Failure to thrive - Mid and late 20s

[Anonymous]

So they likely have hyperactive ADHD, at minimum (your "handful" gives it away), and are in dire need of a psychiatric consult and medication.

ADHD is a condition where neurotransmitters don't fulfill their function of communicating between neurons. They either do it too much, or too little. Hence the problems with impulsivity, disorganization, tardiness and possible emotional disregulation.

So start there. You may have to pay for their consults and meds at first, until they get into better habits and find jobs.

[Anonymous]

Anonymous wrote:I am a therapist who specializes in failure-to-launch patients in their 20s. Many of them have personality disorders (especially narcissistic personality disorder) that create difficulties in work and romance.

Narcissistic Personality Disorder basically forces someone's personality to have a "grandiose" self and a "vulnerable" self. This often presents as failure to launch since 20-somethings will have a false sense of grandiosity (since most failure-to-launch cases are still on their parents' payroll and aren't withtaking the proper role of adulthood and financial independence) as well as a fragile sense of vulnerability (many of these failure-to-launch patients had demanding "Tiger" parents who had unrealistically high expectations for their kids and instilled a deep sense of shame in them if they failed to reach said high expectations).

This leads to paralyzing amounts of self-absorbent and self-pity that often prevent launching. I use a form of therapy called Transference-Focused Psychotherapy with my patients to help them develop a realistic sense of self that can withstand the challenges of financial independence, work, and romance. I also incorporate CBT and DBT techniques when helpful as well.

These presentations are merely consequences of ADHD and autism, which are the medical conditions behind it. I strongly disagree that most failure to launch people have NPD. Some of them, no doubt. But the majority have autism-related learning disorders. Did you know, for example, that while ADHD exists as a stand-alone diagnosis, there are very few cases of autism without anxiety and ADHD symptoms?

[Anonymous]

Anonymous wrote:I am a therapist who specializes in failure-to-launch patients in their 20s. Many of them have personality disorders (especially narcissistic personality disorder) that create difficulties in work and romance.

Narcissistic Personality Disorder basically forces someone's personality to have a "grandiose" self and a "vulnerable" self. This often presents as failure to launch since 20-somethings will have a false sense of grandiosity (since most failure-to-launch cases are still on their parents' payroll and aren't withtaking the proper role of adulthood and financial independence) as well as a fragile sense of vulnerability (many of these failure-to-launch patients had demanding "Tiger" parents who had unrealistically high expectations for their kids and instilled a deep sense of shame in them if they failed to reach said high expectations).

This leads to paralyzing amounts of self-absorbent and self-pity that often prevent launching. I use a form of therapy called Transference-Focused Psychotherapy with my patients to help them develop a realistic sense of self that can withstand the challenges of financial independence, work, and romance. I also incorporate CBT and DBT techniques when helpful as well.

Very interesting. Do any of your clients ever “launch” and go on to lives they are happy with and objective people would deem reasonably successful?

[Anonymous]

Anonymous wrote:And that is why I judge families with too many kids to raise properly. Quality over quantity for the win.

Maybe the two duds are the two oldest. Then OP would be stuck with only deadbeat children.

[Anonymous]

I think the responses here are harsh

[Anonymous]

Everyone I know with failure to thrive kids is giving these same kids money.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I am a therapist who specializes in failure-to-launch patients in their 20s. Many of them have personality disorders (especially narcissistic personality disorder) that create difficulties in work and romance.

Narcissistic Personality Disorder basically forces someone's personality to have a "grandiose" self and a "vulnerable" self. This often presents as failure to launch since 20-somethings will have a false sense of grandiosity (since most failure-to-launch cases are still on their parents' payroll and aren't withtaking the proper role of adulthood and financial independence) as well as a fragile sense of vulnerability (many of these failure-to-launch patients had demanding "Tiger" parents who had unrealistically high expectations for their kids and instilled a deep sense of shame in them if they failed to reach said high expectations).

This leads to paralyzing amounts of self-absorbent and self-pity that often prevent launching. I use a form of therapy called Transference-Focused Psychotherapy with my patients to help them develop a realistic sense of self that can withstand the challenges of financial independence, work, and romance. I also incorporate CBT and DBT techniques when helpful as well.

These presentations are merely consequences of ADHD and autism, which are the medical conditions behind it. I strongly disagree that most failure to launch people have NPD. Some of them, no doubt. But the majority have autism-related learning disorders. Did you know, for example, that while ADHD exists as a stand-alone diagnosis, there are very few cases of autism without anxiety and ADHD symptoms?

I have a child who I know has autism, adhd, and anxiety and now depression as well. They do present narcissistic because they can't do a whole person analysis of themselves or anyone else. I feel terrible for them and it's a strain on our family but there really aren't a lot of therapists that understand this behavior. The schools don't understand it. It feels like we've hit a dead end. All they know how to do is give medication. PP who is the therapist? Where do you work out of? I think the poster was spot on that these are neurological issues that aren't easily solved and the cause behind the behavior.

[Anonymous]

Anonymous wrote:Everyone I know with failure to thrive kids is giving these same kids money.

Likely true but have some compassion. Some of them are brats and can do well on their own but just want to blame anyone but themselves. Others have disabilities that the school system just didn't provide for. With kids that are disabled for life it may be ok that the school system doesn't give them everything because the parents will be taking care of them forever or the state. I mean it's a huge strain on them but the school system can just say that it was beyond their ability and no one is expecting these kids to launch and thrive. There is an entire other group of disabilities that has very little support and they are expected by society to launch anyway. A lot of times money is the only way a parent can care for a child like this knowing that they are not well enough to make enough to support themselves. Would you rather them on the street? We have a lot more disabled than what people currently think of the adult population. Many of these people live at home or are supported at home. They can barely handle a job and paying for their incidentals.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I am a therapist who specializes in failure-to-launch patients in their 20s. Many of them have personality disorders (especially narcissistic personality disorder) that create difficulties in work and romance.

Narcissistic Personality Disorder basically forces someone's personality to have a "grandiose" self and a "vulnerable" self. This often presents as failure to launch since 20-somethings will have a false sense of grandiosity (since most failure-to-launch cases are still on their parents' payroll and aren't withtaking the proper role of adulthood and financial independence) as well as a fragile sense of vulnerability (many of these failure-to-launch patients had demanding "Tiger" parents who had unrealistically high expectations for their kids and instilled a deep sense of shame in them if they failed to reach said high expectations).

This leads to paralyzing amounts of self-absorbent and self-pity that often prevent launching. I use a form of therapy called Transference-Focused Psychotherapy with my patients to help them develop a realistic sense of self that can withstand the challenges of financial independence, work, and romance. I also incorporate CBT and DBT techniques when helpful as well.

Very interesting. Do any of your clients ever “launch” and go on to lives they are happy with and objective people would deem reasonably successful?

Therapist PP here. Most of my clients, if they stick with therapy, go on to “launch” and have fulfilling lives both professionally and personally. That being said, this type of therapy usually takes place for at least two years and is pretty demanding on the client.

[Anonymous]

Everyone screaming mental illness might wind up being off base. Remember that the average IQ is 100. Even someone with that IQ will struggle through school. Under that? You're going to struggle with life in general. Now consider how many people have an IQ in that range.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I am a therapist who specializes in failure-to-launch patients in their 20s. Many of them have personality disorders (especially narcissistic personality disorder) that create difficulties in work and romance.

Narcissistic Personality Disorder basically forces someone's personality to have a "grandiose" self and a "vulnerable" self. This often presents as failure to launch since 20-somethings will have a false sense of grandiosity (since most failure-to-launch cases are still on their parents' payroll and aren't withtaking the proper role of adulthood and financial independence) as well as a fragile sense of vulnerability (many of these failure-to-launch patients had demanding "Tiger" parents who had unrealistically high expectations for their kids and instilled a deep sense of shame in them if they failed to reach said high expectations).

This leads to paralyzing amounts of self-absorbent and self-pity that often prevent launching. I use a form of therapy called Transference-Focused Psychotherapy with my patients to help them develop a realistic sense of self that can withstand the challenges of financial independence, work, and romance. I also incorporate CBT and DBT techniques when helpful as well.

These presentations are merely consequences of ADHD and autism, which are the medical conditions behind it. I strongly disagree that most failure to launch people have NPD. Some of them, no doubt. But the majority have autism-related learning disorders. Did you know, for example, that while ADHD exists as a stand-alone diagnosis, there are very few cases of autism without anxiety and ADHD symptoms?

I have a child who I know has autism, adhd, and anxiety and now depression as well. They do present narcissistic because they can't do a whole person analysis of themselves or anyone else. I feel terrible for them and it's a strain on our family but there really aren't a lot of therapists that understand this behavior. The schools don't understand it. It feels like we've hit a dead end. All they know how to do is give medication. PP who is the therapist? Where do you work out of? I think the poster was spot on that these are neurological issues that aren't easily solved and the cause behind the behavior.

Therapist PP here. The inability to do a whole person analysis of themselves or anyone else is a key sign of Narcissistic Personality Disorder. One of the most important questions we ask in the assessment is “describe yourself, and describe your best friend.” If these descriptions are superficial or self-extended or extremely one-sided (either all very positive or negative), it’s a sign of an unintegrated personality between your grandiose and vulnerable self.

I work out of NYC, as do the vast majority of therapists who specialize in this. Other major metro areas like DC or SF have a severe shortage of TFP therapists — I was just talking to a TFP therapist in Chicago who mentioned that she was one of only two therapists in Chicago who deal with Narcissistic Personality Disorder.

Yes, these people often have neurological issues that are not easily changed and cause most behavior deficits. TFP by definition is a very lengthy process (twice a week for at least two years), and change is initially very slow. The therapy itself is pretty demanding of clients.

Please be gentle with yourself as a patient. This is a very difficult, but a fixable problem.

[Anonymous]

Anonymous wrote:I think the responses here are harsh

Yeah, well my life is harsh and tough.

Speak your truth.

Don’t stifle others’ truth.