Dear Therapist:

My son (age 26) was diagnosed with anxiety by our family physician a few years back. I took him to a psychiatrist and he was given medication. He does very well when he is on the medication but I find he constantly skips doses. Even more concerning is that without telling me he will try and take himself off the medicine to see how he can do without it. I will often notice that he isn’t doing well and will confront him and realize he isn’t taking them. The difference between when he is taking his medication and isn’t is very significant but he doesn’t realize and/or doesn’t care. My question is really twofold. 1. At what point do I just say it’s his life and I can’t always police him to make sure he does what he is supposed to? 2. Do you have any suggestions on how to get him to be more responsible with taking his medication?

 

Response:

Your questions are specifically about your son’s medication, but the broader question relates to many aspects of parenting and relationships.  To what extent should we be involved in helping our children and others in our lives to make decisions?  Of course the answer to this question depends on many factors.  The response will depend on age, personality, self-awareness, the nature of the relationship, and many other factors. 

As discussed last week’s column, we want the people in our lives (and specifically our children) to attain the level of decision-making at which they will make appropriate decisions with little or no outside assistance.  However, there are times when we feel the need to step in so as to avert a problematic situation.  Sometimes this is the correct approach.  Often, however, the question is whether we are missing the forest for the trees—are we too focused on the short-term problem to recognize any impact on the long-term goal?

Each time we make decisions for others, we take the chance of reinforcing in them the notion that they don’t need to make their own decisions.  Even more problematic, this can reinforce their sense that they cannot make their own decisions.

With regard to your son’s anxiety, I don’t know all the factors involved in the situation.  You have a much better idea of how he might respond and to what degree your involvement or lack thereof will impact on his decisions.  If you think about your son’s qualities and personality, you also probably have a good idea of how his decision-making abilities will continue to develop with and without your involvement.

Your decision should be based on how you can best help your son given all factors and with a view to both short- and long-term effects.  Although the ultimate goal is for him not to need your help in order to make proper decisions, each situation should be viewed from a pragmatic perspective. This will help you to arrive at a conclusion that will lead to the end goal without causing too much angst in the short-term…which can in turn affect the achievement of the end goal.

-Yehuda Lieberman, LCSW

  psychotherapist in private practice

 Brooklyn, NY  |  Far Rockaway, NY

 author of Self-Esteem: A Primer

 www.ylcsw.com / 718-258-5317

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