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Speaker 1: My book of the Year this year is called Searching

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Speaker 1: for Normal. It's by Sammy to Mimy. He works in

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Speaker 1: the UK as a child and adolescent psychiatrist and psychotherapist,

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Speaker 1: and it's taken me a couple of months to get

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Speaker 1: through this one. There's some pretty heavy concepts. At times,

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Speaker 1: it feels like you're reading more of an academic book

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Speaker 1: than a a popular trade book that you buy on

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Speaker 1: the shelves, and yet the conversation about mental health, the

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Speaker 1: conversation about diagnoses, about neurodiversity, trauma, and so much more.

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Speaker 1: It may be one of the most important books that

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Speaker 1: is on bookshelves at the moment. So today a conversation

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Speaker 1: with an author that I have been so excited to

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Speaker 1: talk with, Sammy to Mimy. That's coming up in just

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Speaker 1: a sec on the Happy Families podcast. Stay with us, gooday,

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Speaker 1: Welcome for the Happy Families podcast. Real Parenting Solutions every

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Speaker 1: single day on Australia's most downloaded parenting podcast, Dr Sammy

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Speaker 1: to Mimmy's new book is called Searching for Normal. It's

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Speaker 1: a new approach to understanding mental health, distress and neurodiversity,

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Speaker 1: and it asks a question that every parent is quietly

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Speaker 1: wondering have we started treating normal childhood struggles as medical problems?

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Speaker 1: Has psychology become too medicalized? After thirty five years in

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Speaker 1: child and adolescent psychiatry, Doctor to Mimmy has seen how

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Speaker 1: quick diagnoses like ADHD in autism and anxiety can sometimes

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Speaker 1: overshadow what kids really need, which is understanding and connection

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Speaker 1: and support. He helps parents to tell the difference between

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Speaker 1: genuine mental illness and the very real pressures of growing

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Speaker 1: up in today's world. In the book, he says, your

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Speaker 1: child isn't broken or abnormal. Psychiatric labels are cultural inventions,

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Speaker 1: not biological destiny. When distress is medicalized, it steals our hope.

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Speaker 1: But if we can find another story, we can break

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Speaker 1: the cycle that has trapped too many for too long.

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Speaker 1: Doctor to Mimy, so good of you to join me

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Speaker 1: on the Happy Family's podcasts.

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Speaker 2: Thank you so much for inviting me. I'm delighted to

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Speaker 2: be here.

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Speaker 1: So as I said in the intro, I was reading

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Speaker 1: your book, I had a few pages to go, and

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Speaker 1: then your publicist got in touch and said, would you

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Speaker 1: like to interview this man on your podcast? And I

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Speaker 1: just thought, oh my goodness, what a great opportunity. How

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Speaker 1: can I say no, I've loved the book. In the book,

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Speaker 1: you argue that much of what we label as a

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Speaker 1: disorder may actually be an understandable human response to difficult circumstances,

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Speaker 1: and immediately, in the context of ADHD and depression and anxiety,

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Speaker 1: I thought, this is the kind of thing that is provocative,

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Speaker 1: it's volatile, It's the kind of thing that a lot

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Speaker 1: of parents are going to take potentially offense at, because well,

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Speaker 1: we love our labels, and in the current psychological state

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Speaker 1: that we're in, there seem to be more and more

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Speaker 1: people who are saying, my child is definitely not right.

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Speaker 1: So I'd love for you to talk a bit about

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Speaker 1: how parents can tell the difference between ordinary distress or

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Speaker 1: ordinary hyperactivity and impulsivity, the typical ways that you want

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Speaker 1: and behave, versus a real clinical concern that needs extra help.

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Speaker 2: One of the things that I was trying to get

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Speaker 2: across in my recent book Searching for Normal, is one

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Speaker 2: of the difficulties of trying to figure this stuff out

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Speaker 2: is that we don't really have an understanding of what

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Speaker 2: we mean by things like normal. So I know the

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Speaker 2: title of the book is searching for Normal, but the

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Speaker 2: idea of normal assumes that we have an understanding of

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Speaker 2: what we mean by normal?

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Speaker 1: Is there a problem with that definition normal? Like from

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Speaker 1: a clinical or mental health sense? What can be problematic

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Speaker 1: with definitions like normal?

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Speaker 2: The problem is all the definitions that we use in

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Speaker 2: mental health are subjective and therefore their concepts that are

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Speaker 2: and be expanded in all sorts of different directions, because

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Speaker 2: we don't have what you would call empirical anchors, something

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Speaker 2: definite in the physical world that can make you differentiate

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Speaker 2: between something that's a problem in the hardwiring, if you like,

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Speaker 2: of the brain or the body, from things that aren't.

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Speaker 1: Can you got a little deeper on that?

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Speaker 2: The problem then becomes because our definitions are all subjective,

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Speaker 2: we literally don't know what we're talking about when it

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Speaker 2: comes to mental health, and it becomes in the eye

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Speaker 2: of the beholder. And the thing that we all have

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Speaker 2: in common is that when we have various issues, various

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Speaker 2: problems that we're trying to understand, is that we are

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Speaker 2: meaning making creatures. And the frameworks that we use to

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Speaker 2: make sense of these presentations of things that worry us,

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Speaker 2: of things that can us are very powerful in terms

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Speaker 2: of how we then understand and how we then react,

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Speaker 2: and how we then imagine what the type of problem

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Speaker 2: that the person is experiencing is all about. The thing is,

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Speaker 2: you can't see a thought under the microscope. So one

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Speaker 2: of the difficulties for all parents, and one of the

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Speaker 2: things that I say to parents when I meet with

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Speaker 2: them is that one of the things that I can't

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Speaker 2: do for you is deal with guilt, because all good

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Speaker 2: parents feel guilty most of the time. That's just something

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Speaker 2: that we have to accept because we love our children

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Speaker 2: and we're surrounded by these narratives that are in our

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Speaker 2: society at the moment that make us imagine that there

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Speaker 2: are all these disorders and problems and that you should

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Speaker 2: should identify them early and that you should intervene early.

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Speaker 2: So you can't blame parents who are wanting to go

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Speaker 2: down these pathways.

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Speaker 1: Ah, totally right. But what are some of the problems

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Speaker 1: or issues that can arise if parents do choose to

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Speaker 1: go down the pathway of early identification and intervention.

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Speaker 2: The problem is, if you go down these pathways, there

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Speaker 2: is a danger that your children are going to be

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Speaker 2: exposed to the issues of labeling. And sociologists have known

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Speaker 2: about the problems with labeling and the power of labeling,

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Speaker 2: and then you're exposing your child to the potential harms

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Speaker 2: that can come from them internalizing an idea, and you,

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Speaker 2: as a parent, and the teachers and all the other

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Speaker 2: people who they're going to come into contact with internalizing

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Speaker 2: this idea that there's something wrong, that there's something broken,

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Speaker 2: that there's something about them that means that they're unable

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Speaker 2: to function in society as it's made at the moment.

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Speaker 2: So rather than being able to help parents tell the

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Speaker 2: difference between a clinical problem and a non clinical problem,

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Speaker 2: which I think is, you know, that depends on each

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Speaker 2: person's situation and what's going on in that family, in

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Speaker 2: that young person, in their peer group, in their school,

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Speaker 2: and so on. What I would give some pointers to

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Speaker 2: are a few things that I think would be helpful

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Speaker 2: for parents to keep in mind in helping them negotiate

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Speaker 2: this difficult area because we're so surrounded by this narrative

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Speaker 2: that there's all these vulnerabilities and potential disorders lurking in

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Speaker 2: the background. So my first tip would be, don't try

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Speaker 2: too hard, because we live in a society that puts

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Speaker 2: pressure on us and our children to perform, and the

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Speaker 2: problem is we can then see our children and or

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Speaker 2: ourselves as primarily vulnerable, and then we get drawn into

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Speaker 2: noticing all sorts of ways in which their mental or

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Speaker 2: behavioral health could go wrong, and we could then be

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Speaker 2: launched into as seeming never ending search for the right

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Speaker 2: diagnosis or the right treatment, and in doing that we

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Speaker 2: risk collecting labels and the various accompanying interventions. So that's

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Speaker 2: one thing I would say, Please don't try too hard.

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Speaker 2: I think when we're very worried about our children, when

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Speaker 2: we're driven to guilt, there is the temptation to intervene unnecessarily.

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Speaker 1: What's the second one.

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Speaker 2: The second thing I would suggest to parents is don't

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Speaker 2: fear emotions. When we put emotions in the class of

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Speaker 2: problems that can only be solved by special expertise, like

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Speaker 2: a specific therapy or worse, as I said, psychiatric medication,

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Speaker 2: what we risk in doing that is losing agency and

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Speaker 2: alienating ourselves from parts of ourselves that are to be

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Speaker 2: experienced rather than feared. Our job as parents, if we're

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Speaker 2: going to allow our children to grow and develop psychologically,

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Speaker 2: is to understand that we can't prevent all suffering disappointments,

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Speaker 2: and our job instead is to be there when our

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Speaker 2: children have these difficulties in their life, when they're going

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Speaker 2: through emotional upheaval and emotional distress, is to be there,

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Speaker 2: to be patient, allow this to happen, and help them

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Speaker 2: on their way.

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Speaker 1: You've mentioned the first two things, don't try too hard

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Speaker 1: and don't fear emotions. Tell us the third idea.

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Speaker 2: The third thing that I would say is see nurturing

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Speaker 2: relationships as a greater priority than controlling behavior, because when

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Speaker 2: we're distressed by behavior of our children, we often have

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Speaker 2: we can get through to them so that they change

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Speaker 2: in a way that would stop them doing the sorts

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Speaker 2: of behaviors that we're considering, things that we're worried or

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Speaker 2: frustrated about or irritated by. Unfortunately, when our attempts to

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Speaker 2: kind of control behavior can accidentally damage a relationship. So

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Speaker 2: for me, one of the things that I've put as

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Speaker 2: a priority in my work with young people and families

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Speaker 2: where there's a lot of worry or where there's a

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Speaker 2: lot of worry about behavior and behavior that is causing

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Speaker 2: distress or frustration or irritation to the parents, is to

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Speaker 2: focus on emotional flow, So on the emotional dynamic between

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Speaker 2: the young person and their parents or their family more widely.

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Speaker 1: Okay, so we've got don't try too hard, don't fear emotions,

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Speaker 1: prioritize nurturing the relationship versus controlling the behavior. I love

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Speaker 1: this one. It's something that I still struggle with with

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Speaker 1: my own kids, So I love this one. Tell us

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Speaker 1: your fourth and final one.

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Speaker 2: The final one that I would put in there is

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Speaker 2: beware of what I call concept creep. So concept creep

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Speaker 2: is something that's been happening quite a lot in our

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Speaker 2: culture recently, where concepts that were originally developed in clinical world,

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Speaker 2: whether it's in psychiatry or psychotherapy, have sort of leaked

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Speaker 2: out into our culture. My kids, when they were growing

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Speaker 2: up they're now adults, started talking about some years ago

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Speaker 2: feeling depressed, not feeling miserable, not feeling frustrated, but feeling

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Speaker 2: So that was I think one of the first examples

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Speaker 2: of words that came from a clinical world and crept

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Speaker 2: into the everyday life. But we've got all sorts of

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Speaker 2: concepts that have now crept in from emotional regulation, emotional intelligence, meltdown,

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Speaker 2: so children now have meltdowns, they don't have tantrums. So

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Speaker 2: these kind of more ordinary bits of language and the

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Speaker 2: reason why I think you should be careful of starting

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Speaker 2: to think in those terms is that they draw you

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Speaker 2: towards an idea that what your kid is experiencing is

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Speaker 2: outside of the realm of the ordinary, side, of the

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Speaker 2: realm of what we consider to be the social world

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Speaker 2: of expectations, and in the realm of a potential problem.

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Speaker 1: Today and the Happy Families Podcast, we're talking to doctor

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Speaker 1: Sammy Timimi, who has over three decades experience working with

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Speaker 1: children and families as a psychiatrist and psychotherapist, and it's

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Speaker 1: the author of the new book Searching for Normal. After

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Speaker 1: the break, we'll talk neurodiversity and the increase in ADHD

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Speaker 1: and autism diagnoses. Stay with us. This is the Happy

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Speaker 1: Families Podcast Today talking with doctor Sammy to Mimi, author

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Speaker 1: of Searching for Normal, which I reckon is one of

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Speaker 1: the most important books at the moment that covers issues

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Speaker 1: such as mental health, trauma and neurodiversity, ADHD and autism diagnoses,

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Speaker 1: and just the idea of neudiversity. There's been an extraordinary

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Speaker 1: increase in exposure to a conversation about that. I would

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Speaker 1: say probably over the last let's say ten to twelve years.

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Speaker 1: What do you think is driving the surge and what

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Speaker 1: should parents do about it?

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Speaker 2: There are many factors that would be driving this, and

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Speaker 2: it is quite an extraordinary expansion. What has happened over

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Speaker 2: the years is what I call a mutation of constructs.

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Speaker 2: And this comes back to what I was saying earlier

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Speaker 2: that because the definitions are subject because they refer to

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Speaker 2: behaviors rather than you know, you don't get a blood

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Speaker 2: test for ADHD and get a brain scan. What you

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Speaker 2: do is you have a questionnaire. Or in terms of

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Speaker 2: autism diagnosis, there's also some observational tools, and I've done

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Speaker 2: all the training in all of these, and I'll be

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Speaker 2: quite honest with you, they're no better than pop psychology

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Speaker 2: quizes that you might find on even the ones that

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Speaker 2: appear to be more sophisticated, they're just more sophisticated versions

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Speaker 2: of the same thing. They don't have any empirical anchors.

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Speaker 2: And what that means is that they can be expanded.

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Speaker 2: And they've become expanded in two directions, So they can

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Speaker 2: become expanded horizontally by including lesser degrees of behavior presentations,

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Speaker 2: so lesser behaviors can be included, or lesser severe behaviors

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Speaker 2: can be included, and then they can be expanded vertically,

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Speaker 2: which means that new populations that previously didn't have the

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Speaker 2: likelihood of these diagnoses enter into the realm of diagnosis.

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Speaker 1: Sammie, can you give us some ideas, some examples in

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Speaker 1: terms of ADHD and autism.

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Speaker 2: With ADHD and you can see a very similar pattern

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Speaker 2: with autism that happened a few years later. It starts

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Speaker 2: out as in my clinical lifetime, I trained in child

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Speaker 2: psychiatry back in the mid nineties, and we didn't diagnose

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Speaker 2: anybody with ADHD. There was something called hyperkinetic disorder which

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Speaker 2: was focused on levels of behavior, so activity levels, and

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Speaker 2: this was a very rare disorder. So in my first

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Speaker 2: nine months of child Psychiasha, I didn't see anybody who

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Speaker 2: was diagnosed with this condition. And it was also at

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Speaker 2: that time considered that if you had signific learning difficulties,

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Speaker 2: that would automatically exclude you from such a diagnosis, because

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Speaker 2: it was considered that learning difficulties by itself would be

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Speaker 2: a reasonable explanation for why you might be struggling with

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Speaker 2: your behavior. Then the concept of ADHD got imported from

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Speaker 2: the US and it starts out with a prevalence rate

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Speaker 2: of about zero point five percent of children. Over the years,

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Speaker 2: this expands and eventually it becomes about three percent of children.

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Speaker 2: At this point it still thought of as what we

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Speaker 2: call a developmental disorder, which means that the expectation was

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Speaker 2: as children grow up, most of them would grow out

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Speaker 2: of it. However, by the early two thousands in this country,

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Speaker 2: the concept of adult ADHD was beginning to creep in.

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Speaker 2: So this is your example of beginning to vertically expand.

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Speaker 2: So the idea that it was a lifelong disorder and

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Speaker 2: something that was not likely to recover from was happening.

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Speaker 2: And now the concentration was also on ideas of attention,

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Speaker 2: so attention comes more into the picture levels of attention.

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Speaker 2: So this is a new behavior being brought in. And

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Speaker 2: then in the last five to ten years, but particularly

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Speaker 2: in the last five years, the concept of masking allows

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Speaker 2: it to go even further. So the concept of masking

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Speaker 2: is you actually have the symptoms, but you should don't

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Speaker 2: show them.

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Speaker 1: Because you're keeping them hidden and chilled them inside until

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Speaker 1: your home and it's safe to let alone exactly.

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Speaker 2: And so this allows a greater degree of women to

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Speaker 2: come into the diagnostic category women and girls. So by now,

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Speaker 2: the it's expanded to you know, five percent in some countries,

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Speaker 2: ten percent of the population and rising, and in doing

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Speaker 2: that it also starts to become incorporated into identity politics.

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Speaker 2: So as it expands, you also got a group of

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Speaker 2: people who understandably rejected some of the medicalization of this,

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Speaker 2: but instead still kept the whole idea that there's something

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Speaker 2: neurological going on. So that's where the neurodiversity comes in,

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Speaker 2: which I think is a Bonker's concept. I'll be perfectly

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Speaker 2: frank with you, because we're all neurodiverse, but this idea

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Speaker 2: that we can separate a group who are neurodiverse, who

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Speaker 2: are unable, if you like, who have a problem functioning

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Speaker 2: in society as it's made at the moment, and a

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Speaker 2: group who are neurotypical in which society is made for us. Well,

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Speaker 2: all of us are struggling with the way society is.

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Speaker 1: So if you look at the big picture, what are

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Speaker 1: the potential drivers of this expansion.

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Speaker 2: They are, to my mind, partly a crisis of economy,

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Speaker 2: So of people are feeling insecure, pessimistic about the future,

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Speaker 2: so there's a greater degree of distress. This level of

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Speaker 2: distress level of insecurity that people have becomes a potential

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Speaker 2: something to exploit for profit.

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Speaker 1: Yeah, it's a gold mind for big pharmaceuticals.

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Speaker 2: And it's been a gold mine. And this is why

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Speaker 2: I call what's happened the mental health industrial complex, because

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Speaker 2: in the last few years there's been a rapid expansion

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Speaker 2: of expensive assessments, of books, of podcasts, of magazines, of

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Speaker 2: self help manuals, of online programs. Not just the pharmaceuticals,

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Speaker 2: but there's a whole raft of things. I really feel

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Speaker 2: the current generation of young people growing up I have

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Speaker 2: been the most pathologized generation that there has been, and

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Speaker 2: that really worries me because I think we've been setting

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Speaker 2: young people up and there's so much evidence now to

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Speaker 2: suggest that that's what's happening. We're setting young people up

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Speaker 2: to be disempowered and sometimes to be unnecessarily disabled.

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Speaker 1: It's a solid take, it's a provocative take. It's the

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Speaker 1: kind of take that gets people to sit up and

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Speaker 1: pay attention, and I'm sure that there's going to be

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Speaker 1: a lot of people that have a lot to say

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Speaker 1: about it. Personally, I think the book is needed. I

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Speaker 1: think it's a vital insight into where we are from

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Speaker 1: a mental health perspective in the current climate, and a

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Speaker 1: great call to action in terms of how we can

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Speaker 1: make some changes. Sammy, I could talk to you all day,

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Speaker 1: I reckon if you and I could sit down over

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Speaker 1: a coffee table with a couple of nice drinks and

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Speaker 1: some snacks, you and I could probably talk for two

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Speaker 1: weeks and solve all the problems of the world. It

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Speaker 1: would be so much fun. But for now we're going

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Speaker 1: to have to leave it there, simply because time gets

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Speaker 1: the better of us. Thank you so much for being

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Speaker 1: generous with your time and having a chat with us

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Speaker 1: about your new books, Searching for Normal.

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Speaker 2: Thank you so much for inviting me.

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Speaker 1: The book Searching for Normal is available right now everywhere

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Speaker 1: that you buy your books. One of my favorite books

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Speaker 1: of the year. There's no way for me to say

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Speaker 1: it without being any more excited about it than that

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Speaker 1: I just loved the book. Doctor Sammy to Mimmy, practicing

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Speaker 1: consultant child an adolescent psychiatrist and psychotherapist, working previously with the

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Speaker 1: NHS in the UK. He's written forty book chapters, mainly

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Speaker 1: in academic books, although his most recent one, before Searching

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Speaker 1: for Normal, was called Insane Medicine. How the mental health

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Speaker 1: industry creates damaging treatment traps and how you can escape them.

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Speaker 1: Check out Searching for Normal and new approach to understanding

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Speaker 1: mental health, distress and neurodiversity wherever you buy your books.

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Speaker 1: The Happy Family's podcast is produced by Justin Ruland from

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Speaker 1: Bridge Media. Mimhammonds provides research admin and a whole lot

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Speaker 1: of other support and if you'd like morofo to make

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Speaker 1: your family happier, please visit us at happyfamilies dot com

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Speaker 1: dot a u