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Navigating Adolescence—And Understanding Your Kid’s Perspective

As pediatrician and New York Times bestselling author Cara Natterson hammers home below, you don’t meet many parents who proclaim a lot of excitement about steering their kids through adolescence—it’s a cliché because it’s true, but it’s a time of undulating hormones, escalating peer pressure, awkward body changes, and strained relations all around. And nobody makes it through the gauntlet with dignity completely intact—on either side of the parent/child equation. All that said, there are ways to ease the process, which starts with understanding exactly what’s going on. Below, Dr. Natterson—whose Care and Keeping of You series is must-read materials for tweens—explains more.

Dr. Cara Natterson on Making Sense of Adolescence

When I was in the hospital having my first child—more precisely, when I was on the delivery room table and her birth was imminent—I turned to my husband and said, “Honey, enjoy the next 12 years.”

“What are you talking about?” He looked at me like I was nuts.

But I wasn’t crazy—I was a pediatrician. I had watched sweet, loving, cute little girls grow and evolve slowly until, sometime around their twelfth birthdays, they transformed as if a switch had been flipped. Most were still polite, followed rules, aimed to please… their outward-facing selves were relatively unchanged. It was whom they wanted to impress and how they decided to achieve that impression (snippy comments, fits of giggles, sobs from out of nowhere) that was radically yet predictably new. And then came impulsive decisions from seemingly-rational kids. I saw this so many times over and over in my office that I wished it had been a diagnostic code. We label Asthma and Upper Respiratory Infection and Arm Fracture, so why don’t we have a diagnosis for Entering Adolescence? It happens 100% of the time. Not one of my patients was ever fully spared—I knew that would include my daughter.

It is now twelve and a half years later. My daughter has transformed from a precious little baby into a bright, beautiful, bold tween. I, meanwhile, have gone from being a general pediatrician to leaving clinical medicine and authoring several books about puberty and adolescence. I write, speak, and teach about the very topic that currently rules my house. I have, quite by accident, become an expert in the very thing I feared most.

In general, I prefer to write content for kids over adults. I believe that they are both old enough and motivated enough to receive the information and then do something with it. Wellness should be direct-to-consumer, even when the consumer is young. Mostly because kids will listen.

That said, parents cannot be left out of the equation, even though they tend to be ambivalent at best and terrified at worst when considering raising teens. I mean, think about it: How often do you hear a parent cooing about how she or he is looking forward to the adorably charming years of adolescence? The ones who are in the trenches—living under the same roof and setting the rules for a tween or teen—often describe being regularly confounded. The more entrenched I become in the world of adolescent health, the more parents ask me to teach them what I teach their kids. And this turns out to be a winning approach, because when adults understand physical, mental and social development through the lens of their kids, they find they can parent more effectively.

So here are the top 10 things I teach tweens and teens about their bodies, their brains, and their emotions during puberty. It’s also precisely what I teach their parents— separately, but imparting the same information. My underlying premise is that knowledge is power: If kids know what the heck is happening to them, they can take control and make better decisions. Ditto Mom and Dad. This is exactly how I say it, whether I am in a classroom of 20 students or on a stage in front of hundreds.

  1. Puberty isn’t embarrassing—it’s inevitable and happens to everyone.

    It’s a process, and for many adolescents sitting in my classes or reading my books, it started a long time ago. The average girl in the US enters puberty sometime around age eight or nine, and the average boy around nine or ten. And remember, these ages are average, so half of all kids started before then. The first signs can be subtle—or not. The two most common are mood swings and increased sweating. The mood swings lead to fights with friends or snapping at family members or even uncontrollable laughter (moods aren’t all negative). The sweating leads to body odor, particularly in the armpits and the feet. See what I mean when I say almost everyone in 4th grade has entered puberty?

  2. When I say everyone, I mean everyone.

    Somehow puberty is often defined as a girl thing until, from out of nowhere, the boys are visibly in it. That’s party due to the fact that girls tend to enter puberty first, and partly to the fact that their changes are a bit more obvious in the beginning. They also tend to wear their emotions on their sleeves more, though certainly not all of them. But don’t kid yourself, boys, this is happening to you, too.

  3. 100% of tweens and teens tell me they don’t like how mood swings feel.

    They know they are being over-reactive or jerky or disrespectful or sullen, they just can’t help it. Here’s why: the brain matures very slowly and steadily between birth and adulthood. And while kids can look a lot like adults and are even expected to act a lot like adults, their brains don’t think like adult brains. By the tween and teen years, the emotional center of the brain (also called the limbic system) is fully mature—this part fuels impulses and risk taking behavior and motivations and even memory. It’s the innovative and disruptive part of the brain, and it’s fully engaged. Unfortunately, the part of the brain that balances the limbic system, called the prefrontal cortex, is not ripe. The prefrontal cortex is the part of your brain that makes smart, long-term, rational decisions. It tames impulses and counterbalances the desire to take risk. But it does not dominate in the adolescent brain. In fact, it won’t be fully mature and able to truly rule day-to-day choices until your late 20s. Don’t get me wrong—teens have a prefrontal cortex that works! It just doesn’t work as efficiently as the emotional part of the brain. Once kids understand this, they are almost relieved because they can grasp why they might know the right answer but still do the wrong thing.

  4. You can outsmart your brain.

    I spend a lot of time teaching kids how their brains mature and then how to make smart choices even with an immature prefrontal cortex. The tips I give them include things like:

    • Count to 10. Before you do something—like post a comment on social media; get in that car with someone who is intoxicated; shoplift; gossip; you get the idea—just count slowly to 10 (or 20, or 100) and let your prefrontal cortex weigh-in on the choice you are about to make. If you take the impulse out of the impulsive decision, you may find yourself making the smarter choice.
    • Don’t beg for something you aren’t ready for. If you know that you are going to be in a situation where you cannot make a good decision, why put yourself there?
    • Use your parents’ limits as an excuse. It is so hard to say “No,” especially to friends. Sometimes your parents’ rules are sitting out there waiting for you to lean on them. Go ahead, throw your mom under the bus—say how awful she is that she won’t let you do whatever or go wherever. But then let her rule be your out. You don’t even have to thank her.
  5. Starting around age 12, you’ll probably find yourself going to other kids for information rather than your parents.

    This was the thing I saw most consistently as a doctor, and it scared me the most when I had kids. The truth is it is okay to turn to your friends so long as you understand the limits of their knowledge. It’s totally fine to go to your friends for all sorts of opinions, but ask your parents or an adult you trust when it comes to points of fact.

  6. If you can’t talk to your parents, find another trusted adult.

    And on a related note, the Internet is not a trusted adult. This is a huge one. First of all, the Internet has tons of unvetted information and information that is frankly wrong but formatted to look like fact. Even more seriously, the Internet is packed with imagery—and kids often search by scrolling through images. This is how a lot of kids wind up accidentally viewing porn. So set a plan with your folks to have a go-to person in the case that you have a question you cannot ask them. And parents, don’t take it personally if they want someone else to go to. Consider the alternative—and then pick an adult you both agree on.

  7. The basics remain. Nutrition, exercise, hygiene, sleep…

    all sources of battle between parents and kids. Look, these aren’t really negotiable. If you want to grow well and stay healthy, these are things you need to have down by the teen years.

    • Eat well—you know when you are eating too much junk and no one needs to tell you for the thousandth time that water is better for you than soda.
    • Exercise. Just do it. Moving feels good. Play a sport or jump rope at home or get cardio…even on a video game. Exercising an hour a day is a physical and emotional game changer.
    • Hygiene means keeping yourself clean. Very few people are going to have the guts to tell you that you have food in your teeth, let alone that you smell. Get the basics done by showering (with soap!) every day, washing your face and brushing your teeth/flossing every morning and every night, and putting on sunscreen and deodorant before you leave the house for the day.
    • Sleep is a gift for you. It is the time when you grow, so if you want to eek out some extra height your best chance is with extra sleep. It’s also where memories get filed away into long-term storage. This means that sleep probably results in better test scores than late-night cramming. Sleep also helps our metabolism, so the day after a good night’s sleep you burn through your calories better and store less fat while the day after too little sleep results in the opposite. And we all know that sleep allows us to reset our moods. That limbic system is torturing you enough—getting extra sleep makes a big difference.
  8. Your parents went through it too.

    Yes, the world has changed dramatically in a generation, but the body and the brain haven’t. When you need help or advice, ask for it. If your parent is taking it in the wrong direction, say something. Sometimes kids will go to their parents with a worry or a question, and 10 minutes in they will deeply regret it because they are hearing a lecture on “When I was your age…” You can fix that, you know. Just tell them it’s not helpful and help them redirect.

  9. Speaking of words, use the right ones.

    Questions about body changes are awkward enough. But if you are using a code word for a body part, there’s a decent chance the person you are talking to won’t know what you are talking about. Suddenly a conversation that you think is about one thing can mean something totally different to someone else—and that’s where there is a lot of room for misinformation. Some people stay away from using correct anatomical terms because they think these are “bad words,” but there is nothing bad about using the right words.

  10. The world has, indeed, changed. Communication is entirely different.

    So is entertainment, access to information, the nutritional content of food, and the chemical content of everything we put into and onto our bodies. But these changes don’t mean that you cannot talk about what is happening to you and around you. Put down your screens and carve out time to have a real conversation. Explain to you parents what life as an adolescent feels like. Trust me, they want to know.

  11. Adolescence isn’t bad. It’s phenomenal. It’s a time of innovation and passion and growth. But your kids are going to make mistakes—sometimes big ones—and so are adults. Parents, remember that you are human and therefore you will get some things wrong. When you do, take a do-over. If you give your kid access to something or permission to go somewhere and you come to regret that decision, then change it. Just because you said yes doesn’t mean you cannot say no. You are the parent, after all, and your only task is to keep your offspring safe and healthy. But be mindful of how you do this: keep the lines of communication open by acknowledging that you made a parent-fail. Tell your child why you have changed your mind. This isn’t an apology but rather an explanation. In the end, it may be the most powerful parenting move you can make because, when it’s your kid’s turn to mess up, she or he can come to you the same way.

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