Have you noticed changes in your social experiences and how you connect with others during these tough times? Listen in as Dr. Shari Barkin discusses what social reintegration is, why it’s so important, and how we can do it successfully with 5 Tools to Create Meaningful Connections!
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Bridgette Butler: Welcome to this edition of the Vanderbilt Health and Wellness Wellcast. I am Bridgette Butler with Health Plus. Today, our guest is Dr. Shari Barkin with the William K. Warren Endowed Professor and Chief of General Pediatrics at Vanderbilt Medical Center. Welcome Dr. Barkin and thank you for joining us today.
Shari Barkin, M.D.: Thank you. So happy to be here.
Bridgette Butler: Dr. Barkin, you have said before that we are designed to be a social species and that we survive because we are connected to each other. I think we have all realized at this point how to true that is and it is also easy to notice that our social experiences and how we connect with each other has changed. We are finding ourselves exploring what it looks like and what it feels like to interact with one another again. Can you explain what social reintegration means and now this personally affects us?
Shari Barkin, M.D.: Well, you said it really well that we are designed to be a social species. That means it is actually in our DNA, it is in our anatomy, how our brains function, it is in our physiology and what it means to be healthy in terms of our mental health and physical health and we were then thrust into the pandemic and social unrest and these things together created a disruption to our social connection. It is so important what it is to be human is what we mean to each other and that is about connecting to people and really connecting to them in real life. So, when we talk about this notion of social reintegration, we are in a much better place now, not perfect, but better. This allows us, because of so many medical advancements such as the vaccine and other things, to actually now begin to reintegrate in real life with real people and that process sounds like it is simple. It sounds like it is just a simple flip of a switch, but it is not, and it is not because all of these elements have created a disruption in our sociology and physiology. So, reintegration is the notion that it is time for us to learn or relearn how to connect in deep ways in real life with each other.
Bridgette Butler: It sounds like we are going to be experiencing it just a little bit differently now. As adults, what challenges do we experience with social situations at this point?
Shari Barkin, M.D.: Well, I think the first one is again sort of wired in our brain is, is this a safe situation? The first thing that happens and it might not even be slow and intentional, it might be automatic at this point is, do I feel safe? Is this the right environment to be in? If I were to put myself in that environment, am I affecting my health, my family's health, people that I work with, the people in my community? I think because that is our knee-jerk reaction it creates cortisol cascade, creates a lot of stress and anxiety. So, that is a big challenge, is slowing it down that automaticity in saying, all right, wait a minute, am I safe? The answer might be different now than it was a year ago. In fact, it should be depending on context. I think the other piece about that is, how do I do this? Now, some people, if you are an extrovert, and I am a big extravert, I am so excited that I might enter into a conversation and just completely overwhelm you with all of my deep interests and questions for you. So, my reintegration approach is being mindful to turn that down so that it is slow and steady. Whereas if you are wired more than introvert, your first reaction might be, I do not know if I want to do this. It is going to take a lot of energy, or I would like to reintegrate, but I am not exactly sure even how in a social situation where I am going to get started with conversation. We are kind of out of practice with that on all amps of that spectrum and in between.
Bridgette Butler: How about children and families collectively? What are children and families experiencing?
Shari Barkin, M.D.: I see this a lot in our clinic. It depends on the age. It depends on whether you are a COVID baby or not. So, I am actually going to start with our littlest people that are COVID babies. In fact, when I meet people in the clinic they will say, this is my COVID baby, and they are not a baby anymore they are a toddler. This toddler's experience is really uniquely different than the toddlers that were pre-COVID. They have not interacted with a lot of other children. They are not really sure how to interact. That is something really critical that your are learning how to do in infancy, toddlerhood, preschool period is that social/emotional learning. It does not end after that. We are all still involved in our own social/emotional learning throughout our lives, but it is really exceptionally important because it builds a foundation of how you interact with people and expectations of what social norms are and communication and behaviors are. So, for our youngest children, this is an incredibly challenging place and families are asking us, how can I socialize my kids who really have not ever experienced "normal" social contacts? As children are older, if they have experienced being in a school setting or being on a sports team which maybe they did not go out for because of the COVID context, they are really craving that connection and craving that structure. So, for them, there is an infinity to be back in that space. They too need to sort of reintegrate and understand what are social norms and behaviors that are acceptable in a variety of situations. Then, you move to adults and families and families have had to be everything to their children. So, not only a parent, but in many cases a teacher and maybe even a mental counselor and the parents are the classic multihyphenate in coming out of COVID. That means that they are, depending on how you feel and sort of your natural inclination about how you are interacting, you might as a parent feel like I am not sure how to get back into this world and what is available to me. It is experienced, I think, differently at all different ages depending on your prior experience and what your expectations of today are.
Bridgette Butler: Excellent points. What is important to consider that may help us feel motivated and comfortable to reintegrate?
Shari Barkin, M.D.: Well, I want to reemphasize something you started with Bridgette and that is the valve of social connection. So, social connection improves depending on the people that you are connecting with. So, a big caveat here. Imagine your favorite people you are connecting with it improves your mood, it reduces depression and anxiety turning the volume down. It improves your memory. It improves your ability to learn. If you look at the level of your functioning, it improves your immune functioning as well as many other metabolic health pathways. So, in so many ways, strong positive social connection is the best treatment around for a lot of the things that are ailing us right now.
Bridgette Butler: That is very motivating. What actionable steps can we take while deciding when and how to reintegrate with our different social circles?
Shari Barkin, M.D.: Great. So, I am just going to throw these things into the tool kit recognizing that it is different for everybody. So, here are just some tools and you all decide how to use them and what is meaningful to you. The first tool is deciding what you are comfortable with and that means paying attention to context and the latest information and evidence. We live in a world that is uncertain. It is not that it was certain before, it just felt more certain than it does now, and so paying attention and deciding what you and your family are comfortable with recognizing that the context is shifting and changing. The second thing is to be intentional. By being intentional, you can identify something that is motivating to you and your family or the people that you love. So, for some people that might be setting up a play date or it might be going on a picnic with one neighborhood family. It might be gathering up, if you have musicians in your life or brining along your guitar or harmonica or kazoo and sitting outside but being intentional and playful and creative were you feel like you are controlling the environment a bit, but inviting at least one other person, family, into that circle. The third thing is to be proactive. So, I encourage you, I challenge all of us to just reach out to one person that we have not seen for a while that we really enjoy in making that connection. I know we feel like people should reach out to us and that is true. On the other end of that, we need to do the reaching out. So, even if we can reach out to one person that we have not spoken with for a while and find an opportunity maybe to go hiking or biking or have a conversation on a rocking chair outside or in the grass that intentionality plus proactivity, you will see that you will get an immediate boost from that. The fourth thing is to stay flexible. We know that everyone's lives are chaotic right now and unpredictable, so you might plan something, it might fall through, don't worry about it. Let it go. Try again. The fifth thing that I recommend is practicing random acts of kindness. So, a random act of kindness that connects you to somebody. It might be somebody that you know or somebody that you do not know, but it really highlights and underscores what it is to be truly human, what we mean to each other and bringing out the best of humanity. So, that can look like a lot of things. If you are on campus, it might be going to a Susie's and getting a gift card and giving it to somebody randomly to make their day. It might be bringing food to a sick colleague. It could be volunteering. Some of my favorite places to volunteer are the Nashville Food Project, Second Harvest, Faith Farms where you are outside and your actually, I am not a farmer, but I do like that kind of connection to the earth and maybe even reading to young children. I recently became a Book 'em volunteer. So, things that allow you to connect with other people, people that you do not even know where you are able to see really the best of humanity and bring that out in yourself recognizing who we are to each other is what makes us truly human.
Bridgette Butler: That is wonderful. Thank you so much for outlining some very actionable steps that we can take to motivate and to begin to socially reintegrate. We really appreciate you joining us today, Dr. Barkin.
Shari Barkin, M.D.: Thank you so much for this opportunity.
Bridgette Butler: Thanks for listening. If you have a story suggestion, use the Contact Us page on our website at www.vumc.org/health-wellness.