Transcript - Episode 97 — SEND Parenting

EP 97: Effective Communication and Emotional Regulation with Dr. Gilly Khan

Please excuse any errors in this auto-generated transcript

Dr Olivia KesselHost

00:06

Welcome to the Send Parenting Podcast. I'm your neurodiverse host, dr Olivia Kessel, and, more importantly, I'm mother to my wonderfully neurodivergent daughter, alexandra, who really inspired this podcast. As a veteran in navigating the world of neurodiversity in a UK education system, I've uncovered a wealth of misinformation, alongside many answers and solutions that were never taught to me in medical school or in any of the parenting handbooks. Each week on this podcast, I will be bringing the experts to your ears to empower you on your parenting crusade. Before we start with the episode, I'd like to invite you to become a member of our Send Parenting what's Up? Community. It's a private space designed just for us. Parenting neurodiverse children can come with its own set of challenges, but it's also full of incredible moments of joy and growth. So I wanted to create a space where we can come together as neurodiverse parents to connect, share experiences and offer support to one another with no judgment and a lived in understanding. If you're a neuro navigator like me and have felt alone on this journey, then this is the community for you. Join us as we navigate this unique journey together. Join us as we navigate this unique journey together. The link can be found in the show notes or you can direct message me on 078-569-15105, and I can personally add you in Looking forward to hearing from you in the community.

01:47

In today's episode we are going to speak with Dr Kahn, a clinical psychologist, adhd advocate, writer, educator and mother from the US. She's a blogger for Attitude Magazine on topics covering emotional regulation to social skills, to the impact of migraines and ADHD. She was late diagnosed herself and now follows her passion helping spread knowledge about ADHD and supporting mental health. Today we're going to explore communication in neurodiverse families communication between parents and also between parents and their children. Dr Khan will discuss with us strategies to navigate these challenges with communication and also how emotional regulation and hormones can really play a role.

02:26

Very interesting episode. So welcome, julie. It is such a pleasure to have you on the Send Parenting podcast. I'm really looking forward to our discussion today about everything communication, because communication is so important and there can be such disjointedness sometimes with communication both with parents, with each other, parents to children, and then even outwards, towards our family members, towards our friends. So I'm really happy to have you as an expert today, a clinical psychologist, someone who's walked the path of ADHD yourself to come and discuss with us some of the foibles that we can have of communication and how we can think of some strategies to navigate them. But before we start with all of that, tell me a little bit about yourself and your journey.

Dr Gilly KahnGuest

03:13

Sure, so I'm a clinical psychologist, I'm based in Atlanta, georgia, and I'm also a mom to little ones and I am also a writer. So I'm writing my debut book on the emotional component of ADHD and women and I'm expecting it to be out probably in 2026. It's kind of in the hands of the publisher now. But yeah, my clinical work focuses on um, neurodiversity and emotion regulation, and I mostly work with teens, but I see people across the lifespan.

Dr Olivia KesselHost

03:52

And you yourself had a late diagnosis of neurodiversity as well. Is that correct?

Dr Gilly KahnGuest

03:57

Yeah, yeah, so I have ADHD and I got my diagnosis at 33, but it's something I thought since I was really young and I think it's just because you know ADHD in females unfortunately is just not very well understood, so even professionals have a misconception of how ADHD should actually look, and I believe that really is what has contributed to my delay, along with a lot of other women's delay in getting diagnosed.

Dr Olivia KesselHost

04:28

Yeah, and even with children as well my daughter. I didn't pick up on it and I'm a medical doctor as well until it was pretty much like slapped me in front of the face to actually figure it out and then going back and unpicking okay, why didn't I recognize this? What were the reasons? And, as you've highlighted there, we don't really recognize the signs in girls and in women as much. So it's just at the tip of the iceberg, I think, of people beginning to understand that and your work with emotional regulation.

04:57

I think that ties into our discussion today on communication, because when one becomes emotionally dysregulated, whether it's parents or children, communication kind of goes by the wayside as well, because we stop being able to communicate with each other. I would love to get your kind of thoughts in terms of when parents try to communicate, and it's kind of I think there's two phases to this. There's kind of the pre-diagnosis, when you're starting to kind of question whether your child has a diagnosis or not. That that's kind of where there can be this disconnect between parents as well, in terms of one parent maybe wanting to pursue, often the mother trying to get answers, and then maybe the other parent not wanting to face. Are you familiar with that in your practice?

Dr Gilly KahnGuest

05:45

Oh yeah, yeah, I see it all the time.

05:48

Yeah, when I read that question I was like this is a story on repeat that I experienced with my clients.

05:56

And you're right, it almost always is the mom who thinks that the child should get tested or that they should visit a psychiatrist, and then it almost always is the dad who, for whatever reason you know, says they disagree with whatever professional opinion is given, and it takes them time, you know, I guess, to kind of be a little bit more open to even asking questions. You know, like, the way I explain it is, here's what I think. I'm only one person, I think you should see another professional and I will give them, you know, recommendations of different psychiatrists. I could even, I even say, like, maybe talk to your pediatrician, I would be happy to consult with them. Um, and just, you know, talk to them. That way, you're getting information from two sources and you can, you know, think about it, and I can send you some readings, um, rather than just, you know, no, yeah, I think it's almost like a different journey sometimes, and I know that it can be.

Dr Olivia KesselHost

07:06

Sometimes, you know some of the parents that I've spoken to they don't want their child to be labeled with something and they might not the father might not, you know view it as a real negative towards their child's future, whereas the mom might, might, also be thinking, or more closely aligned, with the struggles that the child is having, so wants to get that diagnosis, to kind of go that next step, to get them the support and help they need. So I think there can be a disconnect there in terms of the um where each parent is at.

Dr Gilly KahnGuest

07:39

Yeah, I'm thinking back now to some research I was recently doing for a paper I wrote and I said dads for whatever reason, and now I realize what the reason is. Um, I think it's like you said. You know, I think women in general, um, they just tend to be a little bit more in tune with their emotions and they're more empathetic and they and this is supported by research, it's not stuff I'm just saying and they're more intuitive and are able to, you know, pick up on others' thoughts and emotions much more fluidly and accurately than men. And especially when you're thinking about a child, a child is like an extension of you. So, of course, you know, moms are going to be more attuned, you know, in terms of the child's struggle and what they may really be struggling with emotionally. So it makes sense.

08:39

Men, on the other hand, tend to think a lot more analytically, so they think about things in a lot more kind of objective ways. So it makes sense. We look at the criteria for ADHD. They're very objective. Well, she's not fidgety or she's not impulsive, but a lot of times, and you know, moms actually misunderstand this too, not because they're not able to understand it, but I think it's because of misinformation. Impulsivity can surface in different ways, you know, like if a mom's telling me about her teen and she says, well, she's not fidgety, she's not impulsive, and then she starts telling me that well, she's very blunt and a lot of times she says things before she thinks, you know, or she'll say things in social situations, it'll offend someone. And She'll say things in social situations, it'll offend someone and then she'll feel badly about it and I'm like hello, that's impulsivity. You know, I mean, these are just different, different presentations manifestations, yeah, manifestations of the same.

Dr Olivia KesselHost

09:36

Yeah, and it's that understanding actually, that you know that it's not just the hyperactive little boy.

09:43

You know, and it's interesting to me because that was my misconception too, because my brother was that way, my father could maybe be described in that way, so that's kind of what I. You know, that was my label for ADHD, but actually it's it's it's only 10 to 20% of boys even that are that typical hyperactive little boy, but for some reason that's what we all think of as ADHD and it's not necessarily the case. So then then it becomes more difficult, I think, as you say, for parents, especially um, potentially male parents, to, to, to make that jump or or to make that, that leap in terms of um, and, and then that creates a kind of angst between the two parents, which is you know, so how have. So you've navigated that kind of in your practice by getting them to seek second opinions to get more educated themselves.

10:36

What advice would you give Because I know I get this from a lot of my listeners is that you know moms who are really questioning this and they can't get their partner to agree to actually come in. You know they won't even take that first step. Is there any kind of tips that you could give for that mom who's listening?

Dr Gilly KahnGuest

10:52

Yeah, so if yeah, so I do really try to have a session where I include dad. If dad seems resistant to just getting a second opinion or talking to a different provider, or even just humoring, you know, the thought that maybe their child is neurodivergent. But if that's not possible, then I you know it's not possible but I'll work with the mom and the kids, depending on how old they are, like if they're a teen, then I ask them you know well, what do you think, based on the stuff that we've talked about, and I educate them about ADHD or autism and I ask them how do you think you fit into this? Do you think that getting a diagnosis might help you? And then they might say, well, I don't know. And then I would say, well, here's how it has helped some kids. Here are some things that some parents are worried about. Here's how maybe it might hurt you. And we go through all of the kind of angles of getting diagnosed and getting treated. And then I say here are some ways.

12:08

If this is something you want, here are some ways you can talk to your dad about it, and maybe you can talk to him while your mom is there, or maybe you can talk to your mom and say, hey, I'm planning to talk to dad about it. Here's what I'm planning to say. Maybe you can support me, um, because if dad won't talk to me, you know he won't talk to me. Uh, I also had um recently, actually, uh clients, you know. Just the mom, I guess, basically convinced the dad okay, let's just talk to the pediatrician, um, so the mom will basically go with the kid, you know, to the pediatrician, get more information, and then whatever information they get, they can share it with that Um.

12:49

But you know, at the end of the day, there's only so much you can do as a clinician. And you know, the nice thing about kids is they're young, there's time and um, you know, we can't be blind to the fact that there's still stigma associated with diagnosis, and so I think it's like you know, I had a mentor on internship while I was doing my graduate studies who always said you're planting a seed. If you don't plant a seed, then you know you're not going to get anywhere, then you're not going to get anywhere. But once you kind of introduce the subject, then that provides time for the person to think about it, and time, I think a lot of times is what gets people to a point where they change yeah, no.

Dr Olivia KesselHost

13:42

I completely agree, and it's slowly, slowly, to use another analogy, rome wasn't built in a day, and I think that it's you know it is, and then also getting it from, as you said, those different angles. So you have mom, you have the kid, if they're old enough, and then you have external kind of specialists that can, either directly or indirectly, through mom or the child, kind of educate. And you know, it's it's through that knowledge that you actually oh, oh and you know the light bulbs kind of go off. So I think it's important for moms who are struggling to to take that kind of slow, graduated kind of approach and to make sure that it doesn't hinder them from being able to get the support they need for their, for their child or their child needs. You know which is tricky, because then you know post-diagnosis and you know I have a lot of, I would say the majority of my listeners are moms. I do have some dads, but the majority are moms who are the ones that you hear or the ones that I speak to as well, the ones that you hear or the ones that I speak to as well.

14:49

And it's, you know, oftentimes the case that marriages do disintegrate and there's a lot of single moms out there as well who are raising neurodiverse children, and I mean it's not just neurodiversity right, there's horrific statistics with marriage period, but it adds an element of complexity. Challenge Exactly. And I also think what's interesting is, as I'm neurodiverse myself, as are you, we tend to be attracted to neurodiverse partners as well. So you're throwing that into the mix as well. So you have neurodiversity potentially from your child.

15:22

You might have undiagnosed neurodiversity as an adult and oftentimes you can see some of the characteristics in your child and that diagnostic kind of pathway in yourself which has led a lot of mothers I don't know the data on fathers, but I know it's led a lot of mothers to be diagnosed as well. But there is that complexity of how do you parent together either together or if you're separated and how do you communicate and how do you get on the same page. No, that's a lot to end. I mean I'm not asking you to solve all those problems, but it would just be interesting to hear from you of how parents can navigate that, what I can only call a minefield really.

Dr Gilly KahnGuest

15:59

Yeah, yeah, I mean this is a challenging question, I think in terms of at least, well, I'll say ADHD, adhd too, but ADHD and autism. If they're kind of open to hearing or listening about whether it's present in their child, usually like pretty soon after the dad even will say, oh yeah, I think I have that, or they will already know and they'll say, yeah, I'm not surprised. And so you know, there is some level of insight, I think, at least from personal experience. I think it's harder when the couple is not both neurodivergent, like if there's one person who's neurodivergent and one who is not Um, and I've seen that also in people I know. Uh, when both people are neurodivergent, they seem to get each other more and they're a little bit more um on the same page, kind of forgiving yeah, and forgiving like um, even professionals I've worked with on stuff like this.

17:14

You know, if someone needs to cancel, um sometimes, just I'm very honest and I think we appreciate that about each other someone cancels and I say, oh, thank god, I was so, you know, so stressed out already and I was like fully booked this week, like you're doing me a favor, it's okay, we'll plan for the future, and they're just like, oh my god, I love working with very emergent people like they're just, you know that easy going, whereas someone who's like neurotypical might think it's rude or, you know, think it's a huge inconvenience or, you know, like, just relax. I think we have that going for us a lot of times. It depends, though. I mean, there's personality, everyone's different but I think when one parent is not neurodivergent and I think this is true for even chronic pain, you know, like for migraine, for example, which is more prevalent in women, you know what I've seen and also personal experience like when you have a migraine attack, I think a lot of people don't really get it, like they'll, they'll think it's just a headache.

18:21

Don't really get it Like they'll, they'll think it's just a headache, you know. And then you know your partner will like talk to you as if you don't have a migraine attack. But you're standing there feeling like and I say this to, I used to say this to my husband before I found like the right treatment for me, but, um, I was like you're talking to me and it feels like someone's taking a pan and repeatedly banging it on one side of my head.

Dr Olivia KesselHost

18:40

I suffer from migraines as well, so I'm nodding here because I yeah, you know, just yeah.

Dr Gilly KahnGuest

18:46

Yeah, and there are so many other symptoms that go along with migraine too that people don't know about, just like with ADHD and women, uh, where it like makes your processing slower. Obviously, you know, if you have like a horrible it's not even a headache, like I can't even explain it, it's like nausea and you know you feel sleepy and groggy and it's just awful but it also affects your language production. So, in addition to you know being slower at like processing information, you're also slow at producing words and on top of ADHD, then it's just, you know, magnified because it's already hard, yeah. So I guess the gist is that you know, if I guess, if one person in the couple is really struggling with something, the other person isn't necessarily walking in their shoes, so they may not fully get it and that would make it harder to, I think, communicate between the parents and to parent, even because your parenting styles are probably going to be different and your reactivity is going to be different.

19:56

Like you know, when my kids are really loud in the car, especially for a long period of time, and then we walk inside, I usually need silence, like to walk into. I'll usually come down to the basement and wear my noise, canceling headphones and just like, sit in silence for a few minutes and then I can come up and be a person again. But you know, for a parent who might not really understand that they might be like where are you disappearing to? Or you know, if there's conflict at home that can be sensorily overwhelming, and so an appropriate coping strategy for someone who's neurodivergent would be to remove yourself from the situation, calm down and then return right when you're regulated. But it looks like you're disappearing and like you don't care.

Dr Olivia KesselHost

20:44

Yeah, so it's mixed messages where if you are both neurodivergent you might have more of a. I guess there's pluses and minuses. You might understand each other better but you also might meet each other in in dysregulation and I know that's one of your kind of specialisms is emotional dysregulation and I completely.

21:02

I've read some of your articles from Attitude magazines as well about emotional dysregulation. I have to say I completely agree with you in that you know why was it removed from the diagnostic criteria? Do you know what I mean? Because, and in fact it was emotional dysregulation that was the key symptom or sign for my daughter was struggling with and that was kind of the watershed moment, so to speak, because I couldn't cope with it and you know so. Then you add into that a parent who also might have difficulty emotionally regulating, and they may or may not know that they're diverse, neurodiverse or not. They may or may not know that they're diverse, neurodiverse or not. You know it's interesting, those complexities and how parents can deal with it together, but also how parents and children can deal with it while they're trying to communicate with each other. How has that played a role, maybe personally and maybe also in your clients' lives, in terms of emotional regulation and communication.

Dr Gilly KahnGuest

21:54

Um. So in terms of the how I approach that in therapy, especially with kids and teens, I use a lot of visuals. So, for example, with social skills training, like if we're practicing, starting and maintaining conversations, I like to have like a poster behind my head with reminders of the strategies, because then you know, they can kind of look up at the poster behind me and they have a little bit of a cheat sheet and then eventually I just remove it and we can practice without it. And so I feel the same way about coping skills, because ADHD and autism too, they're more well in some respects, it's more ADHD where it's not necessarily a knowledge deficit, it's more a performance. I don't even like the word deficit, but like not even a challenge with like knowing. It's more a challenge with carrying out what you've done.

Dr Olivia KesselHost

22:56

Yeah, absolutely you know.

Dr Gilly KahnGuest

22:58

So that's why research with vignettes is problematic. Like if you ask kids, you know what should you do in this social situation. Like if you have ADHD, you probably answer it correctly A lot of times. When you have autism you might answer it correctly too, but with ADHD it's more so like being able to actually do that in the moment, because if you're impulsive and easily dysregulated, it's like easier said than done. Right, like you know the information, but it's hard to actually do it in the moment.

23:28

Which is why I usually will make like a poster with the kid and the parent and we come up with some kind of a plan or like an agreement as to how they're going to use the poster and then getting rewarded for using the skills in the poster.

23:44

And so the first step is you know, even before we even get to the poster, like it's just basic, you know like psychoed or just talking about emotions, what happens in your body when you feel this emotion or specific to them. You know when you're feeling angry or in this specific situation, what happens. And if they don't know, then usually I'll have them like make a poster or like draw themselves, and then in the situation they can go and say or like right after say well, my muscles were tense and you know I was feeling dizzy and whatever, and they can get rewarded for that too. It just kind of depends on the motivation of the kid If they're just like I'm not doing that. If you say well, you know you can get like two points that go toward earning, you know, a prize by just walking over to the poster and pointing and saying, here's where I felt this.

Dr Olivia KesselHost

24:37

Then you see compliance increasing and so I'll divide, which is interesting because you know like there's a huge, you know, among neurotypical parents. I'd say, oh, you shouldn't reward, rewarding is bad. I said, you know what With ADHD kids and I'm not sure about autistic children, but I know with ADHD kids rewards are super, super important because they don't have so much the intrinsic motivation. So the extrinsic motivation really is powerful for them.

Dr Gilly KahnGuest

25:04

I think they do have. I somewhat agree. So I think they do have the intrinsic motivation. It just depends Elaborate, yes, it really depends. So the ADHD kids, autistic kids that I see like if they have to do something history related and they love history, then it's, you know, easy for them. That is intrinsically motivating to them. If it's something they love and they truly care about and it could be academic, then they'll do it. Then they'll do it.

Dr Olivia KesselHost

25:38

Yes, no. I guess my example was more in things that they don't want to do, like maybe share their emotions or clean up their dinner plate, or things that are less attractive, the things that they're hyper-focused on or hyper-interested in you have troubles drawing them away from it. In fact, it's almost the reverse, but using rewards for things that are maybe less intrinsically motivating for them.

Dr Gilly KahnGuest

26:03

Yeah, yeah. And I also think, you know, even for neurotypical kids, I don't see what the problem is with that. I mean adults, you know, would we go to work if we didn't get paid? Like really, you know, think about us. Like most of the things that we do in life, we do them because we're getting some form of extrinsic motivation and when you're a kid especially, you have very little control over the things that you have to do on a daily basis, like for me.

26:35

I chose to study psychology and to write and I love my profession, so it's intrinsically motivated and motivating. But kids don't get to do that. They have to do homework on topics that are very challenging and not interesting to them. And you know they're expected to do chores at home, but they don't really get anything out of it. Chores at home, but they don't really get anything out of it.

26:58

You know, as an adult, you do because you do the chores and then your home, which you invested in, is nicer. There's a reason for it, and so I think there's nothing wrong, you know, with rewarding kids, and I also think that when you do reward kids, you should be coupling it with labeled praise so like good job, you know bringing your plate to the sink and eventually they don't even need the. That reward like the praise is enough. And the praise is also extrinsic motivation. And I know for me professionally like I need and I don't want to sound like I need to, you know like be raised up like on a pedestal or something, but you know I need praise, like I need people to give me positive feedback, otherwise I will get unmotivated.

Dr Olivia KesselHost

Well, it's hugely validating and I think you know, when you get that positive feedback from either a client or, in my case, a listener, it, it validates and it kind of it fuels you, you know, yeah, it is, yeah, it's fuel and that's extrinsic, you know.

Dr Gilly KahnGuest

28:08

But that's. I think what really helps is what helps people with ADHD, but it also helps kids without, yeah, so I forgot the question.

Dr Olivia KesselHost

28:17

So we were talking about emotional dysregulation and how you can navigate that with kids, and then I think we're really and how you described, that is really great. But then what about the parents that are getting emotionally dysregulated as well? Because I'm not going to throw any rocks out of my glass house, because I'm definitely one that gets emotionally dysregulated too and I have to manage that through exercise to make sure that I can stay calm, but you know it's a struggle for me too, and so how do you or do you have any advice for parents as well, who also can we focus on the child? But I think also and I find this for myself too I play a huge role in my daughter's emotional dysregulation, or where we can go together in emotional dysregulation.

Dr Gilly KahnGuest

29:01

Yeah, so I think you know, the skills that we're teaching kids are skills that we should implement ourselves.

29:08

And that's because you know I mean one, they're modeling us and two, I think if you have this open communication with them and you show them I'm doing the same thing, then it becomes much more normalized and you guys are kind of on the same team and you can help each other. But yeah, I was going to say like so the poster. Usually I'll have them identify their anger cues and normally like what stuff that they feel in their body, something concrete, and we might even talk about common triggers. And then on the other side of the poster we'll write you know specific strategies they can use, depending on the kid, but I would say 99.9% of the time it ends in taking a timeout, which means basically, you know, I rehearse with the kid. Like having the kid say Mom, I need five minutes to calm down. Or Mom, I need a few minutes to calm down, I will come back when I'm ready. Need five minutes to calm down. Or mom, I need a few minutes to calm down, I will come back when I'm ready. And then they get rewarded for either saying that or agreeing when their parent prompts them and then they leave the room.

30:12

Usually we come up with some kind of like a calm down corner for them and then they can. They need to come back. I mean the expectation is that you reconvene and you talk about it once your emotions are, you know, back to baseline. But adults I mean the expectation is that you reconvene and you talk about it once your emotions are, you know, back to baseline. But adults, I think, should handle it the same way and they could even say the same thing to their kids Say, hey, I'm feeling overwhelmed, I'm going to take a few minutes to myself and you know, I'll come back once I'm calm, once I'm calm.

30:47

And I think that really is the best way to handle emotion dysregulation when you're neurodivergent, especially ADHD, because if it's a performance problem, then you can stand there and do deep breathing from here to the moon, but it's going to come out. So you need to separate yourself, you know, calm down and then, once your, your emotions have gone back down, then you can approach the situation in a much calmer way. And that also requires your partner to understand that. You know, like I know just very commonly, they'll like, follow you and, you know, want to talk about it then and there. But there's nothing worse you could do as a partner of someone who's neurodivergent and who's really struggling emotionally in the moment. You're making it worse and I see it in classes too, like in school with kids like especially autistic kids. When they're having a moment, all the teachers approach them. You're lighting a fire.

Dr Olivia KesselHost

31:42

Yeah, less is more, you know, and I think that's something I've learned on my journey with my daughter as well. Is that not talking giving the space that those less is more you know, until you're both, as you say, back to that baseline again? And things like breathing and these things that they have in school to do, you're not ready to hear that? I mean my, and that also almost lights the flame as well, because you know, I don't know about you, but when I'm really upset and someone tells me to take a deep breath, I want to tell them where they can shove that deep breath.

Dr Gilly KahnGuest

32:11

You know what I mean yeah, and I think kids appreciate that too. Like I know, I've had a few, especially like preteens and teens, who have said to me thank God, you're not like a breathe therapist, you know, you're just like just breathe, you know not everything. Not breathing can't fix everything, you know. I think even for anxiety, yes, it can help a little bit in the moment, but it's not like a cure.

Dr Olivia KesselHost

32:37

Yeah, and yeah, exactly so it's. It's refreshing to hear you say that as well. You know, my daughter and I have actually had a really good chuckle about it together. It's like what, what would actually make you feel better? And it's like either either understanding the person but also just giving that space and having that space. Like you talked about, I go and visit our.

32:55

We have a lovely rosemary bush in the back garden which has lovely scent to it. So I walk in the back garden and I go smell that and that that just calms me down. And you know, she goes upstairs to her swing, she swings and we, you know, we both know that we need to calm down and then we can come back to a place where it's really good and that's. You know. I just have a picture of you with you know someone following you, your partner following you, like around it. Just it doesn't, it doesn't help. So understanding and communicating that is so helpful, and in schools as well, because oftentimes they want a solution right in the moment, and that isn't. That's never going to happen. When you become emotionally dysregulated. There's no solution in that moment.