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A
Arnold Guptes Weithausen dreidsehen wirstein farat.
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Begledung, Herr der Griste vorth ist das Wirfudi unter NEMS 4.
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Dan wehrhe die Platform das eigenliche Farat
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sist einferty Grundlage unde ganzes geft Loft uber Shopify Staate Jetstein kostenlosen Test of shopifypunk.
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Com welcome to this Is so Awkward the podcast. I'm Dr. Karen Adderson.
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C
And I'm Vanessa Kroll Bennett. Everyone on earth goes through puberty, so it shouldn't be cringy.
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A
With science guidance and humor, we cover all of the physical, emotional and social changes that happen between the ages of 8 and 18.
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C
We have tons more on lessawkward.com where members can get answers to all of their questions all of the time. This stage of life is awkward for everyone involved, but it doesn't have to be.
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A
Okay, buckle up and let's get into today's episode. Welcome to this Is so Awkward the Podcast.
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C
Okay, don't worry. If you came here to listen to the Puberty podcast, you are still in the right place. But what we've learned from all of you listeners over the past three seasons is that you want to hear about puberty and so much more.
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A
So it's high time our podcast name reflect how much we actually talk about Vanessa. You want to know what's really awkward?
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C
What?
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A
Talking about digital wellness with your kids.
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C
So our guest today is Dr. Michael Rich, who is a pediatrician. He practices adolescent medicine at Boston Children's Hospital, Associate professor of Pediatrics at Harvard Medical School. But the reason he's here with us is because he is the founder and director of the Digital Wellness Lab. And that may seem like an anathema to some of you, but they're doing incredible work and this episode, we believe is going to be super helpful.
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A
It's helpful because of the way Michael Rich approaches this topic. He looks at digital wellness as completely achievable. He recognizes the pros of what's happening on phones and screens everywhere and the very real cons. He talks about the data and he focuses on authentic communication with kids. Enjoy this episode. He has so much to say. And if you love it, you can also read more in his new book, the Mediatrician's A Joyful Approach to Raising Healthy, Smart, Kind Kids in a Screen Saturated World.
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C
We're so thrilled to have Dr. Michael Rich with us, the Mediatrician, which Cara loves puns more than basically anything on Earth.
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A
So I like my children and puns.
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C
Yeah, I think your children are slightly behind a good pun.
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A
Yes, I'd agree.
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C
So, Michael, it's not just a moniker. It means something. Why do you call yourself the Mediatrician? What does it mean? What is your path that has led you to this esteemed title?
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B
It is, to quote George Harrison, been a long and winding road. I spent my wicked youth in the film industry as a screenwriter and filmmaker. I actually had the privilege and honor and, frankly, torture of being assistant director to Akira Kurosawa in Japan on a film. And it actually ruined me for the film industry because coming back from this sort of pinnacle of cinematic genius to Hollywood was a real downer. So I had an early midlife crisis and went to medical school. And that's a midlife crisis.
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C
Different torture.
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B
Yeah, but that's a, you know, a midlife crisis that'll really screw your life up, you know, because you're committing to years and years and years of training. But when I was in my, you know, pediatric residency was right when the American Academy of Pediatrics was starting to get concerned about screens, particularly in that case, television. And I got involved with them in terms of writing practice policy statements around what pediatricians should say to parents about their kids screen use. And in the process of that, realized that there was a real dearth of good scientific evidence of exactly how we are changed by the screens we use and how we use them. And that led to now 30 some years of research into exactly how we are changed in terms of our physical, mental and social health and really bringing public health rigor to looking at this rather than just what had been going on, which was everybody was upset about how long their kids were sitting in front of the TV and now in front of smartphones. And so the Digital Wellness Lab, which I founded at Boston Children's Hospital, is really all about providing exactly how we are affected in positive as well as negative ways and how to live well in both senses of that word, in, frankly, what is now for kids, a continuous physical digital ecosystem that they move seamlessly in and out of.
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A
So I'm going to start by saying you are not the first doctor I know who is a recovered Hollywood person. There is a small group of you, and you've done very interesting things. But let's start there. Adults who are raising kids are starving for information and frankly, for data around all of this, mostly because while puberty has totally changed, while the experience of adolescence and growing up has totally changed, nothing has changed as radically as this one corner of it. Because we grew up without screens in the palms of our hands, and today's children are growing up with them. So, you know, everything else is sort of a variation on the theme, and this is just radically, radically different. Where I'd like to start is understanding how you collect data, because people will often acknowledge that the technology is shifting so quickly. And as soon as you study one thing and you publish those results, 12 other things have already not just come onto the horizon, they're part of everyday life for kids. So can we start there with how do you tackle that issue?
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B
Oh, that's a very interesting and complicated question. I'll try to simplify a little bit, actually. The book that I just published tackles that in specific. And it also tackles the fact that most parents, including myself, are concerned but confused. So we shouldn't feel bad about that. What we are dealing with, quite frankly, is studying three moving targets, one being the developing human from infancy to childhood to adolescence to adulthood, which we have about 100 years of research on and are starting to understand. But a second moving target is the environment in which it is occurring. And, you know, the digital ecosystem is rapidly changing, and it is both affecting and reflecting that development. And the reason I say reflecting it is because kids now are not just consumers of screens. They're creators on screens. Every snap they send, every insta they make. So they are both feeding into and educating and informing each other and themselves at the same time. The third moving target is the dramatic change in all of our behavior now that we are in an environment with screens. In every built environment, we have them in our pockets and on our wrists and think about what happens when we get on an elevator. We don't look at each other, smile, or say hello. We pull our phones out. We pull our phones out on when we get on a bus. And, you know, I was leaving the hospital a while ago after a really hard, exhausting day, turned westward toward where my car was parked and there was a brilliant sunset and everyone on the street was staring at their phone. And I felt. I felt rejuvenated and saddened at the same time.
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C
So let's dig into that because there's a kind of a grief, right, about what adolescence looks like these days in the context of loss of in person interaction, loss of free play, and then a whole host of things which we'll get into later, including what you call the pornification of pop culture. But we're going to save that for the capstone question at the end, Michael. How do we manage our grief that, you know, we Always tell parents, leave your baggage at the door. Your kids adolescence is not your adolescence. You can't expect it to be the same. So we're leaving it at the door. And yet we're like kids walk around with their faces, looking at their phones. They don't go out on a Saturday night, they'd rather stay in and game. You know, they're not having playdates, they're happy to be online with someone. There is a sense of loss, and yet we know that there are lots of upsides to tech and social media. Can you help us walk that line? Both thinking about what is lost, right? The not seeing the sunset at the end of a day, what is lost, what is truly lost, and what is gained in this new reality.
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B
I want to add another G to grief, and that is guilt. Virtually every parent I talk to feels guilty about having introduced these devices, these technologies to kids. And I say to all of them, let go of the guilt. We're all in this together. Do not expend energy feeling bad. But let's fix it. Let's put that same energy into fixing it. You know, when I grew up, there weren't seatbelts in cars. You know, should I feel guilty or should my parents have felt guilty? They didn't put me in a seatbelt or just be thankful that I survived. And now I put my seatbelt on and I put my kids seatbelt on. So I think we have to look forward, for starters. And, you know, grief is, you know, very subjective, of course, and it's based on the premise that we did it perfectly and they're not doing it. Right. Right. And you know very well that we didn't do it perfectly. We just remember the good stuff and forget the bad stuff. So what I actually try to do with the kids and the families that I take care of is help them understand that it is not toxic to be looking at a screen, but they have to do a risk benefit analysis between what they gain from that screen and what it's displacing, what they are not doing, like seeing a sunset. So a lot of times with kids, I'll say to them, you know, when you want to connect with someone, always think about how you can upgrade by one. You know, most of the people who talk about screens talk about how it should be restricted and limited, et cetera. I'm sitting there saying, wait a minute, let's humanize it. And if you're thinking of texting or tweeting, pick up the phone and call. Better yet, video call. And best of all get together in person. And ultimately smartphones are great, but you can't learn to make out with a smartphone.
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C
Wait, so I want to follow up on that. We sometimes will create a sort of a hierarchy of good, better, best. Don't play Xbox by yourself. Get on FaceTime with a friend and play Xbox with your friend. Don't play in our house and their house. Get together and play together in someone's living room. Better yet, ditch it. Right. But kids really push back on that prioritization. They push back that one form or one type of interaction is better than another. Is there data, Michael, to suggest that for the human being there is one form better than the other?
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B
I think it's hard to create a hierarchy of good, if you will. And I think one of the reasons that we get in trouble around the whole screen issue is that we try to think about it in terms of good versus bad. A values based approach. I try to. And this kind of gets back to Kara's question about how do we collect data. I want to look at healthier versus less healthy. And good versus bad. Are values laden to the point where you can take any 10 people, put them in a room, they'll have 10 different value sets. They will discuss and argue as long as you let them and walk out with the same value sets. But if you can present them with data, you can present them with, here's what we know. You can come to a consensus, you can come to agreement about what choices they make. But ultimately we have to respect each other as individuals and as parents to make the choice that's best for them and their family. Right? So, you know, everybody has different values and they're going to act on those values. But let's at least do it with knowledge about how we are affected. And to answer the question about the good, I mean, what would the world be like if we never had Fred Rogers and Sesame Street? I mean, we have phenomenal things that have been done in media that have brought us closer together, et cetera. But the flip side of it is that these devices have allowed us to substitute near infinite connectivity for deep and meaningful and sustained connectedness with other humans. And unfortunately, our tendency, particularly as adolescents and preteens who are immensely self conscious and awkward and feeling weird, it's easier to do this at arm's length. But we expect that social media is going to give us that same sustenance. And it doesn't. It's a relatively weak or attenuated form of connection with other human beings. And so that mismatch creates what I see as a wave of loneliness among us all.
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A
There's a third side to this coin if the coin's allowed to have three sides, which is parental hypocrisy or adult hypocrisy. Right. So it's bad for you or this attempted hierarchy for you, child. But I'm going to tell you that, and then I'm going to walk over here and pick up my phone, and I'm doing all the same things you're doing. And so that's another way we have to thread the needle here. Just because our brains are at different developmental stages does not mean we're not all vulnerable to the giant sucking sound of social media and all the rest of it. Right?
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B
Right. Well, that's why I tell parents the best way to raise a child is to observe the three M's. The first is model. Model the behavior you want to see in your kids. And you're absolutely right. It is the height of hypocrisy to be staring at our smartphone at all important emails and yelling at the kid to turn off Grand Theft Auto. So be the change you want to see in your kids. The second is mentor. When we introduce a device, a platform, an application to a child, we should do it side by side with them. And the reason I choose the word mentor is mentorship goes both ways. You teach and you learn. And a lot of parents don't go there because they feel like the kid knows their way around a smartphone or a tablet so much better than they do that they feel less than and they feel unable to do it. But mentoring is really about learning it together and discovering together what the upsides and the downsides might be. And the third, and this is the one that gets parents and kids the most worked up, is monitor. Monitor your kids online. Behaviors have their usernames and passwords. And the reason why I say that is not because they're going to be watching the kid all the time. Parents push back on this. I don't have the time to watch everything she or he does. It's because if they can monitor it, the kid behaves differently. I tell kids to observe the grandma rule. Don't put anything online you don't want grandma to see because she can. Okay, here's the good side, Carl. Wait, wait, wait. There are two more M's that you get from this. The first is mastery of these incredibly powerful, useful tools. And mastery means using these tools for what they do phenomenally well, better than any other technology before, and turning them off and doing other things when they're not the best tool for the job. And most importantly, make memories. I argue that we don't remember a damn thing of what we did online or what we saw unless we were watching that movie or that TV show with mom or friend or a romantic partner. That's what we remember is the human stuff. We make memories when we take walks in the woods and we try to make spaghetti and spill sauce all over the floor. That's the stuff that sticks with us. And so ultimately it comes down to 5M's that we work toward, you know, and with as we help our kids learn to live in this seamless, physical, digital environment.
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C
The best summer pieces are the ones you end up wearing on repeat. Comfortable, versatile, and somehow right for almost every occasion. Cara I bought the leather hand woven convertible clutch for this summer and coincidentally you bought almost the same bag in a crossbody.
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A
I mean, Purses aside, Quince's 100% European linen pieces are the ones I'll be reaching for all summer long because they're lightweight, effortless to style and Vanessa they start at just $32. Everything at Quint's is priced 50 to 80% less than similar brands because they work directly with factories. You're paying for quintessential quality, not brand
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C
markup, so make your summer wardrobe feel easier. Go to quince.com awkward for free shipping on your order and 365 day returns. Now available in Canada too. That's Q-U-I-N-C-E.com awkward for free shipping and 365 day returns.
- [19:43]
A
Quince.com awkward raising tweens and teens can feel totally overwhelming. So can finding a therapist to support you, not to mention one who actually takes your insurance. That's where most online therapy platforms really fall short.
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C
I've had times when I needed to find mental health providers but found it impossible to find a therapist online who took my insurance.
- [20:07]
A
Rula does things differently. They offer therapy from licensed professionals for an average copay of just $15 per session. Go to rula.comtisa to get started today. That's R U L A.comtisa for quality therapy that's covered by insurance.
- [20:25]
C
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- [20:59]
B
A and we're live on match day as Doug reaches for a buffalo wing. He's got it. Oh, and he's gone for a can of Pepsi too. What a finish. There's no doubt about it. It just tastes better. Match days deserve Pepsi.
- [21:15]
A
I want to add a sixth M, which is make it work, because I really want my tech savvy children to make all of my broken parts of my computer and phone and all that work in there.
- [21:24]
B
Is that violation of the child labor law?
- [21:27]
A
Yes, it is. But I val I value them.
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C
I do pay rent. It's how they pay rent, Michael.
- [21:34]
A
So I want to go to monitoring for a second and drill down on monitoring because I want to get practical. So there's monitoring a young kid, first, second, third grade. They don't really own their own devices. They have access to yours, they're getting on yours. There are a whole host of things that can go wrong, but there's that, then there's monitoring as they begin to acquire devices and logins of their own. And then there's monitoring when kids are so much older and really it's almost an overstep to monitor, and yet sometimes they want it or they need it because they have these adolescent brains that are not making the best decisions. So can you walk us through how monitoring evolves as kids get older?
- [22:21]
B
Well, I see monitoring actually as an extension of the mentorship, if you think about it. And the reason I talk about mentorship is that it allows the parents to introduce these tools not when they want them because everyone else has them, but when they need them. And when the parent, in their best judgment, which is not always perfect, believes that they can handle it responsibly and with respect for themselves and others, understanding that they are creating a digital footprint. And then what it does is it makes the digital space a shared space. Kids don't necessarily like, but they accept the fact that when they are going to someone's house for a party, the parent may talk to the other parent may ask, are there going to be alcohol, drugs, weapons, who's coming, et cetera, because the parents want to, as best they can, create a safe space for their children. And that's what this is, hopefully an extension of, is the mentorship starts with an open dialogue about what is Instagram, what is Snapchat, what can it do, what it can't do. How would you feel if this happened to you? And it starts an open dialogue that then even when you're not actively monitoring the child, the child doesn't feel like they have to go over underground. If they see something that weirds them out or upsets them or scares them, they know they have an ally in this, that you're not going to be mad at them. And in fact, that means we have to change up our act and not be mad at them for Grand Theft Auto, but sit down next to them and figure out how to steal cars, right? And when we have finished being the student and we know the 47 different moves it takes to steal a car and we come to them and say, I finally figured it out. Let's talk a little bit about why you might want to practice this over and over again. You're coming from a very different place. You're not wagging your finger at the top of the basement stairs. You are saying, let me understand this. And they may push back, but you've got them thinking and you got them realizing that they are in a life simulator and they can simulate all kinds of things from stealing a car to killing terrorists, to building a city.
- [24:47]
C
So, Michael, you're giving us all this great guidance, right? And it's like, here are these lessons through which we can achieve this. I want to think for a minute about the parents who maybe didn't start down a path they're feeling super great about now. Those are families that come to see you. Those are people you work with day in and day out. So the first thing we're going to do, as you advise, is we're going to get rid of the guilt, right? Like, we didn't ruin our children by allowing access to these devices. We didn't ruin them by allowing them to log on to these platforms. We didn't, you know, destroy their futures by allowing them X number of, you know, hours of screen time. So we're all going to let go of that. Help us with some language and some framing for the parent who needs to take the do over. In terms of anything from how much time a kid is allowed to play Xbox on the weekend, to what social media platforms they're allowed on, to where they charge their phone when they go to bed, to any number of things. And I'm sure you have a gazillion examples of ways in which parents have to walk back what they initially gave their kid permission for. What is the argument we make to kids that feels authentic and honest and vulnerable, that does not feel like a total punishment to the kid? Or it may, but is a compelling enough argument about why we're making these changes, about why it's important to their wellness. Give us that framework for folks listening.
- [26:26]
B
Well, first of all, I encourage parents to approach their child with curiosity, with creativity, and with compassion. So to understand what draws kids to this. If you think about it, the screen environment is an incredibly fertile place for the key tasks of adolescent development. In particular, first of all, they seek experience. They are filling up their library of experience, and this gives them all kinds of vicarious experiences, positive, negative, and otherwise. They are coming into an awareness that they are a social creature and they're looking outside the nuclear family to connect with others in the world. They are building their identity. They want to be different than their parents, but they are building their identity not just from a lot of their parents, whether they like it or not, but also from things they see and like out there in the world, and also things they see and don't like and don't want to be like. And then ultimately, they seek connection with others beyond their family. And, you know, if you think about it, Facebook is now the largest nation on earth. Right. With. With the number of people who are on every month. So I think that we have to take a step back and understand why it is such a strong draw and not make it us versus them, but us with us. Learn from them. That's why you play Grand Theft Auto with them. Learn from them what they like and how they're good at it, and show them that you respect and love them for what they are able to do, and you're pushing them in the right direction. Now, here's the other interesting thing you mentioned about screen time limits. Screen time limits are an obsolete concept.
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C
Yeah. To share with our listeners the framing you use. Because it's a great reframing of the concept.
- [28:24]
B
Right. I mean, this does not mean we limit screen time, but screen time limits of one to two hours of quality educational screen time a day, as recommended 20 years ago by the American Academy of Pediatrics, never worked, even in the days of television when there were broadcasts on at a certain hour and off at another hour, et cetera, because it made it the forbidden fruit. And first of all, parents couldn't tell quality from lack thereof or educational from lack thereof either. So it left them at sea. But what would happen is you'd say, you have an hour to watch screens today, and the kids would rush home from school and they'd get in front of the screen an hour later. What would happen? Absolutely nothing. So an hour and 15 minutes an hour and a half goes by and mom or dad comes up and says, hey, you got homework? Or hey, your friend wants to play basketball or whatever. And it's always, can I finish this program, can I level up in the game, et cetera. And it became a conflict every single time. So what we actually suggest is we turn the paradigm upside down and think about their 24 hour day as an empty glass that we fill up with this many hours of sleep, remembering that adolescents actually need more sleep and than when they were a few years younger with a sit down family meal every day. Single most protective thing you can do, not just for their nutrition, but for their mental health that needs to be without screens. It means no smartphones, no television in the other room, no anything going on but getting face to face and talking to each other, which after all was the original social media. And absolutely everything gets charged in a neutral space in the kitchen or whatever, including mom and dad's phones. So it's respecting both the power of these tools to help what they do well, but also respecting what they displace and remembering that our human to human connection as parents and children are probably the most precious thing we ever get. And this is time limited. This is not. They're not going to be 3 or 5 or 15 forever and we need to enjoy and wonder at them. And I think that this is really, really important. So it's not about screens being toxic, it's about screens being part of a rich and diverse menu of experience they have in a day.
- [31:08]
A
You know, what I did not hear you say was that you lead a horse to water. You're not telling parents, introduce your kid to Grand Theft Auto because they're going to get there anyways and so you want to take them there and be the one. And this is the pediatric mindset, right? It's the idea here is not since something feels inevitable, we're just going to do it. The idea here is it's the curiosity piece and something we talk about a lot on this podcast. It's getting curious with what they're curious with, which is a way to connect with, with them. Show them you care about what they want to do. Show them that you care that they're having a great time. I mean, I have an 18 year old who is getting ready to leave the house and, and he'll be the last out the door and it's going to be a very empty nest around here. And just last night he was playing a game with a very close friend of his who lives three minutes from Our house, but they were gaming together on two different screens in two different houses. And I haven't heard him belly laugh like that in a long time. And I went into the room and I was like, I gotta know what's so funny. And he showed me on the game they were playing how they had lost the game, but they were watching the kids who were still in the game and how amazing some move was and how hysterical it was. And I think that's the nugget of the advice that you give, which is, meet them where they are. It's like with everything else, just meet them where they are. And if they are in a place and we're going to get to porn, because this is a very important place to get to. If they're in a place that does not feel okay to you, you still have to know where they are in order to begin to engage them in conversation. That, as Vanessa would say, it's like they're at the bottom of the well and they're looking for a hand up out of the well. And the only way you can do that is, is by acknowledging where they are. So, Vanessa, do you want to. Do you want to tee up?
- [33:10]
C
Yeah. I mean, well, you have two choices, Michael. I'm going to give you. I'm going to give you two options, like I did when my kids were
- [33:16]
B
door number one and door number two.
- [33:18]
C
You want hot dogs or pizza for the eighth night in a row? Okay, so here are two final questions. You can choose which order.
- [33:27]
B
Okay.
- [33:27]
C
The first is how do we help our kids with the pornification of pop culture and how porn has seeped into every aspect of their lives, including how and when, and if, if ever they choose to have physical intimacy with another person. So we can talk about that. The other thing I really want to talk about is this issue of the teen mental health crisis and what many believe to be not coincidental timing between the teen mental health crisis and the rise of social media use amongst teens. Right. It's essentially contemporaneous. And yet the research so far, and you may know better than we do about what the research is definitively saying, is saying that it is correlative and not causal. And no one, from what we've read who's doing the research is willing to come out and say it's causal. So my question is, A, are you the person who's willing to say that or not? And B, is there data, Is there research coming out that is going to give us a clearer picture of the relationship between social media and the Teen mental health.
- [34:45]
A
So notice that Vanessa has given you no easy and light choices here.
- [34:49]
C
So between porn and mental health, I
- [34:51]
B
mean, let's, you know, nor are there choices that, I mean, you can answer succinctly in the amount of time for a podcast, unless we're going to do something like Andy Warhol's sleep movie where it lasts just eight hours. Okay, so just because sex sells, let's start with the pornification of culture. One of the things that I think we're really struggling with around this idea of good, bad, values based and healthy versus unhealthy is centered on this, you know, because there are strong moral, you know, ideals around sexual activity. Right? And we are living in a country that has an incredibly diverse amount of sex education and quality of sex education offered. The Internet provides one click sex education. The kids are going to go there anyway, whether their mom and dad and clergymen frown on it or not. It looks like the average age of exposure to porn is going down, down, down, and it's now around nine years old, long before puberty, right? At a time when it confuses, it freaks them out, but everybody's into it. So to be cool, I've got to be there, right? And my concern is not so much that we're turning into a society of perverts so much as it is that we are learning about sex in ways that are completely disconnected from trust, intimacy, caring and nurturing and all the wonderful things that makes sex good. And so we've turned sex into a commodity. We've turned it into something transactional like getting a pizza. And I think that that is the real loss. And actually, the kids that I see in clinic or the young people, the young adults I see in clinic around this issue, have essentially been arrested in their sexual development because as pre adolescents and adolescents, they had easy access to pornography, which meant that they had easy ability to reach orgasm without the awkwardness of talking to someone, of feeling embarrassed, of realizing that it's not the way porn looks. My body doesn't look or perform the way those bodies do. My partner's body doesn't do that. And every, everybody doesn't want all sex all the time. And these, these are the illusions of pornography. And so actually what I hope to instill in young people is that they are giving up real pleasure by going to porn because their sex life will never be as portrayed. Right? And I use the example of entertainment media. You know, life isn't action movies, life isn't heroism. Life isn't as funny as you see on Television or, you know, in a movie. And sex is the same way. So I think that what, what's happened, of course, is, as you say, the pornification of all culture. Sex sells just like violence cells. These very primal urges of humans are very easy ways of getting to people to by everything from actual sex to hamburgers. So what we have to recognize is that we are changed by what we see and what we make. And we have a choice in this and we have an opportunity to teach younger people what potential outcomes are. But don't make it the forbidden fruit, because it'll make it. It'll just make it that much more attractive.
- [39:02]
C
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- [39:30]
B
Sounds like breakfast is ready because Quaker's coming in hot with morning nutrition 100% whole grain oats and a good source of fiber to fuel the rhythm of your morning and kickstart your day.
- [39:44]
A
And that sounds absolutely delicious.
- [39:48]
B
Fuel to start whatever's next Quaker official sponsor of FIFA World Cup 26. So now I have to talk about health. Okay, now, now that we've dealt with sex. Okay, I think that first of all, we have to take a step back and understand that even in the most rigorous public health research, there is very little that we can do to prove causality. The actual reality is we still haven't proved causality between smoking cigarettes and lung cancer. Right. We have incredible reams of data showing that your relative risk of getting lung cancer goes up dramatically when you smoke cigarettes. But we still don't say you smoke a cigarette and you get lung cancer.
- [40:41]
A
Right.
- [40:41]
B
They're always the. My grandfather died at 98 having smoked three packages of cigarettes a day, et cetera. So I don't think we should be looking for causality. We should be looking for relative risk. What is the relative risk of dying if you don't put on a seatbelt in the car? Well, lots of people drive all over the place without seatbelts on and don't die. But when you look big picture, it's odds. It's odds ratios. What odds do you want to play? So there's that. I do think, though, that we run the danger of big Data coming to causal conclusions, that we see this going up and therefore it is caused by this. I think that one of the interesting things that we learned during the pandemic and the lockdown is that screen use went up. The severity and frequency of arguments between parents and kids for screen use went up. And yet, in retrospect, when we asked the parents and the kids how it went, a lot of them attributed social media as their life raft during this, the place where they could actually be with their friends. And in fact, Fortnite is still a big thing, but not as big as it was a couple of years ago. When I talked to kids about Fortnite, they didn't talk about it being a first person shooter. They didn't talk about winning or losing. They talked about it as hanging out with their friends. So, Kara, just like your son with the belly laughs, this is how they hang out with each other. This is the basketball court or the city park or the mall as it used to be. And we have to be able to evolve with them, to use these tools in ways that allow them to laugh with their friends even when they're not in the same room.
- [42:36]
A
I mean, it feels to me like there should be a third C in there in between correlation and causation, and it should be contribution, like, you know, right. Smoking contributes to lung cancer. We know that. And likewise, I think it's, at this point, having read all this data, all three of us on this podcast, having read all this data, it feels impossible to say that social media use in particular has not contributed to some of the mental health effects. But, you know, we stand right there with you in terms of acknowledging the good with the bad. And the hardest part to parent through. And I think that the place to land the conversation is, even with the same kid, the same medium might sometimes be positive and sometimes be negative. Life is easier when it's analog. It's easier when your kid, if they do this thing, they have a negative reaction. Okay, they won't do that thing. But tech in general and social media in particular can be both. And. And that's complicated, and it's hard. And those are the conversations that, that get the most interesting with kids, because kids acknowledge it. And they are. The older they are, the wiser they are as consumers. And they, they understand, you know, something that you speak about and something we believe fully in is the one truth is they just don't want to be manipulated. And once they feel like they're being manipulated, they're out. You know, that to them is like the ultimate offense. And so getting into conversations in that way feels right. But Vanessa and I are, I think, tipping slowly, slowly, slowly towards imagining there will be a day when the causal link is made. Because it's the. It just. The numbers are overwhelming.
- [44:23]
B
But why do we need causality?
- [44:25]
C
I. I love causality.
- [44:27]
B
Means one to one relationship, Right.
- [44:29]
C
I like your framing of relative risk. I think that's a really helpful way of thinking about it because it feels less black and white, which also means that parental guilt, sense of failing, sense of sort of falling short in our jobs is also not black and white. Like, we're doing relatively okay or relatively lamely in this particular week, and therefore, lamely to bring back a word that we used in our adolescence. But I think thinking of it as relative risk, because we know, Michael. Right. That the two kids can spend the same amount of time on the same platforms and one will walk away totally great. There will be deep negative repercussions for the other kid. And so it's not a monolithic answer one way. And I really appreciate the concept of relative risk.
- [45:28]
B
Absolutely. And, you know, it is not that they use social media or how long they use social media. It is how they use social media. And the mistake that all of us make, and kids probably more so even than adults, but adults are pretty guilty of it, is that we use social media the way corporations do. We market ourselves to the world. We show the great vacation we went on or how gorgeous our kid or our boyfriend is or dad's new sports car or whatever. We don't use it authentically. We don't use it in ways that we make friends with other people, which is, think about who you have your closest relationships with. It's not with people who are perfect. It's with those people whose flaws we accept and we love them, not despite their flaws, but in some ways because of them. Because we complement each other. Right? And we are comfortable with each other being real. And this leads to my great optimistic pediatric fantasy for social media. And that is that think about if we had a kid in Ukraine and a kid in Russia who are online with each other on social media, being authentic, being their real selves, talking about what they like and what scares them, what they do and what they avoid doing because they're too scared to try it, whatever. And their respective leaders say, that is the enemy I want you to go kill. And they'll say, screw you. I know this kid better than I know you. And I see social media, if we can learn to use it as humans, authentically as an instrument of peace.
- [47:22]
A
That is so beautiful. That is so. I mean, and that is where we started the conversation is everything is evolving so fast. How do we even talk about what's next? And that is where it should go. Right. And some platforms do go. Some are far more authentic than others.
- [47:36]
C
Yeah. But for those of you who want a slightly less, because Cara and Michael are clearly the two optimists on this
- [47:43]
B
podcast, Pediatricians, what do you say?
- [47:46]
C
I'm going to just like, I'm going to bring it down. I'm going to bring it out down a notch. Which is to say, I'm coming back to something you said earlier, Michael, which is kids and adults can use social media and technology as a way to avoid discomfort. When we're uncomfortable in the elevator or in a social situation, or not wanting to put ourselves out there in an in person situation. It's a way to avoid discomfort. And your message over and over in the book and today is that, no, we need to move through this discomfort. It's important to grow as human beings and to grow connection with other human beings and to have that discomfort and know we can move through it. So the beautiful ideal children in Russia and the Ukraine are the extreme example of moving through that discomfort. Let's hope Putin doesn't do anything to those beautiful children. And for those of us living day to day here, we have tiny versions of overcoming obstacles, we, ourselves and our children. And encouraging all of us to learn to be uncomfortable on the path towards greater connection. And meeting, I think, is a wonderful message that you offer here and in the book. And when I sit down at dinner tonight with my children and I share with them that concept, I'm going to get the most wonderful eye rolls as they ask me to pass the chicken.
- [49:17]
A
But I pass my cell phone, please.
- [49:19]
C
I am going to find ways to message that concept, Michael, in ways that speak seem authentic to my kids. Because I think that is ultimately the goal, that our kids find deep human connection in their journey towards adulthood so they can find meaning and purpose with other people.
- [49:36]
B
And I think actually the way to push through that is for them to understand that that other person is just as uncomfortable as they are, just as awkward, just as worried about it. And if they approach that person not with worry about what they'll think of me, but with compassion for how they are feeling, then you can get to that, you know, and if your kids can let them roll their eyes, but if they can carry that away, they're going to have more friends than anybody. And that's what you realize is that friends are the ones that you really can depend on, that you really are comforted by. And frankly, to dis social media a little bit. We lost a lot when friend became a verb. We lost a lot when friend became a verb. And the flip side of it is the word parent is more importantly a verb than a noun.
- [50:34]
C
And we all. I don't know if you feel this way, but being called a parenting expert is basically the funniest thing we've ever been described. Because I'm like anyone who calls themselves an expert in parenting, like, needs to get in line with all of us who blew it today, yesterday, and for the last 21 years.
- [50:53]
B
Yeah, they're BSing themselves and everybody else totally.
- [50:56]
C
I mean, we sat on stages in front of hundreds of people and just started laughing when they referred to us this way. And we're like, thank you so much. You should really check with our children because they would beg to differ on that one.
- [51:07]
B
Yeah, I am. I'm an expert on everybody else's adolescents and completely stupid with my own.
- [51:15]
A
Come, come sit by us, Michael.
- [51:17]
C
I mean, this was such a joy. We hope you will come back again and we're so thrilled that your book, the Mediatrician's Guide is out in the world. What day does it come out, Michael?
- [51:29]
B
It has come out. It came out on SAFER Internet Day, February 6th. Oh, and I do want to say the subtitle is A Joyful approach to raising Healthy, Smart, Kind Kids in a screen saturated world.
- [51:46]
C
So I have the early copy, but now. Oh, it's so excited.
- [51:50]
B
Okay, great hardback.
- [51:51]
C
Woo.
- [51:52]
B
Look at it.
- [51:54]
C
And the child on the COVID is very cute.
- [51:56]
B
Yes.
- [51:56]
C
So the book is out. It's excellent. For those of you who are feeling at sea, Michael's got you. Don't worry, there's tons of excellent guidance, so do not fear.
- [52:08]
B
And also I will offer that the Digital Wellness Lab at Boston Children's Hospital has a very active website with up to date information. One of the problems of course, with the book is we're dealing with these moving targets and you can't fix on paper. So I think that if they want to resource stuff that is very fresh, they should build off of the book. The book is written in a very foundational way, so it's not like it's going to be obsolete tomorrow. It's really more more broadly about our relationship with screens of all kinds, et cetera. But go to digitalwellnesslab.org for the latest and greatest.
- [52:47]
C
We will link to it in the show notes also because it's an excellent resource. Michael, thank you so much for coming on. It was so fun.
- [52:55]
B
Oh, it's been fun for me too. It's always fun to talk about our foibles.
- [53:03]
C
Thank you so much for listening. You can email us with questions, feedback or or episode requests@podcastawkward.com if you want
- [53:13]
A
to learn more about what we do to make this whole stage of life less awkward for everyone involved. Our parent membership, our school health ed curriculum, our keynote talks, and more are
- [53:26]
C
all@lessawkward.com and if you want products that make puberty so much more comfortable, visit myumla.com.
- [53:42]
B
Hey, it's Ryan Reynolds here for Mint Mobile. Now. I was looking for fun ways to tell you that Mint's offer of unlimited Premium Wireless for $15 a month is back. So I thought it would be fun if we made $15 bills, but it turns out that's very illegal, so there goes my big idea for the commercial. Give it a try@mintmobile.com Switch upfront payment
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A
of $45 for three months, $90 for six months or $180 or 12 month plan required $15 per month equivalent taxes and fees Extra initial plan term only greater than 50 gigabytes. Me slow when network is busy. See terms.