In my sixth decade of life, I’ve gotten much more comfortable—and familiar—with bafflement. It’s something of a paradox of the years that my increase in confidence in so many areas of my life seems to be intertwined with growing acceptance of my ignorance. In fact, it’s a relief to be this unabashed in declaring, “Well, I have no idea. Please tell me.”
In particular, although I’m surrounded day and night by millennials—my children and their friends, my doctoral students, most of my clients, and many of my fellow marchers and canvassers this past year—I’m intrigued by what I don’t know about this younger generation. Sure, I’m pretty well versed in the theoretical issues of emerging adulthood and am also a stalwart fan of these “kids,” so I have moments when I assume I understand what it’s like for them as individuals, and even as a cohort. But there are striking moments with every millennial I treat, when, truth be told, I know I’m missing something that’s fallen into the generational gap between us: perhaps the fact that I still call them kids is a good indicator of that.
So I decided to consult with a small group of millennials, all with firsthand knowledge about providing and receiving therapy—a few current and former doctoral students and a smattering of young adults I know from my nonprofessional world who’ve put in time as psychotherapy clients. I picked four different cases off the top of my pile, outlined a couple of aspects I found a bit perplexing, and sought their insight. Here’s how their advice and fresh perspectives have energized my practice.
Kat and the Tyranny of Choice
Kat comes to therapy right from work, so she’s usually early. She likes to sit in my waiting area and read fantasy novels until I’m ready. She says there are so many demands on her time that she appreciates the few minutes to herself out there. When I welcome her in, she shoves the paperback into her bag and with a tight smile pulls out a small, pink notebook before getting up to come into my office. Wordlessly, she hands it to me as she sits down. She’s prepared for our time by jotting down events and thoughts that she wants me to read and ask her about. Since it’s hard for her to summarize what’s on her mind, she prefers we begin this way.
Though we meet infrequently—Kat just aged off her father’s plan, and her work insurance has a steep copay—certain themes always come up: incapacitating college debt, overeating and weight concerns, stress about living back in her childhood bedroom at age 27, the boredom and frustration of her menial receptionist job, and her social isolation. On a deeper level, she’s in a holding pattern in her life, and can’t seem to move forward. The attendant anxiety costs her in sleep, chronic headaches, and binge eating. I also sense an almost obsessive paralysis about making any decisions.
For example, one day Kat brings in some job possibilities to discuss with me, and it’s clear how overwhelmed she is by the small list she’s placed on the ottoman between us: she nervously toys with her water bottle, and her eyes dart around the room. She has, at the ready, compelling reasons not to apply to any of them: she won’t earn much more, insufficient opportunity for advancement, a tough commute in the winter, the likelihood of too much competition for the spot, feeling discouraged by previous rejections. The education she paid dearly for seems disconnected from the endeavor. It took me a few weeks to catch on, but I now realize our conversations around strategizing and problem-solving were only contributing to her hamster-on-the-wheel processing. She’s simply too defeated and paralyzed to make much use of my logistical support.
Kat isn’t one of those “lucky” millennials who grew up being told she could be anything she wanted or attain whatever her heart desired (there are surely fewer of those types than we’re led to believe), but even so, she feels as if she’s drowning in a sea of options. Like many of her peers, she has an unfathomably hard time committing to a course of action, whether it’s about work, career, relationships, purchases, use of leisure time, or social causes.
Kat admits that she’s really afraid of making a wrong decision, and we dig into how this has happened. We examine her life story as an only child of older, hardworking parents and how she never wanted to disappoint them. We talk about the impact of intensive exposure to other people’s lives on social media and how it may be leading her to idealize what others have accomplished, giving her an acute sense of defeat before she even begins. More ambitious than her parents ever were, she also lacks a road map to achieve her goals. As the first person in her family to attend college, Kat had personal aspirations that seem remote to her now.
Like Kat, many of my clients her age seem stuck in the disconnect between what they imagine their lives could, or should, be and a penetrating sense of the harsh reality that they may never get there. Kat has said on numerous occasions that she doesn’t like having all these “shabby excuses” for feeling so stuck. But I treat lots of millennials, and I can easily see that she’s not alone in feeling this way. Am I framing the conversation wrong with Kat, not really understanding the paralysis?
Indeed, my group of young consultants emphatically underscored that they shared her experience of the tyranny of choice. One noted, for example, that even in rural Vermont, someone with a Tinder account willing to drive 30 miles could have dozens of possible partners for the evening; the potential number of meetings in more populated areas is mind-boggling—enough to make a person just end up staying home.
In a similar vein, another consultant confessed that he watches the same 10 shows over and over on Netflix, because it’s too hard to decide on a new one. A third millennial told me he felt overwhelmed when just picking out a fan for his room: “The amount of research is endless, and you can never make a choice. I look at the contradictory reviews, and that makes it even worse.” Another concurred, “It feels like every choice is going to affect your life. We feel this way about big things and small things. One wrong choice means you missed a better option.”
Now, I’ve begun to grasp that I underestimated what a big deal choosing has become. My frame that was supposed to be encouraging with Kat was actually pretty invalidating: I believed that because she’s young, she could simply right her course if it didn’t work out. I’ve since made several adjustments in my work to help her take hold of her life and approach her paralysis differently.
First, I dive more sensitively into the worst-case scenarios. Specifically, I no longer ask, “What’s the most terrible thing that could happen?” believing that by pondering it, she’d see it might not be the end of the world and would feel emboldened. I understand now that tyrannized-by-choice millennials wanted me to acknowledge the very real, significant costs of committing unwisely. Indeed, when I first entered into a worst-case job conversation with Kat, she made a compelling argument that, given her mountain of debt, the wrong employment choice might actually bury her under it. Now I want to better understand and empathize with how bad it could be.
Second, I work even harder to help her tolerate her paralyzing self-doubt and uncertainty. This means getting her to sit with feelings she doesn’t like talking about and validating that she has good reasons to feel overwhelmed. I’ve used my ignorance mostly to good effect on this score; I really don’t know what it feels like to confront a list of jobs (or prospective partners or causes) this way. By being curious, I engage in a kind of compassionate exposure therapy with her. And even as we focus on finding a better job, I strive to open up space for the novel idea that I value who she is even more than what she ends up doing. For example, before she goes on an interview, I tell her, “Whatever happens tomorrow, you’ll be the same lovely, bright, and talented young woman you are right this moment, and I’ll care about you just the same, too.”
Third, with Kat and my other young adult clients, I now break decisions down into much smaller steps, both to make them more manageable and to be able to view even little decisions as acts of bravery. This attention to courage, wherever it emerges, offers millennials a kind of paradigm shift away from all-or-none deciding and toward valuing steps as accomplishments in their own right. For example, as Kat and I worked on a generic cover letter together, I encouraged her to reflect on how she sees herself, her accomplishments, and her work ethic. She’s been feeling so burdened by life decisions that it’s difficult for her to “brag” about herself; however, crafting the letter itself became a small, significant cause for celebration.
More and more, I talk with millennial clients seriously and lovingly about how they manage the toxic effects of making an inevitably imperfect decision. I acknowledge how fast the world has changed since I came home from school and had to wrangle with my brother about whether we’d be watching Superman or Mr. Ed on our lone TV, which didn’t even have a remote. It’s harder now for many young adults to make all manner of decisions—and older therapists do well to recognize and explore this overwhelming new world with them.
Avery and Instant Gratification
When he manages to get to our appointment—which even with reminders can be a challenge—Avery, age 23, is usually so anxious that he can’t stay seated. He talks to me rapidly as he walks around the room, assembling Legos from a bucket he’s lifted from the play area or fidgeting with his phone. He straightens books on my shelf one moment and knocks over a jar of colored pencils the next. He’s so full of thoughts and feelings that our conversation often darts around much as he does.
Avery works with his dad in construction, which he hates, but he’s a recovering addict with an infant he needs to support, so he’s lucky to have this option. Though he graduated from high school more than five years ago, and boasts about his daughter like the proud papa he is, he often seems to me like a younger teen who’s suddenly realized he’s late for class. The adult world crept up on him quite suddenly, and he’s in a state of bewilderment about how he got here. But he’s committed to being clean and “getting his head right in counseling” so he can see his child. The baby’s mother has established certain terms for contact, and I’m part of the deal.
He’s also trying to stay clear of the bar scene—the preferred venue for socializing 20-somethings in rural New England—so he’s lonely. His friends are all still getting high, and, he claims with a grin, that after extensive research on Tinder, he’s met every attractive female his age in southern Vermont. At more serious moments, he admits that he’s still pretty hung up on his ex, who may not yet be entirely done waiting for him to grow up. I imagine that the years of partying have slowed his development: though he’s in his own apartment, he still brings his laundry to his mother, plays video games in his free time, and lives on fast food. During work, his father keeps Avery’s wallet and keys for him in the glove box of his truck, so they don’t get lost on a job site again.
As is frequently the case with addicts, he doesn’t have much insulation from strong affect. He still needs tangible evidence of a feeling to know he has it—to well up with tears or realize that he’s clenching his fists before he recognizes he’s sad or mad. But he’s come a long way in the last few months, and I frequently remind him of that. Still, without irony, he often asks me to “speed it up!” and help him get a handle on his impulsivity. He wants me to do something painless and transformative with him that will persuade his ex-girlfriend to take him back.
In our work together, I endeavor to slow Avery down, to have whole thoughts, to focus in a deeper way on what he’s experiencing. He’s not manic, but the pace of his expectations is. And his sobriety seems tenuous to me, though I have no reason to believe he’s relapsed in the few months we’ve been meeting. I express concern that that he has so few self-soothing strategies and that many of them, like video games and porn, can be addictive, too, particularly for someone lonely and limited in his tolerance for emotional discomfort.
While Avery’s situation has unique characteristics, his impatience seems generational. Indeed, when one of my daughters comes home to Vermont from Brooklyn, she gripes about my perfectly decent internet speed: “God, it’s taking forever! How can you stand this?” The mere seconds it takes for a page to load seem to feel entirely wasted to her. I realize that the pace of my older life (which, honestly, seems like it’s “loading” at breakneck speed) is as incomprehensible to millennials as their need for immediate results is to me. And when it comes to therapy—slow, confusing, ambiguous, and without any guarantees of satisfaction—the generational divide clearly requires extra attention and exploration.
One millennial therapist I consulted cautioned, “We haven’t had much opportunity to value time and waiting the way you did. Maybe we have unrealistic expectations, but you older therapists should know that we don’t have much tolerance for things taking longer than we expect. We’re less skilled in ‘not-knowing’ than you might imagine.”
The success of online therapy sites, like TalkSpace, that offer help 24/7/365 may be testimony to the millennial’s desire for immediate assistance. Waiting for a therapy appointment is perhaps not a typical experience for a generation that seldom needs to delay gratification. And leave messages on their cell phones at your own peril: voicemail takes too long to listen to, and I’ve learned the hard way that it’s much easier for clients like Avery if I just text information about the next appointment.
After pondering this with my young consultants, one of the conversations I’ve been having with Avery recently focuses more explicitly on how the process of therapy is so different from the rest of his life. I realize that my initial efforts to “set the collaborative frame” was much too goal oriented. I didn’t warn him—as I’d subsequently been advised to do—about the slog he might be signing up for.
When I asked him last week about how closely our sessions allied with his expectations for what would happen, he perched briefly on the arm of the sofa and told me, “Well, people have been telling me my whole life I wasn’t good at talking about my feelings. I thought you’d just give me a few pointers and write a letter saying I was all set. Honestly, I had no idea it would take weeks and weeks and weeks.”
I encouraged him to give me an example of the kinds of pointers he’d expected from me. “Like I should say, ‘I feel angry’ instead of slamming the door,” he posited. I beamed at him silently. Of course he knows how hard it is for him to do just that—and that he’d be skeptical if I ever tried to proffer something so glib. “Okay,” he sighed, flopping down onto an actual seat like he might just stay awhile. “It takes time. I get it.”
Perhaps it’s a secret superpower that I’m so comfortable these days with being clueless. I’m helping Avery become more patient with “not knowing,” too—it’s a great portal into the deeper work of psychotherapy and joins us in curious exploration about, say, angry feelings and doors that somehow stay open.
Avery’s addiction recovery presented an additional area of uncertainty for me. Trained back in the day when addiction specialists and psychotherapists had different domains, I worried that a more integrated approach to his treatment might be an overreach. But the opportunity for addictive behavior is everywhere: substance abuse is just one in a vast array of strategies available to millennials for distraction and sedation.
Contemplating Avery’s therapy from an addiction lens, a young therapist offered additional reasons for an integrated approach: “I think we millennials are particularly attached to the object of our addiction, whatever it is at the time. We’re not sure that a therapy relationship will sustain us without it.” Avery self-medicates to contend with intolerable feelings of stress and anxiety. So it’s on me to show him, in real time, the comfort of human connection—and how slow, deep attachments to people might eventually be even more gratifying than a case of beer or Grand Theft Auto V. It’s an uphill climb because no matter how reliable I am, Avery still has to wait to see me. His other strategies for soothing are right there, the instant he needs them.
Heather and Her Smartphone
I first treated Heather weekly for suicidal depression back when she was struggling in high school. She’d been cruelly bullied on top of having significant learning and attention challenges. At that time, about six years ago, she was thinking about dropping out, running away, or killing herself as the best options she could come up with for dealing with her pain. We connected quickly, and by the time she graduated, she was in a much more stable condition, with plans to move out of town and work in the tourism industry up north.
She’s back now, living mostly with her boyfriend or in the basement of her mother’s home when she needs a break from him. She’s not suicidal, but she’s struggling with some new challenges: passing her LPN exam, which she’s failed twice, and standing up for herself in important relationships. We still have work to do, and based on our histories, I have reason to believe I can help her some more. Except for this: her phone drives me nuts!
Heather never lets go of it. I feel sometimes like I’m doing couples therapy with one inanimate partner—it’s that much of a focus of her attention. More than once, she’s arrived in a panic, begging to borrow my charger because “it’s about to die.” I think I might be found guilty of phonicide if I withhold the cable. But then, not content to leave it to charge on its own, she sprawls on the floor next to the outlet. In sessions, she uses it in a variety of ways: reads me entire transcripts of text-fights with her boyfriend, shows me hazy pictures of her latest travels to see the musician she follows, pulls up YouTube to share videos she thinks I’d enjoy, corresponds with people about plans for the evening, and even answers it if someone calls, so she can tell them, annoyed, “I’m in therapy. Call me later.”
For a while now, I’ve been a tad fed up with the whole arrangement. The phone seems to be diverting her attention away from us, or interfering with the deepening of a conversation. We’ve known each other a long time, so I think I’m also frustrated that she doesn’t trust us to regulate her when she’s getting uncomfortable. When she starts messing with her phone, I suggest, fruitlessly, that it might be interesting if she could just tell me about the “insane” thing her drunk boyfriend wrote, or that I’d be thrilled to hear her full description of the frenzied crowd at the arena. But she brushes me off, saying, “No, no, I want to find it. I want you to see this.” Then we sit together in silence while she taps and scrolls like she’s hunting for Waldo.
Of course, older and younger clients have been pinging, ringing, and dinging their way through plenty of therapy sessions, too. But the millennial relationship with this technology seems most passionate and encompassing. To me, it’s an attachment relationship, and not always the healthiest kind. But this love is here to stay. And I think I can do better, even as an old digital immigrant, making meaning and use of this ubiquitous, beloved object in the therapy room.
The millennials I spoke with about this issue all basically told me to settle down and stop making such a big deal about Heather’s phone use. Following their advice, I’ve stopped being such a fogey about integrating the phone into sessions and found that Heather is using hers in an astonishing number of communicative ways. With my new awareness, I’m now able to be more helpful to her. Here are a few recent examples.
Anxiety. Heather was telling me about the tutor she’d hired to help with exam prep, and suddenly she started worrying she’d somehow missed their session. She dove for her Google Calendar app, swiping with frantic immersion, talking and swearing out loud to herself, head down, panic in action. It was a couple minutes before she tapped it off and, relieved, looked up at me with no idea of what story she’d been telling me. Instead of me patiently reminding her, as I might once have done, we engage in a much more useful discussion of the obvious stress she was under, and what it felt like to be scheduling her time this way. On the spot, we practiced a few of our old favorite grounding exercises from back in the day.
Disconnection. I tend to stick with any given topic longer than Heather has interest in. I often have “just one more question” when she’s abundantly ready to move on to the next thing. We don’t see each other every week, and she stacks up experiences to share with me like salmon at a dam. I now recognize that when her eyes start to slide, none too subtly, down to the screen that perhaps we’re not in it together as much as we were only seconds before. I’ve started using her “slidey eyes” as a nonverbal signal that she has other items on her agenda she’s ready to discuss. I tell her, “Whoops, you’re done with this conversation,” and she invariably concurs enthusiastically before launching into the next topic.
Anger. Heather has come miles in her ability to express anger and advocate for herself, but she’s still working on that. So when she came in on the verge of angry tears, I was prepared to support her in any way I could as she alternately raged about how furious she was with her stepfather for leaving the family dog out in the rain and looked at photos of the dog on her phone.
I observed her going back and forth this way and asked her to tell me what was what’s happening. She replied, “I know I have a right to be mad because Barker is here looking at me, and seeing him all cute and small, I know what he needs me to do.” We talked about how strongly she felt she should advocate for her vulnerable dog—and for herself at times when she wasn’t being treated well. I asked if she had any pictures of herself also looking cute and small: naturally, she did. (It was a good intervention with a phone if I do say so myself.)
Processing Life Events. One of my biggest shifts in practice with Heather has been to use her actual text-fights with her boyfriend to help her problem-solve, role-play, and better see her contribution to the conflict without the distorting bias of memory and reporting. We unpack her responses in the fight, get objective confirmation that she was being treated badly and how that felt, and brainstorm about how to handle the “conversation” next time.
Back in the day, we psychotherapists didn’t have so much real data; we were stuck only with the meaning-making shared by a client, and we thought that was plenty good. Even though I now sound like my father seeing a Walkman for the first time and complaining, “What was so bad about listening to Benny Goodman on the Victrola?” I can see that this new tech-informed approach can lead to a deeper understanding, too.
Also, I’m engaging more directly with Heather and other young clients about their relationships with their phones to be more proactive about meaning-making. I now ask questions like, What can you tell me about your relationship with your phone? How often do you use it? What kinds of things do you do with it? Have you ever tried to use it less? What’s it like for you not to have it with you? What’s it like having to explain all this to a digital immigrant? Did you know that if you swipe right on the compass app, a carpenter’s level appears?
Amelia and the Firehose of Information
Amelia, age 24, is a hard-driving social activist with plenty of causes to keep her up at night. Her father and two little brothers, though they’d probably like to see more of her, are delighted to have her back at home for the year while she saves money and applies to grad school. Her mother died after a prolonged illness when Amelia was still in middle school. Being back home could become emotionally challenging for her, but she focuses on the fact that it’s temporary and tells me she’s too busy to be much help to her father anyway.
Amelia and I meet weekly during her one free hour in the day; she fits me in between her job and a part-time unpaid internship. In the last month, she’s also begun getting up very early to train with a friend for a marathon. In therapy, she’s similarly intense and focused, but surprisingly unskilled in reflecting more deeply. When I ask her to sit for a moment to let feelings rise into awareness, she sighs and looks at the clock. Amelia wants skills to help her sleep better, but it’s hard to get her to become more curious about why it’s so tough for her to sleep in the first place. She tells me her mind races at bedtime, and no wonder—the kid is in overdrive.
A few weeks into our work, I ask Amelia about her consumption of news. It’s dawned on me that my exhortations about good sleep hygiene—like turning off electronics a while before bed—are having surprisingly little effect on her insomnia. She chuckles and then describes a typical day in which she reads and listens to news from several online sources, as well as other incidental inputs she’s exposed to—conversations of friends and family, the radio or TV at home, whatever is up on her social networking sites, and of course, all the chatter at her internship learning about restorative justice.
Like many of my other young adult clients, she’s anxious in part because she’s hyperaware of all the reasons to be anxious. She isn’t able to shut off the firehose of information—and this includes the chyron newsfeed of her own worried, hopeless thoughts. It’s hard not to see the connection between stress and how very awake millennials are to the condition of the world. (I was strongly advised not to use “woke” here, which I still think I’d use correctly.)
Amelia struggles to acknowledge her own suffering, in part because she’s painfully aware of her relative privilege in light of the world’s burdens. She’s torn between self-validation (“what I had to endure was terrible”) and self-recrimination (“compared to those kids being ripped from their parents and stuck in jails on the border, maybe my life isn’t so bad”). I see the impact of coming of age in this crazy time and wonder why my thoughtful, comforting strategies aren’t all that useful.
At times, for example, I’ve tried to reassure Amelia that things will get better: the transition to adulthood doesn’t last forever, and her generation will figure out solutions. I’ve also been moved to shoulder the blame for the world’s woes on behalf of my own profligate generation. My millennial consultants suggested that these deflections are not only unhelpful, but may even do harm, piling on the expectations for them to fix this broken world and carry more of the burden than they already do.
Following this consultation, I’ve made two changes in my approach to working with Amelia. First, I no longer try to take away or diminish her pain by reassuring her that “it’ll get better.” After all, if we’ve learned anything, it’s that none of us know what’s going to happen. So I’ve dispensed with the crystal ball and see my work more simply as helping her become better able to bear her experience, to feel more grounded and connected.
The first time I suggested that there’s a lot that sucks about the world now and I have no idea if it will be okay, Amelia looked at me wide-eyed. But when I asked her how my comment had landed with her, she said with a grin that it was “weirdly satisfying.” I think this opportunity for authentic joining won’t do much to turn off the news firehose that keeps Amelia up at night, but it seemed to help her feel less alone under the pressure.
The second, perhaps subtler, adjustment in my work with her concerns my clearer understanding of why Amelia seems so incurious about her inner world. Like many young women I know, she’s proficient at tuning into the experiences of others, but I’d become frustrated by our lack of progress at increasing her self-awareness and self-compassion. I hadn’t appreciated fully the possibility that I was stumbling along another generational divide. I wonder now if so much millennial effort expended on creating and curating public identity might be coming at the expense of attention to thinking about how it really feels inside.
I recall teaching a first-year grad class on theories of intervention a few years ago and seeing the astonishment of a few fresh-faced students hearing about existential psychotherapy for the first time. With incredulity, they asked, “You mean people go to therapy just to talk about the meaning of life?” Hilarity ensued.Now when I encourage Amelia to become more reflective about her internal experience, I consider how this is a new kind of exploration for her. I don’t think she’s avoiding deeper conversations, but see her struggle as another indicator of a life lived so emphatically reacting to what’s happening out there that she hasn’t made sufficient room for the therapeutic sort of reflection. There’s a road that connects those likes on Instagram to Victor Frankl. I’m newly alert to my role along the route—perhaps beginning with the selfie and leading to the self.
If I were to invent the best possible counterbalance to the weighty anxiety that so many of my young adult clients carry, I might just create something a lot like a reliable psychotherapy relationship. It offers so much that they seem to need. For example, it’s slow, not fast; focuses on internal experience more than outward presentation; and grows tolerance for risk and imperfection.
Here’s one more benefit: embodied attention. Months ago, when I was still agitating about Heather’s smartphone, she’d been a little dismissive with me, scoffing, “Oh, your generation still likes it all IRL.” Once I understood that acronym was shorthand for “in real life,” I valiantly tried to make the case for the difference between relationships that take place on a screen and those that unfold in person. Although Heather listened patiently, I didn’t think that she got much of value from my diatribe.
But a couple weeks ago I got a text from her that indicated some of it may have seeped in. She wrote, “I have some things to talk about IRL. Can I have your next free hour?” We both knew that she was looking for the special solace that’s a rare experience in millennial lives: a cozy hour of compassion and undivided attention, in person and heart to heart.
Want to earn CE hours for reading this? Take the Networker CE Quiz.
ILLUSTRATION © JOHN LUND/GETTY IMAGES
CategoriesIn the Therapy Room Therapy in the Media The Larger Conversation Issues & Developments Anxiety & Depression Clinical Skills & Experience Professional Development Society & Culture The Field
Earn CE Credits
Just for reading the Networker!