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The 180 Podcast Mar 24, 2022

The 180 Podcast: Pamela Cantor, M.D.: 7 Tips for Talking to Children about Ukraine

Pamela Cantor, M.D.: 7 Tips for Talking to Children about Ukraine


Our topic today is ripped from the headlines: the war in Ukraine.  

The horrifying images of Russian military attacks on Ukrainian cities, on civilians, are everywhere. We see the stories. We hear the pleas for help, for an end to the violence. And so do our children. They internalize what they hear and see. If they feel concerned or worried, they might ask us about it. Of course, they also might not. 

So how should adults – parents, caregivers, teachers, student support staff – talk with children about what’s happening in Ukraine? Reassure them? What should we say? And is there anything else we can do? 

Pamela Cantor, M.D. can offer guidance. She practiced child and adolescent psychiatry for nearly two decades, specializing in trauma. She is also the Founder and Senior Science Advisor of Turnaround for Children and the author of two books on human potential, the science of learning and development, and educational equity. And on top of all that, she worked in Eastern Europe in the 1990s after the fall of the Soviet Union including with Ukrainians and with Russians who were healthcare professionals. 


Complete Transcript

Chris Riback: Pam, thanks for joining. I’ve been looking forward to talking to you about such an important topic.

Dr. Pamela Cantor: Thanks for having me, Chris.

Chris Riback: Pam, we have all seen those pictures of death and fear from the war in Ukraine, they’re everywhere. And so are the images of bravery and patriotism and the generosity of strangers. That’s been as inspiring as those other images have been just devastating. Our children see these images, Pam, they hear the news and now many are asking, “Will this war come to us? Will we be safe?” Pam, what are we supposed to do about that?

Dr. Pamela Cantor: Chris, not only are these questions about safety, normal, how could you not worry about safety today? And these questions are not easy to answer, mainly because none of us has all the answers right now. So, adults really have to prepare for these conversations because on the one hand, you want to be totally honest, but you also want to be reassuring. So this is why the connection to adults is so important at a time like this, because children get their sense of safety from the adults around them.

You know this, they’re going to read your face, listen to your conversations when you don’t think they’re listening, and they will know if you are afraid. And this is going to be the biggest signal to them about their safety. Safety is one of the most important things in a child’s life. And kids believe that if you’re going to be okay, they’re going to be okay. In virtually every study that’s been done on youth development, one thing is always at the top, that children will struggle to focus and concentrate, even sleep or eat, if they don’t feel physically, emotionally, and identity safe.

Chris Riback: Pam, how am I supposed to provide a sense of safety for my children when they’re asking questions and I might not have the answers, I probably don’t have the answers to their questions?

Dr. Pamela Cantor: You know the sense of safety is not from the answer. It’s from the safe space you create for the question. That’s the most important thing, is that you create a safe space for kids to talk about anything. And most kids will tell you that what they get in terms of reassurance, is from the experience of being able to talk with someone they trust about a worry. That’s the biggest deal to them. You don’t have to have all the answers.

Chris Riback: And what happens in kids’ brains when they don’t get reassurance or a sense of safety?

Dr. Pamela Cantor: When we feel stress, there is actually a biologic hormone called cortisol that floods our bodies and our brains. And we get that feeling, that tightness of fight, flight and freeze, all of us have had it at one point or another because it’s normal. It’s something that helps us prepare for a test or a performance. But cortisol affects the parts of the brain that help us focus, organize, and even regulate our emotions. But here’s the thing today, there is a lot of stress in our lives and most of us can’t even remember a time when there haven’t been so many different and serious things to worry about.

And when stress accumulates, sometimes these feelings don’t let up. For kids or adults, this affects our concentration, our focus, our moods and emotions and our behavior. But there is an antidote, adults can provide a sense of safety to kids and to each other, through trustful connected relationships. And just like cortisol, relationships have a biologic mediator in a hormone called oxytocin. And oxytocin hits the same parts of the brain as cortisol. But it’s the more powerful hormone, especially at the level of the cell. So this is why relationships that establish trust release oxytocin. And this not only helps us manage stress and prevent the damage from cortisol. It provides safety and resilience to future stress.

Chris Riback: Pam, even before Russia invaded Ukraine on February 24th. Wasn’t our sense of safety already under tremendous stress?

Dr. Pamela Cantor: Yes, Chris, this is so very true. And the thing is, stress is actually cumulative. We know this from things like sports. If we use our elbow or our shoulder, and it has constant stress because of athletics, it can get frayed. It can wear out and get injured. We know this. Well, the brain is also a target of stress and it too can get frayed or even injured. Like when symptoms of depression appear or anxiety, that just won’t go away. Our sense of safety and stability has been battered over the last two years by the pandemic, by economic insecurity, the murders of innocent black people like George Floyd and Ahmaud Arbery and then the January 6th insurrection. And now the war against Ukraine. Many of us are just worn out by all of it. And when that happens, our emotional states are like embers. It doesn’t take much to trigger them into yet another emotional fire.

Chris Riback: And it feels like there are triggers in the news everywhere we look every day. I mean, Russian president, Vladimir Putin, threatening to use nuclear weapons, the talk of World War III, God forbid. And I can imagine that children may be wondering if their own family members who are in the military will be sent into fight, or they may be worried about Ukrainian relatives in harm’s way or the safety, now that he’s become such a fixture on American television – we all feel connected with him, even the safety of Ukrainian president Volodymyr Zelenskyy and his family.

Dr. Pamela Cantor: It’s a big list and it’s probably not even a complete one. But you could have children today actually asking themselves, “Am I going to have a future?” Or, “Will I have the future I thought I was going to have?” For many children, the belief in the future has really, really been shattered. And think about how much of our lives is about planning for our future or our children’s future. It’s not like we haven’t had bad times before, times with a huge amount of uncertainty and worry, but there are some things that are always good to do when you’re talking to kids. 

That’s what I want to share with you now, whether your listeners or parents, educators, or even young people themselves.

Chris Riback: This is a list that you have, Pam?

Dr. Pamela Cantor: Yes. I’ve got seven tips on talking to kids.

Chris Riback: Excellent. Let us hear them please.

Dr. Pamela Cantor: So first for context, why should we and our kids care about Ukraine? Kids learn to care about what’s just and unjust, what’s fair and unfair, or even what a democracy is, from events like these, if we talk to them. And there is something very unjust, unfair, and cruel playing out on a big stage right now.

Chris Riback: Even though it’s very far away.

Dr. Pamela Cantor: It is far away, but it’s on our kids’ minds. And how do we want our kids to think about it? That it’s okay to be a bully, that bullies win in the end?  Or that people stand up for what is wrong and use their People Power? And today, the Ukrainian people are fighting for their lives, their culture, their dignity, and their freedom. And because of that, many in the world are standing up for them right now. I think there are really important lessons here to talk about. Lessons about humanity, about courage and about life.

Chris Riback: Pam, can I ask you a follow up on that word “bully”? We all hear about bullies in the schoolyard.

Dr. Pamela Cantor: Absolutely. I doubt that there are many kids today in school that haven’t been either victim of or witness to bullying.

Chris Riback: Yes.

Dr. Pamela Cantor: So these moments with our kids, when we are watching something happening, like the Russian invasion to Ukraine, it sets up an opportunity to talk to kids about things that actually aren’t that far from things that they’re experiencing or have experienced. 

Chris Riback: What’s tip number two, Pam.

Dr. Pamela Cantor: We have to prepare for conversations like these. Young people are going to be watching your face. They’re going to take their cues from reading emotions and expressions. So it’s always important not to shoot from the hip, but to prepare to have these conversations. Because before we speak, we want to think about not just what we want to say, but how we want to say it. And most of all, what we want it to mean to them. 

You can take out a map and kids will see where this is going on. Younger children will be comforted by the fact that this is really far away. But teens, they’re able to understand a concept like, this is a time when everybody’s got something to lose, if this war gets any bigger. So there’s a lot of pressure on all sides to not let that happen. But we have to be truthful. We have to be authentic. And we have to explain things like this.

Chris Riback: You know for me, this segues back to what you said earlier about, you don’t have to have all of the answers. If you say, be prepared for a conversation, my instinctive sense is, “Oh my God, I can’t keep all the facts straight. You mean, I’ve got to be aware of who’s doing what to whom and what’s the latest news?” And in listening to you, being prepared isn’t about having the answers. It’s about being prepared to present a sense of safety, being prepared to listen and react in a reasonable, responsible way.

Dr. Pamela Cantor: That’s exactly right. It’s all about creating the space where you can talk about something like this with somebody that you trust.

Chris Riback: But removing that pressure for parents to feel that we always have to have the answers. I’m sure that guidance that you’re giving in this instance is applicable in so much of what we do with our children. Pam, what’s tip number three.

Dr. Pamela Cantor: It’s about bringing the subject up, start the conversation, be proactive. Don’t avoid the topic. We don’t want our kids ever to carry their worries by themselves. We don’t want them to think that things that are more dangerous than they really are. But the chances are that they’re getting information about the war someplace, maybe on TikTok or Instagram or YouTube, and much of it could be from unreliable sources.

Chris Riback: And would you give that guidance to teachers or non-parents as well, about being proactive?

Dr. Pamela Cantor: Yes, I would. I actually think there’s an incredible opportunity for teachers, with what’s going on in the world right now. There’s an opportunity to talk about what it means to be a free society. There’s an opportunity to clarify what are facts? I mean, kids will bring up spontaneously, well, I heard this and I heard that. And there’s an opportunity for teachers to make sure that they have the correct facts.

Chris Riback: And to follow up on the proactive point for parents, how direct do I want to be? Because my fear as a parent would be that in my question, I would be triggering fear in my child, because why would I be asking about it if it weren’t a problem? So how probing should my proactive question be? Is it simply, “Hey, I know you’ve seen Ukraine is in the news. Has that been on your mind at all? Or any questions about what’s going on in Ukraine?” Or more targeted than that?

Dr. Pamela Cantor: I don’t think probing gets you very far, especially with teenagers. I think what does get you far is reflecting on something that you are thinking about, or some question that you have. And that’s going to allow kids to spontaneously either give you advice, correct something that you said where they heard something else that contradicted the point that you made. But earlier, you said something about, a parent doesn’t need to have all the answers. And I think that is so true. I don’t think it’s comforting for kids to actually hear from a parent, something that feels like a lecture. I think what you want is a dialogue. You want the safe space to talk about what they’re hearing – a  question like, “What are you hearing about this?” Or “Are folks in school talking about this?” Anything like that is going to raise the subject and allow you to have the conversation. And that’s actually the goal. It’s not the right answer.

Chris Riback: This is consistent with guidance that I have heard you give in other circumstances. And this line you said a moment ago: they may correct you. You’ve said that before about the power of the kids having the opportunity to actually correct you – for them to take, I don’t know if “leadership” is the right word, but for them to help guide you, there are all sorts of other benefits.

Dr. Pamela Cantor: It has many benefits. I mean, kids can get a kick out of having information that you don’t have. The fact that they’re in school means that they may in fact be exposed to information that you aren’t exposed to. And it gives them a sense of agency and power in the relationship and in a discussion of something like this. So that’s something to welcome.

Chris Riback: Pam, what’s tip number four.

Dr. Pamela Cantor: It’s about hearing the truth from someone they trust. Sometimes just talking about it can be reassuring, because it is so different than what they’re going to be hearing from other sources or on their smartphone or these images that are played over and over again on TV. It’s also an opportunity to talk about other cultures, other histories, and to demonstrate a way to empathize with what this other culture and country are going through.

Chris Riback: Pam, can I stop you for a moment? Because there are some very difficult images, very difficult images that we’ve all seen. And I mean, here, I’m thinking of the terrible images of the women and children who’ve been killed by Russian mortars, of pregnant women wounded, of the refugees. We’ve all seen them, millions of them pouring into Poland, Germany and Romania, for example. What do we do about all of these images that I know they’re, on some level, inescapable? What are we supposed to do?

Dr. Pamela Cantor: With younger kids, we have the ability I think, to limit exposure to media. And this is so important because there is something that media organizations do where they tend to replay the most dramatic and most alarming events over and over again. I saw this with 9/11, and replaying the planes going into the towers over and over again. And with Sandy Hook and the killing of George Floyd. So, I think with younger kids and by younger, all I’m really saying is kids where you have some ability to control their access to media. I think it’s a really, really important thing to do. If kids do see these alarming images, then what we’ve been talking about, which is bringing them into a conversation, is a hugely important thing to do. Because often these images are presented without any context, making it really difficult for kids to understand the why, the context for what they’re looking at.

Chris Riback: Not visualizing it over and over again is, having listened to you previously, I know such an important tip. Pam, much of the guidance so far is around conversation. Obviously hugely important. Aside from talking, what else can adults do?

Dr. Pamela Cantor: It’s a really important thing. It’s how important it is for kids to learn through watching what adults do. So the sixth point that I would want us to talk about is about where compassion comes from, because learning compassion comes from modeling. If we see the adults around us, our parents, our teachers, or other kids especially, modeling compassion, we absorb it. So we talked about stress and the hormone cortisol and the feelings of fear that it causes. And then we spoke about oxytocin, the hormone that helps us manage stress, but I bet many of your listeners don’t know that acts of altruism and compassion trigger these helpful hormones too. And those make us feel good and relieve stress.

So families can do this. Families can take action together. They can try to help by bringing relief and supplies to families that are under stress. And this sets a great example for kids, families working together to bring relief and supplies to families who are suffering. And there are great organizations that are focused on this, like Save the Children, The International Rescue Committee or Razom for Ukraine. It’s really, really important because there’s the double benefit of you’re helping, you’re triggering these helpful hormones and you’re modeling, I guess that’s three.

Chris Riback: I don’t mean to be trite or silly with this, is doing something as simple as a bake sale or a clothing drive or a book drive, is doing something, maybe it’s with younger kids. And it’s something that obviously is very, very minor in terms of monetary value, but feels actionable. Can it be something that small?

Dr. Pamela Cantor: I think you’re exactly on the right track. I think these actions that are local and personal, matter the most to kids. And it seems a long time ago, but when the pandemic first happened and people were running out of supplies and families didn’t have food, we saw many examples of this kind of generosity.

Dr. Pamela Cantor: And maybe we didn’t know that doing good makes you feel good. And that, that has a biology behind it, because of these helpful stress relieving hormones that come into play when we act with compassion.

Chris Riback: Do good. Feel good.

Dr. Pamela Cantor: Exactly.

Chris Riback: It’s a good motto. What is number seven, Pam?

Dr. Pamela Cantor: Well, it’s in a way something we’ve been talking about in different ways, and that is communication. You can’t communicate enough, but it’s also about communicating in the right ways. It’s pretty easy right now to be angry about why this happened -who needed a war now after everything that we’ve been through? And we can focus on who’s at fault for this war, but this is a time not to go to racial, ethnic, and cultural stereotypes. We’ve got an opportunity here to say that aggression against anyone because of race, culture, individual power is wrong, wherever it occurs. And standing up against it in the ways each of us can, matters a lot.

Chris Riback: Pam that list of seven is really, really helpful. Prepare yourself, bring it up, give them the facts, avoid racial and cultural stereotypes, limit media exposure, I understand, if possible, when possible, model compassion and communicate regularly. I want to ask you simultaneously though, because we’ve been speaking about giving advice, as adults who are speaking to children who are not in the war zone and have not had to take shelter in their basements or subway stations or flee their homes in a crush of millions of other families, just desperate to escape the violence. What is your advice for speaking with children who are traumatized by the war?

Dr. Pamela Cantor: The kind of trauma that children in Ukraine are experiencing leaves an indelible mark and memories. There’s no question. Memories that are going to have flashbacks. And some that persist for a really long time. Many of the things I’ve spoken about are going to be useful in preventing that from happening: trustful relationships, constant communication, reassurance, adult modeling, modeling a belief that we will get through this together and modeling compassion. All of these things apply overseas as well, and they can reduce the risk of longstanding emotional problems. But if children begin to show things like an inability to sleep, eat, communicate, function day-to-day, then something more is likely going on. Because these things are the early signs of post-traumatic stress disorder. This means a child is going to need special help, lots of support, maybe even medication once it’s available, in order to prevent long term damage.

Chris Riback: And I would assume, Pam, that this in some cases might show up in the near term, but in other cases might not show up until the medium or even long term. Is that possible?

Dr. Pamela Cantor: I suspect, like you, I have been looking at the faces of children on TV and the stories and the drawings that they’re doing. And these reflect enormous, enormous fear and worry about whether they’re going to be okay. Whether a father that’s left behind will still be with them, their grandparents who said they weren’t going to leave the country. I think that what I see on these faces is an enormous amount of trauma and sadness. So a lot of the things that I’ve been talking about in terms of the bond that they have to the person who is taking care of them and how that person communicates with them, makes all the difference in terms of what the consequence of this is going to be to them.

Chris Riback: It is such a difficult way to think about what’s going on. We look at the physical damage and we think, “Oh man, this is really going to be a problem for so many years, so many years.” What you’re describing takes it obviously to a whole other level. This is a generational infliction of damage that these families, these children are going to have to endure. That’s very hard to process.

Dr. Pamela Cantor: I think you’re right to use the word generational. I think that is what it will be for them if they get through it.

Chris Riback: And Pam, I know for you personally, you’ve been to this part of the world. 

Dr. Pamela Cantor: I have.

Chris Riback: You’ve worked there. Tell me about that. Tell me about your own experience working in Eastern Europe, in the 1990s, after the fall of the Soviet Union. You were sent to help restore the health and mental health professions that had been suppressed and even outlawed behind the iron curtain. What about the time with the Ukrainians that you worked with then, stands out for you today?

Dr. Pamela Cantor: This was an incredible time because, this was early nineties, where the iron curtain was lifted and many of the countries in Eastern Europe had a shot at democracy. And I was part of a group that were coming to Eastern Europe because the health, education and mental health systems had pretty much been destroyed under Soviet rule. So the whole idea was that there would be teams of professionals that we would train and help them form themselves into NGOs, non-governmental organizations. It would be nonprofits in our country. But these non-governmental organizations, were going to begin to restore health and mental health and learning to these countries, with the idea that you can’t have a democracy if kids don’t have access to health and education.

But I think the big thing I saw, and this was particularly true of the Ukrainian team, if you could have seen the team that I worked with, everything that you’re seeing on TV would make sense. They are fighting with everything they have, they know exactly what it would mean to lose their freedom again. And when I see President Zelenskyy, I think of this team because they know exactly what they stand to lose. And they are not going to give up, not without a ferocious defense, not without dying if they need to, not today and not ever.

Chris Riback: You’re not surprised by what you see.

Dr. Pamela Cantor: Not at all. 

Chris Riback: That spirit is really inspiring to hear about. And I guess what you’re giving us with your tips and guidance, is empowering for parents as well.

Dr. Pamela Cantor: It is. I think that we often think that relationships are this thing that we just have. I don’t think most of us know that relationships have biologic power. They have the power to release hormones and neurotransmitters that do incredible things in our brains. They motivate us, they engage us, they give us energy, they give us a sense of purpose. So this kind of connection between a parent and a child during a difficult time, can do unbelievably powerful things for a child and for a parent. 

But I actually see the same thing happening on TV. I see the place that parents have in their children’s lives during this unbelievably challenging time. And then I think of the purpose that I witnessed in the Ukrainian people when I worked with them, and what freedom meant to them, what the idea of their culture and their history meant to them and the fact that they would do anything to preserve that experience for themselves. But even then, they were thinking about their children and future generations. And that’s what they built. And they’re not going to give it up.

Chris Riback: Pam, thank you for this guidance and these tips and the help for these, for all of us as parents on how to talk with our children about this very, very difficult and terrible situation. Thank you.

Dr. Pamela Cantor: Thank you, Chris.

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