Dr. Billy Garvey on Supporting Our Child’s Mental Health Through the Years

Debbie:

Hey, Billy, welcome to the podcast.

Dr. Billy Garvey:

Thanks, Debbie. It’s really nice to be chatting with you.

Debbie:

Yeah, same. The last time we chatted, I was gonna say it was over pie. I don’t think I had pie but did you have a piece of pie?

Dr. Billy Garvey:

Yeah, yeah, I did actually off your recommendation in a beautiful cafe in Brooklyn. It was lovely. 

Debbie:

Yeah, Four and Twenty Blackbirds, which my child and I are missing dearly. yes. So OK, I’m already going off script. I would love it if we could start by you kind of telling us a bit about your story and how you and I even came to know each other, because I think it’s what you’ve gone through over the past couple of years in your own kind of exploration and investigation is so interesting.

Dr. Billy Garvey:

Yeah, great. Yeah. So I’m a developmental pediatrician in Melbourne, Australia. I’m also very fortunate to be a parent of two gorgeous kids. And yeah, in my work, I’ve been working with families for over 20 years, over two decades. And I really, really love it. I feel like you’re like this. It’s just such a privilege to our own kids and share supporting other kids in the community. But our wait list is really long. over two and a half years. And Australia, similar to other places in the world, has really high rates of mental illness in kids from a very young age to entering adult life. And it’s really hard to get help. So I was very lucky that in 2018, I applied for a fellowship to travel around the world and learn how we can better share all the evidence and theory and science of child development and mental health more broadly and get help to families sooner. And that is how I got to meet you because I knew of your book and your podcast and things like that. And I was very lucky that you made time for me. And a lot of your fellow professionals in this space and kind of people that have been really powerful voices for advocacy. I was very lucky. And then I came back and I have a podcast that’s part of a social enterprise called guiding growing minds. It’s called pop culture parenting. 

And I’ve just written a book which is called 10 Things I Wish You Knew About Your Child’s Mental Health. And they’re kind of really in the same way as your work, trying to ease the burden and help provide guidance to those that are supporting kids in the community. especially like, it wouldn’t mean anything to listeners outside of Australia, but I grew up in a town that’s quite notorious for being fairly rough. I was brought up by a single mom who was waitressing and working full -time, raising my three brothers, and neither of my parents finished high school and then I got kicked out of high school. So I kind of, really feel for those people that are finding it really hard because, you know, my mom wasn’t a bad parent. was an amazing parent, but she just didn’t get the support that she needed. And so it’s this real privilege now that I’ve been fortunate to, you know, gain skills and experience from all the kids and families I’ve met to be helpful. And that’s really what I’m trying to do, just really, just really help and make it a bit easier for lots of people.

Debbie:

Yeah. Yeah, I think that’s what struck me when we met and one of the reasons, and I think it was Tina Payne Bryson who initially connected us as well. And, you know, and she’s like, had such wonderful things to say about you and your heart and your kind of commitment and passion for this. And that’s just something I appreciate so much in your work is that you see such a strong need and you feel so strongly pulled to be a part of the solution and I just find that really awesome to hear.

Dr. Billy Garvey:

Well, yeah, mean, Tina is amazing. And like you, is just doing this amazing work about trying to guide families. yeah, I feel like I’m a really small player in the lives of the kids and even those that read my work, because I’m inspired by the parents. And I did my PhD with primary school teachers. And the stuff that they do every day is amazing. As you know, it’s not unique to be passionate about this stuff, because so many people are and they’re doing amazing stuff in the community. I’m fortunate to be in a privileged position where I can do it and I get to do it. you know, it’s, yeah, it’s just, it’s so much fun and meeting yourself and Tina and a lot of your colleagues and people in this space was a real highlight last year. So yeah, really fond memories of Tina as well.

Debbie:

Yeah, the people who do this work are the most generous, lovely people. I’m so grateful that my career has brought me into these spaces as well, because people who do this work are the real deal. And I find that really cool. I, I actually want to go back if you don’t mind, because I, you mentioned that you got kicked out of school and you talk about that in your book and then in a chapter about bad kids. Would you be willing to talk a little bit more about how you went from, you know, being identified or kind of maybe self identifying as a bad kid to you’re such a you’re a success now, right? You’re a doctor, you know, you kind of made that journey. And I think for so many of us raising kids who might have that label, it’s inspiring to hear what that journey could look like.

Dr. Billy Garvey:

Yeah, yeah. And they’re my favorite kids to meet in clinic. Every Wednesday morning, we run a clinic at the biggest public hospital, kids hospital in the country, one of the biggest tertiary pediatric hospitals in the world. It’s the behavior clinic and it’s all these kids from a very young age that are having a really hard time and have often been told or feel like they’re a bad kid. And it’s this really privileged opportunity to hear that story, but then change that narrative. And I think that’s, you know, you know this, like, you know, your book talks about this in Differently Wired about how, how do we accept and lean into who the kids that we’re supporting are, not like who we want them to be. And I think for me, I was, I was just really struggling and you know, I, I still struggle and I’ve got a sensitive temperament and I’ve always had one. always will have one. And I just bucked against everything. You know, I was that kid that just didn’t feel like he fit in. So I was hostile. didn’t have secure self -esteem. I was really emotionally reactive. I wasn’t great at learning, you know, and I just didn’t feel, I didn’t feel good about myself at school. And so I, you know, I kind of lent in almost to that bad kid narrative. And I was like, I’m going to be the troublemaker. I’m going to be this person because it’s safe and predictable and something I can do. And yeah, when I got kicked out of school, none of the other schools in the area would take me either. And it looked like I wasn’t going to be able to finish my formal secondary schooling. And then I just had this beautiful meeting with a school principal at like the last school that was really ahead of its time, this school in terms of genuine true inclusion. And it’s really funny, Debbie, I still remember like one of the hardest experiences I’ve had in my life was as a 16 year old, work walking into that school ground and walking up to a bunch of teenagers that I didn’t know and like saying hello and introducing myself. But I don’t think I would have finished school and would be on a different path if I hadn’t gone to that school. And they just, they just accepted me for who I was and stopped fighting me. And, you know, just said, this is the stuff that you need to do will help you do it. If you don’t submit it or can’t submit it, you won’t be punished. You know, we won’t come down on you. We’ll just think about, are you getting enough support? Things like that. so that was, you know, I didn’t understand that. I hadn’t experienced that before and it was just amazing. And then, you know, I just had this really slow change in the narrative around me as, you know, where I got to have success in those interactions and relationships and all that stuff. And it was, it was really beautiful. And I spend more time in clinic thinking about how do I change the narrative around kids than I do writing scripts, giving diagnoses. Like, you know, that’s, that’s the stuff that’s not as powerful as how do I shift the story that’s around this kid? Cause I really believe that the story you hear about yourself is a big part of who you become. And I was very lucky that that story changed for me because I meet lots of kids that hasn’t.

Debbie:

Yeah, for sure. And was that experience that you went through, did that kind of getting it being seen finally and accepted for who you are and changing that narrative? Did you kind of instantly know, okay, I really want to help other kids like me? Is that what pulled you in that direction?

Dr. Billy Garvey:

No, that’s no, I worked, yeah, that’s a really good point. No, I think it’s a powerful thing, but I think I’m still a little bit insecure about all that. I think a lot of us that have had those experiences, it never leaves us. I still think, it’s a bit philosophical, but I still think I’m looking for myself in clinic, like I’m thinking about who were the kids out there, because I couldn’t, couldn’t help my mom then. She had really significant mental illness and really struggled with things. And I was aware of that as a teenager and I didn’t really know what to do and I felt really helpless. And I think a lot of that motivation for me to skill up in like really serious mental illness in kids and parents is me trying to make up for not being able to help them or the kids that I am. I was then really lucky that I worked, went to a childcare center, like as I was a little kid, outside of school hours and holidays and all that kind of stuff. I hated it. Like I just wanted to be with my mom. My mom worked three jobs and I was, one of the things I feel guilty about is looking back and thinking that I gave her such a hard time about how much she worked as a kid. But I ended up working at that childcare center for six years. And it was this beautiful experience because this disadvantaged community, like lots of kids that are really struggling. And I just got to hone like being with kids and playing with kids and understanding who they are and all that stuff. And I reckon I learned more in that six years than my embarrassingly long 14 years of full-time university. you know, those opportunities to just be with kids and struggle with them and butt heads with them try and be an authority and fail at it. All of that stuff was really powerful for me, but I also knew I knew I couldn’t be a teacher. think teachers are amazing, but I was drawn to science. So I went and did science and then medicine and then went and did a subspecialty in developmental pediatrics and then met all these kids again. It was beautiful because it took me back to that playground, but I wasn’t able to spend as much time with these kids or be as big a part of their life, but I had other ways that I could try and help them. And, and it’s just this amazing feeling. Like, I hope you feel like that with all the work you do as well. But I, I just genuinely, I made the mistake of saying to a kid the other day, a teenager who’s been really, really struggling and has been kicked out of school and is, you know, really biting heads at everything. And I’ve, you know, he’s, he’s a gorgeous kid. And I made the mistake when I said goodbye to him the other day, I was like, It’s been so nice to spend time with you. I can’t believe I get paid to do this because I’ve just been talking to him and learning who he is and what he cares about and what he’s good at and all of that stuff. so, it’s pretty amazing. And I think, yeah, I guess the other thing about what you said is I’m not sure that I am some exceptional role model, but I think that because I’m a doctor, I don’t think that makes me any better. I’m just trying to get better at my own parenting, I’ve got this real privilege that I get to every day think about it from a scientific lens, trying to be a good partner, trying to contribute to the community and give more to it than I take from it and all of that stuff. And I fail at that almost every day, but I’m really lucky that I’m also, that’s what I work in. So I get to be the so -called expert that comes home and has the same struggles that everyone else does.

Debbie:

Yeah, I mean, as you’re saying that, think too, in your book, and we’ll get into your book in a little bit, but you talk so openly about your experience as a dad and of these two young ones and your journey. you it’s kind of like you are, you are kind of narrating or rewriting your own story for all of us to, you know, you’re kind of learning through this and you’re sharing your learning with us as you go along.

Dr. Billy Garvey:

Yeah, definitely. it’s, yeah, it’s, funny. There’s bits in the book. I had to read the audio book with a guy who was a bit older, cranky, gruff, know, blokey bloke. And he was pretty harsh and pretty hard to connect with at the start, but I get quite emotional in the audio book and he just kind of went with me a bit and he really softened up over the days that I was reading it. and he’s kind of like, you know, he’s like, I don’t think we should take that bit out because I’d stumble through it emotionally a bit because I talk about my own kids. talk about, you know, these amazing kids that I’ve had the privilege of meeting over the last 20 years, what I learned from them, what helped guide them and all that stuff. But yeah, a big, big part of it is my journey. Like how do I, how do I guide those two little kids that I’ve got in a way that, you know, knowing everything I know, how do I do it? And I certainly don’t do it perfectly, but how can I kind of share what I’m learning so that someone who’s also struggling with a tantrum or the severe anxiety or whatever can think, well, this is how you practically apply the evidence. This is what they do in the clinic. If you get to that two and a half year wait list. And that’s, you know, a lot of the book is me pulling my hair out that families wait so long to see me. And then I’ll say something and then I’ll say it again later that day. And I just think this is wild. You shouldn’t have waited this long to hear someone explain co -regulation to you or whatever the thing is that I’m talking about. And so, it’s really amazing. But yeah, my own kids are constantly reminding me that there’s a difference between the textbooks in real life.

Debbie:

I can totally relate to that. I do want to ask one question if you, if you’re okay going there, just in terms of Australia, you’ve mentioned a couple of times this two and a half year wait list. you know, here, while I’m in the EU now, things are very different here and I need to kind of re-immerse myself into the process here. in the U S six months to 12 months wait list to get, you know, services or an evaluation. We do have a lot of listeners in Australia and I’m just kind of wondering based on your travels and your learning. Any insights you could share with us about the state of things in Australia and maybe even if you feel comfortable answering this specifically within the neurodivergence space, do you have any thoughts on where we are, on where Australia is in that movement?

Dr. Billy Garvey:

Yeah, definitely. So yeah, in terms of the situation at the moment, yeah, we’ve got pretty bad wait lists all around the country where our rates of mental illness diagnostically between four and 17 years of age is one in seven or 14%, which is kind of meeting clinical criteria. So that’s pretty high and concerning. We know that disadvantaged communities or communities that, you know, experiencing diversity have much higher rates as well. In terms of access to support it is really difficult. There’s a couple of different systems that exist in Australia, but essentially to see a specialist is quite hard. Our equivalent of family physicians or general practitioners see the most of these kids and even they only see 35% of them. A psychologist sees 24% of them, pediatricians, general and developmental see 21% of them, and child psychiatrists only see 7% of kids in Australia with clinical mental illness. So, you know, it’s really, really hard. About half of kids with mental illness never get seen, which is pretty scary about what we know about early intervention and correct identification, support and therapy and all those things. In terms of neurodiversity, I think we’ve still got a really long way to go. I think that, you know, schools and communities are trying to get better at it and trying to understand how can we be sensitive to the individual and unique needs of every child and every parent and every person in our community. I think the thing that I always, I actually really love to hear what you think about this, Debbie, but I think in true inclusion, especially when it comes to neurodiversity can falsely be the same as this like kindness that we should do that we should give to people. But actually it’s a really selfish thing because we are missing out on the strengths of people in our community by not. You know, giving them opportunities to have avenues and expressions of that and pathways for success. And, you know, I don’t know how comfortable you feel talking about it, but I think you’ve got a really powerful voice in this space about what does true inclusion actually look like because, you know, superficial inclusion is potentially harmful. If you show kids that you’re safe in a space or that you’re welcome here and then they’re not, they lose faith and trust in people that say that. And so I think I need to spend more time doing it as well, but all of us need to listen more. And I, yeah, I’m really lucky that I get to be a part of a lot of kids’ lives that are experiencing those challenges and try and lighten that load for them. yeah, I think all of us, I don’t know how you feel about the States and Europe, but I think we’ve still got a long way to go until we’re unlocking the real potential of our community.

Debbie:

Yeah, I absolutely agree. And it’s interesting. I just released an episode a month or two ago about the state of the neurodiversity movement, just reflecting on the past 20 years. And there has been so much progress in so many ways. And there’s still so much work to be done. And I think the US is probably ahead of the curve having lived there and experienced what’s happening there, that’s a hard pill to swallow. You’re like, okay, so we’re ahead of the curve and there’s still a lot of problems here. I definitely believe that we all lose when neurodivergent people aren’t truly included and seen and celebrated for who they are and what they can contribute to the world. They lose because they don’t get to, you have fully realized lives where their gifts can be shared and they can contribute to the world. And we all lose because we know that they have so much to offer. So yeah, I think it’s kind of like a shift, right? Inclusion on paper. It’s like, okay, you can come into our classroom and maybe we’ll support you in this, this or that way. But true inclusion, I think, involves the people in power in systems, right believing that neurodifferences or neurodivergence isn’t a deficit, right? And it’s just a different way of being. And that right there is such a fundamental shift. And it often takes a personal experience. It takes someone kind of knowing someone and experiencing what it’s really like, whether it’s their own child or someone in their family to be like, I get it now. But until it impacts someone really directly, I think it’s hard for people to really make that shift.

Dr. Billy Garvey:

Yeah, you’re so right. Like we know one of the most powerful things that schools can do is tell stories about this stuff, you know, and have powerful narratives about what it’s like, what the experience is like. And the other thing is like our similarities bind us, you know, and just because there’s a difference in height or something like that, we don’t say, well, I can’t be friends with you or I can’t relate to you. And so what we’ve got to realize is that there’s so much we share all of us together. And I think the hard thing is that it’s really vulnerable. And I always worry that I’m overusing self -disclosure, but I try on the podcast and in the book to tell my own story, to try and make someone else feel okay that’s experiencing the same thing, the same insecurity about, you know, am I going to be a good parent? You know, am I actually helping? You know, is this all about my ego? Whatever it is so that someone else goes, cool. I’m not alone in thinking like that or feeling like that. And I think that’s the trick with inclusion is like, there is actually lots of common ground, but I think sometimes we get stuck in like the difference and, you know, conflict and uncertainty. You know, I think that’s where a lot of the negative experiences come from, like, I’m not sure, I don’t understand that. I’ll be hostile instead of I’ll try and learn about it and see, you know, do I grow because I learned about that? Am I actually need to have a better different perspective about things and all that stuff? And yeah, I do this every day and I’ll stop doing it when I think I have figured it all out, you know, because if, as from every perspective, isn’t it like reflective practice, once again, a powerful tool you use in your book, just reflecting on things is really important and thinking about am I genuinely inclusive or we are genuinely inclusive community? Is there a diversity of voice in our collective kind of conversation? Like it’s really important. But I also, I hope I’m not an unrealistic idealist, but I’m really optimistic that we will keep getting better at this. And you must feel the same. The young kids coming up now are just amazing, you know, they’re so much better than I was when I was a teenager. you know, so I think there’s some beautiful stuff that’s happening. We’ve just got to make sure that we also create space for them.

Debbie:

That’s exactly right. I couldn’t agree with you more, especially on this generation. Yeah.

Dr. Billy Garvey:

Yeah, yeah, so does that give you hope? Do you find yourself optimistic because of that?

Debbie:

Yeah, I overall am optimistic. I really am. I often say this, it might be who I’m hanging out with because I am spending a lot of time with people who are very committed to this. And I know that you met with Mona Delahook and she’s someone who I think has just her contributions over the past five, 10 years have completely changed the conversation. So I see so much hope and the neuroscience and what we’re learning. And I do think, yeah, to bring up this younger generation, they don’t stand for any bull crap. They’re just like, you know what I mean? I think that once they really step into their power, things can change pretty quickly. And they just don’t see stigma the same way. They often self -disclose you know, without shame, you know, they kind of own who they are. And I do think that, you know, cis generation gets older and gets into these systems that change can happen pretty quickly.

Dr. Billy Garvey:

Yeah, totally. And I think, you know, one of the funny things is that I, often on podcasts, I don’t know if you get this, but I get asked like, kids these days are too soft. You know, everyone’s on top of them too much. They should be out there running around on their own. And I’m like, look where that got us. Like look at the adult mental health in the community, how much loneliness there is, how much clinical depression and anxiety and complete social isolation and insecure self-esteem is. We need to be more gentle and more careful and provide more guidance and support to kids. And also like what the evidence shows us, including Mona and Tina and Dan and everyone who’s created it is that warmth always comes first. To help someone grow, you have to start with warmth and you have to connect with them. And that’s why this like tough love, it’s not possible to have tough love, you know, can’t, they’re the opposites, you know, and I just think that, you know, if you start with every kid feeling like they’re unconditionally supported and loved, that doesn’t mean they can get away with whatever they want to do. That just means I will unconditionally, unquestionably be here by your side, whatever happens, whatever your behavior is, whatever comes towards you. And they feel safe and secure, then you can move towards things about how can I guide you towards a better behavior? How can I help you understand the perspective of others? How can I help you not feel like you’re socially isolated? How can I help you express all the things you’re passionate about and good at? But if you don’t start there, you’re hitting your head against a wall and often blaming it on a child, thinking why are you not better at this? I’ve told you so many times.

Debbie:

Yeah. And then the shame cycle begins and then yeah, away we way we go. Yeah.

Dr. Billy Garvey:

Yeah, yeah, there’s few things that are as harmful as shame to all of us and it’s very different to guilt, you know, and that’s an important distinction that we shouldn’t never challenge who kids are. And we should always separate their behavior from who they are, including success. So I see lots of kids in clinic that have so much fragility because the only thing that they identify as is the one thing they’re really good at, you know, and we just praise kids too much for you’re the fastest, you’re the best at the sport, you’re the smartest. And there’s a huge vulnerability in that because if they feel like their love and their identity and everything is tied to that, then they’re really vulnerable when they’re not the smartest or they’re not the fastest or whatever it is. So yeah, it’s, it’s tough, but it’s just, yeah, that unconditional love and support is often the most helpful thing that we can make kids genuinely feel.

Debbie:

So in the beginning of your book, you, you share a comment that someone when let me start that over, my words are getting mixed up. In the beginning of your book, you’re talking about the fellowship and you were in this interview process and the fellowship is what kind of led to this book and you said that he said, we’ve read your application and frankly, I don’t believe there’s any evidence that how we raise our children impacts their mental health. Please explain yourself. And I read that and I was like, my gosh, this is someone in a position of power and decision -making. so you said that that’s the question that you went in search of answers for. And so can you just talk about that a little bit?

Dr. Billy Garvey:

Yeah, I mean, there’s so much that we can influence. That’s the huge risk, but the beauty in being a part of these kids’ lives is that there’s so much. And I think that, you know, if we think about two really big components about a child and their development is their attachment and their temperament. And their temperament, like we can often pick their temperament. We run an unsettled babies clinic that looks after little bums that are struggling. It’s our only clinic that has a short wait list and we work really hard to keep it like that. often these kids as they’re approaching one year of age will be showing us they have a sensitive temperament. They’re vulnerable to the experiences in the world and reacting and struggling with novelty and all of those things that the people where I’m very lucky and even better than me have done a lot of work in this space. And that kind of stays with us, that sensitivity, but we know that attachment changes. And I think that the trick is, you know, how do I match the needs of my child’s to their temperament? But how do I always ensure that I’m trying to make them feel like they have secure attachment? And if there’s a challenge to it, I repair it. So there’s kind of this one bit that we have to adjust and change all the time.

And that’s a moving target, you know what I mean? As kids get older, the needs of that sensitive temperament change. Thomas Boyce, you know, is amazing in this space about these kids who have sensitive temperaments, calling them the orchids, you know, are not doomed, just like my kids are not doomed because I have a history of mental illness. It actually gives me an opportunity to be sensitive to their needs and the sensitivity of the environment means that when kids with a sensitive temperament have warm, responsive, predictable, know, unconditional love that is sensitive to their needs, they thrive and they bloom and they do so well. And the resilient kind of dandelions don’t move much either way compared to them. The orchids, I’ve met a lot of them in clinic, they’re much harder to parent. But I think once you get the guidance on understanding that sensitivity, it’s really powerful. you know, like attachment, attachment is not set in stone when you’re a little kid either, you know, feeling secure in the world and that you’re deserving of the love you receive is something that’s important to me now, you know, and so I think kind of understanding just how we feel about ourselves is built in the relationships that we share in the early years it’s primary caregivers, but as we go through school it’s interactions we have with peers, it’s our educators, it’s you know there’s even powerful evidence that shows one really protective positive childhood experience is having two non -parental adults that have a genuine interest in you. And so how can we think about the kids in our community and think about who is there out there that I can support, I can really learn about and care about and be involved in what they’re passionate about, what their fears are, supporting them, showing them that they brighten up my life, they enrich our school community, they’re a powerful part of our community traditions. Like that stuff changes kids’ lives. And when we understand that, and if we have to, we pull weight off the vegetables or the homework or the other needs, which are way less important sometimes gives us the room to prioritize that. And I’ve sat in clinical day today and I’ve had some moms cry. I’ve had some dads, you know, finally let their frustration out and all these things. And almost every family we’ve agreed as they’ve left that the priority is just experiencing joy with that kid. And some of them are really playing up. Some of them are really antisocial behavior. Some of them are really struggling. They’re behaving in ways that their parents want to pull their hair out. But the important bit is that how does that kid feel really safe and secure in that relationship, feel like they’re really celebrated and they’re genuinely valued specifically for who they are. Like, you know, it’s, that’s the stuff that influences and changes it. The biggest predictor of adult mental illness is developmental trauma. You know, those experiences that once again, I was lucky to spend time with Bruce Perry. Those experiences stunt development and those are things that if they’re not addressed and repaired, we can hold for the rest of our life. And the evidence shows that 50 % of adult mental illness starts in your childhood. So how do we identify early those kids who are struggling and put in really rich protective factors for everyone and the kids that are, you know, showing early signs and sending up flares. How do we go to them then and meet them with what they need and give them that support? And I love what I do in clinic, but it’s every single kid I’ve ever met in clinic and I’ve probably met 15 ,000 or more. I wish I met them earlier, you know, because there is so much we can do. I’m never stuck about what to do. And that’s, that’s, yeah, that’s why the book and the podcast and all this stuff exists because I can see them one at a time and see them 14 a day. And I’m really lucky I get to train other specialists. I get to, you know, and other professionals in the community. But how do we get to people sooner? How do we show them, you know, like bullying, whatever it is, there’s a lot of evidence about this, but people are just a bit lost about how to do it. But the people that have the trusted relationships are the most powerful people. And I’m not really one of them. That’s the people in the community that know everyone intimately and you know, every single community I’ve ever been to, I’m really lucky that I’ve traveled around a bit has people that you can tap them on the shoulder and say, I’m drowning and that person will help. And we’ve lost a lot of that because of the pandemic and a lot of families feel really isolated from that, but that’s the stuff that we should reinforce. And that’s, that’s how you influence a child’s developmental trajectory. You know, make them feel like they’re a part of something and that they’re valued.

Debbie:

So good. And you talked about attachment and one of the things I just want to see if you can share with listeners, because we hear about attachment. We’ve talked about it on the show before and you said that it’s never too late to identify and work on issues with attachment. And I thought that was, that’s an important thing to emphasize because I know that there are parents who feel, did I, is this, know, who blame themselves for a child who’s dysregulated, they wonder if it’s because they did have an, you know, this term unsettled, I had never heard before, but that just, you know, this unsettled baby who was really hard to soothe and to nurture. And so maybe that parent was like, I need a break. And now does my child have insecure attachment? Is it too late? And so I think there’s a lot of fear around attachment. so it is something then that, you know, if a child had insecure attachment as a younger person that they can kind of cultivate as a child and a young adult.

Dr. Billy Garvey:

Yeah, definitely. meet teenagers in clinic who are 17, 18 years of age who are hostile, think the world is against them, relationships are transactional, they’re insecure, they completely shut everyone out or at any sign of difficulty or risk to relationship, they become really hostile and act out and sometimes really aggressively. And those kids need to go back to the core principles of, you know, you are loved, you are supported, you are valued and help them feel secure in the world again. And that’s where we fall down. Like Australia is having a hard time with this at the moment of these really punitive measures. You know, we need to drop the age of being able to incarcerate kids because they’re out there doing, stealing cars or doing whatever. And we don’t think what does this kid actually need to succeed? Where is this coming from? These parents need more support and no parents has, you know, I meet families and there’ll be similar systems in your country, in Holland where you are now, but in the States as well. I meet families that come and see me because child protection has said you need to see someone. And sometimes that kid has been out of their care and I still see those kids transition and journey back to a place where they’re loved and that parent is a hugely positive part of their life. Because every single parent out there is trying their hardest. It’s just that a lot of us are carrying way more weight in our own childhood experiences, our own mental illness, the other burdens we experience in our life, domestic violence, household dysfunction, know, whatever’s happening with us. But I’ve never, I’ve never ever met a kid that I’m like, it’s too late. I’ve it’s and yeah, so I think that it’s a really, yeah, I think it’s a really powerful point about if you are ever reading something or listening to something or thinking I’ve stuffed things up, you haven’t. Like it’s, it’s always repairable. And it’s just, yeah, I mean, yeah, once again, you talk about this, you just lean in and be led by the child and think about what does this kid in front of me need? How can I do it gently and consistently and predictably, sensitively, and cause they won’t, they’re not going to, just cause we decide they’re not going to go, okay, cool. This is where everything’s turning around. But with time, you know, they can see us as a safe harbor that they can come to and that celebrates them when they leave us as well, which is essentially a circle of security and attachment theory.

Debbie:

Yeah, that makes so much sense. Everything you shared about attachment and that actually is very comforting, I think, to hear and to know and to hear about teenagers that that can be impacted. And it made me think of another chapter in your book, which I wanted to bring up. But before I do that, I haven’t actually even said the name of your book. And I want to do that now. And of course, listeners, it’ll be in the show notes.The book that Billy’s written is called 10 Things I Wish You Knew About Your Child’s Mental Health. It’s kind of like hanging out with a wise father, doctor. It’s very story -based. You take these kind of 10 top concepts, I guess, that you kind of felt are the really key pieces for supporting our kids and growing up into adults who can thrive. When you write about them with gentleness, accessibility, you share stories from the clinic, which I thought were so powerful, but you also share these personal stories of your life as a parent and your two young children. But there was a chapter in here on self -esteem, which I really appreciated as well. That’s something that comes up a lot in my community. So many of our kids, because of messages they’ve gotten over time that there’s something wrong with who they inherently are. They have been identified as the bad kid. Maybe they’ve been bullied, maybe they’ve been ostracized. So that becomes kind of part of their story and they do have lower self -esteem. And you talk about this concept of staple self -esteem as kind of what we’re working towards. And I was wondering if you could share what that is.

Dr. Billy Garvey:

Yeah, so I think we get a little bit lost sometimes with self -esteem and we think that we want high self -esteem. And actually, like high self -esteem, if we think back to when we were kids, there were those like jocks that walked around or the people that were really full of themselves. But often they had fragile self-esteem and a lot of kids who are the bullies actually have a fragility in their self -esteem. And one of the reasons that they bully is to reinforce that power imbalance and say, I’m more powerful than these people. need to keep reinforcing that to feel okay about myself. And when we work on their self -esteem, it can be a really powerful thing. But yeah, it’s, so what we’re actually aiming for is secure self -esteem. can, I can take on feedback and it doesn’t, you know, I see it as an opportunity for growth. I don’t need to win everything. I don’t constantly need reassurance. I’m not hostile and other people get attention. I’m not kind of overly clingy and saying things like, and catastrophizing and thinking about those things and highly reactive that people will abandon us. And that gets built through childhood. Once again, it’s never too late, but it gets built through childhood for, you know, through the experiences of success and growth at the things you invest in and are passionate about and the relationships that celebrate those things and also share our failures with us as well. And it’s a really important thing. I, the last kid that I saw today is a beautiful kid in his early teens who has ADHD. And, you know, we got some teacher feedback for him and he’s like this sporty kid, but he just, like, cried in the clinic because he just doesn’t feel like he’s good enough. You know, he’s failing at school. He’s struggling. He’s trying really hard, but he’s really distractible. He can’t focus. And he just doesn’t want to be there anymore. You know, me and mom spoke about how important his self-esteem is as the priority now, because he’s just not feeling, you know, the way he values himself is influenced by how he feels others do. And there’s just been too much of a focus on all the things he’s not good at. And, you know, we’re trying to explore how he can experience success every day in his life about the things that matter to him and he cares about. it’s hard because his mom was trying to take him to all these different sports and trying to do all these different things with him, but he’s kind of losing motivation. And his mood is really suffering because of it. And I care way more about that kid’s self -esteem than anything else, because I need to try and repair that and guide those that are actually doing all the work, his family, his teachers, about how they do that with him. You know, it starts by thinking about how most of his interactions in this home and most of his interactions in this classroom are successful ones. You know, this is not a time to stretch. This is not a time of pressure and growth. This is a time of you succeed, you know, and that’s all of us need that. We all need that. Like, you know, and that’s where secure self -esteem comes from.

Debbie:

Yeah, so it’s not like our self-esteem, our kids’ self-esteem is filled by these huge things like winning the science fair or whatever, but it’s more of like having a bank account where you’re always just putting in little like deposits through these little interactions. I think we kind of can get mixed up on what actually contributes to a positive self -esteem or a stable self -esteem.

Dr. Billy Garvey:

Yeah, in clinic, every single kid that I meet, I ask them two questions. And the first is, what do you find fun? And the second is, what are you good at? And they’re really two important metrics for me because kids should have specific answers for both of those things. You know, they are triggers for me to think if they don’t have any, if they genuinely can’t say there’s anything they find joyful, I worry that there’s something going on in terms of their mood and mood being bigger than emotions, mood being a stretch over time of how they feel about the world and themselves. And then, you know, when they can’t answer, what are you good at with specific examples, I worry a lot about their self -esteem. And every kid should have multiple different specific answers to both of those questions.

Debbie:

Yeah. Yeah, I read that question in your book and it really struck me. Such a simple question, but can provide such important information depending on what the answer is.

Dr. Billy Garvey:

Yeah, yeah, and how are those two questions, how do we reinforce that every day for kids that have answers to them? And for those that don’t, how do we find them? You know, and it’s, yeah, it’s hard, but creating the space and protecting that time is really important for kids.

Debbie:

You have a chapter in the book. It’s the second to last chapter. It’s called Bad Kids. But I, first of all, I completely relate it to so much in that chapter, both as someone who was a “bad kid” in her own way as a young person, but you know, just in my work in this community. What I really appreciated and wanted to touch upon in this conversation is you said that in your experience there are two diagnoses where the benefit never comes close to the risk. And you talk about oppositional defiance disorder and conduct disorder. You said these are two diagnoses I’ve never made and I hope I never have to. And so I just would love to just touch upon that because those are certainly labels and diagnoses that many listeners have had know, including me, think ours was disruptive behavioral disorder, not otherwise specified at some point. I’m like, what even is that? And, you know, there’s a sense that it’s, the parents have really screwed up, right? That’s the vibe when a child gets kind of labeled with this. It’s like, well, it’s the parent’s fault. over the years, I’ve come to think, you know, similarly, like these, These labels don’t mean anything. they’re, what are we doing here? They’re not a diagnosis. So could you talk about that?

Dr. Billy Garvey:

Yeah, definitely. You know, the DSM -5 has a pretty awful history of some pretty horrific things that it pathologized. And, you know, the diagnosis, yeah, I, whenever I’m thinking about it and families, so my job is to share all my skills and families opportunities that I might be able to help and families guide me. They actually, they’re the more powerful person in the room when I meet them in clinic and they, I will ask every family when they come and see me, what’s the priority? How can I be helpful? You know, and sometimes it is about is there a diagnosis here? And, you know, I diagnose kids with lots of conditions such as ADHD and autism and anxiety and those types of things. But I do it really carefully and I do it like when it’s the right thing to do by the kid in front of me. It’s going to actually help people provide more purposeful, accurate support to put around them and that it won’t risk their self -esteem and their identity and also create this false ceiling around them. But well, he’s got that thing. So we’re not going to expect, we’re not going to include him. We’re not going to give him opportunities because of that diagnosis. So it’s really tricky. Like some people don’t understand why we can’t just look at a kid once and go, well, how come you can’t just diagnose them straight away? And because, you know, anyone that does that.

I’d be worried that they’re not actually thinking about it really carefully. We also know that a lot of these kids have comorbidities. You know, 40 to 60% of these kids that have one of those diagnoses will have another, including conduct disorder and oppositional defiance disorder. And I see heaps of kids that have been given that diagnosis. The reason I don’t give it is because I find that the benefit is way lower than the cost. You these kids get labeled and they miss out on lots of opportunities because people have low expectations of them or they write their destiny for them and say, he’ll be lucky if you get a job. I was like that. I remember they were like, I got told you’d be lucky if you have a job, you know, and that’s just so there’s the risk in that is so big. And like what you’re talking about, oppositional defiant disorder and conduct disorder is a collection of signs that the child is demonstrating, it gives you nothing about the reason. It doesn’t explain it at all. ADHD helps us because we think this is executive function. This kid is really good at thinking quickly, at thinking creatively, at saying stuff in environments that we don’t see. They might struggle to focus on something that they find quite boring and not interesting, especially if it’s in an environment that doesn’t harness the things that they find challenging. Oppositional Defiant Disorder and Conduct Disorder give us almost none of that guidance. They just say this kid is hostile and aggressive and violent and won’t listen to all these things. But every time I meet one of those kids, I think, why? Why is this child like this? This kid, no kid in the world wakes up and goes, I want to be oppositional to the world today. I want to be defiant. I want to be antisocial. There’s a reason. And when you find that reason and be curious about it and genuinely curious, not judgmentally curious, but curious about why that’s the path out of it. And, you know, when we identify that in those kids that have been given that diagnosis, we should take those diagnoses away and say, actually, what we’ve realized is your self -esteem was insecure. You’ve been traumatized by this experience that’s happened. You have been severely bullied and now you just act out and lash out and want to burn school down. And we need to repair that damage that’s been done, show you you’re safe and take that diagnosis away. You know, one of the best things that I get to do is meet those kids. And I, I love meeting them and people think I’m crazy, but I, I love meeting those kids, you know, and it’s once again, goes back to the start of the conversation. I’m probably looking for myself in clinic a bit, but if there’s one thing that you can do, and this is, I can’t do this all the time personally. I can do it professionally pretty much all the time. I reckon I must hit 60, 70% the time at home is when a kid is struggling, just thinking, why? I wonder what’s going on for this kid in front of me. If they’re answering back or swearing or telling us to get stuffed or on the ground, throwing their hands up and down and screaming at us or whatever, thinking, I wonder what’s happening. I wonder why this kid is struggling so much. And if you can be genuinely curious, it’s one of the most powerful things that we can do for kids. It also helps. It’s like I talk about this in the book, but I try not to say it’s okay to my kids, know, mainly my daughter when she falls over or is having a tantrum or whatever. And I just say, I’m here because it might not be okay. And I don’t want to dismiss how she’s feeling, but I also need to remind myself. My role is to be here with you in this experience that you’re having and think about is there something going on that I can actually help so that you’re not experiencing this distress and that’s the same for the teenager that’s antisocial, stealing cars, trying to burn the school down. What’s going on and why is this happening and how can I actually repair it and heal it? It’s very easy to say but it takes a lot for it to do but it’s really powerful to experience that journey with kids.

Debbie:

Yeah, yeah, it’s so great. It’s a great note to kind of wrap this up on. Again, listeners, the book is called 10 Things I Wish You Knew About Your Child’s Mental Health by Dr. Billy Garvey. I’ll have links in the show notes page. I highly recommend you check it out. At the moment, it’s only available in Australia, is that correct?

Dr. Billy Garvey:

Yes, so Penguin who are amazing, the book is really a reach tool like the podcast trying to get support and evidence into communities. And what we’re hoping is that there’s a way to partner with the publisher or someone overseas who actually has avenues. And so we’re still exploring those opportunities. And if we can’t find them, we’ll probably just start sending it ourselves as a social enterprise.

Debbie:

Yeah. Yeah. And for listeners who want to kind of dive in right now who don’t have access to the book, I really recommend you check out Billy’s podcast. It’s called Pop Culture Parenting. It’s so good. Like I went down a rabbit hole and started listening. I just listened to an episode where you talk about co -regulation and Jurassic Park and it was so brilliant. And you really use pop culture to it’s such a powerful way to explain really complex concepts in a way that resonates.

Dr. Billy Garvey:

Yeah, those, yeah, like the biggest influence on how we parent is how we were parented, but also our cultural references that we grew up with and influences. And we grew up with these movies about being a man, being tough and just not showing your feelings or, you know, different types of things like that. And I can, you know, I can use these influences on us and then I pick a part of saying, and think about what the evidence would look like, you know, and the neurodiversity one in Blade Runner was one that was really important to me. And I was really, you know, I was really worried I was going to stuff it up and people thought it was helpful. And the other one is Forrest Gump and Kids Who Are Different was just based off a single email that got sent into it. So the best thing about the podcast is the community. And we know we’ve got listeners in States and in Europe and we adore them. The podcast happens. It doesn’t have ads. like, it’s just generally a reach tool. And the best thing about it is all the listeners because I did the movie thing and explained the theory to one of my best mates and then who’s also a parent. And then part two, get hundreds and hundreds of questions coming in about how do you actually do co -regulation? You know, how do you actually support self -esteem? You know, we use Pretty Woman, which is such an amazing movie, and Thelma and Louise for Mental Health First Aid, because we built a curriculum around a national course for that. And then I just went, I’m going to do it as a movie and podcast topic and Thelma and Louise is amazing because that kind of unconditional partnership and support about, you know, two people that are going through real genuine adversity and hardship. So, so yeah, thank you for sharing that as well, Debbie, because yours, yours is amazing too.

Debbie:

Very different vibe. I think yours is more entertaining. And I, yeah, and I’m a pop culture junkie. So I appreciate that. So listeners, I’ll have links in the show notes for the episodes that Billy just mentioned. So you can kind of check, check them out. I think we could just keep talking for hours. But I want to thank you for everything you shared today and congratulate you on the fellowship and your work. I’m just so glad that you’re, feel like it’s so important that you are where you are doing the work you’re doing. It’s making such an impact.

Dr. Billy Garvey:

Yeah, thank you. But I’m really conscious of you and Tina and all those people that like, you know, and yeah, it just really means a lot to me. So I don’t know how I’ll ever make it up to you guys, but yeah, just honestly, I don’t, I just don’t want to say it in a cheesy way, but it really does. Like I hope that I get to come overseas again and then thank you in person. If there’s, you know, in Australia, it’d be great. Even down the track, if I get the ability to do it, to like bring you over and do stuff to be like, you know, it’d just be, yeah. It means a lot to me because I, a big part of why I’m sitting here is because of all the work you’ve done, but also just the fact that you are happy to connect.

Debbie:

I was happy to connect, but thank you. I would love that. Here’s to future collaboration. So I will let you get on with your evening and thank you again for everything you shared today. It was great to hang out with you and chat.