Welcome to "Tell Me More."

I'm Kelly Corrigan.

I'm a writer, a podcaster, and a mom.

This season, number seven, is unlike anything you've seen from us before because everyone who works on this show is reading the same headlines.

There is so much unsettling news about how people are actually feeling.

So, we have recruited the best scientists and researchers to separate fact from fiction and surface a set of practices we can all live by.

Join us for a 10-part conversation on wellness-- how do you get it and how do you keep it.

♪ The idea of supporting adolescents through this incredibly difficult phase of transition between childhood and adulthood, all of the tools have to change when social media emerges.

Kelly: This is Dr. Dima Amso.

She teaches psychology at Columbia, where she also runs the Developmental Cognitive Neuroscience Lab.

In other words, she is the perfect person to talk about the effects of nurture on our well-being.

When I think about nurture as a layperson, it just comes down to the early relationships and the early environment.

Is that everything?

Am I missing anything?

I think that's a great way to think about it, except that you want to define what "environment" is.

So, what is environment?

Environment is everything.

If you are a child who's learning how to walk, it's a safe space to do that.

If you're a child who is, um, learning to communicate, it's how many languages you have available to you in the home to learn from.

If you're looking at somebody who is growing up in an environment where they don't have multiple caregivers to care for them, it's whether your primary caregiver has paid leave.

Okay.

So, when I think about well-being, what I mean is that you feel good in your life, and you feel good about your life.

It doesn't mean that you're happy all day long.

It doesn't mean that you have no negative emotions.

So, if you're good with that, then can you backwards-design us a nurturing environment that would take us there?

Early life experience... interacts with the biology of a person to shape you.

The idea is that there is no prescription for well-being as you described it that is gonna fit everyone.

There are some things that are really common to us as a species, as a biological organism.

So, for example, that idea of early responsive caregiving, we need that because we would not survive without it.

So, if you think about the human infant, they can't walk, they can't talk.

They're not gonna be able to get their own food.

And so, they're highly dependent on that caregiver.

But very quickly, they're able to learn tremendous amounts.

They're getting both the emotional support from the caregiver, but they're also getting information about the world from the caregiver, and they're learning how to be in relationships through this relationship that's incredibly formative and that's relevant for survival.

So, that relationship turns into, not just a form of learning how to be in the world, it's also learning how to be with other people.

And sometimes those relationships are super responsive, and sometimes you do have instances where the caregiver is perhaps not a great fit for the way the child learns.

And so, in that case, there's this... this lifelong journey towards well-being that is a little bit more challenging.

That's somewhat anxiety-provoking for me and maybe for others.

We are flawed people raising children.

So, I guess I want to ask you how flawed can you be without really screwing things up?

I think, as a species, we're really supremely resilient.

Also, our environment is almost never made up of one relationship.

It can be multiple people in your environment that are giving you all of these responsive, um, caretaking inputs and informative pedagogical resources that then, you know, are helping build the way that you see the world and interact with the world, and carry forward, um...

I'm thinking of a scene in, um...a Pixar movie where there's a box of opinions and a box of facts, and the person who's carrying them drops them by accident, and things bounce into the wrong box, and someone else says, "Don't worry about it.

It happens all the time."

For a layperson, could you guide us as we try to tell the difference between opinions and facts?

When media puts out some information that seems like we found the magic bullet for "X," I tend to think that it's overstated because-- And there are so many positives for every negative.

I will look for words like "risk," and then I will try to interpret them.

Early trauma is a risk factor for later mental-health problems.

Okay.

Well, what's the base rate?

Is the base rate like, okay, well, it's 2% probability.

And then a particular risk factor will make that 100% more likely.

Now it's 4% probability.

You will still read in the media that it's 100% more likely if you've had this early risk factor, and that's very scary.

Risk is not the same as deterministic outcome.

So, that's, for me, important for not panicking.

Most people don't really understand probability.

Mm-hmm.

If it sounds like people are drawing causal relationships between, you know, extremely, um... correlated things-- if you go to an all-girls school, then you are more likely to make a lot more money later.

Well, there are lots of things that come with going to an all-girls school that would make that association very difficult to understand, including you might have money to go to a private school.

And then there's this idea of risk.

What kinds of early-life nurture experiences are likely to raise risk?

The next question is are you drawing a straight line between one experience and one outcome?

And if I see that, I start to think, okay, that seems to me like a sensational way of describing development.

That's not how I've seen it play out.

What I see play out is something that looks like a push-and-pull and a series of tradeoffs.

Well, that's actually one of the most encouraging things that you find when you dig into the literature, is that-- We had a great conversation with a guy named George Bonanno.

Yes.

Resilience is not exceptional.

It's understandable to me that people would not believe that resilience is the norm, given the headlines about plummeting mental health.

Yeah.

So, how do you square that?

Science is an evolving being.

It's never done.

And that's unsatisfying for... for getting information out there, which is why, for example, you know, with kids and pediatrics, pediatric practice keeps changing.

Thank goodness, right?

Because it keeps getting better because we keep finding different ways to think about things.

So, even with things like growth charts, even the growth charts that we all know and love... Sure.

Even that's changing now in pediatric practice.

I guess there's some data out there that suggests that perhaps these were normed on a particular subset of the population, and perhaps that wasn't representative.

I've seen that some of this is now being called into question.

Right.

And that's a really stressful moment for the general public.

Like, every time we see something debunked, like "10,000 hours to mastery" or whatever has been, like, totally debunked.

Well, forget it.

Like, nobody knows anything.

You're supposed to have this many carbs.

Now you're supposed to have this many carbs.

It's painful to be reminded over and over again that science is somewhat reliant on failure to evolve in ways that are ever more accurate but never completely accurate.

So, I think this is really an interesting place to have a conversation about mental health.

So, with respect to something like heart disease, right, an outcome is... it's incredibly clear what that outcome is.

With respect to mental health, the reason that we're sort of struggling is that the meaning of well-being is not the same for every individual, and the things that support mental health support everything else, right?

So, they're intimately tied into the physical system-- insulin, cortisol, diabetes.

It's who you are in every way, both physical, psychological, emotional, et cetera.

And we are going to have to keep working on this because each person is different.

So, to come up with one thing that works for everyone is...is...is going to take some time.

And it's also the case that the goalposts keep changing-- right?--in society.

Society is a big part of mental health.

Social media is a big part of mental health.

We see that a lot, especially in adolescents.

So, um... Tell me a way that the goalposts have changed in your time as a working scientist.

People sort of are measuring their own happiness in different ways, now that they have access to something like Facebook, where everybody's happiness is on display at all times.

That's a very different world than 30 years ago.

For young people, we're seeing it a lot, the idea of supporting adolescents through this incredibly difficult phase of transition between childhood and adulthood.

All of the tools have to change when social media emerges.

Right, because it's changing the nurture, it's changing the super-environment that we're all operating in.

Exactly.

Can I run some... some elements of an environment by you and ask you just have these been studied, and do you respect the...the research?

I wondered about environments that were rich with play... like, the difference between living in a house with a backyard or a community park nearby versus living in a high-rise with 700 families.

So, this is where this gets a little tricky.

In the desire for the field of developmental science to... offer something meaningful to society-- So, scientists sometimes do things just to understand them, and sometimes you have this pressure to add to society.

So, I think we kind of went through a phase where there was a little bit of a moment where everybody was trying to find all of those good things, right?

Of course having green space is great, right?

And of course having great schools is great in your neighborhood.

In fact, outside of the sciences, there's this great project called the Opportunity Insights Project coming out of Harvard, and they're a bunch of economists that study neighborhoods and the variables that impact neighborhoods.

And what they do is they go back to the census, like, back to the 1940's, and they look at what the neighborhoods that, let's say, somebody grew up in, how much-- like, what kind of schools did they have?

What kind of health care did they have?

Whatever.

And then they follow those people to see whether they had intergenerational mobility, that is, they make more money or whatever than their parents did after the age of, say, 37.

You can get all this data from the census.

In doing that, what ends up happening is that you oversimplify the answer by suggesting things like, well, of course having more money and living near a park or having a big back yard and going to a school that is local that has fewer teacher-to-student ratio, those things are great.

Those things are great, but there's nothing wrong with not having those things, and that's a hard thing to square.

The child who has the experience of living in an apartment building has other tradeoffs-- right?-- other things that are positive in their lives that maybe we didn't measure.

Mmm.

And so, this idea of... what emerged is called the "Deficit Model."

And, in fact, any kid growing up in New York City would tell you about all the things that are incredibly enriching in their lives.

I remember being schooled by one of my students when I was teaching at Brown, and I was saying, "Well, let's think about Head Start, "and let's think about kids who are... "who don't have a lot of opportunities "to go to preschool before they start kindergarten, "and how do we develop interventions to support, "you know, kids from low-income communities who don't have that access."

And I remember I had a student raise her hand, and she's like, "Professor Amso..." Ha ha ha ha.

"I grew up dancing the samba with my grandmother "and making delicious food in the kitchen, "and I don't... wouldn't trade that time for any preschool in the world."

Right?

And maybe it wasn't exactly the right way to prep for American public-school kindergarten, but the thing is that, just because one thing is missing doesn't mean 10 things don't take its place that are substantially enriching.

I mean, it's a very adult assignment you're giving us all, which is to think with nuance and to doubt the simple headline and to remember that there are a myriad of inputs creating a myriad of circumstances and conditions within each of us and within society.

But think about the number of people in the world that you would exclude from your definition of well-being if that's how you want to see it.

Yeah, yeah.

Here's a sort of different angle on this.

What's at stake with nurture?

Like, if it goes wrong, what are a person's chances, or is everything survivable?

There are a couple of different studies that start to address this that are sort of large-scale.

One is a study that was done in Romania, in Romanian orphanages.

I feel like this is one of the two studies that laypeople have ever heard of.

I mean, I remember reading about it.

It's so devastating.

It's devastating.

So, in sort of post... and during Ceausescu's era in Romania, people ended up having a lot of children that they couldn't care for.

The government didn't provide the kinds of subsidies that would make it possible to care for them.

So, they created all these orphanages but that were really low... like low-resourced, that there would be, like, many children, many infants to one or two caregivers.

And, like, no touching.

That's what I remember.

They weren't getting held.

And so, three really excellent scientists, they went over there, and they basically were like, "Whoa!

This is breaking every rule of nurture--right?--for humans."

Basically babies just sitting around, getting no input that is valuable.

And they've been following these children up for some time.

And what I think that the punchline that what I always think about is that, if they were placed is foster care before the age of two, they tended to do pretty okay.

Somewhere after the age of two, it became harder.

Language came later or was more difficult.

Executive functions maybe looked a little different.

That's in part because...two reasons.

One is, the developing system, the more it learns, the more it becomes entrenched in that information, and now you have to undo it somehow, and that's much harder to do later.

It's like you learn your native language, um... and then you're supposed to learn another language when you get older and you have an accent.

It's not like you can't learn it, but you're not learning it in the same way as you did when you were a native, because you're now building over other information.

Is that, in any way, what some people are doing in therapy?

Yeah.

I mean, there are all sorts of ways that therapy might approach the problem, but one way is you have a particular pattern or a behavior.

For example, I might be anxious about health issues.

Okay.

Well, why?

Let's work backwards.

Let's try to figure out at what point that happened.

Let's try to understand the experiences that might have associated health issues with something scary or painful for you.

Or maybe doctor's visits.

Okay, let's understand the source, and then, once you understand the source, then try to create a new association around this.

There are other therapeutic approaches that simply don't care so much about the source and just want to use learning theory to build a new association.

Is there research on which one is more effective, or is it personal?

I think it's personal.

They're both effective.

Um, the approach where you're really digging deep is very time-consuming.

The approach where you're just... you know, you're like, "Okay, like, I have this reaction.

I want to change this reaction.

How do I do that?"

Then I think that tends to be a little bit more, um, rapid.

To the extent that that doesn't work for deep-seated early traumas, well, the other approach might make more sense, right?

There's that word, that "trauma" word, and it makes me think of all the words that are right now flying around between people of all ages, between 10-year-olds are saying, "I have ADD.

He's a narcissist."

You know, "That guy's bipolar."

This terrible new comfort people have with diagnosing themselves and others.

Where do you think that comes from, and what do you think the consequences of that are?

I think information is really readily available these days in ways that it wasn't.

You know, I learned those words in college from an abnormal psychology book.

Right.

I think processing that information is a different, um... beast these days.

So, there are two elements.

On the one hand, they're getting a lot of information, but it's not deep or meaningful-- Or potentially well-sourced.

But on the flip side, um...when young people are overwhelmed with information, it creates uncertainty.

And uncertainty is very uncomfortable.

People want to find a label to reduce the answer into.

Right?

"Why is that person saying that?

Why am I behaving this way?"

A Google search is easy, right?

And then you identify that one thing, and you stick with it, and now your uncertainty feels different.

And so, there's both.

There's both this element of information is easy, but also, their world opened up to such an extreme degree that it's stressful.

It's like, "I can't focus in class."

Well, you're not thinking that "It's because I didn't sleep all night.

It must be because I have ADH," and it might be.

But the point is that that information is now available to you, and it's overwhelming.

It seems like there's this terrific opportunity for whatever the data is telling us about great nurture to inform policy.

Does it?

I think that... that it does, but not as much as it could.

Part of, I think, the challenge is that policy-makers are dealing with limited budgets.

So, paid maternal leave came up.

A colleague of mine did some work where she showed that early brain development is... Signatures look better, holding other things, as much as possible, constant, when there was paid maternal leave.

Well, why?

Because parents are more present, they're less stressed.

So, not just physical presence of the parent, which is important, but they are less stressed.

They're less worried about making ends meet.

That is a policy-level decision, paid maternal leave.

So, to turn around and say, "Okay, let's give that to everybody uniformly," that's more complicated, because there's all of these constraints.

There's still the challenge of translation of good data, and I think the data are strong for things like paid maternal leave, or paternal leave.

Um, but they're... but they're not, um... they're not inexpensive, and I think that makes policy challenging.

Have there been culture shifts or policies that you've seen that you thought, "This is not comporting with the data"?

A lot of things that have happened recently-- There have been some shifts in the way public schools have resourced the enrichment aspect of education and shifted to focus a little bit more on, you know, teaching to tests, that, I think, has been a shift that has been difficult for my community to understand, um, because there is so much more to well-being and education than just getting, you know, somebody to a particular place in the content domain, um, you know, the arts enrichment.

Physical exercise reduces your stress levels.

That's really well known.

It also allows for your physical health to be stronger, which, of course, supports learning.

The kinds of things that I think, at a policy level, would be amazing, um, include, um, supporting caregivers early, um, in ways that we don't have as a norm in this country.

There are places that do do this, like Finland or Sweden, where caregivers have many, sometimes years to raise their kids.

You know, when we talk about nurturing, we talk about quality caregiving and responsive caregiving and not an over-stressed caregiver.

Their mental health is really the most important thing for making sure that you, you know, support children.

Those are things that I think we could do a lot better with, things that were... that are now called AECEs, so Adverse Early Childhood Experiences.

The more you had, the more the long-term impact on health.

What kinds of impacts?

Um, diseases like cancers, um, diabetes, um, high cholesterol.

All of those were more prevalent he more AECEs you had early in life-- abusive relationships and trauma, violence, poverty, parents-- incarcerated parents, which is a terrible way to separate families.

There is that relationship between these early exposures, but in a chronic, toxic form.

You can have an isolated event that's severely traumatic, but the AECEs study suggested actually, like, the impact was larger.

Yeah.

Mm-hmm.

Is there anything that you've learned in the lab that's totally affected the way you raise your son?

There are two things that I want for my son.

One is I want him to be confident.

Agency and confidence go together, right?

So, I want him to be agentic.

If something is not working in his daily life, if a relationship is not working, I want him to have the confidence to put that out there.

And the other thing is I try to deliver information in an age-appropriate way, but I don't withhold information.

Children are incredibly capable of learning really complex ideas and thoughts.

But they have to be presented in a way that's consistent with what their system is capable of processing.

You know what I see referenced all the time, is "attachment theory," that there are these styles where you're "secure attachment" or "insecure" or "anxious."

What do you make of all of that?

Is that more like Instagram science, or is that really showing up in your data?

The way that I tend to think about attachment theory is that attachment really solidifies the value of the caregiver and the responsivity to the child, but what it doesn't insist on is that you are perfect all the time.

There is good-enough caregiving in human relationships.

And we find ourselves resilient in such a way that a parent doesn't always have to be perfect, doesn't always have to be responsive, but you're present.

Yeah.

So many people who have been sitting where you're sitting on "Tell Me More" have said that they had one person who was critical to their development in life, and it wasn't a parent.

Is it the case that almost any loving adult can put a kid on a path to well-being?

That seems to be the case.

Someone who you can trust-- also very important-- who engages with you.

That person does not have to be a blood relative.

That person could be a teacher.

It could be a boxing coach.

Um, it could be anyone, and, in fact, in adolescence, families drop in their... in their value, and peers go up in their value for regulating us.

I'm very familiar with that... Yeah.

Me, too.

Both as the teenager I was and the teenagers I raised, who just turn their back at some point, and it's all about peers.

Yeah, but that's normal, right?

Because ultimately, they have to wean from the nest and start a life independent of it, and peers sort of allow you to build family outside of that nuclear home.

So, it's a really natural process.

It's really depressing as a parent, but, um...

But essential.

But essential.

Thanks a lot for every minute of your time.

Thanks for having me.

Yeah.

Here are my takeaways from my conversation with Dima.

Number one, parents need not be perfect.

Good-enough caregiving works.

Number 2, P.E.

is an essential mental health strategy.

Number 3, unsatisfying as it may be, science always evolves.

Number 4, like it or not, social media is now part of our nurture.

Number 5, put the arts back into K-12.

Number 6, it turns out our nature is not fragile.

Our nature is resilient.

If you'd like us to send this list to you, just email us-- PBS@kellycorrigan.com.

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