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Question: Our 19-year-old daughter has always been a handful. She suffers from generalized anxiety disorder and anoroxia diagnosed at age 13. She is in college but will not live on campus and refused to drive until age 18. Now she leaves our home at 8:AM every day but will not return home until past midnight. She will not contribute to our home, leaves filth everywhere she goes. She is dating two young men who look as though they have crawled out from under a rock. She is intelligent and beautiful. When confronted about her filth and lack of contribution at home she claims her stress level is off the charts. Her therapist claims she is a normal latent teen due to her earlier issues. She reals me in with advice about juggling her beaus or classes but lashes out at me when I advise her to slow down or ask her to clean her filth. I have become resentful of her and she of me. We got into an altercation where she pushed, shoved, and hit me. I hit her back to get her off of me. Then she left home claiming she was afraid to come back. Her father took her side saying I must have provoked her when all I asked her to do is clean her room. She is back home but nothing has changed except now I am dealing with her verbal disrespect.

Example: Me - "Good morning, last night you left used sanitary products exposed in the downstairs bathroom. Will you take care of that immediately?"

Her - "Isn't it so nice to be greeted with griping and complaining first thing in the morning."

Me- "Seriously? Go clean that up--no one wants to see it."

Her - "I will if I get a chance. You are stressing me out."

Me - "You need to be stressed out, clean your mess up now."

Her - "I am late for class." Door slams, car drives off, mess stays.

Me -???

Response: I dealt with a very similar situation with a client who had an adult daughter living at home and a husband taking the daughter's side. This requires a bit of finesse and is a three-step process. It is probably best for you to see a cognitive-behavioral therapist to help with implementing these steps. You may not like what I have to say but keep in mind as your read this that I'm not taking her side but I'm trying to give you a blueprint for a realistic way of changing a difficult situation.

First, it is necessary for you to recognize that you can't change another person. You can only change yourself. The goal here, I assume, is to have a more tolerable living condition. At the moment your focus is on what she should do to make it more tolerable for you. Even though you are not using the word "should" I see it implied throughout your description: "She should get herself together", "She should make better choices in her relationships", "She should be more respectful", "She should at least contribute at home and clean her room." Such "shoulds" are demands and expectations for her to change. But as I said, you can't change her. Only by changing yourself do you have the opportunity to change a situation. Why is that? Because every family is a system that operates together. If you change any part of that system, the other parts have to change in response, for better or worse. But the only part of that system you have control over is yourself. So that is the only part you can change. However, if you plan a change carefully, you can potentially have a positive impact.

Am I saying that the problem is all you and she is not contributing to it? No--I am saying that people typically change only when their behavior causes them a problem. In this situation her behavior is causing you a problem, not her. So she doesn't have any incentive to change. The goal, then, is that by taking these steps and changing your behavior you can give her a greater incentive for change.

The second step is to recognize her mental illness and the struggles she has to overcome so that you can focus on more positive interactions. Again, from your statements there is an implied blame for her mental illness. "She...will not live on campus and refused to drive until age 18" does not recognize her anxiety about those things. Instead, you say it as if she should be able to do these things and just doesn't want to.

From what I am hearing is that your relationship has devolved into attacking her with criticism and her defending herself by attacking back. As I have written elsewhere, this pattern can change by you choosing to focus on positive qualities and behavior. This does not mean you can't ever criticize but it is best to keep criticism to a ratio of five positives to every criticism--since your situation has deteriorated so much, a ratio of ten positives to every negative may be better. Criticism can better be heard in the context of an overall positive relationship. And the positives can't be general as in "You are intelligent" or a backhanded compliment as in "You are so beautiful. I'm sure you could find better men to date." Praise needs to be very specific. You might say to me "She doesn't do anything that is positive! How can I possibly say positive things to her?" And that is the challenge. By committing yourself to having five positive interactions for every negative one it forces you to look for the positives. It also tends to reduce the criticisms because you know you will have to make up for it with five positive interactions.

Finally, you can begin to set consequences for her behavior. I know it will be tempting to start with this step but don't do this without the other steps first or it will backfire on you! And step two may take quite awhile before you start noticing positive changes. Also, this step may not be necessary because she might respond to the improved quality of your relationship.

Consequences for adult children living at home can be very difficult especially when you don't have the support of your spouse. So you have to determine what you actually have control of. You don't have control of her nor do you have control of your husband. You only have control of what you do. For instance, you can close the door to her room because you don't have control over her cleaning her room. If she leaves things laying around the house, put them in a box (yes, including the used sanitary products), and put it in front of her door. Don't explain or criticize. This may seem to be passive-aggressive retaliation which is why it is important that it be done without anger and by first establishing a more positive atmosphere. I had one mother whose daughter wouldn't clean up her dishes so the mother started putting the dishes in the daughter's doorway without saying a word--eventually, the daughter started cleaning up her dishes.

Another type of consequence is not doing things that you would normally do for her. For instance, if she makes a request of you, check internally with yourself and see how you feel about her behavior that day. If it has been positive, grant her request (if reasonable), otherwise don't. It is important to do this without explanation and to not carry your resentment over from previous days. If she asks "why not?" tell her calmly "I don't like how you treated me today and just don't feel like it."

Also, stop giving advice. That can be a passive-aggressive trap. Instead, just listen to her and ask what she thinks. In other words, just help her think it through. For instance, when she tells you what she thinks, ask (without any sarcasm) "How do you think that will help?" or "If you do that, what do you expect will occur?"

So, if you take these steps and make these changes, what incentive is there for her to change? One reason is that people with mental illness often have low self-esteem. You are an important influence in her life and by increasing the positive interactions you are likely to increase her positive feelings for herself and her desire to have a better relationship with you. Another incentive for change is the consequences. When her behavior affects her more than you, then she may change the behavior.