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Ep. 129: Dr. Elizabeth Laugeson - From Socially Awkward to Socially Outward

October 29, 2020 Sucheta Kamath Season 1 Episode 129
Full PreFrontal
Ep. 129: Dr. Elizabeth Laugeson - From Socially Awkward to Socially Outward
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Full PreFrontal
Ep. 129: Dr. Elizabeth Laugeson - From Socially Awkward to Socially Outward
Oct 29, 2020 Season 1 Episode 129
Sucheta Kamath

Japanese author Haruki Murakami said it well, “A person's life may be a lonely thing by nature, but it is not isolated. To that life other lives are linked.” A key ingredient in transforming lonely human nature into a well-linked life is the faculty of mature social skills which make it possible to show interest in others, know how to make friends, read social situations, reciprocate in person or via text, put oneself in others’ shoes and collaborate successfully. Executive Function is equally essential in managing social goals, solving social problems, and propelling our social connectivity with thoughtful reflection. However, not everyone is intuitive and equipped to form social connections and nurture interpersonal relationships well and hence may require specific skills training.

On this episode, Founder/Director of the UCLA PEERS® clinic, associate clinical professor in the Department of Psychiatry and Biobehavioral Sciences at the UCLA and  licensed clinical psychologist, Dr. Elizabeth Laugeson discusses key components of evidence-based social skills program for preschoolers, adolescents and young adults with Autism Spectrum Disorders and other social impairments. 

About Dr. Elizabeth Laugeson
Dr. Laugeson is a clinical psychologist and an Associate Clinical Professor in the Department of Psychiatry and Biobehavioral Sciences at the UCLA Semel Institute for Neuroscience and Human Behavior. Dr. Laugeson is the Founder/Director of the UCLA PEERS® Clinic,  an outpatient hospital-based program providing parent-assisted social skills training for preschoolers, adolescents and young adults with ASD and other social impairments. She also serves as the Training Director for the UCLA Tarjan Center for Excellence in Developmental Disabilities (UCEDD).

Dr. Laugeson has been a principal investigator and collaborator on a number of studies funded by the NIH and CDC investigating social skills training for youth with developmental disabilities from preschool to early adulthood and is the co-developer of an evidence-based social skills intervention for teens and young adults known as PEERS®. 

Books:

About Host, Sucheta Kamath
Sucheta Kamath, is an award-winning speech-language pathologist, a TEDx speaker, a celebrated community leader, and the founder and CEO of ExQ®. As an EdTech entrepreneur, Sucheta has designed ExQ's personalized digital learning curriculum/tool that empowers middle and high school students to develop self-awareness and strategic thinking skills through the mastery of Executive Function and social-emotional competence.

Support the show (https://mailchi.mp/7c848462e96f/full-prefrontal-sign-up)

Show Notes Transcript

Japanese author Haruki Murakami said it well, “A person's life may be a lonely thing by nature, but it is not isolated. To that life other lives are linked.” A key ingredient in transforming lonely human nature into a well-linked life is the faculty of mature social skills which make it possible to show interest in others, know how to make friends, read social situations, reciprocate in person or via text, put oneself in others’ shoes and collaborate successfully. Executive Function is equally essential in managing social goals, solving social problems, and propelling our social connectivity with thoughtful reflection. However, not everyone is intuitive and equipped to form social connections and nurture interpersonal relationships well and hence may require specific skills training.

On this episode, Founder/Director of the UCLA PEERS® clinic, associate clinical professor in the Department of Psychiatry and Biobehavioral Sciences at the UCLA and  licensed clinical psychologist, Dr. Elizabeth Laugeson discusses key components of evidence-based social skills program for preschoolers, adolescents and young adults with Autism Spectrum Disorders and other social impairments. 

About Dr. Elizabeth Laugeson
Dr. Laugeson is a clinical psychologist and an Associate Clinical Professor in the Department of Psychiatry and Biobehavioral Sciences at the UCLA Semel Institute for Neuroscience and Human Behavior. Dr. Laugeson is the Founder/Director of the UCLA PEERS® Clinic,  an outpatient hospital-based program providing parent-assisted social skills training for preschoolers, adolescents and young adults with ASD and other social impairments. She also serves as the Training Director for the UCLA Tarjan Center for Excellence in Developmental Disabilities (UCEDD).

Dr. Laugeson has been a principal investigator and collaborator on a number of studies funded by the NIH and CDC investigating social skills training for youth with developmental disabilities from preschool to early adulthood and is the co-developer of an evidence-based social skills intervention for teens and young adults known as PEERS®. 

Books:

About Host, Sucheta Kamath
Sucheta Kamath, is an award-winning speech-language pathologist, a TEDx speaker, a celebrated community leader, and the founder and CEO of ExQ®. As an EdTech entrepreneur, Sucheta has designed ExQ's personalized digital learning curriculum/tool that empowers middle and high school students to develop self-awareness and strategic thinking skills through the mastery of Executive Function and social-emotional competence.

Support the show (https://mailchi.mp/7c848462e96f/full-prefrontal-sign-up)

Sucheta Kamath: Welcome to Full PreFrontal, where we talk about executive function, and I'm your host Sucheta Kamath, it's going to be a great conversation because I have somebody who knows a lot about how to relate to each other. And before I get into that, I wanted to kind of tell you a little bit about the connection of this topic to executive function. As you know, I talk a lot about executive function being the set of skills that allow us to manage our emotions, our thoughts, feelings, and attitudes and our actions. So we can achieve goals that are meaningful and important to us. And we cannot achieve these goals without really considering other people in our lives, because they are the ones we are cooperating with or need cooperation from. And so that requires incredible social skills. And it's fascinating to me, getting into this field that I came across social skills as something that needs to be taught because it can be absent, because I grew up in India, and there were a lot of etiquettes that you have to follow to belong to a community and to follow a certain protocol how to greet people, and and you got a lot of feedback about how to behave. And so I find that fascinating. But a couple of things I wanted to talk about that executive function skills are context dependent, and effectiveness of those skills change based on the arena. So there's interpersonal arena, environmental arena, and symbol systems such as reading, writing, mathematics, computer usage, and even internet usage. So with that in mind, I am so thrilled to welcome our guest today and her name is Dr. Elizabeth Laugeson. She is a licensed clinical psychologist, and an associate clinical professor in the Department of Psychiatry and Bio-Behavioral Sciences at the UCLA Semel Institute of Neuroscience and Human Behavior. She is the founder and director of UCLA PEERS Clinic. And she's going to talk about this method, which you're going to love, which is an outpatient hospital based program, providing  parent assisted social skills training for preschoolers, adolescents and young adults with autism spectrum disorder, and other social impairments. She has lots of books that she has written, and one of my personal favorite is the one that talks about these, The Science of Making Friends. So I can't wait for her to talk about that. But we will be linking a lot of resources that she has created for us. And welcome, welcome to the show. Elizabeth, how are you?

Dr. Elizabeth Laugeson: I'm fine. Thank you so much for having me.

Sucheta Kamath: So I asked this question of all my guests, since we talked about executive function, that over self awareness, strategic thinking, managing emotions and behaviors. May I ask you, how are your executive function? And when did you fully become aware of the need to regulate the way you think and behave and act?

Dr. Elizabeth Laugeson: Well, interesting question. I don't think I've ever been asked that before. I think my executive functioning may depend on the time of day and how much coffee I've had times but yes, I think like everybody, I mean, it, you know, I it's a struggle, sometimes you're talking about things like self regulation, and you know, in the heat of the moment, it can be very easily easy to lose that even when you can teach, you know, self regulation for a living in sometimes have to, you know, stop and take a deep breath and sort of remind myself of what I'm supposed to be doing in this moment, rather than just going with an impulse, you know, and saying whatever I want to say. So, I think like everybody, those are things that you have to kind of check yourself sometime.

Sucheta Kamath: So do you find yourself to be on the more proficient side of things? Do these things come more intuitively to you? Do you have a far better understanding of how to change your behaviors to get better outcomes? Or do you feel you had to work at it?

Dr. Elizabeth Laugeson: Um, maybe a combination of both? I think, you know, in terms of my executive functioning, I think I've been lucky in that. I come from a long line of very organized women who are good planners. And, you know, I think that I was raised that way, whether it's a genetic thing or not, I definitely have probably one of those strengths that I'm very grateful for, but in terms of sort of navigating the my social world and, and understanding, you know, complex relationships that involve executive functioning. I think that that's all learning process and something that I've had to, to study and research and learn more about. And hopefully I've been improved in my social interactions as a result of that.

Sucheta Kamath: So that brings me to the topic that you study in research and have dedicated your career. What got you interested in learning more about social skills in particularly Autism Spectrum? You know, children and adults? 

Dr. Elizabeth Laugeson: Well, I mean, there's sort of a perfect, like, a professional answer to that, and then a personal answer, maybe I'll start with

Sucheta Kamath: I would love both.

Dr. Elizabeth Laugeson: Okay. Um, well, the personal that, you know, I moved around a lot as a child, and by the, went to a lot of different schools and had to learn how to interact with people, very quickly how to make friends very quickly. I think by the time I was 23, I lived in 21 different places. And by the time I

Sucheta Kamath: Oh, really? Why?

Dr. Elizabeth Laugeson: My family moved a lot. And so for work, and so I just ended up being in a lot of different places. And, and ended up going to a lot of different schools. By the time I got my doctorate, I had gone to 13 different schools. And so this is not a sad story. But it's actually part of probably what helped me to become the person that I am today, I had to learn very quickly, how to decode my social world and, you know, learn how to make friends and figure out every sort of social situation and social group is slightly different. And you have to know how to navigate that. So I started decoding my social circumstances, I think, at a very early age. And so when I discovered as a psychology pre doctoral psychology intern, the world of social skills training, I was completely fascinated. I was at UCLA, studying developmental disabilities and working with people on the autism spectrum. And people with other developmental challenges, who often struggle socially. And I discovered this wonderful program called children's friendship training. It was developed by Fred Frankel and Robert Myatt at UCLA. And the first time I'd ever been exposed to an evidence base social skills program, and just fell in love with the process. And I, you know, I think what I love so much about social skills training is very proactive, it's very positive. And it's giving people tools that they maybe don't normally or naturally have, but it has a lot of impact and influence on other aspects of life. So you know, just simply having one or two close friends is very much correlated with things like self esteem and independence. And it's also negatively correlated with things like anxiety and depression, and well being and quality of life. But it's also very much related to things like anxiety and depression. So people that experience a lot of peer rejection, they end up experiencing a lot of depression and anxiety. And so what I love about this method of helping individuals with their social skills and their friendships is that it's another route to mental health services, it's another way to help people to lead better quality lives.

Sucheta Kamath: Well, I love that not only that, you have shaped your life experience into something meaningful, but you have also left a path for others to follow. So I really appreciate that. And let's talk about some framework issues here. You study social skills. So what are they and why do they matter?

Dr. Elizabeth Laugeson: Well, you know, social skills are very broad, that can include many, many different things. We focus a lot on friendship, skills, making and keeping friends and other programs who focus on things like dating etiquette, how to, you know, develop and maintain romantic relationships. And we even have programs on things like finding and obtaining maintaining employment. But I mean, really, there's a broad range of social skills, it could even be ordering a meal in a restaurant, right, or elevator etiquette, or you know, you name it independent living skills. But these skills are very critical for, you know, adaptive functioning and being able to live in the world effectively. And I think they often they go unnoticed, or maybe they're noticed that people don't know how to exactly address them. And so what I love, again, about teaching these skills is that, you know, very often people think that social skills are sort of these abstract ideas, sort of, you know, there's like almost art to having a conversation. And actually, we've discovered there's really more of a science to it, and that, in reality, we're all falling very concrete rules and steps of social behavior, we may not be aware of the fact that we're doing that. And we may do that naturally, or we may learn that without realizing it, but there are concrete rules and steps that we all follow and we can break those down and teach those to others and that's an important aspect to living an effective and successful happy life.

Sucheta Kamath: You know, it's so interesting you say that. One of my favorite papers that I ever read was Steven Pinker's the evolutionary social psychology of off record indirect speech acts. So this veiled conversation, if you serve me broccoli, and I say it's delicious when I hate it, I am, I am kind of concealing my true emotions about it. But I recognize your effort to serve broccoli, or make broccoli is greater than my preference for broccoli, or lack thereof. So so. So tell us a little bit about what what, how do social deficits emerge? Or appear in in in the population who has alternative learning profile or actually a true genuine disorders such as autism spectrum disorder?

Dr. Elizabeth Laugeson: Yeah, I mean, I think often when we think about social deficits, and, you know, we often think about individuals that are on the autism spectrum. But these social deficits don't even just affect people on the autism spectrum, they can also affect, you know, many other people, people with ADHD or anxiety, depression, executive functioning deficits. I mean, it's, it's a broad thing, and I actually keep commenting to people, I think we're losing our social skills as a society. I think that, you know, right, everyone's spending so much time over on their electronics and not really interacting in person and out with COVID. And this pandemic, it's making it even more complicated. But, but in reality, a lot of people do struggle socially. And when it comes to those social deficits, they usually play out in one of two ways. You'll either either get people who experience a lot of peer rejection, or those who experience social neglect. And those look very different on the surface. So the ones that are peer rejected, these are individuals who are actively seeking out their peers, but they're actively getting pushed away. They're doing something that other people don't like, they might be barging into conversations, and they're off topic, or they're talking about whatever they want to talk about, maybe they're being very repetitive and their themes and what they talk about, maybe they're trying to be a funny joke teller all the time, whatever it is, they're doing something people don't like, and they get rejected. And then the socially neglected, you could probably guess, right? These are the individuals that aren't even trying. They're they're not engaging other people in conversation. And they're often seen as shy or timid, maybe kind of withdrawn, they might be a little bit more anxious, or even depressed, but they go unnoticed, very often by their peers. And so I often think about social deficits in those two categories. Rather than giving it a diagnostic category, like autism, or ADHD, or whatever executive functioning deficits, I often think of social neglect versus peer rejection. And the good news about this is that regardless of whether or not someone is socially neglected, or peer rejected, the skills that we're going to teach are going to be the same. And the reason is that we want to teach good social skills, right? What socially successful people naturally do. So it doesn't matter if you're rejected or neglected, the skills that we're supposed to use are the same. The only difference will be what people struggle with, you know, it might be a little bit more challenging in different areas based on that neglect or that rejection.

Sucheta Kamath: What I really like that, I think this is a very compassionate way of looking at deficits. Because it doesn't say you're in or you're out, you can also always kind of put some focus back on. There's something you're doing that's making you not get into the group that you want, or you're not trying, which is leaving you out. And it's literally based on your effort and right kind of effort. So there's a little bit more optimism around it. And I'm not saying it's it's kind of a sugarcoating the issue. But it's really important to think that these are skills. Most often if, particularly parents, if their children are inappropriate, inept, they tend to do a lot of adjusting and the child is oblivious to that  adjustment. And then other side, I give this example often and tell me what you think of that. But when I was I was not born and raised in this country. So I have a little bit different perspective. But I look at the sitcom world as a way to capture social evolution of acceptability of inappropriate social behaviors. So you remember Mork and Mindy show? It is to depict inappropriate behaving, or those who don't understand etiquette as aliens. Then came Third Rock from the Sun, where the aliens who were migrated and on earth and they have a whole family and their professors, they have jobs. They're not that odd, but they're still unfit or they're trying to fit in but they can't fully And then now we have Big Bang Theory. So they are fully assimilated that weird and they're proud of it. So I feel the social skills training that you and I do lie somewhere in the middle of let's not call them aliens or somebody, we don't even comprehend who they are. But let's not just fully accept and say, Oh, well, right. So what do you think about this spectrum of social definition change?

Dr. Elizabeth Laugeson: I mean, I love the analogy with the sitcoms, you're so right. I mean, yes, I remember watching Mork and Mindy, as a child and being, you know, completely amused by, you know, this interesting way of looking at the world. And it made me think, even as a young child, and yet Third Rock from the Sun, and then now, Big Bang Theory, there's Yes, great, great analogy, thank you for that, I'll be pondering on that for a while. Um, but no, I think that, you know, it's, it's true that we don't want to pathologize these things. First of all, I mean, everybody struggles a little bit, socially, I have my social errors, just like everyone else, and I teach social skills for a living, so just being aware of it. But another aspect too, that we haven't talked about that I think is really important to mention, is the social motivation piece, the fact that I would never want to sort of force social skills onto anybody. And in fact, you know, with the, the the popularity of the neurodiversity movement, which a lot of that came from self advocates that are on the autism spectrum, kind of talking about not wanting people to try to change them, but to actually just want to be accepted for who they are, initially, that the neurodiversity movement and in some corners was very anti social skills training, because they sort of thought of this, as you know, we're trying to change them in some sort of way. And I really think of social skills training in that way, primarily, because we don't include anyone in our programs that doesn't want to be there. You know, one of the first questions we always ask as we're screening, or adolescents, or adults or children that we're working with is, you know, do you know about this program? And, you know, we share a little bit more about it and ask, Is this something that you would be interested in doing, and we don't include people who don't want to be there. I'm not even sure it's ethical, right? To force social skills. Yeah, someone that doesn't want to learn them. These are, I mean, just like you and I, we make decisions about whether or not we use our social skills, you know, we do we actually make a choice. Like, we're using our social skills right now I speak for a little while, and you listen, and you shake your head, and, you know, make good eye contact with the camera and all that stuff. And I listened to you and, and we're choosing to do that. So choosing to use the social skills, you know, that should remain a choice. But instead of thinking of social skills training as a method of trying to change someone, what they think of it as is a way of trying to enhance somebody's social interaction skills, so that other people can appreciate them for who they already are. I don't want to change their interest, you know, people are special and important for their own unique reasons. And we don't want to change that. But there are a lot of people who do want to help us or have us help them decode the social world and and understand these concrete rules and steps that everybody else seems to be following naturally. And so in that case, I think we need to give them the tools that they need.

Sucheta Kamath: I really like what you're saying, I think primarily because the idea of inappropriate social behaviors or unacceptable social behaviors, or social behaviors that are have a tinge of lack of competence, I see them different. And I always like to ask my clients and my patients that what is the rub? Where are you finding life to be inside dissatisfying because your motivation to change comes from life experiences that are not favorable to your ultimate goals? And and that seems to be an end to your rightfully described, two factors that you earlier talked about, is that rejection, you know, feeling constantly getting rejected, is a huge motivator for people to want to change. And that basically comes down to not knowing what is the acceptable protocol that is lacking in my behaviors or my practices, and that framing in that way always goes well with people. I do have a question though. What do you think of harmful social behaviors and, and the reason to change them because it's causing harm to others? And I'll give you an example. Recently, I had an opportunity to interview I was moderating a panel and a, a neo-nazi who eventually has changed his life or radical change, and he has become this amazing motivator. And for last 30 years, he works with young people to change their ways. And he, his name is Chris. And he talks, I interviewed him. And one of the things he talked about is a large portion of the population that he works with have some form of ASD, some sort of autism spectrum behavior, that they have been isolated, and they had harbor incredible. There's cognitive inflexibility on top of that, and lack of exposure to various ways of living. And so they have entered the cyberspace where there's no regulation, there's, if your child or if your young adolescent is hanging out with somebody, and if you see them, you can rein them back, but somebody is locked into their room and they're on their computer, joining some groups, you have no ways to know. So. So what happens is, then you're engaging in cyber bullying, or you're, you're expressing your viewpoints that may be not so savory, but genuinely causing, I don't want to say harm, because it's a psychosocial harm. So in that context, how do you, how do you see us helping them, but also kind of pointing out the harm that they may be responsible for?

Dr. Elizabeth Laugeson: Yeah, I mean, there's a lot of elements to this to address me. One is that, you know, we talked about peer rejection, being a pretty, pretty big issue for a lot of individuals. But I didn't mention is that peer rejection is actually one of the strongest predictors of some of the behaviors that you just described. So juvenile delinquency, very strongly predicted by things like peer rejection of maladaptive behaviors, also things like anxiety and depression, very strongly predicted by things like peer rejection, early withdrawal from school, you know, poor academic performance at its worst, suicidal ideation and suicide attempts, strongly predicted by peer rejection, really significant mental health issues. But in the area of the sort of maladaptive sort of antisocial behaviors, I mean, again, there is often a history of peer rejection with these individuals that engage in those types of behaviors. And they often will find social connection with other people with this common interest of sort of hate, essentially, of a disliking of maybe some other group and feeling disenfranchised, for some reason and blaming that on something external. And so there is often this connection with those types of groups, and a feeling or an experience of some sort of rejection from their peers. In terms of how do you treat that? Well, first, there has to be a willingness, first of all, is to talk about it, to address it and to want to change it. But I think it would probably start with finding a place of, of empathy and working on things like social cognition, often when people have so much of hate, for others, or disregard for others, it often comes from a place of not being able to take on the perspectives of others, if you want to go to a place of executive functioning, we would call that social cognition, right perspective, technically, putting yourself in somebody else's shoes, and being able to anticipate how they might think, or feel or react in a given situation, coming outside of yourself to understand someone else that we call it empathy or social thinking. And I think in order to correct those, those maladaptive behaviors or practices, we'd probably have to start with just being able to understand the perspectives of others.

Sucheta Kamath: I think Thank you. And I do want to clarify, his name is Christian Picciolini. And he has written wonderful, he does a lot of work, he has produced documentaries, and he has written a book. So sorry, I'm referring to him in a wrong way. But going coming back to your point. So let's talk about a little bit of importance and value of this, which you just mentioned, but particularly in the ASD crowd, what are the some of the poor social outcomes if we don't intercept or if we don't provide the support? And sounds like a from your work? In my experience, too, that timing is so critical. When you're younger, you have lots of opportunities to learn these skills. These are teachable skills. These are very, very, we understand them. Well. Now, it's not like some enigma that we don't have a real clue and we just have to shoot in the dark right? So what are the risks of these problems if they don't get proper attention? What happens to these people when they become young adults?

Dr. Elizabeth Laugeson: Yeah, well, we know there's a huge rise in mental health problems, sadly, for a lot of individuals that are on the autism spectrum are kind of struggling socially. So anxiety and depression being the big two. We also know that, you know, the difficulty with social isolation and not having friends that's compounded once they reach adulthood if this hasn't been addressed, also, very little post secondary education. So even though many of the young people that we work with are incredibly bright and talented in many ways, they often are either unable to attend college, or they might start college but don't finish college, because of the social issues that get in the way of doing that. Additionally, things like difficulty with independent living, many of the young adults that we work with, that are struggling socially, whether they're on the spectrum or not, they often live at home, they often don't have a driver's license, they often don't work. Individuals on the spectrum, I think it's something like about 80% was the most recent statistic that I saw 80% of adults in spectrum don't have employment or not gainfully employed. And you know, again, it's terrible. It's it's really is I mean, how do you how do you live independently, if you don't work, if you don't have a job, very few even marry or in a romantic relationship, even though many want to so the outcomes, they don't look great, unfortunately, for a lot of people on the spectrum, and many people argue that a lot of these, these outcomes relate to the social deficits that maybe haven't been addressed. And you know, just because you have maybe a child, it's always good to start young, right with working on the social skills, the social skills that you need, when you are in preschool, or you know, early childhood are different than the social skills that you need when you're an adolescent. So true, different when you reach adulthood, I mean, there's different, you know, developmental phases, and the social skills will change. So we also not only want to intervene early, and set our young people on a good social trajectory, but we need to stay on top of this and keep up with the social demands as they change across the lifespan.

Sucheta Kamath: And, um, thank you for pointing that out. Because I think that is so critical. When when you're younger, you're talking about, you know, being polite, or say hello, and and that may be adequate. But when you're older, or an adolescence, most of the conversations are, like learning effectively to text, or kind of showing interest in somebody but not being too aggressive or too forthcoming, or, you know, charming someone, I mean, these are some layered, nuanced skills. And and what really annoys me is, I don't know if you saw this, read the book, Malcolm Gladwell spoke about, you know, Strangers Amongst Us, that he quoted one of the studies where you take, you know, sitcom, like friends, where all complex emotion somebody feels is expressed on their faces in their body language, with their gestures, their language is impeccable, and they're acting. So they are impeccably representing all the feelings in a smile socially, dynamically, but in in real life into communication, we may actually or may be disappointed, but my face says, "Thank you, Elizabeth." So my disappointment may be veiled. And those kind of complexes are complex nuances are completely lost on people who don't learn these at a very young age. So that brings me to this next question. Can you tell us a little bit about secret ingredient in making friendship? What, what are the ingredients that you see that are really essential to becoming other people finding you interesting or wanting to be worth taking interest in?

Dr. Elizabeth Laugeson: Well, I mean, the first thing that we all have to acknowledge is that friendship is a choice, right? We don't get to be friends with everybody. And not everybody gets to be friends with us. And there are also good choices and bad choices when it comes to friendships. And so thinking about the qualities of friendships, and also the fact that there's different types of friendships, you know, there's online friends, and there's acquaintances and casual friends is regular friends, there's best friends, there's romantic relationships, there's all these different types. And we have to be able to understand the differences between these different types and how those characteristics of friendships vary based on the type of friendship that we have. But ultimately, friendships and even romantic relationships are based on common interests. Right? So think about this, who are you friends with? Or who have you been friends with, you have things in common with these people and these are the things that you talk about with your friends. These are the things that you do with your friends. And we need todefinitely make that very clear from the get go that if friendships are going to be based on common interests, then we better be looking for common interest with people If our goal is to make and keep friends, and so the way we do that varies depending on the age, but you know, young children, they're playing with their friends, they want to play games that they both like. But once you hit adolescence, and then on through adulthood, people are talking, right, they're communicating through through words and language. And so knowing how to trade information in a conversation and go back and forth and find common interests, is going to be critical to making and keeping friends. But not only that, you have to find just a potential source of friends, and move right with with hopefully, common interest. And so, you know, typically developing kids who are socially successful as well as adults, they they join extracurricular activities and social activities, clubs and, you know, meetup groups where they meet other people that they have common interest with, it's not a guarantee of a friendship, but it's a good start, because you already fundamentally have these common interests. And so there's many ingredients, obviously, to making and keeping friends. But those are some pretty important ingredients. And once you've found that source of friends, and you've interacted appropriately learned how to talk with them. Also, you know, developing close meaningful friendships, comes from having get togethers, and hanging out with your friends outside of those activities. That's how you develop stronger relationships with others. So that's the short answer to a very complex, you know, question with lots and lots of parts. But, but yeah, it all comes down to common interest is the shortest answer I could probably give for that question. 

Sucheta Kamath: And it actually resonates with me, because that's how I to find myself making friends. And common interest then can lead to more investigation of anything more you have in common. And once you have something in common, you can even bring in your personal idiosyncrasies or quirks and get other people to tolerate you talking about it, because they recognize in so many ways you and I share that interest. So that's wonderful and well explained, I would say. So let's talk about peers. So we know there's a problem. And then we also know the problem can be a costly affair if we don't intercept but intercepting means teaching social skills. But as you said, it's very complicated. And so tell us a little bit about how do we assess what what what's the baseline on somebody's social skills? And in your view? And what will be the appropriate protocol, and particularly the one you have developed peers training? Tell us how you have conceptualized that?

Dr. Elizabeth Laugeson: Well, I think the first thing is to figure out well, what is the goal of the individual? You know what I mean? If they have a social goal? What is it? Are they looking to make and keep friends? Are they trying to date? Are they trying to get a job or live independently? I mean, first, we have to figure out what what is it that they want to get out of this, because again, this should be intrinsically motivating, it should be socially motivating, and it shouldn't be forced upon anyone. And then kind of based on what the social goal is, then you choose the sort of appropriate intervention and tools to give this individual. There's a lot of overlap, though, between, you know, programs, you know, it you have to learn how to be a friend, for example, before you can be more than a friend and date. So I mean, those skills overlap as well. You have to know how to carry on conversations and, and, you know, find common interests and maintain conversations in order to find friendships, and in order to date, but also in work situations with coworkers, you need to know how to use those communication skills as well. So it kind of I think, all starts in terms of the assessment piece of what is this person seeking? What do they want to gain? And then from there creating a program that's going to be supportive of that.

Sucheta Kamath: So do you shape? Are there any ways? One of the things I find that people who have difficulties, they really don't know what's making them have those difficulties? They can say, Yeah, I don't have friends, I would like to make more friends. But what do you go into the more deeper aspects Do you know how to introduce introduce a topic? Like, I don't know if you when I was studying linguistics, one of the Tanya Gallagher was in 70s, I guess you talked about this social, pragmatic protocol. And I used to use a lot of that. And one of the things that I specialized in was called conversational repair, which was my favorite topic, I love this even phrasing of it that most of the breakdown happens when like two people are not even talking about the same thing or one person is talking about something that deeply interest when they have lost their audience, because audience is not interested or they have not properly introduced the topic or any such thing. But so do you kind of do code switching training? Do you teach them there's Formal context versus informal context, do you talk about the you seem to talk a lot about etiquettes? Regarding kind of scripts or context in which different types of speech production or communication skills are used is that, how have you designed PEERS?

Dr. Elizabeth Laugeson: Well everyone teaching PEERS is using these concrete rules and steps of social etiquette that socially successful people are naturally doing. So it's sort of ecologically valid would be the term, not what adults or professionals think that young people should do. So maybe I could give you an example to explain how this works. Now, one of the interesting things we've found in our research is that really well intentioned adults and professionals will sometimes give really bad advice when it comes to social situations. And one of the examples would be, how do you meet new people? You know, how would you teach someone to do that? And we asked young people that question all the time, like, what what do adults tell you to do? And they'll say that, you know, imagine they're going to a party or some social gathering, they've never met anyone where they told to do, they're usually told to go up and say, Hi, or your name? Yeah. And so you're in go and introduce yourself? Exactly. And I asked that question, you know, with every group of young people that I work with, they all say the same thing. But have you ever thought about what that would look like? Like, imagine that I walk up to you and some of your friends at some social gathering and say, Hi, I'm Liz, you know, like, what will you think of me?

Sucheta Kamath: Great reason to leave Liz behind. The way she approached,

Dr. Elizabeth Laugeson: Right? I mean, you're gonna think I'm weird. Like, that's just a weird thing to do. And yet, that's the advice across the globe, that people are given to meet new people go up and say, Hi, go, come Introduce yourself. So instead, what we want to do is teach what socially successful people naturally do. So let's break this down. Like Imagine that you are in a social gathering, there's a group of people that are talking that you want to join their conversation? What are you going to do with your eyes and your ears? Well, you're probably going to kind of be looking over at the group, and probably be listening, but you don't want to look like a creepy stalker, like staring at them, right? So you use a prop, like your phone or something like that look like you're kind of distracted or but you're listening. You're essentially eavesdropping, but you don't want to look like you're eavesdropping. Yes. And you're trying to identify the topic, like what are they talking about? Now, you probably need to know something about this topic, right? I mean, if I try to join a conversation, right, I don't know anything about the topic, it's going to be kind of boring for me, it's going to be kind of boring for them. So I need to know something, I need to have a common interest essentially, in the topic. Let's say I have a common interest I want to join, and I can just yell from across the room? No, of course not. I'm going to move closer with my body, right? Probably no more than an arm's length away from the group, I'm not going to want to interrupt the conversation. So I'll wait for a little pause in the conversation. And then I'm going to mention the topic. And I'm either going to do that in one of three ways. I can either make a comment about the topic, I can ask a question about the topic, or I could give a compliment related to the topic, but I'm mentioning the topic in some way. And then I need to start to assess the group's interest. Now, this is interesting when you ask people, how can you tell if somebody wants to talk to you, most people will say that it's a feeling that you get, but the reality is there are concrete behaviors that are giving you that feeling. So if the group wants to talk to me, what are they doing with their eyes, they're looking at me, they want to talk to what do they do with their body, they're they're turning towards me, they're opening the circle, they're talking to me. And then if things are going well, then I can introduce myself. But that was the steps that people naturally follow for entering the group conversation and meeting new people. That's what you want to teach in social skills training.

Sucheta Kamath: I love that. One is it's it again, it's a science, it's not some random, random thing that you have to imagine really hard. There's something concretize I love that. You also talk a lot about handling arguments and and these disagreements where you may not be on the same page with somebody, but that is not a reason to not be friends with somebody or do not have a relationship, particularly this to me, is a huge reason. I'll tell you a quick story. I had a client who came to me after five years in a row, which, right there is a bad sign that he was not promoted. And they unfortunately never gave him the reason why. And he was really angry and he wanted to sue the company. But the lawyer said you may also want to get your social skills checked out. So and then he came to me but I think one of the interesting things he never thought what is it that he's he's not doing one of the things he was doing is stead of like collaborating, he would always argue, because he had a point of view that was not necessarily oppositional. But he just presented it. That was exactly contradicting to what the other person's viewpoint was. So why do you have? Why do you have? Have you placed such an important importance to this argument, argumentation skills or this confrontational habits of people which become kind of roadblocks to communication?

Dr. Elizabeth Laugeson: Yeah, I mean, we there's, there's so many elements that are, you know, in play in that example. I mean, one element is just just basic conversational skills, how are you communicating with other people and people that often get into arguments and disagreements, they will sometimes have sort of black and white thinking, where they sort of think of the world and just sort of these black and white ways and they don't see the middle ground or that that gray area. And they sometimes even do this thing, we call it policing, where they tell other people what they're doing wrong all the time. And I think that's that black and white thinking again, where the person might, you know, be naturally following rules and believing in these rules and trying to do the right thing. But notice that other people are breaking the rules that they value, and maybe pointing it out all the time. And it's fully seeing other people, it's going to create a lot of contention in any social situation, then some people are just simply argumentative. They just want to kind of argue things and have things their way. However, it manages to manifest itself. You know, we also need to teach the strategies for how to handle arguments and disagreements, because the reality is, you know, everybody gets into arguments and disagreements with their friends, their family, their co workers, their partners. And if these arguments aren't too explosive, and they're not too frequent, they don't have to really harm your relationship, in some ways. They can even strengthen your relationship if they're handled appropriately. So we actually teach very concrete steps for both responding to disagreements, and also bringing up disagreements. So as usually those two sides of things, I'd be happy to kind of share with you some of the steps that we teach if you're interested in how we teach these skills. 

Sucheta Kamath: Yes, would you please? 

Dr. Elizabeth Laugeson: Yes, absolutely. Okay. Well, getting back to the idea of teaching social skills and very concrete rules and steps, you're responding to disagreement. This means that someone's may be upset with me, what are the steps I follow? Well, the first step is always you got to keep your cool, right, what could be the problem with losing your cool, now you're arguing about things that like the way they're talking to you or the way you're talking to them, and you got to keep your cool. And there's different ways that people do that maybe deep breathing or counting to 10 to kind of distract yourself, maybe taking a timeout, just to keep your cool and you have to listen to the other person. You know, one of the things that people often do when they're upset and disagreements is they try to jump to explaining their side. But if somebody's upset with me, I need to first listen to them. And let them sort of say what they have to say. Now, the funny thing about listening is you could be sitting there making good eye contact, shaking your head looking like you're interesting. But until you do this next step, the person doesn't feel heard. And the next step is technically referred to as active empathic listening. We don't use the technical term, we just simply say repeat what they said. Right? Yeah, paraphrase summarize what they said. Just kind of let them know they've been heard if you don't summarize or paraphrase what they said, they don't feel heard. And they keep telling you why they're upset. Now, the next step is most people's favorite step. This is where you get to explain your side. But you don't just explain your side you have to explain your side using I statements. Okay, so I statements start with a pronoun, I, I felt like this, I thought this I felt this way when this happened. And that makes people less defensive when use I statements. If you use use statements like you did this, you did that you made me feel such and such people get defensive, and they don't want to hear what you have to say. Alright, fifth step, is that you need to say you're sorry, even if you don't think you did anything wrong, you still need to say you're sorry,

Sucheta Kamath: I find this really hard sell. Do you find that? Because some of these black and white thinkers tend to really dig their heels thinking that if they're not wrong, they don't have to say sorry. So one of the rules I also talked about is apology is for them. It's it's serving ice cream after dinner. So it's just please, the menu requires you to serve ice cream.

Dr. Elizabeth Laugeson: Yeha, that's a good analogy. And I think they could get pushed back if I just left it at you know, you have to say you're sorry. But there's a there's a little caveat to that. Well, first of all, you don't just say sorry, because what are they going to ask? What are you sorry for that? I kind of think you're sorry, you have to say what you're sorry for. And even if you don't think you did anything wrong, you can still say you're sorry. You can say you know, I'm really sorry that this happened. Or I'm really sorry that you know that you're upset or I'm sorry that you feel that way. That is not accepting blame. That is just simply saying that you're seeing this happen. Yeah, I mean, if you don't feel sorry about that, then maybe you shouldn't be friends with this person. That's not a good fit. A final step is one that I think a lot of people either don't know to do, or Maybe forget to do. And that's what we have to try to solve the problem. So in that case, when we have to say what we're going to do differently, maybe next time, maybe we can't change what already happened, but maybe say what you'll do differently next time, ask them what they need you to do. Maybe you could ask them to do something differently. But you have to follow all of these steps if you want the argument to be over. And that's just simply responding to a disagreement. But you know, the good news is that we can teach these skills, and you don't have to have autism. You don't have to be socially neglected or rejected to benefit from knowing these skills. I mean, I think everybody could actually benefit from knowing this skills to you know, conflict resolution.

Sucheta Kamath: Maybe countries can learn this Elizabeth, really. Conflict resolution is at the heart of getting along and creating a peaceful world. Yes, truly, as we come to conclusion of this interview, a couple of things come to mind one, do you have, a so one of the assignments I give my, my clients is to identify one or two personalities who exhibit great social skills? So do you have anybody comes to mind when you think about awesome social skills that can be emulated? And, of course, when you talk about a show somebody acting, but you can have a role of Rick, incredibly, wonderfully socially apt person versus inept person, right?

Dr. Elizabeth Laugeson: Really good social skills. Um, I mean, I guess maybe Barack Obama would be someone that comes to mind pretty recently had a really good way of sort of making his point without necessarily being offensive or condescending. didn't lose his cool, you know, when people would disagree? I know where they go low, we go high kind of a situation. Yeah. I mean, there's lots of people that come to mind, but I guess he's the first one that came to mind. But that's

Sucheta Kamath: Wonderful. And I appreciate his sense of humor, and people who tend to be one of the things that I work on a lot is the joke, a joke is on me, you know, having the the sensibility to make fun of yourself in a more self respecting way can add a great, it opens other person to see that you're accepting or acknowledging your flaws, which can be really useful skills, social skill. As we end Elizabeth, do you mind sharing some of your favorite books? Maybe something professional and something personal debt has had a meaningful impact on you?

Dr. Elizabeth Laugeson: Wow. Again, another question that no one's ever asked me. Um, okay, well, but truthfully, my favorite book for reading for pleasure, is Pride and Prejudice by Jane Austen.

Sucheta Kamath: I love that.

Dr. Elizabeth Laugeson: I never thought about until this very moment, like why that might be but you know, she has such a satirical wit and she sort of pokes fun at society and the way people be...so there is that I think it fits with really my my career interests, my life and just so but anyway, love, I love anything. Jane Austen is very, very funny writer. And then more professionally, I, I love anything by John Elder Robison, he wrote, Raising Cubby and Look Me in the Eyes, he's on the spectrum, didn't discover that he had autism until later in life after his son was diagnosed, and he has a very witty way of writing and it's just, he's full of life, his words just kind of, you know, take off from the page and sort of come to life in a way that I think other people you know, can appreciate. So, um, yeah, I guess that's lovely. I would, I would highly recommend anything by John Elder Robison.

Sucheta Kamath: Lovely, thank you so much for being with us today and sharing your wisdom, and most importantly, actually walking all of us through these skills, because to me, they're so doable. And people please freely say sorry, to other people. It can be great repair work, I think, sorry, is such a wonderful way of acknowledging the discomfort in the space that we house with each other we have created, who started it may not be important, but you can be responsible for ending for ending it. So I really appreciate that. Elizabeth, thank you for your work and and developing this program. And I know I one of the things that's so interesting to me was how it's been translated in so many languages, and in so many countries, which just tells that you have brought hope in so many places. So thank you once again for being with us.

Dr. Elizabeth Laugeson: Well, thank you so much again for the invitation. It was lovely chatting with you.

Sucheta Kamath: All right, stay tuned everybody with our podcast. If you know someone who might be interested in this topic, make sure you share it. And if you like it, please leave us a leave us a review. And thank you again for tuning in. With our podcast Full PreFrontal exposing the mysteries of executive function. Have a great day.