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The Freshman 40

August 20, 2012

This week about 20 million students, will be entering freshman or upperclassmen returning to college. Most are young adults. Many will be living away from home for the first time in their lives. Virgin parents in attendance at this rite of passage will get the helicopter parent speech–don’t hover, be happy–from the College President. But there’s one bit of advice that neither parents nor students receive about what I’ve dubbed The Freshman 40.  The Freshman 40 is not that familiar weight gain (that’s the Freshman 15).  The Freshman 40 (a misnomer since it can hit anytime during college years) refers to the estimated percentage of college students who will experience a serious depression. Substance abuse often coincides with depression for this age group. The American Psychological Association released a recent report on the rise of serious mood disorders among college students. The good news is that depressed students who seek help often experience more rapid relief than older adults.

What’s a parent to do? I’m a big fan of talking with your kid and informing him about the signs of depression, and then giving them a tour of the college counseling office. Knowledge and intervention help. While we’re all familiar with that blue feeling that blows over in a few days, depression lingers, deepens, and disables. There are 5 types of depression:

  1. Major depressive disorder affects sleep, appetite and everyday functioning.
  2. Dysthymic disorder is mild and chronic, lasting 2 years or more.
  3. Minor depression looks like major depression with less severe symptoms and is of shorter duration.
  4. Psychotic depression resembles major depression with features of hallucinations and delusions.
  5. Seasonal affective disorder often begins during late fall and winter, lifts by spring.

How to help? First, don’t panic–normalize this for yourself. Your student is not alone. Remember college is a time of rapid transition and of many social as well as academic adjustments. Talk and listen carefully.  Empathize. Don’t pull for only the happy news. From a distance, SKYPE can provide an “eyeball” take of your child’s demeanor. If you’re concerned, encourage your student to visit the college counseling office, or even student health, which can do a baseline assessment. If your student refuses, keep trying, but don’t push–visit. Nothing substitutes for a face-to-face encounter. Early treatment offers important  relief. Your acceptance, support and encouragement will make a difference.

Aurora, Colombine: Mental Illness & School Shootings

July 29, 2012

Following the Aurora massacre,  Dave Cullen, a Columbine reporter reminded us that our first instincts about that earlier shooting were wrong. You may recall that most of the media/nation rushed to the conclusion that this was the act of psychopaths. That’s actually a bit more comforting than imagining that the shooting could have been committed by one of your own teenage children, suffering from a mood disorder; one who entertained suicidal thoughts for more than a year before the killings. Granted the initial judgment was half-right, as the second killer at Columbine had more the profile of a psychopath.  But as a psychologist, I think we owe it to ourselves to understand the context of those kids who become suicidal, then homicidal. 

One quarter of those who have a mood disorder are diagnosed by the age of 14. The rest are diagnosed by the time they’re 26. A significant risk then are those kids, ages 18-26 who no longer live at home, and are no longer overseen by a parent who might catch the early symptoms of distress. Fully 40% of college students will experience a debilitating depression.  Ten percent get help. 

When students are in transition (as Holmes was who had recently fallen off his stellar trajectory of a doctoral pursuit), they are more at risk.  The use of drugs or alcohol add to impulsivity as well. The stringency of reporting danger to self or other requires a high bar, and often when successful, only gets a 3 day hospital admission. And let’s not forget that the vast majority of us with a diagnosable mood disorder are not violent.

We can blame the college or general mental health system. But all mental health systems rely on self-report. I’d suggest that most troubled individuals don’t reveal their premeditated plans, or report a build up of an arsenal of weapons, such as Holmes had. 

While increasing the public knowledge of risk factors in youth is an excellent start,  we also need to ask our elected officials to acknowledge that “the right to bear arms” was a constitutional artifact of the founders’ wish to enable citizens to protect themselves from an overpowering rule by monarchy or dictatorship.  That is no longer the case.  Whet Moser presents a compelling argument for limiting and highly regulating the sale of assault weapons and semi-automatic weapons. There are just as many despairing youth in other countries. Not as many mass murders. 

As you read the tragic  accounts of the victims, and their families, please do not feel helpless. Please do not blame out of that sense of powerlessness. Please respond–the culture and its laws need to change.


NAGGING: Radio Times Interview and Podcast

March 4, 2012

Today* on Radio Times, I’ll be a guest of Marty Moss-Coane.  The topic is nagging.  A recent Wall Street Journal article dubbed nagging, “The Marriage Killer.” Nagging starts benignly enough with a request. When the request is ignored, a pattern begins: The request is repeated with increasing annoyance,with harsher tone, eye rolls, deep sighs on the nagger’s side, and over-promises, resistance, stonewalling or aggressive defensiveness on the naggee’s. Nagging creates a toxic cycle,  and a loser/lose all problem.

Everyone in relationships is familiar with nagging. You’ve either nagged or been nagged. Nagging starts in childhood: “How many times do I have to tell you to clean up your room? Have you done your homework? Did you remember to walk the dog? ” In intimate relationships, nagging also has a parent-child feel. One partner scolds, the other makes excuses, or becomes surly and withdrawn. Not a recipe for romance. While women have the reputation for being nags, it’s an equal-opportunity offense.  Clients in my book refer to nagging as their “stupid fights.” These arguments seem petty, but are damaging because they’re repetitive. Ongoing complaints become personalized. “If you loved me you’d do what I’m asking.”

The genders split over topic. Women more often nag about the home burden, aka the “honey do” list.  “Honey, don’t tell me you forgot to call the repairman again? or “You’re such a slob–you expect me to pick up your dirty, smelly socks off the floor. You’re so disrespectful of me.”  Men more routinely nag about money: ” You went shopping again? How much did you “save” today? “and decreased intimacy: “You’re too tired again? Give me a break.”  The nagging cycle often gets worse with the advent of children, because the tasks on the “to do” list sky-rocket exponentially, while romance may plummet.

Characteristics of naggers include: Planners and organizers, and those with a high attention to detail.

Naggee’s are more often “laid back,” spontaneous, and may have undiagnosed A.D.D.  They often mean-well, but are distractable and poor on delivery.

When the cycle turns into “I can’t count on you/ You’re always on my back,” then relationships falter and may fail.


  1. Think of benign explanations: Not lazy, but forgetful; not doesn’t care, but tired.
  2. Resist the urge to ask repetitively–schedule a weekly business meeting instead.
  3. Don’t promise more than you can deliver.
  4. Create a timetable  or DO IT NOW.
  5. Write notes instead of verbal request that convey irritated tone or annoyed facial expressions.

*Tune in and Call in to Radio Times on Monday, March 6th  from 11 noon, and join the discussion!

Leaving the Garden of Eden: Playing Fair between Parent and Child

February 22, 2012

Last week, Mary Quigley, NYU Professor of Journalism, interviewed me for her terrific blog, Mothering 21: A blog for “parenting”the over-21 set. Mary is an exceptional writer, author and journalist.  We spoke about a range of issues of concern for parents and children (growing and grown). I very much enjoyed speaking with her. Yet, the best interviews surprise me by what I learn about my own views. Towards the end of our interview, Mary asked me, “Is there anything you’d like to add that we haven’t covered?” I replied, without hesitation, ““It’s really important for people to understand that we all operate within a three- generational context of give and take. Some of our expectations on what we expect from our children are based on what was expected of us. We always have to be very careful to evaluate whether what we gave to our parents–and what we got from them–was reasonable or not. Otherwise, you’ll pass along your unfinished business to your own children.”

When children leave “the garden of Eden” of their childhoods, they may leave in a huff–after all, if the garden were too wonderful, you’d never leave. And some young adults do struggle to leave home, either emotionally or physically. Yet, you can’t truly leave the garden by either idealizing or devaluing the relationships that were part of it. To truly grow up, you must return to the garden to weed it. You must understand who the gardeners were; what shaped them, what shaped you, what took root, and how you’ll tend your own garden one day.  

Parents and their children, growing and grown, share and transmit a legacy of relating for the next generation. Despite love, no parent perfectly imagines his or her child, and so hurts them, however unintentionally. It’s not good enough to say, “they did the best they could.” That sentiment allows for love, but stunts growth. Parent-child relationships can continue to grow through and grow beyond injuries by addressing and caring about experiences– whether there was unfairness, painful misunderstandings, unreasonable expectations, feeling unknown or even sometimes unloved.  All these feelings take place alongside love and family loyalty.

I often encourage my clients, long past 21, to imagine their parents in the context of their lives: as a vulnerable child, a sibling, a spouse, and then as a young parent to them. Then take the risk to let their parents now better know, care, and imagine them. Beyond love, you gain closeness, and a better garden to leave the next generation.

New Year’s Resolution: To a Healthy Relationship

January 7, 2012

Many New Year’s resolutions are good for business, because the failed resolutions annually renew themselves.  Stop smoking, eat less, lose weight.  There’s a lot of money to be made (think nicotine patch manufacturers, and gym memberships) from these resolutions that falter as January fades into dreary February.   Did you know that only 3-8% of smokers quit on their own, and that losing weight (and keeping it off) is a lot harder than most of us imagine (think genetics)?  My resolution has to do with your relationship health. Once mastered, it’s a gift that keeps on giving.

‘Tis the season in my office that I have more visits from family members, parents and adult children, who are trying to resolve festering hurts.  Today I read a review of a new book on an old theme:  toxic parents. Admittedly, there are abusive and emotionally destructive people who become parents. But many parent-child relationships can improve.  One reason I transferred from the field of psychology to family therapy was my interest in shifting the focus to what can heal, rather than “name that pathology,” the mainstay of my early training in psychology.

Thirty years ago, my mentor casually tossed off this remark, “It’s in the nature of parent-child relationships for parents to hurt their children.” I thought her statement was breathtaking, distressing and yet liberating. So I was normal. I was a normal former child who’d been injured, and was soon to be a normal parent who despite my very best efforts, sometimes truly failed to imagine my children’s reality. I couldn’t take comfort in how much better a job I would do. Instead, I had to make peace with my parents, their limitations and my own limitations as well. I began a years’ long process of learning their histories, trying to make sense of their perspectives, imagining their realities as young people, young parents, and most importantly talking with them. We talked about the intergenerational sweep of parents and children in our family. We talked about how we each had both loved yet hurt or disappointed each other. From all this, I became wiser, lighter and more loved simultaneously. It wasn’t an easy resolution. I didn’t engage in it as an archaeology dig–let me uncover the past. I resolved to have a more thoughtful present and future. So far, that resolution of 30 years ago has been a good investment. Happy New Year.

Loyalty, Lies and Pedophilia: Best Lessons from Penn State

November 14, 2011

Like many of us, I’ve spent the past week devouring the unfolding child molestation scandal involving Penn State. I’ve also culled what I consider the best ideas and lessons we might draw from this sordid affair that has indicted Sandusky on felony charges, and led to the firing of Joe Paterno, as well as Penn State’s President, and other university administrators. While court proceedings may eventually answer the  legal (rather than moral) issues of Guilt vs. Innocence  it’s up to you and me to learn from this Category 5 moral disaster.

WHY?  Why did apparently good men collude in covering up and inadequately reporting accounts of Sandusky’s molestations?  There’s Loyalty and then diffusion of responsibility.

LOYALTY: If the initial twitter count is correct, 50% of initial tweets thought the Trustees had done the right thing by firing Paterno & others. That leaves about 50% of the culture showing institutional loyalty over the moral care for dreadfully abused children.  Loyalty isn’t always a good thing–it can be misplaced in institutions, as well as in family life.  But loyalty, like justice,  is a primary motivator for behavior.  Misplaced loyalty likely played a part in the complicity of those who had been longterm colleagues of Sandusky.

LESSON: Evaluate what loyalty you owe and to whom. Evaluate your first gut response. Don’t trust it too much. Too often that instinctive first response leads us to believe we’re in the right (and the other side is wrong). This is how wars as well as culture wars start, and how moral outrages are minimized and rationalized.

DIFFUSION OF RESPONSIBILITY is the pass the “hot potato” feeling that you’ve done your job by reporting it to your superior. If more people know, you’re  less likely to feel responsible. It’s the “someone else will take care of it” rationalization.

LESSON: Institutions are not good at policing themselves. In the same decade  that the Penn State scandal was occurring, the Catholic Church was in the news weekly with ever new accounts of pedophilia by priests.Background checks are necessary but not sufficient. After all, pedophiles often prey on the most vulnerable who are reluctant to (or cannot report). Each of us should consider ourselves mandated reporters. As a psychologist and marriage and family therapist, I am a reporter by training, ethics and law. But you could be too. Pick up the phone to Child Protective Services if you suspect or get a report of a child being sexually abused.  Every institution, by law,  should have its own administrators trained in these laws and ethics. Until then, consider yourself a mandated reporter.

Navigating Emotional Transitions in the Second Half of Life

October 16, 2011

This Wednesday, October 19th at 5 p.m.,  Paul Hilt and I will  be presenting an enrichment workshop  in Philadelphia for the Friends Life Care community, on the topic of Navigating Transitions in the Second Half of Life. Although we often anticipate new goals and meaning, more leisure time, and improved social connections in the second half of life; personal and family transitions can make it feel more like a game of 52-card pickup.  There are individual challenges, and then the relationship skills needed to negotiate them fairly.

The individual challenges identified by Hilt & Associates include five crucial emotional aspects of transition in pre-retirement and retirement.

  1. Uncertain Identity
  2. Unstructured Time
  3. Unclear Purpose
  4. Missing Community
  5. Unknown Territory
And that’s only for an individual. Now jump to light-speed, where you have a partner, sometimes a young adult in transition, an aging parent, or grandchildren, and you have a rubiks cube of competing needs to negotiate. Elizabeth Mosier, a fellow Bryn Mawr alum and author, interviewed me for an excellent article she published on this topic. The key to resolving these issues is learning how to be fair. As a family psychologist and relational ethics author and expert, I see many collisions of good and well-meaning people who struggle to find what’s fair. Each of us thinks we know what’s fair, but  when we disagree, we can’t all be right.  I’ll be talking about the intuitive basis of fairness, and where it goes wrong. The most common interpersonal issues in the second half of life include the realities that 55% of us will have a young adult come home to live for more than three months. That a third of us will have an aging parent living with us for more than three months. Women, who got a later start in the workplace, may not be ready to retire when their husbands do. Or one partner may have a dream of fishing all day, while the other has a dream of travel.   What’s fair to one may not feel fair to the other. Who decides and how?
The Wednesday workshop is open to the public. For more information, please call Elise Lamarra at 215-628-8964 or email at: Hope to see you there.