your transparency with that. All right so you’re setting the case so well for the importance of mindfulness, why do you think it’s overlooked then, in our culture?
Dr. Dzung Vo – Mindfulness is simple but it’s definitely not always easy especially in those tough moments when we’re in pain or we’re experiencing a lot of strong emotions. And one thing I would say is that mindfulness is not the only thing to do when there’s strong emotions or there’s pain. And sometimes it’s not even the best thing to do at first. So there are other things that are also important in handling stress and handling pain such as therapy’s even sometimes medication. So mindfulness is not the silver bullet. It’s not the answer to everything. Mindfulness is not a tool. It’s a way to live more fully present, to be able to embrace the wonderful aspects of life and also to be able to ride the waves of pain and distress.
Rachel Cram – You suggest that in moments of stress we get in touch with our beginner’s mind. That was one of your first examples in the book, quite an intriguing practice. Do you want to describe that one?
Dr. Dzung Vo – Beginner’s mind is the attitude of adventure, of curiosity and of openness, letting go of what we think we know about something and approaching it as if for the very first time. So, many of us have had an experience of walking in a forest or on a beach with a young child. Maybe a four year old child or a five year old child. What’s that experience like? What have you observed?
Rachel Cram – They don’t walk very far. They stop and they’re looking at what’s on the ground.
Dr. Dzung Vo – Right. And what are they looking at?
Rachel Cram – Oh rocks, barnacles, the sand in their toes.
Dr. Dzung Vo – And all of those things are miraculous. All of those things are really wonderful. They’re worth discovering and exploring. And then sometimes as an adult we might walk down that same forest or same path but what would it be like for us especially if we’re you know stress we’re worried about work or about bills. It’s very different isn’t it.
Rachel Cram – Well I think often you’re looking out more to the horizon and getting to the next spot, more than where you are at the moment.
Dr. Dzung Vo – Right, but we miss out on all of those things that child sees: the rocks, the barnacles, the leaf, the slug, the plants. We miss out. And so ‘beginner’s mind’ is about opening our eyes to discover what can be discovered even if it’s something that we think we all really know and almost all the time we will discover things that surprise us.
I’ll give one example of that that happened in my own life very recently. Probably at least every day, I walk from one part of B.C. Children’s Hospital to another. I’ve walked this route, you know probably hundreds of times.
And recently I walked this route and I saw the way that the tree was framed against one of the buildings. It almost looked like a painting, like someone had intentionally put it there as a composition. And it was really beautiful and I took a moment to enjoy that and appreciate that.
Normally when I walk I don’t even pay attention. I’m in autopilot. I’m thinking about the next thing I have to do but because that day for whatever reason, I had more beginner’s mind on that walk, I was able to appreciate a new sense of wonder, a new sense of beauty in this experience that I’ve done many many times.
And that’s also important when we’re having times of stress because we start to make assumptions. We start to think, “Oh, I know what this is about. I know whose fault it is. I know what to do.” But if we have our beginner’s mind we can actually see the problem from a different situation. We can discover new things about it. And that always helps us to know how to respond to it in a much better way.
Rachel Cram – In your book you use the example of a raisin for this and I actually did this as a practice on my kids the other night at dinner and one of my kids got really into it and the other two weren’t particularly interested. So the raisin maybe didn’t captivate them. Can you just describe how you do that with a raisin? Because I think that is a really good example of how very purposeful this is.
Dr. Dzung Vo – Absolutely. So what we do is we invite our teens to have a raisin or sometimes it can be something like a Hershey’s kiss or some other snack like that.
Rachel Cram – Ah! If I’d used a Hershey Kiss I would have probably engaged them all
Dr. Dzung Vo – Possibly.
Rachel Cram – I’ll go back and do it again.
Dr. Dzung Vo – Possibly. But there can actually be an advantage to doing something that people think that they don’t like as well, because ‘beginner’s mind’ doesn’t always mean that we like it but it does mean that we’re open to it and we’re curious about it. And so what we do is we have people explore that raisin as if they are visiting from Mars. As if they’ve never seen a raisin before in their life and their purpose is to be like scientists and to observe and to gather data about what life on earth is like.
And so we have them look at this raisin, examine it with their eyes and see, what do I notice about this particular raisin? Not what I think raisins look like but what I’m observing right now about this particular raisin in my hand?
And then we have them smell it. We have them feel it with their fingers noticing if it’s firm or soft or warm or cool. We even have them bring it to their ears and play with it a little bit. So there is a playful quality to it as well. And it’s okay to play with our food when we’re practicing mindfulness. And then we have them put it in their mouth and explore it with their sense of taste and notice what it’s like. All of the flavors as they chew it. How does their body respond? What thoughts and emotions are arising? And how does that experience change from moment to moment as they chew it and swallow it?
And pretty much every time teenagers discover things that they did not know about raisins. Maybe it was sweeter than they thought it was. Maybe they liked it more than they thought they did. Or maybe they like it less than they thought they did. Either way it’s a discovery, it’s a moment of learning and it’s quite different from how they usually eat raisins. And most of the time they’ll say usually I just stuff them in my mouth. I’m trying to eat them as fast as I can. I don’t even think about it. So when they approach it in this way, they always discover something new. And we can approach everything in life this way. Whether it’s something we’ve done a million times or something that’s completely new. We can always learn, discover and grow from our present moment experience just by paying attention with openness and curiosity.
Rachel Cram – I want to say that since I read your book I have been practicing these things on my children. And even the times where I’m having a hard time getting them to do it, like I was just saying when I did this with my teenagers, even the two that didn’t fully engage, there was a real palatable change in how the rest of our dinner time went. It slowed things down.
Dr. Dzung Vo – Yeah. Because when we pay attention we’re noticing the little details, whether it’s the raisin or our family, our conversation. And it doesn’t mean that we always enjoy it. So you don’t have to like the raisin to be able to get something out of that experience.
When we experience something slowly, with attention, with care, we grow from that and we learn from it and we also learn how to handle situations that maybe we don’t like. So maybe people will choose not to eat raisins as much. We’ve had people like that where they used to eat raisins without thinking about them and when they eat a raisin really slowly like this, they’re like, you know what I don’t actually really like raisins.
So mindfulness is not always about enjoying things it’s not always about liking things. It’s about paying attention and discovering things.
Musical Interlude #4
Rachel Cram – Well this intentional, thoughtful, mindset, it’s such a different way than we usually do life and I’m sad to say, that’s what I’m finding with my teenagers, it’s a different way than I’ve done life with them. We’re on the go. I was much slower paced when they were younger. So I love this. I want to keep going. You talk about breathing and smiling as another practice. Can you describe that one?
Dr. Dzung Vo – Sure. So this one I learned from my teacher, Thich Nhat Hanh, the Zen master from Vietnam. And breathing and smiling is mindfulness in a nutshell. Most of the time we go through our life, we don’t even know that we’re breathing. So by just bringing our awareness to what it feels like to breathe, that gets us in touch with life. And it doesn’t mean that we have to change our breath. It doesn’t mean that we have to breathe a certain way. It’s only about paying attention. And then when we smile what we’re doing is we’re inviting an attitude of friendliness and kindness to that present moment.
It doesn’t mean that we’re faking anything, it doesn’t mean that we’re forcing ourselves to feel happy if we don’t but it does mean that we’re inviting a spirit of kindness and friendliness. And just a minute or two of that can really help us to bring our true presence to that moment and maybe approach the next moment in a different way.
Rachel Cram – Now, do you have kids saying this is stupid? A practice like this is a waste of time? Or, even reflecting back on your early years when you were more resistant to the teaching of your Dad, do you find kids are resistant to this kind of slowing down?
Dr. Dzung Vo – Of course, yeah.
Rachel Cram – So what do you do with that?
Dr. Dzung Vo – I think there’s a few things. Number one, I like to get to know what that teenager is interested in. So when I have a teenager who’s really interested in sports, I might talk about a famous athlete that does mindfulness in their sports and there’s a lot of them these days. Or if they’re into art or music I might talk about how mindfulness can be useful in music. So I always try to make the mindfulness practice relevant to the teenager.
But I think the most important thing when teenagers say this is stupid or I don’t want to do it is not to force them to do it but to really show and demonstrate how we as adults bring mindful presence to our own lives. And I think about again my own dad or I think about my high school guidance counselor. They didn’t need to talk about mindfulness or even when they did, it actually wasn’t that helpful for me. What was much more helpful is how they just showed it through their own quality of presence, how they were mindful in their own lives and that was what really inspired me.
Rachel Cram – Dzung, you say, “Mindfulness is simply being aware of what is happening right now without wishing it were different. Enjoying the pleasant without holding onto it when it changes, which it will. Being with the unpleasant, without fearing it will always be this way, which it won’t.”
And I can see how impactful it would be, as you’re describing with your father and teacher, if as adults you can live like that in front of your kids, I’m wondering if we can do one more practice before we wrap up.
Dr. Dzung Vo – Yeah, sure.
Rachel Cram – The book is filled with so many good examples. You talk about the powerful influence that your mood has over your thoughts, which is so true and just even the rumination of thoughts that happens in our head as a result of our moods.
The title of this one you call the school cafeteria. But it could also be called the coffee shop, your family living room, it could be called a number of things but it was a really good example of how our mood really does have power over our thoughts. Can you share that example?
Dr. Dzung Vo – Yeah sure. Would you be willing to try it with me?
Rachel Cram – Sure yeah.
Dr. Dzung Vo – So with teenagers we do the school cafeteria because that’s a relevant situation in their lives. But with you and I let’s do a situation that you might face.
So I want you to imagine that you’re at work and your supervisor at work just got on your case, criticized you about a project that you had done, and said that you had done a poor job and you were feeling really bad about it. So maybe just take a moment to imagine what that might feel like. How would you feel in your body? What thoughts would be going through your mind?
And then you went to the cafe next door to get lunch and you walk into the cafe and you see a co-worker who you really like who’s in the cafe and you wave to the co-worker but they don’t wave back to you. What would you think? What might be going through your mind about why the co-worker didn’t wave back to you?
Rachel Cram – I might be thinking they don’t care about me. They don’t want me to come sit with them so they’re trying to ignore me. That I read something into the relationship that’s never been there and they’re not interested in being friends. Do you want me to keep going?
Dr. Dzung Vo – Yeah. So a lot of judgment, a lot of kind of blaming thoughts which are very normal. Okay so let’s start over. Let’s imagine a different situation. It’s maybe the next week or the next month and you go to work and you have a conversation with your supervisor where they’re really happy with a project that you’ve done. And they praise you and they say, “Thanks for doing such a great job on this.”
So maybe just take a moment to imagine what that would feel like to be praised by your supervisor, to feel like you’ve really accomplished something and that you’re a valued member of the team. And what emotions or body sensations or thoughts might be arising.
And now you walk to the cafe next door to get lunch and you’re feeling really good about yourself, you’re feeling proud and you see your co-worker who’s in the cafe who you really like and you wave to the co-worker but she doesn’t wave back. What would you think about why your co-worker didn’t wave back?
Rachel Cram – I think maybe she didn’t see me wave or she thought I was waving at somebody else or maybe she’s distracted and just not noticing me there.
Dr. Dzung Vo – Right. So those are very different thoughts than you were having in the first situation. And what is the difference between those two situations? It’s really the emotional state that you come in with, right? The coffee shop situation is actually the same, where you walk in, the co-worker doesn’t wave back. But what’s different is that you come in with a different emotional state and then you have very different thoughts about why the co-worker didn’t wave back.
So what this shows us is that we can’t believe everything we think. A lot of our thoughts are just assumptions. Thoughts are just thoughts, thoughts are not facts. Don’t believe everything you think. Our emotional state has a lot to do with the thoughts and assumptions that we make. And so when we’re stressed, when our lizard brain is activated, we’re in fight, flight, or freeze mode, it’s quite likely that the thoughts that are coming to our mind are coming from our lizard brain.
And I tell teenagers the lizard brain is not very smart. The lizard brain often doesn’t really know what’s happening and it distorts our thinking. So when we’re stressed out, many of our thoughts are not actually true. They may be distorted and those are times especially where we maybe don’t need to believe everything we think. Instead we can just watch our thoughts, observe our thoughts but not act on our thoughts. And that’s actually really true freedom, when we can have thoughts, observe them, but we’re not forced to act on our thoughts. That’s a tremendously liberating experience.
Rachel Cram – So Dzung, as we start to wrap up this interview, I’m wondering, is there one last piece of advice you’d want to give to parents as we started to think about introducing mindfulness to our children. Because I think we can fear that we’re not going to get our kids to pay attention to this in the business of their lives. In the rush of their lives.
Dr. Dzung Vo – I think the greatest gift that parents can give to their children and teenagers is the gift of their own presence, their own mindfulness. And the most important thing that parents can do is to start to develop their own mindfulness practice.
Mindfulness practice is a training and it’s a lifelong training and they can start now. They can start to learn their own ways to be mindful, their own ways to meditate formally or informally and let their kids know that they’re doing that. And role model and embody that mindfulness. That’s gonna be way more important than anything they say to their child or teenager about mindfulness, is to live mindfully.
Rachel Cram – I thank you so much for your time today. I’ve so enjoyed this interview. I so enjoyed reading your book and I thank you for the work that you’re doing with children and teens.
Dr. Dzung Vo – Yeah well I want to thank all of the parents who are listening because they’re doing the most important job in our world. And anything I can do to offer support in that work is well worth it to me.
Rachel Cram – Wonderful. We’ll give links to your work and to your book in the show notes of this episode. Thank you so much.
Dr. Dzung Vo – Thank you.
In this powerful book, a pediatrician specializing in teen and adolescent medicine offers a breakthrough mindfulness program to help you deal with stress in healthy ways, improve communication, and reduce conflicts with family and friends.
Being a teen is stressful! Whether it's school, friends, or dating, the teen years are full of difficult changes - both mentally and physically. If you're like many teens, you may have difficulty dealing with stress in effective ways. You aren't alone, and there are things you can do to stay calm, no matter how stressful life becomes. All you need to do is stop, breathe, and be mindful and aware in the present moment.
The Mindful Teen offers a unique program based in mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) to help you deal with stress. The simple, practical, and easy-to-remember tips in this book can be used every day to help you handle any difficult situation more effectively - whether it's taking a test at school, having a disagreement with your parents, or a problem you are having with friends. If you're ready to uncover your own inner strength and resilience through mindful awareness and take charge of your life, this book will show you how.