SPEAKERS

Rosie Gilderthorp, Meg Jay

Hello and welcome to the Business of Psychology podcast. Today, I'm happy to welcome Dr Meg Jay, developmental clinical psychologist from Virginia in the US. Meg writes and speaks about the importance of mental health for young people, and has focused recently on the 20 somethings. Welcome to the podcast, Meg.

Oh, thank you, Rosie. It's great to be here.

So I'd really love to talk to you today about the overall shape of your career and how you came to focus specifically on 20 somethings. And then maybe we could also have a think about the things that we as mental health professionals need to make sure that we're considering when a young adult comes into our therapy room, especially anything that you think isn't given enough attention in our core training. So starting at the beginning then, how did your career in psychology begin?

Well, how it began is actually where it's ended, of that I've been focusing on 20 somethings for 25 years, so basically from the beginning of my clinical training at UC Berkeley, which is where I got my PhD, I was in a college town, obviously, and so I was surrounded by a lot of 20 somethings in college students. I had no intention in specialising in them until I realised that was where all the action was. And so, you know, work is being decided, and love and where you're going to live and who you're going to be and what your habits are. So, you know, being able to get in there early and have an impact, you know, kind of getting in front of life's biggest decisions and most defining moments I realised was very rewarding, and also just very transformative. So I've loved the work. I don't know that I thought I would stay in that space for all this time, but I have, I just love it.

That's really interesting. So when you first came to working with 20 somethings, what stage of life were you at?

Oh, I was about 31 or 30. So, my whole adult life, I've either been in my 20s or I've been talking all day to people in their 20s. So I'm, I'm have a bit of arrested development in that way, but it's really just been a focus in that one area. But, you know, it's interesting because, I tell this brief story in my TED talk, but one of my first clients was a 20 something, and she came in and was talking about boyfriends and this and that, didn't seem like that serious to me, which was a huge relief because I was a new clinician and had no idea what I was doing, and my supervisor really pushed me to take her 20 something struggles more seriously, particularly this person she was dating. And I said, oh, well, what difference does it make? It's not like she's going to marry the guy. And my supervisor said, well, not yet, but she might marry the next one. And the best time to work on someone's marriage is before they have one. And just that example, it's not just all about marriage, but the best time to work on a career is before you have one, the best time to talk about a prenup is before you need one. So just that sense that when you work with 20 somethings, sure, a lot hasn't happened yet, but a lot is about to happen. And so getting in there and helping people be intentional and thoughtful and proactive, it's actually a pretty easy way to help people.

Absolutely. And I don't know if this has changed over 25 years, but what are the sorts of problems that people in that age category come to you for? I mean, I wonder if this might be different actually in the US versus the UK, but I'm just really interested. What do they, what do they think they're coming for?

Yeah, I don't think it's very different in the US and the UK. Both of my Twentysomething books, The Defining Decade and The Twentysomething Treatment are both out and very popular in both countries. So, you know, things haven't changed, I think, as much as we talk about that they have. We can come back to this, but I think we're talking a lot more about mental health than we were 25 years ago, but I've been working on young adult mental health for two decades. And, you know, actually not a lot has changed as much as our awareness and conversation about it. So typically, the hard part about being in your twenties is how uncertain everything is. So I said, you know, everything's about to happen, but, you know, work isn't settled, love isn't settled, life isn't settled, finances aren't settled. So, uncertainty makes people feel stressed and anxious, which is why the 20s actually tend to be a mental health low point. They've been a mental health low point for 25 years, and that's because the brain doesn't like all that uncertainty, that it doesn't have those adult sources of safety and security, like, hey, I know who my people are, and, you know, I can see that my life is going to work out and my, you know, I'm getting some traction in my job, but none of that's happening yet. And so that makes people feel stressed and anxious and unhappy, and that's usually what 20 somethings come in talking about.

That's a really useful perspective because I think often, you know, those of us that maybe work with older age groups, we hear a lot of the anxieties that older adults have about young people. And what I hear over and over again is I'm worried about my children's social media. But I guess maybe social media amplifies some of those concerns, but they're the same concerns that they would have had anyway. And I always wonder if perhaps there were different outlets for that comparison in previous generations.

I mean, definitely the one thing that has changed in two decades is technology and, you know, in all ways, many, many ways for better and for worse, obviously one of the downsides of social media is that people are constantly comparing where they are in life with where other people are in life. And in your 20s, this is really the beginning of everyone shooting off in wildly different directions at different paces. So comparisons don't really work anymore. They don't serve you. Whereas in school, it's pretty easy to say, oh, you got an A, I got a B, we took the same test. That just isn't the way adulthood works. So I do think it is a big challenge for young adults to realise that comparisons will get you nowhere, or as, you know, I tell people, compare and despair. That's usually what happens when people look at others' social media. I mean, of course, there are a lot of amazing upsides to technology that weren't around 25 years ago, but that's definitely more to manage.

Yeah, I think that's really interesting because the place my head always goes is thinking about, you know, comparisons. I've got nieces who are, you know, getting to 18, 19 and going out into the world and start to worry about that and them looking at the highlight reel. But I guess you also, you can't lose touch with people that didn't serve you when you were, you know, maybe in your teens and living in your hometown in the way that perhaps my generation was the last generation that could.

Let's just forget that ever happened. Well, you can, but you have to be very intentional about it. And so I've definitely had clients say, Oh, you know, I should get these people off my Snapchat. It's like, well, what's stopping you? So, you know, I think the onus is really on the individual. And I mean, obviously there's some controversy about whether corporations should be doing more, but currently the onus is on the individual, certainly as adults, to figure out what's, what's going to happen with your social media and how is it serving you? How is it not serving you? I mean, I always say to clients, it's not whether you're using it, it's how you're using it, it's just not realistic for most young adults to say, I'm just never going to use any of these platforms, I have come to learn that that is where they're getting a lot of their education and news, but they have to figure out what makes me feel good and what makes me feel bad.

That's a really, really interesting point. And I guess, you know, just before we move on from the technology thing, do you think, you know, would you be somebody that would want the corporations to do more? You know, where do you see the way for us to intervene and help young people with this?

Hmm. You know, to tell you the truth, I'm not sure I have an opinion on that. I think, I think it's, that's more really, to be honest, social media is more of an issue for teenagers because they're younger and their brains are younger and like that, they tend to get a little bit more wrapped around the axle about social media. 20 somethings are usually more stressed and anxious about jobs and relationships and life and substance use and habits. I mean, they kind of have bigger fish to fry than social media in my experience. I mean most 20 somethings are smart, they come in and they'll say, yeah, I spend too much time on my phone, I'm trying to roll that back a little bit, but it's not really their primary concern.

Now that's really interesting. So, there's so many ways, I've read a bit about you and I've done a bit of stalking across the internet, and there's a lot of really amazing stuff that you're doing at the moment. Could you talk to us a bit about what your working life looks like now?

Because I'm guessing you're not in the room with people all day, every day anymore.

No, yes. And well, that's what I love about your podcast, Rosie, is I love it, that it's you know, talking about what are therapists doing besides therapy? Because I think, you know, we need to hear more about that. With technology we can hear more about that from other people and be inspired and have ideas. So I love that. I guess I was, you know, behind closed doors with twenty somethings, 30-40, I shudder to try to imagine all the hours per week, for many years. And what happened was, is they all were saying the same things and asking the same questions, and this was, you know, I don't know, early, early 2000s. And I thought, shoot, you know, I'm like repeating myself all day long. Same, same concerns, same advice, same education that I'm giving out. So I thought, I need to be able to recommend a book for them that I can say, you need to read this instead of me explaining all this all the time. So, I went over to the Barnes and Noble, which is a popular bookstore in the US, browsed the shelves back when people did that, looking for something, and there was nothing. There was maybe this, you know, the girlfriend's guide to your 20s, or nothing substantial that I felt like really did the period of time justice. So I thought, well, shoot, I guess I'm going to have to do it, because I really felt like that, you know, sure, there are a lot of people in my office, but even more people who would never find their way to my office, therapy, as we all know, does not scale, it's not affordable, it's not accessible, you know, en masse, and you know, I really believe that education is an intervention. So how can I just get better information out there? Most twenty-somethings don't need therapy per se, they need better information. So I felt like, well, you can do that in a book. And this was pre social media. So how else would you do it, right? So I wrote The Defining Decade. That's been really popular. That really changed things for me, of course. I ended up you know, working fewer days in the office with people and then more days writing my next book and my next book, spending more time giving talks. It's really fun to go on podcasts and have conversations with people. I've been on some abroad programs where I can, you know, be with a really, really diverse group of twenty somethings in a lot of different settings. So, you know, there's just a lot of diversity to my week and to my year, even. And even from one year to the next, if I'm working on a book, I might have one clinical day and four writing days. If I'm not working on a book, it might be the other way around.

And what did that feel like, making that transition when you first sort of moved away from spending all week seeing people behind a closed door to spending so much time writing?

I mean, it was great. I love, I mean, you know, I'm a student and teacher at heart I think, you know, I went to grad school and love to put on my jeans and pull out the laptop and spend the day thinking and organising and writing. So I really loved that, but you know, it's interesting when my first book, The Defining Decade was first sold, I remember my editor saying, you know, you don't want to quit your job and write this book, you need to be in there listening to people every, you know, maybe not every day now, but many days, because you're going to kind of lose touch. And he was absolutely right, I've never stopped seeing clients because that's what keeps it fresh. And it's not just, I mean, I have more, I could write a lifetime of books from the clients I've already seen, so it's not that I need the material per se, as much as they're my why. So that's what I get really excited about. Oh, we really need this because of this person, it keeps me connected to the why, why it's needed, why I love this age group, you know, why I'm going to put all the work in to get the book out there.

Yeah, that makes a lot of sense. And I think one thing I always recommend to people if they've got writer's block or they're really struggling to consistently commit to writing something or creating something, it's spend more time with whatever inspires you. So obviously for you, that's the clients themselves, it feels so important.

Yes, and I've had that experience where, I mean, I have a lot of, I don't know if it's useful advice, but thoughts about if you're trying to write a book, how to get it done. And one of them, there's a quote that's attributed to Somerset Maugham, I don't know if he really said it or not, but something about, I only write when the inspiration strikes, but fortunately it strikes every morning at 9am, which means, you know, put your butt in the chair, you know, have a routine, put your butt in the chair and then do something. So that something for me, if I'm, you know, not feeling it some days, I do some research on Google scholar and I read articles that are, you know, they're about topics I'm thinking about, or I'll read emails from people who, you you know, write to me about the books and just anything to sort of get the why and the spark going. But you're absolutely right, what really gets it going is a day spent in the office with twenty somethings that I'm really revved up about, you know, what we need and what we're not talking about enough and how we need to change that. And so I'll never stop doing that.

So, you know, I guess there's so many things that I could ask you about for advice, but one thing that just popped into my mind is, you know, you must meet a lot of clinicians. You know, you're doing this sort of talking, you must get tons of psychologists and therapists coming to your talks. And I expect you do supervision as well. So in your experience, what other clinicians, what do we miss when we're working with this age group that, you know, might seem quite obvious to you because you've been so engrossed for so long?

Yeah. Well, I don't know what, whether anybody's missing anything, but my, my top thoughts for people maybe who aren't clinicians, cause I'm assuming all the clinicians out there are doing an amazing job, but is number one, that the unifying concern amongst twenty somethings is uncertainty. That I think if you can understand that as the backdrop, then you, you know, it helps you understand what's the stress about with work, with love, with where I'm going to live. It's just that there's so much that's uncertain. The brain doesn't like that. So it's really normal for people to react in all sorts of ways of having a panic attack or getting high every day or taking too much Xanax that it's often a reaction to uncertainty. And I think if we can sort of normalise that backdrop, it keeps us from rushing too quickly to, you know, this person has a mental health problem. That's one of the other things is that it's extremely easy for a twenty something to meet criteria for any number of DSM diagnoses, extremely easy, and if we looked at it in developmental context, they really shouldn't, that they, they don't. So I think 50 percent of young adults meet criteria for social anxiety disorder, which tells you that the criteria are off for twenty somethings, that it's really normal to, you know, be worried about public speaking and not know how to talk to someone new at a party and feel worried that, you know, it feels anxious when someone doesn't text you back. Normal, normal, normal, but more and more, especially with TikTok and other, you know, sources on the internet. I have people coming in and saying, I'm borderline. I'm, I've got social anxiety. I have panic disorder, because they had one panic attack. Who hasn't had one panic attack? Usually in your twenties. So, you know, I had a client just yesterday, new client, and I was doing an intake with her and I asked her what, what, tell me what diagnoses you've received previously. And she said anxiety, depression, and ADHD, and those are my, I think those are probably, the ADHD is real, and anxiety and depression often go along with that, so that's really more my focus probably, but she also said that she had a been told that she has traits of narcissistic personality disorder, borderline personality disorder, and histrionic personality disorder. And I said, no, no, no, you don't have any of those. I can tell you from one meeting, young adults are self centred and they don't handle their emotions very well, and they, you know, they have unstable relationships and unstable feelings. That doesn't mean they're borderline. So for you know, my biggest piece of advice is put it in developmental context, that most twenty-somethings are not disordered and it's not helpful for them when they're trying to figure out their identity to find out they have six different things.

That is so useful, but one thing coming into my mind is, I wonder if you've got any opinion on why it is that young people seem to kind of want those labels? Thinking about the young people in my life, they're quite keen on them.

Well, it definitely provides some certainty in a time of uncertainty. So, you know, young adults are into astrology, they're into diagnoses. You know, I'm a Gemini and I have borderline personality disorder. And so like, I get it that they're trying to create structure and understand what's going on. And so I really, through books, talks, podcasts, conversations, I'm trying to give them another way to understand what's happening rather than a diagnosis.

But it feels very clear. Oh, well, this is why I'm doing everything. And then the hope is there's a three step therapy, which we all know as clinicians, there's not, or there's a magic bullet medication that will fix this, which usually there's not. So, and then of course it's quite, you know, somewhat cool at the moment to say, I have this and that and this other thing and connect with other people around it, you know, and there can obviously be upsides and downsides to that. I try to encourage young adults to connect with other people about their strengths and what's right about them and not necessarily about the problems that they're having.

Yeah, it's interesting because just before we started the recording, we were thinking, or, you know, I was reflecting on the fact that I feel that my generation, generations above mine, are quite negative about Generation Z. And I wonder whether maybe feeling blamed sometimes makes people reach for a label because then you can sort of externalise it a little bit.

Right. Yeah, it's interesting. I mean I, my recent book is called The Twentysomething Treatment and it's not surprisingly about age appropriate, I mean age specific approach to mental health, which we've been talking about. And that's really in contrast to the pathologizing, which we've been talking about. But then at the other end of the spectrum, the trivialising. So that, you know, twenty something, there's a lot of trivialising of like, what could they possibly have to be upset about? They don't have spouses, they don't have mortgages, they don't have kids, they don't have careers. However, It doesn't feel so awesome not to have those things and to not know that if you ever will. And so I do think their problems are trivialised. It's very hard to be in your 20s, I will be the first person to say it's extremely difficult. I wouldn't go back. But what I'm also saying is that that's normal and that most twenty-somethings are not disordered because they're struggling. So it's both recognising the struggles are real, but they're probably not clinical diagnostic problems.

So what was it that kind of pushed you to write the most recent book? Was there something in particular?

Well, it was really, so the first book, The Defining Decade, is really about why your 20s are so defining developmentally, why they're so important to everything that comes after. The second book is about the Twentysomething Treatment. It's about why your 20s are so difficult, that because you're, you know, have all the uncertainty and things haven't been sorted. So it's really more about young adult mental health, the inner world of twenty somethings, whereas the first one's more like the outer world, like let's go, get going, you'll feel better. And it really was in reaction to the fact that, you know, everyone's talking about mental health now. When I wrote The Defining Decade, I had a chapter in there about mental health, but my editor wisely said, one, nobody wants to talk about that right now, which was true back then, and two, that's another book. That's a whole other book. And he was right. And so now everyone's talking about it, some of the conversations are more useful than others, which is why I wanted to say, you know, I've been talking about this with people for quite some time now and have some thoughts, particularly around rushing to

medicalizing or pathologizing a very difficult time of life, but a time that does pass and people do tend to get better and feel better as life gets better.

So what is your vision for your work going forward? Are you imagining whole libraries of books or what's the plan?

I don't think I have time to get to whole libraries. I just mean time left on earth. But I would definitely like to keep writing. You know, I've started doing a little bit more on social media, might do something with a podcast because I see that, you know, that's where a lot, you know, meet your clients where they are, that's where they are. Yet, I'm, you know, what I really love to do is write books. So I think that will probably never go away. So I would say definitely writing, continuing with clinical work, because that's where the inspiration comes from, but probably more with different forms of media because, you know, I said I wanted to write books to reach more people, but there are a lot of people who aren't going to read a 200 page book. So that's, that's reality.

And do you have any advice for any other psychologists or therapists who would kind of like to do maybe some writing or speaking, but they just don't know how to get started with it?

Yeah, I mean, there was the, you know, the inspiration strikes every morning at 9 am quote around, you know, you've just got to like block off space in your calendar and before, I mean, I'll be honest, before, I mean I wrote the Defining Decade, you know, at 5 in the morning before my very young children were awake. I mean, I'm embarrassed to say I wrote probably countless pages at the local bounce and play, which is, you know, like the, the kinder gym kind of thing while they were in there. I mean, I had to really steal the time. But I was, you know, felt very fired up about it, which helped a lot. So you’ve got to find the time just to start. But one thing that I didn't do that I wish I had done sooner, and I've really never done it now, but I think it would have gotten me going sooner was to join like a writing group, where you have, you know, deadlines or hey, I'm going to, everybody does chapters and they read and they comment. I mean, I got a lot out of that when I was in graduate school. I had those, you know, dissertation groups, and it made my work much better, and then as a writer myself, I get that from my editor, and I do have other people read my work, but I think I would have gotten started sooner if I had just joined a writing group on my own before I had a book sold.

Yeah, often I think that accountability, but also that window into the fact that other people don't find it easy either, is really helpful.

Right. And just you will often get feedback of, oh, this is so interesting. And I was thinking that, you know, that other people often think your work is better than you do. So you can borrow other people's excitement and yes, keep going, this is amazing, we need this. Because, you know, it's hard to tell yourself that.

Yeah, I'm going to take that advice for myself actually, because I am one of those very irritating people where I'll write a few chapters and then delete them. Because when I read them back, I'm like, oh, it's so cringe, I just can't stand what I've written. Whereas if somebody else had read it, hopefully, maybe that would save my poor words.

Yes, or they would see, you know, I'm sure a lot of it is worth saving. Well, a really great book on writing that I'll plug someone else's book, this has been out there forever, but Anne Lamott's Bird by Bird. Are you familiar with that book?

No, I've not heard of it.

Ah, such a great book. It's something like, you know, meditations on writing and life. So it's all about writing, being a writer. She's a very esteemed writer, but it's all metaphors for life, but you'll love this, the first chapter is called, pardon my French, but it's called shitty first drafts, and it's just about how you have the courage of showing people your shitty first drafts and just let, you know, because they're going to see the gems in there that are winding up being deleted, and that that's just part of the process.

That definitely sounds like a book that I need to read. My husband is getting really annoyed.

So, I mean, coming on to the book then, so where can people find your book? Where's the best place to get it?

It should be everywhere or somebody's in trouble! So, the, it's, the newest one is the Twentysomething Treatment. And again, that one is really young adult mental health, the interior life of young adults. Really what it's like to work with young adults clinically. That should be everywhere. Also out in the UK, my previous one, The Defining Decade. I think the updated version came out somewhat recently, and that's really about starting your life. So how to get that first job and how to think about dating. And so that one's a little bit more about, you know, how to get your feet under yourself when you're first getting going.

Brilliant. So I'll link to both of those in the show notes, because I imagine there's going to be lots of people that want to look those up. Where's the best place for people to follow you and sort of see what you're doing? Maybe check out your TED talk?

Yeah. So I am @drmegjay on Instagram. I think there's a little bit out there on TikTok. You can find me on LinkedIn, Dr Meg Jay Twitter @drmegay, although I don't, I'm not doing a lot on Twitter these days. So mostly it's on Instagram and then the Ted talk, you can just Google Meg Jay Ted. It'll come up. It's called why 30 is not the new 20.

Brilliant. So I'll make sure that all of those links are there for people. Thank you so much for coming on to talk to me today. That has been really interesting and I'm sure it's inspired a lot of people.

Oh, thank you. It was a pleasure to come on and I just love what you're doing of helping therapists do more than therapy. I love it.

Thank you.