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W-H-Y-Y in Philadelphia, I'm Terry

0:23

Gross with Fresh Air Weekend.

0:26

Today, the songwriter, guitarist and singer

0:28

known as St. Vincent. She didn't

0:30

exactly name herself after a saint.

0:33

She took her stage name from St.

0:35

Vincent's Hospital in New York, where the

0:37

poet Dylan Thomas died. Why not

0:39

use her own name? I want to

0:41

have a moniker because I felt like it would

0:43

give me license and

0:45

freedom to be bigger than Annie

0:47

Clark. And she can

0:50

go big in her dark lyrics or

0:52

sometimes shredding guitar and how she dresses

0:54

in performance. Her new album is

0:56

called All Born Screaming. Also,

1:00

we talk with child psychiatrist Harold

1:02

Kopplowitz. His latest book

1:04

is called Scaffold Parenting, raising resilient,

1:06

self-reliant and secure kids in an

1:09

age of anxiety. That's

1:12

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2:44

This is Fresh Air Weekend. I'm

2:47

Terri Gross. My guest is the

2:49

musician known as St. Vincent. She's

2:51

a singer, songwriter, guitarist, multi-instrumentalist, and

2:53

a three-time Grammy winner. Her songs

2:56

can go pretty dark. Her

2:58

guitar playing can be shredding, but

3:00

her lyrics typically read like good

3:02

poetry. New York

3:04

Times music critic John

3:06

Parellis described her as,

3:08

quote, a grown-up fascinated

3:11

by personas, gender roles,

3:13

connections, obligations, self-destructive behavior,

3:15

and looming mortality, unquote.

3:17

In addition to her own albums,

3:19

she co-wrote the Taylor Swift song

3:21

Cruel Summer and the Olivia Rodrigo

3:24

song Obsessed and recorded an album

3:26

of duets with David Byrne. St.

3:28

Vincent has a new album called All

3:31

Born Screaming. Two musicians featured on the

3:33

album have played in bands that deeply

3:35

influenced her in her formative years, Nirvana

3:38

and David Bowie. Dave

3:40

Grohl, who was Nirvana's drummer and later

3:42

co-founded Foo Fighters, is featured on drums.

3:44

Mark Juliana, who played on Bowie's album

3:47

Black Star, is also featured on drums

3:49

on some tracks. When Nirvana

3:51

was inducted into the Rock and Roll

3:53

Hall of Fame, St. Vincent sang lead

3:55

on the band's performance of Lithium. Let's

3:58

start with a track from St. Vincent. since new

4:00

album, All Born Screaming. This

4:03

song has been released as a single, and

4:05

it's my favorite track from the album. It's

4:07

called Broken Man. ["Broken Man"] ["Broken

4:19

Man"] ["Broken

4:31

Man"] ["Broken

5:01

Man"] ["Broken

5:32

Man"] Hey

5:34

Vincent, welcome to Fresh Air. It's such a

5:36

pleasure to have you on the show. This

5:38

is a terrific album. The song that we

5:40

just heard, those lines, what are you looking

5:42

at? Who the hell do you think I

5:44

am? It

5:47

just reminds me of what happens on

5:50

the street sometimes when you accidentally look

5:52

at somebody and they get

5:54

really upset and start hollering at

5:56

you. What were you

5:58

thinking when you wrote those lines? You

6:03

know, all the songs on this album are

6:06

very lived experience. In

6:10

times past, I've certainly played with

6:12

persona. But on this

6:14

record, I would say that this

6:16

is just pretty close to the vest,

6:18

pretty cut to the pink meat, as

6:20

it were. So were you looking

6:23

at someone or was someone looking at you? You

6:26

know, I think that there are these kind of frequencies

6:28

that we can tune into in our brain

6:31

that are like, you

6:33

know, whether it's deep ego

6:36

stuff that underneath that is

6:39

really just a whole lot of

6:41

pain. And you're

6:43

walking down the street and you feel like

6:45

you could fall

6:47

in love with somebody or kick

6:50

over the trash cans. And if someone looks

6:52

at you the wrong way, you just could

6:54

explode. I just I

6:56

have that feeling. I mean, not every day.

6:59

Like I said, it's a frequency you can kind

7:01

of tune into when

7:03

life takes you there. But art

7:05

luckily is a safe place to

7:08

explore all emotions,

7:10

all ideas, no matter

7:12

how dark or

7:15

complicated. And

7:18

you're not saying, haven't

7:20

you ever seen a broken woman? You're

7:22

saying haven't you ever seen a broken

7:24

man? Yeah.

7:28

Why did I say it like that? Was

7:31

it because of the number of syllables you needed? You

7:34

know what? Yeah. You

7:38

know, sometimes it really is as

7:40

well, that's just things better. It

7:43

sings better and it makes me feel

7:45

a certain kind of way. And

7:48

and so therefore that's what it should

7:50

be. The

7:53

chorus of the song, after

7:56

what are you looking at? And I think this

7:58

is on this second chorus. There's

8:01

this really buzzy, dirty

8:03

chord, and I'm not even sure if

8:06

it's your guitar, or you're playing synthesizer,

8:08

or what. What is that? Oh,

8:11

Terry, that's a combination of my guitar

8:15

completely blown out,

8:19

and then also just white

8:22

noise going, pfft. Ah.

8:27

I love that because

8:29

that is the about

8:32

to unravel, explode feeling

8:35

that you're conveying through the song. I

8:37

just think that chord gets it perfectly, and I

8:39

love that it's used as punctuation. It's

8:41

like the exclamation point in

8:44

the song, and it's not happening

8:46

throughout, so it's so effective because you

8:48

use it so sparingly. Thank

8:52

you. I look

8:54

at music sort of like architecture,

8:56

and call and response,

8:58

and tension and release. That's

9:00

the whole game, right? And music is tension and

9:02

release. So you

9:05

get these little just explosions

9:08

of release, and then it goes

9:10

back to tension, and then an explosion of release,

9:13

and then tension. But it's this

9:15

simmering, creeping dread, I guess.

9:21

On this record, I swear, some

9:24

moments are almost

9:27

like horror movie jump

9:30

scares. Like I think that

9:32

chord is like a jump scare. Yeah.

9:36

So I want to ask you about

9:39

David Bowie and the influence he had on you.

9:42

And I'm wondering what it meant to you when

9:44

you first heard him or over time that

9:47

he performed in persona like you

9:49

sometimes had, and that

9:51

he, you know, we didn't

9:53

use the word then, but he

9:55

was genderqueer, and he was called

9:57

androgynous in his time. So,

10:01

as a performer, what impact did

10:03

that have on you? Well,

10:06

I think Bowie even went so

10:09

far as to say that he was bisexual in

10:11

the 70s, which I

10:13

mean... And that was shocking in his stomach.

10:16

Right? Mic drop like that was

10:19

dangerous then. Now

10:22

that's a feather in your cap.

10:24

And I was... Daggers

10:27

were out for him. So, yeah.

10:31

I'm queer. So

10:34

I've always

10:37

felt like gender

10:39

and identity were

10:41

a performance. I've been aware of that

10:43

since I was a young child and

10:45

learning how to code switch

10:48

growing up in Texas and everything.

10:50

So it kind of makes sense

10:52

for me to deal with

10:54

all of that, to deal with persona,

10:56

to deal with identity in my work.

11:00

And as far as David Bowie, I mean,

11:02

gosh, he

11:04

was just an artist. He was

11:06

just an artist with a capital A. He

11:09

took us so many places. In

11:14

terms of persona and

11:16

David Bowie and yourself as

11:18

a performer, did

11:22

or does performing in

11:24

character or in persona liberate

11:27

you in a way? Is it easier to do

11:30

certain songs if

11:32

it's not you? I mean, even having the

11:35

name St. Vincent, which is clearly

11:37

not your birth name, but

11:41

having a stage name, is that...

11:45

Some people might think, oh, she's hiding

11:47

behind that. But is there

11:49

something actually liberating about it? Well,

11:52

I mean, so my name is Annie

11:54

Clark, which, you

11:56

know, it's a lovely name. It's

11:58

a just fine name. But

12:01

there's also, there was already an Ann Clark

12:03

who's a great artist and so that name

12:05

was sort of taken. So I thought, okay, I

12:09

need to, I want to have

12:11

a moniker because

12:13

I felt like it would give me license

12:15

and freedom to do, to be

12:19

bigger than Annie Clark, I guess. I

12:22

think there is a tendency

12:24

to look at people performing

12:28

with theatricality and think

12:30

of it as inauthentic. But

12:35

I find that

12:38

sometimes people who are selling

12:40

you authenticity are

12:43

lying to you.

12:47

You know what I mean? It's like art to me

12:49

is a place where I get to take

12:52

everything that's happening in my life

12:55

at that moment in

12:59

my internal world, in the

13:01

external world, and play

13:04

with it and make sense of

13:06

it and go, there's chaos, but

13:09

somehow if I sit in

13:11

my studio for long enough, I

13:13

can alchemize that

13:15

chaos into something that

13:18

makes sense to me. And

13:21

so whether it's putting persona

13:23

on top of that or

13:27

getting at truths through

13:29

exploring identity,

13:31

sure. I

13:34

will say on this record, All Born

13:36

Screaming, I'm not playing with persona.

13:41

It's really a record about life and

13:43

death and love. That's it. That's

13:45

all we got. We

13:48

need to take a short break here, so let

13:50

me reintroduce you. If you're just joining us, my

13:52

guest is St. Vincent. Her new album is called

13:54

All Born Screaming. We'll

13:56

hear more of our conversation after a break.

13:59

I'm Terry Gray. This is Fresh Air

14:01

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15:11

In 2021, you made an album called Daddy's

15:13

Home and the title of the

15:15

album, which is also the title song, refers

15:18

to your father getting out of

15:20

prison after serving, I think, 10

15:22

years for

15:24

a series of

15:27

financial crimes, including

15:30

in 2010, he was convicted of a

15:34

federal jury found him guilty on one

15:37

count of conspiracies, seven counts of wire

15:39

fraud, five counts of securities fraud, and

15:42

one count of money laundering. He was

15:44

62 at the time. Did you

15:46

even understand the crimes? I was reading about

15:48

this and thinking, I'll just say financial crimes.

15:52

So complicated. Did you understand what he

15:54

did? No,

15:56

I mean, I don't really

15:59

understand. like,

16:01

the stock market in general

16:03

or that. So, no, I'm

16:05

still a little bit unclear,

16:07

but that might be also a question

16:10

of my own financial literacy. Were

16:13

you shocked? Did you know that he'd be capable

16:16

of this? Well,

16:19

I mean, I think

16:22

that my father

16:26

got caught up in some

16:28

stuff, some unscrupulous situations, and

16:30

I don't, he's not, I

16:33

mean, I've seen the man try to figure

16:36

out email on an iPhone. He's

16:38

not a criminal mastermind, I

16:40

can assure you. But I

16:43

think that he was caught up

16:45

in some unscrupulous

16:48

stuff, and everybody

16:51

else pled out,

16:53

and he was

16:56

the guy, he and his partner were

16:58

the guys still holding the bag, right?

17:03

I remember being with my older

17:05

sisters and going

17:07

in for some of the

17:10

trial, and then

17:13

being called in, you

17:15

know, because they call when there's

17:17

a verdict, okay, they've called in

17:19

the verdict, and I just, it just didn't

17:22

ever occur to us that, you

17:26

know, that anything, but like, okay, go

17:28

on home, I don't know, I just

17:30

was so naive about so

17:32

many things, but I, my

17:35

sisters and I were in

17:37

the courtroom when they called the

17:39

verdict and had guilty, and they

17:42

took him away, and, you know, we

17:44

got to give him a quick hug, and then they took

17:46

him away in front of us, and we

17:48

were all just devastated

17:51

and confused and shell-shocked, and

17:54

then trying to help

17:56

pick up pieces, and he's

17:58

got seven kids, so, you know. know,

18:01

I have four little brothers

18:03

and sisters who were, they were kids.

18:05

I mean, they were kids and

18:08

now their dad's gone. And

18:10

I do

18:13

have to say that we

18:15

all did manage to stick together

18:18

as a family and I'm so

18:20

close with my younger siblings and

18:22

I'm so close with my sisters

18:24

and he

18:26

was released. My dad was released in

18:28

2019, kind

18:32

of just before

18:34

the pandemic. And yeah,

18:39

I mean, we'd go and visit him

18:41

in prison and there's a line in

18:43

daddy's home about signing autographs

18:45

in the visitation room, which is just like,

18:48

it was sort of known that like, Rick's

18:51

daughter, you know, she's a singer. And if I

18:53

was on a TV show, if I was on,

18:56

you know, SNL or

18:58

Fallon or whatever, it'd be like

19:01

all the inmates would gather and

19:03

watch. So I was sort of

19:05

like me and

19:07

Kamaru Usman, who's a USC fighter, we're sort

19:10

of whose dad was also in prison

19:13

at the same time as

19:15

my father, we were sort

19:17

of like the pride of the

19:19

prison camp.

19:22

So, you know, so if Kamaru

19:24

was fighting or if I was

19:26

on TV, you know, playing a

19:28

late night show, like everybody would rally together

19:31

and watch. And so

19:33

anyway, I'm waiting for my dad

19:35

to, you know, go in to

19:38

see him for an hour, a couple hours

19:40

or whatever it is. And I'm like signing

19:43

autographs on like the back

19:45

of someone's target receipt in

19:48

a, you know, in a prison visitation

19:52

room. Yeah,

19:54

strange experience. But you know, I'm thinking

19:56

if you're father

20:00

has fellow inmates all watching

20:02

you on TV. Sometimes

20:05

on TV and

20:07

in your videos you'd be wearing

20:09

very sexualized clothes. Terri,

20:11

I prefer not to think about that part. No,

20:13

but I mean in an immense

20:15

prison that must have really been a

20:18

thing like that's your daughter. I know.

20:20

Did you think about that? Well,

20:23

I mean I'm only thinking about,

20:25

you know, what I'm wearing

20:27

is going to be some

20:29

kind of a thoughtful,

20:34

rendering world creation of the music that

20:36

I've made. So I'm not thinking about

20:39

the fact that it will probably also

20:41

be seen at the men's prison. If

20:43

I, you know, if I did that,

20:45

maybe I would have worn more burlap,

20:47

but you know, whatever. I

20:51

wasn't thinking about that. But

20:54

yeah, but you know, he's

20:56

out and life

20:59

is long, people are complicated. You know,

21:02

I love my father. My father gave me grit. He

21:07

taught us to be tough. He

21:11

instilled in me like a love of

21:15

literature and films

21:17

and foreign films and music and

21:21

was the cultural

21:25

kind of guy. So I really

21:27

appreciate the gifts that he

21:29

gave me and we're

21:32

all still truckin'. In

21:35

those ten years, a lot changed in your life. You

21:38

became kind of famous in the ten years

21:40

that he was in prison. It must have

21:42

been so odd for him to see

21:45

what was happening in your life while

21:48

he was behind bars. Yeah,

21:51

it's funny. I mean, again, it's whether it

21:53

was like the late

21:55

night appearances were kind of a thing that,

21:58

you know, were

22:00

getting SNL was that was a thing

22:02

that was I almost like looked at

22:04

it like throwing little

22:06

paper airplanes over the prison walls

22:09

or something. Like

22:11

at least he could see, you

22:14

know, that sort of we were doing all

22:16

right. Yeah. Yeah. Listen,

22:19

Vincent, it's really been a pleasure to talk with you. Thank

22:21

you so much and thank you for your music. Thank

22:24

you so much, Terry. I'm a massive fan and this

22:26

was a real pleasure. It's such an honor

22:28

to hear you say that and I have become a big

22:30

fan of your music. Thank you. The

22:34

new St. Vincent album is called All

22:36

Born Screaming. There's

22:49

so many reasons for children to

22:51

be anxious today beyond all the

22:53

standard childhood problems. There's the setbacks

22:56

from the COVID lockdown, mass shootings

22:58

in schools, feelings they're not

23:00

measuring up to the great lives they

23:02

see represented on social media, fears about

23:04

the whole planet being in jeopardy. It's

23:07

hardly unusual for parents to be

23:09

unsure how to handle their child's

23:11

anxiety, depression, learning problems, anger, tantrums,

23:13

and it can be difficult for

23:15

parents to evaluate whether their child

23:17

should see a therapist or take

23:20

medication. My guest, child

23:22

psychiatrist Harold Koppelowitz, has dealt with

23:24

these issues with many children and

23:26

their parents and there have been

23:28

times he's been confounded about issues

23:30

his own children faced. He's

23:32

the founding president of the Child

23:34

Mind Institute. Its stated mission is

23:36

transforming the lives of children and

23:38

families struggling with mental health and

23:41

learning disorders by giving them the

23:43

help they need to thrive. The

23:46

Institute also conducts related research. From

23:48

1997 to 2009, he was the first director of the NYU

23:53

Child Study Center. Koppelowitz

23:55

recently stepped down from his

23:57

25-year tenure as editor-in-chief of

24:00

the Journal of Child and

24:02

Adolescent Psychopharmacology. His latest

24:04

book is titled Scaffold Parenting,

24:06

Raising Resilient, Self-Reliant, and Secure Kids

24:09

in an Age of Anxiety.

24:12

Dr. Harold Koppowitz, welcome to Fresh Air.

24:15

What are some of the problems and anxieties

24:17

you're seeing now that you

24:20

can connect to outside problems like

24:22

the COVID lockdown and its lingering

24:24

after effects? How are you

24:26

seeing that manifest in the children's

24:28

anxieties that you're seeing? Well,

24:31

I think our kids are not

24:33

okay. And unfortunately,

24:35

they weren't doing very well

24:38

before COVID, but

24:40

COVID has had a negative effect

24:42

on all children, children with mental

24:44

health disorders and kids who are

24:46

typically developing children. Being

24:48

locked up for two years and living

24:51

with fear that somebody close to you,

24:53

someone near and dear will die, is

24:56

very problematic. And we also know

24:58

that one million Americans did die,

25:01

which means that about 170,000 American children lost

25:05

a caregiver or a parent. And if

25:07

we go back to 2001 after 9-11, we

25:11

lost 3,000 Americans. And I can

25:13

tell you that in New York, in

25:15

certain pockets, Staten Island, where there were a lot

25:18

of firemen, and Manhasset, where there were a lot

25:20

of finance people who

25:22

were in the building, and certainly

25:25

people around ground zero, it

25:27

was very hard to get kids to

25:29

go back to school. Attendance rates didn't

25:31

return to 9-10, to September

25:33

10th levels, for

25:35

over a year, and

25:38

sometimes even longer. So we do

25:40

know that this kind of traumatic

25:42

event is going

25:44

to have lingering effects. And we

25:47

have seen increases in anxiety disorders

25:49

and in depression, particularly in girls,

25:52

but certainly even in boys. There

25:54

are higher rates of kids trying to

25:57

hurt themselves, and there is even

25:59

an increase. the number of

26:01

young people who have committed

26:03

suicide. So there is no

26:05

doubt that we had a

26:07

problem before and we have a greater

26:09

problem now. Yeah, our show

26:12

isn't necessarily like watching cable news or

26:14

reading the newspaper, but you pick up

26:16

a lot of this on social media

26:18

and it's also just in the air.

26:21

Like everybody's talking about these issues

26:23

like environmental catastrophe, you know, political

26:25

divisions, is this the end of

26:28

democracy, is the planet

26:30

burning? I mean, you're just, it's

26:32

just in the air now. Well, you

26:34

know, there's something dramatically changed

26:38

between 2010 and 2018. So the numbers started

26:42

to jump when we started looking

26:44

at children's mental health. There were higher rates of

26:47

visits to emergency rooms by kids

26:49

for suicidal thought and suicidal behavior.

26:52

And the increase in the number of kids

26:55

who died from

26:57

suicide went from around 5,000 to 6,000.

27:00

Now, just think about that. If it was diabetes,

27:02

if it was cancer, that would have made the

27:04

front page of every newspaper every single

27:06

day. It would be on cable news 24-7. And

27:10

somehow we don't take mental

27:13

health disorders as seriously as we take physical

27:15

disorders. And so, you

27:18

know, what happened between 2010 and

27:20

2018 is that all

27:22

of us started carrying a device

27:25

with us that connected us to

27:27

everybody on the planet 24-7. And that definitely

27:29

had a

27:33

negative effect on a certain percentage

27:35

of the population. So I want

27:37

to be clear that social media

27:40

is not like smoking. It's not terrible

27:42

for everyone. But it is

27:44

particularly bad for kids who have mental

27:46

health disorders. And we've really looked at

27:48

this very carefully at the Child Mind

27:50

Institute, where we had done

27:53

a study before COVID that

27:55

was looking for an objective test,

27:58

a biological test. psychiatry

28:00

is the only discipline in medicine that doesn't

28:02

have an objective test, doesn't have a chest

28:04

x-ray or a blood test or a strep

28:07

test, and therefore

28:10

that's the holy grail, right? We

28:12

make the diagnosis with clinical information, which

28:14

is how you start all diagnosis in

28:16

every part of medicine, but you can

28:19

confirm it with an EKG or with

28:21

a brain scan. So psychiatry

28:23

is missing that, and so we started something

28:25

called the Healthy Brain Network, where we offered

28:28

any parent who was worried about their child,

28:30

who was between the ages of 5 and 21, free

28:33

psychiatric evaluation, free neuropsych testing,

28:35

which looks for learning disabilities,

28:38

a functional MRI, an EEG,

28:41

physical fitness, cardiovascular status,

28:43

nutritional status, and

28:46

this became the – and still

28:48

the largest collection of the developing

28:50

brain of kids 5 to 21

28:52

that's ever been collected. And we

28:54

share it with scientists around the

28:56

world who make an agreement with

28:58

us that they won't try to

29:00

find out who the subjects are.

29:03

Wait, so is the point of this to

29:05

figure out is there like a

29:09

biological diagnosis you can make?

29:12

Does the cohort of people who

29:14

have like depression or anxiety

29:17

or whatever share certain

29:19

biological markers? That would

29:21

be the point. The real trick is can

29:23

you tell the difference between one atypical child

29:25

and another? Not the difference between

29:27

a typical developing child and someone who may

29:29

have a mental health disorder or a learning disorder,

29:32

but the difference between Terry who

29:34

has anxiety and Harold who has

29:36

depression. And is there something on

29:38

the EEG or on the functional

29:40

MRI? Can we

29:42

find a definitive objective test? The

29:45

good news here is that when you collect all

29:47

this data and it turns out that 9% of

29:50

the 7,000 kids that participated

29:53

did not have a disorder. They had symptoms,

29:55

but they didn't meet psychiatric

29:58

criteria for a disease. diagnosis,

30:00

you now have described very

30:02

accurately and very specifically, phenotypically,

30:04

what these kids look like.

30:07

And then you get COVID.

30:09

And you find that

30:11

their use of social media jumps. They are

30:13

using the internet six to eight hours a

30:15

day in a large... All the kids in

30:17

the state? No, no, no, just a large

30:20

percentage of them. And we start defining that

30:22

as problematic internet usage. Not only are you

30:24

using it a lot, but when you force

30:26

them to stop, they get distressed, it almost

30:28

feels like an addiction, right? And we do

30:31

know that it turns out for the 9% who

30:34

are typically developing kids, that

30:36

when you use the internet more

30:39

than six to eight hours a day, you

30:41

will sleep less, you will exercise less, and

30:43

you'll have less interactions in real life. All

30:45

three of them are important for healthy brain

30:47

development, but you don't become mentally ill. However,

30:50

if you have a mental health

30:52

disorder and you start behaving that

30:54

way, your symptoms get worse. It's

30:56

almost like a toxic agent. It

30:58

turns out that the internet usage

31:01

of over six to eight hours

31:03

a day can make your symptoms

31:06

of depression, your symptoms of ADHD,

31:08

significantly worse, which is a really

31:10

important phenomena. Why do you think that is? Well,

31:13

it's a very good question why. Our guess

31:16

is that for

31:19

these kids, someone who has depression, they're

31:21

already socially more isolated than the average

31:23

person, and they start

31:26

losing their skill set and their ambition

31:28

to interact with the rest of the

31:30

world. Kids with ADHD can

31:33

get very hyper focused with certain

31:35

activities and at times feel

31:38

very lost, very impulsive, feel

31:40

very often like a failure when they can't pay

31:42

attention in school or are missing things that everyone

31:45

else is picking up. So what's

31:47

important about this is that if you're a

31:49

parent and you know your child has

31:52

one of these disorders, you have to be very

31:54

aware that their usage

31:56

of social media could

31:58

potentially be toxic. has to

32:00

be controlled. It can't be unlimited. Not

32:03

that it's good for anyone to

32:05

have unlimited, but it's particularly bad

32:08

for those kids. So we know

32:10

that social media was out there

32:12

between 2010 and 2018, and

32:15

unfortunately, there's no regulation on it. And it

32:17

means that parents have to be more aware.

32:19

I mean, I think of it as, you

32:22

know, a jungle, right? The jungle is

32:24

an exciting place, very nutritious fruit and

32:26

vegetables and lots of terrific stuff. Maybe

32:29

medicines even can get discovered in the jungle,

32:31

but it also has snakes. It

32:33

also has dangerous plants

32:35

that can kill you. It also has

32:38

animals. And therefore, if you're going to

32:40

let your child participate,

32:42

you should be a very

32:44

active participant in that permission.

32:49

My guest is child psychiatrist

32:51

Harold Koppelowitz, the founding president

32:53

of the Child Mind Institute.

32:56

His latest book is called Scaffold

32:58

Parenting, raising resilient self-reliance and secure

33:00

kids in an age of anxiety.

33:03

We'll hear more of our conversation after

33:05

a break. This is Fresh Air Weekend.

33:09

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massmutual.com. So,

34:10

if you think that social media

34:12

can be very harmful to

34:15

certain children, how would

34:17

you suggest parents try to limit

34:20

their time on social

34:22

media? That's something that is really hard to

34:24

do. I

34:26

think it is challenging, but I think it's

34:28

very doable. We also have some good data.

34:31

We know that parents who are using

34:33

the internet in a problematic way are

34:35

more likely to have kids that are

34:37

doing it. Parents have to

34:39

model this. They have to have periods where we're

34:41

putting the phone away at nighttime and you're not

34:44

allowed to look at it because we want you

34:46

to sleep. We do want

34:48

to look and see how much time you're spending

34:50

on it. We want you to be aware of

34:52

how much time you're spending on it. So

34:55

it's not punitive. It's

34:58

a collaboration, especially if they're a teenager

35:00

or a preteen. But

35:03

I also think that it's

35:06

time for us to get much

35:08

more sophisticated about this. I want

35:10

to talk with you a little bit about suicide since

35:12

you brought it up. I want to ask you first,

35:14

just in terms of our show, we always give warnings

35:16

when we're going to be talking about suicide. We

35:19

always give the suicide prevention hotline number.

35:21

The idea being that hearing talk about

35:24

suicide can almost be encouraging

35:26

to someone who has had

35:28

suicidal ideation. Do

35:32

you think that's helpful? I

35:34

think it's important to recognize that even if it's

35:36

a small percentage to give people

35:39

that information, that lifeline is very important,

35:41

and also to let them know that

35:43

they're not alone. So

35:47

I think the way to think about this is

35:49

why are teenagers so much

35:51

more at risk than you

35:54

or me? The way to think about

35:56

a teenager is they feel everything. They're

35:59

boiling. I hate you.

36:01

I love you. What happened to I'm

36:03

warm or it's a little cool in

36:05

here? That doesn't happen. In some ways,

36:07

it's really kind of terrific because they

36:09

are so creative and they

36:11

see opportunity everywhere and they don't recognize

36:14

risk very well. There's some really interesting

36:16

studies of a teenage boy who goes

36:18

and picks up a friend to come

36:20

into his car and the

36:22

teenager driver is wearing a seat belt.

36:25

The teenage male who sits down next

36:28

to him doesn't put a seat belt on and

36:30

the teenage driver takes his seat belt off. He

36:33

goes and picks up a girl and the girl

36:35

gets into the car and she puts her seat

36:37

belt on and the teenage driver

36:39

now puts his seat belt on. So they're

36:41

very easily moved by their peer group in

36:43

a way that they

36:45

hadn't been before. And parents should

36:48

note this that even though the

36:50

peer group becomes significantly more influential

36:52

when you're a teenager, parents

36:54

are still the most influential factor in

36:56

a kid's life. But it's important that

36:58

parents keep talking, keep sharing their viewpoint,

37:00

keep listening to their kid's viewpoint

37:02

and not back off because their

37:04

kids say, well, everyone's doing it.

37:07

A child comes into your office, let's say

37:09

a teenager comes into your office. You

37:12

think that the possibility

37:14

of this teenager attempting suicide is

37:16

real. What do you do to try to

37:19

prevent that from happening? Well,

37:22

it really depends on how serious

37:24

they are about the attempt. Do

37:26

they have a plan? Have

37:29

they been thinking about it a long time? Have

37:31

they stopped doing their usual pleasurable experiences?

37:33

They no longer are hanging out with

37:35

friends or not eating the food that

37:38

they love. And

37:40

you have to really recognize that

37:43

if they're very serious about it, you

37:45

have to intervene. You have to save

37:47

their lives. You have to either say

37:49

to them, I don't feel you're safe

37:52

or ask them if they feel safe. And then

37:54

sometimes make the decision that they have to be

37:57

in an environment where they'll be watched in

37:59

a hospital. Or you'll talk

38:01

to their parents and see can they

38:03

watch them until this mood and this

38:06

ideation actually passes. So I

38:08

just want to pause here and

38:10

give the National Suicide and Crisis hotline

38:12

number. And this is the number to

38:15

call or to text. It's 988. So

38:18

it's a simple number, just three numbers.

38:22

988 to either call or text

38:24

the National Suicide and Crisis hotline.

38:26

So if you are having thoughts

38:28

of suicide, please get

38:31

some help. You

38:33

specialize in ADHD, Attention

38:35

Deficit Hyperactivity Disorder. Why

38:39

don't you define what the

38:41

symptoms are and how to recognize it? So

38:45

it's a challenge for lots of people

38:47

to think about it because they think, oh, aren't

38:50

we all hyperactive at some time? But

38:52

the difference here is a deficit in

38:55

attention toward what's

38:57

normal developmentally. So the attention

39:00

span of a five-year-old is very different than

39:02

the attention span of a ten-year-old. But

39:05

any individual who has ADHD is chronically

39:08

less attentive, tends to be more

39:10

impulsive. And if they

39:13

have hyperactivity, they're moving around

39:15

more. They can get themselves

39:17

into physical problems because they

39:20

basically have ants in their pants.

39:22

They're constantly in motion. The

39:25

diagnosis when you have hyperactivity is much

39:27

easier to make than when you just

39:29

have ADD without age. But

39:32

it's a chronic illness, and therefore,

39:35

it may change over time. Your symptoms

39:37

might lessen. Hyperactivity might go away when

39:39

you become a teenager. But

39:41

you are always going to have a shorter attention

39:43

span and going to be more

39:45

impulsive than the average person your age. I

39:49

think this is one of the problems

39:51

in which brain imaging

39:53

is starting to be used, fMRI, where

39:55

you can see which parts of the

39:57

brain light up. in

40:00

different situations and different thoughts. How

40:03

are fMRI being used in ADHD?

40:07

Right. It's the holy grail for us

40:09

to find that objective test. One of the

40:11

things we've discovered at the Chapman Institute is

40:14

that the way your brain connects

40:16

to itself while a child's at

40:18

rest turns out to be diagnostic.

40:22

It's called connectomes. So does the front

40:24

of the brain connect to the side of the brain or

40:26

to the back of the brain? And

40:28

what's been very interesting is that

40:30

we took a few hundred scans

40:32

and sent them to

40:35

a group of people who were

40:37

statisticians, who were

40:39

electrical engineers, and asked them if

40:41

they could group those different

40:44

scans in different buckets. And

40:46

we found the group that actually won

40:48

this competition were statisticians

40:50

from Hopkins and they said, well

40:52

these 150 scans go together and

40:56

these 50 scans go together and

40:58

these 100 scans go together. And

41:01

these are individuals who've never seen a patient

41:04

with psychiatric disorder, but what's really interesting

41:06

in bucket one, the overwhelming majority

41:08

of those patients had

41:10

ADHD. In the group of

41:13

50, they had autism and the group of

41:15

100, they had both ADHD

41:18

and autism. So we're really excited

41:20

by the fact that we have

41:22

found something that might lead us

41:24

to a definitive objective test.

41:26

Now the important part for everyone to

41:28

remember, it's not just one child. It's

41:31

not a strep test. Yes, you're positive

41:33

or someone else is negative. It's a

41:35

group difference. But that's the way we're

41:37

going to get closer and closer to

41:39

making a definitive diagnosis. So

41:42

in a study like the FMRI

41:44

study that you are referring to,

41:46

how do you know whether the

41:48

brain is reflecting the behavior or

41:51

whether the behavior is

41:53

predetermined by the brain? Do

41:55

you know what I mean? Sure. Well, it's like if

41:57

I move my left arm, if I say I'm gonna move my

41:59

left arm, arm right now and I'm doing it with intent.

42:02

It's going to register on an fMRI

42:04

probably, but it's not like I have

42:06

a disorder that's moving my left arm.

42:09

In fact, I've decided to behave this way

42:11

and it's registering in my brain. So

42:13

let's think about this for a second. This

42:16

is exactly where the field of research in

42:18

functional MRI has gone to. They

42:20

used to give a trigger to

42:22

a kid, you know, pay attention to

42:25

this while you're in the machine or

42:27

we're going to show you scary faces

42:29

and see what happened to the brain.

42:31

It turns out that the most powerful

42:34

way of doing this is just letting

42:36

kids rest or sleep in the functional

42:38

MRI. And your brain is incredibly active

42:40

while you're at rest or sleeping and

42:43

that's when you're going to see most of these connections.

42:45

So in the case of the study, we

42:47

weren't triggering them. We weren't saying, you know,

42:50

this clearly should be what makes, you know,

42:52

we'll catch them being inattentive and then we'll

42:54

look at the MRI. We're just looking at

42:56

their brains at rest. Now that's

42:58

really interesting. So

43:01

has this affected your treatment at all? So

43:04

we're not there yet. You know, it's not ready for

43:06

prime time. I wish it, you know, I could say,

43:08

oh, we're going to give everyone EEGs because they're only

43:10

60 bucks and an MRI is

43:12

500 and we found some correlation. That's

43:14

what I'm hoping for. But, you know,

43:17

science has to wait for real data.

43:20

So at this moment, we

43:22

still have to rely on clinical diagnosis.

43:24

You're asking parents what they think. You're

43:27

asking teachers and report cards because this

43:29

is not something that just pops up

43:31

when you're about to apply to college

43:34

or because you didn't make partner at

43:36

the law firm. This is a lifelong

43:38

illness and you can document that by

43:41

looking at things from a longitudinal

43:43

basis and then you have to

43:45

examine the child. The child basically

43:47

confirms the diagnosis or doesn't. I

43:50

think it's fascinating when you do give a

43:52

kid meds and they do significantly better that

43:55

a young child will tell you the medicine is

43:57

not working. And you say, really? What's changed? She

43:59

said, my children are is much nicer."

44:01

I said, that's really interesting. You take a

44:03

pill and it really is absolutely amazing.

44:07

And they said, yeah, you're eight years

44:09

old. So this

44:11

is a kind of personal question, but knowing what you know

44:13

now, and there's

44:16

so much more research that's been

44:18

done into childhood behavioral

44:20

problems and mental health

44:22

disorders, do you

44:24

think you had any undiagnosed problems as

44:26

a child? I

44:29

don't think so. I don't mean that like I

44:31

recognize symptoms and now you're

44:34

behaving now. But I

44:36

would tell you that I clearly became

44:38

much more of a student when I was

44:40

in college than I was in

44:42

high school. I had

44:44

Eastern European parents. I had parents who survived

44:47

the Holocaust and got to the United States

44:50

in 1949. And they didn't believe

44:52

that education was a journey, it was

44:54

a destination. And they couldn't wait

44:57

until you graduated and go to college.

44:59

So I was

45:01

two years younger than everyone in elementary

45:04

school. And I think that was most

45:06

probably not a great idea, that most

45:08

boys developed late.

45:11

And so that was a problem. And I would

45:13

also tell you that the

45:15

parents that I had when I was growing up were

45:18

much more traumatized by

45:20

the Holocaust than the parents I

45:23

had later

45:25

on in life when they were

45:27

in their 80s and 90s and

45:29

were less anxious and the nightmares

45:31

had stopped and they felt more

45:34

comfortable in

45:36

the United States. And also comfortable that

45:39

I was going to be successful. I had

45:41

graduated medical school. I

45:43

had children. I was

45:45

married and that seemed to really

45:47

calm them down. But I do

45:49

recognize that they

45:52

were overly invested in

45:54

my being successful because they were

45:57

trying to recreate stuff that they

45:59

wanted. lost. My parents were both, by the

46:01

way, my father had graduated law school in 1936

46:03

and my mother

46:05

was in law school in 1938 and

46:08

neither one of them ever practiced law. They

46:11

came to this country as immigrants. They had

46:13

to start all fresh again. My father started

46:15

business. I think they struggled financially. My mother

46:18

eventually went back to school and got

46:20

a BA and then an MSW, but

46:23

there was this idea of what

46:25

could have been if there wouldn't

46:27

have been the Holocaust and therefore

46:29

my sister and I had

46:31

to carry that weight, which

46:33

is understandable but was

46:35

very unpleasant when it was happening. Were

46:38

your parents in camps? My

46:40

father was literally in 14 concentration

46:43

camps and the Warsaw ghetto. How

46:46

was that possible? Well,

46:48

at the very first camp, they

46:50

asked who knows how to make

46:52

airplanes and my father raised his

46:54

hand. When asked about that, he

46:56

said, well,

46:58

they had already killed the lawyers and he figured,

47:00

well, I know how to use a screwdriver. I'll

47:03

figure it out. He went

47:06

from camp to camp and he was with one other

47:08

man who kept being moved with him and

47:10

they got a little piece of metal and

47:12

the other guy was very artistic and

47:15

he engraved a sailboat and a horn

47:17

of plenty. On the other side, every

47:19

time they moved from one camp to

47:21

another, my father inscribed the date and

47:24

the name of the camp and they

47:26

were hoping they would be at least

47:28

a record that what they were experiencing

47:30

would be recorded

47:32

and documented. That piece

47:34

of metal, by the way, is at

47:36

the US Holocaust Museum in New York.

47:39

I'm sorry, in DC, in Washington, DC. You

47:43

mentioned your mother was in camps

47:45

too? No, my mother got papers as

47:47

a Catholic and false

47:50

papers as a Catholic and walked out of the

47:52

ghetto. In some ways,

47:55

it was more trying

47:57

for her in the respect that, think about it,

47:59

You have fake papers. And

48:02

if the Gestapo stops you and starts really

48:04

examining the papers and starts asking you questions

48:06

like, what is your mother and father's name?

48:08

Oh, they're dead. Okay. And

48:10

what was your priest's name? And where are you from? It

48:13

wouldn't take very long. So she moved around 16

48:16

different villages outside of Warsaw working

48:19

as a maid. And she was a

48:21

terrible housekeeper. So it is really amazing

48:24

how she managed to do that because

48:26

she, you know, she really had a very tough

48:29

time. And it was very isolated and just

48:31

basically, you know, surviving from day to day.

48:33

And it was, I think, a little more

48:35

than two years where she was moving around.

48:37

The war ended first in Poland. And so

48:40

my father didn't come and find her

48:42

until several months later. Well,

48:44

they were married before the war started? Well, I

48:46

wish I could tell you that's true. And that

48:48

was the story I was told. But

48:51

it turns out that when my then 12-year-old

48:53

son was doing a, my wife insisted that

48:55

if he was going to be bar mitzvah,

48:57

that it had to be intergenerational. So he

48:59

kept asking my mother her life story and

49:01

recording it. And at a certain

49:03

point, my son said, I don't understand, Grandma. Where

49:06

was the infrastructure and the ghetto for you to

49:08

get married? And my mother said, oh, you know,

49:11

in the Jewish religion, you can get married and become

49:13

the stars and the moon. And my son

49:15

said, I don't think that's true. I think he made a contract. And

49:19

she said, well, August 12th, it was the day

49:21

I lost my virginity with your grandfather. And

49:23

he came home and said, I don't know if

49:26

Grandma and Grandpa ever were married. I think they're

49:28

celebrating the day they had sex. So I called

49:30

my mother and said, I don't understand. Why did

49:32

you tell them that? She said, I never slept

49:34

with anybody else. And I thought, enough. And he

49:37

asked much better questions than you ever did. So

49:40

I think they got married when they were leaving

49:43

Poland to go to a displaced persons camp

49:45

in Germany. But and

49:47

I have to tell you as an example,

49:49

their people, my mother was madly in love

49:51

with my father before the war. She

49:54

lusted for him. He was very attractive.

49:56

And he was a lawyer already. And

50:00

then after the war, when he returned, he

50:03

was skin and bones. And he

50:05

was truly a different

50:08

person, and she was a different person. She was

50:10

no longer a bit of a princess. She was

50:12

a survivor. She knew how—and he came

50:14

and found her, and she said, I'm going

50:16

to let you come in, but

50:18

I'm leaving. I've got papers to go either to

50:21

Palestine or to Australia or Canada or the United

50:23

States. I'm not staying here. And he said, well,

50:25

I am staying here. I'm a lawyer, and we're

50:27

going to make a lot of money. And she

50:29

said, that's okay. The idea that

50:31

they lived together for three months and she got

50:33

the papers and he decided to go with her,

50:36

it's really a very romantic story that they

50:38

fell in love again. And my father, every

50:41

year on their anniversary, would give my

50:43

mother if they had money. He

50:46

gave her red rose for every year they were

50:48

together and three white roses for the three years

50:50

they weren't together with the same note, life had

50:52

no color without you. So

50:54

they really rediscovered each other.

50:57

And I think that bond

50:59

was so close. In some ways, my

51:01

sister and I sometimes felt out of it,

51:03

because they were such a partnership that that's

51:06

what carried them through later on. Dr.

51:09

Harold Koppelowitz, thank you so much for talking

51:11

with us. Oh, it's been a pleasure, Terry.

51:15

Dr. Harold Koppelowitz is the founding

51:17

president of the Child Mind Institute.

51:20

His latest book is titled Scaffold

51:22

Parenting. Fresh

51:26

Air Weekend is produced by Theresa Madden. Fresh

51:29

Air's executive producer is Yanny Miller.

51:32

Our technical director and engineer is

51:34

Audrey Bentham with engineering

51:36

today from Adams-Danishefsky. Our

51:39

interviews and reviews are produced

51:41

and edited by Amy Salat,

51:43

Phyllis Myers, Roberta Shorrock, Anne-Marie

51:45

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51:47

Daya Chaloner, Susan Yakundi and

51:49

Joel Wolfram. Our digital

51:51

media producer is Molly Seavey Nesper. Our

51:54

co-host is Tanya Mosley. I'm

51:56

Terry Gross. from

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