Under Pressure E-Book

Lisa Damour

• Herausgeber: Atlantic Books
• Kategorie: Ratgeber
• Sprache: Englisch

Seitenzahl: 425

Veröffentlichungsjahr: 2019

Beschreibung

Though anxiety has risen among young people overall, recent research studies confirm that it has skyrocketed in girls since the turn of the century. So what's to blame? And how can we help these girls? In the engaging, anecdotal style and reassuring tone that won over thousands of readers of her bestseller Untangled, clinical psychologist Lisa Damour examining the science of stress and anxiety and the many facets of girls' lives where stress hits them hard: - The parental expectations they face at home - Pressures at school - Social anxiety among their peers - Social pressures on social media Exploring the multiple layers of girls' lives, Damour shows us the critical steps we can take to shield them from the toxic stress to which both our culture and also we, as their caregivers, subject them. Readers familiar with Damour's bestseller Untangled or from her New York Times journalism will need to read this important new contribution to understanding and supporting today's girls - and tomorrow's young women.

Leseprobe

Praise for Untangled

“Lisa Damour’s Untangled is the best description of the female adolescent journey that I have ever read. Empathetic and wise, every page is filled with a deep understanding of girls and their parents. If you read this book you will know what your daughter is experiencing, and with Damour’s advice, you will know how and when (and when not) to talk to her about it.”

—MICHAEL THOMPSON, PH.D., co-author of Raising Cain

“This is the book parents have been waiting, hoping, and praying for, because it’s far more than a book. It’s a map, flashlight, and GPS device for navigating the landscape of adolescent girlhood. Lisa Damour proves to be the perfect guide and companion: wise, whip-smart, and relentlessly practical on every page. As the father of three teenage girls, I wish I had this book years ago—and I hope that it is read by every parent, teacher, coach, administrator, and human being who wants to help girls grow and thrive in today’s world.”

—DANIEL COYLE, author of The Talent Code

“There are books about teenagers that are smart. And there are books about teenagers that are practical. Lisa Damour thankfully provides us with one that is both. With palpable empathy and understanding for adolescent girls and the families they reside in, Damour equips parents with a flexible blueprint for anticipating challenge and encouraging growth in their daughters. If you have a daughter (or were a daughter!) Untangled is mandatory reading.”

—MADELINE LEVINE, PH.D., author of The Price of Privilege

“In exceptionally clear prose, Damour—a clinical psychologist—skillfully blends research analysis, psychological insight, and stories of girls and their families into a compelling narrative about what’s right about our daughters. She illuminates the seven transitions that girls must untangle to become fully themselves, with each offering a corresponding opportunity for parents to stretch and transform themselves. Throughout, Damour offers unstintingly practical advice to parents about how to talk with their daughters about what matters most and in ways that they are likely to be heard.”

—KIMBERLYN LEARY, PH.D., associate professor, Harvard Medical School; chief psychologist, Cambridge Health Alliance;Robert Wood Johnson Health Policy Fellow

Also by Lisa Damour

Untangled

First published in the United States in 2019 by Ballantine Books, an imprint of Random House, a division of Penguin Random House LLC, New York.

This edition published in Great Britain in 2019 by Atlantic Books,an imprint of Atlantic Books Ltd.

Copyright © Lisa Damour, 2019

The moral right of Lisa Damour to be identified as the author of this work has been asserted by her in accordance with the Copyright, Designs and Patents Act of 1988.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of both the copyright owner and the above publisher of this book.

Translation of Horace from Horace: The Satires is by A. S. Kline,copyright © 2005, and is reprinted here by permission of the translator.

10 9 8 7 6 5 4 3 2 1

A CIP catalogue record for this book is available fromthe British Library.

Trade paperback ISBN: 978 1 78649 396 5

E-book ISBN: 978 1 78649 398 9

Printed in Great Britain

Atlantic Books

An imprint of Atlantic Books Ltd

Ormond House

26–27 Boswell Street

London

WC1N 3JZ

www.atlantic-books.co.uk

To my daughters, and yours

It is not the presence or absence, the quality, or even the quantity of anxiety which allows predictions as to future mental health or illness; what is significant in this respect is only the ability to deal with the anxiety. Here, the differences between one individual and another are very great, and the chances of maintaining mental equilibrium vary accordingly.

The children whose outlook for mental health is better are those who cope with the same danger situations actively by way of resources such as intellectual understanding, logical reasoning, changing of external circumstances . . . by mastery instead of retreat.

—ANNA FREUD (1965)

Contents

Introduction

CHAPTER ONE Coming to Terms with Stress and Anxiety

Healthy Stress

How Stress Becomes Unhealthy

The Three Types of Stress

From Stress to Anxiety

Healthy Anxiety

The Mechanics of Anxiety

Anxiety Disorders and Their Treatments

Dealing with Ordinary Anxiety

Stemming the Worrisome Tide

CHAPTER TWO Girls at Home

Avoidance Feeds Anxiety

How to Manage Meltdowns

How to React to Overreactions

Snit Happens

When the News Frays Our Nerves

Collecting Emotional Trash

Parents Can Know Too Much

Putting Slack in the System

Money Can Buy Stress

CHAPTER THREE Girls Among Girls

Anxious Is the New Shy

Numbers Bring Drama

Healthy Conflict 101

Freedom to Pick Her Battles

Round-the-Clock Peer Stress

Sleep vs. Social Media

The High Cost of Social Comparison

Finding Comfort with Competition

Envy’s Inevitable

CHAPTER FOUR Girls Among Boys

Daily Disrespect

Helping Girls Handle Harassment

The Harmful Offence-Defence Paradigm

Gendered Sex Ed

Bringing Equity to “The Talk”

Consent Doesn’t Cut It

Sexual Empowerment Protects Sexual Health

Many Ways to Say No to Sex

The Truth About Hookup Culture

Liquid Courage

The Downstream Effects of Mainstream Porn

CHAPTER FIVE Girls at School

School Is Supposed to Be Stressful

Girls, Especially, Worry About School

Moving from Grind to Tactician

Becoming Energy Efficient at School

Helping Girls Build Competence and Confidence

Battling Test Anxiety

Not All Girls Learn the Way Schools Teach

Coping with the Thirty-Hour Day

Changing How We Define Success

Swapping Projectiles for Pathways

CHAPTER SIX Girls in the Culture

Acquiescent by Default

Raised to Please

Speaking While Female

Challenging the Language Police

The Verbal Tool Kit

The Transparent Girl

Full Disclosure Is Not Required

Looks Matter . . . Too Much

“Everyone’s Beautiful” Can Backfire

Celebrating Physical Function, Not Form

The Headwinds of Prejudice

Conclusion

Acknowledgments

Notes

Recommended Resources

Index

Introduction

ON A CHILLY MONDAY AFTERNOON IN NOVEMBER, I FOUND MYSELF IN an emergency psychotherapy session with Erica, a Year 8 student whom I’d seen on and off for a few years, and Janet, her very worried mother. Janet had called my practice that morning when Erica became so overwhelmed by anxiety that she refused to go to school.

“Erica had a rough weekend,” explained Janet over the phone, “because a big group project that’s due soon went off the rails over some social drama.” She added that her daughter hadn’t eaten breakfast for the last two weeks because she had woken up every morning with stomachaches that didn’t let up until midday. Then, through tears I could hear over the phone, Janet added, “I can’t believe that she’s not at school today, but I couldn’t figure out how to make her go. When I told her that I’d even give her a ride instead of making her take the bus, she looked at me like I was offering to drive her to a firing squad.”

Feeling really concerned, I asked, “Can you come in today?”

“Yes, we have to,” said Janet. “She’s got to be able to go to school. I’ve got a meeting early this afternoon that I can’t miss. Can we come in after that?”

“Of course. And don’t worry,” I offered earnestly, “we’ll figure this out. We’ll get to the bottom of what’s going on.”

Something has changed. Anxiety has always been part of life—and part of growing up—but in recent years for young women like Erica and so many others, it seems to have spun out of control. I’ve been a psychologist for more than two decades, and in that time I’ve watched tension rise in girls in my private practice and in my research. I also hear about the mounting pressures girls feel as I spend part of each week at an all-girls’ school in my community and travel to talk with groups of students around the United States and around the world.

At work, I’m able to observe and learn from girls in so many ways, and when I’m home, I gain another perspective on them as the mother of two daughters. Girls are my world, and if I’m not with them, I’m often chatting about them with teachers, paediatricians, or fellow psychologists. In the last few years, my colleagues and I have spent more and more time discussing the scores of young women we’ve met who are overwhelmed by stress or who feel intensely anxious. And we talk about how it wasn’t always this way.

Alarmingly, what we are observing on an intimate daily scale is confirmed by sweeping surveys. A recent report from the American Psychological Association found that adolescence can no longer be characterized as an exuberant time of life, full of carefree experimentation. Except for during the summer months, today’s teens now, for the first time, feel more stressed than their parents do. They also experience the emotional and physical symptoms of chronic tension, such as edginess and fatigue, at levels that we used to see only in adults. Studies also tell us that the number of adolescents reporting that they are experiencing emotional problems and are highly anxious is on the rise.

But these trends do not affect our sons and daughters equally.

It’s the girls who suffer more.

As confirmed by report after report, girls are more likely than boys to labour under feelings of psychological stress and tension. A recent study found that a staggering 31 percent of girls and young women experience symptoms of anxiety, compared to 13 percent of boys and young men. Studies tell us that, compared to boys, girls feel more pressure, and that they endure more of the physical symptoms of psychological strain, such as fatigue and changes in appetite. Young women are also more likely to experience the emotions often associated with anxiety. One study found that the number of teenage girls who said they often felt nervous, worried, or fearful jumped by 55 percent from 2009 to 2014 while remaining unchanged for adolescent boys over the same time period. A different study found that anxious feelings are becoming more prevalent among all young people but are growing at a faster pace in girls.

These gendered trends seen in anxiety are also mirrored in the climbing rates of depression—a diagnosis that can serve as a proxy measure of overall psychological stress. Between 2005 and 2014, the percentage of teenage girls experiencing depression rose from 13 to 17. For boys, that same measure moved from 5 to 6 percent. While we hate to see emotional distress rise for our daughters or our sons, we should probably be paying attention to the fact that girls between the ages of twelve and seventeen are now nearly three times more likely than boys to become depressed.

The gender imbalance in stress symptoms that begins in secondary school doesn’t end after leaving school. The American College Health Association found that undergraduate women were 43 percent more likely than their male counterparts to report feeling overcome by anxiety within the past year. Compared to male undergrads, their female peers felt more exhausted and overwhelmed, and they experienced higher levels of overall stress.

When mental health professionals hear and read about statistics like these, we jump to attention. From there we typically adopt an appropriately skeptical stance and wonder whether there has actually been a dramatic change in the number of girls who are feeling pushed to the limit, or if we are simply getting better at detecting problems that have been present all along. Researchers who study these questions tell us that we haven’t just pulled our heads out of the sand to discover a crisis that we have long ignored; the available evidence tells us that we are truly seeing something new. Nor does research indicate that girls are now simply more willing than they have been in the past to tell us that they are suffering. Rather, the situation for girls does actually seem to have gotten worse.

Experts point to a number of possible explanations for this emerging epidemic of nervous girls. Studies, for example, show that girls are more likely than boys to worry about how they are doing in school. While it’s nothing new for our daughters to strive to live up to the expectations of adults, I now hear regularly about girls who are so fearful of disappointing their teachers that they skip sleep to do extra-credit work for points they don’t need. Research also tells us that our daughters, more than our sons, worry about how they look. Though teens have always experienced moments of high anxiety about their physical appearance, we are raising the first generation that can, and often does, devote hours at a time to fretfully curating and posting selfies in the hopes that they will receive an avalanche of likes. Studies also suggest that girls are more likely than boys not only to be cyberbullied but also to dwell on the emotional injuries caused by their peers.

There are also sexual factors that apply uniquely to girls. Our daughters hit puberty earlier than our sons do, and the age of puberty for girls keeps dropping. It is now no longer unusual to see a Year 6 student sporting an adult woman’s body. To make matters worse, girls develop their grown-up bodies while being inundated by images communicating the strong and distinct message that women are valued mainly for their sex appeal. Making matters worse still, widely seen marketing content often exploits young girls—think of adverts with a “naughty school girl” angle—or targets them as consumers, as in those now peddling thongs and push-up bikini tops for seven- to ten-year-olds. In years past, these images were at least limited to those put out through conventional media outlets. Today, girls are just as likely to come across a sultry selfie posted on Instagram by a Year 7 classmate.

These prevailing explanations for why girls feel more pressure than boys are helpful, if not altogether surprising. But knowing about some of the particular difficulties girls face is not the same as knowing what we can do to address them.

If you are reading this book, then you have probably tried numerous ways to help your daughter feel less anxious and more joyful. You have reassured her that she should worry less about what she scored on that last quiz and do her best to ignore hurtful online chatter. You’ve already told her that she is beautiful or that looks aren’t important. (Most loving parents, myself included, have said both!) You’ve taught her to question and critique cultural messages suggesting that a girl’s worth hinges on how she looks, and you’ve worked to limit the amount of time she spends posting or scrutinizing digital images. Yet, despite your best efforts, you may still find yourself raising an absolutely terrific girl who spends far too much time feeling nervous or unhappy.

This book examines the forces that fray girls’ nerves and suggests how we can help our daughters feel more at ease. I’ll describe what I’ve learned from the growing research, my psychotherapy clients, my colleagues, girls at schools, and my own daughters about the steps we can take to shield young women from toxic stress and anxiety. At times, I illustrate my ideas with examples from my work, but I have altered identifying details and in a few cases presented composites in order to maintain the confidentiality of those who have shared themselves with me.

Under Pressure will start by building our understanding of stress and anxiety. From there, it will consider how tension finds its way into the many facets of girls’ lives, examining chapter by chapter the difficulties that invariably arise for our daughters in their home life, in their interactions with other girls, in their dealings with boys, in their role as students, and in their participation in the broader culture. As parents, we may wish that we could clear our children’s path of any source of discomfort, but there really are no stress-free routes from infancy to adulthood; even if we could make this happen, it would not serve our children well in the long run. That said, it’s much easier to feel relaxed about the stressors that await our daughters when we know what to expect.

Anticipating the difficulties our girls will encounter as they age allows us to respond more helpfully when they become upset. And how we respond to a girl’s worries and fears matters a lot. Every time your daughter scraped her knee as a toddler, she looked first at her knee and then at your face. If you remained composed, she felt better right away. Had you scooped her up and rushed her to A&E, she would have become unnecessarily terrified. Reacting with alarm to normal difficulties can make them worse and even contribute to a girl’s unhealthy levels of stress and anxiety. With this in mind, Under Pressure won’t simply itemize the concerns that arise for girls and young women, it will also offer strategies to help you reassure your daughter on the days that she feels she is falling apart and to help her manage on her own when she is ready.

Many of the stressors that come with growing up are age old, while others are new to the scene, such as the omnipresence of digital technology and the increasingly intense university admissions process. We’ll consider how parents can help their daughters deal with both the old and new challenges effectively. This book should help your daughter to feel less anxious, but it cannot take the place of treatment for a diagnosable psychological disorder. If your daughter already suffers from crippling anxiety, you should consult with her doctor about the treatment options that make the most sense for her.

Under Pressure considers the burdens borne by girls, but don’t be surprised if some of its guidance also helps with raising a son. It’s true that our daughters are statistically more likely than our sons to be anxious, but plenty of boys struggle with feelings of tension and stress as well. And though Under Pressure looks at the topic of psychological pressure through the lens of gender, it will touch on ways that financial insecurity or minority status can add to the challenges that all girls encounter.

When it comes to reckoning with the mental and emotional pressures our daughters feel, there are no easy answers, nor quick fixes. But taking a detailed, comprehensive look at the problem opens a world of new approaches to solving it. We love our girls, we hate to see them suffer, and there is a great deal that we can do to help them feel happier, healthier, and more relaxed in the face of the challenges we know will come their way.

Let’s get started.

CHAPTER ONE

Coming to Terms with Stress and Anxiety

I HAVE GOOD NEWS. ACTUALLY, I HAVE TWO PIECES OF REALLY GREAT news. First, stress and anxiety aren’t all bad. In fact, you can’t thrive without them. Understanding the difference between their healthy and unhealthy forms will change, for the better, how you help your daughter manage the tension she feels. Second, the field of psychology has a lot to say about how to alleviate stress and anxiety if they do reach toxic levels. Indeed, if I were to take an informal survey of my colleagues, the vast majority would agree that we have come to understand the root causes and inner workings of pathological stress and anxiety as well as we understand anything in our field. As a result, we have many ways to help people rein in psychological strain when it gets out of control.

Taken together, these two happy facts mean that you can already start to worry less about how stressed or anxious your daughter feels because, to a degree, these mental states are essential catalysts for human growth and development. And if you suspect that your daughter’s unease far exceeds the healthy mark, then I’m here to reassure you that you and your daughter do not need to feel helpless. We’re going to tackle unhealthy stress and anxiety, too.

Healthy Stress

Stress gets a bad rap. Though people don’t always enjoy being stretched to new limits, both common sense and scientific research tell us that the stress of operating beyond our comfort zones helps us grow. Healthy stress happens when we take on new challenges, such as giving a speech to a large audience, or doing things that feel psychologically threatening, such as finally confronting a hostile peer. Pushing ourselves past familiar limits builds our capacities in the same way that runners prepare for marathons by gradually extending the distances at which they train.

Learning to brave stressful situations is also a skill that develops with practice. Researchers actually use the apt term stress inoculation to describe the well-documented finding that people who are able to weather difficult life experiences, such as riding out a serious illness, often go on to demonstrate higher-than-average resilience when faced with new hardships. I can speak for myself in saying that being middle-aged doesn’t seem to come with a lot of advantages, but it definitely has one particular benefit: problems don’t bother me as much as they used to. Like most of my agemates, I’ve got enough life experience under my belt that I now take in stride events—such as having a plane flight cancelled—that would have put me on the ceiling when I was younger. While the saying “What doesn’t kill you makes you stronger” almost certainly overstates the point, it’s not all wrong.

As parents, we should think of stress the way Goldilocks thought about making herself comfortable while trespassing. We don’t want our daughter’s stress level to be consistently too low or too high. But we can embrace reasonable levels of stress as a nutrient for our daughter’s healthy development that will help her to grow into the strong and durable young woman we want her to be.

Much of what our girls learn about how to manage stress comes from observing how we manage it as parents. Our daughters watch us for cues about how alarmed they should be by life’s difficulties. When we let our own inner Chicken Little take over and panic in the face of manageable challenges, we set a bad example. When we accept that stress often leads to growth—and help our girls do the same—we create a self-fulfilling prophecy for ourselves and for our daughters.

Obstacles, however, only make us stronger when we can surmount them. Accordingly, Under Pressure will address in its coming chapters how you can help your daughter master the challenges she will face as she moves from childhood to adulthood. With your help and over time, your daughter can come to appreciate that stress is a positive and growth-giving part of life.

Except for when it’s not.

How Stress Becomes Unhealthy

Stress becomes unhealthy when it exceeds what a person can absorb or benefit from. There is no single yardstick for what constitutes unhealthy stress, because the volume of manageable hardship differs from person to person and can even differ for a single individual from day to day. Whether stress becomes unhealthy depends on two variables: the nature of the problem and the person upon whom the problem lands.

Psychologists consider stress to be unhealthy when it interferes with well-being in the short or long term. Whether or not a stressor harms well-being has surprisingly little to do with the source of the stress and much more to do with whether adequate resources—personal, emotional, social, or financial—are available to address the problem. For example, a broken arm could be a resilience-building hassle for a girl who writes with her other hand and has lots of friends to help carry her books. Or it could be a full-blown crisis for one who might lose a shot at a desperately needed athletics scholarship due to the injury. In the same way, if the primary breadwinner is laid off, that feels much worse for a family without a financial cushion than it does for one with a healthy savings account.

Knowing that stress becomes unhealthy only when its demands exceed our resources helps us to better support our girls. We can’t always prevent calamities, but we can often summon reserves to help our daughter manage the challenges life puts in her path.

A terrific example comes from my work as a consulting psychologist to Laurel School, a local all-girls’ school that runs from nursery through Year 13. I’ve spent part of each week there for the past fifteen years, and in that time I’ve watched several secondary school girls and their families contend with glandular fever, a particularly tenacious stressor. The course of the virus doesn’t differ much from girl to girl, as sufferers usually miss classes for a few weeks and also need to suspend their extracurricular activities. But the illness turns out to be much more stressful for some students than for others.

Under ideal conditions, a girl’s parents can surround their daughter with loving support to make the best of a bad situation. Her folks ensure that she gets lots of rest, they coordinate effectively with the Laurel staff to keep their daughter reasonably up to date on her assignments, and they find ways for her friends to stop by for visits. One family of a dedicated football player happily drove their daughter to games so she could cheer on her beloved teammates from the bench. When parents have the wherewithal to marshal resources on their daughter’s behalf, I’ve seen a bout of glandular fever amount to nothing more than a bothersome blip in a girl’s secondary school career.

Other families, especially those who may already be at the limit of the stressors they can manage, can provide only minimal support. A girl who spends long hours alone at home can be inclined to choose social media over sleep, thus causing the virus to drag on longer than it should. She might fall far behind on her schoolwork or be dragged down by sadness about missing her friends or the fun parts of school. When students in this situation eventually get better, I’ve heard them ruefully remark, “Thanks to glandular fever, my entire term was messed up.”

The Three Types of Stress

Of course, there are girls and families who do everything in their power to address the social and academic impact of glandular fever yet still find themselves struggling to get back on track. We can better understand their challenges when we recognize that just as stress is not all bad, it is not all the same. When psychologists study stress and its impact on health, we sort it into three distinct domains, namely life events, daily hassles, and chronic stress.

Any life event that requires adaptation, such as a teenager catching glandular fever, is inherently stressful. Even happy occasions, such as becoming a parent or starting a new job, come with the strain of adapting to abrupt change. There aren’t many cardinal rules in psychology, but here’s one: change equals stress. The more change a life event requires, the more taxing it will be.

Moreover, life events, both good and bad, often trigger daily hassles as well. For instance, parents who rearrange their schedules to care for an unhealthy teenager may have trouble getting around to their routine errands. Or they may not be able to clean up the sink full of dinner dishes that are usually loaded into the dishwasher by the teenager felled by glandular fever. While daily hassles seem like they shouldn’t be a big deal, they do add up. Quite remarkably, one research study found that it was the number of daily hassles triggered by a major stressor, such as the death of a loved one, that actually determined how much emotional difficulty people faced down the line. In short, the pain of losing one’s wife is amplified by the stress of trying to figure out her system for paying the household bills.

Our instinctual understanding of the burden of daily hassles explains our impulse to cook for friends with new babies. We stock the fridges of those facing major life events to spare them the added nuisance of shopping and making meals. Appreciating that our own daily hassles really do compound stress can spur us to take steps to minimize them. Eating off paper plates for a few weeks won’t cure a teenager’s glandular fever, but it can help to reduce the level of stress overall.

Apart from life events and daily hassles, there’s also chronic stress. This is the kind that results when basic life circumstances are persistently difficult. Enduring chronic stress—such as living in a dangerous neighbourhood or caring for a relative with dementia—has been found to take a grinding toll on both physical and emotional health. Yet even in the worst circumstances, relief can sometimes be found. Studies of how young people cope with two grave and persistent sources of stress—ongoing cancer treatment or being raised by a severely depressed parent—have yielded valuable lessons that apply to a wide range of chronically stressful situations.

I found myself relying heavily on what we know about helping children and adolescents manage stress, even in the context of unrelentingly difficult conditions, when working with Courtney, a bright seventeen-year-old whose parents were in a drawn out and contentious separation. Courtney and I started meeting weekly in the autumn of her GCSE year after she announced to her folks that she could not bear another day of their fighting. Though they disagreed about many things, Courtney’s parents both wanted to provide their daughter with some much-needed support.

Once we got to know each other, Courtney and I set our minds to figuring out how she could manage the problems at home. Our first step was to determine what she could and couldn’t change.

“Honestly,” she said, “I don’t think that they’ll ever get along.” With an air of exasperation she added, “They say that they won’t fight in front of me, but they can’t seem to help themselves.”

“I’m really sorry to hear that . . . and can only imagine how painful it must be to hear them go after each other.”

Courtney looked at her hands and then back at me before replying wearily, “Yeah, it sucks.”

I reflected a moment before saying, “With regard to the fighting, I think you’re stuck. Your folks are the only ones who can make it stop, and it doesn’t sound like they’re ready to do so.”

Courtney ruefully nodded her agreement.

“So, as much as I hate to say this, I think that you have to find a way to accept that reality for now.”

Indeed, for difficulties that cannot be changed, research shows that practising acceptance is the critical first step. If your nose wrinkles at the new-age aroma wafting from the suggestion to “practise acceptance” (true confession: that was my own first reaction), consider it pragmatically. Why expend energy fighting an immutable reality? Once we find a way to digest a hard truth, we can get on with adapting to it.

Courtney, however, was having none of it.

Simultaneously incredulous and annoyed, she replied, “How can I possibly accept their fighting? It’s awful!”

“I hear you,” I responded as nondefensively as I could. “And if I thought you had the power to help your parents come to a truce, I’d be encouraging you all the way. I do, however, think that there are things you can control that will help your situation. Are you open to some ideas?”

Courtney reluctantly indicated her willingness to hear me out, so I proceeded with more of what we know from the research on chronic stress. Namely, that it’s helpful for young people to seek out happy distractions and enjoyable activities in order to take cover, even briefly, from their monsoon of stress.

“Are there things you enjoy that their fighting can’t disrupt?”

Courtney’s face relaxed as she thought about my question. “You know,” she ventured, “there is something I really like to do . . .”

I raised my eyebrows to let her know that I was eager for her to continue.

“I have a car . . . we say it’s my grandma’s, but it’s basically mine . . . and I love to drive it out on Chagrin River Road.” I smiled to indicate my familiarity with the wooded, hilly route that picks up about twenty minutes east of my office in the suburbs of Cleveland. “I roll down the windows, even when it’s cold outside, and play my music loud. Even after one song, I feel better.”

“Can you take that drive whenever you want?”

“Basically. Unless I have homework or something like that—but it doesn’t take me long to get there from my house.”

“Then I think that should be part of our plan. You can’t stop your parents’ fighting, but it sounds like you have a reliable way to take a break from the stress of it.”

Courtney bit her lip, letting me know that she remained unconvinced.

“It’s definitely an imperfect solution,” I said gently, “but think of it this way: the arguments make you feel bad, and driving makes you feel better. Until your parents sort things out, taking a drive when you need to gives you some control of your mood.”

“That’s true,” she said slowly. She paused, then added, “I’ll try it and let you know.”

We can bring these lessons about coping with chronic stress home to our own girls by guiding them to think about what they can change and what they can’t when they are stuck in difficult circumstances. Should your daughter find herself in a class dogged by unrelenting interpersonal strife (hello, Year 8), you might help her to focus on what she can actually do about the situation, such as keeping ties with low-drama neighbourhood friends. Beyond that, you can support her as she finds ways to distract herself from the social tempest until it dies down (fingers crossed, Year 9). Given that unhealthy stress cannot always be avoided, we should take comfort in what the scholarship tells us about how to reduce psychological strain. Taking a strategic approach—fixing what we can and finding a way to live with what remains—makes it possible to feel less helpless and more relaxed, even in the face of substantial adversity.

From Stress to Anxiety

Stress and anxiety are like fraternal twins. They have a lot in common, but they’re not the same. Stress and anxiety are alike in that they are both psychologically uncomfortable. But while stress usually refers to the feeling of emotional or mental strain or tension, anxiety usually refers to the feeling of fear, dread, or panic.

Though we can distinguish between stress and anxiety, in real life they often coil tightly around each other. For example, a girl who feels stressed by her school workload may come to feel anxious about getting her assignments done. A girl who lives in a neighbourhood where sporadic police sirens cause bursts of anxious panic will almost certainly suffer from chronic stress. We can’t always tease stress and anxiety apart, and most of the time we don’t need to. For practical purposes, we can treat the two concepts as nearly interchangeable (as this book will often do), focusing our efforts on helping our daughters to keep both their tension and their worries under control.

Stress and anxiety are also similar in that they can be good or bad. We’ve already taken a look at the difference between healthy and unhealthy stress. Now let’s do the same for anxiety.

Healthy Anxiety

Anxiety is a gift, handed down by evolution, to keep humans safe. Every one of us comes equipped with a sophisticated alarm system programmed deep in our brains. When we sense a threat, that alarm system triggers anxiety. And the discomfort of anxiety compels us to take steps to reduce or avoid the threat. To put it another way, our prehistoric ancestors who sprinted for the cave when they spotted a sabre-toothed tiger survived to pass down their anxiety alarm genes to us. The caveperson who casually remarked, “Hey, check it out, that’s a really cool tiger” did not.

Our anxiety alarm now rings in response to a wide range of modern-day threats. It goes off when we nearly have an accident while driving, when we hear a strange noise while alone in the house, or when our boss calls an unexpected meeting in the midst of redundancies at work. In addition to warning us about the threats in our surroundings, anxiety also alerts us to dangers from within. You know that uncomfortable feeling that bubbles up right before we say something we later regret? That’s anxiety trying to warn us to zip it. And you know that nagging sense that arises when we’re binge-watching Netflix instead of doing our tax returns? That’s anxiety trying to keep us from having to pay the fines for filing late.

In short, anxiety works to protect us from the world and from ourselves.

Unfortunately, anxiety, like stress, has gotten a bad rap. Somewhere along the line we got the idea that emotional discomfort is always a bad thing. This turns out to be a very unhelpful idea. Psychological distress, like physical pain, serves as a finely tuned feedback system that helps us to course correct. Just as physical pain prompts us to stop touching a hot gas-ring, emotional distress alerts us to pay attention to our choices. For example, if you always feel nervous before having lunch with a particular friend because you never know how she’s going to treat you, it’s probably time to reconsider that relationship.

So here’s the first thing we can do to help our daughters take control of anxiety: we can teach them that anxiety is often their friend.

Several years ago I started working with a sixteen-year-old named Dana whose parents called me after she drank so much at a party that she landed herself in A&E. I had been practising long enough to know not to come to any conclusions about Dana based on the single incident that brought us together, and indeed, when we met, my restraint was rewarded. In my waiting room I found a friendly teenage girl wearing jeans and a plaid flannel shirt. She stood up quickly and stuck out her hand as she introduced herself.

As we shook hands I said, “Hi, I’m Dr. Damour,” to which she replied sincerely, “Thank you for meeting with me.” I pointed the way to my office and followed her in as she walked, actually kind of bounced, ahead of me.

Once we were sitting down, I began. “Look, you don’t know me and I don’t know you,” I said in a welcoming tone, “but I know that something really scary happened.” Back in my early days as a psychologist, I used to make the rookie mistake of putting teenagers on the spot shortly after meeting them. In response, they usually clammed up. Experience has taught me that people (and teenagers are, of course, first and foremost people) feel much more comfortable broaching touchy topics when they’re not cornered into doing so.

“Do you want to start with what happened,” I continued, “or would you feel more comfortable if we just took some time to get to know each other?”

“I appreciate that,” said Dana, “but I’m okay with talking about what happened. I’m actually super bothered about it,” she began while tugging at a lock of her curly, shoulder-length hair. “A couple of weekends ago my friends and I went to a party at the house of a kid I’ve known for a long time, and that was fun. But then one of my friends heard about a party at another house, so for some reason we decided to go over there. I didn’t know the kid hosting the second party, but I knew a bunch of his friends. But there were also tons of kids I had never seen before, which was kinda weird.”

I nodded as she spoke but didn’t interrupt. Dana almost seemed as if she felt eager to unburden herself as quickly as possible. “I was really uncomfortable, just nervous. I drank one beer at the first party and I was totally fine, so I thought it would be okay if I had another beer at the second party.” She continued, “I just wanted to calm down a bit because my friends were having a good time so I figured we’d be there a while.

“While I was drinking that beer, someone offered me a shot, which I wouldn’t normally do, but I thought that would help me relax fast. So I drank it.” As she spoke, I found myself mentally cringing at two things: the free-flowing alcohol, which I hear about way too often, and Dana’s total certainty that she needed to find a way to quiet her nerves. “After that,” she said, “I don’t really remember. My friends said that I kept drinking. When I passed out, one of my friends got really scared and called her mom, who called my mom.”

“That’s a good friend,” I said, to which Dana nodded her solemn agreement. Then I asked, “Can you take me back to when you arrived at the second party?” She nodded again, so I continued, “Do you have a sense of what was making you feel so uncomfortable?”

“Oh, yeah,” she said quickly, “it was nuts. I couldn’t believe how many kids were there and some of them were definitely sketchy. Not to be unfair,” she said in the same offhanded tone teens use when they say “no offence” before expressing an unvarnished opinion, “but they were definitely way too old to be at a high school party.”

“Got it,” I said, “so let me run an idea by you. I’m wondering if part of what went wrong is that you treated your anxious feelings as your enemy, when I actually think they were acting as your ally.” Dana looked at me quizzically. I continued, “My hunch is that you felt really uncomfortable because you are smart enough to know that it was probably a risky party and you wanted to leave.”

“Definitely,” she replied emphatically, “it wasn’t a good scene. But I knew my friends wanted to stay, so I didn’t know what to do.” She paused, then added sheepishly, “Obviously, I shouldn’t have done what I did.”

“True,” I said. “And I’m sure you’re not surprised to hear that I think you should lay off drinking.” She tilted her head to acknowledge my perspective. “I also think that you’ll feel much better, and worry much less about something like this happening again, if you can get to know your anxiety.” Once more, Dana gave me a puzzled look. “Adults often talk about anxiety as if it were a bad thing, but it’s not,” I said. “It can get out of control, and we don’t want that. But most of the time it’s a really useful emotion.” I could see from Dana’s face that she now understood completely.

“Instead of trying to calm myself down with that shot,” she reflected out loud, “I probably should have paid attention to how nervous I felt and found an excuse to go home.”

“Yep,” I agreed, “you’ve got a sophisticated warning system that works well for you. Let’s put it to good use.”

Try this at home. The next time your daughter tells you that she’s feeling really nervous about a test for which she has yet to study, cheerily reply, “Good! I’m glad you’re worried. That’s the ideal reaction, because right now you know you’re not ready. As soon as you start studying, your nerves will calm down.” As she heads out with friends on a Friday night, you might say, “Have fun. Take good care of yourself, and if you find yourself in a situation that makes you uncomfortable, pay attention to that feeling! We’re always happy to spring you if things go south.”

In sum, when a girl gets anxious we want her to take that emotion seriously and wonder, “Why is my alarm going off? And what’s the best way to get it to quiet down?” Given that our culture has slapped a bad name on anxiety and all of the other uncomfortable feelings, we need to go out of our way to help girls attend to and appreciate anxiety as the protective mechanism it is.

The Mechanics of Anxiety

Fear is a powerful emotional experience that can feel alarmingly out of control. But psychologists have come to recognize that anxiety is, in fact, a highly predictable and systematic reaction that activates the cascading involvement of four different systems. First, stress hormones trigger a biological reaction known as the fight-or-flight response. Adrenaline and its chemical sidekicks crank up the heart rate, slow the digestive system, and widen the airways to the lungs in order to direct more oxygen to our punching and running muscles. In response to messages sent to our lungs from our central nervous system, breathing speeds up and becomes more shallow. Our pupils dilate so that we can see at greater distances. Once the perceived danger passes, an equally complex system resets the body to its pre-anxiety state. This is why moments of panic are often followed by an urgent trip to the toilet as the digestive system gets going again. Whatever else we might say about anxiety, it’s hard to deny that it puts on a pretty spectacular biological show.

Almost simultaneously, our emotions get in on the action. We tend to experience nervousness, fear, or dread, though some people also feel edgy or irritable when anxious. When our emotions are affected, our cognitive—or thought—system jumps in. Deep thinking goes out the window as we vigilantly scan our surroundings for information about the perceived threat. Upon hearing an unexpected noise while home alone, we prick up our ears while fretfully asking ourselves, “Did I remember to lock the door? Could someone be trying to break in?” At other times, anxiety simply causes the mind to go blank, or to have exaggerated, irrational thoughts such as, “An axe murderer is at the door!”

Last of all, our action system kicks in. Someone who feels truly frightened by a strange sound in the night might stiffen up so as not to make any noise, reach for the phone to dial 999, or stalk around household corners wielding a baseball bat.

Even when anxiety serves a useful purpose—perhaps helping us discover an outside door flung open by the wind—it’s a biological, emotional, mental, and physical workout. If this elaborate alarm system malfunctions and spins out of control, we are run absolutely ragged. At these times, doctors are likely to diagnose an anxiety disorder.

Anxiety Disorders and Their Treatments

The many different ways our alarm systems can become faulty is illustrated by the variety of anxiety disorders doctors diagnose. When the alarm rings persistently—sometimes quietly, sometimes loudly—but far too much of the time, we apply the diagnosis of generalized anxiety disorder (GAD). Children (and adults) who suffer from GAD are beset by worries they cannot control, their minds racing from one concern to the next: Will I be picked last when we choose teams in gym? Will the teacher call on me unexpectedly? Will our car pool leave without me at the end of the day? This constant ringing of the anxiety bell can undermine sleep, concentration, and, of course, the ability to feel calm or happy.

In other disorders, the alarm is less indiscriminate, but rather blares at unreasonable decibels in response to particular threats. For example, separation anxiety disorder, social phobia, and specific phobia cause debilitating distress when their sufferers are, respectively, parted from caregivers, exposed to the possibility of social scrutiny, or faced with an object or situation of which they are mortally afraid. Given that young children often miss their parents when separated from them, and that most adolescents have moments of feeling uncomfortably “onstage,” and that all humans have fears, we diagnose an anxiety disorder only when a person’s worries are entirely out of proportion to the perceived threat or if they prevent daily functioning. For example, it’s one thing to dislike spiders and quite another to skip an important meeting in a musty old building for fear of encountering one.

When anxiety comes on like a horrific siren that may blare for no clear reason at all, we call that a panic attack. These attacks are no joke. They are acute bursts of terror in which the physical symptoms of anxiety are so powerful that sufferers often think they might be losing their minds or about to die. Indeed, studies find that roughly a quarter of all visits to A&E for chest pain are prompted by a panic attack, not a cardiac event. Panic attacks peak and recede quickly—often within twenty minutes. They can occur in the midst of an obviously stressful situation such as a high-stakes job interview, or can happen out of the blue.

Interestingly, panic attacks are common. At some point in our lifetimes, nearly 30 percent of us will be hit by a wave of anxiety so intense that it includes some combination of nausea, dizziness, numbness, tingling, a feeling of detachment from reality, chills, sweating, and, as already noted, fear that one is losing control or dying. Though having a panic attack is miserable, we diagnose panic disorder only when recurrent, unexpected attacks sow the constant fear of having another attack or cause people to rearrange their lives. Sometimes sufferers will start to avoid situations or places where they’ve had a panic attack—such as staying away from the gym or parties—in the hope of preventing another one.

A few summers ago, a friend whom I’ve known since childhood called me from the side of a highway somewhere in southern Colorado. She and her seventeen-year-old daughter were halfway into a six-hour road trip from our hometown of Denver to Santa Fe, New Mexico, where her daughter would be spending the summer in a long-coveted job with Santa Fe’s chamber music festival.

After filling me in on the background, my friend continued, “We were in the middle of this beautiful drive, and then out of nowhere, my daughter lost it. She started shaking, said she felt like she was suffocating, and explained that she’d never been more terrified in her life, but she didn’t know why. One minute she was completely fine, and the next she said she felt like she was losing her mind. She’s okay again now. But she’s really wigged out.”

After asking my friend a few more questions, I weighed in. “What you’re describing sounds like a classic panic attack. They feel completely awful,” I empathized, “but they’re basically harmless.” My friend was relieved to hear this but wanted to know what to do next.

“I’m wondering if we should tell her boss that she’ll have to start late and head back to Denver to get this checked out.”

“No,” I said, “I think that the best thing will be for you to get back on the road to Santa Fe. Panic attacks happen, but we don’t want to give a single attack more power than it deserves.” I then told my friend about the one panic attack I’ve had in my lifetime. It happened in graduate school when I found myself sharing intelligence test results with a shoot-the-messenger parent who was not at all happy to hear that his really quite charming son hadn’t tested stratospherically. I encouraged my friend to tell her daughter that I remembered the panic attack vividly. I felt terrified and couldn’t end the meeting and get out of the consulting room fast enough. Luckily, however, it has yet to happen again.

“Okay,” said my friend before adding tentatively, “you know, I think that my aunt used to have really bad anxiety. Are you sure we shouldn’t get it checked out?”