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Have you ever wondered if you're spending too much time on your phone or computer? Well, then you're certainly not alone. Screen use behaviors are top of mind for so many people these days - and for good reason. Over the last few years, our world has fully transformed itself around this technology to a point where spending a majority of our day looking at a screen has become the norm in much of our society. And although screen overuse was a problem pre-pandemic, the issue has accelerated exponentially over the last few years, bringing with it an array of crisis-level challenges for so many people. So what can we do to achieve screen time sanity in today's digital world? To help answer this question, I reached out to Dr. Clifford Sussman, a renowned child and adolescent psychiatrist in the Washington, DC area, who supports kids and their families who are at the extreme end of struggling with finding balance in their screen use - and I say balance because, well let's face it... screens are an avoidable part of life in today's world and its future. As a remote-working parent with a tween who loves video games and a teen who loves her phone, I find it very challenging to find a healthy balance, not feel like a hypocrite, and just feel OKAY about my own screen use decisions. However, I learned from my conversation with Dr. Sussman that there are practical things we can all do to find that balance for ourselves and those in our lives we care about. Listen in to our conversation and learn some practical strategies you can use to achieve screen time sanity and find your own balance in our modern digital world.Here are some links to more information about Dr. Sussman and this episode's topic.Learn More About Dr. SussmanDr. Sussman's Website on TrainingsThe Ross Center - Assessment and Treatment of Digital Use DisordersDr. Sussman’s YouTube ChannelThe Ross CenterScreen Use & Executive Function SkillsBeyond BookSmart’s collaboration with Dr. SussmanScreenagers by Delaney RustonContact us!Reach out to us at podcast@beyondbooksmart.comIG/FB/TikTok @beyondbooksmartcoachingTranscriptHannah Choi 00:00Hi everyone and welcome to Focus Forward, an executive function podcast where we explore the challenges and celebrate the wins you'll experience as you change your life by working on improving your executive function skills. I'm your host, Hannah Choi. Hannah Choi 00:00Okay, confession time. Are you listening to me but also looking at something on your phone? It's okay if you are, we can't help it. Instagram, tick tock games, even news websites are created in ways that make you want it. Need it, even when you're doing something else. Our screen use behaviors are top of mind for many people these days. Before the pandemic, it was a problem. Now, for some it's a crisis. Hannah Choi 00:00I reached out to Dr. Clifford Sussman, a child and adolescent psychiatrist in the Washington, DC area, who supports kids and their families who are at the extreme end of struggling with finding balance and their screen use. And notice I said balance. What I learned from Dr. Susman is that balance is the key screens are a part of life, they're not going anywhere. We all know that they have many, many benefits. And when used in a healthy way, we can learn some pretty great skills that apply to other areas of our lives. As a parent of a tween who loves video games, and a teen who loves her phone. And as someone who works remotely from home on a computer for much of the day, married to a partner who also works remotely from home and is literally on a computer all day, I find it very challenging to find a healthy balance and not feel like a hypocrite and just feel okay about my own screen use decisions. I learned from Dr. Sussman that there are practical things that we can do to find that balance for ourselves, and connect with our kids to help them find it. And notice that I didn't say they're easy things we can do. It's definitely not easy. But there is some hope in there that with some focused and thoughtful effort, we can hopefully find that balance and feel better about our own screen use. And if we have kids, there's too. Okay, onto the show. Hannah Choi 00:00Hi, Cliff. Thanks so much for joining me on my podcast.Dr. Cliff Sussman 02:17Thanks for having me.Hannah Choi 02:18Um, would you like to introduce yourselves to our listeners?Dr. Cliff Sussman 02:21Sure, sure. My name is Dr. Clifford Sussman. I'm a child and adolescent psychiatrist. And I actually specialize in treating internet and video game use disorders. So all of my patients pretty much have some form of problems with excessive screen use.Hannah Choi 02:42Yeah, and that is a hot topic, especially after coming out of that, after having gone through the pandemic and even before, so how did you? How did you get into that? Why is that? How did it become such an important issue for you?Dr. Cliff Sussman 02:57Well, I guess it started, or, you know, early in childhood, discovering I love computers, myself, and I love screens myself. And I was I was always on video games when I was younger, or trying to design them myself. And then eventually learned to code and, and, you know, got really into all that stuff. And then when I became a psychiatrist, and went into private practice, specializing in mostly teenagers, parents were coming in from the day I started about 15 years ago, and telling me that their kids were addicted to video games. So this is long before the pandemic. And I would evaluate these kids because oftentimes, the parents had been that had been dismissed by by the providers they'd seen before me. And so but I would evaluate these kids and I find out that, you know, look, they, they, they have a lot of the same problems that the people I'm seeing, that I saw in my addiction rotations during residency had, you know, the seeking the, the constantly lying, the stealing, the aggression, the defensiveness, the, you know, all sorts of problems with, with, with, with the family, in the family. So, I decided to really do some research, you know, just do a lot of read a lot of studies about how the brain was affected by excessive screen use and comparing those studies to how the brain was accessed was affected by use of other substances. And, you know, started finding a lot of similarities. And eventually I decided that this problem was becoming so big and these people really needed help. That I just I decided that I really could just just work on that. And yeah, and so that there was a lot more demand than supply and providers for this problem and So, you know, and I would collaborate with a few other colleagues who are recognizing this too. You know, when we compare notes on how, you know, what was working and what wasn't. And I would base a lot of my treatments on treatments that had been effective for drug addiction, such as motivational interviewing, motivational interviewing, which is a type of psychotherapy, that's like a mix of cognitive behavioral therapy, and psychodynamic psychotherapy. And, you know, and it just sort of took off from there. And then, after the pandemic, the problem got to be so huge, even during the pandemic, but especially when people started returning to schools and having more demands placed on them. That, you know, I decided that there was no way that I could handle all the cases, you know, and my and a few of my colleagues who are who are recognizing this. And so, I decided to start putting a lot of focus and doing things like this, where I can educate the community, and I even have a lot of stuff now, where I'm training other providers, a lot of doing courses for other providers online, and things like that.Hannah Choi 06:16That's great. I would love to talk with you more about that later on. I do have a question for you about the brain. You mentioned the brain, what? What happens in the brain? And I know that there's dopamine involved, but maybe for our listeners, you can explain what happens in the brain when, you know, when someone really feels like they need to be on a screen.Dr. Cliff Sussman 06:43Yeah, yeah, that's, I mean, that that is it is related to dopamine. And so So dopamine is the neurotransmitter that we release, it's thought of as the pleasure neurotransmitter. So people think we just release it when we get pleasure. But it's a little more nuanced than that we release dopamine when we get exactly what we want, when we want. So I think people people think of if you got pleasure, but it was very delayed, you know, you wouldn't release as much dopamine as if you got the same pleasure right away. So that's why things like cigarettes, which don't get you nearly as high as other drugs, but get you that buzz right away, because you smoke it, and the smoke goes right into your bloodstream, they release a lot of dopamine, and our, you know, easily as addictive as much more intoxicating drugs that have more delayed. So, you know, it was a real survival, a real survival neurotransmitter. Because, you know, when you're, let's say, a caveman, you, you need something right away, it helps you survive if you get it right away. Right, right, you know, so you know, you want to satisfy those needs immediately. Before you get eaten by a saber toothed Tiger.Hannah Choi 08:14We don't want that to happen.Dr. Cliff Sussman 08:16So yeah, so what happens in the brain when, when, when we're on anything that gives us instant gratification. And in particular screens, because that gives us not just instant gratification, but continuous instant gratification, is it the brain releases lots of dopamine. And you know, there's nothing wrong with that, what's the problem is when you keep doing it, and when the brain keeps releasing dopamine for hours and hours on end, right, like cavemen never got what they wanted for that long at a time. I mean, so the brain wasn't designed to handle that much of getting what you want for that long time. And so what happens is you become desensitized to dopamine, the receptors in the brain for dopamine, they, they go through a process called downregulation. And that and a bunch of other more complicated processes, basically result in you needing to work even harder to get instant gratification. And, and getting the same amount of dopamine that you did before won't feel as good. So you need even more. And so that's why that's one of the reasons why it's just so hard to get off screen. When you've been on it for a really long time. You know, when when you get off and stop getting that dopamine. Now you you actually feel worse than before you start.Hannah Choi 09:43Right. So you want to get back on to avoid that feeling.Dr. Cliff Sussman 09:49 Yeah, and that's really basically the process in all addictions.Hannah Choi 09:52Yeah, right, right. Yeah.Dr. Cliff Sussman 09:54So it's like it's like too much of a good thing. You know, I don't and I like it. said I enjoy gaming, you know, so I don't I don't think that that using a video game for a half an hour or an hour is such a terrible thing. I think it can be a great experience. And there's lots of even educational opportunities or, you know, opportunities to solve puzzles are make friends or do all sorts of great things, right? Yeah. But it's the hours and hours and hours on end. And when people during the pandemic, we're living in the virtual world instead of the real world, it really got to be a big problem.Hannah Choi 10:31Yeah, right. So I had a personal experience with this. A couple of weeks ago, my son and I both had COVID at the same time, so he and I were all like, we're Yeah, it was, yeah, it was not fun. And, and so we were both isolated, we're both the same room, and I had work I had to do, and he did not feel great. So I let him use his, like, play Minecraft and do screens like, kind of all day. And I, I felt so guilty because I know!Dr. Cliff Sussman 11:03And that was the first time you'd done that? Because most parents I've worked with have found that out, have crossed that a long time ago, you knowHannah Choi 11:11Yeah, I mean, I guess I had done it. But it hadn't been in a while. And it hadn't been for so many days. And I did notice afterwards, he had a hard time, like thinking of something else to do. And, and I didn't feel great. So I had a hard time motivating myself to encourage him to do something different. So I can see how...Dr. Cliff Sussman 11:36Everything else starts to pale in comparison. Yeah, you know, it can turn an, you know, I like to divide activities into what I call high dopamine activities. I use HDA for short and long dopamine activities, or LDA. And I call you know, the, there's a lot of low dopamine activities that are enjoyable, meaning activities that just require more patience that have more delay in their gratification, but they're still gratifying. Right? So you know, so we're not just talking about homework and exercise, we're also talking about things like putting together a jigsaw puzzle, you know, painting a picture, learning to play an instrument. These things, you know, those are the types of things that your son might really enjoy doing, until they've, you know, gotten a taste of a high dopamine activity for a very long time. You know, and then all of a sudden, those other things, just, you know, well, the thing you heard all the time during the pandemic was I'm bored. There's nothing to do.Hannah Choi 12:39Yeah, there's nothing right. Yeah, yeah. It's funny that you say play an instrument. So my son plays piano, and I, I'm thinking about it, like I did notice when we came out of isolation, and we were back in the real world, it was harder for him to like, sit down and play the piano, but I am noticing over the past few days, he's, he's kind of getting back into it now. So that's not permanent.Dr. Cliff Sussman 13:04And you don't want to forget that. I played the piano when I was a kid for a couple years. And I think I said to my mom, you know, look, for my seventh birthday, can I just quit piano because the processing is really boring, and I don't want to have to learn all the skills. And she's like, okay, you know, and, and then a couple years later, I guess when I became a teenager, I was like, I really wish I knew how to play an instrument. Mom, why did you let me I took up guitar instead. Okay, so that's good. But yeah, it's important when kids get bored with their instruments, not to like, Forget everything they know, and just come away from it to try and just pick it up every now and then keep it a little fresh.Hannah Choi 13:48Right, right. So that makes me think of like, how can this might be jumping ahead a little bit, but how can people balance? How can people find a nice balance between those LDAs and HDA active, activities?Dr. Cliff Sussman 14:04Well, you're hitting the nail on the head. I mean, to me, that's the real key is finding a balance, right? Because you're definitely let's face it in this world, you're not going to have abstinence from the digital world. You know, and it's impossible. Yeah. And and, you know, you wouldn't function very well if you did, to be honest. So it really is about finding balance. And so I have a lot of suggestions for how to do that on my website that you were referring to earlier at CliffordSussmanmd.com. But I can try to highlight some of the main ones. So I think the some of the biggest keys are having a lot of structure in your schedule. You know, having and keeping a schedule, you know, keeping a routine that was so important during the pandemic, when you…
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