By Leslie Lindsay
What Happens When your Emerging Adult Needs to Come Home? Dr. Melissa Deuter Talks about this and so much more in her book, STUCK IN THE SICK ROLE
In her psychiatric urgent care practice, Dr. Melissa Deuter has been an expert in assisting families with ‘failure to launch’ young adults who seem to be stuck—whether that’s in a sick role (broadly defined as struggling with mild-to moderate depression or anxiety but may include more severe psychiatric diagnoses), but also those who are unready emotionally and socially to move into the next stage.
Through a series of vignettes, Dr. Deuter takes us on a journey in which we ‘meet’ these young, emerging adults. Her style is down-to-earth and conversational; in such a way it feels as if one is eavesdropping on friends at a coffee shop. You may recognize familiar stories as if they were your neighbors, your best friend’s son, or your brother’s daughter. Don’t worry, everyone mentioned in STUCK IN THE SICK ROLE has a pseudonym. The point is, the phenomenon of ‘failure to launch,’ is so widespread, so common, that we’re beginning to see a trend.
STUCK IN THE SICK ROLE is not exactly science, though science absolutely supports that the brain is not fully developed until 25 years of age. Here, Dr. Deuter gives parents—and perhaps some ambitious emerging adults—the tools they need to go from emerging to actualized.
‘Failure to launch’ is such an important—and often neglected—topic in parenting. Parents of children of just about any age ought to tune in because kids, they grow.
I’m honored to welcome Dr. Deuter back to the blog couch. Please join us in conversation.
Leslie Lindsay: Wow. I finished this book last night and turned to my husband and said: “I see a lot of so-and-so in this and also…” He nodded slowly. Neither of us had been ‘stuck’ as young adults, we did what we had to do. Yet, expectations have changed. Why this book, why now?
Dr Deuter: This book came to life because I found myself having the same conversations with parents of late teens and twenty-somethings again and again. Most of the patients had been in mental health care treatment, and they just weren’t getting anywhere. The patients looked remarkably un-sick on clinical examination and they always showed up with parents who were baffled by their complete inability to function.
I would point out that their child was lost and flailing, and that it appeared to be a stage of life problem more than “mental illness.” Many of the parents would say, “Wow! I never thought about it like that before. Why didn’t our previous doctor our therapist tell us that?” I realized I was saying something useful and unusual. I thought maybe more people needed to read what I was saying in the office, so I started writing.
L.L. Can you talk a little about what it means to be an ‘emerging adult’ versus a ‘full-fledged’ adult? What skills and responsibilities should we possess at each stage? Is it that clear-cut?
Dr. Deuter: Emerging adulthood is basically just a term to describe young adults who aren’t in the roles of adults yet. The term was coined by a college professor and researcher (Arnett) who noticed that college students were more like teenagers as long as they were dependent on their parents and not yet self-reliant.
A full-fledged adult solves her own problems and pays her own way. An emerging adult looks to parents for guidance, emotional support, and often financial support.
I think understanding that adulthood is a series of roles rather than an age can help a lot of people understand why kids these days seem so different than past generations. Society is different than it once was, so kids are affected in ways no one anticipated.
L.L.: When I was in college, a couple of peers had a ‘breakdown,’ that is, they became very anxious and perhaps depressed. School work was too much. They fretted over grades. They missed the comforts of home. They had difficulty living with roommates and structuring their time. For one, a female, this sent her packing and heading home where she lived with her parents but attended a (well-respected) local college. The other, a male, had me take him to the student health clinic for a script of anti-anxiety drugs We spent long hours talking about his issues. Do you see any gender differences in how these things are handled?
Dr. Deuter: Actually, I don’t see gender differences as much as family culture differences. I have seen young men and young women alike follow both courses. If a family has a “pull yourself up by your bootstraps” philosophy, staying at school might be expected. If a different family is worried that little Tommy or Suzie can’t tolerate being so far from home, that student is probably moving back home with parents.
L.L.: Just as there are as many different responses as individuals, how might parents best handle these situations?
Dr. Deuter: In cases where young adults get “stuck” before becoming full-fledged adults, their parents are an important part of the recovery equation. I urge parents to observe how life skills play a role in getting stuck, and how they (the parents) may be enabling unhealthy coping if they step in and allow their child to return to teenager roles after a crisis.
L.L.: What can parents do—before there’s a ‘problem’—that might prevent college students coming back home to the comforts of their childhood home?
Dr. Deuter: There are two major things I wish all parents could do in advance of a mental health crisis in their child: 1. Parent with the end goal of adult independence in the front of your mind. Don’t just teach your children to be obedient students, make sure they have the confidence and experience to persevere and solve problems. 2. Resist the urge to rescue your child, and know that at times, it will be really hard to step back and let him figure it out. That doesn’t mean you won’t help, but as a parent, you have to address your own hang-ups and fears before a crisis hits so you’ll behave in a healthy way after.
L.L.: Much of what we’ve been talking about has to do with college-bound individuals. It might be implied that they are relatively intelligent, middle-class, and perhaps, Caucasian, with at least one involved parent. Are you seeing this trend in other populations and across SES?
Dr. Deuter: Yes. Across socioeconomic groups, parents are sheltering kids more and helping their kids longer- well into their twenties. That said, emerging adult students are more vulnerable to the lack of skills problems than other groups. Students can be going along, meeting their goals and still not be taking on adulthood. Those who are employed acquire more adult skills than those who only attend school.
L.L.: And what happens when the person of concern has a legitimate mental illness (bipolar disorder, schizophrenia, MDD) or major mental health crisis, such as rape, alcoholism/addiction, and they must come home to cope, recover? What then?
Dr. Deuter: This is a really important question. Young people can become very stuck after a crisis. Supportive families need to understand that loving involvement is a really essential part of recovery, but support should stop short of rescuing or enabling. No matter what crisis our kids have endured, we want to teach them that they can recover. They are strong and they can find the answers to healing. We don’t want to send the message that only we, the parents, can be strong and competent.
L.L.: What do you hope others take away from STUCK IN THE SICK ROLE?
Dr. Deuter: More than anything, I want people to understand that medications don’t sufficiently get people back to normal healthy lives after a crisis. Our kids are not just bags of neurotransmitters that we can “fix” with pills; they are growing up in a psychosocial and spiritual context that cannot be ignored. To address the health and functioning of our young people, we have to look at the whole picture.
L.L.: What question should I have asked but may have forgotten?
Dr. Deuter: I guess I might want you to ask: “Is your advice to parents and patients working, and how do you know?”
I will answer with a story:
One parent who has been coming to me for years to figure out how to handle tough situations with her kids (ranging in age from elementary school to mid twenties) came in with a copy of the book. She had dozens of page markers flagging different points throughout the text and she said, “Oh my gosh! I finally get it! Everything we have been talking about regarding how to make sure my kids are healthy—it’s all right here! Thank you for this and for helping us find our way all these years.”
L.L.: Melissa, it’s been a pleasure. Thank you so much for taking the time.
Dr. Deuter: Thank you.
For more information, to connect with the author via social media, or to purchase a copy of STUCK IN THE SICK ROLE, please visit:
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ABOUT THE AUTHOR: Dr. Melissa Deuter is and expert and trendsetter in the world of mental health care. She founded Sigma Mental Health Urgent Care and in doing so is on the forefront, redefining how psychiatric services are delivered. Dr. Deuter is a board certified psychiatrist in San Antonio, Texas. She received her undergraduate degree from the University of Arkansas and attended medical school at the University of Arkansas for Medical Sciences. She completed psychiatry residency at the University of Texas Health Science Center San Antonio and served as Chief Resident. Dr. Deuter currently holds an appointment as Clinical Assistant Professor of Psychiatry at UTHSCSA and is the course director for the resident training seminars on Eating Disorders and Sexuality and Sexual Development. She is a former President of the Bexar County Psychiatric Society, a current member of the Texas Society of Psychiatric Physicians Ethics Council, and a current member of the South Texas Psychiatric Physicians Research Network’s Executive Committee. She has been recognized as a San Antonio’s “Top Doctor” and a “Best of” Doctor, a Texas Super Doctor’s “Rising Star,” and has received the American Registry “Patient’s Choice Award.” Dr. Deuter has a special interest in early stage psychiatric care, differentiating serious illness from normal brain development, and the unique mental health needs of emerging adults.
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[Cover and author image courtesy of PRbytheBook and used with permission]
Leslie A. Lindsay| Writer & Creative 