Understanding Mental Health Challenges in Youth

Welcome back to another episode of the Drug Prevention Power Hour. I’m your host, Jake White. And today I’m talking with Sarah Zilmer. She’s an equine assisted mental health professional. And the reason why I wanted to ask her to be on the show is because when I heard about equine therapy and with her title, I was like, wait, there’s probably so much we can learn from why this works and apply it to our work in addiction recovery and prevention. So Sarah, thank you for being on the podcast today.

Yeah, thanks for having me.

Of course, and just so people know a little bit about you, tell us where you are in the world and just a little bit about your day to day job.

Yeah, so I’m currently in Minneapolis, Minnesota, born and raised in the Midwest. So after some years away, I’m back here. And I initially came back for just a private practice kind of talk therapy job and did a lot of work with honestly, mostly like adolescents and teenagers. And then through just volunteering at a barn kind of for my own fun, I don’t know extracurricular activities. I just fell in love with equine therapy. The barn that I was volunteering at eventually asked me if I would train in the model so that I could do sessions with them doing equine assisted mental health counseling. And so I got trained up and I’ve been doing it for, it’s been exactly like three years now. 

And it took me just a few months before I realized that I wanted to make the full transition to equine and I left my private practice. So yeah, I’ve just been doing this here now kind of out of the Twin Cities metro area.

Okay, that’s fantastic, Sarah. I didn’t know too that you had your private practice before. So you know it’d be fun. I would love to hear from your practice before when you’re working with adolescents, maybe what were some common themes or things that young people are struggling with that they’re looking for help? Whether it’s from that experience or this one now, yeah, what are you seeing?

Gosh, yeah. I think mostly what I saw was a lot of anxiety, depression. And there’s, I mean, there’s so many things that go into that, but it feels like now more than ever, there’s just been a huge spike in that. So a lot of anxiety, depression. And then to be honest, like the biggest thing I saw was just kind of identity confusion. Whether it’s just, you know, we’ve been through the typical middle school, high school years where I like everybody’s trying to figure out who they are. And it can be a rough time for a lot of people. But now more than ever, and not going any political direction with this, but I think the number one issue I saw was a lot of confusion in regards to gender and sexuality. And so I think, yeah, just probably overall identity felt like the biggest thing that I saw in teenagers.

Wow. And they have a lot more to consider nowadays because there’s so much more information available and it is part of our culture that’s like, you think about your gender more. Yeah,  And I don’t know, when I was working as a youth pastor at our church during the pandemic, normally, know, I’m having light conversations with students, getting to speak, getting to share and help them start drug prevention clubs. But when I was doing that work, it was like really getting deep with students about what challenges they’re facing. And I was, I saw a very consistent theme with those as well, anxiety, depression, and it wasn’t, they enjoyed talking about mental health, but usually they were trying to self diagnose a mental illness when they did that. 

Because they almost think this is so popular, I should have one or like should I be struggling with this or am I different? And I don’t know if that’s literally the psychology that was going on, but maybe because it was so frequent and I do think the same thing was happening is I heard students say, I don’t know how I identify, like my gender or my sexuality. And when you hear that from a middle school student, it’s a little sad. Yeah.

Yeah, yeah, I listened to actually another great podcast and there was a transgender man speaking about it with Preston Sprinkle, who’s a pastor and he the term that they used was rapid onset transgenderism and so typically where that came from just somebody is struggling with the mental health disorder of gender dysphoria now because there’s such an openness to it, which in ways probably comes from a heart of wanting people to feel loved and accepted. I think at times it has swung so far the other way that now we’re just confusing a whole generation of kids. And so now it’s kind of we’re, I would say from the mental health side, try and figure out, okay, how do we help people? I would say my goal as a therapist is like, how do I help people?

Be true to their values, who they are, and really believe in just kind of accepting reality of what our lives are and where we’re at and how do we move forward in that. Which is very interesting when it comes to that topic. So when it comes to teenagers, really trying to come alongside them and let them feel safe and secure and be in a non -judgmental atmosphere. But while also trying to help them figure out who they are and what is truth? What isn’t? How to kind of process all the different narratives going on in the world. It’s really confusing and I would say even in the state of Minnesota, you have to be very, very, very careful with what you say and how you say it. Because as a therapist, you can get in trouble if they feel like you’re trying to lead someone a certain way. And so how do you balance being for your client? Try and help them move forward in a healthy way when there’s a lot of mixed messages out there, what is healthy? And that’s a challenge.

Transitioning to Equine Therapy

Yeah. Yeah. Well, I like what you said, which is to help them identify their values because that’s the danger in my mind is like, I am not here to judge anyone who’s different than me or anything like that. And I know that’s your heart too. But it’s also, don’t be conforming to something just because you think others want this for you or you think you have to do this. It really is what’s best for you. And now that there’s choices, you know, it’s not as easy as growing up and not considering, your gender, you know, like that’s another decision for a young person to make. since your frontal lobe helps you with forming your identity and that’s not done to like 25 years old, it’s like, dang, I don’t want to put that on a young person. I’m not going to bring it up. I’ll say that. Like that would be my posture. 

And that’s why I think it’s so tough as somebody who really, really cares for young people and is trying to do great work is like you said, hey, let’s go back to your values. What’s important to you and who are you, not who are you trying to be or who are you trying to please, anything else. So I would probably agree with you 100% on like that posture and there’s a little uneasiness because you don’t want to make it harder for someone or make them think that they have to change or conform. I’m curious now that you’re in equine therapy or equine counseling and you’re in the therapy role. How are those different?

Gosh, they’re, they’re so different in some ways and very similar in other ways. My demographic has totally changed. So even though I feel like I’m most passionate, honestly, about teenagers and adolescents, when I took on this new role, my main focus or the clientele that I took on was mostly military and first responders. And so I do a lot of trauma work in that realm.

I would say ways that it is different. mean, these are grownups, adults who like we’re talking about their prefrontal cortex, their frontal lobe is fully developed. And so it’s just a completely different demographic, different group. A lot of the challenges are different because I’m mostly doing trauma work related to the job. And yet what I find true of anybody is everybody has a story.

And whether you’re doing private practice, which is mostly just sitting down and hearing people’s story, helping them make sense of it, trying to like, okay, are there ways that we want to change the story? Or are there ways as a viewer, we want to view your story differently to help you report in a healthy way? That’s completely what we do in equine therapy. The model we use is called ARCH, and it stands for Arenas for Change. And it is completely a story based framework where we just come alongside people and using the horses we go, okay, if these horses of this setting, if this barn or the paddock or location, whatever was like your storyboard or it represented a scene in your story, who or what might these characters be showing up as in your life? And so it kind of helps people take an area of life that they’re struggling with. 

They want to see transformation in and put it out on the horses. So rather than, you know, just you and I talking about it, now we get to see that story play out. You get kind of a different viewpoint. You get to see it rather than just be stuck in it and feel it. And it allows people to see their story through a different lens. And then we can figure out. So this is where I feel like there’s a lot of overlap for a lot of my, let’s say cops that I was with tons of anxiety, tons of trauma. Like, okay, well, let’s say there’s this one big horse that’s, it’s big, it’s overwhelming, it’s in their face, they don’t know what to do with it. It’s bringing up those feelings of anxiety in them. And let’s say that client goes, that’s like my anxiety. It’s big, it’s overwhelming, I don’t know what to do with it. Whether you’re a 54 year old police chief, or you’re a 15 year old teenage girl, like anxiety can feel really similar depending on what life circumstances got you to that point. And so anyone can name that horse is like, yeah, that’s my anxiety. And then we get to figure out like, okay, well this horse has a purpose. So if this horse has a purpose, what might the purpose of your anxiety be? How can we build a relationship with it rather than just fear it? What is it trying to communicate to us?

Do we need to learn to set boundaries with it? Do you need someone else to step in and help you set boundaries with it? Or when you feel like you can’t control it, how can someone else help you get a sense of control over it? And so that’s where it really is an amazing model for anyone because it helps you just visualize and see what’s going on internally. And it allows for like crazy powerful transformation.

The Power of Storytelling in Therapy

Dang. I can imagine that feeling trapped inside your own head, your own problems, your own feelings, and then something as simple as using your story in this, I mean, it’s a metaphor, but you’re living with it, right? Like you’re there. Would be a very, very powerful experience. And I love the idea of getting to look at your experience from the outside. That would be so helpful.

I’m thinking of areas in my life that I could do that right now. When I feel the most anxious, the most helpless and being able to say, what could that be used for? what is the purpose? Is it trying to tell me something to change or to adapt or to walk away from instead of boundary? That’s really cool. Sarah, there was this student that was part of the Arizona Capitol Hill Day.

So we went to MC, probably a hundred students from across the state who care about mental health and drug prevention showed up to talk to their legislators. And so we did some leadership content with them. And one of the students wanted to give his story. And he was, I was coaching him before. Cause he’s like, Hey, you’re a speaker. Can you coach me on it? I was like, yeah, of course. And one of the key points and was like the most powerful message of the day was him realizing that the anger was a, was a sign to change something. Like it was, he was anger at his circumstances. was trauma, but it was a sign that things needed to change and to learn to become a friend with that feeling instead of thinking it’s always the enemy. So that for me, even as an adult, I was like, whoa, mind blown. It’s so, so cool.

Yeah, Yeah, I think we forget that we are emotional beings and so many of us just kind of work out of our cognitive side, but we forget that we were created with both. We have the cognitive side and we have the emotive side. And I think a lot of this is probably upbringing, but when we don’t know the language of our emotions or when we don’t know how to understand the purpose for emotions, I think they just feel like this terrifying thing. 

And actually, Adam Young, who’s an amazing counselor out of Fort Collins, Colorado, he does a podcast and something I learned from him that completely shifted my view of anxiety was that anxiety is unexpressed emotion. And so when you don’t know how to speak the language of emotions, when you don’t know how to understand it, speak it, communicate it, express it in healthy way. And typically what we do is we just bury them. Eventually it’s got to come out in some way because we’re emotional beings and it comes out as anxiety. So I always use the analogy that anxiety is just like a fire alarm going off. It doesn’t have to be something huge. It doesn’t mean the entire house is on fire. It could just be like burnt popcorn in the microwave.

But when we begin to learn the language of emotions, then when we’re anxious, we can go, okay, wait, if this is like a fire alarm going off telling me there’s something else going on inside, there’s some unexpressed emotion, it allows you to kind of pause. You don’t freak out so much with anxiety because you go, this is actually here to help me so that I don’t completely burn down. And then you can kind of check in with yourself and go, what might be under the surface?

And it allows you then to explore what you might actually be feeling. And then that’s, think where therapy can be helpful is, then how do we learn to understand where that emotion is coming from? How do we wanna express it in a way that’s healthy for you and for others? And that’s like the part that having been like a chronic anxious person my whole life, that has helped me so much. And I love working with people with anxiety because it has such a we just need to learn to understand what it is and then kind of go deeper with it.

That’s so good. I’m curious, is there a strategy or a trick to get that maturity from your own body? Because you know how when you are under stress, like your cortisol levels are going and you’re getting into that fight or flight mode. like for me, sometimes it shows up when other people are treating people a certain way. Like my whole body gets hot. I’m so mad. And I’ll think about it for at least a day, like it’s, it’s potentially ruins my entire day or two. And, you know, being a man of faith, I’m like giving it to God, right? 

Like I’m asking God, please take this from me. And, but also not wanting to be passive too of like, do I, do I need to learn something or do something? And to knowing like your background and your faith, is there anything that’s that’s helpful for practically getting out of that zone of like just fight or flight to create a moment for yourself where you don’t go in there and instead you can have a different reaction to that. Is that possible? And does that happen?

Yeah, I think it’s really growing and maturing in responding versus reacting. So okay, this tool again, these are all things I’ve just learned for myself. So then when I share I’m like, it’s not some beautiful thing I created. It’s like, no, this is what I’ve learned and has helped me. There’s this amazing model called the window of tolerance. You can YouTube it, Google it. There’s so many materials out there on it.

But basically we all have this window and when we’re within our window, we feel a full range of emotions. We feel angry, we feel sad, we feel happy, but we’re able to tolerate them. We’re able to tolerate the things in life that we’re encountering. You can still give love, you can receive love, but what happens is it can be one thing that pushes you out of your window or it can be like a lot of little things that just kind of chip away at you. But eventually when we leave our window of tolerance, you can either go up high to what’s called hyperarousal state. And that’s the fight or flight. That’s when literally the blood leaves your prefrontal cortex and you only are operating out of your amygdala, which is fight or flight. And the blood literally goes to your arms and your legs because you’re getting ready to either fight or to run away. And when you’re up there, you’re not thinking logically. You’re not able to reason because this part of your brain is not working. You are only in fight or flight mode. That’s where you see anxiety. You can see angry outbursts or rage. Sometimes people, can see OCD symptoms like the dishes that normally never bother you that are in the sink. Now all of the dirty dishes are the most horrible thing in the world and you just gotta take care of those because you’re so upset and you’re so angry. Or if you don’t go into that hyper arousal state, you can drop down into what’s called hypo arousal. And this is the freezing or the numbing. And this is when you just shut down, you don’t feel anything. And both, there’s a purpose for both, right? We’re created with that amygdala to go into that fight, flight or freeze mode.

But when you live there long enough, that’s where it’s unhealthy. And the goal is how do I either get grounded if you’re in that hyper state or kind of get aroused again to come back within your window of tolerance. And so I think when you’re not in your window and you’re either in hyper arousal or in hypo arousal, that’s when you’re reacting because you’re not thinking logically. You’re just reacting quick. When you’re in your window of tolerance, you’re able to reason and think about things. You still get upset. You still, if you see someone mistreating someone else, it can still totally piss you off. 

But you’re able to kind of logically think about it and go, okay, how do I need to respond? What do I want to do? And so really the goal is one, when you’re not in your window, just recognize it. When you can kind of help yourself name it or even a parent, a spouse, a partner, a friend, is it like, like my husband now goes like, honey, you kind of seem like you’re not in your window right now. I’m like, you’re right. And just recognizing it can kind of help me come back down. Doing things like going outside, going for a walk, doing things that kind of help you get out of your fight, flight, or freeze mode will help you get back within your window. And the more you practice that, the more your window grows. So you’re able to tolerate more. It’s when I think people don’t have the tools or don’t know how to, one, recognize when they’re not within their window of tolerance. They don’t recognize or don’t know how to get back in their window when they’re out of it or have healthy tools of what are things that I can do to help me stay within my window. I think that’s when people struggle. But when you can grow in those areas, that’s when I think we mature and are able to be better at responding versus just reacting.

Window of Tolerance and Emotional Regulation

Okay, wow. That was super helpful for me personally. That was so long, so I hope that made sense. Yeah, I’m learning a ton right now. This is so, so good. So there’s just to recap, because here’s what I think. If anyone’s listening to this, this is something our students are facing, like us as adults we’re facing. And I mean, even our jobs are so stressful sometimes that we can feel overwhelmed and maybe go into that hypo one you were talking about where we just want to shut down like our veg out and not do anything. Or like you said, go into OCD mode up top. And like you said, they have a purpose sometimes and they serve us sometimes, but being able to recognize and think with our frontal lobe instead of just the amygdala. So here’s what’s so cool is what we just talked about, that’s so helpful for students to understand too.

If you’re listening to this podcast and you’re in this field is that window of tolerance. What a great, great thing to know about and to be able to try to communicate that with young people. and also explaining how that fight flight or freeze works so that they can understand when are we put in that situation? How can we recognize it? Because now when I know, and I have like certain spots that I go like, I’m going to play basketball later today.

That’s usually where I see people acting like I don’t want to act. cause competition brings that out in people or it’s, you know, it’s all of us, you know, we’re all messed up in some way. So it shows up on the basketball court. yeah, so that’s, this is something that I’m going to get to practice later today as well. and students love learning about the brain. That’s, that’s something that’s so helpful.

And then giving a practical tool, like to say, Hey, just remove yourself from the environment for a little bit if you can, or recognize what it is and take those deep breaths. Think about what you’re going to do afterwards. that healthy coping mechanism, going fishing or playing a sport, practicing your music, whatever that is. that’s, that’s really, that’s awesome. Is there anything else that you think from your field that would be helpful for professionals who are working with students, they’re not necessarily counselors or therapists, but they’re around students enough that giving them practical tools like you just did, or little strategies, are there any little strategies that you teach a lot that would be helpful for them to know so they can pass it along to their youth leaders to be good examples and all that good stuff, but these little strategies are great.

Okay, I don’t know if these are necessarily strategies, but this is the only thing coming to mind right now. I think just not pushing your values on teenagers or others. And that doesn’t mean you don’t have them and that doesn’t mean, like as a therapist, I will always counsel aligned with my values, but that doesn’t mean I’m pushing my values or putting them on.

And so I’m never gonna do something to me that feels like it’s going against my values and yet I will always find a way to make sure that I’m not pushing them on someone else. And if you are, I think that’s when it takes a lot of humility to kind of take a step back and check in with yourself and your own story of why am I doing this? And so I would just say like if you’re an adult, if you’re in some kind of field or area where you’re working with youth, teenagers, whatever, I think just remembering that they’re trying to figure out who they are. They’re in a really vulnerable time of their lives and they’ve got a million messages coming at them. think helping them figure out what their values are, just being a safe place for them to process, knowing your own story and being willing to be humble to even share your story with them I think can go a really long way.

And I also think that doesn’t mean you just go around with whatever they say, right? Like, I like how you named it that I didn’t realize this, but that teens or they love knowing about how your brain works and things like that. Yeah, like I don’t, I don’t want my adolescents just going with whatever, you know, new message or stories out there that they’re like, I can do this or I can do this. Like, because that’s not healthy for them.

So it doesn’t mean that, it just means I think if you want to meet them where they’re at, you have to know where you’re at and you have to be willing to check in with yourself, put in your own time to work on your own story. Yeah, and just be a safe place for them to process, to be with, to share. Because I think when they feel that sense of safety, all the other confusing messages out there don’t feel as appealing to them.

That’s good. That’s the power of that caring adult in their life that is strong, is dependable because they know who they are. And sometimes students don’t have that example in their life and we might be one of the few people they get to meet and that makes the lasting impression. And I love what you said because we have very strong values that influence our decisions every single day. But that student doesn’t have that experience yet and you can’t force it on to them. They have to figure it out. They’re going to go through their challenges. And if we’re lucky enough, we’ll get to be there during those pivotal moments because they trust us and they know they can come to us in a moment of need to be able to say, well, here’s how I dealt with that situation. Or I was just asking questions and seeing what they need to move on and learn from it. Yeah, without pushing our agenda, but just focusing on theirs. So that was beautiful, Sarah.

Strategies for Supporting Youth

Thanks. It’s not easy. don’t want anyone to think that I’m like, it’s easy. Just do this. It’s it’s really hard because ultimately it means you’ve got to do your own work. And I have a very strong personality and when I believe things passionately, I just want to like cram it down other’s throats. So yeah, it’s it’s really hard. And yet there’s such a difference when you’re able to just listen, be present and speak in a way that is true to who I am, but also kind of honoring the process that they’re going through. It makes a difference for them.

That’s great. Well, just to recap this episode, because I learned so much and it might be something people who are listening want to pass along to their students. Number one, I think what we can learn from eQuad Assisted, you know, processes and the analogy that you use is to help students get out of their own story and kind of see it as an outsider, as someone looking in and a metaphor or analogy is a great tool to use for that. And if they have access to someone like yourself, going to a spot where they can be around horses and barns and these physical places that are really, really powerful and different, getting out of their own environment and into that one, that’s so powerful. 

And that we all have trauma. We all have anxiety and things we feel, even if it’s from, like you said, the police chief experiencing one thing, a student might feel the same exact thing from the pressure at home or on social media or at school and that there are real tools that we can use and understand about how we operate as humans, the tools given to us to be able to cope in healthy ways. And I love that window of tolerance that you talked about. So Sarah, this has been super helpful for me personally, and I hope to our audience as well. So I really, really appreciate you.

Thanks Jake.

Of course. And for everyone listening, before I let you go, I want to let you know we have a new Vibe 18 course that is free. If you want to learn how to develop a youth prevention club in your community, ask us about this free resource. Because then you have students to influence and that sustainability in what we’re doing. If the knowledge stays with us, it’s not going to grow. But if we can help young people understand this work, then we’re going to see culture change and it’s something that can last in our communities for a lot longer. So go to vive18.com or email me jakeatvive18.com to ask about that. Sarah, if people want to follow you online, which socials are you on? Or if you have a website that you want people to go to, how can they stay in touch with you?

Yeah, so I do have socials, but I have to admit I’m really bad at them. Yeah, I’m kind of one of those people that when I watched the social dilemma, was like, social media. I do have them. One of the best ways is so my company that I work for is called Abijahs on the back side. If you just go to Abijahs.com, you can look that up and we’re an equine assisted mental health therapy.

And that would probably be, I feel like, the best way to get connected. I would love to put my socials out there, but really, I think it wouldn’t get anyone anywhere. I would say start with my work website. You can get connected to me through that. Yeah, and we’d love to be resource for anyone who needs us.

Perfect. I’ll put that link in our show notes too so they can just click on it and check out the website. perfect for everyone listening to this podcast. Keep up the amazing work you’re doing. You’re changing lives and hopefully you found something helpful on today’s episode of the drug prevention power hour and we’ll see you next Monday for another episode.