Teens in Balance - Tara Cousineau, PhD

When should kids have a Facebook account?

When should kids have a Facebook account?  This is truly a contemporary dilemma that gets more confusing as the privacy debate is being wrangled by the Federal Trade Commission, Congress, and the online pundits.  For me, the almost weekly stories and essays on the misuse of FB by teens just drives a knife through my heart.  The Sunday Boston Globe cover story (The Agony of A Girl Who Just Wanted to Fit In ) was about one girl’s story of relentless bullying via FB on the third day of starting high school – one of those apparent grudges by a former friend that took off like wildfire.  The girl, Lexi, is toughing it out according to the article – but a girlfriend, cyberbullied by association, left the school district.

It could happen to my girls. 

One would think that I, as both a parent and a psychologist, might have some sort of advantage on understanding this topic. This is not the case.  It is my opinion that the Internet is simply a communication vehicle. It is neither good nor bad.  It just is. How people use and manipulate this communication is another matter entirely and this is the heart of the privacy matter. It also is a call for public policy, research, and education.

Because I am creating in an online health tool for teens, bodimojo.com, I confront this privacy issue daily. Currently, I am debating whether we should use the FaceBook Connect module for elements of bodimojo.com where teens can post a positive affirmation or health-promoting goal to their wall.  It seems simple enough in theory. I mean, why create a healthy lifestyle program that doesn’t filter up into the networks kids already communicate in. Right?  A no brainer.

But as an online content creator for children (and teens are still considered children) everything needs to be assessed.

On the personal side, however, I am forming an opinion on the FB issue. I have tweens and it will be any day now that my 12 year old asks for an account. Here’s my momentary thinking:

A member of Facebook must be 13 years of age.  This is not an arbitrary rule set by Facebook, but is set by the Federal Trade Commission to protect the use of personal information for commercial purposes.  (It is a privacy rule not a safety protocol.) Any younger age requires following the COPPA rules for children 12 and under where parent permission is required for online membership and a parent email confirmation, etc. There are rumblings about changing it to 18 years of age. (To read about the complex set of issues – and the downside of COPPA when it comes to access to mental health or suicide prevention sites, visit online culture expert danah boyd’s blog).

Ok, that makes one thing easy right now: a clear guideline intended to protect the use of personal information by outsiders. Kiddo, you have to wait until 8^th grade.

Of course, many parents help their kids fudge the age limit and kids inadvertently are taught it’s OK to break that rule.  After all, their kids can now FB their grandparents, Uncle Joe in the military, and friends from summer camp. My opinion:  Children don’t need FB to communicate with loved ones.   Have the family use Skype if computers are more convenient than old-fashioned cards and phone calls – and keep it centralized as a family activity.

I’ve spent a good hour surfing the net and reading parents’ opinions on the FB issue. It’s pretty polarized.  The Academy of Pediatrics put out a guideline on their website in 2009 about parent supervision of Internet use.  About.com has several “how to” pages on privacy settings for FB, including 22 tips (but there is no article date and I have no idea if this includes the recent FB privacy changes).  I think when these help guides broach the length of a workbook on how to ensure your child’s online privacy, one needs to take a step back and evaluate. (I know several grownups – one a social media expert – who closed their Facebook accounts because they’d had it with the constant changes to privacy settings.  (For a timeline of changes, check out the Deeplink’s blog.)

With social networking as a contemporary medium for tween and teens to socialize, when is the right age?  Does it depend on the child, as many parents comment on?  Is refusing to allow a child on a social network just fodder for teen rebellion? What about teens who do not have engaged parents and seek education, information, community or help in the digital space because they can’t get it at home?

My hunch, and being pretty connected to my kids, is that FB is something they can join when starting high school – sort of like a right of passage or coming of age event.  By then, I estimate, the emotional and cognitive maturity will have kicked in for common sense use, respecting self and others in this medium, and they’ll have more than an abstract understanding of what a “digital footprint” is.

Then again, let’s take Lexi’s story.

I could be all wrong.

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Update:  Facebook Privacy Scanner, click for scan of your and your teen's FB page.

Eating disorders and the brain: A new direction for treatment?

Eating disorders are pernicious.  People suffering with anorexia or bulimia nervosa have the highest risk for death of any mental illness – from starvation or heart failure.  I move in and out the circle of researchers and clinicians treating ED patients or conducting research on prevention and intervention.  At this year’s conference of the Academy for Eating Disorders (AED) there were some very interesting developments.  Because I’m intrigued in the workings of the teen brain and adolescent development, I attended a talk: “The Neurobiology of Eating Disorders” by Walter Kaye, MD, and Laura Hill, PhD.  The intricacies of the brain systems studied are a bit complex, but here’s my takeaway.

The symptom of anorexia and bulimia are puzzling and often fraught with stigma.   For instance, the perception exists that anorexics may have a personality flaw, are willful in their restriction of food, or that there may be a parenting problem that is the cause of their child’s psychological issues.  So, patients just need to change their eating behaviors and work through their psychological issues, and parents need to change their styles, to get well.  If it were that easy!  But as we know, blaming the patient is not uncommon, even with the most biological of mental illnesses.

Eating disorders are indeed complex. Medications don’t seem to work that well. Yet, there are various characteristics that are fairly consistent and are more manageable with interpersonal, cognitive and family-based therapies.  These similarities are found in many patients and as such suggest some sort of biological influence.  With eating disorders, young women and girls (as well as boys) have certain characteristics that are apparent early on: childhood anxiety, perfectionism, obsessive tendencies, and a drive for achievement and self-control.  Add to this puberty, major physiological shifts, as well as psychosocial transitions – peer pressure, academic demands, media messages on beauty ideals – you have yourself the makings of complex syndrome that can persist over the lifespan.

What the emerging brain research suggests is quite fascinating and potentially important in the treatment of the illness. One of the mainstays of treatment is getting girls to a weight that reduces their risk for illness and death.  But eating food seems to have a neuro-physiological response of skyrocketing anxiety. Anorexics seem to have a blunted signal in the brain, almost like a “food blindness,” per Dr. Kaye.  The reward system in the brain that tells healthy people, “I’m hungry” or “This food tastes delicious!” does not work this way. Anorexics do not have “intuitive eating” and may never have this ability.  With both anorexics and bulimics there is an altered modulation of the reward and emotion systems in the brain.  Their emotional states get heighted with the prospect of food but their higher order cognitive functions go into an exaggerated state of self-control. Feeding causes anxiety. Staving oneself reduces it.  (Bulimics, one the other hand, seem to have a diminished inhibition for food that leads to binging as a way to reduce anxiety).

Here enters into the discussion Dr. Laura Hill, CEO of the Center for Balanced Living, in Ohio. She challenges us to ask: How might eating disorders be any different from childhood (type I) diabetes?  How do you think of that disease and the treatment of it? It’s clearly both medical and behavioral.  As a medical diagnosis, it also reduces blame on the child and the family. Perhaps we should consider eating disorders as a biologically-influenced illness.

From the psychological side – which is so potent in eating disordered patients, she posits that since the neurobiological system is thwarted but the cognitive side – decision making planning part the brain is in over drive – health professions should consider targeting that part of the syndrome.

Picture anxiety as a “noisy brain” with layers of noise that make it impossible to think or to calm oneself.  Dr. Hill demonstrated this with the high frequency sounds of a tape recorder while she was delivering her talk.  It was distressing to listen and concentrate as an audience member. Thus, her point was well taken.

People with ED are largely managing anxiety through food.  If these young women are so rule-bound and excel at following their own regimes for eating, then work with their fine-tuned ability to set the rules that will help them recover.  What does this mean in practice? It means when it comes to meal management and self-care, patients and families can plan meals where there are a fewer options rather than more. Do not give too many options or open-ended questions with the idea you are empowering her with choice, “Well honey, what carbs would you like to have today?”  This will spin her into anxiety and she’ll shut down from eating.

This is intriguing. It shifts the paradigm to one of hope.  It means bringing in the education of how the brain works into the intervention picture. This emerging research broadens the context for an illness that shatters many lives. It may be just one piece of the puzzle to the etiology of eating disorders, but alike all puzzles, each piece brings the bigger picture into closer view.

Taking some health cues from Europe: Hikes, bikes and the likes

This past week I attended the annual meeting of the Academy of Eating Disorders, in part to present BodiMojo.com in the technology portion of the conference. I may have been the odd one out talking about health promotion rather than clinical intervention. Yet, the location could not have been better: Salzburg, Austria.  I brought my 12-year-old daughter along on her first trip to Europe.

I asked her several times what she noticed about the people or places we visited. At the stop over in Dublin she noticed that passengers waiting to get on a flight to Eastern Europe “weren’t as fat as Americans.”  It was true.  Of about 100 people waiting to board that flight, maybe three appeared overweight.  I, on the other hand, noticed that the boys sported spiky or cropped hair vs. the floppy mop trend of the Justin Biebers types. From that point on we tried to predict which teens were from the US or not.

She also noticed how neatly dressed the Germans and Austrians are.  No oversized sweatshirts, sports tees, or baseball caps. (You only see baseball caps in the souvenir shops intended for Americans). Her observation was true for the European adults – they were smartly dressed.  The teens looked like most teens, but you did not see girls with belly shirts even on scorching hot days; no pajama pants; no Uggs, either (for some reason we see girls wearing those hot fluffy booties all year long in New England).  We saw lots of tattoos, though.

During a few days in Munich, Germany, we could not get over the number of people on bicycles. Granted it was a Sunday and the apparent first beautiful day of the summer season.  My daughter observed the interesting paradox of an active people, either on bike or on foot, as well as many more people who smoked – a now uncool trend in America thanks to successful legal action against the tobacco companies and tons of health promotion initiatives paid for by tobacco funds over more than a decade.

A friend of ours, working in Germany, told us that her diet is much better now (with the one exception of beer). In her previous environs of corporate New York, she’d have a bag of chips with every sandwich.  No chips here.  Stopping for food was an almost daily errand, with fresh fruit and vegetables available or fresh baked breads – no special trips to a Whole Foods or conveniently calling for take out. One has to think through and plan most meals – but access is fairly easy. And walking goes without saying.

As travelers we found it a challenge, though.  Without a kitchen, we got stuck with eating lots of pizza, würst with pomme frits, or croissants. Hardly a healthy, balanced diet.  Again, we had to remember to grab some fruit at a local corner market on our way to one city or the next, or be fluent enough in German to wind our way to a food store. (I can get by with broken German).

Maybe the most striking observation my tween made, was just – like its citizens – how cultivated and clean the cities and towns were.  Even the farmlands were stunningly picturesque – neat roadways and pastures and well-kept tractors that looked like toys from afar.  How different from the sites we often see, with junk and rusted old equipment lying in fields, or miles of strips malls and convenience stops at so many intersections.  One is never more than a few minutes away from coffee and donuts in the US.

I do think now of how apt is the slogan: “America runs on Dunkin.”

Did you know: Just being an American puts one at risk for obesity? Maybe we should take some cues from our EU friends.

New dance trend at proms: A stab to the heart of promenading

I’m a pretty calm and collected person. I confess, however, that there are a few things that provoke the raging feminist in me. Of course, these triggers are unexpected and typically cause a burst of shock or outrage that really has no constructive outlet and then gets mopped up by the reality of the human condition.

Last week I expressed my annual concerns over teen milestones and celebrations that may involve drinking: proms and graduations.   This week it is the new wave of “dance” that has trickled from urban dance halls to high school proms.  It’s called “daggering.”

Hmmm. What does that word conjure up for you?

Kinda of hard to pair daggering with dance unless you might be an opera fan. My guess is that the word dagger may elicit, let’s say, the notion of violence.  In fact, the trend of daggering stems from Jamaica – where the pelvic-wielding motion of this dance – has been a popular trend. The music has also been banned.  It is basically mock sex with a rough edge.  One might think of rape when watching any of the YouTube postings (a search you will regret). It’s not that sexualized dance hasn’t appeared on dance floors in the past, of course.  Rather, it is that this form of dance seems to have taken on a right of passage, “I’m hot, your not,” group-think mentality among teens.

According to a description in the Boston Globe, Against the Grind, by L. Harmon, “Acrobatic forms of daggering add an element of physical danger, such as diving from a foot ladder onto a woman who is splayed on the ground. Daggering isn’t suggestive.  It’s rough, artless, simulated sex on a dance floor.”

The double edge here is that it is girls who are participating in order to belong.  One girl in the Globe article was quoted: “It requires no skill…. The girl doesn’t do anything but bend over.”  And some girls – thankfully – are protesting.

One urban high school initiated an educational seminar and had students sign a pledge to refrain from sexually explicit dancing as a requirement to attend prom. Gosh, what it must be like to be a teen!  Pledging this and that – no drinking and driving and dance. It makes those virginity pledges – by teenagers who promise to be sexually abstinent and later deny that they took the pledge – seem rather quaint and charming.

Of course, the real concern is safety and how daggering is translated off the dance floor.  Daggering clearly represents male sexual domination over women.

I’m really not a prude.  I love dance. Cultures all over the world use dance as a form of self-expression and covey the traditions and values of many peoples. And the variety! Think Irish step dancing to royal promenades to African rites of passage and American Indian rain dances.   Dances tell a story.

Dance researchers suggest that humans are vocal learners – that our brains are uniquely wired to tap into a beat which results in movement and motion. It’s ancient and primal.

Dance also is used to express courtship and mating rituals. Some early cultures had rather crude fertility rituals, including sacrificing a budding adolescents to the fertility gods.

Apparently, dancing fosters the selection of partners who will extend the gene pool – the strong, efficient, and productive. Research shows that people are attracted to bodies that are symmetrical.  Both sexes are captivated by those with balanced physiques.  (The two-left footers are in some peril.) This is in line with research on beauty and attractiveness, too.  Mating is about survival of the fittest.

But daggering has resulted in certain consequences: penile fractures, for one. Can you (guys) imagine that?  Surely, that will kill this dance trend sooner or later. Can’t disrupt the flow of future danclings, can we? But why let it go that far.

Girls, stand your ground.

 

Resource:

SF Dingfelder. (April 2010) Dance dance evolution. APA Monitor (Vol. 41, No.4)