Dr Ramiz Audi Of Arizona’s Children Association On Raising Children With Healthy Social Media & Digital Media Habits

Young people today are growing up in an era where screen time is a given from a very young age. Unfortunately, studies show that large amounts of screen time can be damaging, and social media can be even worse. Our children are facing enormous challenges before their brains and bodies have had a chance to develop fully. Social media can potentially keep kids from developing social cues and lead to increased mental health challenges, bullying, and much more. So what can parents do to create healthier habits around social media? How can kids be taught to use social media in a healthy way that causes as little damage as possible? In this interview series, we are talking to authors, and mental health professionals, about Raising Children With Healthy Social Media and Digital Media Habits. As a part of this series, I had the distinct pleasure of interviewing Dr. Ramiz Audi.

Dr. Ramiz Audi is the Medical Director for Arizona’s Children Association and is double certified in adult and child psychiatry. He has years of clinical experience treating patients at inpatient units, emergency rooms and urgent cares in outpatient settings. Through his work, he has created psychiatric urgent care models for nonprofit agencies in Virginia and Arizona that help reduce recidivism of children. Dr. Audi worked previously as a clinical assistant professor at the Department of Child Health and Psychiatry at University of Arizona, a clinical assistant professor in psychiatry at Creighton University and an instructor of psychiatry at Mayo Clinic. He developed a psychopathology lecture series and supervised child and adolescent fellows while assisting in the development of Phoenix Children’s Child and Adolescent Fellowship Program.

Thank you so much for doing this with us! Before we dive in, our readers would love to “get to know you” a bit better. Can you share with us the backstory about what brought you to your specific career path?

I’m a patient first. I’ve had to see doctors ever since I was young. That peaked my interest in medicine. I was also very interested in science and my parents fostered that side of me by buying a microscope, anatomy of the eye that I can put together, and books etc. In college I was very interested psychology, so I took extra psychology courses on top of my philosophy degree and all the other medical school pre-requisites. Growing up I was very much an introspective person, psychology and philosophy (as well as physics) came as a natural interest for me.

Surprisingly, when I was in medical school I never once thought about a career in psychiatry but rather surgery. Toward the end of medical school, I knew I had to have surgery after I graduated. Due to the level of rehab I needed, I knew I would not be able to go into surgery residency. I eventually decided to go into Internal Medicine. During my training I saw many adults struggling with mental illness for various reasons. By that I mean, each individual had a reason or cause to struggle with depression and/or anxiety and some had schizophrenia. The cause of their mental illness, not just the mental illness itself, persisted long enough to create more medical problems or make it difficult to regain their health back. It felt helpless to see these adults in the ICU or in the outpatient clinic because it was just a matter of stabilizing or treating the acute exacerbation of a chronic condition.

This also resonated with me as a patient as well. I needed another procedure at the end of my second year of residency. After taking time off to take care of my health, I reflected on being a physician and patient, how being a patient made me who I am, and talked to friends and family. I ultimately made the decision to go into psychiatry with the goal of being a child psychiatrist. Being a child psychiatrist is one of the more difficult subspecialties and also the field where one can make the most impact on children and their family.

Can you share the most interesting story that has happened since you started your career?

I could not choose just one! I prefer to focus on the other questions.

Are you working on any exciting new projects now? How do you think that will help people?

Currently, our goal is to bring more outpatient services to our organization such as incorporating occupational therapy for children with sensory sensitivities. Many kids with various diagnosis can have sensory sensitivities that can create more anxiety and dysregulated behavior. Occupational therapy can help with evaluating and recommending treatment to stimulate kids’ brains to help with self-regulation. We are also interested in creating an Intensive Outpatient Program for adolescent stepping down from inpatient psychiatric hospitalization to help prevent recidivism, increase coping skills, improve communication, insight and psychoeducation.

Is there a particular book that made a significant impact on you? Can you share a story or explain why it resonated with you so much?

Consistent with my introspective personality, I gravitated to books that cut through the noise. In the words of Mister Rogers, “I feel so strongly that deep and simple is far more essential than shallow and complex”. A couple of my favorite ones are “The Old Man” and “The Sea Change” by Ernest Hemingway, “The Alchemist” by Paulo Coelho, and “Siddhartha” by Hermann Hesse. In essence, these books exemplified the concept of being psychospiritual. As a human species, we are anxious creatures and we allow ourselves partly due to biological evolution of our brains, to distract ourselves with unnecessary details that we have no control over to cloud our judgement.

Fantastic. Let’s now turn to the main part of our interview. For the benefit of our readers, can you tell us a bit about why you are an authority on how to help children develop healthy social media habits?

As a board certified Child and Adolescent Psychiatrist, I see many kids and their families struggling with having healthy boundaries with electronic devices and social media use. Parents have a difficult time implementing and following through with the rules and children have a difficult time obeying the rules. Furthermore, this leads to significant distress in family dynamics leading to children escalating their behavior. It can be so severe, that children will literally threaten suicide for not having their cell phone. When this is brought up to me in our session, my role is to teach the family how to sit and negotiate boundaries, everyone needing to have say in what the rules are and the consequences. This will help teach collaboration and respect for authority. Parents will also have to hold themselves accountable with following through on their word as well.

From your experience or research, can you help articulate some of the downsides of children having access to social media? Is there an amount of time, or certain content, that is just too much?

There has been a significant amount of research in our field discussing the negative impact of social media on depression and suicide. Social media is a significant factor, but not the main cause leading to demoralization, poor self-image, decrease in confidence and depression with suicidal behaviors. Adolescents will make negative social comparisons in their accomplishments, abilities, etc. Studies have shown that social comparison leads to depressive symptoms, poor eating behavior and body image concerns. The immediacy of information on social media quickly and consistently reinforces their behavior leading to overvaluing peer relationships, intimacy, and increasing independence from parents. There have also been a couple studies that have looked at social media being a moderator of suicide clusters. One article found associations between viewing the Netflix series “13 Reasons Why,” during the suicide clusters in Ohio and suicidal ideations among students without previous history of suicidal ideation. Furthermore, there is a difference when kids are only viewing versus actively posting during a suicide cluster. Those who had passive exposure were associated with suicidal ideations. Those who were active with posting content were associated with both suicidal ideations and suicidal attempts during the cluster. Those producing suicide cluster-related content may occur among kids who are at higher risk on the spectrum of suicidal behaviors. However, it is very difficult to establish whether social media exposure preceded suicidal ideations and/or attempts.

There is also the concern of cyber bullying. Negative videos or images can go viral from an anonymous source that will cause significant demoralization due to concerns of being viewed negatively and not being accepted by peers. Cyber bulling is another significant risk factor for suicide.

Lastly, we have video games that cause high dopamine release due to stimulation and reinforcing the pattern of instant gratification. The rush unfortunately comes with a low after the game is discontinued and leads to dysphoric mood.

Is there a positive side too? Can children gain and grow from social media?

There definitely can be a positive side. There are many social groups that can be very supportive. Parents should actively monitor and teach their kids to be active in choosing groups that will support their growth in various interests and can positively increase their self-image and confidence. These support groups can be a healthy way to meet new peers with common interests and values which can be a nice foundation to begin a friendship. Parents, guardians, and therapists, etc., also have a responsibility to teach kids that they are in control of who they choose to be friends with and which groups to follow. The need to encourage that the child can choose to not follow and proactively disconnect with them on social media.

There are video games for education in topics like math, science, and vocabulary. Also, playing video games can strengthen a range of cognitive skills such as spatial navigation, reasoning, and memory; however, this needs to be balanced out with healthy amount of time to spend on video games.

Social media is an accepted part of life today. We know that along with all of the good comes a lot of challenges. From your experience or research, what five steps can we take to raise children with healthy social media and digital media habits?

1. We must remember that making and engaging in friendships solely through social media robs the child from learning how to socialize in-person. We need to make this a priority and an important family value. Meeting and engaging with people teaches social emotional reciprocity, how to socially negotiate, how to read social cues, such as picking up on vocal intonations, facial expressions, body language and the use of gestures. All of this is lost when communicating important thoughts or expressing feelings over text messages. Instead, it reinforces the child to keep their guard up when communicating and not being vulnerable. As a result, this will foster and/or reinforce social anxiety.
2. Digital detoxing: taking scheduled time to unplug can help distress and improve quality of life by lowering stress levels. It can also help with focusing on being present with what is around you in real time and help you be more productive with work and attend to your personal and family needs. Lastly, it will help you feel good about yourself by not constantly comparing yourself with others. Cutting back on media use can help improve your self-image and esteem.
3. Setting limits to when children can use their devices for video games or social media platforms. It should be privilege, a reward if you will, to help motivate them to take care of the more important responsibilities. Parents should remember that they are constantly modeling for their children. So, while enforcing rules for your kids, parents should also be following the same rules and boundaries when using devices. How the parent maintains boundaries with where, when, and how long you use these devices will lead to more compliance with your children.
4. Have kids partake in physical activities. We have an obesity epidemic in our children. An over emphasis or lifestyle around screen time only reinforces inactivity leading to further weight gain that is associated with increased heart disease, diabetes, elevated cholesterol, triglycerides, and joint problems. As we mentioned above, physical activity is a way to meet new friends and help improve their social communication skills, self-confidence, and building relationships.
5. Parents should learn what age appropriate material is, teach kids about privacy settings and safety with various apps, and learn how to use parental control settings. Be aware of cyber bullying, sexual content, and inappropriate advertisements to the children. Lastly, recommend friending your children on social media and not going behind their back and stalking them. This will fuel distrust which we do not want, and it would be best to have an open communication about following each other on social media apps.

How do you effectively respond to the constant refrain of “but all my friends to this!”?

The thinking behind this phrase is the fear of missing out on what their friends are doing. It is important the parents have an open conversation with their children about WHY that particular activity, device etc. is so important to them. It’s important to put in perspective that they are not missing out. A frank conversation needs to be had that they can’t have “everything” their friends have or do everything that their friends do. To underscore this point, there may also be a situation where their friend(s) want to join their children in some activities, but they are not allowed. The important thing is to maintain boundaries. Kids can go on forever asking “why” to every reason you give for your answer. This can be exhausting. At some point you just have to maintain the boundary and stay the course.

What are the best resources you would suggest to a parent or educator who would like to learn more about this?

This is one of the main resources I often recommend: https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Children-And-Watching-TV-054.aspx#:~:text=Between%2018%20and%2024%20months,limit%20activities%20that%20include%20screens.

https://suicidology.org/wp-content/uploads/2019/07/SUICIDE-SOCIAL-MEDIA.pdf

I also recommend looking into books that discuss child development and parenting strategies.

Can you please give us your favorite “Life Lesson Quote”? Do you have a story about how that was relevant in your life?

My Great Grandmother said “God gave you have two ears and one mouth” — — Observe more and speak less. This pertains to all aspects of life. Many times we use our mouth to react rather than being mindful and respond with intention.

What is the best way our readers can continue to follow your work online?

Currently I do not publish any work online and I do not have a professional social media following

Thank you for these fantastic insights. We wish you only continued success in your great work!

About The Interviewer: Maria Angelova, MBA is a disruptor, author, motivational speaker, body-mind expert, Pilates teacher and founder and CEO of Rebellious Intl. As a disruptor, Maria is on a mission to change the face of the wellness industry by shifting the self-care mindset for consumers and providers alike. As a mind-body coach, Maria’s superpower is alignment which helps clients create a strong body and a calm mind so they can live a life of freedom, happiness and fulfillment. Prior to founding Rebellious Intl, Maria was a Finance Director and a professional with 17+ years of progressive corporate experience in the Telecommunications, Finance, and Insurance industries. Born in Bulgaria, Maria moved to the United States in 1992. She graduated summa cum laude from both Georgia State University (MBA, Finance) and the University of Georgia (BBA, Finance). Maria’s favorite job is being a mom. Maria enjoys learning, coaching, creating authentic connections, working out, Latin dancing, traveling, and spending time with her tribe. To contact Maria, email her at angelova@rebellious-intl.com. To schedule a free consultation, click here.