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PFA Tips: Struggling to Launch (part 1) The Adulting Journey of the Neurodivergent Brain

 

By Rick Silver, MD, Thrive Emerge

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As a psychiatrist working with parents of teens and young adults with neurodivergent brains I am often asked by parents why their children seem to struggle with taking on the demands of independent adulthood. The journey into independence is a tough one – for parents and kids alike. Phrases like “failure to launch” and “struggling to launch” suggest that these young adults have had significant challenges acquiring the fundamental life skills – emotional control, executive function regulation, social skills – necessary to adaptively respond to the demands of independent adult life. Their ability to shape a resilient, joyful, fulfilling life seems to be so much more difficult than for those peers with “neurotypical” brains.

Over the years of working with these transitioning teens and young adults, I have developed a model to explain why I believe they struggle so much at this stage – often requiring intensive, prolonged and complex treatments to get them back on track and headed towards successful independence. Let’s look at the three components: The Vulnerable Brain, The Beleaguered Child, and The Ghost Who Copes.

The Vulnerable Brain
Both parents and kids want to move beyond the “shame and blame” approach to dealing with the challenging behaviors of neurodivergence. To do so, we must understand the biology of the developing brain. Specifically, neurodivergence is first and foremost a biological phenomenon. Brain development in utero begins at about 3 weeks after conception and is driven – as all development is – by genetics.

For the neurodivergent child, there exists what we might call information processing “glitches”. One key function of the brain is to take huge amounts of data – thoughts, emotions, sensory data, physiologic data, impulses, memories – and organize that data into an adaptive response to some demand from the environment.

A key aspect of that data processing is to organize the information into what we perceive consciously and what can remain in the subconscious realm. This is much like our experience with a computer – we see a bit of its processes on our screen, but we know that huge amounts of processing are going on “behind the scenes”. To “adaptively” use the computer, we only need to interact or be aware of a very small portion of the total information being managed.

But the neurodivergent brain suffers from information overload – information is poorly sorted, so too much enters conscious awareness. The child feels poorly regulated inside – sometimes almost uncomfortable in their own skins. Behaviorally, this shows up in a variety of dysregulations – sensory sensitivities, emotional outbursts, poor impulse control, easily distracted, cognitive rigidity.

The child’s inner world is a bit like driving a car on a windy mountain road, in a storm, with cliffs on either side – and a loose steering wheel. All of their psychological effort is put into simply white knuckling their day-to-day experience so that they can survive. They are likely in a continuous state of fight-or-flight response, never able to calm down fully – or as one of my patients so eloquently stated: “I feel like a pendulum without the dignity of center.”

This is the world of the Vulnerable Child. If we compare their early development journey with building a house, they are genetically given a basement that is at best partially formed – and on which to build the remainder of their psychological capabilities.

The Beleaguered Child
Who we become as adults is a combination of nurture and nature. As the child grows, they are exposed to a range of demanding life situations that shape their personality – family dynamics, school, social situations and later, employment. Life experiences are layered on top of foundational biology – the first floor of the house is built atop the basement.

Whereas the neurotypical child can expect to have a balance of struggles and successes that leads to a strong set of life skills, the neurodivergent child is always playing catch-up, often dealing with failures that are repeated, humiliating and confidence crushing. Kids with ADHD who might be extremely bright do poorly in – and become disillusioned with – school. Kids with ASD who might be highly socially motivated find that they are repeatedly the unwanted, even bullied outside their social groups.

If we track the histories of neurodivergent kids who struggle to launch, we can see the development of anxieties, depression, low self-confidence and shame during their school years. With time, a resignation sets in, since no matter what they try, they don’t seem to have the agency to create the outcomes for themselves that bring fulfillment and belonging.

The Ghost Who Copes
For the teens and young adults that we work with, we have observed that sometime in high school, the struggles and failures come to fruition in a psychological state that we called The Ghost Who Copes. The individual is still trying to engage in the neurotypical world, but has retreated and become highly guarded emotionally. We see outwardly a shell of what they are capable of creatively, socially, emotionally.

To survive, a variety of unhealthy adaptive strategies have evolved, typically rooted in avoidance and numbing. These coping mechanisms permeate the person’s inner and outer worlds, blocking growth and progress towards independence. Withdrawal from social engagement, increased use of addictive substances and processes (typically marijuana and screen use), lying and manipulation, avoidance of responsibilities at school, work and home – all these combine in an individual with high levels of learned helplessness and minimal intrinsic motivation. Alongside this shutting down of self to protect a struggling and wounded core, we see the development of increasing depression and anxiety, often marked by acute suicidality and self harm as a desperate attempt to cope with a world that feels unmanageable and overwhelming.

Life skills development has stagnated as well – emotional awareness and self-regulation, social skills, structuring productive time on a daily basis, seeking and maintaining employment, completing post-secondary education, maintaining self-care, establishing a clear identity, developing a sense of and plan for the future – all of the critical skills that underpin resilience and independence have been put on hold. The neurodivergent teen and young adult continue to white knuckle their lives, doing their best to at least minimally show up in life, despite the two decades of exhaustion that comes with navigating a neurodivergent brain in an often hostile and unaccepting neurotypical world.

BEYOND STRUGGLING TO LAUNCH – In my next article, I will explore the role of parents in effectively partnering with their children though this challenging stage, as well as identifying key treatment elements to help these wonderful, complex kids recover their true sense of self. We will look at the idea that our kids were designed to be different – and that by learning to champion their unique experiences of life, they can shape an adult life rooted in how their brains experience the world.

 

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