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David Akiva
David Akiva, BA, MA,
Category: Mental Health
Satisfied Customers: 167
Experience:  Counselor; Behavioral Consultant
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My 25 year old grandson lives a virtual life on his computers.

Customer Question

My 25 year old grandson lives a virtual life on his computers. His only friends are there, he spends his entire day on computer playing games, talking to "friends,". I do not know for sure, but I believe he has computer sex.

I am 69 years old and want to foster as much independence in him before I die. When his parents--my son 20 when he was born, and mother 16 when he was born, divorced, she took him out of state to a neglected and possiblly abusive environment. when she was arrested and sent to prision for cocaine possession, he came to live with me. His father essentially forgot about the child after the divorce.

I overprotected my grandson. Wouldn't let him out of my sight. RJ (grandson) seemed to be a happy child and very social. He started pre-K at 4 yrs. He attended private school through 5th grade, where he was very social, but inattentive to his schoolwork. Homework was a battle. When he was refused by the school, rather than put him in public school, I attempted to homeschool him. Getting him to work was a battle.

At age 15 I took him on a cruise around South America. We were supposed to be schooling, again a battle, and essentially the end of his schooling. Two years later, without studying he passed his GED. No further schooling since then.

He will not learn to drive, says he is afraid.

He has many fears: spiders, flying, dogs. He has developed anxiety attacks. He says he is homosexual. As far as I know he has never had sex, but I could be wrong.

Also, he is growth hormone deficient, and for years was on daily injections of growth hormone. He produces no sex hormones, and uses a daily testosterone patch, and takes thyroid. Left on his own he would not use the testosterone and would take the thyroid about half the time.

He opted to discontinue the growth hormone when he turned 18, although it was explained to him about the possible effects of osteoporesis, etc.

He has never worked. To me he acts about 12 years old. I do not believe he could hold a job.

Three years ago I bought two houses side-by-side, his father, step-mother, and 2 half brothers live next door. This seems to have been good for him, as he is more involved with family activities. His 16 year old brother spends a lot of time with him, although David has his own busy life: string of girlfriends, guitar, private school, building a car.
Matthew the 13 year old brother is a very irritating child, and RJ does not like spending time with him, but is tolerant when he is around.

RJ has some issues with his father. Says he hates him. But seems to enjoy talking to him.

I am profoundly disappointed in his father and his 2nd wife. I do not believe I can rely on them to put RJ's well-being as a prioritiy. My son is not independent either. he worked for years as an auto mechanic, until he persuaded me to back him in his own shop. Ten years ago. I am still giving him money every month for his shop. He lives under the illusion that he is making an income??? I have discussed this with Robert, but the discussions always degenerate, and I continue to support him and his family. He could have gone to college, but he didn't. Speaking frankly, his 2nd wife is not a smart girl. The word geek comes to mind. She is a liar, possibly a thief, constantly talking without awareness of appropriateness. Dresses like an idiot.

How do I sort all of this out? RJ has many physical complaints and anxiety. I started by getting a physical--here in medical-mill south Florida, he was started on buspirone 5mg tabs Bid, but he does not take it, he takes one once in a while when very anxious. His other meds are synthroid 0.125 mg daily (about 50% compliance.) Vitamin D 50,000 Unit once weekly--only takes when goaded into it, but feels better when he does. and Androderm 5mgm, I think he tries to avoid this. He does see an endocrinologist, but since he is noncompliant, mostly get is told to take his meds and come back in 3 months.

I have determined to get this straightened out. I know I have been overprotective and inconsistent and responsible for a lot of this. This consultation is my first step. I will be going to Durham, NC, June 1 for the summer, and plan on taking RJ to Duke. What do I do now, first. How do I sort this out?
Submitted: 3 years ago.
Category: Mental Health
Expert:  David Akiva replied 3 years ago.

Duddy :

Welcome, I am a professional counselor, Behavioral-Consultant and relationship expert.

Duddy :

That is a wonderful, detailed narrative you provided. However, I'd like to better understand your question. Would you mind providing a more precise question for me to work with? When you say "sort this out" what are your specific goals?

Duddy :

...

Duddy :

I notice you are online but perhaps not at the computer. I'll check back for your response shortly. The most helpful thing here would be to "operationalize" specific goals, - for example, to prioritize 2 or 3 specific problem or target behaviors and desired changes or outcomes. Then I can put my clinical experience and research skills to work for you, much more effectively.

Duddy :

...

Duddy :

The chat window is showing that you are now offline. I'll check back periodically for your response, through out the day.

Customer:

I need to know what resources are available for a 25 year old. I need a starting place. And now the thought comes to me that diagnosis of RJ's specific condition is the beginning. would that be correct.

Customer:

My goal is for RJ to function as well as he can and gain independence.

Duddy :

There are both medical and behavioral issues here to disentangle. For example, internet addiction can be a very serious problem in it's own right. The questions on this issue alone are: to what extent is this behavior, life/work interfering and a root cause for other problems? (response continued)

Duddy :

I think a good starting point may be to facilitate having your grandson work with a well trained cognitive behavior therapist (CBT), who strongly implements the behavioral activation (BA) component of that treatment approach. Let me provide you with some links to further clarify what I mean by CBT and BA.

Duddy :

This is what I mean by CBT:

Duddy :

http://www.mayoclinic.com/health/cognitive-behavioral-therapy/MY00194

Duddy :

This is what I mean by BA:

Duddy :

http://www.christophermartell.com/ba.php

Duddy :

This link explains why the behavioral activation component is so important in CBT:

Duddy :

http://en.wikipedia.org/wiki/Behavioral_activation

Duddy :

With a well trained CBT therapist you may be able to avoid any stigmatizing mental health labels, while at the same time getting strong, evidence-based treatment for targeting and changing the behaviors of concern you mentioned. This would include time on the internet, social isolation, behavioral avoidance of prescribed medical treatments that may be contributing factors to his current behavioral presentation. CBT is skills based, so it teaches and trains new more healthy ways of thinking, feeling and acting in the world that your grandson can take with him through out the span of his life. It's also highly targeted and practical, getting lasting results in comparatively fewer sessions (i.e. 7-10 sessions) to less structured talking therapeutic approaches.

Duddy :

A well trained CBT therapist will also be trained to look for medical or psychiatric variables that may need more specialized supports or interventions. Yet, I also strongly recommend that your grandson get a full physical done simultaneously to starting CBT therapy so that the CBT therapist can be aware of your grandson's full health status in designing specific interventions and work tailored to his needs. Finally, a CBT intervention will provide very structured information to inform any further diagnostic work beyond the CBT itself.

Duddy :

Please let me know your thoughts about my preliminary answer to your question.

Duddy :

I'll check back shortly for your next response.

Customer:

Your advise sounds very good to me. I appreciate your assistance. Thank you.

David Akiva, BA, MA,
Category: Mental Health
Satisfied Customers: 167
Experience: Counselor; Behavioral Consultant
David Akiva and other Mental Health Specialists are ready to help you
Expert:  David Akiva replied 3 years ago.
Your most welcome. I wish you and your grandson the very best!

- Duddy.

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David Akiva
David Akiva
Mental Health Professional
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Counselor; Behavioral Consultant