Latest / Pediatrics Now: Cases Updates and Discussions for the Busy Pediatric Practitioner / Talking to Adolescents About Nutrition and Social Media

Transcript

Talking to Adolescents About Nutrition and Social Media · Pediatrics Now: Cases Updates and Discussions for the Busy Pediatric Practitioner

• 0:01
  The part about i think it's so fascinating about the disney epcot uh,
• 0:06
  great as my youngest daughter was begging for hot cheetos last night and i did
• 0:10
  not buy that active for a reason yes and just looking just reading the ingredients
• 0:15
  like kind of scary like what is that and the pressure at school i mean she has
• 0:21
  said before it's like all my friends will have this at lunch.
• 0:25
  People don't bring carrots and apples.
• 0:29
  Right. It's social. People don't appreciate that. Yes.
• 0:34
  Back on the show today, we have developmental psychologist David Yeager.
• 0:39
  He's the author of 10 to 25, The Science of Motivating Young People,
• 0:43
  a groundbreaking approach to leading the next generation and making your own life easier.
• 0:49
  And Dr. Yeager, You're a professor at UT Austin, and I just got to say,
• 0:54
  I think your book is transformational. It's amazing.
• 0:57
  It's helping me. Some of the pediatricians I've talked to, it's helping them.
• 1:00
  Thank you for writing this book.
• 1:02
  Yeah, I'm so thrilled you read it. And this is definitely, pediatricians,
• 1:05
  definitely an audience I was hoping to reach. So I'm thrilled that they're finding
• 1:08
  it useful because I know you guys are busy.
• 1:10
  You have plenty of things to read. So I appreciate that you're finding it to
• 1:14
  have some good stuff in it.
• 1:16
  Yes, it's great. And I guess it's safe to say it seems like there's so much,
• 1:21
  especially, you know, this time of elections, so many people disagree on stuff.
• 1:25
  We could all agree it's really hard to talk to teenagers and influence them.
• 1:30
  Yeah, for sure. And even into the mid-20s, it's just a tough,
• 1:33
  it's a tough age group to deal with, for sure.
• 1:36
  And you say, research shows there's a lot of similarities between the brain
• 1:41
  of someone who's 25 and 10?
• 1:43
  Yeah. I mean, obviously there are many maturations that make us smarter as we get older,
• 1:49
  but the driver of motivation is really similar across these different age groups
• 1:56
  because they come from this same underlying need to have a sense of social status,
• 2:02
  a sense of respect, a sense of acceptance.
• 2:05
  And that starts from the moment puberty strikes, or rather it transforms in
• 2:10
  a new way when puberty strikes.
• 2:12
  And it continues until we have an adult-like position in the labor market and
• 2:17
  in the economy, which for many young people is not until the mid to late 20s.
• 2:21
  Wow. Well, should we dive into some of these questions? I'd love to. Okay. Thank you so much.
• 2:28
  So this one pediatrician, she says, boy, that's easy.
• 2:34
  How do we talk to them about their habit of 10 to 14 hours a day on their phones?
• 2:42
  And what about body piercings? I have a patient, this beautiful 14 year old
• 2:47
  who came in the other day and she had both cheeks pierced.
• 2:52
  What do I say to her?
• 2:54
  Yeah, those, those are different issues. I'll take them one by one and I'm not
• 2:59
  going to pretend like I have the exact answer,
• 3:01
  but the principles that would guide me, and this is drawing,
• 3:05
  by the way, from lots of interviews with great mentors who are excellent at
• 3:09
  creating adolescent behavior change.
• 3:12
  I think for that first one around phones is that it's a little tricky because
• 3:19
  many adults, in fact, most adults are on screens for most of their work time.
• 3:25
  I mean, I'm on the screen 10 to 12 hours a day for work.
• 3:29
  Certainly when I wrote the book, that's what I was doing. It was on screen 18
• 3:32
  hours a day. And I think that there are.
• 3:35
  There's this conversation around screens for work versus screens for entertainment,
• 3:40
  and then it's not clear to
• 3:42
  young people then within the entertainment bucket why screens for entertainment
• 3:47
  are any different than other kinds of entertainment like it doesn't feel like
• 3:51
  a categorical difference to them it just feels like a you know it'd be like
• 3:55
  like it's as weird to say don't entertain yourself with a screen you should
• 3:59
  entertain yourself a different way as that it would be to say,
• 4:01
  don't play card games, instead play board games.
• 4:04
  Like, well, how was the difference? I don't understand.
• 4:07
  And so a lot of the things where it does make a difference are not super obvious to them, right?
• 4:14
  So for young children, of course, screens really affect visual development and
• 4:18
  can have effects on cognition.
• 4:20
  But for 13-year-olds, you know, that's not really the issue.
• 4:25
  And so I think that there has to be a conversation around what is screen time
• 4:30
  displacing in terms of goals that the young person has, where, first of all.
• 4:37
  Are they using screens more than they want to already?
• 4:41
  And there's some evidence that more than half of young people already think
• 4:45
  that they're using screens more than they want to.
• 4:47
  So they're already seeing it as a slightly addictive thing.
• 4:50
  So rather than starting from a position of,
• 4:53
  you, you, you're doing this to yourself and you want to, and that's a problem
• 4:57
  to be more like, all right, well, let's talk about why does this have power over you?
• 5:01
  What is it displacing and why, and why is it hard to stop that?
• 5:05
  And then what I've seen is what's called collaborative troubleshooting,
• 5:08
  which is starting with questions more than telling, and then using those questions
• 5:15
  to bridge toward a shared understanding of how to meet the young person's goals.
• 5:21
  And in chapter six in the book i walk through what this looks like and i tell
• 5:24
  the example of a dad whose daughter was on the screens way too long because
• 5:29
  she had an out-of-state boyfriend.
• 5:31
  And the what he didn't do was take
• 5:34
  what i call an enforcer mindset approach which is just demand that
• 5:37
  she'd limit screen time to a certain number of minutes but instead figured out
• 5:43
  okay well what is she getting out of it and it turns out that since mom wasn't
• 5:47
  in the picture and dad was working a lot that the only form of acceptance that
• 5:52
  the teenage daughter was getting was from her online boyfriend.
• 5:54
  So it actually wasn't the screen she was trying to get. It was this very deep
• 5:58
  and basic need of being a 15 or 16 year old and not feeling accepted and loved.
• 6:04
  And that's what she was getting out of it. It's very hard then to say,
• 6:07
  don't do that because in our heart of hearts, what we actually want for our
• 6:11
  kids is acceptance and love.
• 6:13
  And so the real issue was how was she getting that, not whether she was pursuing acceptance and love.
• 6:21
  And so then the dad said, all right, well, what are some other goals you have?
• 6:25
  How is their screen time getting in the way of those?
• 6:27
  And she was neglecting her sports practice and some of her schoolwork.
• 6:31
  And so they worked out something together.
• 6:33
  And in the end, she ultimately found in the flesh boyfriend and spent time with
• 6:39
  him and then ended up with a good friend group that was everything you'd want for your kid,
• 6:44
  which is that you have a group of friends who care about you and include you and so on.
• 6:50
  So it's a long way of saying, I think on the screen time, that...
• 6:54
  You know, there, there, there's a place for mandates and there's a place for
• 6:58
  hard and fast rules, but we, ideally it comes from a position of trying to understand
• 7:05
  what their, what goal they're trying to accomplish with their screens.
• 7:07
  And usually it's some very good positive social thing and we need to work with
• 7:12
  them to find another way to meet that.
• 7:14
  And talk about reinforce how important it is to be with your friends when you can.
• 7:19
  Yeah, I mean, I think that the challenge is if they feel like they don't have
• 7:23
  real friends or if they feel like they have to be a phony with their in-person
• 7:27
  friends, that they can be real and honest with their online friends.
• 7:31
  So sometimes those arguments don't exactly work. And so there needs to be some
• 7:38
  pitch of how you grow and develop your friends in unexpected ways.
• 7:42
  And also, who knows if you're not going to be the one who's there for somebody
• 7:47
  else who's having a hard time.
• 7:48
  Maybe a friend is thinking about self-injury, and you're going to be the person
• 7:52
  there to save their life because you're there in the flesh, and so on and so forth.
• 7:57
  So I think that there are multiple ways to frame the other approaches to having
• 8:03
  friends and being with them.
• 8:05
  Which is another thing that you talk about in your book about how important
• 8:08
  it is that that message you're needed.
• 8:11
  Yeah, I mean, I think fundamentally, young people are – this drive for status
• 8:15
  and respect I've written about is a drive to matter. And to be of consequence to others.
• 8:20
  And it makes more sense if you think about the opposite.
• 8:25
  How would you feel if you reached the conclusion that you do not matter to anyone,
• 8:29
  that your life is not consequential to anyone else?
• 8:32
  Well, that's like the root of despair and depression. and so when teenagers
• 8:39
  are trying to be consequential and they're trying to matter to others,
• 8:44
  they're not being frivolously short-sighted and selfish with their social lives.
• 8:48
  It's like this deep-seated need that's part of being a human.
• 8:53
  And I know you talked about this in episode one about talking about social media
• 8:58
  and the companies don't care about you. They care about making money.
• 9:02
  They don't care if you're spending too much time on it, more time than you want.
• 9:07
  This pediatrician who, and I know we'll get to the piercings question,
• 9:11
  the answer in a second, but she also, she says it really comes down to almost
• 9:16
  anything a child comes in for now, ear infection, stomach bug, anything.
• 9:22
  It ends up, social media ends up being something that comes up in the room and
• 9:27
  it's such a, such a big issue. Yeah.
• 9:30
  So anything else you want to add? Well, I think that the,
• 9:35
  i mean i i i think that the claims around social media as the cause of depression are overblown.
• 9:42
  But i think it is definitely a
• 9:45
  cause of distraction and so like my kids don't have it well my kids don't have
• 9:50
  it for two reasons one is they got other stuff to worry about i want them to
• 9:54
  be practicing basketball cello and algebra i don't want them you know wasting
• 9:58
  time on social media But the other thing is just the premature exposure to such adult content.
• 10:05
  And that's an issue.
• 10:08
  And so I do think that there's this idea of long-term happiness coming from
• 10:13
  meaningful accomplishment that is won through diligent practice for whatever
• 10:20
  it is that you care about.
• 10:21
  Getting better at it is important and you
• 10:25
  know social media gets in the way of that and this companies would love nothing
• 10:28
  more than to keep you scrolling rather than
• 10:31
  doing whatever else you would do in to find fulfillment in
• 10:34
  life so i think the message of of i the adult know it's good for your health
• 10:40
  and you should listen to me is unlikely to be the most effective but the version
• 10:45
  of you have goals for yourself and how you want to be healthy and happy and
• 10:49
  those companies by making you scroll,
• 10:51
  they're stealing that from you. They're stealing your authentic happiness.
• 10:55
  And don't let them do that to you. Be an agent of your own well-being and happiness.
• 11:00
  And I think that latter type of argument better matches adolescent values.
• 11:05
  That's great. And this powerful pull where social media uses the,
• 11:09
  there's all their friends are on it too.
• 11:11
  So that social status thing to be on social media, that's hard to overcome.
• 11:18
  That's definitely an issue. I mean, whether the companies are doing it for nefarious
• 11:24
  reasons or not is irrelevant to a 13 year old who feels like the only kid who
• 11:30
  can't share an inside joke because everybody else knows what was shared on social media.
• 11:37
  And so that is kind of tricky. And so the framing there needs to be something like, well.
• 11:44
  You know, you're going to build these important in-person skills.
• 11:48
  It's going to, you're going to be funny. You're going to know how to talk.
• 11:50
  That's going to benefit you in a lot of ways. But right now,
• 11:53
  you know, as a parent, I'm not going to let you, I'm not, I'm not gonna let
• 11:56
  the companies make money off of you and your attention in ways that are not
• 12:02
  good for your goals in the long run.
• 12:05
  My, my 13 year old daughter who doesn't have a phone, she came home from an
• 12:08
  activity, a church activity where they were carving pumpkins.
• 12:11
  And she said, mom, everybody else had their phones out for inspiration.
• 12:16
  And I just, I used my mind and not a phone.
• 12:20
  And I, and I carved my pumpkin's eyes as stars. And she sounded really proud
• 12:25
  that she didn't have a phone.
• 12:27
  It was like the first kind of
• 12:28
  positive thing about not having a phone I've heard, I must say. Totally.
• 12:32
  Yeah. And like I said, the majority of kids
• 12:35
  want to use social media less or use their
• 12:38
  phones less you know they're already thinking about the
• 12:43
  the the fact that it's
• 12:46
  getting in the way of their goals and so there's a
• 12:48
  badge of honor to be the one who resisted right i mean odysseus was awesome
• 12:54
  for being able to sail past the sirens and not be called in by the siren song
• 12:58
  you know and so i think there's a there's a certain prestige to be earned by
• 13:03
  being the one who has the self-discipline to choose a healthier life.
• 13:09
  That's awesome. So the piercings question, I mean, what, if anything,
• 13:15
  like as a pediatrician, when you bring that up, does, can it help?
• 13:19
  What do you, well, I think that's an interesting one because,
• 13:23
  you know, I mean, a lot of the stuff's not that permanent.
• 13:28
  It, it is, It does feel like a personal choice.
• 13:33
  There are cultures around the world where piercings are part of what you do
• 13:38
  at that age to show that you're an adult. This is the reason why they exist.
• 13:44
  It's not like an objectively bad thing.
• 13:47
  I think that where a lot of parents get concerned is if it's the beginning of
• 13:51
  a slippery slope of irreversible things you do to your body out of a misguided
• 13:59
  sense of teenage rebellion.
• 14:02
  So I think it's pretty close to this domain of what feels like a personal choice.
• 14:08
  And when adults impose hard and fast rules for things that are personal choices,
• 14:11
  then that's when teenagers rebel the most.
• 14:13
  They tend to not rebel when it's something adults should have authority over.
• 14:18
  So, I think that what I would see the mentors do that I studied in my book is
• 14:25
  to first understand what's the underlying reason for it.
• 14:28
  Is it a revenge thing against the parents?
• 14:31
  Or is it just they're influenced by a certain look?
• 14:34
  Or is that really who they are? In which case, it's more like parents need to be accepting.
• 14:40
  And so i think coming at it from a place of
• 14:43
  curiosity and wanting to understand rather
• 14:45
  than a place of like of starting
• 14:49
  out thinking yes this is definitely wrong and you should definitely not do
• 14:51
  this i think is that that there's
• 14:55
  a line there that's pretty close and and i'm not saying this is the issue in
• 14:59
  this case but in a lot of cases when parents get mad at kids it's because they're
• 15:03
  veering over the line into the social domain of what feels like a personal choice
• 15:08
  and that's especially where kids don't listen to grownups and we feel like they're being rebellious.
• 15:15
  But as kids age, there are certain things where it's like their choice.
• 15:20
  Okay. Here's a question from a pediatrician. As a clinician,
• 15:24
  what's a good approach to medication compliance and nutrition and exercise?
• 15:32
  And I know you talked in our last episode, some about medication compliance.
• 15:37
  If maybe you want to summarize quickly that, but really the nutrition is something
• 15:42
  that they have to deal with a lot and exercise.
• 15:47
  And I was just reading the part again in your book about the fascinating stuff
• 15:54
  about Disney and Epcot and what you did to flip the script. So can you tell us about that?
• 16:01
  Yeah. So the big punchline for the medication adherence is that a lot of the
• 16:05
  ways that we do medication education comes across like we're talking to them like children.
• 16:13
  And so it's really common to educate the teenage patient in front of the mom or the dad.
• 16:19
  And then it feels like the doctor's talking to the parent, not the kid.
• 16:22
  And so that implies the kid has no agency and they just need to listen to the
• 16:26
  mom and listen to the doctor.
• 16:28
  And that ends up giving us this world that we live in, which is that 50% of
• 16:33
  kids with major issues like cancer and transplants don't take their medication as prescribed.
• 16:39
  And it's even worse for dermatology, antibiotics, etc.
• 16:44
  We did an experiment to try to improve adherence with medication advice,
• 16:50
  but not with adherence with medical advice.
• 16:53
  But in this case, it wasn't medicine. It was diet.
• 16:56
  And we partnered up with Disney, actually, to redesign an attraction at Epcot.
• 17:05
  So there was this attraction called Habit Heroes.
• 17:08
  And the way Habit Heroes worked was they, and this is all public record,
• 17:13
  the character you the protagonist would enter the
• 17:17
  event or the the attraction and then
• 17:19
  you would see fit looking good guys and
• 17:22
  overweight looking bad guys and you would go from room to room and
• 17:25
  you would shoot the bad guys in the face with broccoli and so on to make them
• 17:29
  drop their cupcakes or whatever it was and so the implication is you're on team
• 17:36
  health and you're against team junk food And therefore the kids are supposedly
• 17:40
  going to go out after that attraction and eat healthy food and not junk food.
• 17:45
  And that ended up being a scandal. And so they had to shut it down for a lot of reasons.
• 17:52
  And so we worked to redesign the attraction.
• 17:56
  And again, this is all public. It's people can check it out and Google it.
• 18:00
  But the redesigned attraction framed the bad guys as imposing their will on the young person.
• 18:09
  So we depicted normal weight looking protagonists or sometimes overweight looking
• 18:14
  protagonists who were nevertheless making healthy choices because we wanted
• 18:17
  to separate weight from healthy habits.
• 18:21
  Because, of course, there are skinny people, especially teenagers,
• 18:24
  skinny teenagers with terrible habits and overweight teenagers who have perfectly
• 18:28
  good diets. So one of the separate behaviors from weight and then frame the bad guys as,
• 18:36
  stopping you from achieving the healthy aims that you have.
• 18:40
  So we depicted civilians around the world diving towards fruit and vegetables
• 18:46
  who are being held back by evil ghouls that are stopping you from doing that.
• 18:51
  And the descriptive norm there is a behavioral science term is that our description
• 18:57
  of what typical people are doing is that everyone wants to be healthy,
• 19:01
  but there are things preventing them.
• 19:03
  Now, it would have been better if we could have named the food companies as
• 19:08
  the ghouls, because in fact, what happens is the food is often engineered to be highly addictive.
• 19:16
  So hot Cheetos are a great example where hot Cheetos are the optimal combination
• 19:21
  of meltiness, crunchiness,
• 19:23
  and teasiness with the spiciness that deposits some spiciness on your tongue
• 19:29
  to make you salivate the net result of which is your your body like dissolves
• 19:36
  the cheetos before your brain can know that you've eaten any food and then you
• 19:40
  keep salivating and you want more
• 19:42
  and so then it becomes hyper addictive because your brain doesn't know you've
• 19:46
  had any but you crave more and so and then on top of that they have a cartoon
• 19:51
  character and so these things are marketed to children and they want to get
• 19:54
  children addicted from a very young age so that way as they grow old,
• 19:58
  they buy it again and again.
• 20:00
  And the ingredients are made as cheaply as possible so they can make the most
• 20:04
  profit. Right, of course. Right, it's as cheap.
• 20:07
  Few health benefits. And there are other examples too, like one that really
• 20:11
  outraged kids is if you look in a lot of public schools, they'll have the chocolate
• 20:15
  milk and the regular milk.
• 20:17
  And the regular milk is usually 2% and the chocolate milk is usually 1%.
• 20:22
  But the chocolate milk, of course, has 35 grams of sugar added to it.
• 20:26
  And so they portray it as low fat compared, half as much fat compared to 2%.
• 20:32
  But in fact, it's like way worse for you because it's got all the sugar in it.
• 20:36
  So we we tell so what we did is we we took
• 20:39
  that information and we created a new expose treatment
• 20:42
  which we provided to new teenagers and we
• 20:45
  got the those teenagers to read it think about it process it and
• 20:49
  write about it and then we tracked them for months by working with the school
• 20:53
  to see what kids had purchased in the cafeteria using their id cards and what
• 20:59
  we found was that kids bought more healthy options when they received this expose
• 21:05
  article, especially boys.
• 21:07
  And they bought fewer junk food items. And this was two, three months later.
• 21:12
  So it's kind of an amazing result where we were able to shift diet for months
• 21:18
  from a 20-minute message about how healthy eating is actually rebelling against
• 21:23
  a company that's trying to control you rather than acquiescing to it.
• 21:27
  And so it taps into this adolescent value of independence, autonomy,
• 21:31
  and also fighting for social justice.
• 21:33
  So we told people about how every time you choose not to buy junk food from
• 21:39
  these processed food companies, you're keeping money out of the pocket of these
• 21:43
  companies that are harming children in poor communities. And that really seemed to work.
• 21:48
  And so it's flipping the script where it's not, you're having your freedom by eating this junk food.
• 21:55
  If that's what you want, it's you're, you're choosing, you're having the freedom
• 21:59
  to choose these healthier foods that don't have commercials,
• 22:03
  you know, broccoli and water and salad.
• 22:06
  Yeah. Cause like the conventional view is I, the adult have thought through
• 22:10
  what you need to do and I'm telling you what to do because I'm the expert in your health.
• 22:14
  And so if you want to be healthy you'll listen to me without
• 22:17
  without delay and so the
• 22:21
  teenage value of independence and autonomy would push
• 22:23
  against healthy eating toward unhealthy eating so what
• 22:27
  we did instead is we made healthy eating be the rebellious independent autonomous
• 22:31
  thing because you're standing up for your freedom against the food companies
• 22:36
  trying to control you So it flips the association between rebellion and healthy
• 22:42
  eating from one where acquiescence is what you do if you're healthy.
• 22:47
  Or what we say in the paper is healthy eating is for lame nerds who do what grownups say.
• 22:52
  That's the default interpretation. And we could change that to be healthy eaters
• 22:56
  are awesome, independent people who stand up for the poor and the oppressed.
• 23:02
  And then it feels high status.
• 23:05
  And that's the same with exercise, kind of follow the same flip script where
• 23:09
  you're choosing to do something you love and to feel good and to be healthy.
• 23:15
  Yeah, I mean, exercise is a little tricky. I mean, because it feels bad now
• 23:20
  and it's for the sake of something else in the future.
• 23:22
  And that other thing is kind of ambiguous. us also
• 23:26
  a lot of the like recommendations around
• 23:29
  exercise we now know not the
• 23:32
  recommendations but the push for going to
• 23:34
  the gym and stuff comes from the food lobby that's
• 23:37
  like paid for by the food companies because they want
• 23:40
  to deflect the attention from the the
• 23:44
  diet and instead project the intention onto
• 23:47
  exercise and it's so that
• 23:50
  at the end of the day the companies can blame overweight people
• 23:53
  for being overweight because they'll say you didn't go to
• 23:56
  the gym rather than the companies taking the blame for
• 23:59
  producing high caloric addictive food and there's this great i think jama article
• 24:05
  that's titled you can't outrun a bad diet and basically they've done all the
• 24:11
  work on the calorie stuff and like even dramatic increases in exercise wouldn't
• 24:16
  reduce the obesity epidemic,
• 24:17
  but kind of small but sustained changes in intake of high-calorie ultra-processed
• 24:24
  foods would stop or reverse the obesity epidemic.
• 24:28
  So in pediatrics, really, it sounds like focusing mostly more on nutrition in
• 24:33
  those precious few moments in the exam room with a child, that's where the most value could be.
• 24:40
  Well, I think, I mean, I was going to think, you know, exercise is important,
• 24:42
  but it's important for a lot of reasons.
• 24:44
  Like your brain works better. You have more friends, you're learning activities, you're joining teams.
• 24:49
  So like with my own kids, I'd never emphasize going out to go for a run.
• 24:53
  It's always something like, it's so much more fun to play with your friends.
• 24:59
  If you're going to go play basketball or tennis or pickleball,
• 25:01
  if you don't have to stop and be gassed and breathing, you know, gasping for air.
• 25:06
  Right. After every point. And so it's like there's an immediate social benefit of being in shape.
• 25:11
  But the idea that like in your early 30s, you'll weigh 10 pounds less because
• 25:16
  you have good running habits now when you're 12. It's like not realistic.
• 25:20
  Okay, that's great advice. That's really helpful. I know that's something that
• 25:24
  our pediatric practitioner listeners face every day.
• 25:27
  I have a couple of questions from parents, but do you have time to either I
• 25:31
  could say both real fast and you pick one to answer real fast or do you?
• 25:35
  Yeah do that and then i'm eight minutes late to
• 25:38
  the national academy meeting but yeah thank you so
• 25:40
  much and this so from question from a parent tell me
• 25:43
  which one you want to answer my my 14 year old daughter has all of a sudden
• 25:49
  started saying kind of frequently i hate my life so and then she gets mad at
• 25:54
  me when i start and it's when she's frustrated with something and then she gets
• 25:57
  mad at me if i start to talk to her about it do i keep asking her about it is
• 26:01
  it just something that will pass.
• 26:03
  This other parent is asking, is it okay? Should we be tracking our kids on our phones?
• 26:10
  Is there a hidden cost to that? We want to know they're safe,
• 26:14
  but is it okay developmentally to be doing that?
• 26:16
  So I know those are both very different. Yeah. I mean, on the question of tracking
• 26:20
  kids, I think if a condition of getting a phone is that the parents have unfettered
• 26:24
  access to everything you've done, then I think that's fine.
• 26:29
  I think that I wouldn't have liked that as a kid, but I think kids want a phone enough now.
• 26:35
  I mean, it'd be like telling someone, you know, you're going to be on a reality
• 26:39
  show, but they're going to record everything about you.
• 26:41
  It's like, well, I still want to be on the reality show. So they just, they'll say yes to them.
• 26:46
  And so, but, but then I think the challenge for parents is to use discretion
• 26:50
  and have good ways of knowing when to talk about what they see.
• 26:54
  But I think it's absolutely appropriate for kids under 18 to have parents monitor
• 26:58
  what they're saying through all channels, because that's the only way you could
• 27:03
  detect like suicide risk, right?
• 27:05
  Or crime or anything else like it.
• 27:08
  And it has to be like, this is my job. I'm like, I'm not doing my job as a parent.
• 27:12
  If I'm not fully aware of what you're doing. In fact, I could be arrested and
• 27:16
  this has happened like parents of school shooters. Right.
• 27:20
  And so it's like, it's irresponsible for me to, to not be able if I needed to,
• 27:25
  to monitor every single bit of text that you produce until you're 18.
• 27:30
  I just have to. So that's what I tell my kids and...
• 27:34
  That's just the truth is that, you know, it's not no sugarcoating it,
• 27:36
  but then it's like, all right, let's have a discussion about when I should use discretion.
• 27:41
  Like, when do you want me to talk about what, what I see or what I don't see?
• 27:44
  And you could talk about when to intervene.
• 27:47
  And honestly, I think kids feel better knowing that somebody is checking up on them.
• 27:52
  If you have that honest conversation. So that's for that.
• 27:55
  I did for the, you remind me of the other question. Um, the other question and
• 27:59
  what you were just saying location tracking too, because that's a big thing
• 28:02
  like where you are. Yeah.
• 28:04
  The other one was the, her daughter has started saying, I hate my life. Oh yeah.
• 28:10
  So it is really important to look out for that all or nothing thinking that comes up.
• 28:17
  So I hate myself. I hate this person. I hate that person. My life is the worst.
• 28:22
  What I think a lot about is specific emotional language. So hate and shame are
• 28:29
  really bad emotional words because they are in this all or nothing worldview.
• 28:34
  You tend to not be in a gray area if you say you hate someone, right?
• 28:39
  It's like it's 100% black or white with that person.
• 28:43
  Similarly, if shame, so if I feel ashamed, then usually you're blaming your entire self as a person.
• 28:49
  Now that doesn't mean that the source
• 28:52
  of the of the negative affect is bad
• 28:55
  so the kid is saying hey my life might also
• 28:59
  agree that they are angry at people who are frustrating them or they're sad
• 29:04
  about something bad that's happened to them and anger and sadness are perfectly
• 29:09
  good emotions i mean anger is responsible for most reconciliation like you get
• 29:14
  angry at someone you confront them you have a conversation,
• 29:17
  and then you figure out how to resolve things.
• 29:20
  Sadness, you know, sadness can be bad, but it's also just an honest reflection
• 29:25
  of how the state of the world is different from how you'd like it to be.
• 29:29
  And so that can be information that you need to change something about yourself or the world.
• 29:33
  So sadness is perfectly fine. It can often be a good cue to make a change.
• 29:39
  So I think the naive approach is to tell people, no, you don't hate your life.
• 29:45
  Look how good your life is.
• 29:46
  But that doesn't match their experience because their experience is like,
• 29:49
  there's something bad in my life right now.
• 29:51
  And so telling them to mentally average the good things with the bad things,
• 29:55
  and therefore their feelings are invalid, is like not effective.
• 29:59
  But I would say most of the things I've seen is that parents are tempted,
• 30:03
  and other adults, they're tempted to say, your life is great,
• 30:07
  or you shouldn't hate your life, or that's a bad thing to think, right?
• 30:10
  They want you to dismiss and suppress the bad thought.
• 30:14
  What works better is reframing or reappraisal in the emotion regulation literature.
• 30:19
  And that's saying, well, okay, I understand why he came up with hate.
• 30:25
  That's pretty intense. You know, are you angry? And then, you know,
• 30:30
  tell me about how you're angry or tell me about how you're sad.
• 30:33
  And then talk about how those legitimate but negative feelings can be fuel to
• 30:40
  make a change or improve something or to take some action. And then that's productive coping.
• 30:45
  So I think it's like, you really do want to be on the alert for all or nothing language.
• 30:51
  And I think parents need to know if you hear I'm a bad person,
• 30:55
  they're a bad person. I'm the worst. They're the worst.
• 30:57
  I hate this person. I hate myself. I'm ashamed.
• 31:01
  Like those, that all or nothing type language, both emotional and cognitive
• 31:05
  is the root of despair and should be addressed proactively.
• 31:11
  And kind of say the same thing if they're saying they hate their brother.
• 31:15
  Bring out, are you angry? Are you angry at him? You're sad about something he did?
• 31:19
  Angry, annoyed. You wish your brother was different.
• 31:22
  All those other things. Hate is not good. Because when you hate,
• 31:26
  then the way you feel better about yourself is by imagining harm to that other person.
• 31:31
  That's a finding. That's in my dissertation, we showed that.
• 31:36
  And if you say I hate them, then it's like you would be happy if they were harmed.
• 31:42
  And that's a bad place to be in about a family member. You don't want to be
• 31:45
  in that place. And say that. So let's come up with a different language.
• 31:50
  Okay. And so keep that conversation going with the child.
• 31:53
  Yeah, like trying to understand the origin of that feeling and then try to rename it something else.
• 31:58
  Dr. David Yeager, author of 10 to 25, The Science of Motivating Young People,
• 32:04
  A Groundbreaking Approach to Leading the Next Generation and Making Your Own Life Easier.
• 32:08
  Thank you so much for being here again today on Pediatrics Now.
• 32:12
  Yeah, thanks for having me.
• 32:15
  I'm Holly Wehmint, and this is Pediatrics Now, brought to you by the Department
• 32:20
  of Pediatrics at the University of Texas Health Science Center and University
• 32:24
  Health's new Women's and Children's Hospital.
• 32:27
  Click on the link in this podcast for free credit that may include CME,
• 32:32
  MOC, or ethics credit, depending on our topic or podcast.