 I'm Bryn Gefford. I'm the Dean of Libraries here at the University of Vermont. And I also have the privilege of chairing an inaugural committee that was just established this year to guide the Presidential Lecture Series at the University of Vermont. And this BRAC lecture today is one of the four lecture series that are now part of the Presidential Lecture Series. And the plan that the university now follows is to each year, choose a topic and to structure all of these lecture series around that topic. And this year's topic is social media. So the BRAC lecture is bringing in experts on social media from various fields with various interests. Today is the third and final BRAC lecture of the year. We've saved our best speaker for last, Dr. Steve Schlotsman. And you are not going to believe this biography. I want to start by saying I am not making this up, as Dave Berry might say. Dr. Schlotsman has three main appointments. He is the Director of the Vermont Center for Children, Youth, and Families. He is also an associate professor at UVM's Lerner College of Medicine. And he is the Chief of the Division of Child and Adolescent Psychiatry at the University of Vermont. He most recently came to us from Dartmouth. And I am quite proud of whenever UVM manages to snatch people away from the Ivy League. He was for a good while Director of Child Psychiatry at UMass General. And his research focuses especially on stigma surrounding mental health. Now, here's the less known part about Dr. Schlotsman, perhaps. He has a side career as a novelist. And he is, in fact, the author of The Zombie Autopsy's Secret Notebooks from the Apocalypse. And I learned recently that George Romero has actually optioned one of his books. He serves as a board member on the University of Pittsburgh Center for the Study of Horror. He has a TED Talk on this subject that you can find if you do some googling around YouTube. So today's topic, social media and kids, what could possibly go wrong. So welcome to, so glad to welcome Dr. Steven Schlotsman. Thank you very much. You all can hear me. OK. I did write a zombie novel. I'm happy to talk about the zombie novel at a different time, although I will mention it here. It has to be mentioned because of one of the disclosures. And George Romero did option that novel. He has since passed away, but he was an important mentor of mine and actually had a few words to say about social media. But what we're going to do today. So I'm the final speaker on this topic. And I want to thank the University of Vermont and the folks who make this lecture series possible. And also just what a great place for me to have arrived. I got here in September and the opportunity to think out loud about really complicated topics in a civil way. Topics that really bright people powerfully disagree about I think is really special. And it's been emblematic of my time since getting here. And I'm just so grateful. Like it bums me out that it took me this long to find the place. But I'm really glad that I'm here right now. Oh, I keep doing that. That's right. It'll go to sleep if I don't do that. So I can hit it. I'm not going to hit it. So the reason this is a sort of complicated moment for this talk is one of the talks took this kind of libertarian approach. It was, hey, anything goes. Who are we to say folks can't use social media? Who are we to manage it? Maybe we can't even manage. But it was more like we shouldn't manage it. Another one of the talks, all really great, said, hey, this is pretty bad. It's pretty bad for kids, for adults, for humans. So maybe we should just get rid of it all together. I'm not going to take a stand. I'm going to try and complicate our thinking about this. This is not meant to be a polemic. I'm going to sort of present you with the data. We're going to think out loud, and hopefully we'll have some time at the end for some questions and more actually discussion about what do we do with this very, very powerful technology that has both some good stuff and some bad stuff. In keeping with the things I really like about UVM, when they first asked me to give this talk, I gave them one title that I thought would be the title, having spent most of my career a couple years at Dartmouth and for that a long time at Harvard, which are a little bit stodgier. And I called it something like positive and negative aspects of social media and children and adolescents. And I said, or you could call it social media kids. What could possibly go wrong? And I was even kind of cheeky. And they're like, let's go with the second one, which is awesome. So it sort of set the tone for what I like about being here. We have to do disclosures. It's tough to figure out with regard to social media because social media is everywhere. And the guidelines for the university and for most universities are anything that you've done that show up on social media. You got to mention, I have written two novels. The first one, the zombie autopsies, the horror novel. That's the one that Romero optioned. And it still sells. It does well or well-ish. The second novel, Smoke Above Tree Line, I self-published it. I think dozens of people have read it. Literally dozens, probably not more, maybe 14, 15. And then some nonfiction book about the overall benefits of health or of film to health. And then more recently, literally today, we met with the Hogra publishers and myself and a couple of the fellows in our department, which I'm so excited to be working with them on. We're going to publish a book about depictions of pediatric mental health in film, both on screen, like streaming stuff, as well as on the big screen. And all of that, we'll have a social media presence as well. Why are we having this discussion? Well, this is like that part of the talk of every talk where they tell you everything you already know, but it got us at the stage. So social media has been associated with a host of challenges in the United States and pretty much everywhere else. And if you look at the literature, just over the weekend when I was updating the literature as best I could, there were studies from Vietnam. There were studies. There's two separate studies from Iran. Iran has a very vibrant psychiatric literature world. So there's a ton of really cool stuff coming out of that region of the world. Lots of stuff from Africa. Pretty much everywhere anybody's looked at social media and its effect, especially on teenagers, young teenagers, into adolescents, into what we sometimes call transition-age youth or people, college kids, and a little bit older. We've seen that there's been some downsides, some pretty correlative downsides, meaning it's hard to sort of say that it's the absolute cause. But we know that when folks are exposed to social media, what at least correlates with that is them feeling not so good some of the time. It's also been associated with some health benefits. And it's important not to lose sight of those. And I think the real task ahead of us as a culture, really, is to figure out prospectively, like to be able to know who's going to be at risk with social media and who's going to be at less risk and how we mitigate those risks. And the reason that matters is I don't think it's that practical to just have it go away. These are, you know, a bazillion dollar companies that actually think they do some good. The money, it's hard to make money go away. So we need to think in a practical way about what we're going to do about this. And these are debates that are happening in legislatures all over the United States, as well as all over the world. It's happening in the Vermont legislature right now as we speak. As I said, these are all correlations, whether you do better or worse with social media. They're not caused, but still you gotta wonder. There's this famous graph that goes around for anybody who's advocating for less access or less time on social media that looks at the ubiquity of cell phone use in mostly the Western world, but since then it's actually grown to be most of the world. And given that social media comes through cell phones, the cell phones themselves appear to be associated, or at least the acquisition of a cell phone, appears to be associated with worsening overall mental health. And we do know, and we have a crisis that was in pediatric mental health. There was a crisis before the pandemic. The pandemic made it harder perhaps because people spent more time on social media, but we can't say that for sure. We have to be really careful what we say because when we're legislating, when we're creating policy, we don't wanna say things that we can't kind of put ourselves behind because then it'll get taken down. But it does make you wonder, how do we regulate something that feels like an extension of the self? And this is not like my idea that the phone is an extension of the cell. This is all over the literature. People think of their phones. I'm sure everybody in here who happens to have a smartphone with them is aware of right now where that smartphone is on their body. Mine's in my pocket. I know exactly where it is. And there's a huge literature on this. People talk about this as the kind of major stage of the singularity, that point where technology and being human kind of become intermingled where there's no clear boundary. You're in the early stage of the singularity where like a watch, right? Like I don't really know what time it is, but I say, yeah, I know what time it is, but that's because I have a watch and I can look. But I integrate that into self. The cell phone now has become an extension of the self. So how do you regulate something? It'd be like regulating someone's hand. Like how do you regulate somebody's use of their hand in a school setting, in a government setting, in a personal space? Ironically, when I went to look for an image of the cell phone as extension of self, the best image that I could find that was under the fair usage guidelines was generated by AI. So in this world of social media and technology, the best image I could get of the cell phone representing something that makes me a little bit anxious, that the fact that I know where my phone is right now all the time actually came from an AI generator. And it's not a reach to sort of see what this is. This is a, importantly, it's not a kid. It's an adult, obviously, who's surrounded by all of the various icons that represent the different social media platforms, holding his phone and panic choking. Like it's not a pleasant sensation. As in a site, I teach an undergraduate course on coming of age films that we sort of tied to neurobiology, but I took time out yesterday with the students to talk about their experience of social media. They didn't feel about it like this. They said it was rough for them in middle school. Just keep this in mind. It was rough for them in middle school. What my age would have called junior high what they call middle school now. They kind of found themselves not feeling so good about their self image. They backed away from it as they made their way through high school. And this is a bias sample, right? Because people signed up to take this course and maybe there's something about them that would make them put their phone off to the side. But then when they got to college, here, many more freshmen, they found themselves back on social media actually undoing the fear of missing out. So that FOMO that we read about for social media for them actually was made worse by not being on the cell phone because all the clubs, all the announcements were available to them on these social media platforms. So they joined in and then they learned with their slightly larger brains, which is literally what happens when you become older to how to regulate that time. So I wanna plant in the back of everybody's minds that the policy makers, what should drive our rules about this shouldn't be me. I didn't come of age with this stuff. It should be my kids. It should be people who have never not known this. My kids are 18 and 23, 18, 24, sorry, 18 and 24. So old enough to have not really not remember a time when they didn't have these things as options. They're the ones who are gonna tell us how to manage this. Same thing happened with the telephone, same thing happened with the automobile and we'll give some examples of that at the end. So that just sets the stage a little bit. I also wanna remind you that these worries have been part of popular culture for a long, long time. If you're a kind of science fiction nerd like I am, it's not a reach to sort of think about books that talk about always being hooked up, always being kind of somehow interfacing with a larger mainframe computer. M.T. Anderson wrote a book called Feed. Anybody know? I'm just curious if he's read that book. He's a great YA, he was one of the founders of the YA fiction scene. In Feed, everybody, when they're born, they get a device that's put into their head and the internet goes directly into their brain so they can surf the web just by thinking. And there's one character, the protagonist. She decides she doesn't wanna have this feed into her brain, but because of that, she's kind of on the outside. Because everybody else has it. So it's a nifty metaphor for social media. If everybody's on social media and you're not, that can be a problem too. But it also has the opening line of the book which is actually a little bit famous. It's about the spring break, where the kid's spring break, it's been their spring break and they say he went to the moon to have fun but the moon turned out to completely suck. And his worry was that if you could access, this was in 2002, if you could access this material all the time, at any time. This was before smartphones were as ubiquitous as they were. But you could access it in his world through the mind. Then they went to the moon, this incredible thing, this thing we just saw block out the sun. And yet, what did they do? They're bored, the moon sucks. So they buy a lot of clothes at J. Crew. That's what happens in the novel. They go online, they surf the web, they play some Tetris, and then they come back down to Earth again. So it was this sort of cautionary tale about having all of this stuff out that you doesn't kind of give your mind a chance to rest and to appreciate something as awe-inspiring as a zero-gravity trip to the moon. If you wanna go back even further, one of my favorite novels, kind of a cyberpunk novel, Neil Stevenson wrote this book called Snow Crash. It's about something he called the Metaverse because this was 1992, there was no internet. I mean, there was an internet, but nothing that any of us were really in any kind of big way experimenting with. In Snow Crash, nobody wants to live in the real world. They all wanna live in the Metaverse and so there's a sentence about this character, a hero who actually lives in a 20 by 30 box car, but in the Metaverse, he has a mansion. So why would he ever leave the Metaverse? Why would he ever log out? So these concerns, I mean, if anybody watched Star Trek Next Generation, why would he ever leave the holodeck? I know these are very dorky questions, but they're questions I think that are relevant to this kind of technology and this age of technology as we enter into it. They're not new concerns. They've been going on way before 1992. They've been going back arguably to the turn of the last century even and before that. So here's our objectives. I'm gonna give you a brief description of child and adolescent neurobiologic development. That's important because we're saying that social media has either risks or benefits for kids and we gotta define kids and it's important to define what kids' brains are like at that point. We're gonna look at some data also that supports both the positive and the negative aspects of social media and that's important too because I don't think it's so useful to think about this in a dichotomous way, like this part's all good, this part's all bad. I think it's better to say it depends on the kid. For some kids, this is good, for some kids, this is bad and that actually complicates our thinking a little bit but also makes it harder to set policy and then we'll go into what folks have recommended for best practices and best is in italics or with the asterisks on either side. In part because it's hard to know what best practices are. We're flying this plane as we build it so it's hard to know exactly what's gonna work and we're gonna mess up a little bit and I don't think we should hold ourselves super, we should hold ourselves accountable but we shouldn't beat ourselves up for messing up. We should be able to pivot, make changes, figure out how to use this and most importantly, as I said earlier, turn to the people who've grown up with this technology who've had to adjust to it in real time. Okay, so neurobiology piece and I apologize for the folks who already know this but also for the fact that this is massively oversimplified but this will meet our needs. Generally speaking, as kids grow, there's this logarithmic increase in their development. We know that, that's the nature of child development. You get to be around 26, 27, it starts to level off and with that logarithmic change are changes in brain development. What you see are neurons themselves are very roughly the content carrying aspects of the brain, they actually start to disappear to make more room for the white matter. Neurons are gray matter, they're making more room for the white matter dendrite axons, that creates a neural network. That leads to abstract thinking. So when you're younger, one neuron connects to another neuron connects to another neuron so A goes to B goes to C goes to D. As you get older, certain neurons, evolution actually picks those neurons to go away. There's apoptosis, they die and when they die, you lose a bit of content but in losing that content, you make more room for more connection. So A can go to C, you can back to D and over to Q. That's what abstraction is. That's why we have kids read the Odyssey not in fourth grade, it's not because of language, I used to teach high school English. The language isn't hard in the Odyssey but the concepts are hard. Why would Odysseus plug his, you know, sailors up, plug their ears up with wax, not let them hear the siren, but Odysseus requires himself to hear the siren. What is it about Odysseus? Is that grandiosity? Is that a test? Has he been put through something by the gods? Why doesn't Odysseus get to go home? These are more abstract concepts that require a more advanced neural network. These changes happen exponentially fast. Anybody who has had kids or teaches kids or works with kids is always taken aback, at least I'm always taken aback, stunned odd really by how fast these changes happen where kids make these incredible leaps of logic that are directly correlated to these kinds of brain changes. Pictures worth thousand words. So we're gonna do a couple pictures here. At one point, these were timely pop culture references. Right now, they're dated pop culture references because they're from my kids growing up but these are two, the same celebrity, different ages, ages 10 to 13 and I'm showing you these photos and you might even know who they are, feel free to yell it out. I'm showing them to you because the difference between this person when she's 10 versus this person when she's 13 is market. It's huge and sometimes we don't see that unless we look at the two pictures next to each other. That matters because we can assume that if she's going through those changes, which were a function of puberty, also her brain has changed in the way that I just talked about so those neural networks are forming. So anybody know who that is? Just curious. Or what movie? Yes? Can you do the movie? Yes, can you do the movie? Jack Black. School of Rock, okay, we got two. That is Miranda Cosgrove in School of Rock. She's 10 years old and here's Miranda Cosgrove and it's not fair for me to say what show is that because it says it's I, Carly. Somebody got really excited about seeing I, Carly there. That's I, Carly, my kids loved I, Carly. She's only three years difference here and she looks completely different. So this is an important thing to keep in mind that the rate at which kids change, the rate at which their brains become capable of that increased abstract thinking, which is associated with these changes that come with puberty happens very, very, very quickly except for the boys, the poor boys. So this is what makes teaching middle school so challenging. So anybody recognize that guy and that TV show? That's really dated, but I love the show. Fred Savage, thank you and somebody else said it. Wonder Years, that's Wonder Years, that's Fred Savage. Here he is 12 years old. He's looking at the love interest on the show. Winnie who obviously towers over him and here is Fred Savage at age nine. In what movie? Anybody know? Princess Bride, you're really good, you know your movies. It's one of my favorite films ever. So this matters because he looks exactly the same from age nine to age 12 here. So making policy about kids this age is really, really hard to do because biologically individual kids are different and there tends to be a lag for boys versus girls. Girls tend to start puberty earlier. It had been getting earlier every year and now it's leveled off a little bit and we can talk at a different time about possible reasons for that. Whereas the boys don't change quite so much. So until later. So the boys when they're in middle school look like they're nine, the girls can look like they're nine or they can look like they're 17 and it's a really confusing time for everybody that makes social media that much more confusing as well. The generalizations about these two age groups are hard. And all of this begs really interesting questions. Questions that have gotten a lot of time in the popular press but are worth thinking about. If you have this rapidly developing brain, if you have more cortical connections, if you have a neural network in your frontal lobe that's bigger than it'll ever be when you're 17 years old, which is true by the way. It's bigger than mine, it's bigger than any adult or not adult but older than 26, 27 in here. And why do we do dumb things when we're teenagers? And that's been a question that people have often wondered about. Like why is impulse control so off that we're likely to do something that if we had two or three more seconds we probably would resist doing it. And many adults, although we know adults also have their moments, but generally speaking, many adults don't do these same dumb things. It also actually answers a really interesting question which is an aside. Why do we remember lyrics to songs when we don't remember what we learned in US history? I could hear, look, the total eclipse happened on Monday and I couldn't help but be singing that terrible song, the total eclipse of the, I'm sorry, I'm not gonna sing it up here. It was a terrible song and I knew all the words. I couldn't, I hadn't listened to that song in at least 25 years and I knew all the words. I don't remember anything from AP US history. Why is that? Because my brain made a decision. When it was getting rid of some neurons to make room for those connections, it had to decide what information to jettison. And so you jettison the stuff that actually doesn't have the same amount of affective valence, doesn't have that emotional connectedness. And that's because evolution says that you're much more likely to get a date to the prom. If you know those lyrics to a song, then you are from US history unless you happen to meet that person in US history, he's really into US history and then you're gonna hold on to that more. These are really interesting things about development and they're kind of vexing for parents and for adults but if you're like a recovering adolescent which is what I am, they make a lot of sense. Like you remember these song lyrics and you kind of wonder why it is. That's the neurobiology that's going on. Why do we do these dumb things? Well, there's two aspects that we should talk about and this is very pertinent to social media because these are the ways that the brain evolved as you're entering adolescence and making your way to young adulthood that are actually necessary for you to leave the home to take the risks. One is that the brain myelonates from the bottom up. So myelin is the protein that sheets the axons and the dendrites allows it to efficiently send signals from the neuron from one neuron to another. The better insulation you have, the more efficient that signal can be. The efficient signal sending happens first in the lower parts of the brain down here in the fight or flight region, the amygdala region. The region's filled with things like lust, wants, desires. Your cortex is really well developed but it's not well insulated. So as much as your cortex would like to get in on the picture, your frontal lobe, the part of your brain that's responsible for stopping you from doing something dumb like posting something that you shouldn't post on social media, it can't do it as fast as that more primitive region can act because it's a more primitive region that comes online first. It's better insulated. And then you tie that to this concept of neurosynchrony which is a really cool concept. It's basically, it's kind of like sociobiology if you have two organisms with brains in the room being exposed to the same stimuli. At a certain point, let's say you could connect transducers up to those neurons and listen to those neurons fire, you can hear a noise and that noise for adult versions, they do this with mice. So kind of the equivalent rats or mice to adult humans is rhythmic like that. Whereas if you have two teenagers exposed to the same stimuli, everything's asynchronous. The teenagers themselves are asynchronous and they're not in rhythm with one another. So what they're experiencing is quite different than what adults are experiencing. And it's very hard for adults to predict what a teenager will feel in a certain setting. It actually has made me think like nobody's ever decided that they like death metal music when they're 45. I've never seen like a new fan of death metal music at 45. But you get into death metal music when you're 14 because it's asynchronous. Your brain, it actually matches up your brain's rhythms. This is very pop science. I can't prove this. But I just wondered like I missed out on death. I was listening to Grateful Dead stuff. I was not listening to death metal. But I had friends who were really into death metal. Why their brains maybe were more in sync with the asynchronous of that actually pretty complicated music. So that's your neurobiology. That tells us that the adolescent brain changes very quickly in its changing. It has the capacity to think of really clever things like really offensive memes. And it has the lack of capacity to stop itself as much as it would like to from putting those memes online. That's the perfect trap of social media with brain development. But it's also some of the ways it can benefit brain development. That leads us to talk just for a second about emotional and cognitive development of kids. We know that the potency of emotional thinking mixes with social media. We know that. So the more emotional you are, the more likely you are to respond to social media in a certain way. And the more emotional the message of the social media is the more likely you are to feel emotional. So it's a bi-directional thing. We also know that young adolescents, or adolescents generally speaking is about identity discovery. That's what Erickson taught us, a developmentalist. He said, look, when you're getting to be 16, 17, 18, 19, 20, you're trying to figure out who you are, what your identity is, and you do that at the risk of actually having confusion about who you are. If you don't start to nail it down around 17, 18, 19, 20, something like that, then you actually don't quite know where you end and someone else begins. Like you don't have good boundaries, self other boundaries. Gil Noem, who was a, he's still around, he's a scholar at Harvard who worked with Erickson, said actually early adolescence isn't so much about identity formation, it's about belonging. He called it the psychology of belonging, and if you wanted to phrase it in Ericksonian terms, he talked about it as inclusion versus exclusion. So when you're in what was junior high for me and some of you and for everybody else was middle school, it wasn't about who you were as an individual, it was about what group you belong to. It's why popularity matters so much when you're sixth, seventh, eighth grade. And that's why it's actually kind of an empathic failure. If a kid comes home from school and says to their parents, nobody likes you, I'm not very popular, and you say, oh, don't worry, you'll meet more people. It doesn't matter, there is no other time. That is, they live in that moment. At that moment, they're not popular. So interventions, which could go through social media to help kids at that age would be to create cohesive groups. And that's some of the stuff we're interested in at the VCCYF, like how do we create a sense of belonging for folks as they make their way into individual identity formation? All of this though means that teens are more likely to post information online that they might not have done if we could just slow their thinking down. Just a little bit. This is what we do in the emergency room all the time. If a kid comes in screaming, we don't scream back because then it's just one primitive brain talking to another primitive brain. We talk softly, and we talk softly. That gives the higher brain a chance, even though it's less well insulated, to get in on the picture, to actually have a discussion with you. And as I pointed out, adults, sometimes even people who run for president post things that they probably shouldn't. Far be it from me to make a political statement. There will be no more of that. So what are the effects of social media on kids in that lessons? Before we do that, we gotta define social media. There's been a relatively consistent definition of this term that's going back to the early 2000s, or I guess early 2010s around that. Basically it's an interactive, internet-based application, which summarizes, it goes through the internet, like it crosses and goes to billions of people through this amazing, magical thing that didn't exist when I was in residency and then suddenly did exist by the third year of my residency. It's user-generated content, which means it's the people who go on the social media the ones who create the content. It's text, photos, stories, movies, videos, but it's not managed by the users. It's managed by the platforms themselves. So the content is maintained by these big companies by Instagram, Facebook, I know Facebook is all about, whoever happens to own these companies are the ones who manage that. And at its best, at its most aspirational, what social media does is the platforms connect up the people who've gone on using either AI algorithms or just in the early days, just looking at it and saying, this person is interested in being in a model rocket club and wanting to fly model rockets, and this person is, and they live within a 15 mile radius of each other, so let's put them together in a group and then they can find a group, then go hang out with each other. That's its most aspirational. The least aspirational part or the part that they I think would like to not admit to but definitely happens is the kind of bullying and ganging up that can happen because if these people are all connected and they have intimate knowledge of one another and remember the platforms aren't free and that's an important thing to keep in mind. We think they're free because they show up on our computers but there's data there and they're selling our data and the data's really, really, really valuable. So one of the downstream things which I'm really interested in is like, how do we recoup some of those dollars from that data because maybe we could use that money to actually better regulate our use of social media to sort of affect policy. And I'm not sure where to go on that but a lot of people are looking at that, a lot of legislatures and it's hard to figure out how to monetize it for our own good. This is data that's now three years old. The numbers have only gotten bigger. TikTok, I looked it up this morning depending on what source you read. It's over a billion users right now. So it was 699 million in 2021. There's multiple social media platforms out there both in this country and in other countries of the billions of people who are on the internet, roughly 20% are on TikTok. TikTok is the one that's in the news most often lately because of geopolitical reasons and also because of an amazing algorithm that keeps people going for a long time. I just discovered, it was, well, I didn't just discover it. My younger daughter came back, she came back from college to watch Eclipse and she discovered and got my wife to sheepishly admit that she had downloaded TikTok and we found out, because my wife's just sitting there on the couch and was just doing this and this and this and then she's like, Mom, you got TikTok. She's like, no, I don't. Like, yeah, you have, that's a TikTok, like what you're doing, it's either that or Tinder and we'd better not be Tinder because she's swiping this way. So it's TikTok and what does my wife look at? My wife looks like DIY projects. She's like, how am I gonna fix the cabinet? Cause I can't even hang a picture but she's really good at that stuff. And she watches puppies and the algorithm's got her pegged. So it's videos of puppies and videos of how to fix the cabinet. Not a lot of harm there for her. Maybe a little bit of time lost. She's a little bit older. She can say to herself, all it's time for me to put this computer down. Maybe sometimes she loses more time than she'd want to but it's not that different than losing more time on anything that we maybe wish we hadn't spent too much time on. Ben's watching a TV show, reading a book and in my line of work and Daruva's here in our department, anybody who's doing too much of anything misses out on all of these developmental tasks. We ask kids to pivot a lot when they're growing up. So if I had a kid in my office who's reading a book or books, six, seven, eight, nine hours a day, I'm gonna worry about that too. So I'm not saying that one is better one is worse. I'm just saying that these things have more things in common that we're willing to acknowledge because it's a little bit sexy right now to go after social media for good reason but we have to be careful with that. Anything that takes up undue amounts of time I think we need to worry about. And also the average amount of time this is back in 2021. This is for folks ages 16 to 64. It was about 145 minutes a day. So it's not an insignificant amount of time. Now I spent about that many minutes per day watching the NCAA tournament too. So we have ways that we spend time and lose time that doesn't have to be via social media. What are the downsides? These are all things that you all have thought about but it's worth mentioning. This is what's often listed in every article you read. You have increased time at the expense of other activities. Just like you would have you read a book for eight hours a day. You're spending all that time on the internet. South Park did a great episode about this with World of Warcraft which is kind of a social media platform where they just never left the screen ever ever ever even to the point of having a bad pan brought to them. It's bad. You miss out on developmental steps. You're not doing much other than looking at a screen. So there's no exercise. So there is associated weight gain and we do have a problem with obesity in the western world. In the United States maybe especially. There's increased fear of missing out or FOMO as folks will call it. You look online at a curated picture online because we know that Instagram especially in other photo sites are highly, highly curated. It's what people want you to think and see as opposed to what really is. Most of the time I'll show you some data that goes against that in a second. So if you do that and you see all these people having fun there on the time of their lives they all went to the beach. It was the best time they've ever had. Maybe they've had a horrible time but they weren't gonna make it look that way online. So they make it look really, really great. They don't all do it this way but some do it this way. Then you start to worry that you're missing out on this. This can also lead to bullying, right? Because of these connections you can with the true anonymity because you could post something anonymously or the faux anonymity the same way that you're willing to do something in your car, cut somebody off that you would never do in person. More bad things are done from one person to another person and we can talk later about the technical definition of bullying but generally speaking the internet has been and especially social media has been a really, really efficient mechanism for bullying. With this comes decreased self-esteem especially around body shapes and a lot of the students I was talking to in my class yesterday said that when their sense of self took a hit, this was boys and girls, it had to do with looking how some people looked compared to how they looked. The way they pictured their own body compared to the bodies that they saw on the screen was just not in alignment, it was just off. And that led to increased sometimes significant depression that met the criteria as they've been established for depression and the possibility of early identity solidification. So let's say you're put into a group, let's give a dated reference, you're a goth kid, you decide I'm gonna hang out with the other goth kids, I wanna find out where goth activities are going on. I will only spend my time on goth websites so I'm in this kind of goth echo chamber. I don't then try on all of the other identities that you're supposed to be doing when you're making your way through high school. Remember, healthy development is characterized by a willingness to move among different groups. You start out early saying this is my group and as you get later in your life, you say to yourself, you know what, I can be the kid with green hair and be on the wrestling team. I can do both and if the kids with green hair don't like me wrestling and kids with wrestling don't like me green hair, too bad, I wanna do both. That's healthy, but the worry is that if you're stuck in these groups, these echo chambers of social media, you never move from one group to another and what you post is forever. We all know that, but we always, I don't know if we really get our, forever's a hard concept, so it's hard to sort of get our mind around that. You can post something and immediately attract it, say, that was a bad idea, but somebody will have screenshot it and sent it around already. So pretty quickly, once it's out there, it's out there and it's gonna be awfully hard to make it go away. Right now, where I was talking to Drew about this beforehand, we're in this funky cycle in our culture, I think, where we celebrate people online until they do something really horrible and then we put them in the stocks online and it just goes back and forth and back and forth and I think we gotta figure out a way out of that cycle. At least I would like that. What are the upsides? They're kind of the same as the downsides. There are kids who feel actually more connected, especially kids from marginalized groups, so a great example of kids in the LGBTQ community who really can't with the same ease find other kids that they share commonalities with but they can go online and find those kids. They can find meetup places. Kids who like to play Dungeons & Dragons will find Dungeons & Dragons clubs by going online. It's not the kind of question that, before Stranger Things, they were likely to raise their hand and ask about, like, how do I find where Dungeons & Dragons is? With that comes a sense of community, decreased sense of isolation, increased sense of relatedness because you meet other friends and this is especially the case for people who are shy and there's some really good data in support of the internet and especially social media being useful for kids who are shy, not harmful sometimes but also useful. You get increased self-esteem, you get the development of something called social capital, which is not a bad thing, by the way, the way that's been defined is how much capital you have with your friends or with a group of people at your high school and kids who are very, very shy or withdrawn but temperamentally normal, then they don't have generalized anxiety disorder, they are quiet. They actually tend to do better if they can engage with folks online and there's some pretty good data in support of that too and you also get increased autonomy. The internet is like going down the street. The downside, of course, is that people don't go down the street. They spend their time on the internet and that's something we have to sort of work our way through. So the upsides of the down, that's Alice in Wonderland, down is up, up is down, like this is, the things that work badly with the internet for kids also are things that help kids. We have increased time alone and increased time with others in person because you meet up at a group. You say, we've all decided we're gonna go to, I remember my daughter deciding with her friends when we lived down in Boston, we're gonna go to Walden Pond and we're gonna go swimming on this unusually hot day in the spring and that wouldn't have happened had they not had the internet. Now you could have said back in our day we would have made phone calls but I can tell you that in the 1920s and 30s there were similar concerns about phone calls in the same way. So we need to be careful about like, oh, in our day, what was Ronald just making a phone call? The point is they got together and they went to Walden Pond and went swimming and that happened as a result of being online. At the same time, if you're only online and you never go meet up with your friends, then you are alone. You're alone more often and you miss some of those social cues that happen when you're in person. There can be increased weight gain, as I said, from being sedentary but there's this whole body of data that show that when kids play, especially some of the sports games, they're much more likely to go out and actually play the real game with each other. So really cool controlled, both naturalistic and controlled studies, you have kids playing, say, Madden football or something and then after they play for a little bit, this happened with the Wii too, by the way, then after they play for a little bit in a massive multiplayer way which is what makes it a social media setting, then they wanna go outside and actually run around more. So it was actually perpetuating more exercise, not less. There's actually less fear of missing out rather than more. I gave you the example of the college students when they got here, this is where the information was so they weren't gonna miss out and they felt better for having looked online to find out where things were. There's decreased self-esteem for the reasons we talked about but there's also increased self-esteem because if you say, hey, I happened to like this weird book that nobody else likes too and you like it too and I feel better about myself now because it's hard and lonely to be the only person who reads Philip K. Dick when I'm in seventh grade. How great it is that you read Philip K. Dick too. We can get together and talk about Blade Runner. Like that's like a really cool outcome for a kid who would not have had that opportunity otherwise. You have decreased social capital, I'll show you that data in a second, versus increased social capital and that tends to be tied directly to the kids who have a harder time putting themselves out there and then finally you can have, as I warned us about early identity solidification but you can also have the willingness to try on all sorts of different identities which is purely a function of going to different groups in these different social media platforms and I'm not just making this stuff up and these are things that the literature has shown. So for every kid who kind of closes the door and who they might be early, there's also kids out there, not for every kid, but there are also kids out there who discover other groups that then really get them excited about things. I had a patient, I remember, who found a robotics group online and ended up really being interested in robotics and ended up going to engineering school. When he didn't even think he was going to go to college. So these are real benefits of this technology in addition to real risks. What are some of the controversies? I kept mentioning social capital theory. This is just one article, this was in current opinion psychology. This was noting that kids, as I pointed out, who are shy are much more likely to engage with others through a social media platform and when they do that, they then are more likely to engage with others in a real world setting, not on the platform. So the kids who engage with others on this platform who are more shy on that spectrum, normal temperament, so normal shyness, just slow to warm up temperament, they're much more likely to engage with others if they spend time on social media and finding those groups. Should we always remove smartphones from people? That's a really controversial subject. That's why this is on a slide called controversies. I've now managed a consult liaison, which is when you go consult to the hospital floor with psychiatric patients at Mass General and at Dartmouth and a little bit less, or a lot less here, because it's not my main job here. This always comes up. Do we take the cell phone away or do we not? Different hospitals have different policies. I did a poll last year of my counterparts in consult psychiatry. It was really split right down the middle. It turns out that the kids who in this naturalistic study where they were just taking phones, naturalistic meaning it was the policy of the hospital so they didn't have a control group. They would take the phones away by definition. Those kids, at least in the psychiatric hospital, were much more likely to engage in group psychotherapy when the phone was taken away if they tolerated the phone being taken away. If they didn't, if they really went bananas, if they really started throwing things and saying you gotta have the phone back, I can't not have it, they were not so good at engaging in the therapy. So you can imagine taking the phone away as a kind of test to see how connected is this kid, how ready is this kid to connect with people aside from the fancy rectangle that we hold all the time. And then there's this question, well, can we teach healthy social media behavior? And I think the answer to that is increasingly yes. We can definitely teach it. It's increasingly part of curricula around the world. The extent to which it works varies from child to child just like any curricula does, but we should try and we should keep working towards best practices in order to figure out what works best in the classroom. There's been some very interesting recent investigations. I tried to look at some more recent data. The Journal of American College Health looked at Instagram as a site where people might be willing to post disclosures about mental health challenges. It turns out that if you post anonymously, as you might be, wouldn't be surprised at, you're much more likely to tell people that you're not doing well than if you post publicly. If you post publicly, like with your name, it falls prey to that positivity bias, that curated view. So the person you show on Instagram is typically not the person. They have a term for it when somebody younger than me is gonna know the term like a fence dram or something like that, then we know the term. I'm embarrassed. Yeah, are you that much younger than me? You're not, maybe I just don't know it. So it's like a fake, it's like the alternate Instagram site or something like that. And they're actually, at least according to this study, people were much more likely to post how they were doing. And this mattered because their friends would see it. These weren't things they're willing to say in person, but their friends would see it and they would say, hey, John's in trouble or Betty's in trouble. I'm gonna go talk to him. So this was actually a real service that the platform would serve. Not on purpose, it just happened to be a service that the platform served. Eating disorders have been correctly identified on chat sites or social media chats by both real people as opposed to, in addition to artificial intelligence sites. And that's really interesting. These are not sites devoted to people with eating disorders, but you can look for qualitative thematic consistencies and say, this person has a much greater than, say, 80% likelihood of having an eating disorder. And you can de-identify that person in the study. They did and say, I'm worried about you. Let's go talk about your eating. So you can earlier get in the way of an eating disorder before it becomes more intractable. We can't do that right now, but you could imagine using social media in this way. That's why there's a health wing to all of these big tech companies. I'm not sure they do it for that reason. These are busily in dollar companies. I don't really need it, but downstream you could imagine using these social media platforms as a way of identifying way before bad things happen, bad things happen. This already happened in terms of violent acts. And then there's growing literature saying that, geez, if we moderate what people put online, we actually create stigma around the content that they're gonna put online. So if we say, no, you're not allowed to post that. Then the kid says, well, but it's what I'm feeling. Say, nope, you can't post that. Then they think there must be something wrong without them feeling. And then they decide not to tell you what they're feeling. So there is this thinking out loud and a little bit of data to support this. And it's in the very early stages. The study out of Australia that basically said, we probably should let kids post what they need to post and then read it and take it seriously rather than say that's an inappropriate post with some guidelines, right? Like there are certain things that you would just never, ever, ever post. Like everything else in the world, the extremes are easy. It's that stuff in the middle that's hard. What's being said by elected officials because we might say, geez, let's turn to our government. So the Surgeon General issued basically a warning saying we have a problem. We got to understand what's going on. And then President Biden mentioned it in the State of the Union 2022. I think he mentioned it in this year's State of the Union as well. Basically just in 2022, he said, we're doing an experiment. We got to figure out what we're gonna do about it. He didn't say we're getting rid of it. I don't know, I haven't seen a lot of leaders say that. What they're saying is we have to study this. We have to better understand it. So the punchline, it's what you'd expect. Every study has shown that trends are hard to predict that some kids do better, some kids do worse. This makes setting policy really, really hard. We need to base our individuals, I mean our interventions on individual kids and the current data make it really hard to know prospectively who's gonna get in trouble when they go online. That would be a really interesting thing to know about. Like this person's personality type is such that social media is really gonna cause trouble. This person isn't. We don't have good data in that way. Those investigations are happening now but we don't have good answers. So what do we do? This is just a brief look at the screen recommendations for both the American Academy of Child Analysis and Psychiatry and the American Academy of Pediatrics. This is all screens. This is in just social media time. Basically the thing I wanna draw your attention to is that six years and older, some variation from the one hour max per day is allowed as long as it's decided upon through family negotiations. And I just find that kind of a funny recommendation. That's why I'm like, that's so easy. You try sitting down with your kids when they're 13, 14 and have this, we did it. Like I'm not saying that it can't be done. It just doesn't fall into place the way it seems to from these guidelines. It takes real time. You have to set aside time to do it. It can't be something you talk about when they're going out the door. You have to sit down. It's a dinner table kind of discussion. And then you have to be willing to bend on it. It has to be the feeling of a negotiation where the kid says this, you say that, you go back and forth a little bit. So here's what we're going to try for now and see if it works. A lot of professional organizations are outlining this four point plan. Be a good role model. It seems like it goes without saying, but there's nobody in this room, including myself, I would guess, who hasn't taken out their phone at the dinner table at some point or taken out their phone in a public setting at some point and their kids are watching and it's not like you shouldn't kill yourself for that or like bang yourself up, but it does have an effect. The kids see it and they're going to hit you with it. They're going to say, well, wait, you have your phone out. How come I can't have my phone out? So you have to actually be really mindful when you reach for the phone and it's so much a part of us now that that reaching for it is often automatic. And you've seen the data where if even if a phone is in the room, people pay less attention than if the phone isn't in the room. So removing the phone for certain amounts of time seems to be useful. The negotiated family plan is often recommended but it's hard. There's a lot of recommendations to use parental control apps. I want to add a caveat to that but those are the apps that allow you to sort of do everything from monitor the age of your child when they're online to see every single thing they do when they're online and then engage in media-free playtime with your kids. Playtime doesn't have to be like for little kids. This could be hanging out, playing catch. You could think of whatever works for your kid. I'm going for hikes, something like that. The caveat just to add is I worry about the apps that allow for secret monitoring of kids' activities. I think if your parent is watching you in secret and this is controversial but I feel comfortable saying that probably a kid should know if they're being watched by their parent. It's okay for you to say I'm gonna know where you're going and remember also that kids can almost always get around the technology. They're better at it than we are. So if they don't want you to watch them they're gonna figure out a way to turn that off but the idea that they are always being watched actually doesn't allow for greater autonomy. Doesn't allow them to actually be able to move away to kind of progress in that developmental trajectory. And also, geez, if social media had existed when I was a kid and my parents were looking at what I was up to, I didn't do anything that bad but I certainly saw some bands that they would not have been proud of me seeing. I saw the Plasmatics, if anybody knows the Plasmatics. That was not a band, you can go home and look it up. That's not a band you want your kids seeing. And they didn't know, I just told them I was going to see a concert. So part of the use of social media here has to be parents having the ability to check but actually choosing not to. Like deciding saying, look, Sally, I trust you. I wish that you wouldn't do this thing but I know that I can't be there when you're doing it so I'm just gonna tell you my feeling about it. You're on your own because you're 17 years old and I'm gonna let you be on your own. Now if Sally keeps messing up then you might take a different tact. Final piece, we've been here before. When I first was asked to talk about this stuff I started getting curious about, well what was the last big technologic revolution or a big technologic revolution and what was the telephone? So at the turn of the last century, not to the 2000s but from late 1800s to 1900s, the phone came online and it was scandalous. It's really interesting to go into old library files and read about this. That lady's home journal picture is red for a reason. That red is supposed to be the color of scandal and that's because she's talking on the phone to a man and she's not chaperoned. So the idea of talking in an unchaperoned way to a gentleman caller on the phone led to all sorts of worries about propriety being violated in the same way that we see with social media. In a similar way there was this concern about Dr. Jekyll and Mr. Hyde that you could be Dr. Jekyll when you're on the phone. I may start when you're in person be Mr. Hyde when you're on the phone. You would do things later that you would regret all the way to the point where the American Telegraph and Telephone Company, which later became AT&T would send a pledge that you would have to sign, you'd have to sign it, but that was their recommendation. So you'd order your phone from like Sears, Roebuck or something would come to your house. You would sign this pledge saying I will behave when I am on the phone. I will behave like a good person and the whole family would agree to it for that one phone that was in the room. This is just an example of an ad that was taken out in a local newspaper. These ads were all over the place and they're basically just pointing out that, excuse me, that social media, I'm sorry, that phones themselves lead to this bizarre kind of interaction that felt to people to be very foreign to the way you would interact. They're saying, would you rush into an office or up to the door of a residence and blur it out? Hello, hello, who am I talking to? And then when you receive a reply, follow up your wild, discruiting citation with, I don't want you get out of my way. I want to talk to Mr. Jones. Would you do that? I say, no, you wouldn't do that. So don't do that on the phone either. Now, I think we've come a ways with the phone. We figured out how to deal with it and actually when you read about people figuring out how to handle the phone, it actually came from folks who came of age with the phone. It didn't come from folks who had the phone sort of introduced to them. So that brings me back to this issue which is we need to actually trust the folks who come of age with us who've never not known it to exist. So we keep in mind it's not going away. It's not all good, it's not all bad. I think it is this thing that we have to deal with. The effects of it are very, very person specific. So it depends on you, on your child. It's an intensely family, personal relationship or personal discussion and negotiation you have. But I think it is unfair for us to say that one size fits all. And we adults have to be good role models on this. We're not, I'm not very good at this. It's just so compelling to check and we check all the time. We need to sit down and talk about this with our kids. And if you're a child psychiatrist or child psychologist or social worker, you say this all the time and everybody always says, well, but my kids don't listen. I promise you they're listening. And I know, I mean, I know this for a couple of reasons. I know this because I listened even though I pretended I didn't listen. I don't say I know that I listened. But I also have kids who come to my office and say, yeah, my parents were lecturing me. I acted like I didn't listen, but I was listening. And it's just the nature of being a kid that you're gonna sort of roll your eyes and pretend like you're not taking it in, but you're gonna take it in. So it's worth having those discussions with your kids. Remember that kids are better at this than we are. So just lead with the concession that if you're really gonna get online, I know you're gonna do it. I know you're gonna get on social media. I'd prefer that you not. I'd prefer that you let me know, but it is likely that will be sometimes when you break these rules and give them some get out of jail free cards too. If they post something that they really regret, say, you're not in trouble. I would rather you come to me and tell me about this thing. That's a get out of jail free card rather than it's equivalent to saying, I want you to call me from a party if you've had too much to drink rather than try and drive home drunk so you don't get in trouble. You wanna say, come to me, let me know what's happened and let's see how we can do damage control together and be nimble. You're always adjusting the rules. What works will change as a function of the child's development, will change as a function of your tolerance and will change as a function of the technology. As the technology advances, we'll have to change as well. That was a whirlwind talk. I'm now done and I'm happy to take questions. Thanks. Thank you. We'll lock around with the mic so that those have the right to jump off and down. The gentleman in the back. The guy knew all the movies. Knew every movie. Every movie. So this is, this was a great presentation. I appreciate your perspective on all this. Parent of teenagers, study social media myself and it strikes me that the economics of the problem are too big for a family to solve on their own and you're suggesting good things that like digital hygiene things that will help the kids in the house. What role does the school have to impose either trainings for kids about what they're gonna encounter or rules about like where the phone lives in the school. What's your opinion about that and then what do you think about the government deciding that the economics of this problem need to change for example with respect to ads and targeting things like that. So there's three questions there. First of all, thank you so much for your comments and great questions. I think this course has to be involved. I used to teach high school English. Like I can't imagine this not making its way into the curriculum. In some ways it's making its way in English classes because there are now books written about social media like Speak by Laurie Anderson was all about social media. So I can't see schools not addressing this and they'll probably do it best if they address it both directly and also in displacement. You can watch a movie or tell a story or hear something about it. So now you don't feel so shaming to the kid. You can sort of say, what should this person have done in this story or in this book? What would you have done? So you create a little bit of distance in between it. In terms of taking the cell phone away, I have not, I'm just being honest with you. I have not made up my mind about that one. I know that there is a push in Vermont as well as in other states to have the cell phones taken away. I think it probably should be decided not at a state level but at a superintendent by superintendent level. I talked about it. I did it this very scientifically and talked about it with both my daughters and they both said the older one who's a little bit more intense and serious than the younger one, the younger one doesn't care that much about social media. The older one does. She said there would have been murder for her not to have the phone during the day because she would get all these posts and then she would have to respond and she wanted to get her homework done at night and she would spend all this time at the end of the day if she didn't have her phone because she was staying ahead of stuff online. Now I said, could you just talk to people in the hall? And she said, dad, nobody does that. So if we do it, we have to do it for everybody. Like if some kids have their phone and can keep posting and other kids don't, then those kids who don't have their phone are gonna actually run into trouble. And then the economics, as you, I think that's not a more like a comment than a question. Like it's a bazillion dollar industry. The lobbyists are incredibly powerful. They're incredibly savvy. Like I've been to the state house. I'm sure it sounds like you have too or maybe you have too. I think the only people who have the, or the only organizations that have the power to push back against those economics or regulatory organizations within the government. Was that, does that answer what you were? Yeah, thank you for that question. Doesn't yet, what research does not yet exist on this problem that you would like to see occur to answer important unanswered questions? So the general, the 30,000 foot view of that is the naturalistic studies or the prospective naturalistic predictors. So what social media platforms are more associated with say trouble or benefit? Which social media platforms are less associated with trouble and benefit? I'd be really curious to see what would happen if we could somehow, this is just kind of a fantasy of mine, of monetizing that data that we're basically giving away that's worth millions and millions of dollars and then use that money not unlike a tobacco tax to do a sort of education and see whether we could change social media hygiene. And I also don't think at this point we have good data so we need research on, I just thought of one more, but on the educational approach that we should take in the classroom. We don't have best practices in the classroom. Every state has a different way of doing that. And we could probably study that in a more centralized way. The one more I just thought of is people talk a lot about social media addiction. The talk was too big so I didn't put the data in there. The phenotype, so the appearance of being addicted, spending more time on something at the expense of other things maybe losing money, time, work, friends because of time on it. That looks just like substance addiction. And there are some studies that show increased, there's an interesting study that showed the study show increased dopamine reward which is associated with substance use. There's a really interesting study where they put kids in a functional MRI scanner that can look at the dopamine reward circuitry and they showed them fake Instagram posts. The kids were blind, so they didn't know that these were fake Instagram posts. They thought they were real and they would have the same posts or posts that were similar as rated by qualitative assessors but had different numbers of likes. And the more likes there were, the greater the dopamine response. So it sure starts to look like an addiction paradigm. It doesn't make it that different from watching football on Sundays, as I said. But it would be good to know how much of the brain changes. Like literally at the level of the brain as a function of this time online. In the same way that we have similar studies around the television or around other ways that we engage with the world. So, sure. Thank you. Can you speak a little bit about safety? I know that may be a whole nother talk but can you touch on that a little bit? Yeah, I mean I can try. It's, so we hear most often about the times where safety is really compromised, right? Where there are people online who are not there for any kind of altruistic reason or actually kind of praying on kids. And it's very hard to know how to control that outside of the platforms themselves being responsible for spotting those folks. And even then they're gonna let some of them through. I think we need to actually hold the platforms. I feel this, this is my personal opinion. We hold the platforms accountable for that. At the same time, social media allows for some really horrific events to be averted by kids posting things, suicidal thinking, homicidal thinking, a fight that's gonna happen. Somebody sees it, they report it to their teacher, to their family or to their parents. Somebody gets in the way. I've seen that so many times in the last especially 10 years. These are things that I, you know, what we don't know is whether it was made worse in the first place by social media but we do know that by posting it, this kid has allowed somebody to get in the way and averted something awful from happening. And so that's a way actually can be used for safety. I mean, a more, more kind of less, I guess we're obvious way would be like these, like a Twitter blast or something or the site formerly known as Twitter, whatever I think it's called X now, where you find out that something's not safe in the area. I live in Jericho, Vermont and we got a, my social media is the Jericho front porch form. It's not a very sexy social media platform but that's our platform. We got a post that there was a bear wandering around. That was a useful thing to have. We got the dogs inside. So that's like a safety example too. But the predator part, I mean it's a strong word, I don't know how to define that predator but I think we need to hold the platforms accountable for that. All good? I'm just looking to see if there are more questions. If not, why don't we thank Dr. Schlazman again? Thank you. Thank you. Thank you. Thank you.