Plain English with Derek Thompson - The Dark Side of the Internet's Obsession With Anxiety

Episode Date: February 13, 2024

We’ve done several shows on America’s anxiety crisis. This one asks several questions that might get me in trouble. Have we overcorrected from an era when mental health was shameful to talk about to an era where people talk about anxiety so much online that it’s worsening our mental health crisis? Is the very design of algorithmic media engineered to increase rumination and mental distress? Is there a dark side to all this media about trauma, anxiety, and depression? (Yes, the irony of us asking this question is not lost on us.) Today’s guest is Darby Saxbe, a clinical psychologist and professor at the University of Southern California. We talk about anxiety as identity, why talking about anxiety on the Internet is such a mess today, how the architecture of the internet unhelpfully shapes our discussions of mental health, and what a better conversation about mental health online might look like. If you have questions, observations, or ideas for future episodes, email us at [e-mail]. Host: Derek Thompson Guest: Darby Saxbe Producer: Devon Baroldi Learn more about your ad choices. Visit podcastchoices.com/adchoices

Did Don Draper really buy the world of Coke? Did Tony Soprano really die? Or just order more onion rings? The finales of our favorite shows can make us argue, make us cry, and make us crazy. From Spotify and the Ringer, I'm Andy Greenwald, and this is Stick the Landing, a new podcast where we'll be telling the story of modern TV backwards, one fade out at a time. Find Stick the Landing on Wednesdays on the prestige TV feed, on Spotify or wherever you get your podcasts. Today is a conversation I've wanted to have on this show for a while. And it's a conversation that might get me into a little bit of trouble in some quarters,

but we're going to do it anyway. We've done several shows on America's anxiety crisis, taking a particularly close look at the record levels of teenagers in official government surveys by the CDC who say they feel persistently sad, hopeless, or depressed. I've talked to the social psychologist, John Haidt, about the causes of the youth anxiety crisis. I've talked to psychiatrists and clinical psychologists

about how parents and schools and teens themselves can cope and respond to this. And these episodes have clearly resonated. I've spoken to so many people, including parents, about these shows, and several of these listeners had a very interesting, very difficult question for me that I've never really known how to answer

to their satisfaction or to mine. And the question tends to go something like this. They'll say, Derek, my kids or my friends talk about their anxiety or depression symptoms and diagnoses all the time. They talk about it at dinner, in the car, in group chats with their friends. They have taken the diagnoses of OCD, GAD, PTSD, and they've made it something like their identity. Derek, what do you think about that? And the truth is, I've always found this to be a very hard question. First, it's a hard question because I'm very far from being an expert on this stuff.

I'm not a clinical psychologist, and I hope I've never presented as one. It's also a hard question because, you know, I feel, fairly or unfairly, a certain progressive temptation to advocate for the position that we should talk about this stuff more. We should erase the stigma of anxiety and depression completely. Do not cover it up like so many of our parents. And grandparents famously did with silence and substance abuse, right? the generations of the 1920s, 1950s, came home from a world war, never processed their feelings, and drank their way to personal chaos.

We've moved beyond that, and that's really, really good. But as I recently wrote for the Atlantic, for a while I felt somewhat uncomfortably that anxiety today has not been merely destigmatized. Anxiety has been turned into content. it's been turned into a content category on the internet. It's been turned into an identity to be shared and celebrated on social media. Today's social media feeds are absolutely jam-packed with celebrities, influencers, ordinary people, talking about their anxiety and depression.

A routine Google search will uncover 39 celebrities who have opened up about mental health, what 22 celebrities have said about having depression, 12 times famous men got real about mental health, all real headlines. On TikTok, the trauma hashtag has six billion views. And I do hope we can acknowledge that this is something beyond mere destigmatization. This is not therapy, an expert-led one-on-one conversation about mental health for the benefit of oneself. This is something more like therapy media, non-expert, one-to-one million broadcasts about personal distress, mental health for the benefit of an audience of strangers. And that is the crux of my concern.

We've overcorrected from an era when mental health was shameful to talk about to an era where some vulnerable people might surround themselves with conversations and media about anxiety and depression that makes them so vigilant about their own symptoms and problems that it creates more anxiety than it dispels. And so this puts me in a weird position. It's a position that no doubt some of you will consider hypocritical. I am in the media, and I think it's really important to talk about America's anxiety crisis. And I'm also of the opinion that the way anxiety is talked about in the media often turns disorders into identities and creates more anxiety.

then it's helped. Today's guest is Darby Saksby. She is a clinical psychologist and professor at the University of Southern California. Today we talk about anxiety as identity, why talking about anxiety on the internet is such a mess today, how the architecture of the internet unhelpfully shapes our discussions of mental health, and what a better conversation about mental health online might look like. I'm Derek Thompson. This is Plainment. English. Darby Saxby, welcome at the show. Thanks for having me. You are a professor of psychology at USC. What do you research and teach there? Yeah, so I run a lab at USC called the neuroendrochronology of Social Ties Lab, which stands for the Nest Lab. And I study close relationships and health

across the lifespan with an emphasis on the transition to parenthood. So I actually have a cohort of parents who I recruited when they were pregnant with their first child. and I've been following them over the last seven years to look at how the brain and body are changed by parenting. And you and I have spoken a few times about youth anxiety and the CDC's now quite famous reports showing skyrocketing rates of sadness among American high schoolers.

As a clinical psychologist, and is someone working at a big university, and is someone working in the field that sort of joins developmental psychology and the body and the way people, feel about the relationships with each other. I'm just curious before we get into the real meat of this conversation. What is your perception of the youth anxiety crisis? How do you see things have changed in the last few years? Yeah. And I should have mentioned also, in addition to my lab and

my research, I run our clinical psychology PhD program. So I'm the current director of clinical training. I teach in that program. I teach clinical interventions. I'm a clinical psychologist, myself, as you mentioned. But honestly, most of my perspective on this comes from being a parent of a 12 and 14 year old. So I think in the wake of the pandemic, particularly, it seems like youth anxiety has become so commonplace that it's actually hard for me to think of one of my kids, friends, or acquaintances, who doesn't have some kind of challenge related to mental health and anxiety in particular. So just anecdotally, talking to other parents, being part of parenting Facebook groups, and then also with the clinical psych perspective, working with graduate students who are

themselves doing a lot of clinical work, I feel like I have a pretty good sort of ear to the ground. And it feels like the tenor has of the conversations have shifted around youth mental health to sort of mild concern all the way to full-blown panic. like it feels like we're in a kind of unprecedented place right now. So obviously, with this wave of youth anxiety in the U.S., and it really is a wave around the world, there are all sorts of well-meaning schools and psychologists who are trying to fix it. And there have been these efforts to test the effect of delivering therapy to teens on mass.

Because I guess, as you just said, this is not a problem of a handful of kids. It is an on-mass problem, and so it would be nice to have on-mass solutions. Recently, researchers in Australia did a study where they took 1,000 young teenagers and they assigned them to two different groups. There was a middle school health class that basically taught a mental health treatment called dialectical behavioral therapy, DBT, and then there was a control group of, I guess, the other 500 students. If you believe, as I do in DBT or more commonly practiced CBT, cognitive behavioral therapy,

My hypothesis would have been that a program like this delivering mental health help to hundreds of kids at a time will succeed, if not thrillingly, then at least on the margins, at least giving people the tools of basic DBT and CBT is going to help young people. Is that what happened? Unfortunately not. And I share your intuition. I mean, I'm a fan of DBT and CBT. I've taught it. I've trained in it. It's effective. It's known to be effective. And can we actually just stop here? We've talked about CBT and DBT and other episodes, but why don't you give like a 101 definition of what CBT is and then of what DBT is? Definitely. Yeah. So cognitive behavioral therapy stems from the intuition that our thoughts, feelings,

and behaviors are interconnected. And it's very hard to change someone's behaviors. It's also very hard to change someone's feelings or emotions, but it's relatively easier to change how they think. So CBT targets, thinking patterns, and identifies what are called cognitive errors, which are sort of misattributions that lead people to feel less empowered, more hopeless. By reframing or restructuring those cognitions, CBT helps to increase flexibility so that people can then behave in ways that are more adaptive and that help them to feel better.

So that's kind of CBT in a nutshell. There's like a whole alphabet soup when it comes to psychotherapy. Lots of people have acronyms. DBT is dialectical behavior therapy, which kind of takes CBT and adds this sort of like Zen, almost like Buddhist perspective on it. So it's focusing more on reconciling opposites. That's where the dialectical piece comes in. So like holding two conflicting thoughts at the same time.

My life is intolerable as it is. and yet I don't want to change, for example. Sort of learning how to build in the ability to tolerate these kind of conflicting or contradictory thoughts or feelings is a way that people can learn to regulate emotion more broadly. So what that means in practice is a lot of focus on acceptance and a lot of focus on just sitting with difficult feelings and learning how to build tolerance for them.

So if you asked me, let's deliver CBT skills or DBT skills to a thousand teenagers and see what happens, I would have said, of course, they're going to benefit these are incredibly valuable skills. But they did not. And in fact, the teens that were randomized to the DBTIL, it was called, the program was actually called Wise Teens. So it was this sort of like broad scale adaptation of DBT skills. The youth that were randomized to wise teens actually ended up doing worse. So they had worse depression, worse anxiety, worse relationships with their parents. And it's not just the case that they did worse and then over time as they kind of built in the skills they started to do better.

They actually, those that those iatrogenic effects, what we call in psychotherapy as like things that make you feel worse, those effects persisted over time. So even at a six-month follow-up, they were still reporting, worse functioning than people who were randomized to just sit in a regular old health class. So all told, kind of an abject disaster of a mental health intervention. And it'd be one thing if this was the only example of mental health treatment on mass that had failed to make middle schoolers or teenagers feel better. In fact, there are other studies, right, that have shown that efforts to get kids to be mindful or practice this sort of Zen approach to CBT really fails when it is applied

to teenagers. Do you have other examples? Yeah. So there was a large scale, even bigger than the study we're talking about in Britain, 8,000 teens learned mindfulness skills. And same thing. It wasn't just that they didn't do well. It was that they actually did worse when they were in the condition where they were learning those skills. And, you know, I think the youth psychotherapy world is actually riddled with these iatrogenic effects that aren't always studied. We were all familiar with the DARE programs from the 80s and 90s. Like I dare myself as a Midwestern teenager. And there's some evidence that those programs actually made kids more likely to experiment

with drugs and maybe like encouraged curiosity about substance use. So trying to get teens to do mental health things turns out to be sort of a complex and sometimes backfiring proposition. And this is what I find so interesting, and this is really what I want to talk to you about today. So Olga Kazan, Atlantic staff writer, wrote about the failed effort of the Wise program. You wrote about this in the New York Times, and you had a quote in that piece that to me was like this little Rosetta Stone. It was like it really cracked open something for me in the way that I think about anxiety, the phenomenon of youth in American anxiety, and also the weirdness

of the way that anxiety is often treated in the public discourse, especially online. And you said, quote, by focusing teenagers' attention on mental health issues, these interventions may have unwittingly exacerbated their problems, end quote. I think to some people who maybe are studying psychology,

who maybe have been to therapy, that's going to seem like a really wild statement. Like, by focusing teens' attention on mental health issues, you might have exacerbated the problem. Like some people are going to think, isn't that why I go to therapy? It's to pay attention to my problems.

So say a little bit more about what you mean by this sort of ironic, even paradoxical effect whereby focusing someone's attention on their anxiety, it actually leads them to feel worse rather than better. Right. So, yeah, it's an interesting paradox, right? And I think one of the success stories of clinical psychology has been

the destigmatization and normalization of mental health labels and diagnoses to the point where instead of hiding and feeling ashamed about an anxiety disorder or bipolar disorder, people are out in the open with them. That's overall a good thing, right? But we also know from,

we were just talking about cognitive behavioral therapy and how it works, that our thoughts have a big impact on how we feel and what we do. And if our thoughts are constantly turning in the direction of our own mental health problems, to the point that those start, to become a trapping of our identity, then we will function in the world in ways that are less

adaptive, right, that are sort of more reaffirming of those mental health problems. So I think, you know, in the piece that you referenced that I wrote for the New York Times, I talked about this phenomenon of prevalence inflation, which is the idea that when you hear about people having a particular diagnosis or problem, and maybe even if you're online, your feed is kind of populated with people with those particular problems, you start to feel like everyone has them. And then you start to feel like, well, of course I have this also. You start to kind of self-diagnose yourself. And then that becomes kind of a self-fulfilling prophecy. As soon as you start to associate yourself with that identity, then you're going to gravitate towards examples that are

congruent with that identity, you're going to maybe even unconsciously act in ways that affirm that identity. And you're going to get into a bit of a vicious cycle, I think, with your own sort of perceived pathology. I find the phenomenon of prevalence inflation, the concept of prevalence inflation. And this is from a 2022 paper by Lucy Fulkes and Jack L. Andrews. I think they were the ones that coined the term. And they said in their abstract, quote, if people are repeated told that mental health problems are common and that they might experience them, they might start to interpret any negative thoughts and feelings through this lens. End quote. This is such a thorny issue to me. It goes so much to the heart of the tension that I think you put your finger on.

On the one hand, yes, we want to destigmatize mental health issues. We don't want to go back to the 1920s, 1950s, where people coming back from the war, we're drowning themselves in alcohol. But there is a point where the pendulum might swing too far and where the prevalence of the concept of mental distress or anxiety might feel so ubiquitous to people that they can't stop sort of checking themselves, like doing their own sort of interoception, like, looking inside and being like, is that anxiety? Is that anxiety? Am I feeling it now? Am I feeling it now? And it seems really, this is where I wanted you to help me sort of work through this, because I don't think I have the language to draw the line between how far we want to destigmatize mental health, right?

We don't want people suffering in silence, but also this principle of prevalence inflation suggests that the conversion of mental health conversations to like, you know, a kind of popular media content, this has severe drawbacks. How do you think about where to draw the line here? Yeah, I think it's a thorny question, as you said, because I think on the one hand, you know, we want to assume that more education, more knowledge is always going to be a good thing, and that public health campaigns are always a benefit. On the other hand, it's sort of basic kind of human cognition that we're going to be drawn

towards things that we're hearing about. So, you know, there's some evidence from that anecdotally white coat syndrome in medical school, like doctors start learning about the symptoms of different diseases and instantly, you know, start to fear that they're suffering from those diseases. It's the same as, you know, try not to think about a white bear. And then, of course, your thoughts are full of that white bear. So, and there's even some evidence from things like substance use intervention, like college drinking, the extent to which if you ask college students, how much is everybody around you binge drinking? They will frequently overestimate the rate of heavy drinking in their peer group.

And actually just correcting that is an important. intervention in and of itself. So telling them actually two-thirds of people in your dorm don't drink more than two drinks in one sitting. Like that's an intervention in it of itself, right? So that this prevalence, prevalence inflation phenomenon is not unique to mental health, right? It happens in a lot of different realms. But I think where it's tricky is when youth are accessing mental health information, not just from kind of empirically well-validated sources, but from the kind of wilderness of the internet, where you have this combination of mental health information and, you know, you might have ADHD if you do these five things, but also the sort of the phenomenon of the

curated feed so that when you click on something because you're interested and you feel like it might apply to you, you're instantly going to see 10 more posts that are feeding you the same content. And so that's kind of like a prevalence inflation in real time. If I open my TikTok or my Instagram and every single post is about ADHD and everyone who's talking about their ADHD is totally relatable to me, of course I'm going to walk around thinking that I have that condition. And I think it's the same for anxiety and for other problems. And youth are particularly vulnerable to, I think these kinds of influences because the teenage brain

is sort of wired to make peer influences really salient and important and teens are figuring out who they are and forming their identities and so information that they can gather that will help them build that picture of who they are is going to mean a lot.

For people who are listening and thinking, when am I going to hear solutions to this problem of dealing with prevalence and without encouraging my friends, myself, my children to think about mental health as something that ought to be stigmatized.

I want you, Darby, and I also want listeners to know, I'm holding the solutions for the end. I want to be specific about what I see as the problems of the way that we talk about anxiety, especially on the internet first. You touched on what I think of as the second big problem, which is the architecture of the internet. You know, when someone has a therapy session,

you arrive, you open a door, you sit down, you talk, you leave. There's a clock. The session ends. The internet has no clock. You don't leave. In fact, if you like this, then you might like that nature

of algorithmic media that you're just referring to, is designed to keep us hooked into the same content in a way that is very phenomenologically different than being in a therapist's office where there's 45 minutes or whatever, an hour and a half, and then you go. Take the lessons and leave. Go on with your life.

Do you worry that the architecture of the internet might be its own discreet driver of anxiety for some people because they're sort of funneled into these algorithmic rabbit holes that are not the kind of architecture of mental health content that we should want to help people dispel of their distress rather than feel sort of marinated in it? Absolutely. Yeah, I worry about this a lot. So I think, you know, in clinical psychology training, we talk about the idea of the therapy room serving as kind of like a container. Like you have this really fixed space and time, as you said, where you're seeing somebody in a structured way that you can then expect to see them again at the same time in a week.

And it's that sort of like boundary container that allows you to process really deep trauma because you know you're not going to be necessarily talking about that trauma all week long. You can sort of come in, talk about your deepest, darkest experiences, sort of close it up, get yourself ready to face the world, and then be ready to do it again the following week. Like, there's something about those small doses that are structured that I think help people sort of integrate difficult things slowly over time, right? Whereas the internet is designed to hook us and addict us and make us, I mean, the goal, the way these companies make money is by getting us to spend more time absorbing their content.

And so there's no sort of like shut off valve. Like there's no like advisory warning that comes up and says like you've been watching too many TikToks about anxiety. You need to go take a walk around the block. So I think that, you know, kind of like spiraling or sort of like rabbit hole of content is more similar to a phenomenon we talk about in psychology called rumination, which while processing difficult emotions is considered to generally be adaptive, rumination is kind of like the less adaptive

or the darker side of that, which is to say you end up wallowing in distress to a point where you start thinking in circles and find yourself kind of unable to get out of that rumination spiral. And I think that's kind of how the internet can be sort of conducive to rumination, again, especially in youth who are particularly drawn to it. It's kind of spooky to think of algorithmic media, news feeds that are focused on anxiety and mental health specifically as being a kind of engineered

rumination. But that absolutely clicks for me. I've been there, right? You're clicking on one thing, you get the next. Click on one thing, you get the next. And before you know it, you're going deeper and deeper into a dark thought rather than working it out with a professional. And so that's one way in which, you know, I said in the top, there's a difference between therapy and therapy media. Like, therapy is an expert-led, hopefully, one-on-one conversation for the purpose of, you know, dispelling one's anxiety. And then there's therapy media, which is a, often a one-to-one million broadcast of one's feelings, not for the purpose of dispelling the feeling, but for the purpose of amassing clicks, right? And so therapy and therapy media can be unbelievably different, even though

they often use the same language. And so I'm just sort of counting off that the problems that I see in the way that the internet and the way that our much sort of modern discourse talks about anxiety. Number one is the concept of prevalence inflation, which I think you described well. Number two is this sort of algorithmic media and the way that it can engineer rumination to steal your language. Number three, I have a little rant here about viral dynamics and the way that I think viral dynamics underserve us. So I don't know if this is a paradox or just something that I find interesting. On the one hand, the internet has so clearly absorbed the vocabulary of therapy. You know, the trauma and harm and emotional capacity and self-care.

These are terms and phrases that were not ubiquitous 10, 20 years ago, and are much more common in mainstream media now. But the irony is that all this therapy speak on the internet has coincided with the emergence of an internet culture that I find unbelievably antitherapeutic. So like CBT says, don't treat minor problems as catastrophes. But on social media, for anyone who's ever written a post, published something on Instagram, publish something on Reddit, what's the best way to get attention for a boring piece of information? Give it a catastrophic headline. Catastrophe goes aerodynamic on the internet. Everyone knows this. A good therapist will say, you know, anger produces conflict with family and friends. Don't hold on to anger. But what's a good piece of advice for an online

poster who's trying to build an audience? Find something to be angry at and go at it over and over and over. So CBT is like grudges are a waste of energy. The internet's like grudge your way to modernization. So there's just so much research that I know on how intense and negative feelings go aerodynamic on the web. And these are like precise emotions that a decent psychologist ought to tell patients are maladaptive. And so like in some, it's like modern internet culture is more replete with therapy speak than any internet culture that's come before us. but we're setting fire to the actual lessons of therapy at the same time. And I am fascinated by this irony that everyone is talking like a therapist

while participating in fantastically antitherapeutic manners on the internet. And I don't know if you sort of observed something about the sort of the viral dynamic that encourages sort of negative catastrophizing and the ways in which that's so obviously not in keeping with the principles of CBT. Right. Yeah, I hadn't ever thought about it that way, but that makes so much sense to me. I'm really resonating with what you said. And, you know, right, it explains like why our politics are so toxic also, right?

This idea that anger is contagious and that's how people get more attention on their posts. You know, a really good therapy feed would probably be very boring and no one would look at it. It'd be all about taking the temperature down. I think there's another piece too, which in a way that the sort of like the way that we get content is contrary to what we know is good for our mental health, which is that a lot of CBT therapy is about combating avoidance and getting people to behave in ways that are more approach-oriented. So, you know, avoidance means that, you know,

when I feel panicky on the freeway, I don't suddenly just cancel my commute and stay home. It means I drive again and again and again until I can habituate to that feeling and learn to tolerate it. Right. So frequently like exposure therapies, which are all about doing the thing that you're afraid of in a sort of scaffolded way so that you can be more comfortable with them, as opposed to the tendency that we often naturally have, which is to avoid settings in which we feel anxious and uncomfortable tend to further distress because then we learn, I avoided the free way and I felt

better and therefore it's a really effective strategy for getting rid of my anxiety. That's a really counterproductive thing for us to learn again and again, right? So we want to combat avoidance as one of the primary things that we're doing in therapy. A couple things about that. First of all, spending time on our phone or, you know, sucked into social media is in and itself quite avoidant. So, you know, the more time I'm spending browsing my social media, it's usually because I'm either not doing something in person with people or I'm procrastinating on work that I should be doing instead, right? Right. Like it's almost always something that people use to kind of fill time. And in fact, you often see it in social settings. And I see this with my teenager and her friends that when

we're, that when they're all interacting together, people pull out their phones because it's like a way to kind of like cover the social anxiety that they feel face to face with others. Right. Like the phone becomes this kind of like crutch or this safety signal. I'm going to look at TikTok instead of talking to the person across from me because talking to the person across from me is hard. scary and aversive and I have to look at them. And I think a lot of teens do kind of retreat into the relative safety of whatever is happening on the phone screen. So I think that's one thing. I also think there's a culture. And I see this in a lot of the mental health content online of really want, like a lot of it is driven by people who have anxiety themselves. And it's about

here's what everyone else in my life needs to do to kind of appropriately accommodate my anxiety. So they need to not force me to drive on the freeway. They need to let me work from home. You see this phenomenon of school avoidance in young people who are teenagers who are doing Zoom school, not wanting to go into the classroom. And I think very well-meaning parents are doing this as a way to sort of help their anxious kids.

But again, it's totally counterproductive because what we want to help people do is be more approach-oriented. So I think that's another thing that can kind of like spread and become this intuition that people share, that if I'm anxious, people shouldn't make me do things that are harder uncomfortable because then they're, they're sort of like not being kind. And in fact, most therapists would say it's the exact opposite.

We need to do whatever we can to encourage more approach-oriented behaviors from young people. You and I have talked a little bit around the concept of the teen anxiety crisis being predominantly phone driven, because that's not really the conversation that I wanted to have. I've talked to John Hyde about it. I've talked to Gene Twangy about. I've talked to lots of people about the phones, it's the phone stupid theory of the teen anxiety crisis. I assume that you consider phones to be a important part of the reason for the rising crisis and teen anxiety. I'm interested, though, in, in what you see is like the key mechanism. Because I guess we've talked about a couple mechanisms by which the presence of phones and social media might be partly or predominantly responsible for this phenomenon. There is the fact, we've talked about how social media

can be toxic. We've talked about, you know, prevalence inflation of anxiety and the algorithmic engineering of online rabbit holes. We talked about the fact that phone use can be avoidant. And so sometimes it can very literally take us out the physical world, take us away from physical relationships with friends, and put us into a room, into a bed where we're alone and now withdrawn, which is not the best way to work our way out of an emotional rut. Which of these aspects of phone use, or which other aspects of phone use,

do you consider to be the most important when it comes to explaining why so many different social psychologists and sociologists are pointing to phones as being just a key lever here. Yeah, I mean, I think all of the above, can I answer that? It's my like wishy-washy answer, right? Like, I think all of this stuff is multi-determined. There are people that think it's not just about the phones. It's also about our economy and the way that we parent. And I mean, to me, it's all of a piece, right? Like we, you know, there's a sort of rise of youth culture where youth have less physical freedom, but more access to the entire internet, which gives them, you know, like tremendous exposure to all kinds of content that probably isn't developmentally

appropriate. At the same time, we're scared to let our kids walk three blocks away to a friend's house or ride their bike or, you know, like play without the sort of like direct instruction of an adult who's coaching them or telling them exactly what they need to do, right? So that like unfettered play that we know is really beneficial for kids is kind of being stripped away, even just in the structure of the schools and the, you know, sort of like less allowance

that they give for open-ended play. Right? So that's part of it. So part of it isn't just that phones themselves are bad, is that they're replacing other activities that would be better, such as direct socializing, play, experimentation. I'm a really big believer in boredom,

I think it's one of the absolute best things that kids can experience. I mean, I'm all about ignoring my kids for long enough to have them get really bored. And then I find that they become much more interesting and creative when they are given sort of like no other source of entertainment. And I do think like tolerating boredom, you know, if you think about even just like, you know, pre phones like waiting in line at the post office or at the doctor's office and just being bored. because there's nothing to do but look at other people and kind of just like absorb what's happening in the room, but you have to tolerate that. It's like an uncomfortable feeling, right? And I really think a lot of it has to do with can we tolerate distress or do we need to kind of get pulled away from it or distracted by it? And so I think that's where the phones, like I was mentioned that I think

they're sort of an avoidance device, but they're also just something that like zaps us out of whatever present-oriented state we're in and they take us into another world. And I think if we're doing that over and over again, we actually are sort of like losing the inner resources that allow us to just tolerate difficult states or emotions. And I see that that's what leads to a certain amount of brittleness, like the distress tolerance in young people seems to be kind of foreshortened maybe because we've made the world so entertaining

and we've provided so many escape hatches. It's really interesting to think of boredom as an elliptical machine for distress tolerance. I've never quite thought of it like that, but that is a fun way to think about it, because it's true, that being able to sit with yourself when nothing is going on and work your way into a kind of positive excitement

is good practice for being in a bad mood and having to work your way into a kind of positive mindset. I never quite thought of boredom as being a kind of, or fixing, sitting with boredom as being a kind of mental health practice, but that's an interesting way of thinking about it. Let's talk about solutions. I want to go back to the issue of prevalence inflation, because I'm trying to put myself in the mind of, let's say,

a high school counselor who says, you guys have presented an absolutely impossible problem for me to solve here. Young people are anxious. Young people are online. Young people who are online and anxious are going to talk about themselves, and their friends who aren't as anxious will see how they feel, and you're telling me that there might be, I don't know if what you're describing is exactly a social contagion, but there might be a kind of

internalization of these concepts that they're seeing floating around them. They're picking up on the culture of anxiety that's swirling around them, then they get anxious. Well, I don't know how to fix this. All you're telling me, essentially, is that anxiety spreads like a virus, and it spreads like a virus through this mechanism of prevalence inflation. How in the world am I supposed to stop that? Great question. So I think part of it is by reframing the conversation with a more resilience-oriented lens. So when we're talking about anxiety, like it's not that it's bad to talk about anxiety online

or to talk about it in the classroom, but it's that we want to talk about how we learned to tolerate and overcome it. Right? Like we know that anxiety is treatable. People can really learn to live with, you know, even people with severe anxiety disorders, people with agoraphobia,

people who haven't left their house because they're afraid of having a panic attack, eight weeks of really good exposure therapy and those people can be functioning really normally. So I think the message can be like, I was nervous in a social situation with someone I didn't know before, but once we started talking,

I got more comfortable and the conversation was great and I developed a new connection that I wouldn't have otherwise had. I think parents can have those conversations, teachers can have those conversations that like we derive a lot of strength from overcoming obstacles and adversities. And that strength-based perspective can really change the way that we talk about anxiety. I think like there's been a lot of attention paid to the kind of growth mindset idea in education

that if you sort of like see that the harder you work in school, like the better you can get at a particular subject, like the sort of idea that kids go in and think, like, well, I'm just not good at math. I'm not going to succeed in algebra. That if teachers and students can adopt a growth mindset to think, like, I can actually get better at this. Like, I believe that I can change and my math skills will improve. That predicts better outcomes.

But I think we need to think about a growth mindset with mental health as well. Like, anxiety is not a trait. It's a state. It's a condition. but it's not a, you know, life sense. I can be anxious and still go to school and still have friendships and still do all the things that I want to do and my anxiety might run in the background

and I'm going to be able to manage it or tolerate it or accept it or whatever my strategy is going to be and be a really happy and successful person. So I think that's kind of the message of, and that's where I think this sort of natural tendency to accommodate and think, okay, you have test anxiety. Let's just let you do your assessments in a different modality, for example. Like I see a lot of those kinds of accommodations happening in schools.

I think it's coming from a good place, and it's something that parents and students are often asking for, but I think it's sending the wrong message, which is that if something makes you anxious, you shouldn't have to do it. The message we want to send instead is anxiety is a normal part of the human condition, We all feel anxious from time to time, and we can feel anxious and still do things that matter to us.

Last question. I'm no longer a high school counselor. I'm a high school student. Or maybe I'm just a person of any age, and I'm starting to struggle with mental distress. It could be generalized anxiety disorder. It can be depression. I do what everyone who is experiencing something new with their bodies does.

I ask Dr. Google what's going on, or maybe it's Dr. Chat, you know, chat, GBT these days. I go online. I start researching this. One tab becomes 10 tabs. Ten tabs becomes 20. Like any other search, you've said that there is a potential danger of getting too stuck in the algorithmic wormholes of anxiety content. How do I know when I'm in one of those wormholes versus just in a sort of phase of research to learn more about a condition that I'm feeling? Right. Yeah, I think one question is. are all these tabs, is all this research,

is it a means to an end or is it an end in itself, right? So if I want to learn a lot about anxiety because I want to find solutions or techniques or strategies or skills that will help me to either overcome it or live with it, that's great. If I am learning about anxiety because it's now something that I think is defining who I am and who I will be in the future, that's not so great.

So, you know, I think, like, frequently, you know, if we're researching a big purchase, we research it for a while, and then we make our selection and then we move on, right? Like, there's a life cycle of that, like the research stage is, you know, a preamble to the action that we're going to take. So is this research leading to action of some kind? or is this research just sort of like a spiral that we get into, especially when we're being avoidant,

and does it make us feel worse about ourselves? Like one way that we can tell what rumination, like how we can tell rumination apart from useful processing of emotion, is that when people ruminate for long stretches, they typically feel worse. So I think that's the other thing is just to kind of have that barometer of is the time that I'm spending with this content making me feel worse or making me feel better?

Is it making me feel more inspired to act and do something different? Or is it making me feel more hopeless and more stuck? And if it's making me feel worse and more stuck, then I think we need to turn our phones off and try some other things. Thank you very much. Darby Saxby. I appreciate it. My pleasure. Thank you for listening.

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