others the sense of being “heard,” and they often can’t seem to “resonate with” or “mirror” the other person’s emotions.
A few years ago, I had a very enlightening conversation with my then sixteen-year-old nephew about this very issue. We were sitting together at his sister’s high school graduation. The previous time I’d seen him, just six months earlier, he’d been his usual self — friendly, talkative, and high energy, but not able to pay attention to anything for more than a few seconds. If your question was too long, you lost him. Forget about sharing something with him — he wasn’t listening. As we sat there, I was struck by a change in him. We were having a great conversation: he was listening to me, making eye contact, and responding without going off topic. At first I just thought, Wow, he’s really matured. However, as we talked about football, which he’d played that year for the first time, my nephew shared that his coach had instructed the team members to stop playing video games because he felt it affected their ability to focus during games and could negatively impact grades — and therefore their eligibility to play sports. My nephew said at first he only cut back. Then, after realizing the difference it made, he quit completely. He said one of the first things he noticed was that he was suddenly able to talk to adults more easily, and he was speaking up more in class. He said that although he’d felt shy around his peers before, he’d found himself speaking up more in groups. Needless to say I was excited: here was a teen without a psychiatric disorder who’d quit playing video games on his own and was able to verbalize the changes in himself. His capacity for meaningful interaction had expanded dramatically.
Interestingly, my nephew then told me about one of his friends who was diabetic and sometimes faked being sick in order to miss school, either so he could play video games all day or because he’d been up late the previous night playing. (My nephew could “see” online when his friend was logged in to the game.) After quitting himself, my nephew became appalled by his friend’s behavior, especially when he realized that during those long gaming sessions his friend’s blood sugar would go way up. As he finished telling me this story, my nephew said, “His handshake is really weak. It’s like a dead fish.” After imitating it, he said, “I mean, come on, who’d hire a guy like that?”
He’d hit the nail right on the head. Impressions are made in the blink of an eye, and young people with poor social skills will have trouble getting ahead in life. Conversely, as my nephew’s social skills improved, so did his awareness of their impact. This ability to self-reflect is part of what helps children not just survive but thrive.
In school-age children, social impairment related to ESS can manifest as poor sportsmanship when playing games, acting bossy or controlling, or being super competitive. (It doesn’t help that many video games reward competitiveness.) Kids with ESS often have a low frustration tolerance that results in meltdowns and a tendency to blame everyone but themselves. They may also hold grudges or attribute hostile motives to others where there are none, such as assuming a peer purposely bumped into them. All of these behaviors drive other children away.
Because social skills and mood regulation are dependent on good frontal lobe function, children with ESS often act much younger than their years, and they may be teased, bullied, or ostracized because of outbursts. This occurred to Billy, a ten-year-old boy I worked with whose story I tell in chapter 4 (see page 117). In part, this dynamic occurs because screen-time creates a false experience of ease and success: electronic media offers immediate gratification, endless (and effortless) stimulation and entertainment, the ability to control one’s environment or one’s image, and the opportunity to be a hero — features that don’t reflect how things work in the real world. Real life is much more difficult. Screen-time makes children less able to tolerate disappointment and boredom, more entitled, and less willing to work — whether it be for school, at a job, or to improve a relationship.
Disconnected: Empathy and Intimacy Issues
As I’ve already described, both violent gaming and excessive Internet use have been linked to a diminished capacity for empathy. Indeed, brain imaging studies of adolescents with Internet gaming addiction show damage to the insula, an area involved in empathy that helps integrate bodily sensations with emotion.67 Empathy is different from sympathy; empathy is the ability to resonate with another’s state of mind and actually feel what the other is feeling. It helps us bond because the other person “feels felt,” and it fuels compassion and social responsibility by allowing us to feel others’ pain. These characteristics make empathy fundamental to enjoying a fulfilling emotional and social life. But violent gamers and Internet-addicted individuals aside, what about today’s children in general? Does time spent behind a screen impact one’s ability to relate face to face?
Mounting evidence suggests that it does. A study examining empathy score trends of college students from 1979 to 2009 found scores to be falling, with a particularly sharp drop after the year 200068 — right in line with the first generation of children who were born into the age of video games and computers. Much of social competence is learning how to read subtle cues in body language and facial expressions, and studies show face-to-face contact is highly correlated with social well-being, while media use and media multitasking correlate with the opposite.69 I’ve seen this firsthand: children who complete the Reset Program invariably display improved social skills, and their emotional competency grows quickly in the absence of screens. A 2014 study came to the same conclusion: preteens who spent five days at a wilderness camp in which screen media was completely restricted showed an enhanced ability to accurately interpret others’ facial expressions.70 Interestingly, one way we develop empathy is by unconsciously imitating the physical actions of others, so the freedom to move one’s body while viewing others’ bodies — something that being screen-free affords — appears to be important as well.
Eye contact is another element important in determining the quality of our social relationships. Eye contact is an essential part of the bonding process from birth onward. It reflects our capacity for intimacy, and an inability to tolerate sustained eye contact often translates to shallow relationships. Capacity for eye contact is likely related to the amount of an individual’s current screen-time habits, the total years of screen-time, the age at which screen devices were introduced, and the quantity and quality of past and present face-to-face time — which is, of course, related to parental screen-time, too. Note that when a child operates with a defensive nervous system (from frequent fight-or-flight and less face-to-face interaction) on a regular basis, he or she will be less able to tolerate eye contact without unconsciously interpreting it as a threat — much like wild animals do — and will thus avoid it until the absence of screens forces the child to build tolerance.
Nowhere is the capacity for eye contact more critical than in romantic relationships. Although as a parent you may or may not be concerned about your child’s romantic relationship potential at the moment, it’ll be important at some point, usually starting in adolescence. A child’s ability to form close friendships, to be honest and open about feelings, to empathize by putting themselves in another’s shoes, and to communicate during conflict without becoming defensive will dictate the quality of his or her relationships, starting with friends and family and later with romantic interests as well. I see a number of young adult males with screen-time issues in my practice, and many of them want a girlfriend but have no clue about “live” interaction. Others begin relationships only to see them end quickly when their partner senses intimacy limitations and moves on. It takes a lot of hard work and resources to work on these issues as an adult — it’s much easier to prevent them from developing in the first place.
In short, the same stress or fight-or-flight reactions that affect mood and cognitive symptoms also impact social relationships. Extreme shyness, poor sportsmanship, limited empathy skills, and reduced tolerance for intimacy are all made worse when face-to-screen replaces face-to-face. A defensive nervous system in survival mode cannot trust and therefore cannot form close relationships, and a poorly functioning frontal lobe cannot delay gratification, tolerate disappointment, or self-reflect. Aside from predicting relationship quality, these are essential ingredients for becoming a responsible adult with a strong moral compass.
Hijacked: Addiction and Reward Pathways