I'm not sure I understand what the video has to do with trauma-related disability - that certainly is not what I intend with it.

Practitioners, including those at my clinic, may see the young adult, the parent(s), or both. Some of our work with caregivers is to help them step back and avoid undermining their YA's independence by doing things that the YA has already shown they are able to do. This is also an issue in disability, chronic pain, and depression treatment. Family may inadvertently support the problem more than the YA out of concern. For the YA there are many aspects of support, depending on the specifics of the situation, and I have outlined some of these in other videos in the "Failure to Launch" playlist on this channel. You raise, as many do (and all notice), the issue of depression/anxiety in situations like this. The challenge here is that depressive or anxious symptoms are fairly natural consequences of the avoidant/withdrawn lifestyle. We expect them. They may be more a sign of the individual's normality than of any disorder. See CGP Grey's take on this - "7 Ways to Maximize Misery" - which is based on my book How to be Miserable: 40 Strategies You Already Use. ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-LO1mTELoj6o.html However, this raises the question of WHY the YA is withdrawing/avoiding, and the possibility that the anxiety and depression preceded and caused the withdrawal. For many YAs in this situation, this is clearly the case. Shouldn't we treat the underlying issues first? The distinction would be crucial to make if the treatments for depression/anxiety and for avoidant withdrawal were incompatible with one another, but it turns out they are not. In depression, the most evidence-based strategies involve lifestyle stabilization (sleep cycle, exercise, diet, substances, screen time), gradual behaviour activation, distress tolerance work, cognitive therapy, and social contact enhancement. For most forms of anxiety, much the same is undertaken, plus graduated exposure therapy with behavioural experiments. For delayed independence, all of the same strategies are recommended. There are usually (perhaps always) other issues as well - past difficult experiences, family issues, and so on - but these add to the core elements of therapy rather than substituting for them. The trap for parents, clinicians, and YAs is to get lost in an extensive (possibly years-long) investigation of underlying issues before commencing this core work. This leaves the problem in place and allows it to become more entrenched and more difficult to escape. One of the principles of this work is "If nothing changes, it's getting worse." In other words, the avoidant/withdrawn lifestyle is becoming more embedded in the individual's life, self-image, and habitual way of being. By focussing on past or hypothesized underlying issues to the exclusion of present-focussed change, or as a prerequisite to it (instead of working on both in parallel), we run the risk of supporting the withdrawal rather than the health of the YA. This is exactly the trap that parents and YAs themselves can fall into and that therapy is designed to help them escape.

You’re right. TikTok is faster moving. Plus: puppies!

I would not characterize adult life as cold brutality, for the most part. This seems to buy into the idea that failure is somehow damaging or brutal. The goal isn't so much to build up a tough wall or make oneself impervious while cruel fate batters our battlements. It is more about opening up to the realization that much in life requires multiple learning attempts, and that some paths will prove blocked while others open up to us. More equanimity and less gritting of the teeth.

The book is currently on hold, though I have made an online video course for parents (psychologysalon.teachable.com/p/parent-trap) and have a design for another for young adults. Will be presenting on delayed transition to adult independence at the Canadian Psychological Association convention shortly, and visiting Japan in fall and hope to meet with Japanese providers working with hikikomori. One way of dealing with the topic of this video (that perhaps I should have mentioned) is to look at multiple paths forward, given that any one path may be blocked in one way or another.

@@RandyPaterson Actually been in Tokyo for most of my life. Among my kids’ classmates, such cases were not uncommon. These days, things are better than they were (because more resources are being put into dealing with such children - Japan is a super-aging society with a collapsing birth rate - thus such kids are no longer ignored as collateral damage). Back in the day, education was seen as an elevator in this country, kids were expected to get on it and rise to the top (the right university and job).

One strategy that many use is to get out of bed if they sense that they are not going to get back to sleep quickly. Get dressed, start the day. Avoid napping during the day, no matter how drowsy they are. Then go to bed at their regular time. This can lead to several drowsy days, but typically the need for sleep will result in wakening somewhat later. Lying in bed trying to get back to sleep means associating your bedroom with wakefulness, not sleep, which is not helpful. Sleep stabilization is generally achievable, but usually only with effort and tolerance for at least several days when things seem worse rather than better.

You're absolutely correct that humans are social beings and that isolation is depressogenic for the vast majority of people. That said, placing a resolution to anhedonia in the hands of others (I need to be validated and loved by people other than me) can promote a sense of helplessness. The key for many is to shift that power away from others and to oneself, by working on a combination of acceptance (of a lack of interest and enjoyment) and activity (doing things on a small scale that one used to enjoy, or things that accord with one's values regardless of whether enjoyment is a part of that). Generally these activities will take a person out of isolation and into an environment where they may receive some validation and affection that can be a further boost.

Try this: Maybe nothing is wrong with you…. Maybe the weed doesn’t motivate you .. Maybe it’s not that psychiatrist’s fault. Don’t wait on life because it doesn’t wait on you. Find a job you would like to do, get good at it, success will follow

Not as exhausting as doing everything every salesperson, committee, and family member wants you to do.

That’s also true 👍

When we are distracted, it is most often by something that resides entirely within our own minds. We are with friends and begin thinking of work tomorrow, or our financial situation, or those medical tests we haven’t got back yet, or what these people might be thinking of us in the invisible recesses of their minds. By returning to our sensory reality - even a small bit of it, like the sensation of water on our hand - we are attending to something real and present. By practicing the return to the sensory present, we can get better at it. We can recognize more quickly when we have voyaged off into outer space or the imaginary future, and more readily return to the less dramatic, less scary, actuality of our life in the moment.

During anhedonia all things can indeed seem equally unpleasant. The idea here is that many people have a sense of how they would be living their life if they were somehow, magically, feeling well, engaged, and active. "Usually I like walking but now I can't be bothered - I guess if I felt good that imaginary person would be out walking a few times a week." Most of this is based on past experience, if there was a time when the person was not anhedonic. "I liked music, seeing movies, cooking, reading novels, but now they all seem blah." The trap in this is the temptation to identify possible or likely elements of the currently-mythical "well life," then shift the attention to one's mood to see if these imagined possibilities "charge me up." In my experience they seldom do so. There is no draw, or appeal. This is a poor guide, however, to what actually happens down the road. If, despite this, the person can begin doing them to at least some small degree, there is likewise seldom an immediate emotional payoff. It is only with time - and often with other anti-depressive strategies as well (exercise, proper nutrition, working on sleep cycle) - that mocking little flickers of the old enjoyment begin to appear - and only when we aren't looking for them. These can then grow. Every practitioner wishes there was a sure-fire strategy that worked for everyone, but so far there is not. This is one reason that dedicated in-person work with a registered healthcare professional can be a great help. It is always possible that a formerly-loved activity (eg blacksmithing?) does not become fulfilling again, though it is also possible that it may be helping, just not enough. And if a person has never experienced positive emotional reactivity to events (ie not been anhedonic), then another approach may be more helpful.

@@RandyPaterson I am just discontent that it is taking so long. People tell me that you can get over anhedonia in months. I am in my third year now with little progress. I did laugh the other day. It was not something i would be proud to tell most people as I laughed at someone's embarrassment and potential injury.

It’s a common idea that so-called “failure to launch” is all about whether people live in multigenerational households or on their own. But that really isn’t the issue. There is nothing wrong with multigenerational living. The issue is whether the young adult is able to function as an adult and contribute on an equal basis with the other adults in the home. The difficulty talked about here is that many young adults function at an extreme level of disability, not working, not training, fearful of leaving the home, spending most of the day in avoidant activity, lacking many basic life skills, their social skills eroding from disuse, and relying entirely on aging parents for food, finances, meal prep, household maintenance, and more. Some use the term “shut-ins.”

@@RandyPatersonjust 4 asking your opinion. Is it worse to be a shut in or a ghetto lost drug addict? Is it worse video gaming and under employment or going to bad neighborhoods and getting high with bad companies?

I think I recall playing this kind of game when I was eight. That was a while ago, and I no longer find it interesting.

@@RandyPaterson no games man. I grew up in Mexico there’s a lot of crime. Being honest with you, I believe I suffered this “delayed transition to adulthood” and I’m now Living with my dad and have a rent. I’m contributing with services but I’m heavily underemployed. I have friends joining gangs that are in better economic situations than me. Mexico is in a really bad period man I wasn’t making jokes. I honestly believe I have this problem and honestly believe maybe being a shut in is worse than facing the world. In Canada Mexico whatever. Maybe it sounded like a joke but is my bad English. I apologize if it sounded like a joke or something

@@RandyPaterson I think this issue is worse in my country than in the USA or Canada, and a lot of people try to overcome this joining gangs selling drugs etc

Inheritance of parental wealth is indeed a possibility for many who are in this situation. But certainly not all. Many families rent and have scant savings; others have multiple offspring so the largest heritable asset, the family home, will be divided several ways; some parents have all savings eroded by the expense of caring for a housebound adult son or daughter, sometimes via reverse mortgages; and some parents feel that by the time of their death they have contributed sufficiently to their offspring's care and may not make them primary beneficiaries. Homelessness is a real possibility for many. The problem is deeper than that, however. Parents in this situation perform many functions over and above the provision of accommodation or funds. Many shut-in young adults have developed little ability to care for themselves - including cooking, cleaning, household maintenance, the ability to drive, and - most of all - financial self-management skills. It's tempting to think that a hikikomori young adult who inherits a house is set for life. In reality, their ability to manage the home and the inheritance - coupled, often, with cascading addictions - is such that the funds may be depleted quite quickly. In any case, the no-longer-so-young-adult will be faced with learning personal skills that would best have been developed during the teens or early twenties. Whether parents plan to leave their young adult with a nestegg or not, it's best they keep in mind that their role is not to infantilize their offspring but to prepare them for a life without parents. In a word, adultraising, not childraising.

@@RandyPaterson true. Maybe I lacked that. I have debts and adictions and my rent has been a confort zone so I can be under employed with extra money. You’re right I wasn’t raised properly in my early teens . 32 now living with my uncle and both in debts drugs and bad neighborhood. I can’t deny your right. New suscriber here. Hope you do series for 30+ adults struggling with adictions and low self esteem. You’re such a realist psychologist. Good channel man

The "El Dorado" for mental health researchers and practitioners is to find a strategy or medication that works reliably for 100% of the people who experience a problem. Unfortunately we are still waiting. The strategies listed here are those most often recommended and found helpful. Anhedonia tends to promote inertia and withdrawal, which magnify both anhedonia and, more broadly, depression. Graduated re-engagement while cultivating equanimity and working against immediate expectation is a form of behavioural activation that seems to be the primary nonpharmacological path out of anhedonia. Given the impact this problem has on people, I am extremely open to additional or alternative approaches that may be effective for an even larger proportion of people, however.

.... its unbearable. I'm unable to do anything anymore. 😢

@@klanderkal i am able and I am doing stuff just so it doesnt get even worse somehow, but it feels like torturing myself at this point and Im soon just gonna give up because it doesnt work... Time will heal me

Siblings often have a difficult position in this dynamic. They can often see what's going on, but have little control or influence. They are neither the person receiving more help than their limitations require, nor the person overproviding that help. If they advocate that parents pull back and engage in "gradual parental retirement", the dependent sibling will often feel resentful and undermined. Siblings can, however, provide their perspective to parents on what is happening. They have a unique position within the family, having access to the "inside story" and the objectivity (especially if they are independent themselves) to see the family patterns. For example, they can notice when parents are inadvertently undermining the dependent sibling's independence (buying gaming equipment for him, staying home to cook when he is able to do this for himself, providing cash on demand, talking about all the dangers of public transit, criticizing his small efforts). When the dependent sibling has a good relationship with an independent one, there is the opportunity for more. The independent one can have input into the activities they do together. "Hey, let's go to the pub/park/hiking trail/store together" rather than "Let's sit at home watching TV together." An independent sibling can provide a window into a larger world, plus the messages "this is achievable and available" and "if I can do this, you can." As well, it's best for a more independent sibling NOT to enable or engage with a dependent sibling's distraction/addiction/avoidance habits. If you had a brother with alcoholism you likely wouldn't be willing to sit drinking with him. If one has a brother who spends 10 hours a day gaming, then engaging in that behaviour with him would not likely be advisable either. If movies are an interest, for example, you could make it a productive policy to go out to movie theatres regularly together, but not to sit at home watching Netflix. It's generally best to get past the temptations of all-or-nothing thinking: "Either I do what he does, or I give up and pretend I no longer have a sibling." The life of a dependent young adult is a small one, and often tedious for someone who has expanded their horizons. But accepting and tolerating small steps (hey, let's walk the dog) can be the road forward both for the stay-at-homer and for the relationship between you.

@@RandyPaterson i realized i forgot to thank you for such a quick and thoughtful reply. i am meeting with my dad soon to come up with some ideas of how to get him out and about with me. wish us luck. have a great weekend!