Emotional Regulation Over Screen Limits

Author(s): Scott Douglas Jacobsen

Publication (Outlet/Website): The Good Men Project

Publication Date (yyyy/mm/dd): 2025/06/08

Dr. Tom Milam, MD, MDiv, Chief Medical Officer at Iris Telehealth, joins Scott Douglas Jacobsen to discuss young people’s mental health challenges in a screen-saturated world. With a unique background in psychiatry and theology, Dr. Milam emphasizes the importance of emotional regulation over strict screen time limits. He explores how digital content, AI tools, and early caregiver bonding shape resilience, identity, and well-being. From cozy games to developmental lags post-COVID, the conversation highlights actionable insights for parents and educators navigating a rapidly evolving media landscape with empathy, structure, and awareness.

Scott Douglas Jacobsen: Today, we are joined by Dr. Tom Milam, MD, MDiv. He is a practicing psychiatrist and the Chief Medical Officer at Iris Telehealth. Dr. Milam has a unique background that includes graduate studies in theology at Yale University, where he was a Yale Associates Scholar. He earned his Doctor of Medicine from the University of Virginia and completed his residency training in psychiatry at both Duke University and the University of Virginia Medical Center.

Dr. Milam brings deep insight into the mental health challenges facing young people today, particularly around the impact of social media and digital content. He focuses on the growing gap between what technology platforms provide and what children and adolescents need for healthy psychological development.

He encourages parents and caregivers to prioritize emotional regulation over restricting screen time. He also advocates for thoughtful use of digital tools—such as “cozy games”—that can help build resilience, foster secure attachments, and address often-overlooked “silent stressors” in modern parenting.

Thank you for joining me today. Let me begin with a distinction you’re making that hasn’t come up much in prior interviews: the difference between screen time restriction and the development of emotional regulation. Most mainstream advice suggests limiting screen time while also working on emotional skills. But you emphasize emotional regulation more strongly. Why that emphasis, rather than taking a dual-track approach?

Dr. Tom Milam: Part of it is that we want to start early in helping children express their emotions—whether with people in real life, through digital interactions, or in structured settings like daycare, school, or home. You’d be surprised how many children don’t receive consistent or developmentally appropriate modelling of emotional regulation.

Emotional regulation is foundational to mental health. It involves expressing feelings through physical posture, voice tone, facial expressions, or behaviours like crying, anger, or withdrawal. Children and the adults who guide them vary widely in how they show emotion. When children struggle with emotional expression, caregivers need to be attentive and, if required, seek help from a mental health professional.

Screen time isn’t inherently harmful. I’ve seen it be beneficial in some cases. It can offer opportunities for connection and learning, especially when children don’t have regular access to peers or adults.

When I was growing up, we didn’t have this level of screen exposure. Our only screens were televisions—first black-and-white, then colour. Today, screens are pervasive, and children interact with them from very young ages. That’s not necessarily bad, but it requires intentional guidance.

What concerns me most is when screens become a child’s primary source for learning how to express emotions. Too often, screens are used in place of caregiver interaction. But children learn to interpret and regulate their emotional world through those real-life relationships—parents, guardians, and teachers. That is where the real work of development happens.

Jacobsen: When it comes to screen content itself, there’s historical precedent here. At one point, people were saying rock and roll was corrupting the morality of the youth—starting most prominently in the United States with Elvis. That dastardly man swinging his hips—look at him go! It was considered terrible. Then came rock and roll, grunge pop, goth, punk, etc. So, from a clinical perspective, is there any legitimate concern about the content kids consume—beyond just the amount of time they spend on screens?

Milam: The content needs to be age-appropriate. And realistically, there’s no going back to children using screens. They’re everywhere now, including in schools, where tablets and computers often replace paper. But again, the content must be developmentally appropriate.

Developmental stages matter a great deal. Children need bonding time with their caregivers from birth to around age five. That’s when they learn to feel love and affection. While some of that can be conveyed through a screen, ideally, the human bond—physical contact, being held, being nurtured—lays the foundation for secure emotional development. A child needs to know their needs will be met—when they’re hungry, they’re fed; when they’re upset, they’re comforted.

It’s hard to get a five-year-old not to resist being drawn to a screen, but early emotional development is rooted in real-world responsiveness. Crying, anger, frustration, happiness—all of that is connected to whether their core needs are consistently met.

From about ages six to twelve, you see a different developmental stage. That’s when reasoning and logic begin to mature, and school plays a significant role in shaping how kids think and engage with technology. Using screens in an educational setting at this stage makes sense. We need to integrate technology into education thoughtfully. Artificial intelligence is going to be a game-changer here.

As children age, their supervision needs shift. Young children, especially those under five, don’t know what they’re doing and need close monitoring. However, the goal is to gradually reduce direct oversight and help them internalize judgment.

Ideally, by the time children are in their early or mid-teens, they’ve developed a sense of what kind of content is appropriate, what is uplifting, and what is harmful or misleading. Of course, this takes time, and not every child progresses at the same rate.

In many households, when a young child or tween encounters something inappropriate online—or misbehaves—parents will often respond by simply taking away the screen. That’s understandable. But you won’t always be there to take it away. So, the real goal is to instill the ability to self-regulate. Children need to learn that just because something is on a screen doesn’t mean it’s meant for them or that it’s healthy.

There’s much content out there that can be emotionally damaging, especially for children and teens. Early supervision is key, but we must also teach kids to make good decisions independently. And even as adults, we don’t always model perfect digital behaviour ourselves.

Jacobsen: With AI being a potential game changer, how do you see it influencing parental screening of content and device usage? And in terms of entertainment—I’m not talking about journalism here, but broader media—what types of content do you think can positively teach kids nonverbal lessons about social life or emotional regulation?

Milam: Well, what you often see in movies and television shows—especially those on mainstream channels—is a lot of human interaction and emotional expression. That’s where children can begin to observe and model behaviour. As children grow older, particularly after age five, they interact more with adults beyond their immediate family. Their exposure to different models of behaviour broadens.

They might encounter a teacher, a coach, a mentor, or a babysitter—someone they look up to, maybe even more than their parents, in specific ways. They may start to emulate those figures. But if a child hasn’t received enough love, nurturing, and a clear sense of self during their early years, it can be hard for them to seek validation outside the home in a healthy way.

We all struggle with this to some extent. The psychoanalyst Donald Winnicott discussed the concept of the “good enough mother”—or, more broadly, the “good enough parent.” You don’t have to be perfect; you just need to provide enough care, attention, and love for the child to develop a secure sense of identity and belonging.

If a child feels safe, loved, and valued by age five, much of their foundational emotional security is in place. If that’s missing, they may seek it externally well into adulthood. And frankly, many social media and some media programming prey on that insecurity. They feed on fear and anxiety. They’re trying to sell something.

As adults, we’re generally more capable of recognizing this and deciding to turn off a particular channel or exit a site. But children—especially younger ones and even teenagers—often lack the discernment to distinguish between what is real and healthy and what is manipulative or harmful.

So yes, it’s a long answer to your question—but it’s a complex issue. If designed with explicit norms and safeguards, AI can help parents by filtering content, flagging problematic material, and recommending age-appropriate options. That’s a real advantage.

When my kids were young, I didn’t know how to set parental phone or computer controls. There were a few channels back then—you just turned the dial. Today, it’s far more complex. AI could function like an advanced version of movie ratings—G, PG, M, R—but far more adaptive. Parents could speak directly to the AI to configure settings that match a child’s developmental stage.

Of course, it will never be perfect. No one believes AI will fully solve this. But it can help limit access to harmful content and give parents better tools for understanding what’s developmentally appropriate—beyond just the traditional rating systems we grew up with.

Jacobsen: I was speaking with two child psychologists recently who work in schools, and they both mentioned something striking: across the board, they’re seeing kids entering grade five showing the emotional maturity of grade three. Grade sevens present more like grade fives, and so on. There is about a two-year lag in emotional maturity. Is that something you’re hearing discussed more often among professionals?

Milam: Sure. My wife is a middle school reading specialist, so I hear many stories from her. There will always be variability in which children can grasp emotional and social concepts more quickly and which need more time and support.

That’s where the concept of resilience comes in. There’s extensive research into what it means to raise a resilient child. Some children are naturally more resilient and better equipped to navigate challenges, especially during key developmental stages like early elementary school.

Resilience includes learning how to manage emotions and express sadness or anger appropriately without aggression. It involves knowing how to use your words, wait your turn, stand in line, and read social cues. Children need to learn These foundational social skills in real-world settings.

Learning depends on children and families being together and on meaningful interaction between children and adults. Face-to-face social interaction is vital during early childhood development.

I don’t want to lay all the blame on social media. It is a form of social connection, but it’s not as interactive—or at least not in the same way—as in-person relationships. It can be interactive, especially for older children and teens. However, for younger children, digital socialization often lacks the nuance and warmth of real-life human interaction.

What we’re seeing now is, in part, the aftermath of the COVID-19 pandemic. During lockdown, many children were isolated—not just from peers but also from extended family and broader community networks. Some families didn’t have reliable Wi-Fi or data plans, so their kids couldn’t connect virtually. That isolation left a mark.

Jacobsen: And even though the lockdown period was relatively brief, research suggests that it had lasting effects on emotional development for some children. I don’t want to attribute everything to COVID-19, but it has played a significant role. From an evolutionary perspective, facial recognition and emotional reading are survival tools. And, as you mentioned earlier, primary caregivers up to about age five are the ones who first teach us how to read and express emotions.

Milam: If a child is exposed to a wide variety of emotional expressions on screens, but no one can explain which reactions are appropriate—or how to handle their feelings—then the learning process is incomplete. They’ve seen the emotions, but they haven’t been taught how to respond or express them healthily.

Simple things matter: when you’re angry, it’s not OK to hit or hurt people. When you’re sad, it’s OK to cry—regardless of whether you’re a boy or a girl. Crying is a valid form of expression. It’s not a weakness.

That message becomes especially important when working with children who’ve experienced trauma or grief. Helping them process those emotions is key to ensuring they don’t grow up believing that all adults are untrustworthy or harmful.

Social media increases exposure, but it also increases risk. Parents, caregivers, teachers, and coaches play a critical role in guiding children—especially early on—in setting healthy emotional boundaries and expectations.

Jacobsen: That makes sense. Are there certain things digital technology has not touched—lessons or practices that still hold and must be taught directly to children in their early years?

Milam: Digital technology is often focused on gathering data to better understand children, and I believe a great deal more could be done to support children’s emotional health and well-being through these tools. Especially when it comes to identifying early signs of significant challenges—depression, withdrawal, isolation, anxiety, panic, or excessive fear.

If those signs are not recognized, they can be misinterpreted. For instance, a child might seem “quiet,” and adults may assume it’s simply a personality trait. But in some cases, that quietness could be masking fear or anxiety—especially social anxiety or social phobia, which is one of the most common forms of anxiety in children.

If we don’t recognize that as a form of anxiety, we miss a significant opportunity for early support. Digital tools can be part of the solution, such as using interactive scales, simple stories, or emotional recognition exercises like identifying facial expressions: “Which one is this? Is this child angry or sad?” or watching a video and asking, “What did you notice about how that child or parent expressed themselves?”

These exercises help children put words to their emotions, and over time, that can make them feel safer and more comfortable expressing complicated feelings—especially fear or distress.

Jacobsen: It is both fantastic and deeply saddening how widespread abuse and violence toward children still are—not just here but globally. Many children grow up anxious and fearful, shaped by trauma and neglect.

The earlier we can identify those children and help them process their experiences—teach them how to trust again and love and be loved—the better their chances of forming meaningful relationships and living fulfilling lives.

You hear a phrase in North America: “What’s wrong with kids today?” Taking a slightly different angle—are the kids generally OK?

Milam: Yes—and I think it’s important to acknowledge that. Children are incredibly adaptive. However, how they are raised, the cultural context, the family structure, and social influences all shape how they grow.

Cultural differences in parenting and family life are sometimes undervalued in Western contexts. In many cultures, there’s a tighter-knit family orientation than the more individualistic “nuclear family” model we often refer to here.

Many layers shape a child’s sense of identity—first within the family of origin, then through community networks like schools, places of worship, or civic organizations. Whether it’s a mosque, church, synagogue, or local community center, those social structures help shape identity and belonging.

When used responsibly and at developmentally appropriate levels, social media can help children explore identity—especially in urban environments or remote rural areas, where access to peer groups may be more limited. It can provide exposure to different perspectives, interests, and communities.

I often compare social media to walking into a giant shopping mall. Everything in that mall is there to sell you something—each store, every vendor—it’s all about commerce. But there’s also a lot of social interaction happening in the halls, in the food courts, and between friends. That part can be positive and connected.

As adults, we understand that the stores are trying to sell us things. We’re aware of the motives. However, that distinction can be more rigid on social media, especially for children. Many platforms are designed to influence, persuade, or promote a particular viewpoint.

It takes a fair amount of sophistication and critical thinking to recognize when you’re being sold to—or worse, manipulated. Even adults sometimes struggle to discern what is true from what is deceptive. That’s why teaching media literacy and emotional awareness early is so essential.

One of the biggest things I worry about—not just for children but also for adults—is a naivete in how we approach social media. We need to be more discerning about what we expose ourselves to on screens and which relationships we allow into our lives through those platforms.

Some of those relationships are toxic. You see both children and adults being cruel to one another on social media. So the question becomes: how do you turn that off? How do you teach someone to ignore it?

Children now have to learn those skills—skills we didn’t have to teach a generation ago. And when there’s more to learn, it naturally takes longer. That’s part of why we’re seeing developmental lags in children today. It doesn’t mean they won’t catch up, but it doesn’t surprise those of us in the mental health and education fields to see measurable declines in some maturity regions.

We’re seeing it in reading, too. Many schools no longer teach cursive writing, critical writing is fading, and everything’s digital. That’s a massive shift. And yes, cursive writing may have been frustrating to learn, but it was a discipline—an essential cognitive and developmental exercise that is disappearing.

So much of children’s lives are now mediated through screens. I hope that AI can be used to create engaging and effective educational tools that help kids succeed at their individual levels. Right now, many children in our school systems feellike failures. They don’t believe they’re as good as others.

So, how do we help them succeed on their terms? How do we use technology to foster emotional intelligence, to help children understand and celebrate their own emotions and the emotions of others, and to help them learn to respect differences?

That’s why we still struggle with this—even as adults. Our culture has many examples of adults not behaving like adults when respecting diverse opinions or beliefs. This doesn’t happen in a vacuum; it starts in childhood.

If we do not address these issues early, we raise children who grow into adults who can be judgmental, reactive, or unnecessarily cruel. That’s a societal failure we can work to correct by focusing on emotional education from the very beginning.

Jacobsen: Sir, thank you so much for your time today and for sharing your expertise.

Milam: It was nice to meet you.

Jacobsen: Likewise. It’s been an absolute pleasure.

Milam: Excellent. We’ll be in touch.

Jacobsen: Take care.

Milam: Alright. Take care. Bye-bye.

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