I recently had a discussion with a colleague that got me thinking about case that I’d like to share. I was at my office in mid-October, as autumn was descending upon us, when I got a phone call from from an alarmed mom. She described her daughter, a freshman at college in New York, as “depressed” and in “need of medication”. The mother, who lived in Los Angeles, had gotten my name from a friend, whose family had recently seen me for therapy.
I told the mother I didn’t prescribe medication, but I would be happy to see the daughter for an evaluation. Since the mother indicated that her daughter was in crisis, I agreed to meet with her at the end of my office hours that day.
When my bell rang at 9 p.m., a robust-looking 18 year old walked into my office , accompanied by her aunt–her mother’s half-sister–who happened to be in town helping a family member who had just given birth. As they settled themselves into my office couch, the young woman, Leah, began to talk about her very rocky start as a college freshman.
She said she had been crying and in distress since September. She was now on her second college, having transferred from the first school shortly after the semester started. Both schools were high-quality, “artsy” schools-which theoretically should have been a good fit, but she felt alienated and unhappy.
Her aunt clearly empathized with Leah’s unhappiness. She worried when Leah interviewed at the first school in the summer, with no students present. She knew that Leah wouldn’t get a real “feel” for the school that way. Leah and her aunt seemed to enjoy a relaxed, open sort of relationship. Leah also “adored” her mother, and had a less close but loving relationship with her father. Leah’s older sister sounded like more of a straight-arrow, sailing through college without complaint or obvious distress. She and Leah were not especially close, though not in any real conflict.
Leah’s parents divorced about ten years prior, and they apparently enjoyed a cordial post-divorce relationship. Dad’s current girlfriend was a “nightmare” according to both Leah and her aunt. Leah’s mom had ended an earlier romantic relationship with a nasty-sounding guy–a relationship that proved stressful for everyone. This past year, her mom had gotten “serious” with a great guy who won the family’s approval. Leah talked about feeling good about this new relationship.
The most striking thing about Leah, in contrast to what I expected, was her composure. This young woman was very open and in touch with her unhappiness, and spoke thoughtfully about all that’s she’s been through. She talked about the recent selling of the family’s summer home in Vermont which had always been an anchor for her. It seemed to me that she arrived in New York somewhat off-balance, and it went downhill from here.
Though her Dad, a high-powered film guy in Los Angeles, worried about “how it would look” if Leah left college, Leah herself wasn’t much concerned about this. She was actually quite a competent young woman, having single-handedly arranged the college transfer, and now was involved in exploring possible internship and job prospects in L.A. She had researched the issue of financial reimbursement for her father regarding college expenses. She was remarkably unconfused and clear-headed about what she needed. She might has well have been wearing a big “PAUSE” sign on her forehead.
Leah’s aunt concurred that her niece was a terrific, competent kid that would benefit greatly by not forcing the issue of college at this point. Our interview had assured me that Leah’s college distress did not represent a covert worry about her parents. Some times parents send subtle SOS signals that it is dangerous for the child to leave home. Excessive parental/marital anxiety may at times be “contagious”, unconsciously transmitted to the child. Or the young adult may be caught in the parental triangle, inducted as an emotional care-taker, which can make it difficult to focus on their own lives. None of this appeared to be the case with Leah.
I got a call from the Mom the next day thanking me for the session. She said both Leah and the aunt felt good about our meeting, and that Mom agreed that Leah should take some time out to figure out her next moves. Mom’s voice sounded much lighter.
It’s interesting to think that Mom’s initial, not uncommon, reaction, was that her daughter needed medication. If fact, Leah’s unhappiness WAS her medication. Her unhappiness helped her to know what she wanted, and what she needed. Not covering over her unhappiness with medication allowed this young woman’s growing process to continue unimpeded. She needed the feedback of her discomfort to guide her and shape her direction. Medication doesn’t get better than that.
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