Stop With The Unwanted Advice!

60-year-old Steve, aka Dad: “You need go to pharmacy school!”
Katie, adult daughter: “I’m sorry, what was that? Pharmacy school? I’m not interested in pharmacy school.”
Dad: “You don’t want to be a teacher. There’s not enough security in that. You need to get into healthcare. That’s a better deal.”
Katie: “Dad, what are you talking about? I don’t want to change my major! I’m three semesters away from graduation! Why do you always try to run my life? You’re unbelievable!”

After role-playing the interaction, he stared at me. “Am I unbelievable? I just want what’s best for my daughter. She left in the middle of dinner. Why was she so angry?”
 
If it’s confusing to you why this daughter was angry, then this article is for you. Settle in and read on…

Sometimes parent’s advice is helpful to emerging adults, most often when that advice is wanted. But when parents barge in to the lives of still-figuring-it-all-out young adults and push unwanted advice on them, doing so is not helpful at all.

Starting out on their own, young people have big decisions to make. Decisions about education, career, relationships. One of the primary tasks of the teen and young adult years is to “find” oneself. In order to discover the self, young people need to be making their own decisions. When parents invade and offer advice on those decisions, not only can it create conflict, it can also stunt growth in young adult children.

Steve has had a difficult time understanding why the advice is damaging the relationship with Katie. Katie had a rough time through adolescence. Her mother died when she was twelve, and Steve raised her alone. He thought he was a pretty good father. He was lovingly involved, protective, and in his opinion, he had always given his daughter pretty great advice. In middle school and high school, she seemed to appreciate his input. But as Katie has progressed through college, she increasingly becomes offended by her dad’s unwanted advice. 

Steve fails to see how Katie’s stage of life dictates a different relationship with her father now. Like so many young adults, Katie has taken the wheel and become the captain of her own ship. She doesn’t need her dad to tell her which decision to make anymore. In fact, when Dad jumps in with an unwanted piece of advice, Katie says she begins to doubt herself. What she craves more than anything is to have her dad say he trusts her judgment and he knows she will find her way through tough decisions with her growing courage and wisdom.

Unwanted advice can shut down the growth of a young person. Not only can the advice prove counterproductive, it can ignite conflict between the parent who gives the advice and the adult child whom he only wished to help.

If you are a parent whose kid is furious or withdrawing due to your unwanted advice, it’s time to learn to keep your silence. 
Don’t be so smart anymore. 
Stop knowing the answers. 
Let your child be the smart one who comes up with solutions. 
Assume your child has the answers she needs and decide you’ll be quiet so she can listen and find those answers on her own.
The last act of parenting is trusting your child to fly on her own. Trust and let go!

Dr. Deuter is a psychiatrist who specializes in the care of emerging adults.

Be A Beacon of Hope For Your Loved One With Mental Illness

Do you know or love someone who suffers from a mental illness? If you answered “yes,” then you’re like most of us. According to the National Alliance on Mental Illness (NAMI), 1 in 17 Americans suffers from a serious mental illness in a given year. Mental Illnesses are gaining awareness in the national conversation, but many sufferers are still silent about their psychiatric problems with friends and family. More than half of those with mental illness may not be receiving treatment.

If you have a loved one who suffers from mental illness, this list of Do’s and Don’ts can help you be a source of support:

DO
•    Acknowledge the illness.
Mental Illness can leave people feeling isolated and alone. Making the disease subject taboo contributes to isolation.
•    Talk openly and offer support.
Mental health symptoms can be very distressing. Your loved one will likely need emotional support. Ask what you can do to make things easier.
•    Facilitate access to professional help.
Mental illnesses can be serious and disabling. If your loved one needs to see a physician, offer to help him find an appropriate mental health professional or team. 
•    Share your observations with doctors who provide care. 
Offer to attend appointments. Many mental illnesses include impaired insight, so ask if you can share important observations with the doctor.
•    Ask if any current medical problems or medications could be the cause of the mental health symptoms. 
Some mental health symptoms can result from general medical illnesses. Medical tests can rule out underlying medical causes for mental health symptoms. 
•    Attend a support group for families.
The National Alliance on Mental Illness (NAMI) offers groups for people who suffer from mental illnesses and for their families.
•    Report any serious side effects to the doctor.
When your loved one is receiving treatment, notify the doctor right away if he has any problems you believe may be caused by the treatment. All medications can have side effects, and talk therapies can have side effects as well. 

DON'T
•    Diagnose your loved one from a book or a list of symptoms on the internet.
With all the nuances of human mood and behavior, it’s easy to diagnose yourself or your loved one with incorrectly on your own. Make sure you seek a diagnosis from a trusted professional.
•    Encourage self-medication with substances of abuse.
Some people try to control mental health symptoms with alcohol, marijuana, or other substances. Discourage such self-medication. It could make the illness worse.
•    Be judgmental.
Many people who experience mental health symptoms find them embarrassing to tell others. As a result, people may not get the treatment they need. If you say things like, “You wouldn’t have these problems if you ate healthier foods,” you can make your loved one feel worse and drive him away from the care he needs.
•    Tell your loved one to pray or attend religious services instead see a mental health professional.
Although religious faith is a healthy source of strength for those with mental illness, many serious mental illnesses such as schizophrenia will not improve without proper medical treatments.
•    Let your loved one give up before treatments have a chance to work.
Treatments won’t cure symptoms right away. Encourage your loved one to hang in there and give treatments time to work. If he doesn’t get better, the doctor may adjust the plan.
•    Support changes to treatment without consulting the doctor. 
Changing medication or a therapy program without permission can lead to relapse or serious health consequences. 
•    Ask your loved one to stop treatment as soon as he/she starts feeling better. 
Many people want to stop mental health treatment as soon as they begin feeling better, but this is a mistake. Symptoms are likely to return without a long period of stability. Ask the doctor how long treatment should continue once symptoms are fully controlled. 

Dr. Deuter is a psychiatrist who specializes in the care of emerging adults. 

Mental Illness and Mass Violence

On May 23rd, Elliot Rodger went on a killing spree in Isla Vista, California. Unlike many of America’s growing number of mass killers, Rodger not only used a gun, but also a knife.

Why do mass shootings/stabbings occur? 

Can anyone answer the question of why? The mass killers have several things in common. They are angry loners, usually isolated, usually paranoid (they detect some kind of personal meaning in the actions of others). However, many people with the same characteristics don’t go on killing sprees.

Some people say guns are the reason why massing killings occur. But Elliot also used a knife. Others say mental health funding is the reason. But Elliot was actively receiving mental health services.

I cannot dispute that a madman with an automatic weapon is a very dangerous thing. I cannot dispute that funding mental health clinics is important and necessary. These things are true.

But as a professional, treating some of the potentially dangerous individuals, I see another side. The truth of the recent killer in California was that he was showing signs of dangerousness, and people were concerned. His family, mental health professionals, and law enforcement took action. They tried to do something. The police went out to check on him. And here’s what I know that the general public does not: everyone did their job. They followed all the rules.

When the police went out to his residence on April 30th, they would have spent time observing Elliot Rodger. They would have looked for signs of dangerousness and mental illness that might impair his ability to take care of himself or make him a risk to others. Elliot held himself together long enough to reassure the officers. The officers left, and Elliot continued plotting until he carried out his plans on May 23rd, less than one month after the officers visited his apartment.

So why did this happen? Why didn’t they take Elliot into custody? Put him in a hospital? Protect the public?

The law requires officers personally to observe concerning behavior before taking an allegedly mentally ill person into custody. If they do not observe bizarre or threatening behavior first hand, officers cannot take a person in.

To understand why this is necessary, let us consider the scenario from another angle. What if my loved one could call law enforcement and have me taken into custody for mental illness, simply because my loved-one asserted that I was dangerous? What if my therapist could do the same? It would be a set-up for serious abuses of power. For example: what if my spouse could declare me mentally ill and have me hospitalized to prevent me from getting custody of our children in a divorce? Or what if my concerned loved one was paranoid, seeing mental illness in me instead if realizing he or she needed help?

Elliot’s parents did the right thing by asking police to go out and perform a safety check. The officers followed the law when they checked on Elliot but didn’t take him into custody because they found him to be calm, pleasant, and cooperative. 

I sit down with a family at least once a month and explain why I may not be able do anything to help their mentally ill or disturbed loved-one. The reason is this: in America, above all else, a person has the constitutional right to freedom. If a person with mental illness has not committed a crime or made a very clear threat, he or she has a constitutionally protected right to be free from incarceration. Even those with severe mental illness, if they are not hurting anyone, have this right to freedom.

America used to lock away the mentally ill in institutions, not so many years ago, in fact. And then lawmakers decided than institutionalization was expensive, most often unnecessary, and (most importantly) a violation of the civil rights of mentally ill people.

But we need a better system. 

Motherjones.com has published a timeline of mass shootings/killings in America over the past 32 years. It is apparent from viewing the timeline that these types of horrific events are increasing in frequency. The result, in addition to the tragic loss of life, is that mental illness is further stigmatized. Patients fear a diagnosis like Schizophrenia or even Autism will evoke fear and discrimination. They shy away from treatment.

To end the epidemic of mass violence in America, we need to reduce stigma (without overlabeling normal life as mental illness.) We need treatment for the severely mentally ill. We need research to guide us, training for law enforcement and mental health personnel for reporting and treating potentially dangerous individuals, qualified professionals to assess for signs of dangerousness, and funding to provide people like Elliot Rodger with the treatment programs they need.

Dr. Deuter is a psychiatrist who specializes in the care of emerging adults.

Defining A Parent’s Role After A Child Leaves Home

There are tons of books and articles offering advice on how to parent. They span (almost) every stage: Train your baby to sleep restfully through the night; Teach your toddler manners; Get your kids to eat their vegetables; Talk to kids about sex; Improve your relationship with your teen; Help your kid go to the best possible college. But what about books or articles advising when and how to stop parenting? Where are those?

Letting go after finishing the parenting job is perhaps the biggest lesson of all. Parents wonder: What is the parents’ role when a child leaves home?

The stage between childhood and adulthood can last through the college years, into the mid twenties, and sometimes into the late twenties, thirties, and beyond. Without a clear line between childhood and adulthood these days, how are parents to know their role? But, there is an answer: each family must define the process for letting go of each child.

Defining the parent’s role depends on what path a child takes. If a child is going off to college, parents may be helping pay tuition and living expenses. In some respects, parental support extends childhood for a few years. College students are often not expected to be fully accountable for paying all of their own bills or even for making all of their own decisions. A college student is usually more independent than he was at younger stages of childhood, but he is still more dependent on parents than the average thirty-year-old.

In fact, a parent’s level of involvement may determine whether the child will remain in a dependent child role, or be released into the world as an independent adult. When parents continue to pay the bills, offer sage advice, and oversee young adult offspring, then young adults behave and function much more like adolescents than like bona fide adults. With active parental oversight, why would they act like adults? Why not defer to the “real” adults?

If a child is leaving home for the Army, a parent can hug her and write her lots of letters, and essentially let her go. Other than checking-in by phone or email, leaving home for the armed services doesn’t require much parental oversight. The same applies for the Peace Corps, a job on a cruise ship, or an adult child starting a career away from home. In these cases, parents might have in mind some guidelines for how to help if the need arises.

Will you pitch in funds if your kid has trouble starting out? How much? Under what circumstances?

What if she is making a big purchase, like a car or a home? Will you offer financial assistance?

Aside from money, do you intend to offer other types of support? Advice? Resources, like use of your lake house?

Can your child move back home if life out on her own is too difficult?

Just as parents have done throughout the stages of childhood, parents must dial-back involvement as adult children gradually move toward full independence. And then at some point, parents must lovingly let go. The endpoint of parenting is releasing a child, ready, into adulthood. Trusting adult children to manage their own lives is the ultimate goal.

Dr. Deuter is a psychiatrist who specializes in the care of emerging adults.