May 17, 2022
Cindy Lopez:
Welcome. My name is Cindy Lopez, the host of this CHC podcast, Voices of Compassion. We hope you find a little courage, feel connected and experience compassion every time you listen.
Growing up is a process of moving toward independence, becoming your own person and meeting your own needs. In our episode today, we talk about launching and the parental role in a child’s transition into adulthood. We know this process looks different for everyone, for some a bumpier or more meandering path than for others. So how can you best prepare your child for a smooth launch? In today’s podcast episode we welcome CHCs chief psychiatrist and medical director Dr. Vidya Krishnan as she shares her expertise, wisdom and practical takeaways for supporting your child now for life on their own, while instilling the confidence that they’ll need to fly. Welcome Dr. Krishnan.
Vidya Krishnan, MD:
Thank you, Cindy. It’s so lovely to be here. One of my most favorite tasks as a child and adolescent psychiatrist is successfully seeing kids launched into adulthood and their eventual future, and I’m happy to be talking about it.
Cindy Lopez:
Thanks so much for being with us today, let’s talk about launching. So for today’s conversation we’re focusing on individuals who are transitioning from a dependence on parents and caregivers to greater independence or some self-sufficiency. So I’m just wondering, what are you seeing in your practice right now and how are people being impacted by this?
Vidya Krishnan, MD:
It’s the eternal question, right? As a species, biologically speaking, that is what the task is: you are born, you’re raised to eventually succeed in the world on your own terms doing what everybody else is doing. Obviously over the years, this has looked very different. I think there are particular challenges that are happening in today’s world that make this a more challenging process for both individuals and families. I would probably like to talk about it both at an individual level, at a parent/caregiver level and maybe even at a family or community level, because each of those things have changes in ways that we are still coming to terms with – like for example at an individual level, I think the divide lies in the digital versus the analog universe if you will, you know, if you’re grazing children who are digital natives, but what has happened is a large part of the world outside is actually still very analog. And I think kids are very surprised to realize that so much of things in the world outside is not completely surrounded in the digital universe, and they find themselves actually out of sync because of that reason. The other important thing when we think of it from a parent caregiver standpoint is that this is a very important developmental stage like all the other milestones we have looked at, whether it’s walking, talking, dancing, singing, whatever it is, when you can do it, how you can do it, this is an important developmental stage, but because of how the world has shifted, what the stage looks like is actually in a big stage of flux right now. It is changing and kind of piggybacking on that, going into the more family community standpoint there has always been this unsaid social contract that somehow a person is fully cooked and ready at age 18 like it’s a magic switch that will just turn on or off at the age of 18 and that brings up with it a lot of said and unsaid expectations, which I think sometimes harms us more than helps us actually.
Cindy Lopez:
I think that expectation of 18, okay, you’re out of the house. You’re on your own. You’re starting college. You’re independent. What if there are individuals who don’t follow that path and for whatever reasons developmentally are just at a different place? So I’m wondering in the context of this conversation what does launching successfully look like? And just based on comments we just made like do we need to change expectations of launching?
Vidya Krishnan, MD:
I agree with you, first to start with what does launching really look like, and what are the components of launching because I think too often we conceptualize launching in a very narrow context where my kid graduates high school and gets into college, launched, right? I shutter to say it, but there’s so many other complex parts of launching that kind of go along with it which include things like, do you know how to budget? Do you know how to use money? Do you know how to independently go through a day? And it sounds simple, but here we’re talking about things like, I wake up to an alarm. I know everything I’ve got to do with the day. I have to take care of myself, I have to do immediate things and long-term things and keep all of these balls constantly juggled in a way that by the end of the week I am at the place I imagined myself wanting to be. It includes for many people negotiating healthcare, health systems, it includes making your family to be, if you will, your relationships, what companionship and friendships look like. It also includes making life direction changes towards determining a career, eventually what will be a source of financial independence. I mean the number of things, it’s a hydra-headed monster almost of all of these moving parts that need to fit in together to make the wheel of launching if you will, and as the world has gotten complicated launching has gotten complicated. So I think we absolutely must change internal and external expectations.
Cindy Lopez:
It’s interesting when you were just talking about managing money and all those things, but even little things like laundry. What if you’re 18 years old going off to college and your clothes have magically appeared on your bed all washed folded for your life and it’s like, oh, well I wonder how that happened or even eating. Lots of individuals go off to college and they’re in a setting where everything is available to them, right? And so there’s just all kinds of elements of what this person will be as they grow in independence. So thinking about all those things, it seems like it can be a complex process because it impacts so many areas of life as we just noted: school, work, health, housing, relationships. So no wonder it can be a stressful time for the individual as well as families. And what are some of the mental health considerations to be aware of during this launching time?
Vidya Krishnan, MD:
I think it helps our cause to start with where you began this conversation. It really helps to think of launching as a really broad and extremely long ramp. It’s not like something that happens overnight. You start thinking about when the kids like in 11th grade or 17 years old, it’s something you start thinking about that you’re building independence related goals, right from the beginning because in a way I know it’s maybe a simplistic or reductionistic way of thinking, but everything that’s worth doing is hard and requires practice. Um launching is just one such thing. When you think of laundry, each of these tasks has many component parts, and if you start this journey when the kid is say six when the clothes might appear magically folded, but if they have to put it back in piles in their closet, or at some age maybe they’re not doing the laundry, but they are responsible to bring their bin to the laundry so that they know it needs to be done, or they’re at an age where they have to press the relevant buttons. So what I’m doing here is I’m breaking up these tasks, all of them, into age developmental stage-related little, little, little tiny bits where every weekend maybe you spend 10 minutes doing this thing that actually cumulatively makes up the various pokes of the launching wheel. And I can give you examples of something like this and almost every thing that you talked about where you meet the child slowly more responsible for smaller bits, right? Today, you start doing it and then once that is yours that becomes part of your recipe, not unlike say you’re building a complicated lasagna – sheet by sheet layer by layer you build it up until you have the whole lasagna, if you will, or enchilada, if that’s what you prefer. But mental health is a good one for various reasons when this ramp is either filled with a lot of potholes or the journey is not going as anticipated even when all of these little efforts have been made over a very long period of time, it creates a lot of stress and relationship conflict, right, because there’s anger, resentment on both parties because the parents want the child to take ownership. The child wants to have ownership and wants the parent not to be involved because that is the developmental and the social contract seemingly and then it creates a lot of tension and then everybody is kind of in a crisis situation, they’re feeling like, oh my god, what is happening here? How will we manage this? But again, the answer to that, you know, is you go back to the basics. What I mean by that is you still have to build Rome one brick at a time. So even in that situation, it’s not like you’re going to be able to full heartedly download an app that will suddenly teach this child all of these skills, and they’ll just open these files and it’ll all just be there. It still is one skill at a time, one brick at a time, but because the person is now 17, not six it goes a little faster when you try it.
Mike:
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Cindy Lopez:
So, we talked about launching, we talked about what the areas of life that it impacts and mental health. We’re at CHC so let’s talk about learning differences. What happens when you layer on any learning differences or learning challenges to this period of time in life? How does that impact it?
Vidya Krishnan, MD:
Significantly, right? Because by definition learning difference means that this person learns differently. It’s pretty much in the word. I think the best way to approach it is the way we approach it for education. What do we do for kids with learning differences? We modify the education in a way that it’s digestible to this person. What we’re seeing here with learning differences is that this person learns differently, not that they’re incapable of learning. It’s a very important, significant distinction. The same is true for other parts of life. What you have to do in these circumstances is you have to teach them and to train them in a way they learn best. Say, for example, me as a person, doesn’t have a learning difference, let’s assume, maybe I was taught to adult in a very specific manner. I may not be able to copy paste that and do that to my child who may have a learning difference. This is definitely one of those circumstances where they may need to be a little bit of a reinvention of the wheel to figure out how is my child going to adult, what are my target symptoms and how do I do that in a successful manner that will work for them. And you don’t have to completely reinvent it in the sense that there are other parents, other people who have carved the path before you who have done it with their children who may have useful things to share. I was actually listening to two actually wonderful podcasts that were done by Nicole Ofiesh, who is the director for the Schwab Learning Center; she talked about managing some of these college transitions. And had some really interesting ideas in there. So there are other people, amazing well knowledged people in the world who have things to offer, which we can obviously borrow from.
Cindy Lopez:
Yeah, and it’s interesting I read about some research or some studies that showed that for transition aged adolescents with learning differences that they experienced significantly more anxiety than their peers without learning differences. Similarly some kids with learning differences also can lack some social skills. So if they’re lacking some social connectedness, they’re more likely to experience that anxiety. So it’s just interesting that an already potentially anxious time of your life can be even more so because of learning differences or learning challenges.
Vidya Krishnan, MD:
Yeah, no, I agree. It can definitely make it all compounded because of how busy and full your plate gets when you’re talking about this. And if each of those skills on the plate, you have to put extra time, energy and effort into learning, and let’s not forget what we’ve not talked about here as while you’re doing all this you’re seemingly also keeping your academic life on track and all kinds of other things. So one can only imagine this is a very burdensome and a very heavy plate, and I think that is where going back to where we started this conversation, the management of expectations is that I think we make life harder for ourselves when we put these really rigid expectations of what the transition ought to look like and what timeline it needs to be finished in and when you’re really kind to ourselves and be like, you know, what if the goal is insight and the light is at the end of the tunnel, if the timeline varies a little bit and does the pathway looks a little bit more meandering that just got to be okay, and we have to first stop judging ourselves as parents, as caregivers, as children and model that for the children by saying, you know what, we’ll get there. We are going there. We are getting there. It’s just going to look very, very different, and I think it’s not going to fix the anxiety, but it definitely can help to know that you have people in your corner who are looking out for you and who understand.
Cindy Lopez:
Yeah, yeah. And just acknowledging, you just mentioned that meandering path, it’s going to look different and every body is different. So it should look different and Dr. Krishnan, you talked about some of the things that parents or caregivers can do to kind of scaffold the process right of learning like to do laundry, for example. I’m wondering for our listeners how can they most effectively support their young adults as they launch?
Vidya Krishnan, MD:
There are many, many things one can do. The unfortunate reality is that I think maybe a decade or two ago, some of these things were woven into the regular high school education, basic cooking skills were taught in school or basic budgeting was taught in school. The pressure of modern academics has gotten to a point where all of this has had to be subsumed and taken away from it and replaced by academic classes which puts a large part of the burden of teaching these skills completely on parents, which is different than it used to be a generation or more ago, and I think that is one of the challenges, but I think we have something to borrow there, right? Because those are the skills that we are now teaching. So working on certain basic things.
I basically will tell parents, put together a recipe book with five, very, very simple things that you can teach your child to make, which they are open to eating, which are balanced meals. You need to teach them how to prep that in the easiest, simplest possible manner because learning to cook is an important skill. The other thing even if you’ve never done it, I think it’s worthwhile to do it if you can afford to do it is actually have an experience when you’re old enough to actually take public transportation to get somewhere. It has so many multitudes of skills that are required to come together in just the right way where you’re just problem solving and figuring things out along the way. So facilitating that and being like, at the summer, you know what, we’ll give you some money. You go to point Z and come back and you figure out how you get there and how you get back, right, or you know, a good composite would be getting a job because it teaches you multiple of the skills we’ve talked about or doing a volunteer or a paid internship of some kind if you can manage to do that.
The other thing is if you have anybody who’ll take you to be able to stay away from home, like go and stay somewhere else with anybody else by yourself. Like go live with somebody else. Maybe it’s a grandparent, a family friend, who’s somewhere else and you go travel there, you pack for yourself. You go stay at their home for a week or so, you come back, you will realize how many things you have to do on your own. And there’s so many organizational kinds of things that come up with this. The other one I tell parents, I definitely do this with my kids, and I think it’s a useful life experience. I make my children use real money. I actually don’t let them use plastic because I think you know how much you can afford when there’s no limit on that card. It’s easier to spend money and not realize how much things really cost and how much do I have money for. So I always tell people, make your children live within their means, even if it’s not necessary, because it’s a really, really useful skill to have.
Cindy Lopez:
So if they go, like you just mentioned, like go away for a week, stay with a friend, a relative, somebody like get there on your own, pack, do it on your own and come back, and when they come back is it important to kind of debrief that process with them so that they start to cement some of that learning?
Vidya Krishnan, MD:
Definitely in terms of debriefing, I will actually pre-brief in fact, not just debrief. What I’ll say is that this is the purpose. This is why we’re doing it. It’s a project you know, I think putting that context in saying that I trust that you are ready for adulting because all of this begins from a place of trust, respect and mutual responsibility. And when you, as a parent say, I think you’re ready to do this, here take some money, go travel to person A, B or C. It basically demonstrates your confidence in your child, which again, going back to that anxiety you spoke about is so meaningful because sometimes the child is scared. They think my parents are doing all this for me because they think I’m incapable of doing it, right? And the only way to learn whether for the better or the worse is by doing. And then that debrief is an amazing thing to bring back into looking at, okay this was a thought experiment and now we’ve tried an experiment. So, what was easy? What was hard for you? Because now we know what worked and what didn’t work. Any future plans can focus a little bit more of where you need the support as compared to where you clearly have mastered the skills, which makes your life as a parent so much easier because you’re learning as they are learning as to how you can help them better.
Cindy Lopez:
I don’t think parents really think about having to teach their kids these things, right, but it makes so much sense.
We were just talking about things that parents or caregivers can do to support their kids or their young adults as they transition or launch. I’m wondering, looking at the individual who is launching, what can they do? Are there some strategies or tools that you might share that they could use?
Vidya Krishnan, MD:
My favorite thing is just like having the puberty talk or all of these other important talks, I think having an independence talk is also just as important at some particular stage in life and my favorite terminology for it, and it’s not something I coined, I don’t think it’s in any particular book, but I’d like to call it strategic individuation. What I mean by that is each kid has this hope and goal that I want to go away and do these things. And if you’re planful about how you want to do that individuation, it’s a journey and a process that an individual can take full charge of, right? They say, okay, this is where I’m going, this is what I need to do, and to be open to working with their caregivers, other people as to how they are going to move through these processes and what they’re ready for and what they’re not. So when I say this, the reason I bring it up is I want it to be a journey that the individual is the driver of the bus. The parents might set all these things up, but the doing is the individual. So I think if your approach is strategic individuation you have all these tools, the bus is full, your parents are ready. It’s your journey to take the bus where you want the bus to go and how you want to make the journey and craft the journey. And that could be the conversation that the parents and the children are having. Okay, I’m ready for this. I’m not ready for that. I feel totally overwhelmed with this. So maybe then as a parent, okay, break it down further kind of how do we do that? So I think having that at least thought leadership from the individual is super, super helpful.
Cindy Lopez:
You shared so many great things. You shared from understanding that individuals are individuals and this launching thing looks different. You shared how parents can start teaching independence with some skills and some strategies and tools. I’m wondering what else would you like to say to our listeners as we wrap up this episode?
Vidya Krishnan, MD:
Number one is do not feel shy to set up structures and systems in place that somebody can then launch off of, right? If you set up a structure and a system and the kid needs to just operate within the system, they don’t have to create that system. I find that kids really do much better.
The second thing is if your child will let you…continuing for a little bit of time, helping them with their health-related things, because that system is so complicated to navigate that, you know, it can bring tears to the eyes of adults. You don’t have to be involved in what they’re actually telling their doctor, but if you want to help in terms of coordinating, setting up people, particularly for children who have mental health challenges or other things so that that doesn’t fall through the cracks because the last thing you want in the middle of all this is because they didn’t connect with the doctor or didn’t follow up adequately, you know, their mental health deteriorates to a point where it kind of sabotages the whole process.
And the last one is we talked about learning differences and typical children. I also want to bring in kids who are neuro-atypical in other ways, besides having a learning difference. And even in those children based on ability what we want to do is to take this independence process as far as you possibly can. Cause we always surprise ourselves with how much kids are really capable of doing. And the reason for it is every child, no matter who they are really likes to feel as connected as they possibly can and have as much freedom as they possibly can.
Cindy Lopez:
Yeah and I think that’s so important, and you mentioned this previously, too, in your comments that the more that the parents can give the child, the more responsibility, the greater independence that also builds the child’s confidence, right because they’re thinking, okay, well, mom and dad are given this to me. They must think I could do it. So I’m just going to do it. Such an important conversation, such an important time of life.
Thank you Dr. Krishnan for sharing with us today, your expertise, your insights and to our listeners just want you to know one of the things that Dr. Krishnan mentioned was our Schwab Learning Center, and the Schwab Learning Center is at CHC and available to students who need some additional help, you can also access therapy services for your young adult at CHC, you can reach us at 650-688-3625 or email the care team at careteam@chconline.org and to our listeners, thank you for joining us as well, and we hope you next week.
Vidya Krishnan, MD:
Thank you.
Cindy Lopez: Visit us online at podcast.chconline.org. Make sure to subscribe to Voices of Compassion so you never miss an episode and we’d love it if you’d leave us a rating and review. Have a question? Send us an email or a voice memo at podcasts@chconline.org. We’re here for you when you need us.
