Rebecca Avern talking about teenagers on the Qiological podcast

Rebecca Avern talking about teenagers on the Qiological podcast

I was really excited to be invited as a guest on Michael Max’s wonderful Qiological podcast. We had a really wide ranging and interesting discussion on all things adolescent – from the Chinese Medicine view of puberty, to the challenges of being a teen and to working with teenagers in the treatment room. We also focussed on possible reasons for the increase in mental/emotional health problems in teens today. Please do have a listen and share with anybody else who might be interested.

Magic and Emergence – Treating teenagers with Rebecca Avern

Are your teens now at home for the foreseeable future? What will be important to them and how can you support them?

Yesterday I watched the excitement and elation of five pre-teens and young teens as they heard the news that school was going to be out for the next few weeks at least.  One of the first things they did was to download apps to make sure they could easily communicate as a group if they were not able to see each other.  They then began writing their ‘No school bucket lists’, and top of all of them was the resolution to ‘make sure not to become distant from my friends’.

Even in extraordinary times, teenagers are still teenagers. And there is nothing more important to most teens than their friendships.   Whilst as parents, we may look forward to being able to spend more time with our teenage children and to deepen our connection with them, no doubt their main concern will be how they are going to cope with being stuck at home with their parents. It is natural for a teenager to increasingly separate from their parents, to go out and find their own tribe.  It’s a time when they need to explore their identity, and to find out who they are outside of their family.   So, any enforced isolation is likely to jar with their deep drive and instinct to go outwards into the world.  

In Chinese medicine, adolescence is resonant with the Fire Element.  The Fire Element governs how we manage our relationships with other people and ourselves.  The qi of the Fire Element intensifies during adolescence, which is why children of this age tend to feel things very passionately!  This intensity also drives teens to fulfil their developmental role of this time – ie. to make strong connections with others outside the family.

Whilst those of you who regularly read my blog will know that I have written a lot about the potential negatives of screen time and social media, this is one time when the benefits of it will come into their own.  If technology allows our teens to keep those connections with their new-found tribes, it will make this time of uncertainty and disruption a lot easier for them than it otherwise would have been.  

At the same time, although teenagers would rather do just about anything than admit to needing their parents, they really do still need us!  They are in a state of huge internal flux.  Put that together with the enormous external changes they are currently experiencing, and it makes for a potentially anxious time.  The more as parents we can work on managing our own anxieties and fears (which may be great at the moment), the more our teens will benefit.  What they need from us at the moment, more than ever, is to feel that we are solid and stable.  That is not to say we need to pretend that ‘everything is ok’ when it is patently not, but that we need to let them know that, despite all the difficulties, we as a family will come through it.  

So, as well as recognising that over the next few weeks or months, our teens will have a strong need to connect with their peers, it might also be beneficial to ringfence some time each day to put away screens and to connect as a family.  

Here are some other potential benefits for teens of an enforced, prolonged period out of school:

  • Time to catch up on some sleep: teens are growing and changing so fast and good sleep is crucial for this process.  
  • Time to slow down and lean in to a more yin lifestyle: most teens have crazily chaotic lives with little downtime.  Learning how to be still and have downtime at this age will serve them well for the rest of their lives.   Have a look at this blog post – ‘How does a child get real downtime in the 21st century’ – for more thoughts on what actually constitutes ‘downtime’.  
  • Time to reframe what is important: there is a lot of talk about rising anxiety levels at the moment.  But I believe, if dealt with appropriately, this time of crisis could actually help teens to reduce their level of anxiety.   Through conversation, we can help them to see that a lot of things they may worry about, are actually of very little consequence.  One teen, who is prone to huge amounts of anxiety, and who has just found out she won’t be able to take her A levels said to me ‘I was gutted at first but now I’m OK.  It’s made me realise there are more important things in the world.  We will get through this and I trust that my life will work out – maybe just differently to how I expected’.  

William Arthur Ward wrote ‘The pessimist complains about the wind; the optimist expects it to change; the realist adjusts the sails.’ I wish you and your teens, and indeed all your loved ones, all good wishes in adjusting your sails over the coming weeks. 

Eating disorders: how can we help guard against them in our young people?

This week (March 2-8th) is eating disorders awareness week.   It is both sad and shocking that eating disorders amongst young people in the western world seem to be on the rise.  Whilst many in the developing world are starving, more and more children and teens in the developed world are starving themselves.  If they are not starving themselves, many have come to have a disturbed relationship with food and eating.  This may cause a daily misery.

The causes of eating disorders are many and varied.   They are also relatively poorly understood.  Studies point towards a combination of genetic predisposition, psychological and sociological factors.  Trauma and difficult family relationships are known to also play a part.  But in my experience of working with young people, the seeds of an eating disorder lie in emotional dysfunction.  The emotional dysfunction is the root; the disordered eating is the manifestation.  An eating disorder is an expression of internal unhappiness.  It is a misguided, and sometimes dangerous, way of expressing emotions that, for a variety of reasons, are not able to be either managed or expressed verbally.   The young person may not even be conscious of them. 

One particular case illustrates this point.  I treated a 13-year-old girl who had orthorexia (an obsession with eating only extreme ‘health’ foods) and who had rapidly lost an alarming amount of weight.  She was under the care of CAMHS who had put her on a strict weight gain programme.  Whilst this was necessary in order to preserve her physical health, it did not address any underlying, dysfunctional emotional patterns.  What struck me about the girl when she spoke was the mismatch between her words and her demeanour.  She was pathologically polite and did not admit to having any angry feelings at all (even towards her father, who had recently left the family, not responded to her attempts at communication and not acknowledged her thirteenth birthday).  Yet her eyes were hard, her voice clipped and I saw flashes of anger across her face. [1]  Through dialogue and acupuncture treatment to bring balance to the Wood Element (which, in Chinese medicine, is associated with emotions in the anger family), the girl began to recognise that she did in fact feel angry and then to be able to express these feelings.  The more she expressed the feelings, the less she controlled her eating.  

Somewhere along the line, this girl had completely disconnected from her feelings because they felt overwhelming, too painful to sit with or because she had imbibed a value that feeling angry is in some way not ‘good’ or ‘acceptable’.  In her case, the predominant emotion was anger.  But it could be sadness, fear or a feeling of unlovability, and is very often a mix of many different feelings.  When a child disconnects from or ‘packs away’ an emotion over an extended period of time, she will no longer have much consciousness of it being there at all.  At this point, the spirit of the young person becomes compromised and a pathological behaviour often arises.  This may be disordered eating, self-harm, addiction or OCD, for example.  

There are always multiple risk factors for the development of mental illness, as well as multiple protective factors.  As parents, we can influence some of these factors but not others.  For example, we cannot stop our children’s exposure to images of ‘perfect’ bodies on social media and in the press.  But one area where we can have a positive influence is to support our children in becoming comfortable with and adept at verbalising and expressing a wide range of emotions.  Some possible ways of doing this are:

  • With young children, giving them a word for a feeling we think they may be experiencing.  For example, ‘I wonder if you feel jealous that Tommy got that scooter you had been wanting for his birthday’.
  • To avoid ever saying to our children ‘don’t be sad’ or ‘you don’t need to feel angry’.  This conveys the message that the child is somehow wrong to have this feeling.   Sometimes we shut down these emotions in our children because we, the parent, can’t bear the thought that our child is unhappy or because we feel hurt or angry when the emotion is directed at us.  
  • To model to our children that we, the parent, experience a wide range of emotions and are OK nevertheless.  For example, to say that we have had a bad day at work and are feeling frustrated as a result of it, rather than saying ‘I’m fine’ when we are patently not.  We can show them that, despite the frustration, we are fundamentally ‘OK’.  Our frustrated feelings haven’t prevented us from coping, and they will pass.   

Food and eating are so often intertwined with emotion, and eating disorders are especially so. Even though serious eating disorders are mental health conditions, the seeds of them usually lie in emotional dysfunction.  Helping our children to express a wide range of emotions, and supporting them to become more emotionally intelligent, will lessen the chances of them expressing their unhappiness through disordered eating.    

Cicero wrote that ‘diseases of the soul are more dangerous and more numerous than those of the body’. Eating disorders may mean our children’s bodies are poorly nourished but in order to prevent or heal these common and distressing conditions, we need to nurture our children’s souls.

[1] In Chinese medicine, we use subtle signs such as the tone of voice, the subtle hues in the complexion and incongruent expression of emotion to diagnose imbalances in a person’s qi

You love your child, but does your child feel loved?

It is a curious fact that nearly all parents love their children dearly, yet so many children (either during childhood or later on in adulthood) say that they did not feel loved during their childhood.    In the clinic today, I saw a 15-year-old boy who talked of how he felt nothing he did was good enough in his parents’ eyes and how he felt he constantly disappointed them.  At this point in his life, he did not feel that his parents loved him.  Having met both his parents, it was obvious to me how much they did love their son, and also how proud of his many achievements they were.  So how can this discrepancy be explained?  

A child not feeling loved by parents who truly love them is usually down to a mismatch between the parents’ way of expressing their love, and their child’s way of receiving it. Dr Gary Chapman coined the phrase ‘the 5 love languages’.  It is literally as if the parent and child are speaking a different language.  They are both trying to communicate, and want to do so.  But unless they are speaking the same language, the conversation is not going to get very far.  Feeling loved in childhood is, of course, crucial to a children’s future health and happiness.  It will impact the way they feel about themselves, as well as how they negotiate and feel about relationships for the rest of their lives.  So one of the most important things a parent can do is to find the way their child needs them to express their love.

An alternative to Chapman’s ‘5 love languages’, is to approach our understanding of a child through the lens of the Chinese medicine 5 Element system.   This brilliant framework can be an insightful and useful way to make sure we are giving children our love in a way that they can receive.   

The 5 Elements are within everyone.  (For a description of the 5 Elements please click here to see my previous posts on the topic).  However, each child has one Element which predominates and has a profound impact on their personality and behaviour.  It colours how they see the world, how they feel in relation to other people and what they need in order to feel loved.   Whilst it is too simplistic to say a Wood child needs this and a Fire child needs that, the 5 Element system helps to remind us how different we all are.   One sibling may need lots of hugs and physical contact in order to feel loved by his parent.  Another might feel swamped or invaded by too much physical affection.  As a parent, we need to pause and ask ourselves if the way we express our love for our children is truly making them feel loved.  

Imagine a young child is nervous before their first day of a new school.  This is something many children feel, yet each will need a different response.  For example, one child might feel better if their parent listens to them and lets them talk through their worries.  For a different child, this approach might mean their fears escalate.  Another might feel better if their parent lets them know how much they love them and that they will be there waiting for them at the end of the day.  Yet another child might benefit most from the parent organising visits to the school beforehand and from gentle reassurance.  Another child’s fears might be allayed by knowing in advance exactly what is going to happen and how the day is going to be organised.  

It is easy for a parent to assume that what they needed as a child in a particular situation is what their child needs.  However, the more we can withdraw our projections, notice our child’s unique emotional response and then meet their needs accordingly, the more the child will feel loved.  

It takes a fully-trained and skilled acupuncturist to make an accurate diagnosis of which Element is a child’s dominant Element.  However, simply taking some time to reflect on the nature of our children and, crucially, in what ways they are different to us, can guide us to show our love in a way that is meaningful to the child.  The description below of the different Elements should not be read as a ‘prescription’ of how to approach a particular child.  It is more a way of illustrating the fact that every child needs something different and to inspire parents to take a step back and reflect.

Fire children 

In order to feel loved, Fire children need:

  • a lot of warmth
  • a strong emotional connection 
  • time with parents who are emotionally present 
  • fun and laughter

Earth children 

In order to feel loved, Earth children need:

  • attuned mothering (a mother-figure who notices and responds to their needs)
  • to feel listened to
  • to feel understood
  • to have a secure physical home
  • to feel a part of a community/family unit

Metal children 

In order to feel loved, Metal children need:

  • to feel recognised and valued
  • meaningful acknowledgement and praise
  • an orderly home environment
  • permission to have time on their own
  • for their physical space and boundaries to be respected

Water children 

In order to feel loved, Water children need:

  • solidity, reliability and consistency in caregivers
  • reassurance and gentle encouragement when fearful
  • a calm and peaceful home environment
  • permission to develop in their own time and at their own pace

Wood children 

In order to feel loved, Wood children need:

  • Permission to express their individuality
  • An appropriate level of freedom vs boundaries and rules
  • An atmosphere without frequent conflict 
  • Parents willing to take them on adventures and explore the world with them

These are some basic guidelines.  The crucial thing is for a parent to be curious about what their child needs in any given situation and to respond to that as best they can.  Sometimes this will be easy.  The fit between the parent and child is straightforward and the parent’s natural way of expressing love will make the child feel loved.  At other times, it can take a bit more time and work on the parents’ part to work out what it is their child needs.  This does not make them any less of a ‘good’ parent or mean they love their child any the less.  It is simply the case that some relationships need a little bit more work than others. 

One of the most important indicators for good mental health is a strong bond between parent and child.  The more adept we become, as parents, at understanding how each of our children needs us to express our love for them, the better our bond will be.  We don’t need to be psychologists to be able to do this.  We simply need to step back for a while, take a few deep breaths and be curious.  Children are hard-wired to want a deep emotional connection with their parents.  As long as we are willing to truly see and listen, they will usually find clever ways of letting us know how they need us to be.  

Snow plough parenting – what is it and what is its effect?

It’s official.  Snow ploughs are the new helicopters!  Until earlier this week, I was aware that parents could be described as ‘helicopters’ (when they have a tendency to hover over their children) but I didn’t know they could be snowploughs.  Let’s be clear.  None of us get parenting exactly right and that’s OK.  We should hold on to Winnicott’s concept of the ‘good enough’ parent, in this age of perfectionism.  

However, even though these rather derogatory sounding clichés can be overly simplistic, it can also be interesting to reflect on the ideas at their heart.  Snowplough parents are those who have a tendency to remove all obstacles that might get in the way of their child’s progress and success.  With the best of intentions, they try to make their child’s life as easy as possible.  A common example is a parent doing their child’s homework to make sure they get a good grade.  Another is a parent who tries to make sure their child does not experience ‘difficult’ emotions.  I remember being asked by a parent to make sure her child did not take part in ‘pass the parcel’ at my daughter’s birthday party.  The parent was concerned that her child would feel upset if she did not win. 

This concept reminds me of a Chinese proverb.  A farmer wants his crop of sprouts to grow as tall as possible as fast as possible.  So he decides to pull them up through the soil himself.  As a result, his crop dies.  The farmer does not trust his sprouts in their ability to work their way up through the soil in their own time, and in trying to do their work for them, he kills them. 

From a Chinese medicine perspective, all aspects of a child’s physical, mental and emotional self grow strong through being used.  Muscles become strong through being exercised and waste away when they are not used.  But so do other aspects of a child.  If a child is always removed from any source of anxiety, they won’t learn that they can manage the emotion.  If they experience anxiety for the first time as a teenager, when their parents can no longer shield them from it, they are more likely to be overwhelmed by the emotion.  If a child has always been allowed to spend their time doing only enjoyable activities, they may find that when they have to do things they don’t want to do, their willpower fails them.  

Psychologists talk of a concept called ‘stress inoculations’. Children build resilience through small, repeated exposures to stress during childhood.

Life inevitably involves challenges.  The Wood Element within us enables us to react to obstacles that we meet with flexibility, to find a way through rather than give up.  The Water Element also gives us the drive to push through all manner of difficulties    If these two Elements are not exercised during childhood, by being faced with challenges and obstacles, they will not enable a person to face difficulties in adulthood in a robust and resilient way. 

As with almost everything, balance is the key.  Of course, a parent would not want to artificially create challenges for their child.  But supporting a child to deal with challenges that naturally arise, rather than snow ploughing them out of the way, may be the kindest approach in the long run.  

What is the unspoken harm of screen time for children?

There are many documented reasons why excessive screen time may be harmful for children.  Those most commonly cited are its negative impact on sleep and its contribution to rising obesity levels, as well as educational and/or behavioural problems.  While these are all valid issues, a far more detrimental effect is rarely mentioned. 

When children spend a lot of time on screens, they miss the opportunity to go inwards and find out how they are feeling.  A bus journey that might have been spent gazing out of the window and noticing how they feel, may now be spent catching up with the latest posts on Instagram.  Instead of sitting with feelings of anger induced by an argument with a sibling, a child now often escapes this feeling by turning straight to their phone.  I have often seen teenagers pick up their device because something made them feel anxious.  By turning their attention to watching YouTube videos, they can escape the discomfort that their anxious feelings cause. 

Why is this such a problem?  Since Socrates implored people to ‘know thyself’ and Aristotle proclaimed that ‘knowing thyself is the beginning of all wisdom’, it has become widely accepted that good mental health involves developing a certain level of self-awareness.  From a Chinese medicine perspective, emotions become a cause of disease when they are prolonged, intense or repressed.  When a child loses themselves online to escape a feeling of sadness, for example, the sadness does not go away.  On the contrary, it will most likely fester inside them and have a negative impact on their flow of qi.  This can lead to physical symptoms.  But it can also create the unwelcome situation of the child not feeling content or well in themselves, but not really knowing why.  This disconnection from emotions means that the spirit of the young person is no longer thriving.

It is not helpful to demonise screens.  If we do that, we risk destroying rapport with our children, for whom screens are a part of the fabric of their lives.  But when they become a means by which a young person avoids or detaches from the wide range of emotions that are a necessary part of being human, they begin to do real harm.  As Proust said in A la Recherche du Temps Perdu, ‘We are healed of our suffering only by experiencing it to the full.’  

Kids and phones: a cause of mental health problems or a storm in a teacup?

If there is one thing that parents of pre-teens and teenagers are likely to struggle with it is knowing how to manage their child’s phone use.  And looking for science to help clarify whether or not kids’ phone usage really is something to worry about, can create further confusion.  One study will find a supposedly definite link between time spent on social media and mental health problems, whilst another claims the exact opposite. 

So, how can parents navigate their way through this minefield?  And how can the ancient wisdom of Chinese medicine help with such a modern phenomenon?

Children are unique

One person’s medicine is another’s poison, as the old saying goes.  Just as with everything else in life, each child will have a different capacity to cope with technology and the online world.  Rather than making blanket rules about the number of hours kids should be allowed to spend on their various devices each day, it can be more helpful to observe the individual. 

  • What is triggering a child to use her device?

Does she use it to deflect from emotions that she finds challenging, such as anger or anxiety?  Disconnecting with an emotion by doing something on a phone or other device, does not mean the emotion will go away. Strong emotions create imbalances of qi that can cause physical symptoms.

  • What is she doing when she is on her device?

Many children use their devices for really positive ends, for example, connecting with others to fight a cause, creative pursuits or keeping abreast of important world events.  Others use their devices only to play violent games, or to try to find validation from others on social media that they are not getting in their ‘real’ life, for example. 

  • What is her mood like when she comes off her device?

If a child is regularly grumpy, angry or agitated when she comes off her device, it is a sign that she is either too reliant upon it, has been on it too long or whatever she is doing on it is having a negative effect on her qi

  • Has technology replaced other activities in the child’s life?

Whilst technology is going to be a central and important part of our children’s lives, whether we like it or not, it is not usually health-promoting if this is to the exclusion of other activities.  Extremes of anything are rarely beneficial, whereas balance and variety usually are. I often use the American psychologist Dan Siegel’s idea of the Healthy Mind Platter, as a way of explaining to older kids and teenagers the importance of having variety in their activities (

What are the energetic effects of time spent on screens?


At the very heart of Chinese medicine philosophy is the concept of yin and yang.  To maintain health, there needs to be balance between these two poles.  Yin corresponds to rest and yang corresponds to activity.  Over a twenty-four period, there will be a constant flux between this duality of yin and yang.  Night time is predominantly yin and day time is predominantly yang.  To grow and remain healthy, children and teenagers need a balance of yin (restful) and yang (active) elements to their day.

Even though they don’t involve physical movement, most activities that kids and teens do on their devices are yang in nature.  Repeatedly checking social media or playing adrenalizing video games tend to agitate and stimulate a child’s qi.  Children often go on their devices to ‘relax’ and ‘switch off’ yet, ironically, it can have the opposite effect.  It may be that the child’s body can relax but often their mind becomes more stimulated.  If a child’s day consists of mental stimulation at school, and then mental (and often emotional) stimulation at home on screens, then the balance of yin and yang will go awry.  


Chinese medicine describes the Heart (by which we mean the energetic function of the Heart channel) as responsible for the overall state of the emotions.  The Heart is also the part of us which is most affected by strong or prolonged emotions.  In particular, Heart qi will only thrive when the emotions are peaceful, quiet and calm.    

One of the common effects of a child getting a phone, is that it becomes much harder for her to achieve this necessary calm state.  A part of the child’s psyche, whatever else she may be doing, is tuned in to whatever happens to be going on at that moment with her friends. This is usually being played out on a Whatsapp group or Instagram or similar.  The drive to be accepted and become part of a tribe that is typical of this age makes it very hard for the child to ignore the chat of the moment.  She is never able to enter a truly relaxed state because she is agitated or slightly hyped-up by the constant contact. Even if the contact is positive, kind and friendly, it will often still have this effect. 

Of course, enabling contact and communication with friends is a benefit of having a phone.  Kids no longer have to fight to use the landline with other family members to make social arrangements.  But, when it prevents them from ever tuning out or switching off, constant engagement with people online can create agitation and be a cause of imbalance, particularly in the mental-emotional realm.  


While time spent on devices may agitate the mind, it tends to cause stagnation in the body purely by virtue of the fact that it means the child is usually stationary for long periods of time.  Movement is even more important for kids than it is for adults.  Their very nature is yang, which needs expression in the form of movement.  From the Chinese medicine perspective, stagnation of qi can be involved in a wide variety of health problems from headaches and gut problems to depression.  

Yang rising to the head

The natural direction of yang is to rise upwards, like heat or the flames of a fire.  The tendency for this in children is even greater than it is in adults.  Too many activities that encourage this upward movement to become even greater can become problematic.  They can mean that a child becomes out of kilter, with too much energy stuck in her head and not enough in her body.  Symptoms that may arise as a result of this may include insomnia or headaches.  

So, are there any rules of thumb?

Our job as parents is to help guide our children so that the use of technology remains a positive in their life rather than becoming something that makes them ill or unhappy.  Just as we would not dream of letting our child run into the sea on their own before learning to swim, kids need some ‘training’ on how to learn to be safe on devices.  

Is technology preventing your child from having a balance of different activities in their daily life?

If a child is spending the vast majority of her time on devices, it is very unlikely to be health-promoting.  If she is spending some time on devices, as well as seeing friends in person, doing some physical activity, having true ‘downtime’, relating to family and, crucially, getting enough sleep, it is probably nothing to worry about. 

Is your child retreating into the online world as a way of avoiding something difficult in the real world?

If a child connects with people online because she is too anxious to meet up with them face-to-face, then her social anxiety needs to be addressed.  If she is turning to a device every time she feels angry instead of expressing her anger, it will not help her to learn how to manage emotions in a health-giving way. 

Is your child regularly grumpy or agitated when she comes off her screens?

If so, it is probably worth reviewing whether what she is doing on a screen is promoting balance in her body and mind.  Or it could be that the time she is spending on a screen is too much for her (remembering that what is fine for one child might be too much for another). 

Is your child finding it increasingly difficult to be calm, present and peaceful?

If so, it may be because she is too ‘hooked in’ to whatever is going on in her online world.  This can prevent a child from being able to enjoy being in the moment, taking note of how they feel or what is going on around them.  Although children may, on the surface, be furious when a parent imposes limits on their device usage, deep down they may even be grateful for it!  Whilst phones themselves are not addictive, platforms like Facebook, Snapchat, and Instagram leverage the very same neural circuitry used by slot machines and cocaine to keep us using their products as often as possible.  (If you don’t believe me, have a look at this TedX talk ‘Cell phones, dopamine and development’ by Dr Barbara Jennings.)

So, if it is possible to draw any firm conclusions at all, one may be that it is probably not helpful to say categorically that ‘phones and technology are all bad’ or, equally to say that they are ‘really nothing to worry about’.  When used in the right way, and to the right degree, phones can add useful dimensions to a child’s life and increase her happiness.  When used in the wrong way, or to an excessive degree, phone usage can contribute to a child’s ill health or unhappiness. The key is to look at each individual child and ask which is true for them.  

The Water Element

This post is an introduction to some of the key themes related to the Water Element.  Each child has all of the five Elements within her and therefore a discussion of the Water Element is relevant for every child.  However, for some children it will be more relevant than for others.  We are all born with varying innate tendencies, and each child will have areas of life in which she excels and areas she finds more challenging.  If having read this post, you feel that your child has an imbalance in their Water Element, then the suggestions at the bottom will be especially relevant for them.    

Key themes related to the Water Element

Growth and development, assessment of risk; trust; reassurance; drive and motivation; energy reserves

Factors that challenge the healthy development of the Water Element

Your child may have an imbalance in their Water Element without having experienced any of the factors described below. We are all born with an innate, constitutional imbalance in one of the Five Elements.

An atmosphere of fear or anxiety

The emotion that resonates with, and causes imbalance within, the Water Element is fear.  Growing up in an environment that induces chronic or repeated feelings of fear will mean that a child will habitually be ‘on red alert’.   A part of her is constantly under threat, waiting for the next frightening thing to happen.  Her habitual state becomes one of being on edge and she may struggle to find a sense of internal stillness.  

There are big and obvious things that induce fear in children, such as a violent parent or living in a war-torn zone.  However, because a child’s psyche is very fragile, she may perceive there to be a threat in something that most of us as adults would consider completely benign.  Although all growth involves uncertainty, and we would not want to over-protect a child from anything that may be potentially fearful, it is the presence of intense or ongoing anxiety or fear that is detrimental to the health of the Water element.  Anxiety in a child is often focused on school, health, the health of family members, exams or any new challenge that needs to be faced. 

An imbalance between rest and activity

The Water Element embodies the quality of stillness.  If the Water Element in a child is strong, she will grow up with the ability to feel still and peaceful inside, and having the ability to know when to stop and when rest is needed.  These are essential qualities that we need in order to maintain both physical and emotional health.  

In order to develop this quality of stillness internally, a child needs a balance between rest and activity.  Exactly what constitutes a good balance will vary from child to child.  Some children are constitutionally built to thrive off more activity than others.  However, if a child grows up in an environment where he and everyone around him are always on the go, it will be very hard for him to embody a quality of stillness.  A vicious cycle may ensue, where he feels agitated when he has nothing to do and he begins to crave constant stimulation.  

The qi of the Water Element fuels a child’s phenomenally fast growth and development that is characteristic of the first few years of life.  It also fuels the huge changes that go on around puberty.  If the child’s life is such that she is always on the go, and rarely just ‘being’, her qi will be expended on meeting the needs of her external life. This may mean that her physical growth and mental development suffer.

How might we recognise that the Water Element in a child is struggling?

A child may have an unusual relationship to fear

When the Water Element is compromised, a child may find it hard to have a balanced relationship with the emotion of fear and related emotions (e.g. anxiety and panic).  This may manifest in a number of ways:

  • She may have ongoing low-grade anxiety.  She may perceive the world as a place full of potential dangers, and imagine threats where there are none.  She may be fearful in situations that we would not expect or torment herself with thoughts of future catastrophes. 
  • At the other end of the spectrum, she may have an inability to assess risk to an age-appropriate level.  This may lead her to take unusually risk-taking behaviour.  These are the children whose parents you hear say ‘she has no sense of danger’, when they climb to the top of a tall tree without hesitation.  It may be an older child who seeks out activities that include an element of thrill or danger.  Although this is somewhat normal in adolescence, if this trait is particularly pronounced or has been a theme running through much of the child’s life, it might indicate an imbalance in the Water Element.  
  • A child may oscillate between the two above extremes but struggle to have what most of would perceive to be a healthy relationship to the emotion of fear.  She may be overly-fearful in some areas of her life, and lack an ability to appropriately assess risk in other areas. 

A child may struggle to find a balance between rest and activity

When the Water Element is compromised, a child may struggle to attain a good balance with being active and being restful.  This may manifest in a number of ways:

  • She may be always on ‘over-drive’ and find it very difficult to ever stop or be still.  She may have a constant, underlying agitation within her.  She may be very competitive and want to take part in everything.  She will resist being urged to rest or have ‘quiet time’. She may struggle to get off to sleep and wake up early in the morning, however tired she is.  (It is worth noting that, in Chinese medicine terms, an imbalance in the Water Element is not the only possible cause of this).
  • At the other end of the spectrum, she may be constantly lethargic, resist doing any kind of activity and lack appropriate will-power.  Her only mode is doing nothing.  She will resist being urged to get out and be active. 
  • A child may oscillate between the two above extremes.  She may have periods where she is unable to stop, and periods where she struggles to get going.  She will struggle to find a good balance somewhere in the middle where she is able to balance exerting herself and then recuperating. 

Other signs that the Water Element may be compromised

  • The child may struggle to trust others
  • The child may have a dark colour under their eyes
  • The child may be late to toilet train or prone to bedwetting

How can we help the Water Element in our children to grow strongly?

Create a safe and calm environment in the home

This will enable to a child to relax and not be ‘on red alert’.  Children are like sponges and pick up on the emotions of others who are around them.  So if we, as parents, are chronically anxious it is likely to affect our children.  Finding ways to manage our own anxiety is therefore important. 

When possible, try to choose caregivers and teachers who are solid, reliable and trustworthy

This will also help a child to feel safe and to develop confidence that the world is a safe and secure place.  On this note, it is also worth considering how much bad news we expose our children to.  Whilst it would not be appropriate to closet them from the realities of the world as they grow older, neither might it be wise for young children to have constant reminders of atrocities.  

Allow a child to develop at her own speed and in her own time

Every time we push a child to achieve something that she is not quite developmentally ready for, we are teaching her to override her innate wisdom.  Encouragement is one thing, but pressure is another.  The more we can trust our children’s potential to unfold at its own pace and in its own way, the better.  

Support a child to learn to ‘tune in’ to her body, so that she knows when she needs rest and when she has fuel in the tank

One child will need encouragement to be more active, another will need encouragement to have some downtime in her schedule.  Probably the best way to help a child in this area is to model getting a good balance in this way ourselves.  If we as parents are constantly rushing around and never taking breaks, we can only expect our children to do the same. 


Factors that hinder the healthy development of the Water Element

  • Living in a climate of fear or anxiety
  • Lack of balance between rest and activity

Signs the Water Element in a child may be struggling

  • A child is overly fearful
  • A child is especially reckless and unable to adequately assess fear
  • A child oscillates between these two extremes
  • A child finds it hard to stop and rest, and prefers to be always on the go
  • A child resists engaging with any activity and is chronically lethargic

Support for the healthy development of the Water Element may include

  • Creating a safe, calm environment in the home
  • Working to reduce our own anxiety levels
  • Choosing caregivers who are solid, reliable and trustworthy
  • Allow a child to ‘go with the flow’ and take things at her own pace whenever possible
  • Helping a child to follow her body’s signals which indicate she needs to rest or move

The Fire Element

This post is an introduction to some of the key themes related to the Fire Element.  Each child has all of the five Elements within him and therefore a discussion of the Fire Element is relevant for every child.  However, for some children it will be more relevant than for others.  We are all born with varying innate tendencies, and each child will have areas of life in which they excel and areas they find more challenging.  If having read this post, you feel that your child has an imbalance in their Fire Element, then the suggestions at the bottom will be especially relevant for them.    

Key themes related to the Fire Element 

Appropriate levels of joy; relationships; intimacy; speech; enthusiasm; excitement; emotional vitality; emotional stability

Factors that challenge the healthy development of the Fire Element

Your child may have an imbalance in their Fire Element without having experienced any of the factors described below. We are all born with an innate, constitutional imbalance in one of the Five Elements.

A lack of love, warmth, attention, intimacy and communication

The Fire Element is nourished and sustained by healthy contact with other people.  There are very few people who can maintain a sense of joy in life without feeling connected to others.  For a child to grow up with this feeling of connection she needs an abundant supply of ongoing love and warmth.  

This seems almost too obvious to state.  Yet it is quite possible, and very common, for a child to have parents who love them more than anything in the world yet not to feel loved.  Busy lives, work pressures and relationship problems are just a few examples of the everyday reality of many parents, which makes it difficult for them to communicate their love to their children.  

As a child grow older, it becomes more important for them to feel connected to people outside of the family.  If things are not going well at school for a child, it can have a damaging effect on the Fire Element.

Living in a depressed environment

The Fire Element is also nourished by a joyous and happy atmosphere.  Of course, it is not possible (or desirable) for the environment to always be happy. But a lack of laughter in the family, or one or both parents having a chronically low mood, will often make it hard for the Fire Element in a child to develop in a healthy way.  Children are like sponges and internalise the atmosphere in which they grow up.  If the household is lacking in joy, the child may begin to feel this as her default, emotional state.

Shock and melodrama

Chinese medical texts explain that the Heart (by which we mean the energetic function of the Heart meridian – not the physical organ itself) is the first to be affected by shock.  The Heart belongs to the Fire Element.  

Shock may come in the form of a one-off event or may be a more chronic situation.  A one-off event such as a parent abruptly leaving may have such an impact on the child’s Fire Element that she never really recovers from it.  But an environment where there is constant melodrama can have a similar effect.  For example, a parent who is repeatedly threatening to leave, or a family where every week there is some kind of crisis which evokes intense emotions, can lead to a child’s Fire Element receiving repeated blows.  

How might we recognise that the Fire Element in a child is struggling?

A child may struggle to maintain appropriate levels of joy

In the usual course of life, a child will have a wide range of moods.  There are good days and bad days, happy and sad moments.  However, a child whose Fire Element is imbalanced, may struggle in any one of the following ways:

  • She struggles to feel joyful and buoyant when she is on her own or not involved in an exciting activity.  Sometimes, she fails to light up even when with a good friend or engaged in something she loves.
  • She is compulsively cheerful and is unable to connect with any sad feelings.  She fears rejection if she is not constantly entertaining everyone.  She may be ‘the class clown’ at school.
  • She swings between these two states and tends to be either lacking in joy or excessively jolly, and struggles to find a place of balance between the two extremes.

A child may struggle in the realm of relationships

The Fire Element underlies a child’s ability to form meaningful connections with other people.  If the Fire Element is not healthy, it may mean that relationships of every variety is the area a child finds the most challenging.  The difficulties may manifest in any of the following ways:

  • She is closed off and unable to form intimate friendships.  She feels too vulnerable to risk intimacy.  She may have a big group of ‘friends’ but not be able to develop a close friendship with any one person.  
  • She may be desperate for people contact all the time.  This may lead her to count someone she has just met as a new ‘best friend’, leaving her open to being hurt and rejected when this is not reciprocated. She may only feel happy when she is relating to others, and therefore struggle to spend any time on her own.
  • She may feel excessively vulnerable.  She may be devastated when a sibling says they do not want to play with her or a classmate plays with another child.  She may dread big, family gatherings where she is expected to interact with many different people.  

How can we help the Fire Element in our children to develop strongly?

Provide as much love, warmth, communication and intimacy as possible

These are such basic things but it needs saying!  Being busy is the enemy of intimacy.  Sometimes just ensuring there are times throughout the week when we are not rushing or distracted, and have time to really listen to our children can make an enormous difference.

Try to create an emotional stable and constant environment at home

Of course, there are times in life when this is not possible and periods of emotional intensity are not usually detrimental to a child.  However, the atmosphere in the household one of ongoing, chronic emotional volatility, it is worth exploring ways to mitigate this wherever possible.  For example, there may be something that a parent can change in their own life that will relieve some strain. 

Create opportunities for fun, joy and laughter

Modern family life can feel pressured and hectic.  Parents can easily feel burdened by their various commitments and responsibilities.  Sometimes we need to make a conscious effort to remember to laugh.  Laughter, humour and fun all nourish a child’s Fire Element (as well as our own of course).  So it is important for our children for us to ‘check in’ and remind ourselves of the lighter side of life. 

Permission to be low sometimes

At the same time, emotional health means being able to connect with our melancholic  feelings too.  Even children, who to some degree epitomise joy and vitality, have times when they feel sad.  If a child gets the feeling they are expected to always have a smile on their face, it will strain the Fire Element within them. 

Support in managing friendships

Having good relationships is known to be one of the key factors to achieve robust physical and mental health. It is particularly important for the health of the Fire Element.  However,  creating and managing friendships is not something we are good at teaching.  When a child gets to the age of creating connections outside of the family, supporting them to navigate this area well is crucial.  Giving a child an opportunity to talk about what they are finding difficult, and modelling good relationship skills will both be beneficial.  


Factors that might hinder the healthy development of the Fire Element:

  • A lack of love, warmth, attention, intimacy and communication
  • Living in a depressed environment
  • Shock and melodrama

Indications that the Fire Element may be struggling:

  • A child struggles to be joyful 
  • A child finds creating and maintaining healthy relationships of all kinds particularly challenging.  

Support for the healthy development of the Fire Element may include:

  • Provide as much love, warmth, communication and intimacy as possible
  • Try to create an emotional stable and constant environment at home
  • Create opportunities for fun, joy and laughter
  • Permission to be low sometimes
  • Support in managing friendships

The Metal Element

This post is an introduction to some of the key themes related to the Metal Element.  Each child has all of the five Elements within him and therefore a discussion of the Metal Element is relevant for every child.  However, for some children it will be more relevant than for others.  We are all born with varying innate tendencies, and each child will have areas of life in which they excel and areas they find more challenging.  If having read this post, you feel that your child has an imbalance in their Metal Element, then the suggestions at the bottom will be especially relevant for them.    

Key themes related to the Metal Element

Skin; touch; breathing; loss; grief; acknowledgement; sense of self-worth; letting go; taking in the new

Factors that challenge the healthy development of the Metal Element

Your child may have an imbalance in their Metal Element without having experienced any of the factors described below. We are all born with an innate, constitutional imbalance in one of the Five Elements.


Chinese medical texts explain that loss and grieving consume the qi of the Metal Element.  Many people who have recently suffered a bereavement talk of how physically depleted they feel.  Physical tiredness can be a symptom of depleted qi in the Metal Element. 

Of course, loss is a part of life and no child will escape some kind of loss throughout his childhood.  A young child may appear to carry on with life after a bereavement as he always has done, yet he may still have been profoundly affected.  

Loss comes in many forms.  It may as a result of the death of a relative or a pet, which are widely acknowledged to cause sadness.  However, leaving behind a group of friends, a school or a community, dealing with the break-up of her family or an older sibling leaving home, for example, may also induce feelings of loss.  

At some point during the teenage years, most children will also have to face the loss of their previously unquestioning belief in their specialness.  A child may grow up with the dream of scoring a goal on the football pitch in front of their adoring fans but few will ever achieve this.  

The lack of a caregiver who is a symbol of authority

In order to develop a strong internal framework, which is necessary in order to be able to deal with the chaos of the outside world, a child needs a figure in her life who represents the arbiter of right and wrong.  Whilst a child’s fundamental needs are for love and security, she also needs teaching and guiding to be able to navigate the society that she happens to grow up in.  In Chinese medicine, having someone who provides this role in their life, will help to support the healthy development of the Metal Element. 

Lack of positive acknowledgement or too much criticism

For the Metal Element to develop strongly, a child needs to be supported in the process of connecting with her own internal sense of self-worth.  The Chinese character for Metal includes the image of ‘nuggets of gold’ that are buried deep within the ground.  These symbolise the part within all of us that feels of value.  In order for a child to grow up connected to these nuggets of gold, she needs parents and teachers who recognise her value and support her to recognise it herself. 

How might we recognise that the Metal Element in a child is struggling?

The child may struggle to manage their feelings of sadness and grief 

A child with an imbalance in her Metal Element may find it harder than most to manage emotions in the sadness family.  In health, a child will be able to feel sad when she has lost something or someone that was of value to her but not get ‘stuck’ in this emotion.  When the Metal Element is not strong, she may:

  • Have a demeanour of chronic sadness, as if she is carrying around a heavy burden
  • Wear a mask that says to the world she is ‘ok’ and struggle ever to connect with or reveal any sad feelings, even after a loss
  • Oscillate between the above two behaviours

The child may have a fragile sense of self

A child with an imbalance in her Metal Element may be ‘thin-skinned’.  She may feel that she has no ‘armour’ to protect herself.  Her response to this may be:

  • To withdraw and become a loner 
  • To put on a front of being somewhat arrogant or a ‘know it all’ as a cover for her deep vulnerability

The child may be extremely self-critical and constantly strive for perfection

A child with an imbalance in her Metal Element, and who is not connected with her ‘nuggets of gold’ may never feel that she, or what she does, is good enough.  Her response to this may be:

  • To be constantly striving yet never recognise her achievements
  • To give up, or not attempt something in the first place, because it is too frightening to risk failing
  • To be overly critical of others as a way of trying to make herself feel better

Some other signs that the Metal Element is struggling

  • The child is hyper-sensitive to everything in her environment, e.g noise, strong emotions in others, the cold, the texture of clothes, the taste and texture of foods…
  • Her complexion may have a noticeable white hue to it
  • She may catch more than her fair share of coughs and colds
  • She may resist physical exercise and become easily tired by it
  • She may be disconnected from her body and overly reliant on her intellect

How can we help the Metal Element in our children to develop strongly?

Support a child to deal with loss

This may involve allowing a child to express her sad feelings as opposed to telling her to ‘cheer up’ when she does not feel cheerful inside.  In younger children, art therapy can be useful.

Give the child meaningful acknowledgement and praise

Throw away comments or platitudes, such as telling a child we love the picture she has just drawn whilst we are barely looking at it, will not help the child to connect with her nuggets of gold.  It is usually best to save praise for when we really feel praise is due so that we deliver the praise authentically.  Asking a child how she feels about something she has done rather than always telling her what we think can also teach her how to rely on her internal sense of worth rather than always needing external validation

Give your child permission to be less than perfect

A good way of doing this is to model to a child the concept of ‘good enough’ in all that we do and to acknowledge to them when we have done something less than perfectly.  A child with an imbalance in his Metal Element may have a very strong ‘internal critic’.  It does not usually serve him well if parents and carers add their own criticisms of him or his behaviour on top of this.  

Provide the right quality and quantity of physical contact

Every child will have different needs in terms of physical touch but touch is especially important for the Metal Element.  At the same time, if the Metal Element in a child is imbalanced, the child may shun physical contact more than most.  This creates a dilemma for parents.  The aim should be to respond to the child’s cues in terms of when and what kind of physical contact he feels comfortable with, and to take every opportunity that is presented.   

For a more detailed discussion of the important of touch, please read ‘Is there more to a quick cuddle with our child than meets the eye?

Create an orderly environment in the home

The development of the Metal Element in a child will be supported by an stable and secure external environment.  A child whose Metal Element is struggling may even find it hard if there is too much untidiness or messiness.  Living in an ordered environment helps the child to feel ordered internally.  

Create opportunities for the child to be outside in the fresh air

The internal Organ related to the Metal Element is the Lungs.  In order to grow strong, the Lungs need to be ‘exercised’.  Allowing a child a run around outside inhaling clean air is a key ingredient for the health of the Metal Element.  


Factors that challenge the healthy development of the Metal Element

  • Loss
  • Lack of a caregiver who is a symbol of authority
  • Lack of positive acknowledgement or too much criticism

Signs the Metal Element in a child may be struggling

  • The child may struggle to manage their feelings of grief and sadness
  • The child may have a fragile sense of self
  • The child may be extremely self-critical and constantly strive for perfection

Support for the healthy development of the Metal Element may include:

  • Supporting a child to deal with loss
  • Giving a child meaningful acknowledgement or praise
  • Giving a child permission to be less than perfect
  • Providing the right quality and quantity of physical contact
  • Creating an orderly home environment
  • Create opportunities for the child to be outside in the fresh air
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