Full Transcript Introduction to Screen Addiction 0:00 addiction to gaming and screen time is a real thing. 0:04 We see it in the brains. 0:06 The root cause is pain, either physiological pain or psychological pain. 0:10 But screen use stops coming into them more stress, but it doesn't reduce stress. 0:17 Although their brain perceives that as, oh, I'm relaxed a little bit. 0:20 They can pause the stress coming in through their cup, but it's not reducing. 0:24 So it is not coping skills. 0:25 That's how I teach my clients. 0:27 Unfortunately, that's an ineffective coping skill. 0:30 Welcome to Demystifying Pans and Pandas, the podcast where we uncover the mysteries, breakthroughs, and hope behind these life altering conditions. 0:40 I'm Dr. 0:40 Nancy O'Hara, a board certified pediatrician, educator, an advocate with over three decades of experience. 0:48 helping children and families navigate the challenges of neurodevelopmental and neuropsychiatric conditions, especially PANS and PANDAS. 0:58 These disorders can feel overwhelming, but here we'll break down the science, explore transformative treatments, and share stories of resilience and recovery. 1:09 If you've ever wondered what's possible for your child or how to find answers, this is the place to start. 1:17 Let's dive in. 1:18 Hi, everybody. 1:18 It's Dr. 1:19 Nia O'Hara and welcome back to Demystifying Pan's Pandas. 1:23 I'm really excited to welcome Koichi Tanji to the podcast today.
Podcast Welcome and Guest Introduction 1:28 I heard Koichi lecture at MedMaps, our medical academy of pediatrics and special needs, and he really distilled all of the problems with screens and the 1:41 developmental mind and how screens affect pediatric behavior in this digital era. 1:46 And I really wanted him to come on and talk about that. 1:49 So Kochi, thank you so much for being here. 1:52 Thank you for having me. 1:53 My pleasure joining this. 1:55 Yeah. 1:56 So again, let's dive into screen time. 1:59 What's the average screen-time now, sort of post-COVID, as well as pre-Covid in our children? 2:07 Right, for when it comes to screen time, it is a two-part, right? 2:11 You know, a lot of parents and clients themselves claim, oh, this is for school, school use computer. 2:16 But so we need to separate it out with recreational use, such as YouTube, social media. 2:21 I mean, YouTube overlap is just for fun. 2:24 Let's say, you know video games, Social media, that average screen-time for recreational-use before pandemic was four hours. 2:33 for adolescents, adolescents. 2:35 Right? 2:35 And after pandemic, it jumped to almost eight hours a day. 2:39 Eight hours. 2:40 A day? 2:41 Right. 2:42 We can imagine the impact of it, right? 2:44 Yeah. 2:44 Well, eight for school, let's say, or 10 hours and eight hour sleep, hopefully. 2:49 And then eight of screen time that consume entire day or maybe 24 hours night off. 2:54 Wow. 2:55 The pandemic, it's probably more understandable, right? 2:59 Cause we are locked down. 2:59 We had limited access to socializing and stuff. 3:03 But after that's lifted, there's no longer there, but still to this day, average screen time for adolescent age is about eight hours still. 3:12 And how do you distinguish overuse, which eight hours is definitely overused to me versus addiction to screens? 3:20 Yeah. 3:20 So that's the important part. 3:21 A lot of, uh, you know, I took it as more like a dismissive comments of everybody's addicted.
Screen Time Trends After COVID 3:27 This is like, a new normal, right? 3:29 But I disagree with that. 3:31 Not everybody is addicted, and the difference in part is how does that use impacting their social interaction, academic occupation. 3:42 You know, so those starting to get into, if they're starting impair relationship, prioritize over internet use, then building relationship or work or school, 3:52 which is common for kids, you know kids. 3:54 And then that get in to arena of actual addiction. 3:59 And I heard, I was listening to something on the radio the other day talking about AI and how young people are even having relationships with an AI type 4:13 person online. 4:14 And that just seemed very scary to me. 4:17 Yeah. 4:18 I have that concern too of like a next phase is not just the internet now getting to the AI. 4:23 and then again, probably no one has, but I don't have, Right, absolutely. 4:30 So from your perspective, what's the behavioral and mental health impact of all this chronic digital stimulation? 4:38 Right. 4:38 So common symptom is really easy to get frustrated and angry. 4:44 Over bottom is the trigger usually. 4:46 Well, I have nothing to do because their brain is relying on a custom to keep stimulating from the screen, right? 4:53 You know, high dopamine. 4:54 High dopamine stimulated. 4:56 When they don't have that stimuli, really suffer, you know. 4:59 when they were little, kids had creativity. 5:03 Right? 5:03 Made fun from, literally from adult's perspective, nothing. 5:08 Just cardboard and pen and paper, but they were creative and they could, you know, create the joy from it. 5:14 But they lost that. 5:15 Sure. 5:15 It's teenager thing, But also it's the getting to more and more prominent. 5:21 Well, going out with friends is boring. 5:23 Going with, Going out, with family is a boring, that's because I'm teenager. 5:27 but interesting thing that I see is when they reduce screen time, when, You know recover from that, They're happy to go out with parents. 5:35 They are happy too. 5:37 So it wasn't the age, it's the symptom, you know? 5:40 Wow. 5:40 And do you see that in younger children too, as a symptom in them also? 5:45 Not just teenagers? 5:46 Yeah. 5:47 You know, according to study, like a heavy gamers and excessive screen use associated up to like almost like 66% of, people have inattentiveness or attention deficit. 5:59 You know, so, but that's a concern. 6:02 Really easy to get bored, difficult to stay on task, right? 6:07 And then they need to stimulate all the time. 6:10 So yeah, that is for sure. 6:12 Anxiety is really correlated, you know? 6:14 Pandemic fatigue, Right? 6:16 That was actually study was doing during the pandemic time, is it a lockdown or is what else was causing the Pandamic fatigue and skyrocketing anxiety
Overuse vs. Addiction 6:26 and depression rates? 6:27 Yeah, absolutely. 6:29 And then they did a study about restricting social media use during still lockdown was happening and for less than 30 minutes a day. 6:38 Then all aspects of pandemic fatigue recovered or improved significantly. 6:43 So was it the lockdown or it actually increased screen time secondary to the lock down? 6:49 Right. 6:50 What about executive function or cognition? 6:52 You mentioned attention and anxiety, but what about actual cognition. 6:57 Yeah. 6:58 So like a cognitive delay, speech delay. 7:00 Language delay is associated with it. 7:03 And now I think a newer study is showing average screen time by age one is if it's including FaceTime with family member is averaged one hour a day, 7:13 that increase the diagnosis of getting autism double by three. 7:19 Face time use early in life increase their risk of autism. 7:25 Well controlled for all other factors. 7:28 Right. 7:29 So that's the topic that I brought up in the MEDMAPS. 7:33 Yes, a lot of like, you know, I think we need to separate out the different type of autism instead of putting all one bucket, 7:41 right? 7:41 Because some of them are truly biomedical cause. 7:45 The number of autism diagnosis creeping up, yes, it's some environmental toxins and physiological and then many things associated with it, 7:53 but subpopulation bringing up the number so high is potentially due to excessive screen use. 7:59 Okay. 8:00 And you also mentioned neuroimaging findings in heavy gamers, users. 8:05 Talk about that a little bit. 8:06 Yeah, in the study showing a functional MRI, like a brain structure, right, that they look at from imaging, and then the heavy gamer's brain structurally altered. 8:16 And how they altered is very much similar with someone with substance use disorder. 8:21 So, you know, part of the brain for executive functioning is shrinking and the other area, there's imbalance. 8:28 Basically similar finding with somebody with Substance Use Disorder. 8:32 Right. 8:33 And so very similar, it's another addictive thing. 8:36 It may not be addiction to smoking or drugs, but addiction, to gaming and screen time is a real thing, we see it in the brains. 8:48 Yeah. 8:48 Wow. 8:49 So what's the drivers that may be hidden or not of the increase in these diagnosis? 8:55 Do you think screen-time is one of them? 8:58 And talk about that a little bit more. 8:59 Yeah, I think though, when they're studying, i think Massachusetts general study, is data is showing, yes, entire amount of like, 9:07 well they separate into two types of autism, who has physiological, like a physical illness, together with behavioral symptoms of Autism. 9:16 who doesn't have much of physical, you know, like a food allergy, stomach pain and those things are not there, but there they have traits of autism to
Behavioral and Mental Health Effects 9:24 the point they meet the criteria of diagnostic to receive ASD diagnosis. 9:28 That population is really growing high. 9:31 And then we still, we don't know exactly, but the hint is they don' have physical symptoms, generally less, and they have anxiety and inattentiveness is 9:41 the main chief complaint to come to our door. 9:44 And usually they receive later onset, later diagnosis after age 10. You know, so that more like a sitting feeling overlap of screen dependence. 9:55 Yeah. 9:55 As they get a little older, they have more freedom and they're spending a lot more. 9:59 And then potentially the interaction issue, anxiety and those autistic traits starting to become more prevalent. 10:08 Yeah, let's talk a little bit more about the anxiety, because, you know, we certainly have a lot of neurodivergent people who might say that, 10:16 well, this helps my anxiety. 10:18 This makes me feel better. 10:20 Or people with pans pandas, the children that I deal with, it distracts me, certainly. 10:27 Yes. 10:27 but it helps me to feel better. 10:29 And why can you say that the screen time may be causing anxiety versus I'm doing the screentime because I have anxiety? 10:38 Address that a little bit. 10:39 Yeah. 10:40 You know, similar with other addiction case, the root cause is pain, either physiological pain or psychological pain. 10:48 Pain includes stressor. 10:50 You know, a lot of neurodivergent kids went through traumatic experience too, and high stress, I understand that, you know I'm empathetic about it. 10:59 But at the same time, it's really tough conversation might be, but screen use stops coming into them more stress but it doesn't reduce stress. 11:10 Although their brain perceives that as, oh, i'm relaxed a little bit. 11:13 Yes, they can pause the stress coming in through their cup, but it's not reducing. 11:17 So it is not coping skills. 11:19 That's how I teach my clients. 11:21 Unfortunately, that's ineffective coping skill. 11:25 Right. 11:26 And do you differentiate, you mentioned initially the difference between screen time for school, screen-time for work, we're all on it for these days as 11:35 you and I are right now, versus the gaming, the social media, and that sort of thing. 11:42 Does that get differentiated in the neuroimaging finding, in anxiety, or is any screen time negative for all of us? 11:51 I think, though, the study was showing the recreational use, right? 11:55 So they can tease apart, is it 100% accurate, how much is work, you know, recreational? 12:01 I mean, there's a limitation to that. 12:02 However, they define the gaming use as recreational outside of school. 12:08 I have to be on the computer for 8 hours a day. 12:13 Is my brain addicted? 12:15 Usually, most of the cases not. 12:18 I never heard anybody, my clients addicted to Canvas like a learning management system, you know, right? 12:24 Or work platform. 12:25 Although it's a possibility though, like workaholic self-claiming individual may feel that way, but usually they don't prioritize that over relationship 12:33 or other activities. 12:35 Right. 12:35 So it's that interference with the activities of daily living that's such a differentiator. 12:41 And as you've said, there's an intentional design in gaming and social media to almost create this. 12:50 Talk about that. 12:51 Yeah, so nowadays, you know, the video game, maybe you have seen, it's not the same as original Nintendo type of video games. 13:00 You know in the back then was extension of just a digitalized version of board game kind of impression, but now it is really well designed. 13:08 Massive data behind it and then even psychologists involved to come up with the way to hook their brain greater than their capacity right basically what 13:19 it means is brain is telling them I'm tired I am exhausted but they design in the way that still they hook and they cannot get off of the platform how
Cognitive and Developmental Impacts 13:30 they do that is one skill is called randomization of reward like when they're playing micro reward happens could be light, 13:39 could sounds, actual reward in the game like a point or whatever and then they design in a way it's not predictable. 13:46 That would draw hyper-focus from our nervous system standpoint to keep paying attention and they cannot stop. 13:54 So that's one mechanism of how these video game hook. 14:00 Is that the reward loop kind of thing you're talking about? 14:03 Yes. 14:04 What about reinforcement schedules? 14:06 What does that mean in gaming and social media? 14:08 Yeah, so like, yes, right? 14:09 Certain days of the time, they have to be on to claim the, you know, items, et cetera. 14:14 That's a very common way. 14:15 So they are, again, really getting so smart to the point it's really scary. 14:21 And then I live in Bellevue, Washington. 14:23 There's lot of people working in tech field. 14:25 There's a video game company, Microsoft, Amazon, and then I have encountered a group of game designer developers. 14:33 Did they actually raise the concern? 14:35 I ethically don't feel good of how we design this way, because that will hook. 14:41 the really vulnerable young age clients or kids to be on this for beyond just the physiologically capable limits. 14:49 Right. 14:51 And what about the conditioning? 14:54 Like, is there any of that? 14:57 I feel there is, even with the few games I play, you know, to keep my brain sharp. 15:03 We almost become conditioned in a lot of ways, right? 15:06 Yeah, I think so too. 15:07 You know, even adults, Right? 15:10 I mean, everybody has probably awareness that my relationship to screen is not optimal, because constantly checking for no good reason. 15:18 Without phone buzzing, they just check. 15:21 We just checked. 15:22 And then psychology behind it, part of it is fear of missing out. 15:26 They tend to have a fear that everybody's talking about, I'm left out, that's another challenge with parents and teenagers. 15:33 Well, without this, like I cannot join the group. 15:36 I can not talk to my friends. 15:38 Ill be alienated. 15:39 Right. 15:40 That fear missing is a big one. 15:44 How do you counteract that? 15:46 Yeah, so that's like pros and cons, right? 15:49 And yes, you might be up to date with what people are talking about. 15:53 And then, but do you think doing that will give you greater connection with other people? 15:59 When clients are getting into the actual addiction scenario, usually they feel more lonely. 16:04 More they do use, they thought they're connecting with people. 16:07 but actually they feel a lot more lonely and isolated. 16:10 Because again, they're all prioritized screen over actual socializing activities. 16:15 So yeah, I definitely empathize the challenge with it. 16:17 But at the same time, the direction they are heading is literally really damaging to their life and career. 16:26 Absolutely. 16:27 And, and beyond the neurobiology of it, social media also influences several other things, risk taking, sexuality, you know, 16:37 talk about those maybe unsafe practices. 16:41 Yeah, it's a very hard fact or statistic to learn for parents especially is right now, I think possibly this data is getting a little older, 16:53 but average time, average year age that kids is exposing to porn is now 10. 10 years old.
Neuroimaging and Addiction-Like Brain Changes 17:02 Right. 17:03 And then that will impact them really negatively, as you can imagine. 17:09 And I have a few clients, you know, courage enough to brought it up to me. 17:14 I, not that I want to get rid of the gaming for the sake of gaming addiction, but this is bothering me because parents may not know that like those devices 17:24 and console have a setting to change and go to internet without supervision. 17:29 You know, there's no parent restriction so they can access to those contents. 17:33 And initially those are started with curiosity. 17:36 Other friends showed it up, you know showing up to them and then they're like, Oh, what is this? 17:40 You know, initially was curiosity, but getting to the deeper struggle and whole of that side of like a damage, sexuality, 17:50 you know what it means to be like, in the healthy relationship. 17:53 That idea is really impacted by that. 17:56 Right, so a child may click on a picture or something inadvertently, accidentally, or out of curiosity, as you said, but then part of the design is that 18:08 what you click in it, you get more of what click-on, right? 18:13 And I think that happens for us, whether it be reading about politics, it's the way it is designed, and I We even as adults don't understand that intentional 18:26 design of it and it takes us more down a rabbit hole of getting more and more of what we may initially believe or just be curious about and getting Correct, 18:41 Koichi? 18:41 Yes, yes. 18:42 Definitely, you know, getting smarter and then the common topic come up to my door is YouTube. 18:49 YouTube is so smart. 18:50 Once you watch something, the recommendation is, so great that drove their attention. 18:56 Well, I was gonna only watch 20 minutes and they'll stretch it out to two hours, three hours and realize seven hours in some clients. 19:04 Yeah. 19:05 Yeah, so how do you first recognize screen dependence, screen addiction? 19:12 How do recognize that in a child or adolescent? 19:17 Yes, so how I do it, you know, it's the when I ask about bro, bro this bring this up top, and you don't that's topic and then healthy individual even like 19:26 a client younger age kids. 19:28 They say, yeah, It's not good. 19:30 I need to walk on it. 19:31 Or yes, that is too much, but I can control. 19:34 That's a healthy mind. 19:35 But when somebody's already getting to a little bit towards like addiction side, they say like, no, it's fine. 19:40 I have no issue. 19:41 Like starting with denial. 19:43 It's, you know, normalized. 19:44 Everybody's doing it. 19:45 Otherwise I'll be left out. 19:47 That is already like you, know like a flag, I would say, like 80, 90% of kids respond that way. 19:52 And then to have a full awareness. 19:54 Yeah, actually I don't have control and this is impacting me negatively. 19:58 Average in my experience takes about six months.
Screen Time, Autism, and Anxiety 20:03 Just to get into the door of like, well, I want to improve seriously in a meaningful way. 20:07 Yeah. 20:08 So, so is the first step just awareness by the adults in the room and by. 20:15 The adolescent, if they're there. 20:19 Yes, education part is where we are in the society is to bring more awareness. 20:24 That's how I think. 20:26 Maybe other practitioners have different perspective, but I, think most important work is, to share awareness about negative impact of accessible screen use. 20:37 And are you then treating it the same as other substance use disorders? 20:43 Very similar. 20:44 Yeah. 20:44 But in one way, it's harder than substance or alcohol, let's say. 20:49 Because it is everywhere and then... 20:52 Well, first in the morning, somebody drink alcohol. 20:56 You know, probably their partner or friends look at it like, oh, that sounds not healthy. 21:01 When first thing in morning check phone and play video game, I don't know if they have awareness about... 21:07 You shouldn't do that. 21:08 You know? 21:08 Right. 21:09 Right? 21:09 Like, that's a normal thing. 21:10 So that is... 21:12 Another barrier is the lack of public awareness, how this is impacting their life. 21:17 Right, right. 21:19 And abstinence, you know, certainly if you're an alcoholic and have understanding of that and awareness of and can choose to choose abstinent or NAA or whatever, 21:32 that's great. 21:33 You know? 21:34 It's like don't go to the candy store. 21:36 But with screens, Even if we don't want to be addicted to it, in our day and age, it's almost we can't avoid it. 21:44 You know, whether it be school or work or just talking on our phones, It's right there. 21:49 So I can imagine that the pulling back from it is so much harder. 21:54 It is very challenging. 21:56 Yes. 21:57 But the reassuring part, all my clients went through abstinent period. 22:01 They don't regret. 22:02 None. 22:03 Zero. 22:04 You know, they looking back and then without that, I'm not here today. 22:08 I, um, presenting differently. 22:09 It's a, uh, it's really awakening call to realize. 22:17 I was in the different headspace and then actually I do like current state. 22:22 Right. 22:22 So how do you help your clients to do that? 22:25 I mean, and again, if it's not teenagers, do work with parents to help them help their children? 22:31 So talk about that. 22:33 Yeah, definitely parents are important work. 22:36 Important work? 22:37 Let me put it that way. 22:38 And let's say common scenario. 22:40 I'm stereotyping a little bit but like generally speaking, you know, mother is on board but the father maybe not agreeing with it. 22:48 So like parents already they have different view about how this is impacting them. 22:53 Again, I'm a little stereotype in the gender but that can certainly reverse but generally I hear more of that. 22:59 And that is really challenging. 23:02 Kids get mixed messages. 23:03 If mom is like, no, listen to Dr. 23:06 Koichi, this is real, impacting you. 23:10 But then going to his home and they're like oh, fine. 23:13 Right? 23:14 And just, you know, make sure you stop a certain time, do this. 23:17 And that makes Mrs. 23:18 Really challenging. 23:19 So yes, it's crucial to have conversation with parents, especially, uh, the clients are really young. 23:25 Yeah. 23:26 Yeah. 23:27 And, and I can also see the modeling of the behavior. 23:30 You know, as parents, we may not want our children to do it, but there we are on our phones. 23:36 Right. 23:36 Or, or on a computer as we're telling them, you know you're too addicted or you are spending too much time on it. 23:43 That must be a big part of it too. 23:45 How do you handle that with parents? 23:46 Yes. 23:47 I highly encourage to to it with, entire family. 23:51 That would be really supportive, you know? 23:53 And how much are they willing to make change? 23:56 Generally they are, though. 23:57 And then they'll realize, they can emphasize how hard it is to reduce and control.
Reward Loops and Digital Conditioning 24:02 You know, a lot of time I hear from parents, I bring it up like, how often do you eat healthy meal or just eat, exercise? 24:09 It's like I want to do this. 24:11 I should have done that, but I don't have time, I'm not being like really aggressive in this way, but gently remind them, 24:18 is it the lack of time or we don't know to this date or to these days like how to manage time. 24:26 My point is, can you check your iPhone or phone? 24:29 How many hours you're on YouTube, social media website? 24:33 And usually like four hours, three hours. 24:35 Yeah. 24:36 Can we trim that even like one hour and then do exercise? 24:40 Yeah, right. 24:41 It's an awareness part, really. 24:43 Right. 24:43 Right. 24:43 And is that how you approach it? 24:45 Like you try to decrease it or is it, you know, like when I talk about diets, often I'll talk decreasing first before we try go really off of it. 24:56 Or we may cold turkey it how do you approached that? 25:00 Is it decreasing or cold Turkey? 25:03 Yeah. 25:04 So that's how I decide is whether this is actually addiction case or excessive use case. 25:11 Okay. 25:11 If it's excessive used and there are room to kind of improve by reducing it or put the restriction on, put a schedule on et cetera. 25:21 But when somebody is getting to just the full state of addiction state, abstinence is almost necessarily. 25:30 Okay. 25:31 Yeah. 25:31 And I've also heard you talk about Jomo, not FOMO. 25:34 What is JOMo mean? 25:35 Yeah, joy of missing out. 25:37 and then my clients ended up realizing it. 25:41 I feel great that have no awareness about what's going on in the school with other people in drama, right? 25:48 And they feel good. 25:49 They don't feel stressed because negative side of getting too much exposure to either news or, you know, like a sad story, 25:57 et cetera, is their emotion become numb. 26:00 as a coping mechanism. 26:02 Because they cannot be sad or angry every single time, right? 26:06 Hearing news. 26:07 So they become numb. 26:09 When there's a joyful moment happens, they're also accustomed to be feeling numb. 26:14 So they may not feel as much of negative, but they don't feel much as positive either. 26:20 That's a really hard state to being in. 26:23 Yeah. 26:24 And so true of an addictive type with any type of addiction. 26:30 You're kind of explaining the same thing with others that can be addicted to substances. 26:35 Right, yes. 26:36 So let's step back a little bit because I really want to understand the difference between the impact on an adult brain like you or I versus the developing 26:47 brain versus The developing neurodivergent brain. 26:50 Yes, or the anxious brain so talk about each of those a bit Right. 26:56 So, impact to the, you know, how it happens is usually adults perceive, they themselves have played certain video game, maybe a similar or same kind, 27:05 and then from their own experience, from an adult's perspective, They assume, I get it, it's addictive, but it is not as bad. 27:12 They may come to a conclusion. 27:15 But when it comes to developing brain, the impact is really different. 27:19 It's a lot stronger, And then it'll hook them deeper. 27:24 I mean, when we think about smoking, alcohol, drug use, we have awareness this is not good for their pediatric, right? 27:31 Because we are educated, and we know enough about it. 27:34 But when it comes to screen use that risk is the same, but still lacking awareness. 27:39 And then we as adults don't see it different. 27:42 I see differently or same difficulty. 27:47 Let me put it this way, you know, they, as if they treat, this is just benign based on their experience, but it's as risky as drug and alcohol. 27:55 Right. 27:56 And is the developing brain in a child that is predisposed, to be autistic, maybe genetically or have that susceptibility,
FOMO, Loneliness, and Social Isolation 28:06 is that differently, different than a trial that may not be predesposed? 28:13 So that's a more newer area and maybe, you know, a practitioner who is geared towards like a genetics of addiction. 28:20 Probably they can help, shine the lights, which would be great. 28:24 You know there are certain like dopamine receptor mutation or genetic traits makes the people more susceptible for addiction and there is a gene I think 28:34 associated with it. 28:35 So those individuals with family history, I mean, similar with substance use disorder, yeah, it has greater risk. 28:41 Then when it comes to neurodivergent brain, they have another layer of challenge because they tend to have physiological reason to be anxious. 28:50 Like, you know, MAPs teach certain gut dysbiosis and, and you, know pans and pandas certainly will physiologically induce anxiety. 28:59 And then they don't know how to cope with it. 29:02 And I hope they're working with a doctor like Dr. 29:05 Ohara, but not accessible to all people right now. 29:09 So they do not know to deal with. 29:11 The only way that they can find is use the screen to distract their mind. 29:16 Right. 29:18 They have a different layer, right? 29:20 They are not just being mindful about screen use, they need support to reduce anxiety. 29:26 Otherwise, it's really, really tough for them. 29:29 Right, right. 29:30 And I think as a practitioner, you know, I ask about mold, tick exposures, infections, diet and stooling. 29:39 But I also think we need to be asking more specific questions about screen time, and really be looking at How many hours a day is that going on? 29:50 Because I do see that, you know, when parents try to take away the phone or put that down, the rage, anxiety really increases. 29:59 And I think we have to understand why that's happening. 30:04 How do you talk about family's tips to instill that fixed mindset? 30:10 Yeah, so fixed mindset versus gross mindset, right? 30:13 Video games certainly encourage their perspective to become more fixed mindsets, like outcome driven. 30:20 Right? 30:20 If the outcome is not positive, might as well not even try. 30:23 You know, that's the pattern that we do see. 30:26 And then, certainly need guidance, but stopping screen even like a three to four weeks, then they do realize different side of them. 30:35 They're more resilient, they can cope better. 30:37 They can handle boredom. 30:39 They could be more creative. 30:41 Boredom is great. 30:42 That's how I teach. 30:42 boredoms make you more creatve. 30:45 And intelligence is about pattern recognition. 30:49 So when they get bored, they're starting finding the pattern more, pay attention to more. 30:54 So that's definitely a piece of it, you know, by so many things to be discussed, but that is a common thing we discuss in terms of like gross mindset and
Porn Exposure and Online Risk 31:02 fixed mindset. 31:02 Right. 31:03 Do you have any practical tips to help families that want to start to reduce this, that don't really feel it's an addiction yet, 31:10 But want decrease the use? 31:13 Yeah, so definitely have a conversation and awareness. 31:16 You know, that's definitely a must. 31:18 But also, putting the schedule is really important. 31:22 Instead of, all right, you only use two hours, they're using, let's say, six hours. 31:27 Now, what are they going to do with the four hours? 31:29 Right? 31:29 They'll suffer. 31:30 They don't know what to and then very difficult to go through boredom with it. 31:36 So they're going to fill up the schedule in advance. 31:39 You can do this, you can't do that. 31:41 And they may say a lot of things they are interested in, but put those on their schedule. 31:47 So, they can go to sports, meeting, whatever. 31:52 That way, They have less free time just sitting in front of a computer or phone by themselves. 31:59 kid that says, these are my friends, you know, I am now homeschooled or I'm doing online school or, this is the only way I can connect with my friend. 32:11 How do you discuss that with families? 32:14 Yeah, I mean, first of all, when to intervene is definitely if it's starting to impact negatively, right? 32:20 So when they can go to still like complete the home school task, they get sleep still on time, generally, or eating okay, 32:29 you know, and then that's okay. 32:30 Right. 32:31 But when there not doing the schoolwork, there're not do anything, then classical sign is night and day flip. 32:38 They wake up at night and they play game throughout the night. 32:41 During the day, they do sleep. 32:42 Even when somebody has, you know, neurodivergent traits and then they really drawn to screen, when they can sleep at nigh, 32:49 even though need some guidance, hey, stop in 30 minutes and end up stop and can't sleep, that's really positive prognosis with those individuals. 32:58 That's really common. 32:59 They're poor hygiene, they don't want to shower, or they want a brush teeth. 33:03 It's somehow really hard for them. 33:04 And then night and day flip. 33:07 If I see those three traits, I think abstinence at some point is important. 33:15 And how do you help families to, you know, if you have a small child, families are very busy. 33:21 They have three, four, five children. 33:23 Do you recommend that people totally turn off the Wi-Fi, at a certain time of night? 33:29 Do have any other practical tips like that that you helped families do? 33:33 Yeah, so more family gathering, board game time, you know, those are really helpful. 33:38 Yeah. 33:39 But that's an assumption that family has good connection, right? 33:43 Not all families are in that way, unfortunately, Right? 33:46 So that is another limiting factor. 33:48 but when they can, just come up as you do as an entire family is great. 33:52 You know this is like our choice at night after 10 o'clock. 33:57 We'll stop Wi-Fi, you know, we stop using screen. 33:59 That would be great approach, but sometimes sibling who's generally doing okay, they may not agree with that.
Recognizing Screen Dependence 34:09 So it's a tough conversation and needs to be creative. 34:11 How about this? 34:12 How bout that? 34:12 So individualize in each case. 34:14 Right. 34:15 And I think that's so important because each family, each case is different, and we do need to individualize not just our medical care, 34:25 but also what you're talking about here with screens. 34:28 Yes, exactly. 34:30 Yeah. 34:30 So it's not, I don't want anybody listen to this or we have to cut everything out. 34:35 Otherwise negative outcome is waiting. 34:38 I mean, it it a little too simplified. 34:40 Yes. 34:41 It's negative in general, if it is too much, but you know, to get to that point of controlling screen use, we need to be careful of how to implement. 34:51 Right. 34:52 And let's talk a little bit more about the developing brain, because do you see ages, you know, that are like, it should be this much at this age, 35:02 this, much, at, or, I understand what you said and totally agree about, the FaceTime early on in life, but what about between that three and 13 where most 35:15 of my patients lie? 35:17 That's the biggest area of pans-pandas and that level of anxiety. 35:21 Talk specifically about that age group. 35:23 Yes, there are guidance about like, you know, two hours a day of recreational use, for those age, or it could be one hour, 35:31 but I don't pay too much attention about the total duration of use. 35:36 It's more like can they stop when they're supposed to stop? 35:40 That is the most important part. 35:42 Because boiling down addiction is difficulty with boundary to self and others. 35:48 So I decided or family or parents told them two hours. 35:52 And then if they can stop within two, hours, great shape. 35:56 If they didn't do that for three and four, they're in the healthiest state. 35:59 Then somebody has house rule, home rule of like a one hour a day, and they always stop at one, hour and 30 minutes. 36:07 Total exposure is less, right? 36:09 Because only spend one and a half than four hours But when they cross that boundary, that's a trace of dependency. 36:16 And that is my guidance usually to clients. 36:19 Can you stop when you're supposed to stop? 36:22 Even like a five minute matters. 36:26 Okay. 36:26 So how do you learn or relearn those boundary skills? 36:30 Right, so that's a lot of therapy, you know, Saiku educated about those topics. 36:35 So that is a lots of counseling. 36:37 I'm a counselor too, I do that weekly and talk about things and how hard it is. 36:45 Somehow I thought... 36:47 I stop at 1 hour and 50, but realize it's 2 hours and 15. And then they give up. 36:52 Might as well I go 2 hour 50 because I already crossed that line. 36:57 Right? 36:58 Right. 36:59 So those are the things.
Family Modeling and Reducing Use 37:00 Yeah. 37:01 I see that you made a mistake, But let's not go all the way out. 37:06 That's a really crucial skill. 37:08 Damage control. 37:09 When they make a Might as well drink everything today and then restart over. 37:14 Instead, just stop. 37:15 Can you stop when you realize? 37:16 You know, those things is, uh, I don't know if I'm answering question now, but just a lot of them coming up. 37:23 No, no, that's really interesting because, you know that realization, You, know I had this goal set for myself. 37:31 I didn't meet it, but now can I reset and stop now? 37:37 I think that's a very important piece, you know, as opposed to, all right, I already messed up today. 37:42 Let me drink five more beers or whatever. 37:46 That's sort of the analogy that you're saying, having that awareness as a child, if you can, and as an adolescent, certainly as parent too. 37:57 Right? 37:57 Mm-hmm. 37:57 Right, right. 37:58 Yeah. 37:58 And when they're still like in elementary school, generally, they are physically, when the go aggressive, parents can still manage. 38:07 That's why I highly suggest to work on this, and the earlier the better. 38:11 Because when you get to teenage, adolescent age, physically when we go to really aggressive because of the withdrawal symptoms, 38:18 it's just out of hands. 38:20 Then where do we get help? 38:21 Very limited. 38:23 Yeah. 38:23 Right. 38:23 But I see it even in the younger kids that I take care of, that three to thirteen again, you know, when the parents want to take it away because it's time 38:32 for dinner, or excuse me, homework, You know, to leave to go to grandma's or school or whatever, they get very angry, very agitated. 38:42 And that's a sign that this is a real negative. 38:46 How in that moment do you work with families to get through that rage or that very intense anxiety? 38:54 Yeah, so when they even just go through screen fasting of two weeks, the first time generally improved is the aggressiveness and anger. 39:03 It's interesting. 39:04 I don't know why it's the 1st symptom to improve is generally they get easier. 39:09 They still get grumpy, but not escalating to the point like the past. 39:14 So 2-3 weeks of abstinence and then give the feedback. 39:19 How's your mood? 39:19 Would you get upset? 39:21 And a lot of clients say like, no, but they don't attribute to like a screen fasting. 39:25 They tend to say, like that's because nothing bothered me this week. 39:28 Right. 39:28 Cause there's no reason to be upset. 39:30 But in the past there was two no reasons to upset, they were upset though. 39:35 So those awareness, huh, all right, maybe true. 39:39 And then that exercise generally takes about six months to get, alright, now I see this is negative truly to me and I choose not to go back to this way. 39:51 Right. 39:51 Are there different approaches with neurodivergent clients, fact-based approaches, other approaches that you use? 39:58 Study is very limited, but yeah, so, you know, I come up with my own creativity.
Developing Boundaries and Abstinence 40:04 And yes, a lot of stress that they are trying to cope with, screen, that needs to be addressed. 40:11 That's my kind of expertise in counseling is to feed voice of them. 40:15 Right? 40:16 Sometimes I talk to school, communicate, you know, how they're feeling to a school. 40:21 Because that's the, we know it's expressive. 40:25 Output is the challenge, most part, not the input. 40:28 They have actually greater input than average, but output is less than an average usually. 40:33 So that gap frustrated them so bad. 40:36 Right. 40:36 And that why being the voice of them to express their concern and feeling is really validating and reduce the stress. 40:45 So you're saying that you do that with the clients that work with? 40:49 Yes. 40:50 Okay. 40:51 So they're unable, they may feel it, but they are unable to express it. 40:55 They're more aware of it but less able to expression the emotion from it? 41:00 Is that what you are saying? 41:01 Yeah, so like, you know, they have a struggle with how to kind of elaborate how they're feeling. 41:06 So I guide them to, express how their actually feeling, usually they can, if it's open-ended question, it is very difficult for neurodivergent brain. 41:15 How was this week? 41:15 How's today? 41:16 You know? 41:17 how was school? 41:18 Very difficult. 41:19 Usually in those scenario, I give like a, almost like multiple choice. 41:23 Did you feel this, that or this? 41:25 And then they say closer one is that, but a little bit different in this way. 41:30 Now I get more better picture, right? 41:32 So it was not good week. 41:34 Not because of the homework was a lot more, But the teacher, how they treat them was, not right. 41:39 So those things I learned more and then we like understand and became more empathetic about their struggle. 41:45 Right. 41:45 And really understanding where each client, each person is coming from. 41:49 I mean, not to overgeneralize. 41:51 You know, I don't want people that may be listening to say we're saying that about all neurodivergent people or all people with autism or anxiety. 41:59 It needs to be very individualized. 42:02 These are just some generalizations. 42:05 Wow. 42:05 Now, are there any other clinical considerations or treatment considerations that we haven't talked about, Koichi, that you want to mention? 42:14 Yeah, so when people first learn about screen addiction, they tend to assume, all right, that's because of screen use, early exposure. 42:25 But that is a great overlapping in knowledge from, you know, Dr. 42:29 Ohara. 42:30 If it's like a panzen panda is driving this, we got to treat that. 42:34 Otherwise, it mimics addiction but it is different kind of cause. 42:38 Right. 42:39 So that's the part. 42:43 Maps can provide a lot of helpful information to parents so they can understand why my kids are behaving this way. 42:52 Is this truly developed addiction versus underlying is physiological? 42:58 My work is, you know, hard to explain, but when I see clients, I kind of decide how much is psychological, how many is physiological.
Supporting Neurodivergent Kids and Hope for Recovery 43:05 Based on like a presence of a tick, like obsessive tendency, and how they talk. 43:10 That's how kind, oh, this is more like physiological, let's look at organic acid one. 43:15 Do you screen body versus like, okay, This is a more, screen-dependent. 43:20 Let's work on more counseling side a lot more. 43:23 And that's, that how I treat clients. 43:26 It takes all of us being detectives. 43:28 That's our role in trying to figure it out. 43:33 It's all so fascinating, Koichi. 43:34 I really appreciate your time. 43:36 And if somebody wanted to reach out to you or find out more from you, how would they reach you? 43:42 Yeah, we have an email for me directly and Dr. 43:47 O'Hara, can you put that on like info for this podcast? 43:49 It will be in the info, for the podcast, absolutely. 43:53 And you can have that for everybody and any last words of wisdom or hope or anything from your experience you want to leave the families or practitioners with. 44:03 So I have about 100 clients recover from this. 44:06 And then again, I said it earlier, but none of them regret what they went through, although it was hard. 44:11 Then also, a lot of people did believe I could not connect with friends without the screen, But they do realize actually they can. 44:21 So that's hopefully empowering for clients listening to this and family. 44:24 It's really hard for parents to kind of remove them from potential social interaction, but they can connect more in a meaningful way and closely without 44:33 screen actually. 44:34 So, that is my message to clients and families. 44:38 Yeah, there is hope. 44:39 You can do it. 44:40 And let's try to decrease that eight hours of social media and gaming and screen time in our teenagers and also for our families with younger kids. 44:51 Start now in trying to increase it as much as possible. 44:56 Yeah, it's such an important topic, Koichi. 44:58 And thank you so much for joining us today. 45:00 Really appreciate it. 45:01 I hope to see you again soon. 45:03 Yeah. 45:03 My pleasure. 45:04 Thank you for having me. 45:15 I hope you're walking away with insights, tools, and hope to help you and your child on this journey. 45:22 If you found today's conversation valuable, be sure to subscribe so you never miss an episode. 45:28 Share this podcast with anyone who might need it. 45:31 It could be the lifeline they're searching for. 45:33 And if you have a moment, leaving a review helps us reach even more families who deserve answers. 45:40 Also, for more information, training, and community, check out our website, drohara.com and join our annual membership. 45:50 And remember, every step forward, no matter how small, brings us closer to healing and understanding. 45:59 Until next time, be present, Be hopeful, And we look forward to seeing you next on Demystifying Pan's Pandas.
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