#479 Teen Talk

May 14, 2021Scott Benner

The Psychology of Type 1

Erica is a licensed marriage and family therapist who herself has had Type 1 diabetes for over 30 years and who specializes in working with people with diabetes and their families and caregivers—from those newly diagnosed to those experiencing it for decades. She and Scott discuss giving teens autonomy. http://erikaforsyth.com

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Scott Benner 0:00
Hello and welcome to Episode 479 of the Juicebox Podcast.

Today, Erica Forsyth this back. You know, Erica, she's the licensed Marriage and Family Therapist from California. She's been on the show a number of times, and she's here today to answer a question from one of you about something very prevalent with teens living with type one. Please remember, while you're listening that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise. Please always consult a physician before making any changes to your health care plan, or becoming bold with insulin.

California residents if you're looking for a therapist, look no further than Erica forsyth.com. I'd like to remind you that if you're looking for the diabetes pro tip episodes or the defining diabetes episodes, they are right here in your podcast player. But you can also find them at Juicebox Podcast comm or diabetes pro tip comm if you're listening in a podcast player, please hit subscribe or follow. Thank you very much. The T one D exchange is looking for type one adults and type one caregivers who are us residents to participate in a quick survey that can be completed in just a few moments from your computer or phone. This survey is 100% anonymous, completely HIPAA compliant, and does not require you to ever see a doctor or go to a remote site. Why you say what a survey require that? Well, because this data is actually helping people living with type one diabetes, and I wouldn't want you to get confused and think oh, this is a trial. I might have to go see a doctor, huh? No, no, you can actually help people with type one. Without being in a trial without visiting a physician. You just go to T one d exchange.org. forward slash juicebox. Click on join our registering now, and then simply complete the survey. Once you've done that, your information, which again is completely anonymous, will be used to help other people living with type one diabetes, and it supports the podcast. Past participants like you have helped to bring increased coverage for test strips, Medicare coverage for CGM, and have broad changes in the ABA guidelines for pediatric a one c goals. Eric, I have a question here from Aaron. And she said she's trying to give her preteen son some freedom by not micromanaging everything. And he is very capable of calculating his carbs and doses knowing what to do, etc. But he gets lazy about it. It feels wrong to punish him. But if there's no consequences, then there seems like there's no incentive for him to try. Where's the line between keeping preteens accountable and not making them feel punished for having diabetes?

Erika Forsyth, MFT, LMFT 3:19
Great, great question. And obviously, this team's and type one is it's a challenging season. And I know in my professional work, I do work with a lot of teens and families who are kind of battling this this dynamic between the what the parents wanting to offer and give some independence. And teens either asking for it. Or, or sometimes as in this question, maybe not following through the way they said they were going to. And it's it's an all around challenging, excruciating experience, sometimes for some families, and I do want to offer hope that it's a season right, it might it's not going to last forever. But I know when you're in it, it can be feeling it feels really overwhelming and stressful. I would initially in response to this question. I think trying to find ways to incentivize instead of punish if that works, and maybe you've already tried that in your family, but I would sit down with with your teen and talk about Okay, how how can we either incentivize or offer rewards I wouldn't, I wouldn't necessarily structured around food or which could be complicated in and of itself, but maybe maybe the child the teen wants to have a sleep over or the team wants to learn how to drive get get their permit or get their license or maybe work towards earning. You know, whether it's some kind of reward A video game. And so maybe building in incentives for okay if you keep your your blood sugar's in range. For this percentage of time this week, we are going to do X. And if you do it again next week, you're going to get Y, something that but sitting down with them and asking for their participation engagement in that this is a big, kind of like a behavior chart, so to speak, but to incentivize instead of punish, because I think if that cycle begins, where the teen is feeling like, okay, I already feel punished enough for even having type one, which can be a thought, then how come and now I'm being punished for not taking care of something I don't even want

Unknown Speaker 5:46
to have.

Erika Forsyth, MFT, LMFT 5:48
And, and so if that is the case, I would really get allow the child to allow your team to talk about that too, if you've if they're open to it. So that's just one one thought here in terms of instead of punishing, trying, incentivizing. I'll pause there, I can keep going.

Scott Benner 6:06
I have a question. Have I ever told you about chainsaw? About what the chainsaw? No, okay, I just said chainsaw because you would have known if I said it. So I have an episode that I don't believe is out yet. And I know that sounds funny that I'm not certain if it's out yet or not. But I'm a one man show over here. Okay, so I'm a little busy. woman has a teenage son, who really you know, wants to graduate from high school and start a business cutting down trees. And the kid wants a chainsaw. chainsaw is kind of expensive. And while we're talking, she also brings up that she can't get him to Pre-Bolus. And I said, and this is important to remember when you hear me talk that I have no training whatsoever. But what I said was, Well, listen, let me ask you a question. He'll never hear this. Are you gonna get him the chainsaw? And she goes, yeah. And I said, Okay, I said, Why don't you just give him $1? Every time he Pre-Bolus. And tell him Look, I know that sounds like it might be forever, but it's really not. If this sauce, $400, you can Pre-Bolus three times a day, in 30 days, you know, you could be a quarter of the way to your chainsaw, and the money will pile up quicker, and I'll pay you to priests, I'll pay you to Pre-Bolus a snack like you might end up Pre-Bolus and seven times a day. And and I said just I make you're going to spend the money anyway. And that became important to me, because she didn't have a ton of money. He didn't mean she couldn't just go like, leave in a golden trail of dollar bills around the house for the kid. I said, if it's money you're going to spend Anyway, you know what I mean? Like, I was like, let's repurpose that for this. And and I said to me, that's, I mean, the kid doesn't want anything more than that in the whole world, right? And I said, so if you have to trick a 16 year old into learning to Pre-Bolus, then who cares? Because after you get to that the cost of the chainsaw, he really will have done it long enough for to form a habit, I would think, did I give that person bad advice? Or do I do okay, no, I

Erika Forsyth, MFT, LMFT 8:04
think it's great. And I think what's important is what the carrot that you're dangling, has to be something that they are longing for. Yeah, it's not just like, Can I go to the movies or whatever? Like, I think it has to unless you want to start small. You know, some people do want to have smaller incentives. And they they get that kind of immediate gratification, which is important in the teenage years to like, they want to know that what they're doing, they're going to be rewarded for a Ross, what's the point? So some, some teens can hold out and say, Okay, I'm going to, I'm going to save and save and save. And I'm going to be incentivized by this, this chainsaw. I love it. So really sitting down with your teen and saying, Look, what is something and you probably already even know is the parent at that point. What is it that they are really longing for? And it could be something

Unknown Speaker 8:58
that they

Erika Forsyth, MFT, LMFT 8:59
say what is something you're really wanting, but you think you're never going to be able to get or afford? Or ever made to like something that's really thrilling to could be helpful? Yeah, everyone's great.

Scott Benner 9:10
You got to stop and give the horse some of the carrot. You can't just expect it. Yeah, get right. And to be honest, I see a lot of parenting like this, like you're just constantly mentioning things are gonna happen in the future. Even if you just set them up as psychological payoffs. Like, you know, if you do this, this is going to happen, that needs to happen then, you know, like, because, you know, I have to like just to kind of divert for a second. My son's played baseball, like his whole life, like he really has, and since he was three years old, right, right. As he was turning four, he started playing organized baseball, and he still plays now and he's 21 organized. And I used to have this horrible feeling while I was little, that a big a big moment never came to him. He was never up in a big moment. He was never like, and when he was 11, he caught the last ball of a championship game. And I'm telling you, there was a bigger smile on his face than I'd ever seen. And it had something to do with the fact that that game felt more important that it had some, you know, gravitas attached to it. And that he felt like he's the one that ended that. And so sometimes you got to get paid back, like he played just as well on all the games before that, but he never got the feeling that he got out of that one scenario. And so you got to get that feeling once in a while. Or the incentive to keep trying is harder and harder to cultivate,

Erika Forsyth, MFT, LMFT 10:38
I think. Right, right. Because as as a teen, particularly, you're not thinking about the future. You're not saying oh, well, if I don't Pre-Bolus now, yeah, I'm gonna have a high after I eat. Yeah. But I'm not thinking about oh, maybe I'll have long term complications when I'm 40 or 30. Whatever.

Scott Benner 10:56
Well, it's their brains work that way. There wouldn't be any teen pregnancy cuz, cuz I cuz as an adult, you know, how scared you are when you think you're gonna get somebody pregnant? But no one, no one feels that way. When they're 17 for some reason.

Erika Forsyth, MFT, LMFT 11:10
There's, it's impulsive. And you know, instant gratification. Yeah. And I think they're, yes. So allowing them to receive some sort of reward, whatever that is, if you're working towards that, if they're needing to incentivize, I think it's important to do that. Yes. Well,

Scott Benner 11:28
I am glad that I did not lead that person astray. Yeah, no, it's good. Sometimes I'm just like, I get done. Sometimes, like I say, a lot of stuff. I wonder if it's all okay. But I felt really comfortable about that. And it was one of those things. Actually, that was one of those great episodes where we were just talking through a thing. Like she didn't have any reason to come on. She's having like some sort of like a thing. And I was like, come on, and we'll just talk about it, like two people on the phone together. And let's see what we can come up with, you know. Okay, so I have a question here from Bridget, it says, I'd like to understand how to foster a growing independence in a teenager while still keeping a safety net. And I imagine, as you do, I guess, the safety net, she means is the Health Net of safety. Not getting too low or too high or? Yes, yeah. Okay. Yes.

Erika Forsyth, MFT, LMFT 12:14
So I think it's important to understand that it's a great and very common question as well, that what what teams are going through, and we might have all have a general idea that, you know, they want to be independent, they feel like they're, they know everything they know what's best for them. One analogy that I've read in a book years ago, and recently came across from a book called the yard sticks, is it talks about the analogy of the particularly like the 12 1314 year old, and the significance of their room in the house, like it becomes if they don't have their own room yet, or if they do have their own room, their own personal bedroom becomes very significant that they get to decorate, they get to become kind of the, the king or queen, so to speak of their of their territory. But it's significant to think about, that their bedroom is still a part of the house, right? So they're saying, I'm here, but I'm separate. And, or I'm here, but look who I am now. So they're able to kind of exercise some authority control independence over who they are. And they get to kind of make all those choices, right. But with that, then as a parent, you get to have these conversations with your team saying, Okay, if you are, if you are kind of owning your territory of your bedroom, I'm going to be handing over some responsibility, I'm not going to be coming in there and cleaning up your room or doing your laundry. So with that sense, along with their increased freedom, and their need for freedom. And these years, also comes the responsibility. And I think that is the struggle, right, as a teen as they're trying to create their own identity is how do I how do I balance this? Is the team thinking or not thinking about acting? Well, at the time, how do I balance this freedom and responsibility. And also just kind of thinking through and I'll apply this to type one in the second hair, that a parent, they are they shouldn't be afraid to knock on the child's door, right? The bedroom door, but it should be allowed. And so you're kind of shifting slightly, this locus of control, right? If the bedroom is off limits, the parent is knocking, and the child's going to let them in. But you're not relinquishing parental total parental authority, but you're shifting that locus of control. And ultimately, teens, they want to talk to their parents, they really do. And parents want to talk to their teens, but they really don't know how. And so I think going back before addressing the type one I think it might be really significant for for you as the parent and caregiver to understand what it is They are actually going through as a teen to not relinquish parental authority, but to shift some of that control over to them. And then they're you might need to initiate that conversation. And I think remembering that as teens, they just want to be heard. And so I would strongly suggest that parents say little, and listen a lot. And if you do need help in that department of just kind of going back to the basics of re establishing a relationship with your teenager, a really excellent book is by Adele Faber and Elaine Maas lish. The book is titled, how to talk so kids will listen and listen, so kids will talk. Again, that's by Faber and mazlish. So that if you are finding that you are having this battle with your teen around type one, I would maybe take a step back first is the parent and say, Okay, how can I enter my child's world through their lens as a teenager? So that's just kind of my first my first thought.

Unknown Speaker 16:04
Can I add? I can pause? Yeah, go ahead. No,

Scott Benner 16:07
I want to add there that I think I found for myself, I guess I should say that my recollection of my young life is probably not 100%, reminiscent of what it was actually like, or what I was thinking back then. So when you're kids going through a thing, it's so easy to think like, Oh, I remember this, like, but you probably don't, you probably don't really remember what it was like to be that age. And to have those feelings. Um, it's funny, you brought it up as an example about the room. Because when COVID started, and I started noticing a Kelly and I both started noticing art and going a little stir crazy. Arden said, I want to, you know, I was thinking I'd like to redo my room. And there's that first reaction really is nothing wrong with the room you have now and I would like to keep the money I have in my pocket, if you don't mind. But But yeah, but fair enough. She's older now. And she wanted to redo it. And we we let her repaint we let her replace her bed. And she wanted like a table with chairs. And she set it up. It's very much like a studio apartment now and not like a kid's bedroom. She's

Unknown Speaker 17:14
Yeah, How old is she?

Scott Benner 17:15
She's gonna be 17 this summer.

Unknown Speaker 17:17
Yeah, yeah, that's right.

Scott Benner 17:19
Yeah, it's got a little round table with four chairs around it and a lamp which she said when my friends are over and we eat, we can eat around this table. And there it's easy as an adult to listen to that and go I bought a table. It's downstairs.

Unknown Speaker 17:31
Dining? Yeah.

Scott Benner 17:34
Well, we were like, okay, and she said in the bed takes up too much space, I'm gonna get a smaller bed. And your first thought is, well, you have like a double bed. You want to go to a single. And wouldn't that be less comfortable. But that's not what she cared about what she cared about was making more space. She got rid of her dressers and put a system inside of her her closet and moved all of her clothes into her closet. And and she made it exactly the way she wanted it. If I showed you Arden's room, you'd say it doesn't look anything like any kid's bedroom that you've ever seen. And she loves it. And I, the way I can tell is that every couple of months when I'm in there, she'll make, she'll just, she'll comment a little bit, ask me a question. Do you still like the color I picked? I said, I do. It's great. How do you like it? She's like, it's good. I was like, Okay, he's still like that I took up the carpet. I said, I think it's nice, it's easier to clean. What about you know, I hear the noise from downstairs a little more now. And, and just to let her have that experience, it was a really big deal. And, you know, bonus, it took months. So it can write a capper focused on something she was, she was like the project manager of her room redesign, you know, and what ends up costing us in the end, not very much, you know, it was good,

Erika Forsyth, MFT, LMFT 18:52
right? And how much, you know, like we were talking about earlier, like authority and agency that she feel over her life of being able to do that, like what and you know, it's such that's an excellent example of finding those opportunities to relinquish control. I mean, with within, right, then you probably had a budget and you had some probably constraints around that. We did, but you said Go Go for it. Yep. Right.

Scott Benner 19:17
Within this amount of money, you can do whatever you want. Right, right. Also, what it led to then, was I used to separate her clothing. I don't fold the kids clothes, but I'll lay them in like flat piles so they don't get wrinkled and give them to them. But ardens would sit in my room. And then once she had more space in her room, I was like, Oh, well, I can sit in her room now. So I know I take it and I put it in this spot. And I've noticed her being more diligent about putting her clothes away, and it didn't happen all at once. It took a lot of time for her to go Okay, I guess no one's gonna put this away. It's on me. Then she's got to find time in her schedule. Then she got to find the energy to actually do it and then she's gonna have to care about it. enough to do it. That took months and I, I think very fervently about parenting, that my job is really to repeat the same thing over and over again without sounding annoyed until somebody figures it out. And, and that's sort of how I saw this thing. Like I didn't, I didn't say, hey, look, you're now in charge of this, take care of it. You know, do it right now. And if you don't do it the first time, I'm gonna yell and scream at you. I just kept piling the clothes up. And one day, I think the pile fell over. And she's like, dude, I guess I got to do this. And right, that's how it went.

Erika Forsyth, MFT, LMFT 20:29
Well, and that's, that is like, such a great example of she was going through that struggle of like, Okay, I've got increased freedom in some areas. But now I've got this responsibility of putting my laundry away. So she kind of went through that struggle until it became like, okay, it's bothering me, I'm going to show some responsibility and put it away of my own things, right?

Scott Benner 20:48
Yeah, it is unreasonable to expect it because you tell somebody to do something, they're suddenly going to shift everything in their brain that tells them what to do and just start doing it. It doesn't, you know, things don't work that way, I don't think.

Erika Forsyth, MFT, LMFT 21:00
Right. And I think then, applying that to the type one, we were in lies the fear factor of oh my gosh, okay, my, my teen wants his independence wants the freedom in management, and making choices and you know, all of it, but they're, but they're going through this struggle, this identity struggle of, they don't quite have full responsibility. And yet they're wanting to freedom, right? And so,

Scott Benner 21:34
I was gonna say, and when they do it wrong, it's not a pile of clothes falling over, it's a blood sugar going to 55 or 355. And then how do you manage the the slowed necessity of transition with the immediate need of safety and health.

Just gonna jump in here real quickly and remind you of three things. First thing, p one d exchange.org. forward slash juicebox. If you have type one, or you're the caregiver of someone who who has type one, and you live in the United States, this is something you can do in just a few minutes. That will immeasurably help other people living with Type One Diabetes. You can do it from your phone, from your tablet, from your computer, from your sofa, you don't even have to get up. Go take the quick survey. The information that you leave behind will be anonymous, HIPAA compliant, and help a lot of people living with Type One Diabetes, T one d exchange.org. forward slash juicebox. also want to remind you that if you're looking for the diabetes pro tip episodes, they begin in Episode 210, your podcast player. You can also find them at Juicebox Podcast calm or at diabetes pro tip calm at diabetes pro tip calm you'll also find the defining diabetes series. And of course, Erica for Saif Eric is available to California residents at Erica Forsyth comm links in the show notes. Links at Juicebox. Podcast calm. Now let's get back to Erica. The slowed necessity of transition with the immediate need of safety and health

Unknown Speaker 23:28
there Yeah,

Erika Forsyth, MFT, LMFT 23:29
therein lies the struggle for the parent, child and parent teen relationship, right where you as the parent as a caregiver are fearful. So you see that the numbers going up or down. And then the next thought is fear. And you want to you know, you want to protect your child, as a caregiver, you want to do everything you can to protect your child no matter what age. And I think going back to Okay, is this is this a one off? example? Is has my team demonstrated kind of general patterns of independence, I think I think just kind of like with anything, you need to let them earn your trust. And so maybe it's okay. You know, Bobby is saying as a 14 year old or whatever age but around 14, he's saying he wants to be able to look at his numbers and Pre-Bolus without consultation, right? Like that's what they ultimately Well, they want to be able to make decisions independently, right? So you say okay, we are, we are going to give you this opportunity for us to earn trust in you that you can do this. And so you try it for you start with whatever. And you can chart it out to I've done this with families were like okay, we're gonna try this out. You're gonna do it on Monday afternoon, and then we're going to do Wednesday afternoon and then we're going to increase kind of the frequent the time, the length of time and the frequency to say okay, you did great job. No Knowing that just like as caregivers, there are going to be, you know, mishaps. So I think, offering them these opportunities to demonstrate that they can do it. So then you're saying, hey, I want to I want you help me to trust you, right? You need to earn the trust, just like with anything like with driving, taking other, you know, kind of adult life decisions, and building in a plan with them. Yeah. And having their input i think is always significant of like, what do you think feels fair? Should we let you make decisions for all day on Monday? Or should it just be for dinner?

Scott Benner 25:34
What do you think about when to step in? Because, so I'm a long Yeah, I'm a long range guy. Like, I'm, I'm definitely one of those people. Like, if I'm gonna rob a bank, I'm not gonna do it for five years, and I'm really going to get it right. And so, you know, during this pandemic thing, there's been times where Arden's in a room, you know, doing classes in the morning, and I'm in here working. And once in a while she's here, she walks by doesn't say anything, I see her go downstairs, she comes back up with a arm full of food. And I look at her, I go, Hey, and she goes, I got it. And she doesn't got it. Like, I know she thinks she does. But she'll never Pre-Bolus enough, right? Because she's 16. And so I go, okay. And then she goes, and I think of that is like, I'm building trust. She knows I trust her, she'll take care of it. But then there's a moment where if it doesn't go, Well, Bolus wise, I kind of roll up to her and I go, Hey, that Bolus was pretty good. I said, I think it just maybe wasn't enough here. We're gonna have to add a little more now. No big deal, this will be fine. And I let it go. And I let it go. And I let it go. And I've been doing that for six or eight months now. And with the long range goal of her understanding, oh, I am trying but it's not quite working. But it doesn't seem to be too bad. And then it kind of culminated into this morning where she wanted Cinnamon Toast Crunch where we didn't have time to Pre-Bolus. And I mean, it's now been an hour since I told you that. So it's been so long ago that I told you about this in a different episode of the podcast. Okay. Yeah. And and Arden's blood sugar right now, if I told you that she had cinnamon toast crunch, without more than a seven minute Pre-Bolus and then I did not measure the milk or the cereal. What would you guess her blood sugar is right now

Unknown Speaker 27:17
that you didn't that you didn't measure that? She did? No, nobody

Scott Benner 27:20
measured it. It just got poured into a bowl, and then poured into the ball. If you had to guess in most situations, what do you think our blood sugar would be an hour later?

Erika Forsyth, MFT, LMFT 27:28
Oh, I would probably say in the to 200 300. Yeah, it's 118.

Scott Benner 27:35
So yeah, but I that. But I wanted her to see that there was a way to Bolus something that she thought of as vicious on her blood sugar without such a Pre-Bolus. So So now in my mind, she's got a connection, she knows she Pre-Bolus is but not enough when she's on her own, and that it needs to be fixed. But today, she gets to see no Pre-Bolus that doesn't need to get fixed. I just want her to see. While there's a lot of possibility in here, maybe this isn't as strict as I think it is. And maybe this old man knows something he should be telling me that I maybe should be listening to like, And to me, that's a long term plan because I could have walked up to her and told her that but I don't know what good that's gonna do. Anyway,

Erika Forsyth, MFT, LMFT 28:19
so what kind of Yeah, so teaching, you're, you're you're teaching, you're modeling, and you're you're giving her opportunities to see different variables to write, I think that's helpful. Like you can, within reason, and if you're able to manage, eat quickly, or you know, not waiting for whatever your Pre-Bolus, designated tinus. And then she gets to gain that independence over time. That's it, and you guys have a great relationship to trust. It sounds

Scott Benner 28:46
like you know, and I haven't had to give away any of her long term health to accomplish this hurry one still, or a one C is still in the fives. So it's not it's not like that's the one thing that I see people say that always like, turns the screw in my heart the wrong way. It's that, well, they want to take over now. So okay, they're a once he's gonna go from six to nine. But at least they're figuring out I'm like, I don't that doesn't seem like a good idea to me. And there's gotten that me seeing other people do that made me think long and hard about like, how are we going to do this transition without that happening? And I don't know that I'm going to be successful. Yeah, but I'm just these are the steps I've taken so far. And I yeah, I mean, and our relationship is good. I mean, but she's still 17 like, she still you know, says horrible things to me and treats me like I'm a moron. You know, sometimes, and, and I still like, you know, go off the handle sometimes. And I'm like, Oh, my God, like, you know, like, everything seems irritating. I'm a person too. And I didn't exactly grow up. Well, if you're listening to this podcast into this many episodes, you realize I'm almost feral. Like it's it's weird that I ended up even okay. So, uh, you know, anyway, that that's pretty much it. I think that's smart. Well, I

Erika Forsyth, MFT, LMFT 30:03
think I think you were asking you had brought up, you know, when when do you intervene, right? So to prevent either the increase, you know, the raise in your agency or to prevent, you know, the long term complications, I think going back to always asking inviting your team into the conversation of like, okay, on Wednesday, we're going to allow you, or, you know, we're going to give you this opportunity to earn our trust. Now, what? together, let's determine what number Am I good? Okay, am I going to intervene? And getting to and you write it down, and you have that agreement with your team to say, okay, is it gonna be 150? With the arrows, you know, diagonally? Or is it gonna be whatever it is? Right, like, it'd be very clear if you're on a CGM, is it?

Unknown Speaker 30:53
You know, now we're in 20 minutes

Erika Forsyth, MFT, LMFT 30:55
isn't an hour at the time, the arrow position and the number? Yeah. And then you say, okay, and I'm going to text and then what? And then really clearly as inviting the teams, okay, what is our text message going to be like, if they're at school, and one thing is interesting, but I have heard that you've kind of noted during COVID, teams have have done a little bit better. And this is not obviously, across the board, but from what I've heard at home, because you can just kind of you can all manage it together. But you also don't have that pure factor. And so if you are finding as your teams are re entering into school, and you know, so called normal life, and you're seeing maybe a little bit more of this, either defiance, or desire to be independent, or forgetting to Bolus number one, that's, that's just normal. And then number two, kind of inviting your team back into that conversation of like, Okay, this is how we were doing during COVID. I know, it's not always going to be this way. But how can we how can we kind of reestablish what was happening at home and create kind of those expectations and boundaries, but it is, it is a constant challenge. And well, I don't have I have two little girls. I don't have teens yet. But I've worked with a lot of teens professionally and I know what I was like as a teen. And it wasn't always pretty. And so I just I, I cheerlead you, and support you. And just remembering that it's not going to last forever. That is important, too.

Scott Benner 32:29
It is hard when you're younger, because everything I mean, as a younger parent, like everything feels like now is forever. And it really isn't like I you know, I'm almost 50 and I have a 21 year old son and I guess I might be young tab a 21 year old a little bit but I you know, you you look back and you're like, Oh, I remember being so worried about that. And it didn't end up mattering. But it didn't matter in the moment. It just, it doesn't matter now. Like there's a there's a now there's micro and macro to everything. And there's there's what's important now and what later you'll be like, Oh, I guess not nice. That wasn't really important. I can't believe I spent so much time on that. Do you have enough time to talk about kids burning out on technology in this episode? Or do you have to go

Erika Forsyth, MFT, LMFT 33:12
Yes, yes, no, we can. And I before we transition into that, I was just gonna I was thinking I just listened to the episode of the three girls in the Cayman Islands, which was just fabulous. And it made me think of you know, this here they are, they could be feeling isolated on the island as as a type one but yet they have each other and the significance of for your teen if they really are struggling with that, you know why me I feel so isolated I just want to be like my friends. If they are open to it, you know I do encourage you to kind of maybe their outreach through your your endo or whatever your treatment team is to see if you can connect your team with other teams whether and now with you know, every everyone's very comfortable of with remote and virtual correspondence. To integrate that into your team's life whether it's just a phone call or a zoom or FaceTime, whatever it is just to kind of decrease that sense of of isolation and like an I don't feel normal type feeling right. And I want to be like my parents I just that was just my life. What

Scott Benner 34:17
wasn't interesting to see the three of them they you know, you hear kids like I just want to be like my friends. There's these three girls living on this island with not that many people and they are just like their friends.

Unknown Speaker 34:27
They have so beautiful. Yeah,

Scott Benner 34:29
yeah. Yeah. wasn't a great too, that they were too young to feel trapped. Like when I was like, No, how would you get away like and then I like a ramped it up. I was like if Godzilla came How would you get away and they're like, I don't know. Like, they don't even think of it as that way. me as an adult. I'm like you are trapped in a tiny rock in the middle of the ocean. You're gonna die. If they didn't see it that way. They were really lovely. Actually. Yeah, yeah, I enjoyed that a lot. Okay, so, you know, Heather's like how? Yeah, she says, How do you help your child work through burnout. She says she has a nine year old who was diagnosed just over a year. ago. They're using you know CGM and pomp for almost a year. But she feels like they've hit the wall with technology. I hear people say this a lot. I have to admit, I don't know that I understand it. And because then they say, I think we might need to take a break. And even though As parents, we don't want to,

Unknown Speaker 35:18
yes, yes.

Scott Benner 35:19
I'm always weirded out by that, like, so I I'm a bad person to ask because I really have a, I really have a 1978, northeast version of an answer for this, which is kids don't get to make medical decisions in my house.

Unknown Speaker 35:31
Right. Right, right.

Scott Benner 35:34
Because I will always like what else you're gonna put the 14 year old in charge of paying the mortgage, like, you know, they're 14. But right, what's the rest of it that I don't that I don't think about?

Erika Forsyth, MFT, LMFT 35:45
Well, I Well, two thoughts. Yeah. For number one, personally, I have felt that way. I actually was on, I did what we used to call just shots without a deal MDI, I gave myself shots and took my blood sugar, a finger pricks for the kind of first third of my so called diabetes career. And then I transitioned to a pump and college. And again, I'm not giving medical advice, you want to do this with consultant, you know, if you ever decide to do this, consult with your doctor first. But I remember feeling like I just wanted to take the pump off. And if I did that, and I would say, Oh, I'm gonna take the pump off for a week, and I'm gonna go back to injections. And I and I did consult with my doctor, and they told me how to do it giving, you know, do the lantis this amount and do this, you know, I was taking I think regular at the time. And I didn't even last a week, because it was so irritating, to like have to be constantly giving myself injections. And the same and so I probably put the pump back on within the next day or two. Because I'm like, you know what, I'm kind of irritated by having my pump. Because really, it's just like, it's the thing that's on your body that can get annoying, and I get it. And so you feel like mentally if I remove this pump, I'm not gonna have to be thinking about it. Maybe my type one is much. But then then you're having to constantly go back to what you used to be doing. And it's kind it's irritating, too. And I had this experience with the Dexcom or the CGM. I have a Dexcom. And I don't know when this was, but I think I think my time had lapsed, it was 10 days, I was gonna remove it. I'm like, You know what? I just I kind of want to have a break mentally from having it on wherever it was on my body. And I'm gonna do finger pricks, and I did not last through a full 24 hours. So I'm like, What am I thinking? Like, I don't know, I'm so used to knowing my trends and where I am. And I'm having to fingerprick you know, and I would do it 10 or 15 times a day like pretty. It's a lot, right. And I'm like, Oh my gosh, I cannot wait to get the CGM back on and so I don't know again. only do this with the with the support of your doctor. But it might be worth trying. Because then your child might wonder like, Oh my gosh, it's so much easier having these my pump or CGM on me. Anyway, that's my first. Sorry. Go ahead.

Scott Benner 38:14
any correlation? I'm glad you had a personal experience with it because it makes it so much more real. But is there any correlation to you know, when you see somebody break up with somebody? They're like, Oh, this guy's my problem. And then three days later, you're like, turns out he wasn't why I was upset now. I miss him. And you know, like, Is there any of that? Like, is that true? That's called transference in the business. Right? Like, were you mad about one something? You put it on something else? Yeah, every married guy right now listening is laughing their ass off. They're like, Oh, is that what that's called? That's what that's called what happens to me is it? But But yeah, like that, that idea of like, I'm just like, I'm irritated. And I'm aware of this must be my problem. And, and I just I'm so thrilled that that's what you said. Because, yeah, go ahead, break up with me. And I'll wait over here. For you to realize maybe that wasn't a good idea. Like maybe your pump is just sitting in a drawer go and she'll be back. You know, like,

Unknown Speaker 39:10
absolutely, yeah, yeah. Wait, yeah, she let's just count down. Yeah,

Scott Benner 39:14
I'll take a break. She'll be back soon. Don't you worry. She doesn't like, that makes so much sense to me. So don't fight it.

Erika Forsyth, MFT, LMFT 39:22
I mean, that would be my suggestion. And because I think there is something too, though. Yes, it is the like, Okay, I'm frustrated with like, it's, it's can be annoying having type one, right, like you're having to think about all the time. And then you have this visual reminder. And it can get caught on things and all you know, all the and it can fall off. And that can be frustrating. But I think ultimately, once you take a break from all of the incredible technology that we do have and you go back to, you know, the injections in the fingerprick. So you kind of realize, wow, I still have type one. And doing all this is is more frustrating and irritating than actually just having the pump on or the CGM on but then That's kind of a nice thing, because then you're like, Oh, I'm so grateful for this. The thing that I couldn't wait to rip off, I go back and say, Oh, I'm so grateful for this CGM. Yeah. So it's kind of this beautiful process and allowing that to happen i think is okay. Given you know, your own know if you feel you feel safe doing it right, yeah.

Scott Benner 40:19
When one day Kelly kicks me out, right? I know that like a month or two later she's gonna be walking around is like dust bunnies collect around her feet. And she'll go, Oh, I didn't know he was taking care of that. Right? I should be like, Oh, I wonder what else he was doing? I have to tell her if she's ever listened to this? Where do you find out all this stuff I do that you don't have to do? You know, like, it's um, and I do think that about the technology as well. And you made me think a little bit about I know, we're wrapping up. But you made me think a little bit about people who have other medical issues where they can't get away from their technology ever. And it made me realize how lucky you are to have diabetes, that there is an alternative treatment method where you could at least experience it without and by the way, for people who don't use the tech who are doing fine. I think that's terrific. This is just Oh, yeah, this is for people who this was specifically the idea about burnout about technology about like, Oh, I have to get away from this or it's bothering me. But maybe it is just a reminder of the fact that you have diabetes, and you're just going to find a different reminder when those are gone and make your maintenance more, you know, heavier. We're Yes. cumbersome somehow.

Unknown Speaker 41:33
Yes, yes.

Scott Benner 41:34
And you said, I'm sorry, Jeff, another thing you want to say about that? Did I cut you off in the middle of getting a no?

Erika Forsyth, MFT, LMFT 41:39
No, I think? Yeah, I think that that was kind of the gist of it. And allowing, allowing your child to be angry at the technology is okay. Because ultimately, we know, we probably are just angry and frustrated and sad about having the LMS. And so sometimes it's easier to be angry at the things that we need to take care of ourselves. And to say, gosh, you know what, allowing, allowing for those emotions, and giving your child space to maybe they're not verbalizing it, but they're saying it by like, please rip this thing off with me. It's that's okay. And then just to kind of give space to that. Yeah.

Scott Benner 42:22
And they'll likely get back to it.

Unknown Speaker 42:24
Yes,

Scott Benner 42:24
I think so. Because you realize that, that the anger doesn't go away. And then you need to, then that's a new thing to address.

Erika Forsyth, MFT, LMFT 42:32
But so right. Right. Right, then that you allow that whether it's through your conversation with your parents, or or therapist, or whomever your support group, yeah, let that come out.

Scott Benner 42:42
Yeah. And it? I'll tell you, it exists. And I think we'll probably answer this question another time when we record but it exists at ages that you don't expect, because there was a time when Arden was maybe five or six, where she told me just out of the blue, and I would have told you that Arden does great with diabetes, I don't see her thinking about it too much. Like all the, you know, when people are like kids are so brave, I always think like, they're not really brave, they just don't have another choice. You know, like there's a difference between bravery and not having a choice. bravery is, you know, you're across the street and a car blows up and you go pull somebody out of it, even though there are other people that are helping and, and not having choices, you're in the car, and you need to get out anyway, you know, like that. There's right there. And so she says to me, we have a friend who has a child who's I don't even know what the correct term is, but has some some mental deficiency that that impacts a child's life. And she said, I'd rather be him than me. And she was like six or seven. I was like, why? And she goes because I can die from this. He's not gonna die from that. And I was like, wow, I did not know that my seven year old had the bat grasp of all this. And so and so it's easy to say kids don't understand deeper things. But I think they do. And I think they're good at hiding it. And I think you could end up seeing that as bravery. So just because they seem right doesn't mean they don't need support, and they don't have deep understandings of the situation that they're in.

Erika Forsyth, MFT, LMFT 44:19
That's how I feel, right? Yeah. So we often say you know, that children are resilient and we've been talking a lot about that right through COVID and that they are going to transition and be okay. But underneath Yes, they are resilient, and they can persevere, but they still can have that. That sadness underneath their resilience and that's that's okay. Yeah,

Scott Benner 44:38
just because your eight year old doesn't turn to heroin doesn't mean they're not under pressure. It just seriously because that's what you're talking right. Yeah, right. resilient because they don't have another choice and you're in charge of their life and they're stuck in a room like you don't mean like they're not. If you if you let an eight year old out on the street and put too much pressure on it. It I can't believe I said it him or her. It they'll fall apart just like a 45 year old would have that situation. They just don't have the opportunity all the time. And that's why I'm imagining. You see kids internalize, internalize, internalize, and then it turns to something much more drastic when they lash out Finally,

Erika Forsyth, MFT, LMFT 45:16
is that fair? Right? Yes. Yeah, I wouldn't know. And maybe they have the the ability, the develop, they've developed to a place where they can identify and express you know, their emotions, then that will come out. Yeah. Well, Erica, thank

Scott Benner 45:31
you very much for doing this with me again, I am having a great time, I think of you as emotional journey. so

Unknown Speaker 45:38
wonderful. I appreciate that. Thank you guys. Seriously.

Scott Benner 45:48
Hey, huge thanks again to Erica for coming back on the show. She'll be back again. So look out for it in upcoming episodes. You can find her at Erica forsyth.com. You can find the diabetes pro tips, the defining diabetes series, and so much more at Juicebox Podcast calm or diabetes pro tip calm. And please take just a few minutes out of your day to go to T one d exchange.org. forward slash juice box and fill out the survey. All they're asking you to do fill out the survey and your answers will help others living with Type One Diabetes, you have to have type one or be the caregiver of type one. And be a United States citizen. Head over there now support the Juicebox Podcast support people living with Type One Diabetes. T one d exchange.org. forward slash juicebox. Thank you so much for listening. I'll be back soon with more episodes of the Juicebox Podcast.