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This book is a guide for therapists working with families of adult-children who are dependent on their parents in highly dysfunctional ways. It is based on 10 years of our clinical work with hundreds of such families. It summarizes what we have learned about the use of Non-Violent Resistance (NVR) therapy in such cases, and shares what we learned about the processes of entrenched dependence, accommodation and de-accommodation and their roles in perpetuating or alleviating these families’ sufferings.
Chapter 4 presents the NVR approach to suicide threats, which, implicitly or explicitly, are highly present in families with adult-children. Although the literature on suicide is immense, little has been written on how parents can cope with suicide threats. In NVR, parents are helped to cope with such threats by moving from helplessness to presence, from isolation to support, from submission to resistance, from escalation to self-control and from distance to supportive care.
In Chapter 1, based on the notion of emerging adulthood, we define adult entrenched dependence as a failure to emerge. Children’s dependence on their parents can be characterized as functional or dysfunctional. We propose ways to differentiate between the two. We clarify that the goal of our approach is not fostering "independence" (which we view as a rather problematic goal) but helping transform dysfunctional into functional dependence. The main changes we try to promote are: (a) developing a time perspective that allows parents to strive for better functioning; (b) helping parents transition from personal effacement into presence; (c) releasing parents from their "sacrifice mentality" in favor of recommitment to wellness; (d) helping parents counter the adult-child's entitlement; and (e) identifying and resisting various forms of violence, blackmail and exploitation.
Chapter 6 describes how to deal with situations that require adaptations of the protocol described in Chapter 3. Some of these are: emergencies (e.g., psychotic breakdown, suicide attempt or trouble with the police), worrisome conditions that do not yet constitute full-fledged entrenched dependence, very old parents and the implementation of NVR in a psychiatric ward.
Chapter 3 presents in detail the NVR manual for entrenched-dependence interventions. The opening stage is devoted to building the therapeutic alliance, reframing the problem in ways that allow for new options, discussing parental accommodation, working on the parents' narrative of total responsibility, explaining the need for a support network, and training on how to prevent escalation. This stage concludes with the presentation of a therapy roadmap. The second therapeutic stage includes the formulation and delivery of the announcement, and the constitution of a support group. The third therapeutic stage is the gradual and systematic process of de-accommodation, consisting in a series of gradual exposures to diminishing services, infringement of prohibitions and, if necessary, change of living arrangements. The conclusion stage is usually open-ended, offering parents the option of returning to therapy for a short period if crises arise.
Chapter 5 deals with the precursors of adult entitled dependence in childhood and adolescence. The major risk factors are digital abuse, school refusal, social withdrawal, "tyrannical behaviors" and irresponsible financial behavior. Non-Violent Resistance interventions are described that help parents deal with those conditions.
This book introduced the notion of AED as a family systemic condition linked to a failure to emerge into adulthood. It also introduced our treatment approach for helping the parents of adult-children. To our knowledge, this is the first work proposing a systematic treatment for a condition that is probably spreading worldwide. As a pioneering work, it must leave behind it a long trail of unanswered questions for further exploration. We sincerely hope that the following points will inspire clinicians and researchers to investigate this as yet uncharted field.
In Chapter 2, we argue why parental NVR is well-suited to treating entrenched dependence. We describe why attempts at individual therapy for the adult-child or traditional parental counseling usually fail. These failures have different forms, such as: (a) the adult-child refuses therapy; (b) the adult-child accepts therapy, but entitled dependence persists; (c) the parents are advised to show unconditional acceptance, but the dependence remains unaffected; or (d) the parents are advised to be tough, but are daunted when they stumble on frightening escalation. We argue that parents are almost invariably the motivated partners, that they deserve to be viewed as clients in their own right, and that involving the adult-child would distract the parents and the therapist from their job. We elaborate some central insights underlying parental NVR, such as: (a) that the parents' narrative of total responsibility actually prevents improvement; and (b) that parental accommodation aggravates and perpetuates the problem. The chapter concludes with a description of treatment goals and of what changes can be realistically expected.
This book offers a therapeutic approach to a problem that many families and mental health institutions face: a growing number of adult children who struggle to progress to a psychological, social adulthood. The family patterns that revolve around adult children can remain inert for decades, are often resistant to conventional therapy, and can cause chronic suffering to adult children, parents, and extended families. The authors present a guide that addresses parents of adult children as suffering people in their own right and as essential to assisting their child into entering functional adulthood. The authors, one of whom is the originator of the Non-Violent Resistance Therapy approach (NVR), provide an intervention manual that implements NVR principles for helping families of adult children. The book is based on the authors' ten-year journey of helping such families in cases where traditional interventions and therapeutic values seem not to work.
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