Screens, Toxic Stress & Staying Connected with Dr. Nadine Burke Harris

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Dr. Nadine Burke Harris:
It’s this direct interaction between the youth and the media that they’re consuming that the adults in their orbit may or may not be aware of.

Dr. Lisa Damour:
So often as we’re trying to navigate these waters, we want to hold the line without damaging our relationship with our kid.

Dr. Nadine Burke Harris:
The biggest protective factor for kids online is a connected presence in real life.

Dr. Lisa Damour:
Hello! Hi! So happy to be with all of you.
I have the tremendous honor of recording a live episode of my Ask Lisa Podcast with Dr. Nadine Burke Harris, Goddess of the First Degree, who I love thinking and working with. So let me introduce you formally and then let me introduce you informally.
So Dr. Nadine Burke Harris is an award-winning physician, researcher, and public health leader who has spent her career on the front lines of some of our world’s most pressing public health challenges. As California’s inaugural Surgeon General, Dr. Burke Harris successfully launched a first in the nation statewide effort that has trained more than 45,000 primary care providers on how to screen for adverse childhood experiences and respond with trauma-informed care. I know. I know. Today she serves as the Chief Impact Officer for ACE Resource Network, a national organization advancing a bold vision to make the prevention early detection and evidence-based treatment of toxic stress a standard part of healthcare practice in the United States.
Beyond that, she is also an avid gardener and finds joy in engaging her four boys in garden adventures. They grow fruits and vegetables, you put together amazing floral arrangements, and you treat this as your ultimate stress buster.

Dr. Nadine Burke Harris:
Yes, that is absolutely right. Thank you so much. And I feel like we are the mutual admiration society.

Dr. Lisa Damour:
I’m all for it.

Dr. Nadine Burke Harris:
So yes, I’m so happy to be here.

Dr. Lisa Damour:
Now, I’ve known Nadine since 2019 when I had the honor of introducing her at the City Club of Cleveland. I live in Cleveland. And then we just had a really good and productive time in Madrid together in January on behalf of UNICEF and the World Health Organization working on child protections worldwide. So, good time. Okay.
So we put out a call for questions to my audience and I have several, but I actually want to start with one that is really, really central to the work you do, which is about kids and toxic stress and becoming overwhelmed. And all of us know that a lot of what can be out online can be either highly violent or sexual or disturbing or otherwise just flooding for a kid. Can you talk us through sort of with that online context, what it means for a developing nervous system to have that kind of exposure?

Dr. Nadine Burke Harris:
Well, what we know about the science of toxic stress is that when we have repeated activation of the biological stress response in absence of adequate buffering caregiving systems, that that can lead to a dysregulation of the body’s stress response, which when we think about it like stress hormones, almost every cell in our bodies have a receptor for stress hormones. So these hormones act on almost every cell in our bodies. And when that happens repeatedly, what we can see is changes in the way our stress response functions, and that leads to changes in the way kids’ brains develop over time, but not just our brains, our immune systems, hormonal systems, and even the way our DNA is read and transcribed. And so that is what doctors now refer to as the toxic stress response. And where that relates specifically with and interacts with online content is that because of the way so many kids and young people consume media or online content, where they may have something that is activating or stressful or flooding, and it’s delivered in this very personal way.
So it’s not something that’s seen on the playground, right? It’s not something that oftentimes is witnessed.
It’s this direct interaction between the youth and the media that they’re consuming that the people, the adults in their orbit may or may not be aware of.

Dr. Lisa Damour:
Which then really undermines the potential of a buffering response from the adult.

Dr. Nadine Burke Harris:
Exactly.

Dr. Lisa Damour:
Okay.

Dr. Nadine Burke Harris:
Exactly. And particularly if kids are not wanting to talk about what they saw or trying to not share, then that creates particular risk.

Dr. Lisa Damour:
So one of the big themes for this summit has been about the importance of regulation, and this is reason number 400 for the importance of regulation. And I also think, thinking about this as a clinician, as a mother, one thing I think we should recommend is that if kids are online, that we should say, “You may see things that keep you up at night, that are very jarring. I am here to talk and think with you about those you don’t have to carry it alone.” Does that feel like the right way forward?

Dr. Nadine Burke Harris:
A hundred percent. I think that, I mean, that is the conversation that I’m having with my boys and as we talk about content, and one of the things that’s really interesting, and I’m going to actually offer an example that is actually a real life example. I think that one of the very tricky things about online content is that it may be presented in a way that our kids don’t know what to do with. So for example, one of my boys, he’s like, “Oh, hey mom, I want to tell you this joke.” And it was a joke that he had heard online and it was a really racist joke, incredibly racist. And I think part of the reason why he told it to me is because he was on this platform where it wasn’t presented as a racial joke, it was presented as funny. And then when the guys who told the joke, they were, “Ha, ha, ha, ha,” and they laughed. And so my son internalized like, “Oh, this must be funny.” But I think he also felt this like, “Huh, this makes me feel weird.” And I will tell you, when he told me the joke, I immediately burst into tears.

Dr. Lisa Damour:
Oh, Nadine.

Dr. Nadine Burke Harris:
Because it was pretty horrible. Yeah.

Dr. Lisa Damour:
First of all, I am sorry. Second of all, speaking as a psychologist, what I have known about when kids do that is that they see something online and as you described the context, they’re like, “This feels wrong, but the context isn’t signaling it’s wrong.”

Dr. Nadine Burke Harris:
Right.

Dr. Lisa Damour:
And so then they’re like, “Is it my misunderstanding or is there something wrong?” And so then they bring it to an adult and they repeat what happened as it happened. I’m going to do the thing but not give you the context because they want your gut check, but they don’t want to have led the witness. I think that’s often what’s happening. So they’re like, “I’m going to do it the way it came to me and see if you have the reaction that I had deep inside, you do, okay, I wasn’t in the wrong.” And it’s so critical, right? All of that is horrible up to the moment of him taking it to you and you being able to say, “Oh my gosh, that was so far out of line.”

Dr. Nadine Burke Harris:
Yeah. I’ll tell you, I burst into tears for a couple of different reasons. One, because the joke was horribly racist, but the second was because as a mom, I was just like, I can provide … As a pediatrician, as a pediatrician, I can talk to my kids and say they’re going to see uncomfortable things online and open the door and I can make sure that we’re really connected. And I know the data that shows that that’s the biggest protective factor for kids online is a connected presence in real life. So I know that. As a mom, I was like, “How do I keep these people out of my house?”

Dr. Lisa Damour:
Yes. And actually to keep going on this, so we know that not all kids are having the same experience online, that kids of color are having a different experience than kids who are white, and that it often involves discrimination, sometimes directed at them. It often also involves witnessing incredibly disturbing things. What are the kinds of conversations you’ve recommended as a pediatrician or had in your own home about this? And, follow up, what would you have all of us do?

Dr. Nadine Burke Harris:
So the conversations that I’m having with my own kids are these conversations about being an upstander, right? About recognizing that these things are out there, and then also just recognizing how everything … My kids run around and be like, “Like and subscribe.” So it’s like, do not. So really kind of voting with your attention and those types of things, but also taking a little bit of time, and this is one of the things that I recommend to families to be able to break that down a little bit and understand that it is a commoditization of our attention, right? And to be able to look at what are the dynamics at play there, why are we seeing … Why is this content being promoted? And so how do we essentially train the algorithm of like, “Do not send me this nonsense, and this is not valuable content.”

Dr. Lisa Damour:
Those kinds of really clear conversations at home, I think we can’t be having them enough. One of the ways I’ve heard it talked about and have talked about it with my own adolescents is these are advertising companies. They make their money by collecting more and better data on you. And the way they do that is by creating content that keeps you there with no regard for the impact of that content on your health and wellbeing. And we just have to say those things over and over because they are hard to understand and the stuff does seem fun until it’s not.

Dr. Nadine Burke Harris:
Right, right.
And it’s a little bit of, I think particularly there’s a little bit of that playground effect where this is where particularly the consumption of digital media is challenging because when our kids are consuming it, they’re not in a circle on the playground to look around and be like, “Did you think it’s funny? Did you think it’s funny?” It’s just them interacting with the folks who are producing the content, right? And so that’s where that gut check comes in. And that’s why my son brought that particular question to me. And this is really preparing our youth that this is what you may see, this is what it’s designed to do, and here is what you can do to vote with your attention.

Dr. Lisa Damour:
I love that.
Okay. So we got questions about just being overwhelmed by all of this, which we can feel for sure as parents and caregivers. We also got a question I think a lot of us have about the tension between wanting our kids to be shielded from all of this, not wanting to give them access for all of the reasons we’re talking about, and wanting them to know what their friends are doing and be included in stuff. And one of the questions we got is, “I don’t want to give my kid a smartphone, but all of their peers are on WhatsApp.” So how do you think about that tension between we’d really rather not and also, or the way I think about it is social media is bad for kids, social isolation is bad for kids.

Dr. Nadine Burke Harris:
Yes.

Dr. Lisa Damour:
How do we think about that?

Dr. Nadine Burke Harris:
So as a pediatrician and public health person, I am the person who … So one of our boys is 13, and actually our two older boys got phones when they were 13, and they’re nine years older, and I feel like in between the landscape has changed a little bit.

Dr. Lisa Damour:
My daughters are seven years apart, and I agree. I have a 22-year-old and a 15-year-old, and we’re dealing with two different internets.

Dr. Nadine Burke Harris:
Yeah. Yeah, exactly.
And so we did a contract with our now 13-year-old, and we did a contract with our big boys when they got their phones. And it was like a contract for digital citizenship and all that stuff, and we can look at your phone and blah, this is not a private space and all that kind of stuff. With our now 13-year-old, we did the contract a year before he got the phone.

Dr. Lisa Damour:
I have never heard that. That is super smart.

Dr. Nadine Burke Harris:
A year before he got the phone and we said, “Okay, here are the risks and the benefits of having a phone and here are some of the things that we want to see before we recognize that we feel like you’re developmentally ready,” and this is going to be hard for some people to hear, but actually at his 13th birthday, he wasn’t able to meet all the terms of the contract, so it got pushed back by a year.

Dr. Lisa Damour:
Good for you. Good for you.

Dr. Nadine Burke Harris:
And so now he’s getting ready for 14. And a lot of the pieces of it are these pieces of coming to us when there’s concerning content. When we say it’s time to turn it off, actually turning it off, not sneaking, right? If you’re sneaking, that’s going to push back your … And so all of these things, we had this agreement to steward healthy behavior.

Dr. Lisa Damour:
And did you do it around his handling of video games or what was the test drive?

Dr. Nadine Burke Harris:
The test drive is that he has an iPad where he does his screen time and it was around his use of his engagement with just screen time as it is right now.

Dr. Lisa Damour:
The tech he already-

Dr. Nadine Burke Harris:
Right. Versus a phone that he’s going to have in his pocket all the time.

Dr. Lisa Damour:
Okay. This is brilliant. To unpack what’s in there further, first of all, different kids need different rules. As a clinician, I have made recommendations to families with two kids in the same family. That child will be fine. That child probably can’t have a phone till he’s 18, right? I mean, it just depends on who you’re looking at. And I love that you set the developmental markers, that you made clear what was necessary, and that you held the line, which I’m sure was such a bummer for him.

Dr. Nadine Burke Harris:
It was. It was really hard for him, but I think it also, he got a clear message that, “Oh, mom and dad are serious about this.” And the other thing that we did in the interim, which is something that I kind of love, I was talking with him about how a lot of the media interactions are designed to release dopamine and that keep you connected in the work, in the engagement. And I’m not making this up. And listen, I’m going to say it’s my household and I’m like a scientist, a public health person, but literally my 13 year old came to me and he was just like, he also loves music and he loves specifically the guitar and drums. And he was like, “Oh, I’m going to go get my dopamine from the drums.” And he was like, “I found another dopamine release system that I love even more than screen time.” And I was like, “Yes.”

Dr. Lisa Damour:
Go right ahead. Knock yourself out, kiddo. Oh, that is fantastic.
What I also really love in this is that it’s not a no, it’s a yes when.

Dr. Nadine Burke Harris:
Yes.

Dr. Lisa Damour:
And I think that so often as we’re trying to navigate these waters, we want to hold the line, play the role of the adults in the room without damaging our relationship with our kid. And I think it’s really hard on kids when it’s just a no, an arbitrary and they don’t know what they need to do to make it happen. So I love that you were like, “It’s a yes when.” The other thing I have found really helpful … Actually, let me back it up. The one thing I found frustrating in the discourse about technology is we’ve talked about things as though they are a monolith, like a phone, right? No, phones have a lot of levels of possibility.
And so when my younger daughter was in the sixth grade, her sister went to college and they have a really tight relationship and they needed their own channel. And so I gave her a phone at 13, which was younger than I … Actually, might even be 12, than I usually would have. It was an old iPhone of mine with no browser. We don’t talk about … Browsers are where so much goes off course. You don’t need to have a browser on the phone, no social media apps and no ability to add apps without permission. And so it was a texting machine, it was a photo taking machine, it was a music machine. And one thing we know I got to do a survey and got these data, the number one way that kids regulate emotion is actually by listening to music. And so it’s such a powerful force.
And I think when we say no phones, I’m like, well, for a lot of kids you’re taking away actually music. That means a huge amount to them. But I think that that’s part of navigating this tension between my kid needs to be connected, but I don’t want them to have the whole wide internet in their pocket. Well, you can set phones up that way and even give them, and I think this is important. I know there’s all sorts of options for phones that are dumbed down. In my experience, kids are like, no, I want to be able to have the device that my friends have even if you strip it down to very little.

Dr. Nadine Burke Harris:
Yeah, that’s right. So combining that with, as you’re saying, one of the challenges is that the relationship with media and phones and device is also often a source of just parent-child conflict, right? Parents are setting these boundaries and the kids don’t like the boundaries and they think the parents are stupid and they don’t know. And so one of the things that I find to be really helpful, it’s not just saying the no, and also with the contract is giving a very clear, like these are the habits and behaviors that will lead to a yes or that will lead to increased privileges. But also I really like to just, as much as possible, facilitate a sense of care. So when I’m talking with our kids about it, one of the really important things for me to say is just like, “Hey, sweet, you have heard all the stuff that is out there about media and all this stuff, and I love you so much. And as your mom, one of the things that I really want to do is support you to be a smart and healthy consumer of media. And so what that means is that we are going to work and put these things into place and we’re going to do this together.” And really kind of unpacking some of the why behind the what, so that it’s not just a no, but it is, even if kids don’t agree, to be able to understand a little bit more about what our intentions are, so it doesn’t just feel like, “Oh, she’s terrible.”

Dr. Lisa Damour:
I’m going to elevate something in that, the “we.” So when we are so scared for our kids and when we’re seeing headlines that make us so scared, I think it’s very easy to feel like there’s the kid and the tech and I have to stand between them, right? It’s me versus the kid’s desire for the tech or the kid’s interest in the tech. It is so much more effective to do what you’ve done, which is it’s, “Kid, you and me against the potential harms of this tech.”

Dr. Nadine Burke Harris:
Right.

Dr. Lisa Damour:
That’s the framing we want. And you can even do it in schools. I was at a school speaking and they warned me, I was about to speak to all the students and they were like, “Oh, just FYI, we’re putting in a phone band tomorrow. They’re super grumpy about it.” And I was like, “Okay.” And I hit it directly. I said, “Listen, I understand there’s a phone band.” And I said, “I understand that’s not what you want or some of you may not want it. Here’s the thing, there is nothing your phenomenal teachers can put in front of you that can compete with this. You all want to learn. You all want to grow. The bad guy in this is not your interest in the tech, it’s that the tech is so compelling that it stands to undermine the education you’re here to get. So you and the school are working together to make sure you can get the education you came for. It’s not that you guys are the bad guy.” That’s how it often gets framed with adolescents, “it’s that the tech is designed to be so compelling that it can bring all sorts of harms into your world that you don’t want and we don’t want for you.”

Dr. Nadine Burke Harris:
Right, right. That’s exactly right. And I will even, it’s fabulous that we’re sitting here at the Common Sense Media Summit because I will sit down and look at some of the latest information or some of the information that Common Sense puts out on Insta or whatever and I’ll sit down and look at it with my kids and say, “Hey, what do you think about that? What do you think about this that what we’re learning about how the tech companies do engagement?” Because from a public health standpoint, we saw this in the ’90s with tobacco. It went from don’t smoke and you’re a rebel and you’re a bad kid if you smoke to the truth campaign, which was like, why are tobacco companies trying to get youth hooked on cigarettes and at what cost? And so it was really starting to look at not the adults who know better against the kids who are having a cigarette, but it was like, wow, let’s look at the way this industry is designed to make money off of getting kids hooked.
And that’s the conversation that I’m having with our boys.

Dr. Lisa Damour:
And that conversation, so David Yeager at UT Austin has done beautiful work. If you show kids how they’re being manipulated, they become more resistant, right? So it’s such an easy way to walk into the like you and me kiddo versus this highly manipulative industry. The other thing you said that I don’t want to not underscore, kids can be grumpy about this.

Dr. Nadine Burke Harris:
Yes.

Dr. Lisa Damour:
And it’s fine for them to be grumpy. And I think it makes more sense to us as adults, so we’re more accepting of their grumpiness if we consider the alternative, which is you say to your son, “Look at all of these things and this is why. I love you and we’re not going to do this,” no teenager worth their salt is going to say, “I am so glad that you have surveyed the data and decided to restrict me. I really appreciate it and I do feel your love.” So I think the way I ruled out, I make up goofy things all the time and I had these like four Rs of putting in rules for kids or making behavior change. First, what was the first one? I have to remember the first one, but it was like, give them a rationale, right? Here’s why. Then you make a rule, oh, approach with respect. That was the first. Don’t come in like you and your kids and your phones, whatever, that never works. So come in and say, look, I know this is an incredible device and really alluring. Then a rationale. Here’s my worry about this and here’s the data, then the rule. So we’re going to hold off and then be prepared for resistance and do not take it personally.

Dr. Nadine Burke Harris:
Right. So be prepared for resistance. And I also think that there’s an opportunity in resistance, right? So there’s an opportunity to have a conversation around, “Okay, I can see that you are not happy with this rule and I’m going to hear what you’re saying. And also we’re going to have a conversation about how we treat each other when we don’t agree with what we’ve decided. So you can be mad and you can express that you are mad. You are not allowed to emotionally abuse me because you don’t agree with …” So how do we … So there’s also just a natural teachable moment about how we address conflict within our households.

Dr. Lisa Damour:
That is beautiful. Okay. We also got some questions about appearance, comparison, that this is so much part of what happens online. Here was a question we got. “My daughters are 16 and 18, and because of Snap, they feel they need to be made up all day long.” So what would you say to this family? What would you say to these girls? Let’s start there.

Dr. Nadine Burke Harris:
Yeah. I mean, I think that what I would say to these girls as a starting point is what do they want for themselves? How do they want to move through the world in terms of we recognize that young people, they want to look good, they want to compare well with their peers, they want to appear attractive to whatever mate that they’re interested in, but we also want to think about a level of self-kindness in terms of how do you care for yourself in the way that you would care for a good friend, right? And if your dear friend came to you and said, “Oh, I don’t think I’m pretty enough, or I feel like I have to wear makeup all the time.” Is that how you choose your friends or is that how you would want to have someone that you care about be judged and really unpack that a little bit and unpack what they’re worried about, what they’re concerned about, and then how they can show up in a way that feels healthy and authentic to them.

Dr. Lisa Damour:
The idea of saying, “What would you say to a friend in that same situation?” I think it’s such a beautiful way to recognize that all teenagers have a couple sides. They have the side that’s like, “I can’t take a Snap because I don’t look good.” And that same kid has a side that is incredibly philosophical, is incredibly thoughtful, who can spool out a profound understanding and guidance to someone else. And I think that that’s the challenge with adolescents in particular is they show us sometimes one side and we can forget about the other side and we can respond to the first side like, “You don’t need to do that and that doesn’t whatever and that’s being superficial.” And what I’ve learned clinically is the side of the kid you talk to is the side that comes into the conversation.

Dr. Nadine Burke Harris:
Right.

Dr. Lisa Damour:
So if you start with the, “Why are you doing that? You don’t need to do that.” The kid will defend it.

Dr. Nadine Burke Harris:
Right.

Dr. Lisa Damour:
Right. “Well, you don’t get it and da, da, da, da.”
You’re not having the conversation that kid could have. And I have always felt as a clinician that I’m at my best, but also working really hard when a kid puts in front of me a side that I don’t like, right? Either they’re doing stuff at parties they shouldn’t be doing or acting in ways they shouldn’t be acting. And the energy it takes that is always rewarded if I’m like, “What’s over here though?”
I remember one time I had this kid who was not showing very good judgment in my practice and was telling me about the party she was at. And finally I said to her, “What is a smart girl like you doing at a party like that?” And she showed up. The smart girl showed up and we worked together. And it was really like as cool a moment I’ve ever had with a teenager.

Dr. Nadine Burke Harris:
Yeah. One of the things that I think that I love about that also is this question that I like to ask young people a lot, which is like, “Is this something that you’re choosing for yourself or are others choosing this for you?”

Dr. Lisa Damour:
I love that.

Dr. Nadine Burke Harris:
Right? Because it gives them that opportunity to reflect on that and say, “Yeah, where is this coming from for me? Is this because I’m worried about other people’s judgment or am I choosing this for myself?” And I think that we may not like the answer that they give because sometimes they may be like, “Yeah, I am choosing this.” But it encourages that reflection. I think the more that we ask that question, after a while when we’re not around, that question will pop up in their brains, “Oh wait, am I choosing this for myself or is someone else choosing this for me?”

Dr. Lisa Damour:
So important you said that because again, I think people feel like if I don’t hit paydert in the conversation, it didn’t work. And I think that we need to give kids time and room to decide for themselves and reflect and have that actually be a private experience, right? That it’s not natural to adolescents to come back and be like, “You were totally right.” I actually had a very funny conversation with my 15 year old actually right before I came here. Last week our cupboards were bare and you know how sometimes you do your best cooking when you have to invent? So she didn’t have anything for lunch. I was like, “I’m going to make you the best turkey sandwich ever.” And I made a great turkey sandwich. There was avocado and we had roasted red peppers in the fridge, all this stuff I never would’ve done if I had more food.
And so as I was leaving to come here to California, I was running to the grocery store and I said, “Do you want me to get you a bunch of turkey?” And she was like, “No.” And then I went and showered whatever. And then as I was headed to the store, she’s like, “Actually get me a bunch of turkey.” And I said, “It’s the worst when your mom’s right, isn’t it? ” And she’s like, “It’s the worst. It’s the worst.” And that’s teenagers and that’s why we love them.

Dr. Nadine Burke Harris:
Right. The words that come up over and over again in my household, between my husband and me, I was like, “Oh, that sounds developmentally appropriate.” Because I think that we really also have to remember that particularly adolescence is a time, like the job is to individuate from your family of origin.

Dr. Lisa Damour:
While living with them, while they know what socks you’re wearing.

Dr. Nadine Burke Harris:
Right. So that’s the developmental task. And I think that for many of us as parents or caregivers or aunties or adults interacting with youth, it can feel like that’s this big obstacle when in fact, I think that that’s actually our friend. It’s just understanding that’s what they’re supposed to be doing. A young person who is 100% compliant is not going to be a very functional adult.

Dr. Lisa Damour:
We don’t want to see it. Right.

Dr. Nadine Burke Harris:
We don’t want to see that.

Dr. Lisa Damour:
I like them spicy. I like them spicy. And what I will often say to families in my practice is adolescence is a very complex time that your kid is working their way through. Adolescence is not something your kid is doing to you.

Dr. Nadine Burke Harris:
Right.

Dr. Lisa Damour:
It feels like it’s doing to you, but that’s actually, they have their own work to do and you’re pulled in. All right.
To expand this question about appearance though, we are seeing new things happening around boys and their appearance and the online version of this, stuff we have never seen before, right? I mean, and I have cared for all adolescents for a long time, have spent a lot of time caring for girls. I’m seeing stuff with boys that I’m like, “What the heck is this?” You’re a mom of four boys, you think in these worlds, what are you seeing? What are you thinking? What do you recommend?

Dr. Nadine Burke Harris:
I mean, honestly, I think it’s wild. I mean, this is a podcast so people didn’t get to see my eyes get really big as you asked that question.

Dr. Lisa Damour:
We’re getting video too, so yeah. Yeah.

Dr. Nadine Burke Harris:
Okay. On the one hand, it feels really new and a little bit like, oh my gosh, another thing that we have to be worried about. And then on the other hand, I really think that a lot of the same fundamentals apply and those fundamentals include, I think that the strength of the connection “IRL,” in real life, is protective and confers resilience in the digital world. And then also as much as we want to say, “That looks like a bunch of nonsense,” one of the things that I find helpful is kind of resisting my urge to say that and engaging with curiosity, right? Like, “Oh, so what’s going on there? And well, what do you think about that?” “Okay, so is that something that you would want to try?” And just to the extent, as long as it’s not involving harm, to the extent that we can create a safe place to play.
“Oh, so you’re trying this on, or you’re playing with that,” and really exploring and seeking to understand, “Oh, okay, so what about that is interesting to you?” I think that that is just a healthy way for parents and caregivers to try to respond.

Dr. Lisa Damour:
I’m going to pull the technique that you’re doing. You’re doing something that if I could get more clinicians who have my training to do it, it would be great. You’re doing a couple things. One is, as soon as we’re saying to kids, “What do you think about that?” They know us well enough that we don’t ask that kind of question about stuff we feel great about, right? So you’re actually, and I think it is important. I think that they kind of can wonder, “is this okay?” And as soon as we’re like, “Well, what do you think?” That they’re like, “Okay, there’s a check in the column of people I know and trust and who love me are not comfortable with this.” And yet it leaves open the room for them to explore. It doesn’t back them into the corner of, what is this garbage? And at which point the kid’s like, “You don’t get it. ” And lets them also back out of it that they can be the one who says,

Dr. Nadine Burke Harris:
Right.

Dr. Lisa Damour:
“I think it’s weird or I don’t.” Which is where we want this to go. We want this to go there. So it’s such that question of like, “Huh, what do you think about that?” I think stands as one of the most valuable questions we have in all of parenting and raising kids because it does so much work so fast.

Dr. Nadine Burke Harris:
So that is exactly right. The safer the container we can make to explore this stuff that our inside voice is like, no, no, no, no, no. But our outside voice has to create a place for it. Otherwise, it is more likely to go underground.

Dr. Lisa Damour:
Exactly.

Dr. Nadine Burke Harris:
Yeah.

Dr. Lisa Damour:
Okay. We’re going to wrap up with a giant question, a hard one about AI. We’ve had a lot of conversations at this summit about kids and AI. We have a lot of worries. We have a lot of uncertainty. I am thinking about the population of kids that you care for. It’s like my teenagers using right now who have really been through it, really been through it. When you think about kids who have already been exposed to trauma, who have already been through situations that no child should ever be in, and then you marry that with the availability of AI or companions, what do we need to be thinking about?

Dr. Nadine Burke Harris:
This is a place where I think where policy and infrastructure really make an important difference because for kids who are … So first of all, the data is pretty clear that for kids who are struggling, that they’re at much greater risk. And when we have algorithms that are designed towards engagement and designed towards somewhat addictive behavior, and particularly when we’re going into AI where there is a lot of that follow-up and going down a particular road-

Dr. Lisa Damour:
The persuasive, alluring tie, which is different from anything we’ve seen before.

Dr. Nadine Burke Harris:
Exactly. This is fundamentally a safety issue. That when we recognize, and I will just say just looking at the data around ACEs, which is my area of expertise, when we recognize that two thirds of Americans have experienced at least one ACE, one in six have experienced four or more ACEs, we have to build systems that make it safe for that one in six to engage with material. And if that one in six is at much higher risk or much higher vulnerability, we have to have guardrails around safety and what that looks like and how these platforms are built.

Dr. Lisa Damour:
Okay. So I’m going to wrap us up. What I hear us saying together, policy, regulation, especially when we think about our most vulnerable citizens, the power of relationship and also relationship and relationships too, in terms of keeping kids safe as a buffering force. Our kids are going to come across things we do not want them to be exposed to and our relationship with them is the best bet for keeping them safe. I want to thank you for this conversation. And I also just want to thank you, not only are you incredibly brilliant and great at what you do, just the sheer creativity that you bring to child protection, right? The way that you think big in novel systems, in novel approaches, to scale love of kids, to scale protection of kids. I have so much admiration for who you are and how much, much good you do in the world.
So thank you.

Dr. Nadine Burke Harris:
Thank you so much.

Dr. Lisa Damour:
All right. Thanks everybody.