167. Teen Mental Health: Stigma, Social Media, & Starting Therapy feat. Dr. Justin Puder

Nov 4

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Today's guest is Dr. Justin Puder— a licensed psychologist who mainly works with teens and young adults around many mental health difficulties including anxiety, depression, trauma, and loneliness. He also creates social media content under the handle @amoderntherapist to reduce stigma surrounding mental health through vulnerability, knowledge, and humor. We discuss advice for people whose siblings are struggling, differences between how millennials and Gen Z view therapy and mental health, the impact of stigma and misinformation, ways that stigma affects men’s mental health, the role of social media when it comes to being vulnerable, tips for teens on starting therapy, how to sert achievable goals in therapy, advice for parents and teens on navigating a parent requiring their teen to go to therapy, and a daily practice teens can do to help their mental health.

Justin's Instagram: https://www.instagram.com/amoderntherapist

Mentioned In The Episode…

SHOP GUEST RECOMMENDATIONS: https://amzn.to/3A69GOC

Episode Sponsors

🛋This week's episode is sponsored by Teen Counseling. Teen Counseling is an online therapy program with over 14,000 licensed therapists in their network offering support with depression, anxiety, relationships, trauma, and more via text, talk, and video counseling. Head to teencounseling.com/shepersisted to find a therapist today!

About She Persisted

After a year and a half of intensive treatment for severe depression and anxiety, 20-year-old Sadie recounts her journey by interviewing family members, professionals, and fellow teens to offer self-improvement tips, DBT education, and personal experiences. She Persisted is the reminder that someone else has been there too and your inspiration to live your life worth living.

a note: this is an automated transcription so please ignore any accidental misspellings!

Dr. Justin Puder: [00:00:00] and for people listening who you feel that under your skin of like,, but is anybody really experiencing what I'm experiencing?

To a degree. Yeah, no one has the exact same story, but there's someone out there who feels symptoms you do or has felt hopeless or lost or , the shame that you're talking about. But I'm with you that a lot of us because of society and biological components as well. We're just taught to bury that and it, it doesn't go away and it doesn't go anywhere is the unfortunate thing.

Sadie: Hello, hello and welcome back to She Persisted. I am so excited you're here today. We're talking teen mental health and stigma. I am so excited to have Dr. Justin Puder on the podcast today. You might recognize him from the handle at a modern therapist on TikTok and Instagram. He is also a licensed psychologist who mainly works with teens and young adults.

So this was the perfect collaboration, and it's funny when I was looking for his bio and headshot to prep this episode, I searched [00:01:00] his name in my email and I found one of his TikToks that I had sent to my therapist literally like three years ago. So he's hilarious. I love his content.

And this was also just such an incredible conversation. We talked a lot about advice for individuals who have sibling struggle with mental health. We talked about Gen Z versus millennial approaches to mental health. We talked about stigma and misinformation. We also talked about men's mental health, which is a really important topic.

And additionally, we touched on the role that social media can have on being vulnerable about mental health. Tips for teens starting therapy for the first time, how to set achievable goals in therapy, advice for both parents and teens when parents are like, you gotta go to therapy and also a daily practice that teens can do to improve their mental health.

So I really hope you guys enjoy this. We talked a lot in this conversation. We went over so many different topics in a really short amount of time. So this is just value packed and I can't wait for you to listen. So as always, if you enjoy this combo, make [00:02:00] sure to share with a friend or family member, share on social media, leave a review, all the things.

It helps the podcast and yeah, you guys are the best. So let's dive in. I hope you enjoy and I'll see you next week.

Well, thank you so much for joining me today on She Persisted. I'm so excited to have you here to talk about mental health and stigma and really just dive deep on your story and have you on the show.

Dr. Justin Puder: Yeah. Thanks so much for having me,

Sadie: Sadie. Of course. So I'd love to give listeners some context before we dive in to the advocacy work you're doing now and how we as a society are kind of approaching stigma at this point because there's a big shift going on. But before we dive into that, talk to me about your story and how you got into the mental health field and becoming a therapist.

Dr. Justin Puder: Yeah, it really started because early life experiences. I know a lot of therapists we get in the field because of trauma. My story's very similar. So I grew up, my brother had type one bipolar disorder, and I always [00:03:00] wondered, , why, , he was so different than me. And we had the same family, the same parents.

Of course, a lot of people say doesn't mean the siblings were treated the same, which always a possibility, but he would have these episodes of full mania and he would do drugs. He would run away from home. He was in and out of jail, even through his teenage years. But my family, my mom and dad put a lot of resources into him trying to be like,, you know, what is this?

And in the nineties, things were different. , yeah. Especially 90s in Ohio, people weren't talking about mental health the way they are now. , it wasn't until he was in his 20s that even the term bipolar got put on him. But I was always curious, , you know, what was different about him than me.

And also during that time, my dad got brain cancer and he passed away. And then shortly after he passed away, my brother did pass away from a drug overdose. And so going through those traumas, [00:04:00] Growing up and seeing all the turmoil my brother got in because he was dealing with severe mental health difficulties.

It made me want to help people. And I was lucky during that time, , through all the ups and downs, in a time when, , literally no one I knew was getting therapy, my mom, , pushed for me to go see a therapist. And again, , It seems so wild now, but I didn't know anybody who went to therapy or saw a therapist.

I just assumed you had to be locked up in an institution to go see a therapist. That's how different it was. But it helped me so immensely throughout the turmoil that I was , yo, I really want to give and help people in the way that I've been helped.

Sadie: Yeah, we don't often have siblings of individuals who have struggled on the podcast.

I know I had my younger siblings on very early on sort of the podcast and I haven't listened back, but they were probably like 10 at the time and did not know what was going on. But for people that are listening who have a sibling who's currently struggling, which I wouldn't be surprised if they're a teen and they found this podcast [00:05:00] when their older or younger sibling is going through that.

What is your advice or even just pieces of wisdom having navigated that and also going through therapy specifically from the lens of supporting a sibling?

Dr. Justin Puder: I think first off I want to say it's okay for you to get your own help. Cause I know a lot of people when they're watching their sibling suffer, the family can pour a lot of energy into that person.

Not always, but sometimes cause people are like,, this is the person who is having all the outward problems. But you and watching your sibling, you might need to talk to someone. You might need to have a safe space to explore the sadness, maybe the frustration, maybe anything that arises for you. But if your sibling has any sort of diagnosis, , I really would want you to get curious about that.

Nowadays, it's amazing, you know, with TikTok, YouTube, there's so many good educational videos out there. Just to learn a little bit about it. Because it's easy, and I did this, right? I'm like,, well, , you know, he's my brother. , how [00:06:00] different can we really be? But biology can be very different, , of course, we know this, like one sibling can have generalized anxiety.

The other sibling, not at all, never struggles with anxiety ever. But in embracing that there can be that big of differences within family and leaning into that curiosity, you can be compassionate towards your sibling in ways that I think a lot of people who don't collect the information and kind of stay ignorant to a certain degree.

It's hard to be compassionate.

Sadie: Totally, and I think if you are someone that tends to be inclined to research things and want to understand them better, understanding the identified patient dynamic can be really validating and being like,, Oh my gosh, that's exactly what's happening in my family and lots of people feel this way.

And I think that it's definitely not a bad thing to want to learn more. And if anything, I think it equips you to support your sibling better if that is a goal that you have in your relationship. You mentioned that mental [00:07:00] health stigma and just the perception of therapy was really different when you were growing up versus today, and I've definitely noticed that even in the time that I became aware of the mental health world to where we are at in 2023.

What are the biggest shifts that you've seen? seen as we kind of seen Gen Z grow up and become the group that's now starting therapy and sharing quite loudly on social media. What are your thoughts there in the direction that we're moving?

Dr. Justin Puder: The biggest shift for me and me being a sort of is just the openness in discussing it.

, I can't explain it another way, , even when I was in college, and , the dialogue was starting to begin, like, , oh yeah, people have mental health, like,, it still would have been so bold to say, oh yeah, sometimes I, have anxiety or I struggle with depression. But now in Gen Z really moving the needle forward, it's so common for people just to be outspoken about that as they would [00:08:00] if they feel like it about their physical health.

But you see the layers of stigma in my older millennial generation, people would talk about their physical health all the time. But you would never dare say I have OCD, which I do have OCD, but it just, I never heard that from anybody. But again, Gen Z is really displaying that if you're able to talk about it, we can do something about it.

And you also won't feel alone, but so the amount of education that's out there, the amount of people sharing their individual stories, it does feel really empowering. And it's certainly, Is night and day difference than what it was for me again going through high school and college

Sadie: Yeah I would love to ask you from a therapist perspective.

I'm sure you have a lot of individuals that you interface with or clients that you've worked with where stigma is even kind of an issue that they're coming up against, even when getting support themselves. I know I experienced this when I was navigating my own mental health journey. It's something you hear really commonly and [00:09:00] sometimes it's family or friends.

Sometimes it's your community. Maybe it's on social media, but we can also experience stigma with our own mental health challenges. And so I'd love to kind of hear Sure. Thank you. How that shows up and also what you think can lead to that and what causes people to be stigmatizing their own experiences even with mental health, which is so unique, because like you mentioned, it doesn't happen that often for physical health.

It's really an outlier in the health world.

Dr. Justin Puder: I couldn't agree more with that. I, a lot of it is still misinformation. , even though people are being more open and speaking about it, the amount of times I'll hear people confuse something like borderline personality disorder, BPD, and bipolar disorder, and they're very, very different.

Or the amount of times I hear people confuse something like OCPD, obsessive compulsive personality disorder, with OCD. Again, they're very different. I still feel like...... Where even though there's information being shared a lot of it is misinformation. It's not quite [00:10:00] right And so while I'm really happy that people are sharing their own experiences I think sometimes people will jump to conclusions about things without Again, getting a proper diagnosis or properly assessed and there's pros and cons with that on the one hand I'm like,, isn't it great that all this information is out there And I'm like,, yeah, it's great to be empowered.

Look stuff up. You be your own health advocate. The risk at that is sometimes we can just misdiagnose ourselves. It's possible and it's sort of the I, I don't necessarily have an answer, but it's the pro and the con of it, of having access that everyone can have to the information, but at the same time knowing that, especially even me going through a doctorate program, I had no idea I had OCD.

I was misdiagnosing my own symptoms and I was getting an advanced degree, you know, in psychology already had a master's degree, but these things are common. So I think with misinformation, there's definitely stigma. And I [00:11:00] do think there is still a percentage of the population that really struggles to believe the existence of mental health.

And what I mean by that, I still hear and see things stereotypically. It's men to other men where I see the dialogue of like,, this is just something you should suck up. And for me, of course someone who has their own mental difficulties and psychologists in the field, it is heartbreaking because you would never say that to somebody with some physical health difficulty.

And yet I still very much see it when speaking about mental health.

Sadie: Yeah, it's a really interesting dynamic, and it's even, , exacerbated by the fact that it's a biological instinct of males to not discuss their mental health as much. They, , are less likely to pick up on emotional cues from others and less likely to express those emotional cues.

So there's all these deficits in ways that they're almost set up to fail, and it's not only, , the internal battle of [00:12:00] being vulnerable and wanting to speak up and maybe not knowing how to do that, But then you're also, from a societal perspective, maybe you've been conditioned not to. And it's also, like,, biologically, you're not as good as expressing, you're not as good as noticing when other people are expressing those emotions.

You're less likely to talk to your friends about those things. So it's a really challenging situation to overcome because you're almost, , working against what your mind and your environment is telling you to do, and yet it can be really beneficial to be vulnerable and ask for help and normalize those experiences.

Dr. Justin Puder: So, so well said. And I think having had the privilege to co facilitate some men's groups and a lot of different groups across the university settings where that's where I used to work before private practice is you will see people get used to this new way of being like,, I agree with you of like,, what is this thing where I can just say, , I get really anxious when I'm in crowds of people.

Where it's for someone else that might be easy to say like yeah, I got social anxiety that happens to me all the time But for somebody else within their [00:13:00] peers that can be a monumental moment just to be seen of like This is the internal world. I live in where people be like,, oh quote unquote that guy's just weird No, that guy's struggling with social anxiety But again, it's life changing when someone's able to say that amongst their peers and get acceptance and being seen and of course heard for what they're truly experiencing.

But I still think we can minimize that at times because everybody's on social media and people are sharing their story. There's still plenty of people who feel no one knows the inner struggle I'm going through.

Sadie: Yeah, it's very true and I think especially when it comes to shame and even depression and anxiety as well That is the narrative that you get put into and you're like,, no one has experienced this.

No one's in my exact situation No one has dealt with these relationships before and so it seems really counterintuitive to open up about those things because logically you're like Well, no one really is gonna get it, but that couldn't be further from the truth a lot of the time.

Dr. Justin Puder: So well said Yeah, and for people listening who you feel that under your [00:14:00] skin of like,, but is anybody really experiencing what I'm experiencing?

It's to a degree. Yeah, no one has the exact same story, but there's someone out there who feels symptoms you do or has felt hopeless or lost or , the shame that you're talking about. But I'm with you that a lot of us because of society and biological components as well. We're just taught to bury that and it, it doesn't go away and it doesn't go anywhere is the unfortunate thing.

Some people and some clients I pick up, they're in their forties and fifties. They're coming to see me for the first time in their life to talk about their mental health. And it is it's such i'm grateful for picking up clients when that's their experience that they're trusting me in this journey And it saddens me that this couldn't have been something that they opened about decades ago

Sadie: Yeah, I can't imagine getting I mean i'm 20 now, and I'm like,, oh, life is so challenging up to this point, going 40 years without being able to talk to someone else or get that support [00:15:00] or feel what you're experiencing is okay and normal and universal.

It's mentally incredibly challenging. I can only imagine.

Dr. Justin Puder: Yeah. And it is, and I think that's the cool thing about being in private practice now is I have clients across the age spectrum and you do you get these narratives that they just pull at you of . What has the last 40 years been of like,, yes, living with this and, you know, and this is what gives me so much optimism for the future, especially with Gen Z is , I experienced that less and less.

So every time I pick up new teenagers is like kind of my wheelhouse of clients. I see my private practice. It's rare that's the case. It's rare that it's the case. Again, no one knows their whole narrative. Of course, it's different when you're in your private, safe space of psychotherapy with your therapist.

But, it's rare that they come in and no one knows any of their symptoms. Which tells me, we're moving in the right direction. , they've told the teacher, maybe they've told mom, maybe the sister, and of course, [00:16:00] in some families it might be that they haven't told anyone. But it's rare that's the case.

And that, that does, it gives me optimism.

Sadie: Yeah, definitely.

Today's episode is brought to you by Teen Counseling. You guys know that whenever I have a therapist on the podcast or am talking about therapy journeys and the benefits of going to therapy, I like to give you a specific resource to find a therapist. So if you haven't heard of Teen Counseling, it is BetterHelp's branch of online therapy for teens.

They have over 14, 000 licensed therapists within their network and offer support on things like depression, anxiety, relationships, trauma, and stress. so much more. They also offer talks, text, and video counseling, so depending on what level of support you're looking for, you are able to get that need met, and what you're going to do is head to teencounseling.

com slash gpersisted. You're going to fill out a quick survey talking about what you're hoping to work on in therapy and they will match you with a therapist that specializes in that area. And then from there, they send a super discreet email to your parents if you're under 18. I send it to [00:17:00] myself. I try it out. All it says is Sadie or whatever your name is, is hoping to work with a therapist from Teen Counseling.

Click here to provide consent for treatment and learn more. None of your information about what you're gonna be talking about is just closed. So if you wanna check out teen counseling, you can go to teen counseling.com/sheed or click the link in the show notes. I.

For people that want to start speaking up and voicing their experiences to someone else, like you mentioned, whether it's a family member, maybe it's a friend, maybe it is to a therapist, what is your advice and strategies that people can use to be able to help?

Overcome that anxiety that can come from sharing your experience and being vulnerable, especially with relation to your mental health.

Dr. Justin Puder: This is where I think for all the pros and cons and the research, this is totally a side conversation about social media. This is what I think is one of the highest pros of social media is so many of my clients, and I see so many people.

Take advantage of being on I am OCD TikTok [00:18:00] where you're engaging in conversation with people and sharing your experience and sort of liking the comments like, yo, I have the same intrusive thoughts or , oh my gosh, I thought I didn't, I thought there was something really wrong with me that I was the only one exactly like you were saying before.

But I think this bridge of using social media as a way. At times it does feel real intimate, but it sort of feels less intimate for most of us than telling our mom or dad or telling, you know, our sibling or maybe peers at school. But it is real. I mean, it's real people experiencing the same mental health difficulties or struggles.

And I think it bridges lots of connection, conversation, information. And overall, it does way more good than bad for that sense of sharing things that we normally bury inside.

Sadie: Yeah, it's almost a very accessible version of group therapy, but like that first time, yeah, like the first time you go to group therapy and , you're like,, wait, all you guys are also experiencing this and everyone's [00:19:00] also having the same thing going on.

And I remember the first time a therapist brought up group therapy, she was like,, I think you might have some social anxiety. I think it'd be good to Do group therapy and whenever a therapist brings up group therapy for social anxiety, I'm always like couldn't there have been some level of exposure to suggesting group therapy because I feel like that is your worst nightmare.

If you have social anxiety, it's like be super vulnerable in front of a bunch of people that you don't know that are probably the same age as you but it is very helpful and it definitely is that feeling of like people get it and I think social media can also provide that especially when you're not necessarily able to articulate or All right.

Understand, , what exact emotion you're experiencing, or how to describe those thoughts, and when someone else puts a name to it, or is able to describe it in, , a book, or a podcast, or on a social media post, like you were saying, it's so validating.

Dr. Justin Puder: Oh, so much. , I feel like I'm on social media as much as anybody.

It's , when you see that meme... That just relates for me to my OCD or grief. I'm like,, oh my gosh I'm, like yes [00:20:00] And i'll be like I don't I hadn't even thought of it in those words or in that context I'm, that's exactly what I feel But it is it's Yeah, it's a way of feeling seen that , we could have never anticipated, , especially again, my generation where it's like,, I got Facebook when I was 23.

And that was a big deal. So it but it's amazing to connect that way and not feel alone. And again, isolation is such a terrible thing for our mental health. And it's one thing to be physically isolated. But it's another thing to feel the shame of like,, there's no one else like me out there.

Transcribed Yeah,

Sadie: it's really challenging and I think it really does perpetuate a lot of those negative cycles that might be the impulse when you're struggling with depression or anxiety or any of these things. And I definitely agree there. I want to shift gears a little bit. I love when therapists come on the podcast and they work a lot with teens because it's really, I think, helpful to, Kind of, again, break down the stigma and break down the barriers around getting therapy and what to [00:21:00] expect and also how you can use therapy as much as possible.

I think that I've definitely been someone who's gone to therapy and , talked about random things and run out the clock and then been more intentional, been like,, this is what I want to focus on and this is what I want to get out of it. So, having worked with many teens in a therapy setting, what is your advice to teens that are entering or beginning therapy for the first time?

Dr. Justin Puder: It's such a great question. This is important. I would want you to be able to pause and ask yourself, what do I want? Meaning what, if this person were to help me, even if I look ahead, three months, so I know we're recording now, but like if it was around the holiday time and you're like,, I met with this dude, Justin, and he's helped me so much.

What I'd want you to ask yourself is what changed for you? And so I usually ask my teens this a lot, right in the beginning of like,, what gets confounded for a lot of the teens is what your mom wants for you, what your dad's telling you you [00:22:00] need to change, what your teachers are telling you at school needs to be different.

It's different when you can kind of pull back from that and say, but what is it that I'm sitting with that I would want to be different? And sometimes it's different things come out , you know, I'm just. Thinking off the top of my head, but some people would be like,, I would like to be in a relationship.

That's not what my mom's sending me here for why I originally walked through his door, but I would like to feel good enough, confident enough that I could date somebody and be in a relationship that's different. Because when you go inward and you're like,, how could this therapy really help me when you really see transformative versus.

When we're changing something for someone else, which is the unfortunate burden that gets put on a lot of the teens of Yeah, mom's saying I need coming here because I don't listen to her as much but you know There's all these other [00:23:00] factors which is different when you work with adults because unless it's court mandated You don't have that happening But for the teens I like to work with them and be like how can I help you and that is there's self reflection going on of like There might be some things you've never verbalized to someone that you would just want to say and share with someone and be like,, what does this mean?

, what is this thing I'm experiencing that my parents don't know about?

Sadie: I think another thing that's challenging when you haven't been to therapy before is setting goals and understanding, like, what reasonable goals are. I think I've been in different stages to therapy and I was like,, this just isn't gonna work.

I'm here, something's happening in this hour, but nothing's... going to work and there's going to be no outcome. And then there's other periods of time where there's a really specific goal where it's like,, I am not able to get my sleep routine in check. And , that is my goal for the next couple of weeks is making sure that routine is really refined.

And I'm solving any emotional reasons that I'm avoiding going to sleep and scrolling or whatever is happening. So how do you address goal setting and therapy? [00:24:00] And having those be goals that are ambitious and also reasonable so that you do feel that motivation to continue as you keep meeting those goals throughout your journey.

Dr. Justin Puder: I think in having the conversation of , what would be different? What would change? I start to get a feel right away for how specific of goals people have. , is it general? Like,, I want to build self confidence. And even in that you can set specific goals along the way of , Well, what would it mean?

, how are you defining self confidence for yourself of like,, well, I'd start talking to people in my classes. That's okay. Yeah. So what class are we talking about? You know what I mean? Scaling that goal even back of , is there a specific person? , is there a way we start to build up to you asking someone on a date?

Because usually there's a lot of steps of people feeling comfortable in their skin between them. But you start to get a feel early on, a people being like,, Yeah, I can't. I'm not sleeping and that's really bothering me. And then it is. It's exactly what you said. It's , what are the reasonable [00:25:00] steps and things we can get curious about now and the things we can start testing, which is something I think a lot of people in therapy don't quite understand if they're new to therapy is.

You are experimenting as much as like I have this education and I can know the science in this and that. I can't know exactly what's going to work for Sadie. I can't. We can get curious. We can test things out. We can be like,, how about we stop scrolling an hour before bed. And you might come back after a week and be like,, it didn't really make a difference.

And then we're going to look at some other things where , like, what about, let's look at caffeine intake and you're like,, Oh yeah, , you know, I tend to , like, having my cold brew before bed. I have my cold brew at five. What's the big deal? All right. But these are the, it's the curiosity in therapy and the experimentation in your life that leads to change because it's not the same for everyone.

And I think that's what makes therapy so interesting and so unique. Understanding that when you go into therapy, [00:26:00] that there'll be things you have to test out and you might not know what the outcome is going to be. And some might work better or worse for you. That is real therapy, is the experimentation.

Sadie: Definitely. And I think that's also true outside of your sessions. I think part of it is the experimentation about what you bring up in your sessions and what goals you set and understanding like how specific you want to be. And then it's also building that muscle of implementing what you talk about, and then reflecting on it and refining and continuing to build that muscle.

I want to get your perspective on one of my most frequently asked questions that I'm , always at a loss with, which is teens that don't want to go to therapy and the parents are like,, this is happening. And they're either like,, how do I get my teen to be on board with this? Or teens are like,, my parents are making me go to therapy and I don't want to go.

I'm sure you've had clients in that position before who. Come and are like,, I hate this. I don't want to be here. I don't want to talk about anything. How do you approach that and navigate that and then at the end what is your advice to both parents and teens in that [00:27:00] situation?

Dr. Justin Puder: Starting with, it's an amazing question, starting with the parents.

This might feel weird for parents. Let your teen pick the therapist. Trust me on this. Let them pick. I know you, you could even show them psychology today. com to scroll some profiles. If it feels overwhelming for them, you could even like,, it feels like a lineup in a way, but you could show them, send them 10 profiles or five if they don't even want to do that work.

There is the therapeutic relationship is so important with change. It's the number one predictor of outcomes So if the parents pick the therapist, how do you know as soon as the team walks in the room? They take one look at them and they're like,, I don't feel comfortable with this person We know those factors exist and as much as you'd say, well you get to know them try It's different when you empower your team to be like,, I'm going to let you pick again.

I can show you the resources or whatever, but let [00:28:00] you choose. And for the team, I would say, and this is the important part, it is a relationship meaning. In one session, the only thing I would say that must happen is you feel seen, heard, and understood. That's it. Meaning, how many people, and we all , met our bestie or whatever, and you're like,, yo, I just really like them, that's great.

But with most relationships, it takes time. I have to get to know you, I gotta know your narrative, I gotta know the things you like and dislike, and get to know your personality. Therapy is the same because every person is different and so the way you implement change and the way you emotionally and cognitively arrive in that session, you gotta have that therapeutic relationship for it to be effective.

So I'd want teens to know that the relationship building, it doesn't happen in that first like,, 50, 55 [00:29:00] minute session. It does take time. Yeah,

Sadie: I definitely agree. And I think having your teen or child choose a therapist is huge. And especially if you're like,, Welp, you're seeing a CBT therapist or we're only going to go DBT because that's what the recommendation is.

Give them five or ten and be like,, here's your options and you can pick from that. And I remember one time I was talking to a friend and he was like,, yeah, I see this old man therapist. I was , what? You talk to who about your problem? Because I had worked with, , relatively young therapists, thinking, , all female therapists at that time.

And I was like,, I'm sorry, who was sitting on the other side of the couch when you're, , talking about these things? It was so mentally confusing. And I was like,, it is about feeling comfortable opening up to someone, feeling like they can somewhat relate to your experience and relationships and even their background.

, where have they lived before? What is their family dynamic? Can be really helpful in understanding who you're working with. And also. As a parent, if you're like,, okay, I want to put together this list and give it to my teen to decide, I think also understanding therapists specialize in so many different things, like you mentioned, and [00:30:00] being like,, is the therapist that only works with family systems, or do they do more individual therapy with just teens?

Do they only work with adults? It definitely can be overwhelming but even if you don't have to make the final say, then it's on the teen to make that decision, and you can always switch if needed.

Dr. Justin Puder: I exactly what you said and I there is some because this is what the data is. It's called the dodo bird hypothesis and verdict is all psychotherapies tend to perform the same and some people are amazed to find that out.

They'd like when CBT be the best for anxiety and depression and EMDR be the best for you know trauma. It's like no. In the studies that look at all this, in the meta analysis that look at all, all psychotherapy approaches tend to perform the same. There aren't significant differences. So what we know from the research is the significant difference is within the therapists themselves, in the relationship.

So, it's not to say it doesn't matter because I'm with you. , [00:31:00] if I'm going in and I'm focusing on my OCD, And they don't have it listed as a specialty or they, it's not an issue they commonly treat. It's probably, it's not going to be a good match. But at the same time, as far as psychotherapy approaches, yeah, there could be a variety of different approaches, but the relationship is so great that it's a healing corrective and a worthwhile therapeutic experience.

Sadie: Yeah, I have this one story I think I've told on the podcast before, but every time I think about it, I want to, , die laughing. One of my friends went to therapy, and her mom found the therapist. And at first, she was like,, oh god. So it was , this older woman, it was , only via Zoom, even though this was , way past COVID.

She would tell the therapist, she was like,, you know, , I'm struggling with anxiety. And the therapist was like,, hey, I'm going to research that and get back to you. Oh my

Dr. Justin Puder: word. That's

Sadie: what the therapist had to research how to cope with anxiety? Yeah. I was like,, you're kidding. No. And so, , brief screening, make sure it's the right [00:32:00] demographic, they've at least done some work in that area, and then like your, you mentioned, the relationship is really key.

Dr. Justin Puder: Oh my gosh. I know. My biases are coming out because I'm like,, if you polled therapists and you're like,, what are the things that every therapist can treat? Anxiety and depression would be towards the top, maybe trauma right below. But it's like,, anxiety isn't niche. It's not niche. Yeah, no.

Sadie: So that's, wow.

, she couldn't even just spend, like,, do some deep breathing, count some things around you, , she just, , really drew a blank.

Dr. Justin Puder: Needed, needed to take some, , weekend trainings, I guess, to get updated with the, with treating that guy.

Sadie: Wow. Yeah. Yeah. Yeah. The... Last thing that I want to ask you for teens listening is if there was one thing that you wish teens did without necessarily going to therapy, if that's a barrier or resource they're not actively using, but if it's one practice, one exercise, one [00:33:00] piece of insight that you wish all teens were equipped with to navigate all the challenges they're facing today, what would that be?

Dr. Justin Puder: Yeah, I feel strongly about this and the times I've done this And the times I haven't, it's always come up and my clients that do it, it makes a huge difference. It's journal your experience. On good days bad days, but all days And this is as simple as taking a couple minutes A lot of my teens use the notes app.

They're on the phone boom in the notes app And usually what I have them just write is what did I experience today? How did I feel and the reason is this is the thing I want? You to understand about you is you are such a complex, interesting, ever changing being. We think we know what's going on and what all the factors are, but if we don't have the practice of pausing to document, we really don't [00:34:00] know.

And I'm telling you, I'm in this boat too, because when I'm doing it, I'm always shocked by, yo, I was actually super overwhelmed today. And yet if someone would have stopped me on the street and asked me , Justin, how are you doing today? I've been , fine, good. But when I paused to journal, I'm like,, the day started out hectic.

I was racing through, I felt inadequate. I drank too much caffeine and then I was , struggling to get things done. I overbooked myself. But again, what I'd tell you is. There is a practice in strengthening the muscle of slowing down and documenting your experiences that's invaluable as you move forward in life.

Sadie: Have you heard of the How We Feel app? No,

Dr. Justin Puder: but I feel like this is , right up my alley.

Sadie: You're gonna love it. So I feel like...... I sound like a paid advertiser for this. I promise I'm not. I just found it like four years ago and now I tell everyone about it. It asks you how you're doing and you click, it's my thing is not focusing, but you click check in and it gives [00:35:00] you high energy, low energy, and pleasant and unpleasant.

That's an easy freebie rather than being like I'm sad or I'm happy. So high energy, pleasant, having a conversation, and then you get all these emotion words and this is high energy, pleasant, low energy. So many. And so , even if you're high energy, pleasant, it's like,, are you successful?

Are you amazed? Are you determined? Are you eager, are you upbeat? There's so many words. And then you can track it and you can also say , what's happening right now? You can do a photo, you can add a voice note. You say where you are, what you're doing, who you're with, and you can also put your sleep data in there.

And then you track it and it teaches you about the emotions you're experiencing. It was developed at the Yale Emotional Intelligence Center. And they, , built it in partnership with Pinterest, and I'm sure you heard of Mark Brackett. He's, , a big social media. So he helps work on that and help develop it, and it's so good.

If you like tracking things, it's top notch, and I just, they're emotion words, and, , that chart is a game changer. [00:36:00]

Dr. Justin Puder: I love it. I'm kind of shocked I hadn't heard about it before, but. I know. We need to

Sadie: advertise better. No, but yeah,

Dr. Justin Puder: I feel like you're the best advertisement. They need to send you a check for that, Sadie.

Yeah. A lot of people out there, you'll be like,, and I do the same thing. When my OCD is really flaring up and I'm in a ton of intrusive thoughts, I'm like, why? But when I'm keeping an accurate journal. I will see the little things start to rise, the stress, the feeling overwhelmed, the overbooking, all the factors.

So if the app can help you with that, which definitely everything sounds like it's there for it, track all the time. You'll be grateful as you slide into difficulties and slide out, you'll know more about you.

Sadie: Yeah. And even just being able to name the experience that you're having, I think takes a lot of power away from it.

If you're stressed or overwhelmed and you're like,, I don't really know what's happening but I cannot focus on anything and my thoughts are racing, being able to put words to those emotions makes it a [00:37:00] lot more manageable to cope with and ride the wave

Dr. Justin Puder: of. No doubt. There's no doubt about that.

Sadie: So, for people that want to continue to consume your content, and continue to reach out, maybe work with you if they're in your area, where can they find you?

Dr. Justin Puder: Yeah, you can check me out on pretty much every form of social media at A Modern Therapist.

Sadie: Amazing. I'll put that in the show notes. Thank you so much for coming on She Persisted.

This was incredible. Thank

Dr. Justin Puder: you so much for having me, Sadie.

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