The Five Element Phases of Adolescence

Just when you thought you figured it out, everything changes!

One of the profound wonders I get to witness everyday is the way children transform throughout their lives. Preparing parents and children for these changes can help them navigate the deep mysteries of growing up. Nowhere is this more important than in the dramatic transitions through adolescence. Chinese medicine gives us a special lens through which we can support our children and discover the hidden significance of these changes.

The Book of Changes (yijing) is the basis upon which all the classics of Chinese medicine are founded. Bianhua, 變化(transition and transformation) captures the spirit of adolescence that can cause fear and confusion for children and parents living through it. Bian—meaning “transition”—is the pause that permits a kind of necessary chaos that will shake things up in order for transformation and maturation into adulthood to take place. One minute our child wants a hug, the next minute they don’t want to be seen in public with us. The pictogram above of hua—“transformation”—shows a person flipping upside down. This topsy-turvy quality of adolescence perfectly illustrates the yinyang principle. When things are pushed to extremes, they will flip to their opposite.

The Journey of a Thousand Miles Begins Beneath Your Feet

The first step in preparing to help your child move through the stages of adolescence is to embrace the spirit of change yourself. We are all creatures of habit, and as parents we may sometimes assume our children are always going to do things the way we taught them. Growing up is an experiment with life. Parenting is a spiritual practice that begins right in the middle of your life. When we take the time to notice the subtle changes in our children with an open heart, we become role models that can guide them through the stages of adolescence naturally and safely without embarrassment or shame.

The stages of adolescence unfold like the seasons. Chinese medicine offers a unique, ecological understanding of transformation based on seasonal cycles. Winter (Water phase) transforms into Spring (Wood phase). Spring transforms into Summer (Fire phase). Summer transforms into late Summer (Earth phase), the season of the Harvest. Late Summer transforms into Fall (Metal phase). And Fall transforms into Winter to complete the cycle. Each phase has deep physiological and psychological resonance in our lives. Over the course of many years in pediatric practice, I have found this Five Phase model very useful in generating practical advice for parents in the midst of raising their children.


Phase 1: Water to Wood: Where Am I Going?

Somewhere between the age of seven and ten years old (depending on your child’s nature) the Winter to Spring cycle of transformation begins. Change comes in different ways to different kids. Often one of the earliest visible signs of adolescence is that sleep habits change. Your child may begin having difficulty falling asleep at the usual times.

Phase 2: Wood to Fire: What’s New?

As your child moves further into adolescence, their moods may become more intense and volatile. Inwardly your child is asking, “What’s happening to me?”, as physical changes begin to manifest outwardly. These are the first flames of hormonal fire.

Phase 3: Fire To Earth: How Do I Fit In?

One of the natural ways children move through adolescence is by building new bonds outside the family. The loyalty of friends takes on increasingly important meaning in a teenager’s life. This is a subtle sign of Earth’s uniting power. Fitting in takes on a sense of urgency for survival within the emerging subculture of the teen, which will shape their interests and desires.

Phase 4: Earth to Metal: Why?

As children move further into the complexities of adolescence, bodily changes trigger increasing concerns about their personal appearance. Your child’s styles of clothing and hair may begin to take on quasi-religious importance. A teen’s “look” is an outer expression of their emerging personal identity. The power of Metal inspires children to question rules, values, and group dynamics.

Phase 5: Metal Returns to Water: Who Am I?

During the great upheaval of change that is the journey of adolescence, we can help our children discover their own secret powers of wisdom and compassion. Identity begins to regain some sense of stability around 15 years of age. In traditional cultures this is a time for moving out into the world and establishing one’s own family responsibilities.

cowan_000By Dr. Stephen Cowan, MD, FAAP

Dr. Cowan is a board-certified pediatrician and certified medical acupuncturist with more than 25 years of clinical experience working with children. We’d like to thank him for his contributions to and support of TCM World Foundation as we continue to educate the public about mind-body-spirit medicine. For more info on Dr. Cowan, please visit his website at