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Psychiatric News Special Report: Digital Hyperconnectivity: A New Psychiatric Framework · The Medical Mind

0:12
When was last time you were actually alone?
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Not alone in a room, but I mean disconnected.
0:18
No phone buzzing, no podcast playing,
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no Slack notification, no TikTok,
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Instagram, no email, no algorithm showing you the next thing.
0:28
No AI ready to answer whether whatever question pops into your head.
0:32
For most of human history, disconnection was the default.
0:36
Now connection is the default.
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And being disconnected takes work.
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And that raises the question psychiatry hasn't really had to answer before.
0:45
Freud and those guys didn't have to deal with this as much,
0:47
right? What does constant connection do to the human brain?
0:51
My guest today, Dr. Nathan Carroll and his colleagues have proposed
0:55
a new framework for thinking about exactly that.
0:58
They call it digital hyperconnectivity.
1:00
And I think this is gonna be a fun one because I am all about this topic being
1:07
the podcast host, Dr. Salonis Murza,
1:09
and also being a YouTube creator.
1:11
at the kick shrink and doing all the social media stuff and being
1:15
a child analysis psychiatrist and talking about screens and social media
1:18
all day long. So, Dr. Carroll,
1:21
welcome to the show.
1:24
Thank you so much for having me here.
1:26
And you know, we're gonna talk about or I'm excited to talk about exactly what
1:30
you said, disconnecting. Hopefully nobody disconnects yet.
1:33
We've got a lot to cover here,
1:35
but ~ yeah, stay tuned. Got a lot of ground to cover today,
1:39
but thank you so much for having me.
1:41
This is something I'm really, really excited to talk about.
1:43
Yeah, I got I got the topic for their this is for our October special report
1:48
for the Psych News podcast, by the way.
1:50
so we got this, came across the PDF came across and I was like,
1:54
this is gonna be something I'm I'm all about.
1:57
So Dr. Carol, tell us a little bit about yourself,
2:00
your background, blah, blah, blah,
2:01
before we kinda jump on into into this topic.
2:05
Absolutely. So I come from a little bit of an electic background.
2:08
I was ~ philosophy degree ~ in in college,
2:13
obtained my philosophy degree,
2:14
became a family counselor, did that for many,
2:16
many years, ultimately went into medicine as a second career.
2:21
I went back to school. But I've always been interested in how these
2:26
~ these environmental forces kind of shape individuals,
2:29
who they are, how they respond to things,
2:31
just just
2:32
How their approach and their perspective on things and
2:35
how the environment influences all.
2:38
Digital hyperconnectivity, tell me about this DHC.
2:42
So what what is this in your in your own words?
2:46
Explain this to us.
2:48
Absolutely. So it's it's a different way of looking at technology
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and what technology does to us.
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Instead of a direct exposure view of technology,
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it's an environmental view of technology.
3:02
So we're we're adapting ~ in ~ environmental toxicological methods
3:09
to technology and how that impacts us.
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So essentially in a nutshell,
3:16
It's the environment of technology when it's in an extreme and what that does to us,
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our mental health and our physical health.
3:24
I just gave a talk yesterday on AI and how AI psychosis and
3:29
all of that fun stuff. And this is one of those proposed mechanisms
3:35
was how AI and connectivity is an environmental stressor
3:40
and a chronic environmental stressor.
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So I was like, this all again lines up with the timing and all this.
3:47
So yeah. So it's this aspect, right?
3:50
Again, like I talked about my
3:52
My background as a child adolescent psychiatrist primarily and how I've
3:57
had to kind of adapt my intakes,
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my intake screeners, right? When I'm bringing people in to be like,
4:02
tell me about social media and not just I think in your article does
4:06
a good choice good point about talking about this,
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not just like how much, but what what and
4:13
how constant and continuous. So tell us about expand on that.
4:17
So why is how much not a good enough question anymore?
4:21
You know, and you phrase it just right,
4:23
it's it's just not a good enough of a question.
4:26
It's part of the equation, for sure.
4:28
The dose ~ is is part of it. But there's other things that go into
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the dose calculation other than just screen time.
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When we when we're two reductionists and we look at just screen time,
4:40
it misses a lot of nuance. There's elements of salience,
4:44
right? There's elements of volume that are not captured in simple minutes and hours.
4:50
If we're looking at two kids and they both spend maybe four hours playing video
4:56
games, which is a lot of time playing video games for anybody,
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but maybe one kid plays competitively and they train to be on
5:04
a competitive sports team with video games,
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and another plays in a very disorganized manner,
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and they they've stopped to taking care of their homework and they don't take care
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of other things, these are not equivalent.
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And so when we reduce it to simply the
5:18
minutes and hours, we're move missing a lot of context when it comes to dose
5:25
and its impact on people.
5:27
Yeah. And in your paper you guys talk about five proposed domains.
5:33
Can you go over those ~ for us,
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for listeners?
5:38
Absolutely, I'd be happy to. So there's five proposed mechanisms that drive
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an individual into a state of digital hyperconnectivity.
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And it's a it's in its state, right?
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So the first mechanism is ~ acute and chronic toxicity.
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So the exposure itself is a toxic,
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~ it there there's an acute toxicity to it,
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right? If I watch a very violent video,
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if I watch something online.
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Which is stressful to me if if I'm a child and it's beyond my developmental stage.
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~ even if I'm an adult, some of these things are pretty stressful to me.
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But beyond the content, the mechanisms themselves,
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the push notifications. Personally,
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whenever I get that ding of an email coming in,
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I'm like, no, what is it now? And I I I've been trained like Pavlov's dogs
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to open it up. And I maybe even,
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you know, in a position where I really shouldn't be opening my email,
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but I'm I'm looking at it, right?
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So acute and chronic toxicity.
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Is the first mechanism. The second mechanism
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is degenerative functional displacement.
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And so what is this, right? Degenerative functional displacement is skill loss
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or the lack of skill development due to technology filling that role.
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a classic example might be maps,
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right? In the GPS. I I live I'm old enough where I I went to AAA and I
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got the trip tick when I went on vacation.
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And I they mapped the whole thing out and I followed the road.
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~ and there was a lot of calculations going into it.
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I figured out how far it was, I checked the odometer.
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There was a lot of other brain power and a lot of other skills I'm using.
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Now, I no longer use those skills because I just listen to the GPS.
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Now, for me, I have the perspective of the before times,
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right? For kids who grow up on this technology,
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they just don't have that skill.
7:32
Right.
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We also
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have developmental reorganization where the overload state becomes the baseline.
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So the overload state, the lack of attention that they have with because like
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~ videos of certain platforms are only a few seconds long.
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So attention shrinks. So the we we developmentally reorganize around
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the state of overload. That's the third mechanism.
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The fourth mechanism is virtual social contagion,
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where
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The individual's capacity for human connection is degraded along with
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the social fabric that would otherwise support recovery from
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the technological exposure. Example,
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right? AI. If I'm going to AI for social interaction and social validation,
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I'm not interacting with other people and I stop forming those networks that other
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people can rely on for social interaction too.
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And then finally, the last mechanism is called iatrogenic susceptibility.
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Where the technology comes in,
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it solves a problem for us, but it creates a harm in the process.
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And then the technology also rushes in to fix the harm it created
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in the first place. A great example of this might be ~ you know,
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you're on videos, you're on Instagram late at night,
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or or you're on some social media late at night,
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right? And you ~ you're you're not going to bed,
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you're not going to sleep, and so you download an app to fix your sleep.
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So the technology creates the vulnerability that that technology goes into to fix.
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All these taken together is a forms a c a closed loop.
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And this is these are the mechanisms driving digital hyperconnectivity.
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Yeah. It's it's interesting. You know,
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the the acute and chronic toxicity really jumped out to me a lot
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in regards to things like, you know,
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I I I think I've mentioned this on one of the previous podcasts,
9:27
but you know, we're looking at things,
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the conflict in in Gaza that's going on and,
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you know, my background is Pakistani and Muslim.
9:35
My wife is very much invested in everything going on over there
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and we're getting our, you know,
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our the news she gets her news feed is,
9:43
you know, unfortunately
9:44
Because a lot of things like around atrocities happening,
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right? And you know, it's just one thing after another,
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one thing after another. And it's like you can't get away from it,
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right? As much as you try to get away from it,
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the algorithm keeps feeding feeding things,
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you know, the these horrible visuals back to you,
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right? And it's like, you know,
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you n again, back in the day you would just have your news hour
10:09
on TV and that was it. Right.
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But now
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Right. You know, that was when you get your news and that's your exposure
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to all this stuff. But now it's like you pick up the phone and it's always gonna
10:19
be right there for you. It's inescapable.
10:22
Yeah. And again, yeah. Yeah, it's inescapable.
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You can't run away from it. And and again to your degenerative functional
10:28
displacement part, you know, part of bringing in the AI stuff a little bit,
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like there's been this great push of like the AI scribes,
10:37
right, to take your notes. Right.
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And it's it's one of those things.
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I've noticed from using it a little bit here and there that I like again,
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I'm like, do I know my patients as much as I did before?
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Cause I yeah, who is this patient?
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What what is this person? What is their history?
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What are they doing? What are they doing in front of me before?
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And it's like I'm noticing this as I start to use this for newer patients.
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I like, my skill is gr going away by using these tools that are supposed
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to quote unquote make my life easier for me.
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And that's that's what happens with these technological innovations.
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They fill a need, but it's it's it's at a cost typically.
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The ~ oral storytelling, right?
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People used to memorize thousands and thousands of pages.
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And there was this oral tradition with a written word,
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we displaced that knowledge onto the paper.
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So there there's a human arc here with the technology,
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with us developing technology to fill a need.
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But at a cost. There's always this cost.
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And we we often get so fixated on the benefit and the need that it's filling that
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we we aren't thinking about this this loss.
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AI Scribe is a great example of of what do we lose in this trade.
11:52
I mean you bring up an interesting point of like how this has been
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the role of technology throughout humanity,
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right? How like this we've always had this and then this you know,
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I always joke around when parents come and say things to me like,
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the kids these days. And I was like,
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you know, we've been saying the kids these days for as long as humanity
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has been around. And I like, you know,
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I remember like somebody had gone through and had like a Twitter post
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or something of like, you know
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throughout all of human history and like of people saying the kids these days like
12:24
back in World War World Wars and then back in like Shakespeare and back
12:27
in like ex it's like the kids these days has always been a thing and it's right,
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you know. ~ but but this cognitive offloading and the t technology and
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how this does this, is this just the newest thing,
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this this aspect of digital hyperconnectivity,
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is this just the newest thing that we're blaming blaming it on almost to an extent?
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I would say we we have been dealing with similar things for for
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as long as humilization human civilization has been around.
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This is an arc of human civilization.
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I do feel that and this might just me living in this time period
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be reflecting the statement, but I do feel this is a bit different,
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unfortunately. The the inescapability of it is just i is so palpable.
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It's sort of like plastics, microplastics are.
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everywhere. We're almost dealing with the technological informational version
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of microplastics. They're in places we don't even expect them to be in.
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The same thing with this digital technology.
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In in times past you could you could escape it.
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There was that disconnecting where you you could move away from it.
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Now it now there's the the asymmetry is so extreme that it is following
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you to such detail you don't even realize it.
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The technology is is is constantly there.
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Pressure is constantly there.
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One of the other things I really also appreciated was when you talked about
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the Goldilocks effect with technology.
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All right. Because I I get again a lot of parents coming into my office being things
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like I don't want them to ever have a phone.
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And I don't want them to ever be on social media.
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And you know, the kids will be in the office and they'll say,
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Well, if I'm not on social media,
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then I'm gonna get made fun of by my friends or I'm gonna
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be disconnected from what's going on.
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So like and it plays out every day,
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right? Like there is you need to have some exposure,
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but then
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Too much is too much, right? Absolutely.
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Absolutely. So the the idea is that we technology is not cigarettes,
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right? And I ask all the all the listeners how many cigarettes is safe for a kid.
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And hopefully everybody's saying zero out there.
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~ to social media is not cigarettes.
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There's a safe exposure and there's a safe amount of usage for the cell phone with
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video games with all this stuff.
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and if we're applying the same thinking to social media and digital exposure that
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we are to
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Cigarettes, we're we're missing,
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we only have half the picture.
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We're missing the boat here. We live in a very connected society.
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Complete absence of connection for kids just does not work.
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It's ~ there there's this challenge right now,
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~ two for 16, where some families will will give their kids $2,000 to ~ go
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all of 16 years old without social media.
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And what I hear back from parents and from kids is that.
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They go back to social media when they turn 17 because of the missing
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out of what their peers are doing.
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Everybody's online. There's there's no closing this Pandora's box.
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There's no unringing this bell.
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So the trick is finding that Goldilocks zone.
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What is the healthy usage amount that improves wellness before it gets too extreme?
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And we keep mentioning kids a lot,
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teenagers a lot, but like it's not just them,
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correct?
15:46
No, no. I I I primarily work in school systems,
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K through twelve. So a lot of my my framework with kids,
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but it's not just kids. It is all of us.
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It is myself for sure. It is everybody.
15:58
Yeah. I you know, I I'm a gamer.
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I've been a gamer for like, you know,
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most of my life. To some you know,
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to some very some variation of gaming most of my life.
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And you know, my my son is at that age now where he's,
16:11
you know, turning what is he turning?
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Twelve, I think. And, you know,
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he's you know, we're trying to we're having the daily fights about
16:18
the Fortnite and it's time to get off the Fortnite,
16:20
time to get off the Roblox. Like,
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we gotta we gotta stop now. It's like he's like,
16:23
Baba, but you play games too. I was like,
16:25
Yeah. I was like
16:27
But I do it when my work is done and all my responsibilities are done
16:32
and then I play it for a certain time and then I'm done with it.
16:35
So it's, you know, that that aspect where it's like we have to know what that
16:39
balance is and you know, part of it is just teaching that teaching that balance,
16:42
right?
16:43
Yes, absolutely. Absolutely. ~ with the with the idea of digital hyperconnectivity,
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there's this idea of there's passive engagement where algorithms,
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tracking mechanisms, pop ups are engaging with us,
16:58
but then there's active engagement where we're learning healthy ways
17:03
to engage with the technology and setting those boundaries
17:06
and teaching those boundaries to kids.
17:08
~ so it's it's a it's a mix of the both,
17:11
absolutely.
17:13
Another interesting part that again really stood out to me is you you
17:17
you brought up the point of again,
17:19
not just timing, not just the hours,
17:22
but how, right? Again and and in regards to like pickups,
17:27
phone pickups. Yes. Right. How how picking up expand on that.
17:32
Ask what t explain, I guess, the difference between like picking up a phone
17:35
a bunch of times versus like these marathon sessions.
17:38
~ absolutely. So it it's it's very interesting.
17:42
There's there's ~ the this concept of salience with technology,
17:46
right? And there's conscious salience,
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but there's also the subconscious salience.
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So active use really reflects you know,
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active use and actively thinking about the technology,
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but it doesn't reflect the subconscious salience,
17:59
this knowledge of the the technology in the room with you.
18:03
There's some interesting research showing that just having a cell phone
18:07
in the room with you.
18:08
Causes you to perform worse on cognitive tasks.
18:11
You're not even picking it up or using it.
18:13
So active pickups is a measurement.
18:17
Active use is a measurement. And they all capture a part of the picture,
18:21
right? really, we though we want to look at the entirety,
18:26
which is the volume of engagements,
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both active engagements and passive engagements,
18:31
the volume of technology in an individual's life,
18:35
the role of technology in the individual's life.
18:38
We have a concept we we don't go into it in this special report,
18:41
but we do talk about it ~ in some other work we're doing with a book
18:46
on digital hyperconnectivity, the concept of the technobiome.
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What is all the technology in an individual's life and how does
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it contribute to their sense of self and their activities?
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And is it a healthy balance? This these questions are probably more important than
19:02
simply all right, how many hours are you spending on Fortnite?
19:05
How many hours are you spending on on ~
19:07
~ Grand Theft Auto or something.
19:09
Yeah.
19:09
Yeah. How about addiction? My other other board certification is addiction medicine.
19:16
And you know, I get it's a one of those things that I again,
19:20
parents come to me all the time.
19:21
My son is addicted to the phones or addicted to gaming.
19:25
And you've done, I think, some work on internet gaming disorder.
19:30
Tell us about yes, tell us about that and then also why that does not quite
19:36
fit this box.
19:37
Yes. So, you know, yeah with addiction,
19:42
and addiction's a label that's thrown a lot around a lot,
19:47
unfortunately. And
19:48
Incorrectly a lot.
19:50
incorrectly a lot, absolutely.
19:52
Really, there is a spectrum, right?
19:54
There is addiction ~ or addictive behaviors,
19:58
which are often ~ you know, characterized by this functional impairment,
20:03
this ~ uncontrolled use despite problems and
20:07
And a host of other factors. And for the record,
20:10
internet gaming disorder isn't even a a ~ it's in section three
20:16
of the DSM5DR. It's not in section two yet.
20:19
So it's it's the only one we have is gambling addiction.
20:22
And so we definitely don't have social media addiction or cell phone addiction
20:26
or so on, right? So the i it's important to keep in mind that the addiction label
20:32
is misapplied.
20:33
Right.
20:35
~ heavy use does not mean addiction.
20:37
And for a lot of people, they exist as much online as offline.
20:42
~ It's just the nature of society now.
20:45
They may have their social connections online,
20:46
their friend groups online. ~ Most of the time they like to spend
20:50
is through video games or making videos or interacting with videos.
20:53
Heavy use does not necessarily mean pathological use or disorder use.
20:59
It could definitely be heavy and healthy use.
21:03
Yeah. I got into like an argument online recently with somebody about pornography.
21:09
Yes.
21:11
Right. And how they were very much like pornography addiction is not a thing.
21:15
And I was like, sure, it's not a diagnosis.
21:17
But like at the same time, like there's absolutely problematic pornographic use.
21:22
Right. And that yeah, I how it can affect lives in very different ways.
21:27
And people like I have people come into my office for that
21:30
for saying problematic pornographic use.
21:32
Right, it's it's very much it can become an issue and it's just that being able
21:37
to know right again where that line is and how much of a problem it comes.
21:41
So
21:42
Right. Which speaks to the need for really digging into the weeds,
21:46
right? With with the the importance of clinicians to really explore what problematic
21:51
means, how it's being used, the context it's being used,
21:54
for for all of these these digital engagements.
21:58
Digital gambling is another one.
21:59
it's
22:01
Yeah.
22:02
somebody who plays cards with their friends once a week and they all
22:05
do get together does not raise a red flag.
22:08
Same red flags to me as somebody who is,
22:10
you know.
22:10
They're taking out loans, they're they're they're maxing out the credit cards
22:14
and whatnot, and they're playing digitally and they can't stop themselves.
22:17
Very, very different.
22:19
yeah. Especially with all these ~ the sports apps.
22:23
You can't, you know, try to watch watch Sunday football and then
22:27
all the gambling ads come on there and just download the apps and it's just trouble
22:32
after trouble after trouble. So
22:34
God, in the prediction markets.
22:35
Prediction markets have me very anxious.
22:37
The ~ the being able to bet on anything is not good for anyone,
22:42
in my opinion.
22:44
Yeah. And and again, part of like the digital hyperconnectivity is
22:48
you can't get away from these ads for them as much as you would like
22:53
to 'cause they're they're there all the time everywhere.
22:56
It's a constant pressure, constant pressure.
22:59
Let's get into like the neuroscience a little bit.
23:01
You talked about tell me about some dopamine and yeah,
23:05
tell me about that. How does that play a role in this whole stuff?
23:08
This the trendy word half dopamine.
23:11
Yes. So, you know, it's it's very interesting.
23:15
We see a lot of similar patterns behind this problematic technology engagement
23:21
and other addictive behaviors,
23:23
right? ~ we we see the same same same sort of cortical activity,
23:27
we see the same brain regions light up with an individual gets
23:33
~ push notifications or likes on social media that
23:37
Do with other addictive behaviors and it reinforces these cycles of engagement.
23:41
So there it's it's fascinating.
23:45
It's I I I will say with a little caveat,
23:48
this field is still developing.
23:50
It's we
23:50
Yeah.
23:51
we need to do so much more research in this area,
23:55
but it the the research is kind of pointing in the direction that this
24:00
is this is affecting us very similar to other other.
24:05
~ addictive exposures that that can reinforce and cause an individual
24:10
to ~ both seek out increasing levels of engagement
24:15
and have a tolerance level that's increased too.
24:19
So it's it's ~ it's problematic.
24:22
And and my big piece of advice is that we we should we should recognize
24:28
it for what it is as a possibly a neurotoxic exposure,
24:32
right? an addictive exposure here.
24:34
And the earlier we intervene, right,
24:37
not giving kids tablets when they're very young,
24:40
not doing these these exposures when ~ bef delaying it as much as possible,
24:46
the the better that is for their brains,
24:48
for their brain health, the brain chemistry.
24:52
Yeah. There's an interesting paradox in a way.
24:57
Like today's teenagers, more access to other human beings than anyone in history.
25:02
Yeah. Like, you know, I have in again in the DC area,
25:05
we have plenty of kids who are like State Department or working,
25:08
they bounce around and they go country to country every few years and it's like,
25:12
I'm sad, I'm gonna be missing Johnny,
25:14
whatever it is. And then those like,
25:16
but I can just pull them up and call ~ right?
25:18
And just, you know, stay in touch with them.
25:20
You know, again.
25:21
Back in my if o back in my day,
25:23
like if you were in that situation,
25:25
like Johnny's gone for life. You're not seeing him again,
25:27
right? Like if you move out of you could maybe write a letter to him,
25:31
but like again, like you know,
25:33
you can't stay connected like w we are nowadays.
25:36
Yeah.
25:36
Right, it's a big loss.
25:38
Yeah. It's person's gone, right?
25:39
But now it's like again, just bring put him on FaceTime and you're all good to go.
25:43
Or keep an eye on Facebook and or social media or whatever,
25:47
and it's Instagram nowadays, not not so much Facebook,
25:49
but you know. ~ same thing.
25:51
They're all sucker burger owned,
25:52
but so they're all again,
25:56
connected, but we're also hearing more reports of like loneliness
26:01
and profound loneliness. So how can these two things coexist,
26:06
hyperconnection and social disconnection?
26:09
Yes, I think the fact that people feel more lonely and we have this epidemic
26:15
of loneliness and people are more disconnected than ever is because they're more
26:19
connected than ever. I I think these things don't actually stand
26:22
in opposition to each other, but one comes from the other.
26:26
When you are awash in connections and connection becomes cheap,
26:31
then it's it's it's it's almost like you have too many choices,
26:36
right? You're there's a decision paralysis.
26:39
And you lose something. It in the past,
26:42
like with Johnny, right? Moving away,
26:44
there was a value in Johnny's presence.
26:47
And ~ finding his phone number,
26:50
calling him up, there's a value in that.
26:52
And suddenly now everything becomes so easy and everybody becomes so close that
26:57
we lose something in that. ~ we go into an analogy when describing digital
27:04
hyperconnectivity about ~ stalking tagger,
27:06
right?
27:07
If you're in a jungle and there's a stalking tagger in front of you,
27:10
it trigger it triggers a reaction that is very different than watching a video
27:15
of a stocking tagger. You lose something through the medium.
27:19
And the current medium that we focused on,
27:24
social media, right? We lose something there.
27:27
And so that something we feel is causing this feeling of loneliness,
27:33
this persistent feeling of loneliness.
27:34
People are
27:36
So connected it it's almost becoming devalued,
27:38
this connection.
27:40
It's too much, right? It's like it's too much.
27:43
I think it was reading Aziz and Sari's modern romance book several,
27:49
several years ago. And he was,
27:51
you know, it was talking about how people are like,
27:55
well, he's a comedian, but he was actually like a sociology degree,
27:57
and he he was or he has a sociology degree,
27:59
and he was talking about how people were,
28:02
you know, f finding love nowadays.
28:04
And that's the the book. And how
28:08
we've noticed that like again,
28:09
people are getting married later,
28:10
~ having lives later, people are like more people are being single longer
28:16
or del not even never getting married.
28:19
And I think that was one of the main hypothes or main kind of outcomes
28:23
of the book was there's too much choice now.
28:26
Right. We have too much choice and we are looking for the perfect mate.
28:30
And, you know, because I think before,
28:33
you know, you were like eighty percent likely or something like it was some
28:37
huge number of like marrying somebody that lived like within a mile or two of you.
28:41
You know, like that's that 'cause that's what your options were.
28:45
But now it's like you have the whole world and you can go on these apps
28:49
and you can find somebody across the country and find somebody down the street.
28:52
And it's like too much choice.
28:54
So nothing happened.
28:56
Right, exactly, exactly. You're you're every choice in the world,
29:00
plus there is a constant sense of fear of missing out.
29:04
If I make this choice, what am I closing the door on?
29:07
And there's this constant pressure to delay,
29:10
delay or weigh options, and people end up weighing options and delaying until
29:15
the point where they've made no choice at all and they feel incredibly lonely
29:19
and cut off from everybody.
29:21
Another thing that you all talked about in the article was these these thirteen
29:28
ingredients of hyperconnectivity.
29:30
Yeah. You don't have to go through all of them,
29:32
but like as much as you'd like to talk to us about these thirteen things that
29:37
we need to be watching out for.
29:38
Absolutely.
29:39
Absolutely.
29:39
So we identified thirteen of of ~ thirteen core elements.
29:44
Now we're not claiming this is an exhaustive list here,
29:46
but this is thirteen common things which contribute to a state
29:52
of digital hyperconnectivity. So that's state of overabundance of of connection.
29:57
And key things with these thirteen elements is that they are
30:02
a combin it's asymmetric. ~ it's a combination of things which are.
30:08
Passive engagements and active engagements.
30:10
So things like algorithms that track you.
30:12
That's asymmetric. You are you are not choosing to be tracked by the algorithm.
30:16
Well, I guess you can opt out,
30:17
but typically the algorithm tracks you and you don't know what it's tracking,
30:21
right? There are things like autoplay where you go to one video
30:25
and automatically goes into the next video.
30:26
And there's things that are really invisible to people,
30:29
like dark patterns. So patterns that design patterns within platforms,
30:34
digital platforms that you're using that.
30:36
manipulate you, ~ manipulate your your browsing behavior against your own interests.
30:42
~ so there there's a tremendous number of mechanisms that we encounter,
30:47
our patients encounter that mold their behaviors.
30:51
it's it's fascinating and very frightening,
30:53
honestly.
30:55
It's, you know, that that Netflix documentary about the social media stuff that came
30:59
out a few years ago, again, it it visualized and said out loud all the stuff that
31:06
I think that people were afraid of.
31:08
They that they subconsciously kind of like know or they knew that like this stuff
31:13
was happening, that like, ~ this these things are designed to hijack us.
31:18
These things, these social media stuff are designed to like
31:22
we knew that subconsciously when we're using them.
31:24
I was like, I know I can't put this down for a reason,
31:26
but it's like, no, when you like hear people talking about how it's like,
31:30
no, these were i you know, if very d you know,
31:34
decisively directly designed to do that,
31:36
like it hits a little harder. It hits a little harder.
31:40
And and the the real the real thing that really gets me is most of this,
31:46
most not potentially all of this,
31:48
was designed from a place of filling a need.
31:51
The engineers for this said, you know what,
31:53
people would really like it if we gamified everything,
31:56
if we made everything frictionless.
31:58
Yeah. If if we made infinite scroll a feature.
32:02
Like people really want that. And so ~ you know,
32:06
it came from a place of bringing something into the world,
32:09
which was helpful.
32:10
And it turned out to be something which which harmed us.
32:13
It was an unintended consequence of this design choice.
32:17
It's you know, we weren't we weren't ready for technology.
32:21
Yeah. Yes.
32:22
It's it's like we're we're playing out all of the eighties and nineties movies,
32:26
all those ~ dystopian movies of,
32:29
you know, Terminator and the Matrix and we're we're following the pathway,
32:32
right?
32:33
We pretty much are self fulfilling prophecy,
32:35
maybe a little bit of the eighties.
32:36
Yeah.
32:38
So another thing that I really liked from the article was the this the DHC eight.
32:45
So which again, not of not a validated thing yet,
32:49
perhaps. But tell us about what is this DHC eight and what should we
32:53
be looking for in general as c for clinicians and for people who
32:56
are not clinicians as well.
32:58
We we developed this screener.
32:59
We're calling the DHC eight, which i i you're absolutely right,
33:03
it's not validated yet. We haven't put it through the rigorous studies.
33:06
That that's that's ~ something we we want to do next.
33:09
But it is mapped to the mechanistic those five mechanistic domains
33:14
I mentioned before, the utility,
33:17
the degenerative functional displacement,
33:19
the ~ dependency, the acute and chronic toxicity,
33:23
the itergenic susceptibility, the devi developmental reorganization.
33:28
the the social contagion. All of this is mapped to questions in the DHC eight.
33:33
And the idea of this screener is that it can be used by clinicians
33:39
to really dig into where the the breakdowns are occurring,
33:44
where the unhealthy patterns of engagement are occurring.
33:48
So ~ you could go through this DHC eight with a with a patient,
33:53
with yourself even, and see like where where
33:58
is the patient getting tripped up.
33:59
And I've been I've been rolling this out a little bit with
34:02
my clinical encounters and it leads to some really rich conversations about
34:06
the role of technology in people's lives and where there's work to be done.
34:12
And if someone screens high on like the D H C A and you know,
34:17
you run it through them and you're like,
34:18
~ this is a big number, what what does treatment look like for that person?
34:23
Instead of saying like, you know,
34:24
just don't use your phone, right?
34:25
You know, like for people with anxiety,
34:27
tell them to just worry less, right?
34:29
We can't just do that. Very right.
34:31
What do we do in this situation?
34:33
~ so it it begins with with looking at the role of technology in their life.
34:38
Like, why is the heavy use, why does it exist?
34:42
Why is it occurring, right? This is a really ~ important question.
34:46
People don't just stumble into technology,
34:49
they grow up around technology,
34:51
it becomes very important to their functioning,
34:54
you know. But why why is it so high?
34:57
And what can we do to disconnect in a healthy way?
35:02
And the research shows that even a short period of disconnecting,
35:06
a digital detox is just a couple of days,
35:08
lowers ~ things like heart rate,
35:12
it improves sleep, it improves focus.
35:14
It doesn't take a lot to get back to to pull it back and make it healthy again.
35:19
~ but it it this stem scoring high kicks off a much more detailed conversation
35:25
about why it's so high and what that looks like.
35:29
Yeah, it's it's when I talk with parents again when again they bring
35:35
in their kiddos and they say, Well,
35:36
he's playing Fortnite for twenty hours a day,
35:38
it's like, well, what are they getting from it?
35:41
Right. What is the thing that Fortnite is doing for them?
35:44
What are they getting away from at home?
35:47
Are they what are they achieving over there that they're
35:49
not achieving somewhere else? It's like it is again like that that richer question,
35:54
next level question of like, what is that doing for them?
35:58
Absolutely. And the next level question is where the value is.
36:00
Just noting that they scored high is is not,
36:03
doesn't move the needle anywhere.
36:05
We don't go anywhere with that.
36:07
~ we have questions like, do you feel uncomfortable when you're away from your phone
36:11
or your device? Like that is such a rich question.
36:14
I I was at the annual meeting in San Francisco,
36:17
after leaving it, I was driving down that ~ coastal highway,
36:20
the the Pacific Coastal Highway.
36:22
And we hit a point where there was no cell phone reception for hundreds of miles,
36:26
right?
36:27
And I felt it. I felt the lack of connection.
36:31
Like it was this fe I never the pressure,
36:34
I had become so used to the presence and the pressure of connection that when
36:39
it was gone, I could feel its absence.
36:41
And that that spoke to me at that moment.
36:44
I was like, ~ wow. ~ or the ~ and I see this a lot with adults,
36:49
needing the television on when they go to sleep,
36:53
playing things in the background.
36:55
Very common.
36:57
Because they they've ~ again, that developmental reorganization,
37:01
one of the mechanisms of digital hyperconnectivity,
37:03
they've developed around the the baseline ~ exposure,
37:08
the baseline noise, that constant salience of that noise becomes their norm.
37:12
And when it's gone, it becomes uncomfortable and they can't sleep.
37:16
It's scary. So I can hear the critics of psychiatry already popping up,
37:21
right? And saying things like,
37:23
Look at these guys. They're trying to take over and medicalize modern life.
37:28
And this is just how things are.
37:30
So at what point are we saying like this is pathology versus simply describing what
37:36
life is like in twenty twenty-six?
37:39
That is, and you know, that is a great question.
37:42
And it goes to the heart of why we've we've ~ we've been very careful
37:46
to say that there's really three states here.
37:48
Digital hyperconnectivity is just one of them.
37:50
There's that Goldilocks zone with healthy use.
37:53
And then there's digital exclusion,
37:56
where you are overly disconnected and there's an asymmetry there too,
38:00
where you you just don't know how to engage with the devices and
38:03
it lowers your wellness. Where it becomes a pathology is where
38:07
it starts impacting their functioning.
38:09
If you're are fine with it without a cell phone,
38:11
if you're fine with the cell phone,
38:13
there's no functional environment.
38:15
There's nothing for us to do there.
38:17
Great. You're you're you're you're managing it well.
38:19
You're in the Goldilocks zone.
38:20
If there's a functional environment,
38:22
if you feel more depressed and more anxious and more worried and
38:26
you find yourself obsessing on things and not being able to turn away from things,
38:30
if you find yourself picking up your phone and you're not even thinking about
38:33
picking up your phone and mindlessly scrolling,
38:35
then I start to worry about a pathology there.
38:39
The last thing I want to do is pathologize normal life.
38:42
That's that's not the goal. The goal is the extreme end when
38:47
it starts impacting people.
38:48
Yeah. And one of the last couple of things,
38:51
I know we we touched on it a little bit,
38:53
but like at what point is individual behavior a problem
38:58
~ that's one way that people can say,
39:01
but at what point do we say like do we have to kind of look back at the platforms?
39:05
You know, and really point the finger back and be like,
39:08
This is on you guys, like you've done this to us almost.
39:12
Yes.
39:13
It's it's it's hard.
39:15
It's hard. It's it's really hard.
39:17
~ I would say actually we start there.
39:20
if we if we're going to view digital exposure as an environmental exposure,
39:27
we need to look at where that environmental exposure is coming from.
39:30
~ and we need to look at what decisions,
39:33
like those thirteen components of digital hyperconnectivity,
39:36
are intentionally being made that increases ~ unhealthy exposure.
39:41
And then we need to hold the platforms responsible for
39:45
dialing back and putting more safeguards in.
39:47
The the idea is not elimination.
39:50
The idea is harm reduction. And what what do we do mechanistically that furthers
39:56
the goal of harm reduction? I would I would put it on the platforms right away.
40:01
They they really they really hold the incentives for unhealthy usage
40:06
and they're the ones who can move the needle the most towards healthy usage.
40:11
Yeah, I think we're seeing some dips into like a reckoning.
40:17
You know, this social reckoning movie is coming out.
40:19
~ there's other kind of the lawsuits.
40:22
There's a constant barrage of just like I feel like there's always
40:24
a lawsuit against these big corporations and stuff that's going on.
40:28
It's like s stuff is happening,
40:30
but it's like I think we have to always take that other look and be like,
40:34
no, these this is again something that's been placed on us.
40:37
Kind of like I think what you described,
40:38
like the toxins and
40:40
You know, I again grew up in all upstate New York and GE power plant and you know,
40:44
dumping PCBs in the Hudson River was a big thing back when I was in college.
40:48
And, you know, like all these again,
40:51
the toxins, the microplastics,
40:53
like you mentioned, they're they're there,
40:54
right?
40:55
Right. I think this is our technological microplastic moment.
40:59
I don't think it's our big tobacco moment.
41:01
I think it's our technological microplastic moment.
41:03
I think that's the analogy I wanna go with.
41:06
that that that's a nice way to kind of describe it.
41:09
So all right, Doctor Carroll, last question I was asked before letting
41:13
you letting you off the hook and for me to go back to my evening clinic
41:16
in a little bit, but is how do you how do you disconnect?
41:20
What is your preferred method of disconnection?
41:22
I like to go on long runs. ~ I'm a big,
41:26
big runner. I will just go out and I will lose track of time and people will have
41:31
to try to find me while I'm out running.
41:33
The ~ it's it's it that's my big way of disconnecting.
41:37
I I go out there and here's here's a point on the balance.
41:41
It's not that I completely disconnect.
41:43
I still track my my myself and my watch and my phone and things like that.
41:48
~ but I'm able to focus on my run.
41:52
And I stopped thinking about the phone and I stopped thinking about
41:54
all this other stuff. So that's my big disconnecting technique.
41:59
I was gonna say like make sure you have one of those air tags.
42:02
Don't get yourself too too lost on this.
42:04
Yes.
42:05
Where am I now?
42:06
Good. All right. Any other kind of like big parting last kind
42:12
of takeaways for the audience listeners?
42:15
Yes, I, you know, I I'm very excited about this framework that's coming
42:20
out in the October special report in psychiatric news.
42:25
Please reach out to to me and my team if you have any questions.
42:28
Always happy to talk to people about it.
42:30
because we see this shift in perspective from looking
42:36
at technology exposure like the cigarette direct toxicity exposure
42:41
to an environmental exposure.
42:43
As absolutely fundamental to approaching technology the right way.
42:48
From this comes policy changes,
42:52
policy recommendations, comes accountability for the exposure.
42:57
Everything shifts. It's like blaming people for their microplastic exposure versus
43:03
blaming the companies that produce the microplastics.
43:06
We we we have to we have to get this we have to get the scope right.
43:11
And this is a step that direction.
43:13
So we're very, very excited for it.
43:16
Yeah. Awesome. Well, thank you so much for joining us.
43:19
Thank you so much for this article.
43:20
I know it's very topical at this time.
43:23
So and you did my sign off for me with getting us with the October edition
43:28
of Psych News Special Report. So make sure to pick that up and read that.
43:32
And we will see you next month.
43:34
Thank you.