Saul Rosenthal, PhD

Boston Area Health Psychologist

*Spoilers ahead for the musical Hadestown*

I was fortunate enough to see Hadestown when it played in Boston. Anaïs Mitchell’s musical intertwines two classical myths. The main story focuses on Orpheus, a “poor boy” with the gift of music, and Eurydice, the “hungry young girl” who was a “a runaway from everywhere she’d ever been,” until the two meet. Their journey through life, death, and afterlife take place in the context of the conflicted relationship between Hades, King of the Underworld, and Persephone, part-time Goddess of the Spring and Summer, and part-time Queen of the Underworld.

I’m not the first to consider Hadestown (let alone the mythological figures involved) from a psychological perspective. Alisa Hurwitz writes about the play from a cognitive behavioral therapy perspective, while Fletcher Wortmann looks at the role that uncertainty plays in the many iterations of the Orpheus story. I urge you to read their analyses (after reading this one, of course!).

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December 11th, 2021

Posted In: Movies, Television, and Theater, Musings, Psychology

A recent article published in the academic journal Psychological Science questions the generally held belief that lots of screen time, especially around bedtime, is bad for adolescents. The article, Screens, Teens, and Psychological Well-Being: Evidence From Three Time-Use-Diary Studies followed over 17,000 teens in three countries. 

This is an important study for a number of reasons. First, it includes a very large number of participants. Second, rather than relying on retrospective measures of technology use, the study uses a technique in which adolescents’ use is recorded throughout the day. Third, well-being is measured by caregivers as well as the adolescents. Finally, statistical analysis was designed before data collection. In other words, it’s not a fishing expedition. This is a really nicely designed study, strengthening confidence in its conclusions.

The results in general find very small or non-existant links between screen use time and well-being. Using screens within 30-60 minutes of bedtime show even smaller links. In other words, the study’s findings suggest that screen use does not harm general well-being.

Even though I see all sorts of poor health consequences related to technology misuse, I am confident that the study’s results are valid. The large sample size, procedure for measuring screen time, and pre-designed approach to data analysis make one of the best designed studies we have on the topic. It is a study for others to emulate.

In fact, even before the study, I believed that, in general, screen use does not lead to negative outcomes. Unfortunately, there is an almost universally-accepted assumption that screen time is inherently problematic. It’s poorly tested, but concern about screen time drives legislation, regulations, and plenty of articles and books. So much so that while it is still mostly an assumption, we tend to accept it as Truth. One of the points of the Psychological Science study is to take a systematic look at the assumption. The authors do a great job, and find the assumption doesn’t hold up.

However…

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June 2nd, 2019

Posted In: Parenting, Tech

I was lucky enough to attend an early viewing of How to Train Your Dragon: The Hidden World. I watched with a real mixture of responses; sad that it is the last movie in the trilogy, excited to see how the filmmakers deal with some of my favorite characters, blown away by the amazing look of the film. I left the movie with the urge to write about it. Not a review, which would be two words: SEE IT! Rather, I found myself mulling over the parallels between Hiccup’s and Toothless’s journey and our own development from childhood to adulthood. The curse of my decades trying to understand what makes us tick!

First, I, along with my daughter, have a long history with How to Train Your Dragon. We started with the books. I picked up the first and read it to her as part of my not-so-covert attempt to raise her with stories that were both atypical for girls and that I would enjoy. And enjoy them we did. Cressida Cowell draws you in with goofy characters and fantastic storytelling. Of course, Vikings and dragons right away make it worthwhile. But her real gift is allowing the characters to grow more complex, to face dilemmas without clear or simple answers, and to make mistakes. Good characters do bad things and bad characters do good things. Over the course of twelve novels (and a few companion books), Hiccup Horrendous Haddock III grows from a scrawny boy who does not have a place in the Viking world into a true leader and the conduit from one age to the next. Toothless grows from a tiny, naughty, vain, and sub-par dragon into a brave, someday-to-be Seadragonus Giganticus Maximus and one of the important King’s Lost Things (he insists the most important) that will unite the Vikings under a single leader. The films, while very different from the books, chart a similar evolution for both characters.

I can’t help but look back across the story and see parallels in how we develop as people. I think this is the “Hero’s Journey,” which narrates the growth of an individual through a series of crises. The protagonist transforms into a hero by discovering hidden strengths and developing new talents. By the end, they are fundamentally changed. Older, wiser, and perhaps sadder.

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February 3rd, 2019

Posted In: Development, Movies, Television, and Theater

Last week I shared five tips about helping out when you give your child a smartphone or tablet.

But what about you? All those Black Friday, Cyber Monday, and end-of-year prices are tempting. Maybe it’s time for you to get a new device. If you’re taking an opportunity to treat yourself to a new device, take the opportunity to review and strengthen your usage habits. 

First, this is not about denying yourself the enjoyment of gaming, social media, or whatever you  enjoy on your smart device. It’s about preventing the device from becoming a time-waster that gets you into trouble. It’s about increasing your efficiency. Clean your apps up, reduce distractions, tighten up your privacy. Get your digital habits under control and your brand new shiny device will end up enhancing your life rather than controlling it.

It shouldn’t be news to you that our devices play a growing role in all aspects of our lives. We use the same phone or device for work, school, and play. It also shouldn’t surprise you how easy it is for that same device to slowly start stealing more and more of your time. Before you know it, the device has shifted from a life-enhancer to a time-waster.

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December 14th, 2018

Posted In: Tech

With the end-of-year holidays at hand, you might be thinking about gifting your child a phone or tablet. I’ve previously written about helping your child develop appropriate online skills, and now I want to share some tips about setting your child up for success with their new device.

Many parents (myself included!) feel ambivalent about giving their child a smart phone or tablet. On the one hand, it’s convenient, you can keep tabs on your child, it’s the way of the world, and, of course, “everybody else has one!.” On the other hand, devices and subscription plans are expensive, many apps are a waste of time, social media is a jungle, and, of course, “I didn’t have one when I was your age and I grew up just fine!

It’s true that most children over 10 years old have a cell phone. However, that doesn’t mean it’s simply a matter of buying something and tossing it over to them. You would never do that with your car keys, would you? 

With a little thought and planning, you can help your child develop more responsibility in the online world. Be involved, especially when they first start out, and then slowly let them have more independence. Digital devices have a powerful impact on every aspect of your child’s life. They should enhance your child’s life, not control it.

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December 7th, 2018

Posted In: Parenting, Tech

The World Health Organization recently included Gaming Disorder as a new diagnosis for the upcoming 11th edition of the International Classification of Diseases (ICD-11). The ICD is the diagnostic “bible” used by health care providers around the world. While the exact criteria do not seem available, the WHO defines Gaming Disorder as:

a pattern of gaming behavior (“digital-gaming” or “video-gaming”) characterized by impaired control over gaming, increasing priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities, and continuation or escalation of gaming despite the occurrence of negative consequences.

For diagnosis, the behavior must significantly interfere with functioning and exist for at least 12 months.

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September 16th, 2018

Posted In: Internet Addiction

In a recent piece written for the New York Times, Perri Klass, MD lays out ideas for 5 device-free spaces for families. The article does not directly focus on getting our children off of the devices. Rather, parental media use is the focal point.

He starts with Common Sense Media’s 2016 survey indicating that parents spend over 9 hours per day consuming media. About an hour-and-a-half of that time is work-related. The vast majority of time parents spend consuming media is personal. 

What sort of model does that provide to our children? 

Children, whether we believe it or not, do follow our leads. The setting they grow up in becomes the normal and expected way the world works. If it is normal for parents to spend huge amounts of time behind a screen, then that’s what children will also do.

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January 25th, 2018

Posted In: Parenting, Tech

In the article What your therapist doesn’t know, author and psychologist Tony Rousmaniere argues that therapists should incorporate psychotherapy metrics into our practice. In general, I very much agree with him, although it’s a complex topic with no easy answers. Rousmaniere, while advocating for metric-based treatment, does a good job laying out both pros and cons. On the one hand, more and more fields are utilizing metrics as feedback to alter and improve performance. On the other hand, psychotherapy is an extraordinarily complex and individualized piece of work that might not lend itself to influence by statistical analysis.

While there are plenty of reasons to praise and criticize the article (just read through the article’s comments to get a sense), there are a couple of points that really stick out to me.

Speaking as a dataphile, the idea of utilizing objective information to improve my clinical work is fantastic. However, I’m not quite diving into the world of metric-based treatment right away. There are a couple of problems I have with it, particularly in the context of psychotherapy.

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March 21st, 2017

Posted In: Psychotherapy

While I tend to keep my political views out of my professional work, I find myself tentatively venturing into the muck of some current politics with my clinician’s hat firmly on. A recent series of articles has examined a connection between Betsy DeVos, the (at this moment) nominee for education secretary and a company that provides neurofeedback and biofeedback services. Articles like What the heck is neurofeedback? from a site called Motherboard (update: the article seems to have disappeared) or DeVos-Backed Company Makes Questionable Claims on Autism, ADHD from the Education Week site don’t really bother me too much. And in fact these have been well rebutted by the International Society for Neurofeedback and Research.

However, once the New York Times got into the game I felt obliged to respond. The language of the article (actually all the articles I’ve read) are clearly designed to suggest there is something wrong with DeVos’ relationship with the company Neurocore (note: it looks like the company may not be in business anymore). I am not here to comment on politics, DeVos’ qualifications, whether her relationship with Neurocore is problematic or whether Neurocore does good work.

Rather, I am here to discuss Neurofeedback. Because the New York Times article seems to be attempting to criticize DeVos’ relationship by delegitimizing neurofeedback as an effective treatment for numerous conditions. I would like to consider several points in the article.

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February 1st, 2017

Posted In: Neurofeedback

One of the issues that almost always comes up when parents find out I specialize in Internet addiction is whether parental controls and monitoring apps work. I’ve come to realize that what many parents are really saying to me is, “I don’t know how to make sure my child only accesses safe Internet material and I’m pretty sure my kid will get around any control I set up anyway but I don’t know what else to do. Help!” 

Even though I’m a developmental and clinical psychologist specializing in technology use, I realized I don’t really know if parental controls work. I use them for my own child, but I hadn’t given it much thought. I just turned on what I thought was appropriate in the operating system. 

In fact, even though parental controls are ubiquitous — built into operating systems, provided by Internet service providers and developed by a number of third parties — there’s very little in the way of information out there about whether they work or not.

And then I realized the question was more complicated than I thought. What does it even mean to say parental controls “work?” That a child cannot access the Internet at all, at least during particular times? That the child only encounters material the parent deems appropriate? 

To me, the question of effectiveness misses the point, at least in terms of the type of thoughtful parenting which I promote and to which I aspire.

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April 25th, 2016

Posted In: Parenting, Tech

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