Prakash Chandran (Host): Being able to have difficult conversations with your child is an essential part of parenting. Though it's not always easy, addressing sensitive topics like death, serious medical diagnosis or traumatic events can have a profound impact on their emotional health and wellbeing. In this episode, we'll talk about having difficult conversations with your child. And joining us to discuss is Dr. Adrienne Elhai. She's a child psychologist and clinical director for the Cullen Center at ProMedica in Toledo, Ohio.

Host: Welcome to Happily Ever After 40, a podcast brought to you by ProMedica, where we discuss midlife health and wellbeing. I'm your host, Prakash Chandran. So Dr. Elhai, thank you so much for joining us today. We really appreciate your time. It definitely can be challenging to talk to children about difficult topics or experiences, but can you talk to us about when it might be necessary?

Dr. Adrienne Elhai: Of course. As parents, we want to get our children through everything they have in life. And there are a lot of difficult things we have to talk to them about, such as coming of age issues, puberty, sex, a lot of other things that a lot of children unfortunately have to face too early, pornography or drugs. And these are really hard things for us to talk about as parents. We often are thinking about when do I start talking to our kids about these things? How much is too much or do I even have to talk to them about this at all? And in today's age, the majority of children and families also are facing a lot of challenging and traumatic events. They might have lost a loved one. Maybe a family member's been diagnosed with a serious illness. And as we know, there's been a lot of violence in the community, maybe even in their own school that's made our children fearful or upset. And so, these events have been really sensitive and I think parents struggle around how to think about these things themselves or even manage them themselves. And so, it's hard I think for us to talk to children about those things.

Host: Yeah. And I think the hard part about this is we're not given an instruction manual around when to have a conversation with our children. So, sometimes it's just easiest to avoid it altogether. You kind of touched upon like parents asking themselves, "Do I have to do this? If I do, when and how much is too much?" What advice would you give to someone that might be having a difficult conversation with a preschooler, like someone that might be the age of like two to six? Like, what might you encourage parents to talk about and how should they go about approaching that?

Dr. Adrienne Elhai: So, I think a lot of people think that really young children are the least affected by all of these things because they won't remember. But really, even if they don't have a lot of memories, we really do need to talk to them about it. So, a lot of parents kind of avoid these really young children. So, I'm glad you're asking that question. As I answer this question, I'm going to tell you this little analogy that I once heard about young children, I think it really helps explain how to approach these kind of difficult conversations. I think about how toddlers and preschoolers eat an apple, or how they eat in general. You give them an apple and they might take a little bite. And then, they put it down and they go play. And then, they'll find the apple again later when they're hungry and they'll take another bite, a little mouse bite or two. While they're dancing around, they'll drop the apple and they'll kind of go off for another adventure until they're hungry again. And then, they search for their apple.

And I think if you remember that about how young children are, it'll help you, guide you in how you have difficult conversations, and you'll remember that. Conversations will have to be across time. It will never be a one and done. And that's a lot because young children, they have small stomachs and they have small attention spans and they also are kind of managing their own emotions. And so, they only can take a little bit and then they leave when they don't need anymore. And so, you also keep those bites small and to what's developmentally appropriate. So, you just tell them a little bit with each conversation.

You also kind of let them lead. So, they may say, "What happened to Aunt Susie?" And so, you just tell them a little bit, that like maybe Aunt Susie got really sick, her body stopped working and she died and mommy and me are really sad. And then, you stop and you see whether or not they have any more bites or questions. And if not, then you just wait until they come back and they ask for some more. And you just trust that they kind of know how much they can handle and then you wait for them, you know, to come back like I said.

Host: Yeah, I love the way that you articulated that. The fact that kids kind of take in things in these bite-sized manners. And my daughter right now, she's just about to turn four and she's kind of at the why stage of life where everything is a why-why and it forces you actually as a parent to think through, "Wait. Well, why is this the case?" Like, I've never really stopped to even asking myself that. So, I imagine that when you're having a difficult conversation with, for example, a preschooler that might be asking why, maybe it's important to like think through some of those things first. So if one of those bites that they want to take is a why, then you kind of have thought through it already. Would you say that that's accurate?

Dr. Adrienne Elhai: Definitely. I think that it is very important if you are having like a planned kind of difficult conversation that you think it through yourself or you talk it through with your partner, another adult about how that conversation might go, what you might want to say. If they are in that why stage, how would you answer those whys and these kind of short kind of bites and they may take you down to like a very long end or it may just be very short. But I agree that talking that through would be very helpful for you.

Host: Yeah. I think it's so important to put in the prep work ahead of having these conversations with your partner, with someone you trust or even yourself. Another thing I wanted to ask is, as a child starts to grow up a little bit, perhaps they're school age, they're starting to form their own worldviews. Does the method in which you approach having these difficult types of conversations change?

Dr. Adrienne Elhai: It does change a little. And as I kind of think about that age, that school-age child, I think about that preparation in a slightly different way, that having difficult conversations will go so much easier if we are laying the groundwork for having conversations and connections in general. So, the more we're connecting to our children and letting them know that we are the people to go to, to have conversations at all, it's going to make it easier for them to know that we are their people. We are the ones that have that information because as they get older, they're going to turn to peers. They're going to turn to whether they're in real life or on the internet. And we all know that it's good to have peers, but we want them to turn to us. And so, you could do this by having like a two-minute check-in at bedtime where they can let you know how their day was or it can be a weekly ride in the car to the grocery store or wherever. Or it could be like a journal you pass back and forth. We know that kids usually share the most when they're supposed to be in bed or in the car, so those are good opportunities for you. But really what it is, you're setting the stage to being open to discussions and topics that your child brings to you. So, you know, when your eight-year-old then says, he asks you what sex is, then that's good that you're the person that they can come to, and you know that they know that.

Host: So, it kind of begs the question when to be reactive and having that conversation with your child versus proactive. There are so many different things that we obviously as adults have potentially faced that a child as they're growing up, like maybe they don't have any exposure to. So when do you think about saying like, "Hey, I should have this conversation with them proactively and sooner" versus waiting for them to ask?

Dr. Adrienne Elhai: Right. In general, we should be more proactive and reactive. In general. And I think that I would never think that I should be the one to tell anyone when you should do what. Everyone knows their own children best. I think that everyone should take into account that your child knows, is more exposed to things than you think. So even if, you know, as a parent you are keeping them from seeing social media, because we're talking about school-aged children, keeping your child from social media or the internet, I could almost guarantee you that they're still being exposed to that from friends at school, et cetera. So, you're almost better off at having those kind of conversations in a proactive way, at least in very small little bites of information just as we were talking about with the preschooler stage than just waiting because a lot of children will never come to you and ask. And then, you'll get to a much older child, a teenage child, and then it will be a reactive kind of conversation where you're may be cleaning up a mess.

Host: Yeah. So, you just mentioned older children. Let's talk about teens. I don't have any teens of my own, but I imagine it's difficult because they have a much more well-formed view of the world. They have probably pretty strong opinions around things that might be nuanced, like social media, cell phones, social dynamics. How do you have difficult conversations with teenagers on maybe potentially lightweight topics like social media, all the way to serious topics.

Dr. Adrienne Elhai: Right. Yeah. This is where if you've put in the work earlier, it will be easier, but still not easy. Because teens, it's developmentally appropriate for them to look to their peers, both in real life and online for advice, but they still do need the adults in their life more than they're willing to say and, honestly, just as much as the preschoolers that you have in your house right now. They need our emotional support. But it can be embarrassing, right? It can be embarrassing for some of those topics that you were listing off. And teens, they naturally will push adults out of their life. So, it's being that persistent kind of adult, it's being very open-minded, being much more of a listener than an advice giver. And adults aren't very good at that. We more often want to come in and give advice. So, it's kind of coming to those conversations saying, "I'm here for you. I want to talk to you about this thing that I heard." So, you have a wide range of topics that you brought up. But if it was just, "I heard there was something at school and I'd like to talk to you about this, how are you doing?" So, it could be like a conversation like that and then just sitting back and listening or "I'm noticing that something's been going on." And then just again, sitting back and listening and being non-judgmental, that's the best way to approach teens. And sometimes honestly, it's texting them and teens are much better at communicating on text or in a car.

Host: Yeah. You kind of have to come to them where they are. So, you know, a common theme that I am hearing in this conversation is to be proactive and to create the space to have these types of conversations. We've obviously been touching on it, but could you just specify why it is so important that we have these difficult conversations in the first place?

Dr. Adrienne Elhai: For lots of reasons. And it's the kind of conversation that's about like a traumatic event, for instance. Children may create their own narrative of what has happened. They may take on the blame, they're going to fill in those blanks. And we don't want that to happen. We want to tell them how it really is and make sure that they don't do that. So, that's one reason. Also, it's creating the stronger relationship with them. It's letting them know that we're really here for them. And I know I've already really said that. It's also helping with resilience. They're learning to really express their emotions to talk about how they're feeling instead of holding it in. And we're modeling that as adults in their life, that this is what we do instead of kind of the cultural way of doing it, which is, "Oh, we'll just get over it. We don't talk about it," we're creating this new way that we can talk about hard feelings. We can talk about uncomfortable feelings. We can even speak about sometimes the unspeakable feelings, and that's why it's so important.

Host: Yeah. One thing that I am actively going through that I imagine changes with time is a lot of the gun violence and school shootings that we're seeing. My daughter the other day, as I mentioned, she's almost four, she noticed that my wife was very sad because every time one of these things happen naturally, like, especially as a parent, you can't help but think about your own children. And my daughter was like, "Well, why is mom's so sad?" And so, the best way in which I knew how to approach it with her was just to talk about sometimes these bad things happen and bad people do things. And in this case, it happened at a school. Obviously, that approach would change if I had someone, for example, that might be school age and certainly again would change if they were a teenager. How do you think about something that is so serious like that, maybe potentially something that you and I didn't have to deal with growing up? But how do you think about approaching that at the different stages of a child's life?

Dr. Adrienne Elhai: So first of all, I think it's perfect how you answered that or approached that with your daughter. It's important that we are letting them know because, again, just like I had said, they are aware. They're aware even if they're not aware of the actual incident that occurred, they're aware how it's affecting the people around them. Let's say, because you just said perfectly how you would approach it with a preschooler. So if it was a school-aged child, a lot of parents might avoid it. So if it was school violence or, let's say, it was a suicide, I would definitely bring it up. And I would say, "You know, I heard that something happened at your school, or a lot of things have been happening at the school and I just want to check in with you and see how you're doing. And I want to let you know I'm here for you. And we can talk about these things." And I might even say how I've been feeling about it now. I wouldn't want to be so overemotional that they felt like they couldn't share their feelings with me because that might be hard for them then. But I definitely would put it out there, would talk about it, and I wouldn't shut it down. And I would check in with them again a couple times even if they didn't say that they had any feelings about it. And then, I actually would do a similar thing with teenagers regarding an incident like you're talking about. And I would check in with them and see how they are. Because I know a lot of people are afraid if you talk about it like a suicide, especially then you're going to make someone suicidal and that just isn't the case.

Host: Dr. Elhai, this has been a fascinating conversation. Is there anything else that you want to leave with our audience before we close here today?

Dr. Adrienne Elhai: I just want to leave you with the importance of really having those proactive conversations to lay the groundwork with your children, so that when you really do need to have those difficult conversations, you already really have that strong connection. And your children will be able to come to you when they really need to and you will be able to also go to them when it's important to have the kind of conversation that every parent struggles with. It will just make it that much easier. So, thank you.

Host: Yeah. I think that's really great advice and the perfect place to end. Dr. Elhai, thank you so much for your time today. We really appreciate it.

Dr. Adrienne Elhai: Thank you.

Host: That was Dr. Adrienne Elhai, a child psychologist and Clinical Director for the Cullen Center at ProMedica in Toledo, Ohio. For more information about parenting, you can visit www.promedica.org.

If you found this podcast to be helpful, please share it on your social channels. And be sure to check out the entire podcast library for topics of interest to you. I'm Prakash Chandran. Thanks again for listening. And until next time, stay happily ever after 40.