Girls on the Brink Book Club Event | Episode 34
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Sick of the fatigue and fog? Fed up with the unpredictable flares? Hangry from the super restrictive diets?
Hello and welcome to the Crunchy Allergist Podcast.
A podcast empowering those who, like me, appreciate both a naturally minded and scientifically grounded approach to health and healing.
Hi, I'm your host, Dr. Kara Wada. Quadruple Board Certified Pediatric and adult allergy immunology and lifestyle medicine physician, Sjogren's patient, and life coach.
My recipe for success combines anti-inflammatory lifestyle, trusting therapeutic relationships, modern medicine, and mindset to harness our body's ability to heal.
Now, although I might be a physician, I'm not your physician and this podcast is for educational purposes only.
Kara Wada, MD: I would like to officially welcome everyone to the very first Crunchy Allergist Book Club Author Event, and I am thrilled and deeply honored to welcome Donna Jackson Nakazawa, one of my absolute favorite authors.
She's the author of four books that explore the intersection between neuroscience, immunology, and emotion including Girls on the Brink, but also the Angel and the Assassin, which was how I learned of her work which was named one of the best books of 2020 by Wired.
Her other books include Childhood Disrupted, which was a finalist for the Books for a Better Life Award in her writing on health and science. She's received Lifetime Contribution Awards and the National Health Information Award.
She's also the creator and founder of the Narrative Writing to Heal program your healing narrative, which uses a process called rural neural re narrating to help participants recognize and override their brain's old thought patterns and internalize stories and create new, more powerful inner healing narrative that calms the body, brain, and the nervous system.
Her work's been published pretty much everywhere and she has been on all of the popular shows including the Today Show and NPR and NBC and ABC.
She regularly speaks at universities and with healthcare professionals especially.
So thank you Donna for joining us and
Donna Jackson-Nakazawa: Thanks to see here with you.
Kara Wada, MD: Oh yeah.
So I wonder if you might just set the stage. I think most of our group probably has listened maybe to our initial conversation, but maybe they haven't.
And in the opening chapters of the book, you discuss how we're living in this toxic time for girls.
Can you explain why that is and what's going on?
Donna Jackson-Nakazawa: Sure. First of all, let me just set this stage by saying that girls are developing depression and anxiety at earlier ages than we've ever seen before.
Often by age 12 or 13.
There's always been a gap between boys and girls suffering from depression.
But that gap has been growing with girls being several times more likely than boys to develop depression and anxiety around puberty.
We know that, for instance, girls are 2.6 times more likely to have symptoms of anxiety after puberty.
In 2021 the CDC showed that the rate of suicide attempts and ideation had gone at 51% in girls and 4% in boys.
So something's been going on for a long time, but it seems to be getting worse.
The gap between female mental health and male mental health around puberty is getting worse.
Now boys. We'll talk about boys.
I'm the mother of a son and a daughter. I love boys.
Boys present more with other, the other things like ADHD or behavioral issues.
But for a long time it's been a question what's going on with girls?
As this trend gets worse and girls are developing depression at earlier ages and in greater numbers, to be clear, this isn't about diagnosis.
This is about symptoms that are real and tangible, like not being able to get out of bed, like a complete loss of all interest in one's activities or life periods of weeks or months marked by hopelessness, guilt, despair.
We're not talking a bad week.
And we're not talking about girls just being more likely to say, I don't feel good.
So I wanna set this stage for that.
So when I talk about a toxic era for girls there's so much happening. In girls' lives at earlier and earlier ages, and for right now, I just wanna talk about what's happening for all of our kids, right?
Because it's a toxic era for all kids, boys, girls, anyone on the gender spectrum, wherever anyone is.
So we have seen, we know we don't have to look around to see that the world is heating up politically, socially, environmentally, hello.
This is true for girls and boys. There's more hierarchical competition at much younger ages.
Middle school is the new high school and fourth grade is the new middle school.
We have these earlier and earlier benchmarks for kids to succeed faster academically and in their extracurriculars at the same time that 60% of kids say they're afraid their school will be the next site of a school shooting.
It's a peer research finding from this past year and we've had a pandemic let us not forget about that.
But for girls, some other things are also happening.
As we have this advent of social media, which you're supposed to be 13, to log onto social media, many girls start using social media at the age of eight.
They may not be on a smartphone.
Families may not have given them a smartphone, but those little Apple watches can show 60,000 images a day.
Kids can access social media and the media in general through Apple watches.
Whether it's a smartphone or the computer or a watch images have a really much more profound impact on the developing brain than words.
We have studies where you can show thousands of images, but at the same time be saying the opposite message with words and the brain will clock the imagery.
That's just much more powerful for the brain. So as social media comes in and all of this competitive, hierarchical stuff is happening for kids at earlier ages in a world that's really feeling unsafe.
We also see that girls, when they start with social media, they're much more likely to be critiqued, disliked, encouraged to take their clothes off.
Girls in general in the media are being increasingly sexualized at younger and younger ages.
There's very little distinction between being a girl and being a woman.
In our culture and the more a girl poses as a woman, before she's developmentally even ready to consider what that means, the more like she gets, the more popular she is, the more social cache she has.
And this is all of course, cuz we're in a very sexist society.
So anyway, we can get to this in a minute but where this all becomes more problematic for girls is that as puberty comes in and estrogen comes surging on board, estrogen as can be a potent immune amplifier.
And so we can get into that and talk about why that's an issue, especially with puberty happening at earlier ages.
But I'll just pause there and let all that kind of sink in.
Kara Wada, MD: It's hard for me to fathom. My oldest turned seven in about three weeks, and so thinking about her having a smartphone or being on social media is just really scary to think about.
But I'm already seeing hints of she's in first grade and I was already seeing hints from other moms with some of that competitive behavior that I think personally I'm a little bit more attuned to, because the house I was raised in was very focused on grades and getting straight A's it was.
It was not just encouraged, it was expected.
And that's not to say that expectations aren't to some degree helpful, but I also do see a lot of the pressure that placed on me growing up.
I've had this concerted effort that I've wanted to have in my parenting just to let our kids be kids for a while.
Donna Jackson-Nakazawa: Hundred percent. I had a friend say to me once, every time your kids get really good at something and they start like winning awards or being whatever.
First, you're like, Oh, try something else.
And I remember her saying that to me and I think , "Do I really do that?"
And it really wasn't that so much as there were lots of things they wanted to do and try.
And they wanted to, sure, play this and try that.
I just felt these years are for trying all those things and also a big part of my reason for not pushing them to just do one sport or thing for 14 years was because if you did that, all of a sudden you're not just doing an after school sport.
You get invited to do a club team and in the club team you have to travel all around the country.
In fact, with my son, it was a sailor around the world, like you're expected to travel and it gets, it just felt so not childhood.
So you're those years ahead of you coming in through those middle years. It's just so interesting. And I'm not saying that I handled all of that.
But I did.
My daughter was invited for this very big club, so club lacrosse team in Maryland, and I sat down and I said, Do you wanna play in college?
Yeah. She's like, " Oh no, I don't think so."
i was like, " Okay."
Anyway, we diverge.
Kara Wada, MD: No, I saw a statistic just this week.
I was doing a little kind of research for some social media posts, and it was to the effect that you spend 75% of all the time that you'll spend with your children by the time they're 12 years old.
Donna Jackson-Nakazawa: That's right.
Kara Wada, MD: My husband and I, we have our first date night, and I don't know how long scheduled for tomorrow night, but that was something that came up in our little discussions during the week that I think is gonna be really the framework for ongoing discussion tomorrow.
But yeah, and it, I know in our initial conversation we had delved into, some of the. The interface of some of the stressors that children are under and some of the. Discussion in the adverse childhood experiences and sources of stress. And maybe that's a natural segue into discussing a little bit more about that.
Donna Jackson-Nakazawa: Yeah so when I hinted about what's happening with puberty coming in earlier to set the framework,
The developing brain is really asking one question.
Am I safe or not safe?
And everything falls out from there.
Am I safe or not safe.
Psychological safety is key to the developing brain because the brain wants to know what kind of world am I growing up into out here?
What am I going to be faced with as I go grow up and enter this world?
And the more that the answer to that question is, "You're not safe."
The brain begins to factor all of that into how geared up it stays to fight off the next bad thing.
The more geared up the nervous system is to respond to the next bad thing.
The more we begin to see that ramping up of the stress immune response into just colloquially what people might recognize as fight-flight-freeze, right?
The more we begin to see that sympathetic nervous system caught on high.
And over time that leads to inflammatory factors.
So step back from that and that idea that, okay, the brain is trying to figure out, am I safe or not safe?
And at every moment as you get toward puberty, it is almost like a computer chess game.
Taking into account all the past moves on the board to figure out what should those next moves be.
Do I need to go here? Do I need to go there?
If the brain is facing that moment going into puberty based on all of its adversity and all of its traumas and all of its unsafety, if it's going into that moment saying, We are definitely not safe.
The brain is gonna wire up to be prepared.
What that looks like in the brain is the exacerbation of pathways we associate with depression and anxiety and even self-harm.
So now bring in puberty.
It comes in and you know it better than anyone.
We begin after puberty.
You see a big difference in the way in which, in the race at which males and females develop things like autoimmune disease, right?
We know that has a lot to do with estrogen coming in and giving this in a good scenario an evolutionary advantage to women.
Estrogen is that, whoa! It is master regulating hormone. It is the bees knees. It's fabulous. It allows us as women to do everything a guy can do, a man can do in the same 16-18 hour day or whatever, in a smaller body with smaller organs and still make room for uterus.
It's so groovy and we think of it as associated with like that throb of excitement or hormonal surges.
But it's so much more. It's actually the brain's master regulator for females coming across puberty.
When it comes in and the female brain has clocked that there is a lot of uncertainty being sexualized at a very early age.
Seeing the kind of sexism and misogyny that lurks around every corner, being critiqued and disliked on social media.
Seeing, " hey, I better have straight A's and worry about my extracurriculars, my club sports, by the time I'm 8."
All of that puberty comes in and puberty amps up that stress threat response. It magnifies it.
If a girl feels safe, that's great.
Estrogen comes in and the female adolescent brain is a superpower.
It's like the superpower brain on this universe. It's highly flexible. It's responsive.
That corpus callosum between the left and right side brain is really thick and that allows that kind of multitasking.
That spidey sense we think of knowing what's going on in the world around us.
The adolescent female brain is full of all those wonderful things.
But in the face of too much adversity, in the face of too much stress, in the face of unrelenting stress, we see that estrogen and that amped up stress response can flip from an evolutionary advantage to a disadvantage.
It can begin to exacerbate that stress immune response.
In a way that can lead to greater pruning in the brain more than we wanna see, which we can see on brain scans can be associated with depression and anxiety and self harm.
And I will wrap this by saying, we have one other issue in modern toxic times that is making all this even more worrisome and complicated, as if all that weren't enough.
Puberty is happening several years earlier in girls, I think since 1800.
It's actually happening six years earlier and magnifies everything that I've been speaking about because when puberty comes in early, before adolescence.
So think of it this way. It used to be that adolescents came in and then puberty.
So adolescents came in.
You had four or five years to experience the world, have adult support, figure out how to respond to stressors in your environment.
Know when to ask for help.
Know who to be friends with and who not to be friends with.
But puberty, this big rush, this big reorientation of the brain, this remodeling of the brain is happening before adolescents.
And what that means is that puberty is coming in.
This big stress response is coming in years earlier, before the brain has had a chance to learn all of those things.
And this means that the brain has not yet wired and fired up to put the distress.
In context being sexualized really early, the brain doesn't know what to do with it being critiqued or made fun of or early sexualization or whether or not it matters if you won that prize or didn't win that prize or how to respond in tricky friendship situations.
The brain needs time to wire and fire.
In healthy ways, know how to ask for help when it's an overwhelm, but this reverse in a toxic era.
Houston, we have a problem.
Kara Wada, MD: Yeah, and we've been seeing the discussion of that.
Even thinking back to, I graduated medical school in 2010. And there was discussion even then as I was becoming a pediatric resident about needing to talk to eight and nine year olds.
Not knowing what was going on with starting their periods and the discussion at the time was thought maybe more related to changes in diet, improved diet and nutrition.
And now the plot thickens, there's so much more..
Donna Jackson-Nakazawa: Oh wait, it's pretty thick.
Kara Wada, MD: ..going on.
Yeah. And I just, I wonder too, this is where I start hypothesizing or asking the questions of how do things like epigenetics and this occurring over several generations, how is that going to compound ongoing changes in our microbiome in addition to living amongst this, we talk about the exposome, all the things around us that influence our health and our bodies, and so much has changed.
Donna Jackson-Nakazawa: Yeah. It's like a matrix.
And every, everything that was in the matrix, when. I was a child and you were a child.
All those conditions have changed and why?
We think of all this, it's really, it can't really be surprising that our girls are struggling when you put all of this together. Yeah.
Kara Wada, MD: We went I went with Charlotte to her kindergarten graduation field trip, which was to like our science and industry type museum, and they have this section of museum where it's 1865.
And so they have that little area with kinda like old Western town, but then it moves into 1965.
And it's essentially what would've been my mom's childhood.
With the rotary phones and the old radios and first TVs and everything.
And I don't think she quite understood how in awe I was thinking about how different her child hood was compared to grandma.
Donna Jackson-Nakazawa: Yeah, it just is a different, it's a different time. Yeah.
Really all the skills that that we applied or were applied raising us or that we thought we could apply raising girls in this world at this time.
We have to rewrite the rule book.
We have to rewrite or rethink our toolbox.
Yeah. And it's very important that we get a grip on this science that stakeholders understand it and can utilize it across all their levers of power to bring more attention to helping girls who, I've been doing some work with children's hospitals and gave a talk for them recently and they're facing huge numbers of adolescent girls in their ERs, who can't get out of the emergency room to get in bed.
They're just waiting in the ERs for days and weeks, and it's by and large young female or young girls hitting puberty or adolescent girls.
And so we have a really big problem and understanding the science, of course, I'm a science journalist, so I'm partial, I think is really helpful because although the part we've been talking about is scary and overwhelming, especially as a mother of a daughter.
I think what I've learned over the years is twofold.
One.
I would like to say we don't need the science to get off our butts and do more about it.
I would like to say that's not really necessary.
It's enough just to know that girls are really suffering and sitting in emergency rooms in hospitals wanting to die and unable to get beds.
That would be enough for us to just really rethink how we're doing things.
But often we need the science to catalyze change.
And also I think once we have it.
It organizes our brains as adults a little bit and helps us to stop walking around going, What? What?
Is it my imagination? Are the girls really struggling at my daughter's school?
I've talked to so many school principals and school nurses and pediatricians, and putting a frame on this is very helpful for catalyzing those meetings and those conferences to do something about it.
Kara Wada, MD: Yeah. And that's you know what I really appreciated about this book too was that, the whole essentially second half of the book are tools that we can use and go back to as we need them, time and time again.
Donna Jackson-Nakazawa: A hundred percent. A hundred percent.
Kara Wada, MD: Although it's written for girls, I plan on using them for my son too.
Donna Jackson-Nakazawa: No, and I really, I was very clear about that in the book. As I say it over and over again many of these boys are struggling too. Of course they are.
But why did I write about girls? I wrote about girls because the statistics don't lie.
We're seeing, this shooting, this rapid escalation in a decline in female mental health throughout puberty and adolescents.
It's been getting notably worse since 2012.
It existed before the pandemic. But the other reason I wrote about girls is that I've written, as you noted, a few books about the brain and the nervous system across health and development in the face of adversity.
And all of that research was largely based on male research models.
So it was only in 2016 that the NIH requested very nicely that researchers begin to look at the intersection of stress and development in the female brain.
Before that, researchers wanted to keep those pesky hormones out of it.
So you know that preclinical research is what we use as a basis for translational and clinical research.
And so all the work that we have understood about adversity and development was based on this male research model.
And when we began to look, when researchers began to look at the female brain based on a very different effects of stress on, the epigenetic shifts that occur in the brain globally in the female brain versus the male brain.
So I won't bore people with the cool dust, 16 and a bunch of the other ones, but we didn't look, we assumed what applied to boys applied to girls.
It turns out it doesn't at all.
And that said, many of the principles in the book, the antidotes and strategies can be applied to girls or boys, and additionally, look, if we make the world better for girls, we wanna make it better for all children, right?
There's no selectivity here.
And if we make the world better, for boys that will naturally make the world better for girls.
Cuz boys grow up with so much toxic masculinity.
They're expected to be manly, which often means, put girls down or, be more interested in sex than connection, or not be too gentle or not be soft spoken.
And they're often applauded for being those ways and made fun of when they're unmanly, which is supposedly, caring about women or not talking about their body parts and so on and so forth. I could go on.
So toxic masculinity, we can use many of these strategies to help also address, let's just say sexism and stress across health and development for girls and boys.
Kara Wada, MD: The one thing I worry, and I alluded to I think in our first conversation was..
Is this maybe a harbinger for what's to come 10, 20 years down the line?
As it comes to increased autoimmune concerns.
Is there any, I really discussion with the sci, with the basic scientists, with that, because you know that
Donna Jackson-Nakazawa: The future is a hypothesis too far for any neuroscientist for sure.
But I do think it is a concern and anyway I don't know. I certainly don't like where we are right now and I hope we're able to make a change.
Kara Wada, MD: Yeah. I think that it was, we all have our turning points, right? And I think mine came at this crux stuff being diagnosed with Sjogren's about the same time that Josie was diagnosed with egg allergy.
And like this, oh geez, like we've never had food allergy in the family.
We've had a little asthma, running nose stuff.
We've never really had autoimmunity until this generation.
So we need to take a good, hard look as a family just to see what is the science and what are those things that we can modify to try to help do the best we can with what we know which is what we try to do as parents.
And as you've discussed with these different principles and tools, there are some strategies when it comes to how we interact with our children that can help build them up. Has science behind it to minimize some of that potential for increasing the trauma that we could expose them to.
Donna Jackson-Nakazawa: Yes, absolutely.
Any of particular ones you wanna start with or you want me just to jump in?
Kara Wada, MD: I'm curious if there's like a few in particular that you have found in your life, yeah. We all pick ones that. I'm sure that resonate, but
Donna Jackson-Nakazawa: I think one of the ones that really stood out the most for me was a finding out of the School of Public Health at Hopkins, which showed that pretty much the single greatest predictor for flourishing across puberty and adolescence was being able to talk to a parent about anything.
No matter how hard this turned out to be.
Kids about whom this was a yes, they had a 12 times higher rate of flourishing.
And that really stood out for me because honestly, you don't see that every day as a reporter.
And I spent a lot of time with a researcher and that led me, Christina Beth Allen Hopkins, and that led me to a lot further down that path of child parent connection and what that looks like.
And of course we know, and I've reported for a long time as have many other people in the trauma reporting space, that single relationship with a safe, stable, nurturing caregiver is really the most important predictor for childhood flourishing.
But when I talk about childhood connection in this way, what I'm talking about is being able to turn to a parent no matter how hard the thing that is happening may be, and this requires a lot of pre-work on the parent's part.
It's not something that just happens naturally. We wish it would. That would be great.
But it turns out that we have to have created thousands of moments of psychological safety from early on.
And you know what gets in the way of that, our own reactivity and our own stories of trauma, our own past can get in the way and family moments.
Look, I raise two children. You're raising three children.
It's hard work. It's a wonder you get anything done , ever.
It's really hard work and it would be not human to never get frustrated or never feel overwhelmed.
That is simply not human.
However, learning how to be in those moments so that you're not so busy soothing yourself that you can't soothe the child in front of you.
Learning to piece together.
And that's why I teach my narrative writing course, right?
We delve into that past, into those connections between the past and the present, so that you come away with a group of quick tools at the end of this very deep dive to help you go, Oh, I'm here again.
Here's what I do when I am here so that we can come back and ground and not be knocked over quite so much by parenting moments or by family life when we're in overwhelm, which of course we are in overwhelm and get back and not wobble quite so much.
It turns out that It's really important to develop that parent child attunement, or what researchers even call sense of bio synchrony.
And it means that when your child comes to you with something hard, and of course at 5 that's gonna be a lot different than at 15, you're able to enter into that state of bio synchrony where every cell of you is able to be calm, even when you hear difficult things and offer that calm from literally every cell of you to every cell of them.
And so that really stands out to me because it begins with us.
It really begins with us.
And of course I have 15 other strategies in the book but I think that's a good one to start with because we can really dig in and do something about that.
Kara Wada, MD: Yeah, It's the ripple effects and I think that reminder that filling our own cup first really is critically important. It's not selfish.
Donna Jackson-Nakazawa: No and understanding our own story, which takes time and work.
And this is way beyond self care folks.
This isn't going for a pedicure and it's way beyond even meditation.
Although I am a big meditator and highly recommend it.
It's really about actually understanding your own story in a way that allows you to know that you've entered that place in which you're not as regulated as you need to be to help your child find that regulation that she needs and that sense of safety.
And this isn't about coddling your children or being helicopter parents.
Kids need a little wobble, right?
You've gotta step back and let them solve some of their own things.
But often they can't even figure out how to solve things because we as parents are jumping in our dysregulation as the detective or the fixer or the judge, like,
Where did that happen?
Who is there? We've gotta call them. Let's go. Where did you leave it?
And when they're little, that's fine. They fall and skin their knee. You've gotta be the fixer.
But as kids get older, we need to be providing that psychological safety so that we have to get quiet so they can feel safe and know that they can tell us anything without our jumping in.
And I have hundreds of scripts in the book and I'm a writer, I'm a science writer, but I put those in there because it can be so hard.
And I've had moms tell me on book tour, Oh, I have index cards on the inside of my kitchen cabinets because I tell her, Oh, I've gotta get a cup of tea.
Let's have tea. And I make, and look at my cheat sheets inside my cabinet doors, and then I come back and I'm like, that sounds really hard, and just reground.
What do you think? What do you think? I'm gonna tell you what I think, but first I really wanna hear what you think cuz what you think right now is so much more important than what I think.
Just having this language to come back to over and over in every situation.
It was really important to me to put that in the book because when we're knocked off course in our lovely little lives, running around with our kids, doing our work, our brain goes offline.
It is not going to grab the right words when we're thinking, Who did that to my kid?
Or what did my kid do? Or How did this happen? Or I've gotta call somebody.
The brain is off, it's gone.
It's in fight, flight, freeze.
And over time we can retrain ourselves, our minds, our nervous systems to be that state of regulation that is helpful to the developing brain.
Kara Wada, MD: If it's okay with you, I'd love to open up the floor since we have a smaller, intimate group. I know Dr. Ally and I have been talking beforehand a little bit and..
Donna Jackson-Nakazawa: Sure. We have a few more minutes. Let's do it.
Allyson McKenney: Hi, I'm Ally McKinney.
Donna Jackson-Nakazawa: Oh, hi, Ally. Nice to meet you.
Allyson McKenney: Nice to meet you too. So I worked as, or as a pediatric an adolescent HIV specialist in Malawi for seven years.
And we did a ton of work when I moved there.
One of the biggest things that was a countrywide problem was that the girls were forced out of school at age 12.
They were either working in the family, married, getting into transsexual sexual relationships to support their families and the rates of suicide, depression, and whatnot amongst adolescent girls was huge.
One of the big things that we actually realized early on is the word adolescence didn't exist in Chichewa, their language.
It's at age 12, you become an adult. Yeah.
And so a lot of our programming turned into creating that space for that childhood to happen. Sure.
And for kids to have a place to actually feel like kids again. .
But really interestingly our psychosocial department did a study similar to the one that you described and came up with the exact same conclusions that the biggest things that were needed for particularly our girls to thrive was psychosocial safety and a stable guardian at home.
Yes. And then very interestingly, too, encouraging the kids to own their story most of them were born with hiv and were very held a lot of shame to it.
And so there's a word in Chichewa that I love or phrase, it's called Oba em, and it means courage of the heart.
Donna Jackson-Nakazawa: Oh, that's beautiful.
Allyson McKenney: And that was something that the kids learned to claim and to share their stories. And so I look at that when I move back to the US.
And I'm like, Oh my gosh, we've gone backwards. Here I am, going over to Malawi to try to open up this adolescent space. And I come home and it's closed.
Donna Jackson-Nakazawa: Yeah. That had to be quite difficult.
Allyson McKenney: It's very eye opening. My brother-in-law's a middle school principal. My sister's a middle school counselor and we talk about this all the time.
And for their families, the kids were not allowed to have phones until they got into middle school.
Weren't allowed to have social media accounts.
Their parents cut very tight restrictions on it and they thought, okay, this is the solution to allowing them to maintain hold onto childhood for longer.
But then they found out once they got into like junior high area, their kids were left out of everything.
So they go to their friends' houses, all these inside jokes about them at school, and now their kids are equally sad and upset, whatnot because they've been left out.
Oh. And so this conversation that we're having together, the three of us of what is the solution?
How do we create the movement so that it happens with everybody or community moving together so that some of the kids aren't left behind and left out of this,
What I'm hearing sensing from you is that a lot of the problems with social media..
Donna Jackson-Nakazawa: I think social media magnifies.
Toxic the problem, right? That has always been there.
So it's really even without social media, girls are pretty smart.
They can read a newspaper headline and see that they're going into a world with a lot of misogyny and a lot of unsafety for young females.
I think that anybody who grew up female, certainly me, even a long time ago, certainly understood that there was a lot of physical and psychological unsafety for me coming of age.
Now, imagine just having that poured on you and dumped on you 24 7 from the world at large.
I say toward the end of the book, in the conclusion, what I want is for men in power everywhere to think about this.
Think about what this means.
We're changing the developing female brain and we're not offering enough of the supportive look if cycle.
If psychological toxicity keeps increasing, even a really well loved girl's sense of self is gonna diminish over time.
In the face of this very widespread toxic messaging.
And as these levels of toxicity rise for young people and boys as well, we need to increase psychological safety.
So the reason I broke it down into these 15 tools across every lever of power is because we need to be building out all of these things to up the psychological safety so that it's higher then the toxicity.
And to speak to your question about social media, we really wanna make connection in the real world more compelling and exciting in real life, as kids say, irl.
More compelling, more inviting, more magnetizing, more enriching with connection. Then the suck of that other world. So we have a lot of work.
And I guess, my role in all of this as a science journal is really to create headlines and a conversation.
Obviously I'm not a pediatrician, I'm not a school nurse, but I can get a combo going in such a way that it can trickle into all of those areas and give the talks and that's really my hope.
So that in every area across those 15 antidotes, all of which involve adults at one stage or another, many of whom are men.
Men ask themselves, Is this really the world that I want for girls?
And of course, let's include the men who are running big tech, right?
Because all big tech is run by a lot of men at the very.
All the big social media platforms are owned by men.
And to just start asking that question, is this sense of psychological unsafety that's rising, especially for girls, is that acceptable for me?
As a man, whether I'm running a big tech company or in the way that I talk to a girl on the street, or the way in which I respond to her post on social media, how can I as a man, a boy, increased that sense of belonging and mattering?
How do I do it?
And in the book, I think one of my other favorite antidotes is just helping girls reverse engineer sexism by raising our girls when it's safe to speak back by modeling for them how we speak back.
And we break it down. We just break it down. So I know our time is short, but I just I hope that answers your question a little bit.
Allyson McKenney: No, it does an interesting thing when you talk about the boys.
So in Mala, this program, our girls to get on troll and to come and get educated once in their like late teens on relationships and all these types of things.
And our boys came to us and they're like the girls are getting all this education on the importance of negotiating condom use and whatnot.
And it's supposed to be out their empowerment and teach us how to empower them.
That's need to be. You got a problem then teach us how to respect girls. I love that. And again, it was like, Oh, this shouldn't be rocket sciences. But these kids came to us and they're like, Look like I know how to respect a girl.
I don't have any models, role models showing me how to do it.
Donna Jackson-Nakazawa: And what I said earlier is by lifting girls and the way we educate them, we automatically begin to influence boys.
But if we add boys into the picture, if we make the world better for all children and more respectful, it's going to affect girls and boys.
If young people, regardless of sex, feel seen, and that they matter and belong as they are, just as they are.
We will see less cultural toxicity and sexism because boys will already know that they matter for who they are, and there are just so many ways to build this out across childhood and adolescence.
Kara Wada, MD: I wanted to make sure Arlene or Denise, if you have, if you wanna either raise your hand or on mute or don't know if you had anything to ask or to add.
If not, I know we can keep chatting.
Donna Jackson-Nakazawa: Yeah, I'm sure. I'm sure we can fill another eight minutes. .
Allyson McKenney: Think there Kara, like what you were saying when you talked about the autoimmune I don't know.
Like we belong to a group of physicians with BML physicians that have autoimmune disorders.
And I think for us it's been shocking to see how many women in their have autoimmune diseases and how many of us can trace back to having different either adolescent or really, traumas in our life.
Medical school being one of them in training. And that's always, I think, a very hot topic of debate amongst our group is, was this a chicken or the egg?
Donna Jackson-Nakazawa: Yeah, no. And we have very good evidence that mean to Lisa Fairweather is the scientific mother of the research into stress and autoimmune disease in females.
And she was able to show that the association between being female and certain categories of ACEs.
Was as big a predictor for developing not just an autoimmune disease, but an autoimmune disease so serious that you ended up in the hospital as a young woman or as a woman, that link was so profound in females that it was double in males who faced the exact same number of ACEs or categories of adversity.
So for each category of adversity that a girl faced growing up by the age of 18, each category, her chance of developing an autoimmune disease so serious, she was later hospitalized, increased by 20%.
For boys, it was 10%.
Now here's what's interesting.
Other researchers have found a similar relationship between categories of adversity for girls, and their likelihood of developing neuropsychiatric issues is similarly much higher among girls with the same categories of adversity and the same number of ACEs compared to boys.
So we know that across puberty, everything we've been saying earlier, puberty, more stressors.
This rewiring of the brain and remodeling and an inopportune time in the face of magnified stressors is really bad equation.
And again, we have to get on it as the adults because this is a world that we've created for our children.
Allyson McKenney: When I think too, that something that, again, this comes up in our group a lot in discussion and this was your like entire first book on the role of microglial cells and information.
Donna Jackson-Nakazawa: Actually, that was my fifth book. What I hear you book. Yeah, book. I read .
Allyson McKenney: Yeah, the, But just that relationship of mental and the hippocampus and development that connection.
I think that we, at least a medical school, we're always taught. There's not really that connection between the brain and the body.
Donna Jackson-Nakazawa: Crazy, so crazy. I can't believe that they still get away with that when it's just been overturned now for almost 10 years.
That idea that the brain is immune privileged has been so completely overturned.
Kara, this is your area.
Kara Wada, MD: No, I think it's bonkers because I finished my fellowship and I took my boards in 20 16, 20 17, 20 16, 20 17.
And I would hazard to say that microglial cells were maybe mentioned five times in our basic immunology textbook.
I actually could probably look at . This is the clinical one, but the other one's paper back in at the office.
It just it hadn't trickled down there yet. And our fellows still, granted allergy immunology, we don't see quite as much autoimmunity.
It's a piece of our clinical puzzle or, not puzzle, but clinical load, but not as much as rheumatology. But that said, it still should be a part of their education.
And so as their associate program director that's on my mission is to bring in so that they can be more informed.
Because the reality is it neurology and immunology and rheumatology it's pretty siloed.
And I think the pandemic kind of added to some of that.
We weren't milling about the hospital as much and more closed off than, so..
Donna Jackson-Nakazawa: Specialties have been siloed for a long time now, and that's one of the things I do is jump, jump silos and run around and go, wait a minute over here, I was in this lab and they're doing this.
How does that intersect with what you're doing?
Would it be po, would it be right to say that because of X, then Y and yeah, of course. Oh, okay, doesn't that mean this?
And just being able to report on that, and hopefully kinda bring that understanding together. But yeah.
Allyson McKenney: Oh, so did you encounter in, when you were putting all of the research together and interviewing people that were in this field.
Now that we've, but we've identified that the ACEs are directly related to the autoimmune.
Is anyone trying to do intervention programs early in either childhood or adolescents?
Donna Jackson-Nakazawa: Oh, sure. Yeah. There're,
Allyson McKenney: and then trying to.
Donna Jackson-Nakazawa: Not for autoimmunity in particular. Okay. But there are many hundreds of prevention programs, right?
Since I wrote my book on ACEs, Childhood Disrupted, it's just staggering.
It's just, it's a very common term now.
And it's this idea of preventing trauma across development has become, Go to Instagram. It's like trauma trauma. And I go, Wow. Why couldn't we have done this six years ago?
I have to go in a minute. Yeah. For long reasons, but this was so fun guys.
Kara Wada, MD: Thank you. Thank you.
Donna Jackson-Nakazawa: Such a pleasure.
I'm such a fan.
Fan isn't the right word, but I love your heart and your tone and your just, you're just good warm spirit. So we've never met, but it's a pleasure to work with you.
Kara Wada, MD: You too. And we will meet at one of these conferences one of these days.
Donna Jackson-Nakazawa: A hundred percent. Yeah. Allie, great to meet you. Everybody else take good care.
Kara Wada, MD: Thank you for joining us, everyone. Pleasure. Take care.
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