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How do I talk about mental health with my child or teen? P.S. this framing is helpful for adults, too...

by Rabbi Shoshana Meira Friedman

Black family with mom dad and two kids on a couch with a tablet.

Someone asked me recently how I would talk about mental health with a child or teen.

Up top, I’m not a psychologist. I am a rabbi who has worked with children and teens, and I am an Autistic person who remembers my own childhood and teenage years with vivid clarity. I’ve also struggled throughout my life with anxiety, OCD, PTSD, depression, burnout, and self-harm ideation. So I’m writing here from lived experience as well.

For decades I have practiced speaking to young people clearly and without embarrassment about the hard things in life.

Here is how I explain mental health to children and teens (and adult clients). Feel free to use this as a script for talking to people in your own life.

"Mental health is just a fancy phrase for the way feelings move through our body, thoughts move through our mind, and how good our brain is at telling if we are safe or in danger. Here's how it works:

"We have a body. Feelings happen there.

"We have a mind. Thoughts happen there.

"We also, of course, have a brain. Our brain does a lot more than think. In fact, we are not aware of most of what our brain is doing every second to keep us alive! One of our brain’s jobs is to scan our environment and decide if we are safe or if our lives are in danger. We are not aware that our brain is doing this. But just like breathing, it is happening all the time whether we think about it or not.

"If our brain determines we are safe, we will be able to make choices, take care of ourselves, play, learn, and connect to other people. If our brain thinks we are in danger, it will focus only on helping us survive. Our body might fight, run away, hide, or not be able to move or talk.

"If our feelings and thoughts come and go safely, and if our brain only tells us we are in danger when we actually are, then we are in good mental health.

"But sometimes, for lots of different reasons, uncomfortable feelings can get stuck in our body, distressing thoughts can get stuck in our minds, or our brain can fire off warnings that we are in danger when we aren’t.

"When one of these things happens not just for a moment or a bad day but over time, that’s when we say we are struggling with mental health. This is not our fault. It doesn’t mean we are bad or weak. It just means we need some support.

"As soon as we realize we are struggling, even if it doesn't seem like a big deal, that's the perfect time to tell a trusted adult. You don't have to wait for it to get really bad before you tell someone. You can just say, "I keep feeling bad about myself and it's not going away." Or, "I have a scary thought that won't go away and I need to tell someone about it." Or, "I keep needing to run away or fight, and I think I need help feeling safe."

It is common for people in our society to struggle with mental health. When it happens, we all need support. "

If you are talking to a child or teen, be sure to tell them if you are one of their safe people. Make a short list with them of other safe people who they can go to if they are struggling with mental health.

That's the short version of the conversation.


Here is more language for a longer conversation:


Feeling angry, sad, lonely, scared, or extremely excited are all part of being human. Even though we have lots of thoughts about our feelings, the feelings themselves live inside our body. They have a physical sensation, like an ache in our heart, sweaty palms, shallow breathing, butterflies in our stomach. We are in good mental health when we are able to move these feelings through our bodies safely. Safe ways to move feelings through us include:

  • crying

  • beating a pillow

  • working out

  • dancing to music

  • writing

  • talking to a trustworthy person

  • making art

  • screaming in a safe place

  • shaking

  • rocking

  • stomping

  • punching a punching bag

  • hugging someone

  • taking deep breaths

  • Even yelling or banging on something can be safe, as long as anyone around you also feels safe while you are yelling and banging.

Moving our feelings through in safe ways is important, because if we don’t move them through in safe ways we might do unsafe things to escape the intense feelings.

Unsafe things include hurting our own bodies, hurting other people’s bodies or belongings, or doing things while we are upset or over-excited that will have a bad impact on our lives. If this happens to us, it’s time to tell a trusted adult.


Everyone has scary or annoying thoughts sometimes. We might have thoughts that tell us we are not good enough. We might think angry thoughts about another people. We might have a sudden thought that scares us. When these distressing thoughts come, we can:

  • talk about them with someone we trust

  • write them in a journal and write down what else is true

  • make lists of things we are grateful for

  • use affirmations to replace the thoughts

If we do this and the distressing thoughts go away, then the thoughts are no problem. When we are able to let thoughts go and come back to our centered self and see reality clearly, then we are in good mental health.

If thoughts loop over and over so much that we have trouble feeling good about ourselves or functioning in our lives, it’s time to ask for help from a trusted adult. Some people are more prone to these kinds of thoughts, and if that is you it is not your fault. You just need specific support, possibly for a brain wiring called OCD.


If we have experienced a very difficult event or series of events, or if we didn’t get some important needs met when we were young, or if we are neurodivergent, our brain might easily think we’re in danger when we’re not.

This might feel like the urge to fight, run away, hide, or do things to please other people because you are afraid of them. It can also feel like not being able to move your body or not being able to talk even if you usually can. These are called the threat responses of fight, flight, fawn, and freeze.

When we are having a threat response, we can’t think clearly. We might hurt our own bodies, hurt other people’s bodies or belongings, say things we don't mean, or do things that will have a bad impact on our lives.

If we are going into threat often, we need compassion and help from adults who can help us make changes in our lives that will let our brains relax. The right kind of therapist can use tools to talk to the deep part of our brain that is stuck. This is called trauma-informed therapy.

If you are PDA, you are likely especially prone to going into threat response. PDAers need a low demand and neurodivergent-affirming lifestyle that allows us to use our strengths and special interests to learn, work, play, and socialize. If you are in PDA burnout, you will need a period of deep rest and special interest time to recover.

Many people who struggle with mental health benefit from medication. The right medication will help a person to move feelings through their bodies safely, help thoughts not get stuck on loop in their mind, and help them not go into threat response as easily.


1. Start to notice what your body feels like when you are upset. Not the stories about the feelings, but the physical feeling in your body. Numb? Tingly? Heart racing or aching?

2. Start to notice what thoughts come up in your mind when you are upset. If thoughts loop over and over in your mind, start to notice them too. Notice that the thoughts and physical feelings often come together but are two different things.

3. Start to notice when you are going into threat response. You may not realize it until after it happens, and that's OK. Notice what threat response feels like in your specific body.

4. Work with a trusted person to make an action plan for the next time a feeling gets stuck in your body, a distressing thought gets stuck in your mind, or you go into threat response.

For example, an action plan might be:

a. Call Mom or Sister or Therapist

b. Get to a physically safe location

c. Do ten jumping jacks with deep breaths while on speaker phone

d. Stay on the phone til I feel calm again

4. Keep this action plan on your phone or somewhere easy to find. It can be hard to follow action plans when we are upset, but the first step is to make one. You can experiment with how best to support yourself in following it.



Are you ready for compassionate, neurodivergent-affirming support from an Autistic PDA person who gets it?

I bring the full power of my rabbinic training, lived experience, & deep study of Autism & PDA to my coaching sessions.


I work with Autistic & PDA people, 

our family members, & allies.

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