• Anxiety, depression, stress and perfectionism are all reasons that millennials are heading to therapy

  • Following on from her earlier post, therapist Sally Brown shares what she has learnt about working with this age group in therapy

  • If you are a millennial feeling the pressure, find a therapist 

With more and more millennials seeking support in therapy, here are three things I have learnt as a therapist working with this generation. 

Flexible boundaries

Millennials have been brought up in increasingly non-hierarchical families, where children’s needs are seen as being of at least equal importance to those of adult family members. Their parents tend to spend more time with them than in previous generations, and intergenerational closeness generally is on the rise. Parental involvement is more likely to continue into adulthood – research has shown that a third of the costs of parenting are spent on children after the age of 18. When they come to therapy, even in their 20s and 30s, it may be the parents who are paying, and the therapist may find that those parents expect to have a say in what happens in the therapy room.

So what does this generation expect from their relationship with their (usually) older therapist? I no longer worry if a text from a millennial client to rearrange a session ends in a kiss, which seems to have replaced the full stop. But I wonder at times how they experience my boundaries – the lack of physical contact, for instance, for a generation that seems to greet everyone with a hug, and the lack of self-disclosure, when they are so open to sharing their lives online.

Most of us would hold fast to the belief that boundaries are important. As Jane Darougar, a psychotherapist working in a college counselling service and an executive member of BACP’s Universities and Colleges division, believes: ‘When lives are unstable, the reliability and predictability of your therapist being there at the same time every week is very grounding.’

Psychotherapist Aaron Balick agrees: ‘I think that there has been a levelling out of hierarchies between parents and their children, and a diminution in how “authority” is perceived. Unlike in previous generations, younger people may think it’s OK to email or text a therapist between sessions. I think therapists need to be flexible, but I also think they need to maintain boundaries, as negotiating them is so important. The main issue here is avoidance of difficulty or conflict in face-to-face relationships. For example, it may be easier to “ghost” a therapist than to discuss ending therapy.’

Digital awareness

For me, one consequence of working with millennials in my private practice has been a reconsideration of the meaning of the word ‘talk’. I have come to realise that clients who refer to ‘talking’ are as likely to be referring to texting, WhatsApping, Snapchatting or Facebook messaging as they are to verbal conversations. We risk alienating or failing millennial clients by holding a false distinction between real and online life, says Balick. ‘For most younger people, these are just online expressions of real life. I think that many non-millennial therapists are making this faulty distinction, often implicitly or unconsciously, in ways that are not helpful – for example, by dismissing people’s online experiences as “less than”.’

At the same time, an increasing number of millennials are reporting feeling overwhelmed by their digital lives and are seeking new ways to manage the constant onslaught of information. Supporting them is not simply a case of suggesting a ‘digital detox’, says Bridgette Bewick, Associate Professor in Psychological Health and Wellbeing at Leeds University. ‘For the majority of people, not engaging in online life for extended periods of time is just no longer feasible. It’s how we navigate the world, read books, get news, do banking, keep in touch with family and shop for clothes.’

We would be wrong to think of all millennials as engaging with technology in the same way, says Bewick; her own research shows a very varied picture. ‘Some young people have made a conscious decision not to look at their phones at certain times and they feel positive about their phone use. Equally, others have made a conscious decision to be always contactable and to respond quickly, and many seem to be doing OK with that. For millennials, it’s about finding ways to take back control, and one solution doesn’t fit everybody. Young people need space to think about what they want from the digital world and to be supported in how they achieve that.’

More understanding of mental health

Millennials are also notably readier to admit to and seek help for mental distress. There has been a well-documented rise in the number of under-30s seeking help for mental health conditions, and millennials have been in the vanguard of breaking down the stigma attached to a mental health diagnosis. They are an emotionally literate generation with an astonishing willingness to articulate and share their vulnerabilities.

But there is a downside to this readiness to admit to mental distress, believes Jane Darougar. ‘Notions of privacy and how much access people feel entitled to have to each other’s lives are very different for this generation. I work with young clients to consider what they share [on social media], and the impact potentially on their lives in the future. I also see an increasing lack of distress tolerance and a growing trend towards the pathologising of normal emotions,’ she says. ‘Labels such as “my anxiety” or “my depression” can become prisms through which they view their whole life. A lot of my work is about normalising – helping clients to consider that feeling nervous about walking into a lecture theatre or breaking into a new friendship group may be normal, rather than a sign that they suffer from anxiety or are “being triggered”. They can profoundly limit their lives because of a perception that they have mental health issues. We need to educate them about the spectrum of normal emotions and experiences.’

So acceptance, understanding, challenge and the time and space to work out what they are really feeling – these are what millennials need from therapists. Perhaps what we are finding is that, while every generation is unique, what each needs from therapy does not differ so very much after all.

Further reading

Dolly Alderton: 'Therapy was the best decision I ever made'

Why are millennials coming to therapy?

How CBT helped me overcome anxiety at work

Work-related mental health issues: how therapy can help