Reality vs. reality shows Keeping healthy kids healthy means making them aware of media messages they receive, and how these messages can match or conflict with their reality. Teens don't always identify connections between the media they consume and their personal beliefs, values, and behaviors. Sometimes kids feel that media doesn't influence them at all. Often young people can appreciate the artistry of a television show, ad campaign, or pop song and disconnect it from their own life. Health and wellness don't seem to be top of mind for many messages from entertainment, commercial, and political entities. Media outlets—from social networks, to gaming, to magazines and TV—create memorable experiences for youth by evoking emotion. Pop culture can make its consumers feel as if they have an intimate relationship to a product or entertainment experience, as well as its underlying messages. "My daughter cries every time she watches the season finale of a reality show." —parent of a teenager So we question, for any media in which our teens participate: What is the emotional connection our teens develop? How do the messages accurately or inaccurately portray healthy choices for young people? How can we steer children toward health in the midst of a sometimes less-than-healthy media culture? In this article, we'll explore how media messages impact the teen brain and decision-making. Then we'll discuss some common misperceptions that young people may hold, and prepare you to debunk these myths while encouraging healthy choices. How media messages impact the teen brain Though some teens might try to persuade us otherwise, there is a known connection between increased teen media exposure to alcohol consumption and increased risk of use. We all might guess that a popular show or song could minimize the perception of the risk of alcohol and other drug use for teens, while glorifying the recreational aspects of use. But the increased risk of use is not completely due to the entertainment value. Instead, what research tells us is that exposure can also influence choices through brain mechanisms of imitation. Neuroscience has coined the term "Mirror Neuron System" to refer to the brain-based recognition and then imitation of behaviors among animals. In humans, brain imaging experiments using functional magnetic resonance imaging (fMRI) have shown that the human frontal cortex—the last part of the brain to develop in the transition from adolescence to adulthood—becomes uniquely activated when a person sees another individual performing an action they are prone to imitate. As studies continue to look at areas of the brain that encourage imitation from person to person, the link between what we see and what we do is becoming clearer. For instance, a study published in Current Biology found that certain neurons in the human brain have mirror properties not unlike those in animals. Countless other research studies have demonstrated how infants and children build their capacity to perform new actions through the simple repetition of the adult behaviors they see around them. The propensity for the teen brain to imitate what it sees can have an unhealthy impact when young people witness others engaging in unsafe or unhealthy behaviors. The media has a real health impact on the teen brain's tendency to imitate risky behaviors: Teens who use social media are five times more likely to smoke tobacco cigarettes, three times more likely to drink alcohol, and twice as likely to smoke marijuana than teens who don't use social networks. Teenagers who watch more than three R-rated films per month are five times more likely to drink alcohol compared with teenagers who watch none. Misperception and imitation In our work with schools, Hazelden Betty Ford's Prevention Solutions has the opportunity to deconstruct media messages with students in classrooms all over the world. Often, kids are surprised at how complex and deeply embedded the media messages they see are, and even more surprised that these messages can influence them so directly. We talk about this in order to help young people understand how media can influence their lives and choices, from their health-related behavior (smoking, drinking), to their external identity (brands they wear and buy), to the very forming of their morals, values, and beliefs about themselves and their world. Our job as caring adults is to help kids interpret messages so that they can form their own perceptions—instead of blindly imitating the many unhealthy behaviors seen via the media. It's also our job as a community to reduce alcohol and other drug addiction risks by helping young people identify positive role modeling and media messages that portray healthy social norms, including the non-use of substances. In advertising Young people often recognize the traditional marketing of alcohol, tobacco, and other drug products. However, we also need to encourage them to be wary of ways in which they may unwittingly seek to imitate these advertising messages. For instance, Absolut Vodka runs the ad campaign "Absolut _____," featuring the name brand paired with another catch phrase or word, such as "Perfection," "Magnetism," "Magic." The premise of such ads promotes the false notion that alcohol and its use are ubiquitous, sophisticated, and transformative. Plenty of other advertising campaigns imply that alcohol can make you successful and sexy. According to such messaging, many life situations we regularly find ourselves in are ordinary and dull without alcohol. Teens may understand the takeaway message from such ads, but be less prepared to assess their own choices by asking themselves if they are choosing to use substances in attempts to enhance their daily lives. Non-traditional media advertising of alcohol and other drugs directed at teens, based on demographics and internet search histories, is likely to have an influence, too. Young people may underestimate, for instance, the background media landscape they so often encounter in the form of sidebars, banners, and ad words using search engines and social media on a daily basis. This barrage of messaging is likely to increase a young person's propensity to imitate the unhealthy choices around them. In music In one music video, artist Nelly is seen swiping a credit card down a woman's backside, while other women in the same video clamor for the attention of the men. The overall scene is one of affluence, glitz, and abundant alcohol. In this often-typical representation of manhood within popular culture, male and female participants alike seem to support aggression, objectification, and hyper-masculinity, while alcohol and other substance use provide the backdrop. Many unhealthy attitudes and behaviors are packaged and broadcast as desirable for teens who may have initially just enjoyed the melody of the song. These teens may have a hard time separating their appreciation of the music from other aspects presented to them that are risky for their health. A song by Miley Cyrus speaks to drug use more directly within its lyrics, saying of the psychoactive drug methylenedioxymethamphetamine (MDMA, Molly, Ecstasy), "We like to party, dancing with Molly, doing whatever we want." As the social norms approach to substance use prevention suggests, we, as social creatures, tend to overestimate our peers' alcohol and other drug use. These types of lyrics, therefore, are not benign. In fact, they can paint images for teens that overly inform what they think of as acceptable, normal, and rewarding parts of their recreational lives. Without drawing necessary attention to the healthy reality that most teens never use MDMA or similar drugs, young people may put too much stock into unhealthy portrayals of use that they hear and see within music media. In movies and television In a popular scene from Project X, a garden gnome cracks open, spilling thousands of Ecstasy pills on a lawn where already intoxicated young people scoop handfuls of the pills into their mouths, to a soundtrack song entitled "Pursuit of Happiness." (The movie is about a main character who believes he only "got the girl" because he threw a big party fueled with alcohol and other drugs.) The sheer number of alcohol references in Project X, and many movies like it, is staggering. Moreover, the majority of those references portray alcohol in a very positive light, noting no negative consequences to it, even among binge-drinking teens. Studies of teens viewing this type of media indicate that exposure to alcohol use in such a positive light can lead young people not only to favorable attitudes toward alcohol in general, but also to specific intentions to use alcohol themselves. The effects are strongest when, as in Project X, The Hangover, and other popular films, alcohol use is linked to tension reduction or stress management. Television provides perhaps the most pervasive media influence because of the amount of exposure young people have to it on a daily basis. Youth between the ages of 11 and 18 are watching more than 20 hours per week of TV, and more than 77% of the shows they watch contain references to substance use. Jersey Shore, for instance, which used binge drinking and the negative consequences of substance use for entertainment value, was the most watched MTV show of all time. As another example, in one episode of the animated Family Guy, Brian, the dog, finds himself addicted to cocaine and sent to treatment only to end up in Los Angeles as a director after his rehabilitation. In addition to the exposure to substance use that puts young people at risk, in television situations where risky behavior inevitably leads to humor and reward, kids receive a variety of mixed and otherwise unhealthy messages. Decreasing digital drama: media interventions for educators and others start the opposite conversation Adults can and should use the same media that poses risks to our young people as segues to teachable moments about the extreme behavior we often see as entertainment. We can use what seems to be a very risky, but ever-present, influence in a way that promotes health. We can have discussions about the portrayals of negative stereotypes and the unrealistic depiction of substance abuse in our media outlets. Consistent education for teens from all sources—schools, families, and other community institutions—is so necessary. This education must use a variety of strategies and frameworks toward media literacy, including debate, discussion, and critical thinking exercises, as well as less formal chats in youth groups, on family trips, and in study halls. It can change attitudes and behavior through knowledge and the re-direction of healthy social norms. Highlight the healthy Although Hollywood may at times depict substance use as inappropriately funny or sexy, there are real-life actors, musicians, comedians, and athletes that promote positive messaging. Some have spoken out about the real dangers of alcohol and other drug use, and how it had a negative impact on their own lives. We can look to those people as positive role models for youth. For example, Demi Lovato once said in a tweet, "I wish more people would lose the stigma and treat addiction as the deadly and serious DISEASE that it is." The now-sober entertainer went on to post a poignant open letter shared with fans. "Drugs are not something to glamorize in pop music or film to portray as harmless recreational fun. It's not cute, 'cool,' or admirable," she stated. Make the most of existing resources Efforts such as the National Youth Anti-Drug Media Campaign spearheaded by Drugabuse.gov and the Partnership at DrugFree.org have been effectively targeting youth with anti-use messages since the early 2000's. Part of the campaign's plan has been to partner with media, entertainment, sports, civic, professional, and community groups to strengthen local anti-drug use efforts. When communities work together to help youth understand how to unpack carefully crafted and confusing media messages, the overall health of those community improves. Whether it's checking out website resources or speaking about media literacy with your child, you can take yet another step to keep your healthy kids healthy in the midst of pervasive media messages.