Either your family is messy and complicated at times or you’re lying. Author Laurie Frankel talks us through her wonderfully complex novel exploring adoption and the very concept of family. Mayo Clinic psychiatrist Dr. Sandra Rackley gives us her perspective on the nuanced realities of family relationships.
Either your family is messy and complicated at times or you’re lying. Author Laurie Frankel talks us through her wonderfully complex novel exploring adoption and the very concept of family. Mayo Clinic psychiatrist Dr. Sandra Rackley gives us her perspective on the nuanced realities of family relationships.
This episode was made possible by the generous support of Ken Stevens.
We talked with:
Laurie Frankel is the New York Times bestselling, award-winning author of five novels. Her writing has also appeared in The New York Times, The Guardian, The Washington Post, Poets & Writers, Publisher’s Weekly, People Magazine, Lit Hub, The Sydney Morning Herald, and other publications. She is the recipient of the Washington State Book Award and the Endeavor Award. Her novels have been translated into more than twenty-five languages and been optioned for film and TV. A former college professor, she now writes full-time in Seattle, Washington where she lives with her family and makes good soup.
Sandy Rackley, M.D., is a psychiatrist within the Division of Child and Adolescent Psychiatry and Psychology at Mayo Clinic in Rochester. Her clinical practice focuses on care of children and teens presenting to the Emergency Department in a psychiatric crisis, and of youth who need psychiatric care while undergoing inpatient treatment for medical or surgical conditions. Dr. Rackley is an Assistant Professor of Psychiatry in the Mayo Clinic College of Medicine and Science and the Assistant Dean for Trainee Well-Being for the Mayo Clinic School of Graduate Medical Education.
This episode references another RTG episode, listen here: 1. It's complicated: Making decisions about your reproductive health
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Dr. Denise Millstine: Welcome to the “Read. Talk. Grow.” podcast, where we explore health topics through books. In the same way that books can transport us to a different time, place, or culture, “Read. Talk. Grow.” demonstrates how they can also give us a new appreciation for health experience. Books can provide understanding of health topics and provide a platform from which these topics can be discussed.
At “Read. Talk. Grow.,” we use books to learn about health in the hopes that we can all lead happier, healthier lives. I'm your host, Dr. Denise Millstine. I'm an assistant professor of medicine at Mayo Clinic, where I practice women's health, internal medicine, and integrative medicine. I am always reading and I love discussing books with my patients, my friends, my professional colleagues, and now with you.
I am so excited today for our book, which is “Family Family” by Laurie Frankel, and we'll be talking about adoption. My guest today, a repeat visitor, Laurie Frankel, is the “New York Times” bestselling award-winning author, now of five novels. Her writing has appeared in many publications. She's the recipient of the “Washington State Book Award” and the “Endeavor Award.” Her novels have been translated into more than 25 languages and optioned for film and television. She's a former college professor. She now writes full time in Seattle, where she lives with her family. And since this is our second time around, Laurie, are you still making good soup?
Laurie Frankel: I am always making good soup.
Dr. Denise Millstine: For those of you who buy Laurie's books and listen to introductions of her, it ends with that she makes good soup. So it's good to know that that continues. And as I told listeners on our prior episode with Laurie, which was called, “Imagining a more inclusive world for people with autism,” focused on her book, “One Two Three.” Laurie's work is actually one of the inspirations for “Read. Talk. Grow.,” especially with her book “This Is How It Always Is.” So really excited that you published another book and that it had health information in it. So I'm so glad you're here.
Welcome back to the show.
Laurie Frankel: Thank you. Thank you so much. I'm thrilled to be doing this again.
Dr. Denise Millstine: Our second guest is Dr. Sandy Rackley. Sandy is a psychiatrist within the division of Child and Adolescent Psychiatry and Psychology at Mayo Clinic. Her clinical practice focuses on the care of children and teens needing emergency psychiatric care, as well as youth needing psychiatric care while undergoing hospital treatment for medical or surgical conditions. Dr. Rackley is an assistant professor of psychiatry in the Mayo Clinic College of Medicine and Science, and the assistant dean for trainee well-being for the Mayo Clinic School of Graduate Medical Education.
Sandy, welcome to the show.
Dr. Sandra Rackley: Thank you so much for having me. I'm also a reader and so excited to be a part of this conversation and loved your book, Laurie.
Laurie Frankel: Thank you. Thank you so much.
Dr. Denise Millstine: So for our listeners who haven't read it, “Family Family” is a novel built around India Allwood, a successful actress raising her two young children, who has just put her foot in her mouth at the beginning of the book. She's the star of an ongoing series which makes her famous, and she's highly successful in Hollywood, but she's just appeared in a movie about a woman 20 years after a teen pregnancy in which she had placed her child for adoption. That character was devastatingly sad about it, as we'll hear, is the typical story told about adoption, but not necessarily lived with adoption. So an adoption association is so unhappy with India that it sparks this controversy that goes across social media and leads to a number of interesting life events for her. All in the public eye.
Laurie, oh, dear. You have done it again.
Laurie Frankel: Thank you.
Dr. Denise Millstine: You have made us laugh, cry, and most importantly, think. Based on your bio in the book's dedication, we know the theme of this book is inspired by your personal life. Can you tell our listeners about that?
Laurie Frankel: Yes, I would be delighted too. It is true. I am an adoptive parent. I adopted a child andit's so often the case I end up writing novels about things that are making me angry, that I am ranting about to myself in the shower or ranting about while I'm walking the dog. And this absolutely fell into that category.
So often when we talk about stories that don't get told when we talk about representation matters, we're talking about things that we don't hear anything about. And adoption isn't like that. We hear tons about adoption. The story is all over the place. You know, it certainly orphans is something that like most kids grow up reading about. It's like classic children's literature. That notion of being orphaned, of being adopted, of growing up without parents. And I think most of it is lies. And it makes me very angry because I feel like stories fall at both ends of the spectrum, but never in the middle. Like we get the story where adoption and the causes and circumstances surrounding adoption have ruined everyone's life.
That this child is going to be alone and heartbroken and different and without a sense of belonging forever. That the birth mother who has placed this child for adoption has befallen the greatest tragedy and is never going to get over it. That the adoptive parents are settling for a child who isn't and will never be theirs because they have no other choice. And they've resorted to this bottom of the barrel worst case scenario. And I just think, well that's not true.
But also the other end of that spectrum, that pendulum swing that we hear sometimes, which is like, oh, all you need is love and everything is just sunshine and roses all the time...and you just put this child into a new family and Bob's your uncle, everyone lives happily ever after. And of course, that's not true either.
So therefore I think, well, great. Like, let's talk about all of the complications in the middle. Which, I mean, for my money, is what novels suit up for, like this is something that you need 350 pages to do, rather than 350 characters to do. It is not a story that you can tell on social media. It is a story that did you need like, you know, ten hours and and several cups of tea to like, really, really get into.
Dr. Denise Millstine: Yeah. I love how you phrase that. It's so complicated. And because of the tales we've been told, there's so many assumptions that are made from all of the people involved. And we're going to dive into that a little bit. Sandy, tell us your reaction to the book.
Dr. Sandra Rackley: I think as we're talking, one of the things that I loved about your book, Laurie, was the complexity of each of the characters and their feelings and their emotions. You know, in psychiatry, we talk a lot about dialectics and the ability to hold seemingly contradictory things to be true at the same time. And that was my experience of reading your book over and over and over again. You had these two contradictory things being true for each of your characters and for the story, and just the beauty and humanness of the fact that that is so often true in our lives, in health, in family and in mental health, in all of these things. I just thought you captured something so essentially true about us as human beings.
Laurie Frankel: Yeah. Thank you. I'm so thrilled. I am so thrilled you thought so. And indeed, I think that's actually another really good example. Like we don't imagine, like for instance, that like therapy is going to be, you know, one 20 minute session and then, you know, everything is fine. We don't expect it to be uncomplicated. And yet so often the stories that are told are really, really uncomplicated, so much so that people get really offended if you suggest anything else and it's just very puzzling to me.
Of course, first of all, families are always complicated, and when they are difficult or unusual or, you know, have circumstances other than what we think of as normal, of course it is bigger than what we've been offered, and that's a good thing, I think. Not a bad thing.
Dr. Denise Millstine: Well, and once again, we've been fed this narrative of what the family should or does look like essentially for everyone but you, because you're not living that idyllic life. Almost certainly, maybe somebody is, if you're listening right now, I don't mean to single you out, but I think everybody it's family has stuff, no matter who is is making up that group.
And Sandy, that's a question I wanted to ask you. How do you think of family? Not define family, but tell us what that term even means to you, particularly when you're working with your patients.
Dr. Sandra Rackley: You know, again, this is one of the things I loved about Laurie's book is in many ways, it completely defies categorization. Right? Part of the central thesis weaving through this book is that blood is not what makes a family, but there's something deeper than just our current emotions or thoughts about people that make them family for us. You know and so thinking about, I mean, yes, blood and choice, I mean, queer people have been forming families of choice for forever because those bonds of blood did not hold for them. We've, over the course of human history, structured family in all sorts of ways. And so I was trying to think about what would be the essence for me of family? And it's hard to come up with something, but I think there is something about a tie that can't be undone.
I don't know, maybe this is a spoiler, but I thought this was one of the beautiful things about this narrative, that India realizes that Bex and Lewis are family by the end. And that they needed family. Different parts of…they were missing parts of family, you know, and it was this beautiful idea that we can't family each other either. That's part of what makes us family is that we can't undo it.
Laurie Frankel: I agree with that. I think that's true. What I think is family is who you're stuck with. And it's not necessarily that you're stuck with them because your blood related to them. And it is not because your blood related to them that you're stuck with them necessarily. But to my mind, that's the difference between family and friends. Like, even like very, very good friends. But then you have those very good friends who, you know, for better or for worse, you are stuck with those people. Those I think are the friends who rise to family.
Dr. Denise Millstine: There's a quote from the book that says, “There are lots of ways to make a family. Suggesting yours is tragic unless everyone's blood related isn't serving anyone.” So like the first time, I think it's the first time we see the phrase, “Family Family,” is through Fig. So Fig is India's daughter who reaches out to a young woman who India gave birth to and says on messaging, “I'm your sister.” And of course this, her name is Bex. Bex says, you know basically, who are you, creeper. That's not the quote. And she says, well, not I'm your family, well not family, family. Was it intentional to have Fig be the one to say that?
Laurie Frankel: It came out of my fingers, I typed it and I thought, oh, there's the title of the book. Which this is my fifth novel, it's the first title I've ever been able to choose myself. So I wasn't thinking, powers to be have always changed the title. They changed the title the first four times. So as soon as it came out of my fingers, I thought, oh, this is the title. But I also didn't necessarily think I was going to keep it because historically I have not been able to. And so I was very well, very gratified that that that got to be the case. But also, I kind of knew not to build the book around that necessarily. But yes, as soon as she says that, as soon as I typed that, I thought, ha, ha here we are. And, you know, that's a lovely moment when it happens and sometimes it doesn't. I mean, often I Figured it out after draft, you know 405 or so, and then I go back and plant it. With this one, it came out and, you.
Dr. Denise Millstine: You know it's meant to be. And maybe also, you know, it's your fifth novel and then they decide to trust you with the title.
Laurie Frankel: I mean, we'll see. Maybe they'll be my only one who knows.
Dr. Denise Millstine: Sandy, can you talk about the language around adoption? We see in the book that India says in her first pregnancy she's going to give the baby up for adoption and she's very quickly corrected by her mother, who's a lawyer, that she'll place the baby for adoption and or she'll make an adoption plan. What's the language that is preferred now and why?
Dr. Sandra Rackley: I actually will lean on Laurie for that too, as somebody who has lived experience of this. But in general, I think it's a really important point that the language we use structures, the way we think about things, and it's always imbued with value judgments. And so it also evolves over time as the emotions and the values change. And so often what I'm doing when I'm working with families, when I'm working with kids, is try to understand what language they use.
How do you describe your people? And it's not at all uncommon to talk with children who have multiple people in their lives that they call mom or call dad or whatever. And that signifies something really important and, and trying to use the language that they use. And conversely, it's not uncommon in the way our families form and the way people bring people in that we've got my children, but we've also got, you know, my bonus child or, you know, my stepchild or there's other terms that really signify we've created a family bond and we've chosen a term for it. Like, I love the word Momala, right. The Emhoff children found a name for their mom that seemed like it fit.
Laurie Frankel: That was about to be my example to. Me, too, I love it, I love it, and yes, I agree entirely. To my mind, it's the previous point to like we have to have conversation in that we have to be listening and having a conversation. It's a lot, it's and I mean, there has to be a lot of back and forth. We have to actually be listening rather than knee jerk thinking like, oh, you use the wrong term, you're on the wrong side of this debate. You're out. You know, words. I guess the opposite of that too. Like, oh, you've used the right term. Congratulations. You pass. And I just think that's not what we want. In any case, we want to talk to each other and find stuff out and see where we differ and have that be a positive rather than a negative, which I think is true about, I don't know everything. And which isn't just, like woefully short supply these days, I think.
Dr. Denise Millstine: Yeah, that's a really excellent point. I mean, I think if we come into conversation looking for people to say things the wrong way, we will almost always find it and it's very hard to progress from there. I would say for me, the flip side, though, is the phrase, “given up for adoption,” has become such a part of the parlance that until I read your book, I never paused to consider it. And this is where language, I think, is so powerful. And if we're considerate with it, not judgmental with it, but considerate with it, we can to your point, Sandy, then talk about situations in ways that can be framed as opportunities as opposed to, you know, I gave something up or there's this inherent mistake type of quality to it, which I think, Laurie, you're making the case, is not always the way that it is with adoption.
So let's talk about India's mom. Laurie. So she's fierce. She's really amazing. Single mom, also a lawyer. There's a great conversation towards the middle of the book where she essentially says to India, do you want me to be your mom or your lawyer right now? And she answers the question in both ways. But during India's first pregnancy, she raises this question about abortion. She's 16 years old and she says, you could have an abortion and you are lucky that you can. Lots of people can't. The book came out in early 2024, on the heels of some really important shifts in reproductive rights for women. So this is not an issues book, and it's certainly not a political statement about pro-life, pro-choice, etc. But you had to frame the choices that India made and this topic within that context, at least in some of the interactions.
Can you talk about how difficult that was?
Laurie Frankel: Yes, it was very difficult. There was a lot that changed. So I started this book on March 3rd, 2020. Basically, everything in the world changed over the course of my writing it, and Dobbs was certainly one of those things. And there were several chapters in this book that I rewrote wholesale because even though it is not at all a book about abortion, the conversation around abortion had to be had. And it changed. Really, the central scene in the book I threw out and started again, because the first time I wrote it, it was it was sort of tongue in cheek. And then it stopped being funny because of what was happening politically and so I changed it.
It is also true that it one of these, I think, myths and even manipulations of the stories surrounding adoption in this country at the moment, is that pro adoption is being framed as anti-abortion and or vice versa, that that the anti-abortion lobby has really glommed on a little bit to adoption as, as this as if those two things go together and they do not. I mean, at all.
So I really felt that though I didn't necessarily want to entirely wade into this in this book, that it was necessary to pull those things apart. And to make clear that being pro adoption is often also being pro-choice, or at the very least, that they are certainly not mutually exclusive. And certainly, you know, again, I think this kind of idea that's floating around, which is the only reason you wouldn't have an abortion. The only reason you would enter into an adoption is because you were anti-choice or anti-abortion and I and it isn't true. So I really wanted to to make sure that I was pulling those things apart as much as possible.
And I mean in the simplest, simplest terms, India is 16 and could have an abortion. And it's not because her mother, you know, she can't tell her mother. She does tell her mother. It's not because she's trying to keep this a secret. It's not because she's ashamed. It isn't for religious or political reasons. It's because of choice. She is pro-choice. She makes a choice. And, you know, and that's what choice means. Is that, you know, it's that you can choose any of a number of options. So it was very, very important to me to, to make that point.
Dr. Denise Millstine: So our listeners who haven't read the book can see this is an area where Laurie introduces humor even into difficult topics, where India and her boyfriend create these index cards and they play a game of like war, like you would play with cards, so that when adoption comes against having the baby and getting married, they then have to have a conversation. Well, which of these cards is the winning card? Which is just such a brilliant image of the two of them having this conversation, going through the cards again and again and again. So thank you for treating it that way.
Laurie Frankel: Can I just say also like that another one of the cards is abortion. That this is on the table. It's something that they are talking about. And again I just think so often what is framed is like, okay, abortion is not even a possibility. It's totally off the table, either because you personally are against it for any number of reasons, or because you live in the increasingly 50% of this country where it isn't an option and that therefore, the reason why you were left with is, well, should we get married? Should I raise this child as a single parent or should I placed for adoption? This is not true for everyone. We can add this fourth thing, or you could get an abortion. And it was really, really important to me that that be an option. And it is it happens in this particular case. She doesn't take it, but it's not because it isn't on the table.
Dr. Sandra Rackley: Again, you captured the complexity of these decisions and that there's so many different motivations that go into them. And, you know, I think since Dobbs fell, we've been learning how complicated those decisions are with things that have really never entered into the national conversation about pregnancy complications or about assisted reproductive technology or all of these other things, and recognizing that an issue that in our political dialog, we framed as very black and white, is actually far from it.
Dr. Denise Millstine: In our first episode of “Read. Talk. Grow.,” we interviewed Susan Wiggs about her book, “Sugar and Salt,” which does an excellent job of looking at reproductive rights for those who haven't listened to that early episode, check that out.
Okay. Let's pivot. So Sandy, I want to talk about India's children. So you mentioned Fig, who's ten and just precocious and delightful, and her twin brother Jack, who we haven't mentioned yet, but Fig and Jack have been adopted after a horrific, traumatic event that's revealed about halfway through the book.
Can you talk as a psychiatrist about early life trauma and its impact?
Dr. Sandra Rackley: Yeah, I mean, and again, Laurie, this is one of those places where I was so appreciative of your sensitive kind of telling, especially of Fig’s story, and of the way Fig and Jack, even though they were twins and shared very similar experiences, were living those experiences very differently at age ten. And so that's again, kind of this, one of these themes from reading your book, Laurie, is everybody has their own story.
And for some kids and for some adults, trauma becomes a really central part of their life and their ongoing experience. For some people, it is not so much a part of their experience at all and for a lot of people, it's somewhere in the middle.
When we talk about recovery from trauma, whether it's for kids or for adults. Again, this is a place that I think we often oversimplify and think that somebody is going to just finish their counseling, and it'll all be better now. And I think it comes to our American tendency of like to pull ourselves up by our bootstraps. And you know, we're just going to will away our feelings and then march forward.
And, you know, Laurie, the way you were able to write Fig as having so many gifts and functioning and not having your life defined by our trauma, and yet sometimes having her trauma intrude in ways that were really hard. And watching her family support her in those moments, in ways that kind of got her righted again. But it wasn't a story that was over perfect, and it wasn't a story that was over for her mom or for Jack. But it also was not the only part of her story. And again, it's that both and, right?
Laurie Frankel: Yes, always both and. Yes and gosh thank you, I am thrilled you thought so. It is exactly that. Finding something between discounting the story and the story is the only story, and it defines you and everything forever. I just think, well, okay, but maybe there's something in the middle and you know, and what I think happens is that, like the parlance is, that if you move off, either pole, you're all the way at the other one. You know, that just seems untrue, in addition to unhelpful to me.
Dr. Sandra Rackley: In grief, you know, we've kind of had this model and Elizabeth Kubler-Ross, with the five stages of grief, you know, was a very helpful conceptualization that grief happens over time, even before we die, there's different phases of it. But again, I think in some ways, culturally, we've decided that there are five steps. And when you're done five steps, you're done.
Where a lot of the research about grief and the struggles and grief really come to the oscillation, and that the distress of grief is the quick whipping back and forth between the acute pain of the loss and the looking back and the looking forward without the loved one. And, you know, those other moments where you could almost go forward as if things are okay, and it's the we don't, none of this is linear as human beings. It's not linear. And a lot of our suffering, whether it's grief, whether it's trauma, whether it's depression… You know, what we're understanding from psychology is that your suffering often comes in when we try to deny our reality and the challenge of our emotions, rather than sitting with them and all of their complexity and living our life out of our values and choices.
Dr. Denise Millstine: I love that description of grief. It's so perfect, and it is our way to kind of think, shouldn't you be over that by now? But as you pointed out, everyone's experience, even with the same events, is going to impact them differently moving forward.
Pivoting again Laurie, let's talk about Camille. So Camille is Bex' mother, and she looks at adoption in a different way because she doesn't want to be the cookie baking, soft and gentle Mom. She is very forthright. This is actually what appeals to India about her, that she knows who she is, and she wants to raise a child, and she just puts out there very clearly who she is, and that she would love to love a child and have a daughter or a son. What inspired Camille?
Laurie Frankel: One of the things that surprises 16-year-old India and I think surprises a lot of people is that, you know, she and her boyfriend having decided to place this child for adoption, that the decision about where that child is going to go is hers. The decision is the birth mother’s and, you know, she doesn't know that because she's 16 and she has yet to enter into this world. And a lot of people don't realize that because they have not entered this world. Who makes that decision and how it varies enormously, but in this particular case, because she is making this, because it is a domestic adoption, because she is, because she does it through a private agency, because she's able to make this decision herself, any number of reasons. And in my case, for plot reasons, she is tasked with choosing who will parent this child. And so then I spent some time thinking, well you know, if you're 16, who do you choose?
I know that there is a lot of anxiety among would be adoptive parents who are waiting, who have submitted these dossiers and are waiting to be picked. There's a lot of anxiety that comes from who will pick me, and especially for parents who are something other than heterosexual couples, there's this notion that that is second best, and that if you are choosing for your child, why wouldn't you choose a perfect home? By which we mean, a married man and woman and I think, well, first of all, that's not true.
But second of all, it's especially not true if you're 16. And it's especially, especially not true if you're India, who has herself been raised by a single mother and therefore, to her, that seems like the ideal situation. She and her mother are close, so why wouldn't you want that for your kid? And and so that's what she's set out to find. Or it's not so much that she sets out to find it is that that's who she chooses. That's what she's drawn to. And of course, also she's 16. She doesn't know who she is. She's lost in the world. She's confused. Whereas then this woman comes who knows exactly who she is and what she wants and how to walk through life. Of course, that's who appeals to her. Of course that's who it seems to her is the perfect person to have raising you and guiding your life going forward.
Dr. Denise Millstine: And I love this idea of not trying to cram yourself into what our culture tells you should be the vision of a mother. That it is, and I think you've done this in so many aspects with all of your work, Laurie, is that the more we're inclusive of all different approaches, whether you like musicals or not, right, If we can bring in the musical lovers and the nonmusical lovers, that is more inclusion and of course, in more serious ways too.
Laurie Frankel: Yeah, I mean, wider ranges of normal make the world a better place for everyone. And even if you happen to fall into what we think of as normal on what, for whatever category we're talking about, you don't in others, no one is normal all the time. So sometimes you fall outside of that norm, and the wider we press those borders, the wider we can make normal, the better things are, not just for the people who aren't falling into that, what we're calling normal, but for everybody.
Dr. Sandra Rackley: Laurie, this is one of the things that I love about fiction, actually, is that fiction allows each of us as readers to expand our mental repertoire of what's normal. It allows us to enter so many other worlds that we may not experience in our day-to-day lives, and it builds empathy in us, and it helps us not say, ooh, wrong. Yeah, about a wider range of human experience.
Laurie Frankel: Me too, me too. That's what I like about… I mean it is for my money, it's why I read. It's what I want out of a book, is to let me live for a while with people and as someone I'm usually not.
Dr. Denise Millstine: I love it too. That's what we do at “Read. Talk. Grow.”So thanks both of you for bringing that up.
Sandy we see this really heartfelt, poignant moment when Rebecca, who becomes Bex, is born. We have India in the room, Camille is there, Bex father is there, Robbie. And then after when India goes home, she says to her mother that she feels sad and happy and tired and grateful and excited and scared and worried and weird.
Can you talk about what's going on after giving birth, and whether some of the peripartum mental health concerns also happen with mothers who place their children for adoption?
Dr. Sandra Rackley: Well, I'm glad you asked it that way. I had not even thought about the peripartum aspect of it, and some of the biological and hormonal shifts that go along with that. And it's really interesting, because not just birthing mothers, birthing people, but fathers or co-parents, we can see have, as we've learned over time, about hormonal shifts on the brain related to relationships, our oxytocin, our attachment circuitry, those kinds of things, all of those things get affected. There's a biological pull in us to help the young survive. And they are, babies are attuned to us to kind of maintain that connection. And both baby and, and caregiver get a little surge of happiness in their brains when they've got that connection and they get a little struggle when it breaks. And so thinking about what India was thinking and feeling, I mean, we talk about hormonal shifts and we talk about physical exhaustion and those kinds of things, but also thinking about the relational pieces of that in that matrix and the way that those feelings, again, can kind of have those mutually contradictory things all happening at once.
But the other thing that I read in that, and even as you requote it, is just the nature of adolescence and all of us, but especially adolescence, where, you know, we talk about 13 year olds who can be three years old, one minute and 33 the next, and how much that is the nature of being a teenager and the parenting a teenager. And our characters are finding this even in the book, that you're just going back and forth between trying to protect this tiny little precious thing, while also letting go and letting your heart wander out in the world that way and that that child themselves can't tell from one minute to the next. Like, do I want to be taken care of? Do I want to be held, or do I want to be set free?
Laurie Frankel: Both and.
Dr. Denise Millstine: Always, both and. Absolutely. So speaking of teenagers, let's talk about teenage Bex. So Bex has not met India except at the time of her birth when she now is a teenager and she's made a lot of assumptions. So she's assuming that India feels embarrassment, shame, regret around her teen pregnancy. But then, Laurie, you go out of your way to flip that message to show that India is actually quite proud of the choice that she made. That she says that she wanted to make someone else's dream come true with her pregnancy. Talk about that.
Laurie Frankel: Yeah. How to talk about that? That's it's such a big question. It's such a big part of the book and it was really important to me to think about, you know, I think generation ago, maybe the advice was, was not even necessarily to tell a child that they were adopted, but if it was possible to just never let them know. There are so many problems there, you know, one of which is just that, practically speaking, the secrets come out and then instead of a child growing up knowing this about themselves, they, you know, find out at 30 and, you know, and everything is really terrible.
But beyond that, it also implies that this is something that one would be ashamed about because otherwise, why would you be keeping it a secret now that pendulum has swung. And, you know, I think that most adopted kids are told that they're adopted from their adoption. And so they grow up knowing this. And that has been the case for Bex.
In her case, she is in this very unusual and indeed fictional position, that her mother is wildly famous, her birth mother is wildly famous. And so, you know, she knows that. And look at, you can watch her on TV every week. And that's a very different sort of a situation. She assumes that India is ashamed simply because India has been the subject of 80 kajillion magazine articles and never said anything. So she makes this assumption, not so much because she has the idea that it's shameful, as that, well, like, why wouldn't she? Why wouldn't she talk about it? And then when she has the opportunity to meet her, India says, oh my gosh, no, it was just that, you know, you are entitled to your privacy. So I didn't want to out you, especially because Bex is a child and has not consented to, you know, be the subject of 80 kajillion magazine articles.
And so I wanted to think about all of those implicit assumptions and what they mean. Like where the shame comes from. Among other places, it comes from all of these assumptions that you know that we may and don't ever articulate, and that as soon as you sit down and say, okay, well, I assumed this thing, then you have an opportunity for somebody to say, no, no, that was not the case. But you only get that if you're having these conversations. Did I answer that question?
Dr. Denise Millstine: You absolutely answered that question. I'm really interested in Sandy's perspective on making assumptions and how that can impact our mental health or our development. When we think, oh, this must have been so terrible for somebody and never either have the opportunity or take the time to go and check in, that our assumption was correct.
Dr. Sandra Rackley: Well, I think that's this grand human experiment of social media. Which we've got data suggesting that especially for teenage girls, that the more time they spend on social media, the worse they feel, the higher their rates of depression, the higher their rates of anxiety. The more they dislike their bodies, the more self-critical they are.
We tell our kids when we're teaching them on the inpatient unit. When you're looking out at social media, you're comparing your insides to other people's outsides. And that idea that what we see, whether it's in the media or specifically in social media, that's curated and it's at a distance. We don't have even that empathic connection where we can feel somebody else's feelings from a direct conversation. And so it's really a deception.
And whether it's malignant or not, it's at least an incomplete picture. And especially for teenagers who are trying to understand and make sense of their own experience in part by referencing others. They can constantly feel like they're different than everybody else, that they're not part of the human family. Which is actually…Shame is the emotion that we feel when we're being excluded from human society, or feel like we are or should be. And so of course, people feel shame when they're looking at social media and thinking, well, I don't look like that or feel like that because they're comparing themselves to this very, very curated and carefully edited image.
Laurie Frankel: I couldn't agree more with that. I'm actually really thrilled to have it from somebody, like from a doctor, because I just think, oh, I just feel like that. But no, it turns out to be true. So I'm thrilled to hear it.
Dr. Sandra Rackley: Science.
Laurie Frankel: Science, yes, I love it because, you know, I make things up for a living. So it's really good to hear that. Actually, it's true. And I would only also add that social media pretends to be a conversation, but isn't. Often in fact, when social media posts are replied to, that is taken as a threat or as combative and you know when even if it weren't, it is just not a forum for a lot of back and forth. As soon as there's any back and forth, it's a lot of yelling. It is, social media is not a conversation. So in addition to everything you just said, there's also the fact that if you could talk, then you could you could clear things up. You could understand, you could say, oh, it's interesting, it's like that for you because here's how it is for me. And then you could say, oh, well, you know, I actually just put on a ton of makeup for that picture. I don't really look like that when I wake up. Whatever. But because we don't have those conversations, that feeling is heightened. That feeling of shame is heightened.
Dr. Sandra Rackley: And I'm asking Denise, can I ask a kind of a related question? One of the other things that I thought was lovely in the book was the decision making. And a lot of the plot pivots come out of decisions being made, and it's often the decisions that children are making are being made with incomplete information. Right. And so they're acting on in ways that make a lot of sense based on their understanding of what's going on. But they don't have all of the information. And so their actions can be complicated. And the adults in the book also are making decisions, but it it seems to me often they're making them on the basis of self-deception rather than on not having all of the information. Was that intentional or did that just happen?
Laurie Frankel: I mean, I think well, I think both I think it was intentional, but I also think it does just happen all the time. I like to write. I'm often writing about kids, and that is what is interesting to me to write about kids and from the perspective of kids is like, they don't know as much as the reader because they are….the reader knows more than they do because they're children and they're young. And so you think, oh, you know, it's it's such a shame you think that or it's okay, you think that or, you know, whatever. But of course you're wrong. But then I think we are thinking the same things about the adults and characters in most books, and they don't have that excuse. They're not children and that that contrast is never not interesting to me.
Dr. Denise Millstine: I think that just shows there is so much to unpack about this book. I think everybody who hasn't read it yet, or has read it only once, should go out and reread a “Family Family” and then talk to people that you consider family, because this is how we grow.
Laurie, thank you for this amazing book and for coming on to have a conversation. And Sandy, thank you for talking to us today as well.
Laurie Frankel: Thank you both. This was a delight.
Dr. Sandra Rackley: Yes.
Dr. Denise Millstine: “Read. Talk. Grow.” is a product of the Women's Health Center at Mayo Clinic. This episode was made possible by the generous support of Ken Stevens. Our producer is Lisa Speckhard Pasque and our recording engineer is Rick Andresen.
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