Navigating Modern Girlhood with Dr. Suzanne Garfinkle‑Crowell

0:00Dr. Suzanne Garfinkle‑Crowell:We're already helping you wrap up your weekend with a smile, so why not let us start your Monday with an encouraging boost, too? Wake Up Happy is the newest addition to our mission to make every day happier, and it's a Monday morning lift you don't want to miss. When you sign up, we'll send you one quick, uplifting text every Monday morning to kick those beginning-of-the-week blues to the curb and help you rise and shine a little easier. Think of it as the best wake-up call you'll get all week, delivered right when you need it the most. Sign up, sleep well, and let us help you start your week with a smile.

0:34Dr. Suzanne Garfinkle‑Crowell:To get your weekly Wake Up Happy text, visit livehappy.com and sign up for our Sunday Sillies newsletter. You'll get the option to receive a free Wake Up Happy text every Monday. And if you're already getting Sunday Sillies, you'll see a prompt asking if you'd like to opt in. So sign up and let us give your Monday mornings a makeover. The other days we'll be so jealous.

0:59Dr. Suzanne Garfinkle‑Crowell:Welcome to Live Happy Now, where we explore the science and stories that help us live with more joy, resilience, and connection. I'm your host, Paula Phelps, and each week we sit down with experts and everyday heroes who show us how happiness grows when we put it into practice. If it feels like teen girls today are talking a different language, it's because they are. And that inspired Dr. Suzanne Garfinkel-Kroll to write Girlhood Translated, Understanding Young Women in the Age of Therapy Speak and Self-Diagnosis. As a psychiatrist who treats children, adolescents, and adults, Dr. Suzanne saw a growing disconnect between what teens were feeling and how they labeled it.

1:38Dr. Suzanne Garfinkle‑Crowell:So she's developed a guide to help parents and other adults understand and navigate this new landscape. Let's dive in. Dr. Suzanne, thank you for joining me today on Live Happy Now. Wow. Thank you so much, Paula. I'm so happy to be here. You've got a new book out called Girlhood Translated. And I think most parents would agree we need a translation guide. Yeah, I was thinking about as I was preparing for this and thinking about how adolescence has always been such an intense period of identity formation. But what is it about today's environment that is uniquely challenging? Because it's a different ballgame than it was even 10 years ago.

2:16Absolutely. Well, I'm so glad you asked because girls today are speaking a new language. That is the language of therapy speak. So for example, when I started practicing about 15 years ago, a girl would come in and talk to me about the problems she was having. She would say, you know, I'm not getting along with my mom. School has gotten really challenging. You know, I'm starting to feel kind of bad about myself. And now it's, I have attachment issues, ADHD, and depression. And so that really presents a kind of a translation problem for a lot of parents.

2:59Dr. Suzanne Garfinkle‑Crowell:So what is it about this that tells you, it's more than just a trend in language and how we're speaking about it. It's actually a change in how we're approaching our mental health. Yeah, absolutely. Well, I can tell you a story about this that really got me interested in this issue. So a couple of years ago, I was working with a young woman who I describe in the book as under the name Violet. And she was this incredibly sophisticated, smart, articulate, older high schooler. And she came in and she could talk volumes about lots and lots of subjects. But when it came to her self and her identity, and especially about her feelings, it was like her language had shrunk down to this handful of clinical terms.

3:51So when I asked her, you know, nice to meet you, Violet. How can I help? She told me this story that was like, you know, Saturday, my OCD was really flaring. And then And yesterday, you know, I was having the worst ADHD meltdown. And today, I really feel my anxiety coming back. And I'm sitting there and I'm starting to kind of try to process all these diagnoses and, you know, what could possibly be going on for her. And I asked her, like, okay, so let's start with Saturday. You know, tell me more about that. What were you experiencing? What were you feeling? And she looked at me, like, confused that I didn't just get it.

4:30She was like, well, I was just so OCD. and what I realized was you know we went around and around I kept trying to get closer to her and understand her story but I realized for Violet the label had become the story I sort of shopped it around to my colleagues are you seeing this and everybody was having the same experience where For this generation, these labels kind of contain their own story. I think there are a lot of really complicated reasons, but a huge one is social media. Yeah.

5:06Dr. Suzanne Garfinkle‑Crowell:I figured that's where we were going with this. Oh, we get so much of it from social media. Tell us how that is changing the way that they view. Well, do they even view it as mental health or are they identifying it as a disorder versus a feeling? Yeah. Yeah. Well, I think it's very confusing because as you say, teenagers love labels. They are a label-seeking group. And that is developmentally appropriate because they are trying to figure out who they are. And, you know, teenagers love a label. Social media, social media is all about labels. And one of the things that's very alluring for social media is that not only is it causing lots of problems for teenage girls today, and everybody's heard plenty about what those problems and pressures are, but it is also alluring to them because it offers an explanation for why you are suffering, why you feel self-conscious, why you're unhappy.

6:15And it gives back all of these mental health labels. If you're a 14-year-old or 15-year-old and you have had a hard day at school and you come home and let's say you're anxious about six different things, right? You've got a math test. Somebody looked at you the wrong way. You're not sure what's going on between you and one person in your social group, right? There's some confusion over a crush that you have, right? Maybe something's going on at home that doesn't feel so great with one of your parents or your sibling. You know, everything is kind of piling on. It's one of those afternoons. And you come home and you, you know, you kind of type a question or a feeling into social media, you're going to get a barrage of influencers, of products, of quizzes that are saying, you know, well, of course you're struggling because you have this, this, and this.

7:11And it's very confusing for teenagers because they don't know the difference. They're not trying to exaggerate symptoms or make things up, but they are being fed this language. And, you know, there's a really interesting long history there of how this came to be.

7:28Dr. Suzanne Garfinkle‑Crowell:Well, so what then happens and what gets lost in normal development experiences like heartbreak or anxiety, insecurity, these things, what do we lose when we start looking at this as a diagnosis instead of a feeling and an emotion that we need to work through? Absolutely. Well, okay, so I'll give you a great example of that. There's a story in the book of a patient who I call Becca. And Becca is one of the many, many girls in my practice who says, I have anxiety all the time about everything. And, you know, like I had a bad time last night because of my anxiety, right? Today has been kind of difficult because I have anxiety.

8:15And so Becca also was part of a community online called the Anxiety Girlies, which is a very heterogeneous bunch, but lots of videos on TikTok about people experiencing anxiety and what that's like and a real feeling of connection. So that's another thing with social media is it offers you community and belonging. And I actually saw a really interesting study that most of the people who are negotiating for diagnoses with their doctor, not even looking for treatment necessarily. They're looking for an identity and sense of belonging. That's a separate issue. So back to Becca. So Becca says, I have anxiety, like as in the medical disorder, clinical anxiety.

8:59And here's why that was a problem for her. So she keeps saying it. She keeps saying it. I'm not quite sure what she means. Eventually, we start to look at, OK, so you have anxiety. Let's look at a time that your anxiety was more noticeable to you, like what was going on. And so we talked about what it was like for her physically. And she was certainly experiencing anxiety without a doubt. But it turned out that a time that she experienced it more was she was hanging out with her normal group of friends. And that for her included her boyfriend and a best friend that they kind of shared. And most of the time, you know, they bounced along.

9:43This is kind of like a happy social life. But she mentioned her friend is sometimes flirtatious with her boyfriend. and she didn't really realize that this was bothering her until we started looking at the anxiety she experienced when that was going on. And of course, that is an uncomfortable thing to realize about your best friend, that she's doing something that you really don't like. And Becca didn't even want to know this. She didn't even want to know that she was annoyed because she felt like maybe there was nothing she could do. You know, she didn't want to have a fight. She didn't want to have a confrontation.

10:27You know, her best friend was kind of maybe a little more socially powerful than she was, right? The relationship also was on the line. She didn't want to come off as being jealous or being the wrong kind of person. So her own brain didn't even let her know that that's how she was even feeling. and what she knew was that she was feeling anxious and she could label that as having anxiety right and there's a million other girls saying on the anxiety girlies saying oh you have anxiety i have anxiety right but it prevented her like this version of the story even though it wasn't wrong she she was experiencing anxiety but it prevented her from looking at a much more difficult feeling which was that she was angry at her friend.

11:18And for thousands of years, this has been a problem for women, right? But it is still a problem. It is still a problem because teenage girls have never lived before, right? They've never been adults. They still don't have any perspective. And they still have these social relationships that are extremely important and all-consuming, especially in early adolescence. And that stuff is really hard to figure out. So if you are pathologizing all of your anxiety, that prevents you from looking at those feelings underneath the anxiety that are so important to develop the skills to resolve conflicts and to have healthy relationships with people and to have resilience and be able to work through challenges, right?

12:10I mean, social media just wants people to label things and then, you know, throw it away. So it really is a problem.

12:19Dr. Suzanne Garfinkle‑Crowell:We'll be right back with more of Live Happy Now.

12:25Dr. Suzanne Garfinkle‑Crowell:We're already helping you wrap up your weekend with a smile. So why not let us start your Monday with an encouraging boost too. Wake Up Happy is the newest addition to our mission to make every day happier, and it's a Monday morning lift you don't want to miss. When you sign up, we'll send you one quick, uplifting text every Monday morning to kick those beginning-of-the-week blues to the curb and help you rise and shine a little easier. Think of it as the best wake-up call you'll get all week, delivered right when you need it the most. Sign up, sleep well, and let us help you start your week with a smile.

12:59Dr. Suzanne Garfinkle‑Crowell:To get your weekly Wake Up Happy text, visit livehappy.com and sign up for our Sunday Sillies newsletter. You'll get the option to receive a free Wake Up Happy text every Monday. And if you're already getting Sunday Sillies, you'll see a prompt asking if you'd like to opt in. So sign up and let us give your Monday mornings a makeover. The other days we'll be so jealous.

13:23And now let's hear more from Dr. Suzanne Garfinkel-Kroll.

13:27Dr. Suzanne Garfinkle‑Crowell:then also that diagnosis as as you illustrated in this story it's not necessarily correct they're quick to latch on to a diagnosis i have a a friend of a friend whose daughter believes that she has autism because she read a went through the checklist and and she matches up and so now she's convinced that she has autism. And the mom's like, I'm not seeing that. I don't understand. So is there also a sense of I can belong if I have this disorder? Is that also driving some of the appeal of finding a disorder? Absolutely. Well, I mean, I think with autism, especially right now, that's a very popular diagnosis.

14:17And it's complicated because, first of all, I think to be fair, sometimes self-diagnosing teenagers are absolutely correct. You know, not everybody has access to a psychiatrist. In fact, most don't. And so the reason that so many people, you know, another reason that they're looking online to figure out what's wrong is because they may not have access to a professional who can help them think it through, right? These are complex case-by-case clinical decisions, right? But yes, there are certain categories of mental illness that have been thoroughly destigmatized. And that is a very good thing, by the way.

14:58You know, like we don't want to go back to the world where mental illnesses were not accepted or human vulnerabilities were just made fun of, right? So that is part of what is so tricky here is that we've made a lot of progress, right? But yes, I do think that this is a way young people are offering themselves compassion. And we have to ask, why is it that this seems to be the only way, right? That human vulnerability or even human flaws are like not acceptable unless they're part of a medical problem.

15:38Dr. Suzanne Garfinkle‑Crowell:And so how do we then as parents, as society, start looking at this as the adults, literally the adults in the room and make a change? Because again, social media is a huge machine. And if that is where they're getting their information, where they're getting their diagnosis, a parent isn't going to be able to undo that. So how do parents start? Parents have a really difficult job right now. A lot of the time, parents fall into one of two traps when they're hearing therapy speak and self-diagnosis. The first is taking it too literally and just panicking. Like, oh my God, you know, my kid is mentally ill.

16:20The second trap is being too dismissive and rolling your eyes and saying, you know, it's probably just normal teenage stuff. And both of those leave a kid feeling very unheard. And one of my patients calls this over-freaking out and under-helping. So, right? Exactly. I recommend a lot of things in the book, but one of the things I recommend is something I call small acts of translation. And so here's what I mean. And this is something, by the way, that's not just for parents on an individual level, but also for society. Because you have half of the people saying this whole generation is mentally ill and beyond the teen mental health crisis.

17:06Everybody is so sick. And then you have half the people saying, no, this generation is just too sensitive and they need to just get tougher, right? So I'm really hoping to get parents and society unstuck from these binaries and judgments. So the small acts of translation goes like this. It's a two-step process. And the goal of the process is to take clinical jargon and flesh it out with plain language that is relatable and universal and human. So step one is something parents can do in their own head. Your daughter comes to you and says, I think I'm depressed. So you're not going to freak out and you're not going to underhelp, but you're going to think.

17:56Step one is a thinking step. Depressed. What words come to my mind when I hear the word depressed, right? Depressed person is sad. Depressed person is lonely. Maybe they're exhausted, right? Maybe they're hopeless. These are non-clinical words. These are just words. And you think those words in your head as you are listening. And that may seem like a small thing, but it is actually a huge act of service that you are doing for your child. Or, by the way, anybody who is using this language with you. Because you're thinking about what's in their mind. And that is a very special thing to do for another person.

18:39That's something we don't spend enough time doing, right? Absolutely. So step one is just a thought exercise. And you're just being really present and you're thinking about plain language that can connect, that can make that human connection. Okay. Then step two is dependent on, you know, who your kid is, your relationship with them, and whatever moment it is. but you're going to offer back one of those plain language words and you're not doing it to correct them. You're doing it to understand. So you might say something like, okay, that sounds like it could be pretty lonely. Is that part of it for you?

19:26You know, and then you wait and you see if that resonates. And if it doesn't resonate, then you try again another time. And by the way, this is not a one and done kind of thing, right? Like this is an ongoing conversation. Ongoing conversation. And probably this will be the beginning of many conversations that you will have and that may include a professional at some point. But regardless of whether it goes to there or not, you know, parents still have a role to play because teenage girls, just like everybody, want to be understood first and foremost as human beings. So whatever their diagnosis is or is not.

20:06So this is a way that can really help us remember that and get unstuck from the current situation

20:13Dr. Suzanne Garfinkle‑Crowell:we're in. And how do parents keep from minimizing it? Because I think that is a big concern. You talked about the freak out and overdoing it, but minimizing it, we see the news stories where parents say, I didn't think it was that bad. And now your child's gone. And so what are some constructive ways that they can be active with it and not minimize their girl's emotions? Well, I think checking in is extremely important and asking questions and also paying attention. I mean, just being observant and vigilant and perceptive about your child. But we should never mistrust the mental health system to the expense of our kids.

21:02A good therapist does not want to just pathologize and medicate a problem. A good therapist wants to really understand. And so if there is any doubt or any question, parents should always turn to professionals for help. That is what we're here for. There are helplines. I mean, pediatricians can help. Psychiatrists can help. Counselors can help. But we should never shortchange our kids or not give them what they need or a little bit more even than what they need. It's always better to err on the side of caution.

21:33Dr. Suzanne Garfinkle‑Crowell:Sure. And what about parents who have younger daughters who haven't yet entered this social media sphere and – or should I say circus? and things that they can do to kind of circumvent this situation, to prepare their daughters and give them some of the language and tools that they'll need to navigate this world. So it's not an instant diagnosis. It's not a label that they give themselves. Yeah. Well, I think a couple things. One is to have conversations about feelings and make sure that your daughter is able to label her feelings. when she's having them, right? And also checking in about the atmosphere of your home, because many families inadvertently create a culture where things aren't necessarily taken seriously when people are having emotional moments, right?

22:32And I mean, I worry about this, especially on the side of the, like, you know, the FAFO parenting, the, like, you know. And, you know, a lot of the time there's kind of like a macho attitude about, you know, we're not like that. We're not going to fall into this, you know, therapy speak and stuff. And so there's like a joking and a mockery of people's frailties or vulnerabilities. And that can happen in a very subtle way in families. And that is probably one of the main forces that is leading girls to reach for medicalized language. Because if you feel like your problems aren't going to be taken seriously, then of course you're going to start escalating the rhetoric around it.

23:16And that's not because you're making something up. That's because you're looking for the word that feels like it matches the intensity of your feeling. And that's going to actually get somebody's, get someone to pay attention. We can't change society as individuals in this way, but we can look at the culture of our home and make sure that we are, you know, families that are available and interested in the difficult moments of life.

23:44Dr. Suzanne Garfinkle‑Crowell:Are there ways to create a safe space for talking about this? What's kind of like a cheat sheet, I guess, is what we're asking for, to give parents, like, how do I do this? How do I start this? I think a lot of the time it comes back to one-on-one conversations. You know, kids don't always talk when we want them to talk. So we have to resort to, you know, the old book of tricks like talking when you're in the car, you know. observing when they may be trying to tell you something without telling you directly. So sometimes when kids talk about problems their friends are having, you know, they may not even know it, but they're really kind of asking about themselves too.

24:30So not to blow it off like, oh, well, I guess that person's struggling because, you know, they come from a bad family or something or, you know, but actually really showing empathy and curiosity for, you know, whoever is being talked about because a lot of the time it's harder for kids to talk about. It's too intense to talk about their own feelings. And I think just not letting your kids push you away, like to keep coming back. And I mean, that's really the main thing that a parent is, right? Is you're a person who is just going to keep coming back, you know, every time.

25:05Dr. Suzanne Garfinkle‑Crowell:This is a terrific book. I think it's so helpful for parents or educators, anyone who is is dealing with adolescent girls. It's a very, very important book. Great addition to our mental health library. And so I appreciate you writing it. We're going to tell our listeners how they can find you, follow you on social media, buy your book, and learn more. So Dr. Suzanne, I really appreciate you sitting down with me today. Thank you so much, Paula. It's been great.