Anger on the Surface, Anxiety Underneath: How to Help Your Child or Teen

Episode Transcript

Dr. Nicole Beurkens

Hi everyone, welcome to the show. I’m Dr. Nicole, and on today’s episode, we are going to talk about anger and anxiety in kids and teens, specifically how anger can actually be a mask for anxiety some of the time especially as kids get into those teen and young adult years. It can be really tough as a parent or a professional to sometimes decipher what’s at the root of a kid who is being more hostile or dismissive, or seems like they are angry, but when we can dig a little bit deeper and see that anxiety is actually present, it helps us to support that in a more effective way. It also helps kids understand more of what’s actually going on for them. So to explore this with us today, I’ve invited Kelsey Torgerson Dunn on the show. Let me tell you a bit about her. She’s a licensed social worker and the author of When Anxiety Makes You Angry. She specializes in anxiety and anger management therapy for teens and college students, and founded her anxiety focused group practice Compassionate Counseling St. Louis in early 2017. She’s going to talk with us about this and share with us where we can get her new book on the topic, but let’s dive in. Welcome to the show, Kelsey!

Kelsey Torgerson Dunn

Thanks so much for having me. I’m excited to talk with you today.

Dr. Nicole Beurkens

So let’s start out with your story. You have a very specific focus in your clinical work, of this issue of anxiety and anger in older kids and young adults. Tell us how you got interested in doing that kind of work.

Kelsey Torgerson Dunn

Yeah, absolutely. So when I was right out of graduate school, I went to Washington University in St. Louis for my master’s degree in social work. And then after graduating, I got a job at a behavioral school, and at the behavioral school, it was kids who were not able to be successful in a typical school environment, and had a lot of angry, aggressive behaviors. And so for some of those kids, truly, it was an anger issue and a behavioral issue, and we needed to be really behaviorally-focused. But for some of those kids, there was an underlying trauma or anxiety issue. And if we weren’t treating the anxiety or the trauma, we weren’t really seeing a big change in their behavior. And so that’s how I really got into it, and moving forward in other school settings, just so often, teachers would tell me, “This kid has a conduct issue”, and “This kid is oppositional”. And yes, that’s what it looked like on the outside, but internally, there are all these stressed-out emotions going on that really needed to be addressed.

Dr. Nicole Beurkens

Well, I think that’s a real shift that we are seeing and that some of us are advocating in our entire field of mental health and education, it’s understanding that what we have traditionally called conduct disorder or oppositional behavior, or just behavior problems in general, all are rooted in underlying emotion regulation issues, nervous system dysregulation. No kid just wakes up and goes, “I’m just going to be a total problem for everyone and not do anything anybody says and be angry, and violent.” We know that there are underlying issues. So yeah, I think this is part of that shift in that direction of saying, when kids are having what looks on the surface like these angry, hostile, belligerent kinds of behaviors, it’s really our job to look beneath that and say, “What’s actually going on there?”, right?

Kelsey Torgerson Dunn

Yeah, 100%. Because if you are only dealing with the surface level stuff, even if you are a really awesome therapist or a really awesome teacher, you are just dealing with the surface level. It’s like you are chopping off the dandelion versus like digging into the root and really getting to the meat of what’s going on.

Dr. Nicole Beurkens

Yeah, that’s a great example. So let’s start by talking about how anxiety can show up as anger. I think that people are pretty familiar with that. We have done episodes previously on some of the common ways that anxiety shows up, both in younger kids and older kids, but this idea that anxiety can show up as anger. Talk to us about that. What does that look like? What are the symptoms of that?

Kelsey Torgerson Dunn

Yeah, absolutely. So right off the top, I want to say that about 25% of teenagers meet the criteria for an anxiety disorder, and about one in three of those teens with anxiety also have behavioral issues. So just in the studies, there’s like a really big population of anxious kids and teens who look like behavioral issue kids and teens. With anxiety and how it looks like anger, I talk a lot about fight, flight and freeze. So we all know what fight, flight and freeze is, it’s when your body is responding, your brain is responding like you are in a dangerous situation. It’s really easy to say, “Oh, this kid who ran out of the classroom”, or “This kid who’s so shy and they don’t talk at all, they must have an anxiety issue.” That fight response often doesn’t get categorized as an anxiety issue, even though it is, because that teenager looks so angry, so aggressive, and ready to defend themselves, it’s masking that anxiety and that fear that’s underneath it.

Dr. Nicole Beurkens

Yeah, I think that’s a good point. I think it makes us more comfortable when kids manifest their anxiety as more of the internalizing like, “Oh, I’m going to be shy” or “I’m not going to talk” or “I’m going to avoid things.” It can be uncomfortable, especially as kids get bigger and older, when they are in more of that fight mode. But to recognize that that is a way that anxiety shows up. I’m thinking too, there’s that overt, literal fight mode, right? I’m feeling anxious, I’m feeling uncertain, unsettled. The kids who will flip desks over or at home will punch holes in things or will physically threaten. But I’m also thinking about this anger, and maybe you can comment on what you see in your patient population, showing up even just a sort of a hostile attitude. Like parents will come in sometimes, and they will say, “My kid’s just angry all the time”. And they don’t mean he or she is like punching holes in the wall or hurting people, but it’s more like just this sort of angry, brooding, hostile kind of attitude and communication. Is that a piece of what we are talking about here, too?

Kelsey Torgerson Dunn

Yes, 100%. I think with that fight reaction, it can look like “Oh, I’m fighting a bear. I’m fighting a tiger, I’m getting really physical about it.” But internally, you are experiencing all this tension and your heartbeat is racing, and you are ready to go. So if you are starting to feel that level, you might look just angry on the outside, not at this physically aggressive part, not even at yelling. The ramp up to it is just maybe a parent thinks that their teen is being kind of snotty or bratty or disrespectful or getting ready to have an argument. There’s the levels of it before you reach that really huge, aggressive piece. And some people like myself, when I get angry, I don’t ever have that physical aggression piece of it, but I’m still feeling that stress and that tension, and it’s maybe coming out as I seem mean or I seem really sharp with somebody, but underneath it is still that anxiety that’s going on. So I would say at my private practice, a lot of the teenagers that we work with don’t really seem so physically aggressive. It is more that just — maybe a parent would call it a “disrespectful attitude”, or maybe they are getting in trouble more at school, or maybe they fight with their friends a lot. they are not getting physically aggressive, but they still have that emotional kind of component to it.

Dr. Nicole Beurkens

Yeah, and I think this really makes it relevant to anybody raising kids, but particularly if you are raising kids in those preteen, teen, young adult years, this really does impact kids at this age a lot. Anxiety, whether it’s diagnosed as an anxiety disorder or not, these are these angsty, more anxious years. And you also have all of the other shifts in physical development and peer relationships. And so I think that is really at the heart of why kids in these developmental stages sort of can get a bad rap sometimes for being broody, brooding, and sort of angsty, and angry. And part of it is that they are feeling so uncertain and so anxious about lots of stuff.

Kelsey Torgerson Dunn

Yeah, absolutely. I think there are all these different stressors that are happening internally and externally, especially at this age, and especially right now, thinking about coming out of a pandemic, and all these kids who switch from virtual to in person, to virtual to in person. There are things happening in the environment that are increasing stress levels for everyone. There’s things happening internally for your preteen and your teen years, hormonally and also emotionally and also thinking about these big changes coming up for you, like going to high school, or what am I going to do with my life? So it’s just this big roiling mess of stressors. Whereas with these teens that I love to work with, those stressors come out as more of an anger issue, but it’s just the stress and the nervousness that’s really going on. That’s typical. And then to the point where maybe it’s a little bit more apparent to people, as a parent, you might have someone say, “Oh, your kid seems mad all the time.” Or “How do you let them talk to you like that?” But it’s all the stress and worries that they have.

Dr. Nicole Beurkens

That’s right. But I’m curious about your perspective on why you think anger is such an effective mask for anxiety, because as adults, in our more mature regulated brains, it’s one thing to say, “Well, if you are anxious, just be anxious. Just tell me it’s anxiety.”  But anger actually is a really, common and effective mask for anxiety in kids and adults. I don’t think many adults realize how often they use anger as a mask for their own anxiety. What’s your perspective on that? Why is it even easier for us to be angry than to feel anxious?

Kelsey Torgerson Dunn

My hypothesis is that anger can be a more comfortable emotion to a point because you are on this defensive side of things. But then you get to a point where you look so angry on the outside that then you are the problem child or whatever. And then it’s really not okay to be angry. So there’s a tipping point there. With anger, a lot of times, what it’s looking on the outside is you look like you are going to fight or get aggressive with someone or whatever. And so as the parent or the therapist or the teacher, you might have this emotional reaction to it, like “I don’t want to dig into this or talk about this,” or whatever, “because I’m feeling like I’m getting triggered, or I’m getting heightened too. They seem like they are going to defend themselves, I’ve got to defend myself”, versus what maybe looks more typical anxiety, like they are running away or they are being really shy or just being really nervous. That might be easier for a parent or a teacher to feel “I can talk with this kid about it”, but anger, not so much. So maybe even for some of these teenagers, anger is more comfortable for them to present with because they don’t want to dig into it.

Dr. Nicole Beurkens

That’s right. It keeps everybody at arm’s length, right? It’s an effective avoidance, which I think your point is well-taken that that becomes a double-edged sword, because of course, kids may think in the moment, “I just want everybody to stay away from me, I don’t want to talk about this, I don’t want to deal with it.” But of course, then when we don’t, then they end up feeling alone and like they don’t know what to do, and nobody’s helping them. So it is a tricky position for adults, parents in particular, to be in, right? I think this is part of when we live through the preadolescent and adolescent years with our kids, it’s part of why we get that sense of, you never really know, it’s sort of that “Come here, go away”, stage that you feel as a parent, where one minute, my kid seems to need and want me to come closer, and communicate and care about them, and then the next minute, it’s nope, get away from me. And it can be tough for parents to navigate that.

Kelsey Torgerson Dunn

Yeah, it absolutely is. I think too, when you are getting into those teen years as a parent, you are also balancing that “I want to support your independence and help you grow into a healthy, happy, fully enriched adult. And I also want you to do your homework and complete your assignments and do well.” So figuring out how much do I guide my teenager, and how much do I try and let them figure it out for themselves? And so if you have a teen who is not just snotty with you sometimes, but seems mean to you and mean to other people, and maybe is having these issues in different settings, it can be really worrying as a parent, because your mind starts to go to “Well, if they can’t control themselves now, how are they going to control themselves when they are all alone at college?” Or “If they are fighting with their teacher, they can’t fight with their boss, what is a terrible thing that’s going to happen?” It can provoke fears for the parents, too, for sure.

Dr. Nicole Beurkens

Yeah. And then sometimes we get a situation where the kid is acting out in angry ways to try to manage their anxiety, and then when we have a parent, or caregiver, or a teacher, or whoever, who also then is responding in anger to mask their own anxiety, exactly like you just said. Boy, then we really just get into these power struggles, right?

Kelsey Torgerson Dunn

Yeah, absolutely. And it can be really tough to break that. I always tell parents: Misery loves company. So if your teenager is feeling really anxious, really stressed, and the anger is coming out, or it’s looking anger, even unintentionally, they are trying to get you to have a strong reaction too. And to break that cycle, you as a parent have to be careful and say, “I need to take a step back”, or “I need to take a break and calm down before we can address this problem that’s going on”, instead of just jumping into the conflict that might keep happening over and over again, without the kind of outcome you want to see.

Dr. Nicole Beurkens

Yeah, that’s a great point. Let’s dive into some strategies around this. I know that you are a fan of using cognitive behavior therapy tools, you have written a book about that, you have developed resources around that. Let’s dive into that a bit. Why do you feel some of the CBT kinds of approaches or tools are so effective for this particular issue of kids acting and feeling angry, but really, they have got this underlying anxiety? Why is CBT a good tool to have in the toolbox?

Kelsey Torgerson Dunn

Yeah, that’s a great question. I think CBT is such a powerful framework to help kids and teens understand, “Okay, this is what’s going on, and this is why, and these are the points I can change.” So I really love to go through the cognitive triangle with people and talk about “Your thoughts are here, your feelings are impacted by your thoughts, and your behavior is impacted by your feelings, and they are all interwoven together.” So you can change what’s going on at each point of that triangle. So with your thoughts: In this situation, what are you telling yourself? What is the first thought that your anxious mind is kind of jumping towards? And what behavior is that leading to? And what emotion does that leading to? So what can we tell ourselves instead? Or what would be a healthier behavior? Instead of getting aggressive with somebody, what if you did a relaxation strategy? Or on the emotional side, checking in with your levels of emotions, and the emotional elevator, which I talk about in my book, where maybe it’s really hard to turn things around when you are feeling a 9 out of 10 anxiety, right? You are so heightened. It’s hard to relax, it’s hard to tell yourself something helpful. So what are ways that we can lower that elevator or catch your anxiety level before it reaches that tipping point where you feel you are going to explode? CBT is a great way to kind of talk about those points, but also to give you some tools in terms of really figuring out what happened first, and what happened next, and what is changeable within that. But the book is not just CBT skills, it’s also a lot of relaxation, positive thinking and problem-solving stuff. I think sometimes teens who’ve maybe been in therapy think, “Well, CBT is hard to do when I’m angry because I’m so overwhelmed. I can’t stop and think at that moment.” So figuring out, “Okay, what is my strategy moving forward? And how can I practice those skills before I need them, so that I’m ready the next time it happens?” It’s not the kind of change that is going to happen overnight, it’s going to take a lot of practice to start to feel more in charge of your emotions instead of maybe feeling your emotions are in charge of you.

Dr. Nicole Beurkens

So with the CBT approach, thinking about “What are my thoughts? What are my feelings? What are my behaviors?”, that can be a really important starting point for kids even to help them become aware of those things. So many kids — and I’ll put adults in the mix of that too, but we will talk about kids for now, don’t even have any idea of the difference between those things. I’m sure you see this, but I see it a lot where it’s about helping teenagers, young adults even, distinguish between “What’s a thought that I’m having?”, and “What’s a feeling?”, and even getting in touch with the range of feelings and really tapping into it. So building that awareness of “Oh, when this thing happens, what am I actually thinking about here? And then what am I feeling?” That can be such an important starting point, and parents can start to model that for their kids too, right?

Kelsey Torgerson Dunn

Yeah, absolutely. One of my favorite things to have these kids and teens do is an activity, I call it “The Body Clues Activity.” So there are certain things about anxiety-driven anger. Anxiety and anger are all interwoven, and it gets kind of confusing. So what we have them do is draw an outline of their body. And then they think about “Okay, the last time you felt anxious, where did you notice that feeling in your body? And let’s color it in. Alright, the last time you felt angry, where did you notice those feelings in your body? And let’s color those in.” And a lot of times, these teenagers with anxiety-driven anger — adults, too, of course, it’s kind of happening in the same spots, so it gets confusing for your mind to say, well, when I’m anxious, my stomach feels all funny. And when I’m angry, my stomach feels all tense. So if my stomach has something going on, what am I feeling right now? And the response I’m going to have is going to happen so quickly. For parents, the strategy is maybe exploring that with your teen. You can have that conversation with them, and share, “Here’s what I notice about my feelings in my body.” As the adult, what are you noticing and how does it look like on the outside? Because you might be assuming your teenager is angry because they look really angry on the outside to you, but it’s not like that.

My framework that I love to teach parents is called “The 3 Step Approach.” So first of all, the pre-step is if you are getting really anxious and overwhelmed as a parent, you need to calm down. But step one is to Identify and Empathize. So helping the teen figure out what they are feeling right now, and whatever they are feeling, it’s okay. There’s no such thing as a bad emotion. I remember when I was working at the behavioral school, I had a situation where one of my clients in the classroom was having this huge meltdown, and I had to be the one alone in the classroom with her to kind of help her handle it, which was overwhelming for me. So I told her “You seem really angry right now. You lost recess. I’d be angry. It makes sense to be angry.” And she said, “I’m not angry. I’m sad because I got in trouble.” And I wouldn’t have known that if I hadn’t started with “Let’s talk about these emotions.” Step two is calming down, helping your kid calm down, coming up with some relaxation strategies for them. And then step three is the game planning. So as the parent, helping the teen strategize. What can you do next time? How can I help you out next time? But not jumping to that problem solving before you have identified the real emotion and before you have calmed down enough to think clearly. So that’s kind of the three steps.

Dr. Nicole Beurkens

That’s really helpful and clear. And I think that the piece about making sure that we are clear about what is going on, you are right, we make a lot of assumptions, especially if the kid is looking angry or hostile or using a tone, we may jump to some conclusions or make some assumptions about how they are feeling, and that might not be accurate. And so I really like your point about: Let’s check in, let’s make sure that we understand what emotions are actually happening for the kid here first.

Kelsey Torgerson Dunn

Yeah, absolutely. It’s really easy to say, well every other time they have looked this way, we have gotten into a huge argument, so they must be mad, they must be frustrated, or whatever. So really taking that time to calmly explore it, and knowing the first time you do it, it might not go so well. You might get the same reaction as always. But using that as a framework, moving forward to start figuring out and exploring the depth and the breadth of these emotional experiences that they have. And maybe taking the heat out of the moment a little bit, because you are taking a step back to explore it instead of trying to jump right in and stop something from happening.

Dr. Nicole Beurkens

Yeah, and that emphasizing, that letting them know that how they are feeling is okay, because some kids, I think, feel angry and defensive because they feel like they are not allowed to feel how they feel, right? It’s like, “Oh you are telling me I shouldn’t feel this way or that I shouldn’t be doing that.” And so it’s to empathize with that first, that’s very regulating and soothing for the nervous system too, yeah.

Kelsey Torgerson Dunn

Yeah, absolutely. And I think too, feeling angry or feeling anxious, that stress and tension is not comfortable. I’ve never worked with a teenager who was like, “Oh, yeah, I really love getting in trouble all the time”, or “Oh, yeah. I love that I explode and yell at people all the time”, right? We don’t know what that does to us. So I use a lot of ACT, Acceptance and Commitment Therapy in my practice, too. So just not fighting against that emotion, but acknowledging it and sitting with it, that can really help to make things feel less overwhelming because you are not trying to push it away or just stop it from happening, which is impossible. You’re just letting it be there in the moment, and that gives your body a chance to kind of regulate too, not fighting it, but allowing it to happen.

Dr. Nicole Beurkens

Yeah, and I think for parents who are listening, or professionals even, who say “My kid, when they are worked up, they won’t hear any of that, they won’t do any of this”, an effective starting point is for parents to be spotlighting and modeling this themselves, right? What do you say to parents who are like, “Listen, my kid goes 0 to 100, instantly. We are not able to have a lot of these conversations at the moment.” What are some of the things that you encourage them to do? Because I think that the inclination on a lot of parents’ part is just give up and say, “Well, this doesn’t work. These tools don’t work. My kid is the exception”, but we just need to find a back door, right? So what are some of the things that you talk to parents about or or encourage them to do to sort of ease into this?

Kelsey Torgerson Dunn

Yeah, for sure. Well, so the first thing I would say is, ask yourself: How long has this been a problem for you and your child? It’s probably been going on for a long time, you can’t expect to try a strategy a couple times and make a big change. Change takes time. We get these connections in our brain. This stimulus leads to this response, and that gets strengthened. So every time a kid looks this way, I respond this way, and then we fight. We are used to that pattern. Breaking that pattern and choosing something else is going to take a lot of time. So be patient with yourself and be patient with your teen, and figure out: “What are one or two things that I want to start doing that I can do on a regular basis?” A lot of times too, as parents — and I’m a parent of a toddler, which is totally different than a teenager, but I noticed myself getting angry and anxious and overwhelmed with her sometimes when she’s not following directions. My big job as a parent is to stay calm and in control of myself in that situation. So as a parent, figuring out what are ways I can kind of attune to my own anxiety or anger that’s coming up for me? What can I do to regulate myself so that at least I’m taking that piece out of this puzzle, right? I’m removing myself as one of those stimuluses as best as I can. And then also if you are experiencing this struggle with your teen, you are trying a lot of things out, you are not seeing as much of a change as you want to, or it feels you are still stuck, I always encourage parents to look into counseling, for themselves potentially, but also for their teenager. And we do individual therapy mostly at Compassionate Counseling St. Louis. So we will do a parent check in, but it’s mostly the teen working on themselves individually, that’s really important because even if I’m saying the same thing that you are saying as a parent, I’m a different person, I’m their therapist. So it’s being heard and understood in a different way. So definitely, if you are trying things and it’s not making as much progress as you want it to make, bring in someone else to help out with it.

Dr. Nicole Beurkens

So true I can say that just from personal experience. My four kids are teenagers and young adults now, and I do this for a living, and them hearing it from someone else is often a much more powerful shift for them than hearing it from mom, right? Because I’m their mom, of course, I don’t know anything about any of this. So I think that that’s a really good point. I’m thinking too, one of the things that I have found helpful, both in my own life with my kids, as well as in my work with families is when we, as a parent, notice for ourselves that maybe there’s been a situation that’s come up where we have said something in an angry way or acted out or done something with anger, but really what was going on is we were feeling anxious or uncertain or stressed. I think that circling back around and talking with our kids about that can be really helpful for helping them to understand how this happens for them. To say, “Oh, gosh, I was thinking about that situation that happened earlier today, and I realized I really was kind of angry in my tone with you, and I didn’t have much patience. I just really kind of snapped, and I realized that actually, I was feeling really stressed and anxious about this big presentation at work, I had a lot going on today. So I acted out in an angry way towards you, but really, it was because I was feeling nervous or overwhelmed”, or whatever. I think that when we talk about our own stuff like that with our kids, especially if it’s an experience they have had with us, that’s a very powerful tool, not only for repairing our relationship with them, but for helping them then to get in touch with that for themselves in a way that isn’t focused on them. It takes the pressure off of, “This is about you”, right? It’s like no, I’m actually talking about myself right now. But kids, once they get past the age of 8 or 10, they are able to connect the dots and realize that that could be relevant for them too. So I have found that that can be a powerful tool.

Kelsey Torgerson Dunn

Yes, I think it totally is. Repairing is super, super important. Apologizing. If you want your kid to apologize to you when they get upset, you should be apologizing to them when you get upset. But also modeling it for them and not putting them under the microscope all the time. So exactly like that 3 Step Approach that I talked about before, using it for yourself and saying “I’m noticing we are talking about this. I’m feeling kind of angry, but mostly kind of just stressed about what’s going on. So I’m going to go take a walk and cool down, and then we are going to come back and talk about this some more, because I want to make sure that I’m calm enough to really be effective in this conversation and not just get upset with you.” So whenever you can model that, it makes it okay for the teenager to do the same thing and to identify, “Here’s what I’m feeling, here’s what I’m going to do about it before, and here’s how we are going to maybe solve this problem going forward.”

Dr. Nicole Beurkens

Yeah, I love that. What comes to mind, I’m thinking about kids that I’ve worked with, where perfectionism is an issue for them. And I think about perfectionism as being sort of in that broad category of anxiety, right? Fear of making mistakes, fear of not being perfect. But I have encountered some kids who really can be pretty well-regulated, they are usually very high achievers, they are the sort of type A, straight A student, or they do the extracurriculars, but they can have this really sort of sudden snap angry side to them, that very often, it’s just the parents who see that. But I’ve had them come in for treatment around that, and parents will say, “Nobody would guess that my kid snaps and gets angry like this”, and I think that a lot of times, that does have its roots in this idea that I have to be perfect, that perfectionism, anger can be a close relative to that, too. I’m curious if you see that in your practice at all?

Kelsey Torgerson Dunn

Oh, yes, we see it a lot in our practice. It’s like there’s this tension, right? Like, “I have to do this and be the best that I can be. And any small thing that doesn’t go according to that plan, or any small stressor that I hadn’t expected, I’m totally off track, and I feel really overwhelmed by that.” And that overwhelm might come out as snapping at somebody, snapping at a safe person, like “I can show this to my mom and dad, I’m not going to ever show it to anybody else.” But yeah, they are very, very closely entwined. So it all comes back to that regulation piece. We talk about the Window of Tolerance a lot. So there’s this side at the top where it’s anxious and angry, and the side at the bottom is depression and sad. And for some of these teenagers with a lot of anxiety, they have a really small window of tolerance. There are only so many stressors that they can experience before they are going to explode. The way that we make that window of tolerance bigger as we practice coping skills, we maybe go to therapy, we maybe do CBT, or Acceptance and Commitment Therapy or whatever. We build up our skills so that we can regulate and handle more things. For those kids with perfectionism and anxiety, they are experiencing the exact same thing as those teens with anxiety driven-anger. And I would also say a lot of times, if you are anxious, and you are worried about what’s going to happen, you have this over control, right? If I can control the situation to the best of my ability, I’m not going to have to explode. But that’s not true. Control is just an illusion, we are not in control of all these different things in the world around us all the time. And so it can be really overwhelming when you get that A minus, or when you don’t get the lead in the school play, or whatever. And might not always look like anger in every situation. But it’s still anxiety, overwhelming, and something we need to learn how to identify and treat and deal with. Perfectionism also means that a lot of times teens can look so good on the outside, but they are not getting the mental health help that they need.

Dr. Nicole Beurkens

That’s a great point. And as you are talking about this, it’s occurring to me in a way — We had touched on earlier, just our hypotheses about why it’s easier to feel angry than it is to feel anxious or to express being angry instead of anxious. I think as you are talking through some of these examples, it occurs to me that really, in our society, anger is more socially acceptable than anxiety. It’s a less vulnerable thing to be, especially I think, if you are a teen boy, if you are a young adult male, it is absolutely more socially acceptable to present as angry or sort of bitter or hostile or aggressive or whatever, than it is to admit to feeling scared, fearful, nervous, any of those things. And so I think that that probably plays a role in all this as well.

Kelsey Torgerson Dunn

Yeah, I definitely think so: What is culturally acceptable for us? And for girls too, on the other side of things, it’s not so acceptable to be really aggressive and angry all the time. And so when they are maybe showing that, then they might get in a lot more trouble than a boy. Or we have worked with a lot of high achievement athletes too. Where it’s, yes, you want this feeling on the tennis court, you want to be angry and upset about things on the football field or whatever, or in competitive cheer, and then in every other situation outside of that, it is unacceptable. And so your brain gets confused. “Well, I can do this in these situations, but not in these situations. What are you talking about? I’m going to do this all the time.” And then you get in trouble in these different situations. But yeah, going back to what you said, I think that vulnerability is why therapy can be so helpful, because it is a space where you can start to talk about it and explore it and not worry about “What is my parent going to think about me? What are my friends going to think about me?” Here, I can actually talk about what’s really going on.

Dr. Nicole Beurkens

Yeah. And I think that’s also why it’s important for us as parents and other adults in kids’ lives, to be modeling that out loud to them ourselves, because that takes the stigma away from it. If I’m willing to say, “Boy, here’s how I’m feeling, and this is happening for me.” And I think for boys, particularly to hear that from men, whether that’s a father or a father figure in their life, or a male teacher or a male therapist or somebody to, to be modeling that for them, that “Hey, yeah, these are feelings that we have, and we don’t have to act out in angry ways. We can actually be in touch with our feelings. We can communicate other feelings that we are having besides anger or defensiveness, and that that’s okay.” I think that’s really powerful, especially for young men.

Kelsey Torgerson Dunn

Yes, definitely.

Dr. Nicole Beurkens

So you have got this book that has come out, you have talked about some of the strategies. Kind of walk us through how a parent would find this helpful with their child? Obviously, we have talked through a lot of the concepts of it, but I know the book is really meaty on strategies and tools, right? So what kinds of things can somebody expect to find in here?

Kelsey Torgerson Dunn

Yeah, for sure. So When Anxiety Makes You Angry is my CBT-focused self help book for teenagers, and it basically walks the teen through how I would structure ongoing therapy in my own private practice. So I like to really focus on a lot of skills building and jumping right into that because you need the skills right away if you are in these situations. So it goes through a lot of relaxation skills, a lot of effective expression stuff. So helping you to identify: Here’s what I’m emotionally experiencing. Here’s what I know; I reached this level on my emotions elevator, and I’m going to have a big reaction. Here’s what I know; I’m getting to the edge of my window of tolerance,” building in this awareness of those different levels of emotions instead of just feeling 0 to 60 all the time. You might get heightened really, really quickly as a teenager, but we want to be building and using a lot of coping skills and problem-solving skills so that you are able to catch yourself a little bit quicker. Or be practicing these skills before you need them so that you do have that toolbox ready to go.

I think for the parents, this is a book for teens, and there’s a little parent introduction with it and a parent guide on my website, which is just my name, kelseytorgersondunn.com. So some starting points for you as the parent, but with the teen years, as we talked about this earlier, there’s a balance between helping them out and helping to foster independence. So it really is directed and written towards the teens so that they feel ownership with what’s going on. And that they can kind of start coming up with problem-solving, and hopefully checking in with you about it too. But giving them the space to really explore: Here’s me on personal experience with anxiety and anger, and here are some strategies that I want to start trying out on my own. I think it would be helpful though, for a parent to kind of read it and review it and see, “Here’s what my teen is learning. And here are some things that I can maybe try too as a parent if I’m noticing the same kind of thing in myself.”

Dr. Nicole Beurkens

Yeah, I think that’s such a helpful thing because any book or workbook written for kids or teens, the issue that parents always run into is “Well, they are not going to read it or do it.” Some kids are motivated to do it, some kids less so. I find the whole just buying it and just happening to leave it out somewhere where they can see it or find it, you just sort of nonchalantly — “Oh, yeah, you might find that interesting,” and then leave it alone. But I think for us as parents and caregivers to be aware of the content and to know what they are learning or what they are working through in a resource that is helpful, because we can be reinforcing that or at least modeling that for ourselves, right? Being a model of that. And the book is written for a teen and even a young adult, a college-age audience, right?

Kelsey Torgerson Dunn

Yeah. Teens and college students. And, also I think that I’ve written it in a way where it’s really approachable. If I were a teenager, and my parent was like, “Here’s this book, and we are going to talk about it every single week”, I wouldn’t want to read it. Just be like “I’m going to leave it out. You do it when you are ready to do it.” Or if you are in therapy, “I’m going to give this book to your therapist, and you guys can work on it if you want to. Whatever, no stress.” It makes them much more likely to actually do it.

Dr. Nicole Beurkens

That’s right. We just stay very unattached about the whole thing. Where can people get the book? On your website? kelseytorgersondunn.com?

Kelsey Torgerson Dunn

Yeah, it’s on Amazon, it’s on Bookshop, there are all those links on my website that people can click on.

Dr. Nicole Beurkens

Fantastic. And I know that your website has a lot of other resources, too. you have got downloadable worksheets and guides and things there. So I really encourage people to check that out. Kelsey, thank you so much for being here with us today, for talking with us about this really important topic that lots of families are dealing with. So thank you for your work around this.

Kelsey Torgerson Dunn

Thanks so much. It was a pleasure.

Dr. Nicole Beurkens

And thanks, as always, to all of you for being here and for listening. We will catch you back here next time.