Told from the perspective of mothers who’ve lived it, Difficult focuses on mothering challenging adult children.
Difficult brings to life the conflicts that arise for mothers who are confronted with the unexpected, burdensome, and even catastrophic dependencies of their adult children associated with mental illness, substance use, or chronic unemployment. Through real stories of mothers and their challenging adult children, this book offers readable, provocative, and, at times, shocking illustrations of the excruciating maternal dilemma: Which takes precedence—the needs of the mother or of the distressed adult child? Difficult addresses a family situation which too many keep secret. The book allows readers to see that they are not alone. It includes resources for getting help: finding social support, staying safe, engaging in self-care, and helping the adult child.
Judith Smith speaks empathically to parents, acknowledging and illuminating the embarrassment, shame, and helplessness that women can feel when their adult children’s problems puncture their own feelings of self-worth. In the absence of sufficient supports and affordable housing for persons with mental illness or substance misuse disorder, mothers feel that they have no choice – “if not me, then who?” Unpaid and unrecognized maternal caregiving work continues to limit women’s quality of life, even, into their later years. Smith addresses this as a societal issue which requires structural solutions.
Difficult is for parents, concerned family and friends, health and mental health professionals, and policy makers. The book provides resources for women to find social support, stay safe, and engage in self-care.
Judith R. Smith, PhD, LCSW, is a leader in gerontological research focusing on women’s experiences as they age. She is a senior clinical social worker, psychotherapist, and professor of social work at Fordham University. She lives in New York City with her husband.
Part One Intro– Through A Mother’s Eyes
Chapter 1: What is a Difficult Adult Child?
Chapter 2: Once a Mother, Always a Mother?
Chapter 3: Give Me Shelter
Chapter 4: Shame and Blame
Chapter 5: Torn in Two
Chapter 6: Mental Illness in the Family
Chapter 7: Who Cares for the Mentally Ill?
Chapter 8: Substance Abuse in the Family
Chapter 9: Chromic Sorrow
Chapter 10: Violence in the Family
Chapter 11: Pain of the Past
Part Two Intro– Small Steps
Chapter 12: Stages of Change
Chapter 13: Seeing and Not Seeing
Chapter 14: Self-Assessment
Part Three Intro– Helping yourself
Chapter 15: Social Support
Chapter 16: Self-care
Chapter 17: Staying Safe
Chapter 18: Helping Your Adult Child Get Help
Chapter 19: What comes next?
Appendix A: Resources for Mothers and Adult Children
Appendix B: Research Methodology
Appendix C: The Mothers
Difficult: Mothering through conflict and commitment
Table of Contents
About the Author
This fine book will be profoundly helpful to all the women who needed it yesterday. At last, we have a book on the subject of difficult children that is profoundly sympathetic with and empathic toward mothers. It is excellent cultural therapy.
Difficult will appeal to a wide audience, most notably to women whose lives are consumed by the emotional, financial, and temporal demands of adult offspring who are unable to independently
manage their own lives. It will also be informative and useful to practitioners and academics in social work, sociology, gerontology, elder abuse, developmental psychology, and mental health. It can serve as a primer for anyone who wants to understand how and why some women feel the need to remain involved, even in control, of an adult child’s life. Any reader is sure to come away with a deeper appreciation for the immense burden carried by mothers who recognize an adult child’s chronic state of crisis and those mothers’ subsequent decision to mobilize when their adult child’s limitations manifest in consequences too dire to tolerate, thus necessitating their intervention and ongoing, active involvement.
This is an important and much-needed book. Professor Smith examines the many ways that mothers are profoundly affected by the struggles, sorrows, and needs of their adult children. I’ll be recommending it widely not only to parents, but to my colleagues. Difficult explores a neglected area of research and guidance that families, psychologists, and physicians, can learn from.
I am someone who has lived in fear in my own home, afraid of my own adult son. This book brings to light the unfair AND unsafe burden that has been placed on families of adult children with serious brain illnesses and substance use disorders. I hope every legislator, health care provider, social worker, and community leader reads this book and is moved to create the much-needed treatment policy changes, funding, and #HousingThatHeals for our adult children living with serious brain illnesses and substance use disorders.
The difficulties of having an adult child with problems, particularly those who are mentally ill, abusing substances, or violent is often overlooked by mental health professionals, the media, and the public. Any mother with difficult children who reads this will undoubtedly no longer feel so alone. It is a book of despair and of hope, anger and love.
We all know parents who are struggling with their difficult grown children. They would do well to read Difficult, a wise and insightful book. Judith Smith tells the hard family stories and offers both compassion and hope.
My father, my grandmother’s only child, was wrapped around her apron strings and purse strings that were tangled up to define a dependency that manifested chronic abuse. I wish I had Difficult to read as I helped save my grandmother; more, I wish she had Diffcult to read, to help prevent her abuse; most, I know Difficult will help many mothers, today.
This is an eye-opening book for many mothers, who may blame themselves for their adult child’s serious struggles. Smith tackles serious topics that are often considered off-limits, even within the family circle, like drug abuse, chronic unemployment, mental health problems, and violence. By combining solid research and evidence-based approaches with personal narratives of mothers across the sociodemographic spectrum, Smith helps readers make sense of how and why guilt, shame, love, and fear can drive behaviors that puts women’s own needs and well-being last—because “that’s what mothers do.” Just as critical are practical assessments and guidelines for self-care, stopping the enabling behavior, and getting help for themselves and their adult children. Every mother who has serious challenges with their adult child should read this book.
Difficult spotlights a mostly hidden problem and shows how re-framing can lead to creative problem solving. The labels we give to our troubled adult children—"mentally ill," "addict," "criminal"—are pejorative and lead only to shame and guilt in everyone concerned. When we consider someone or a situation as "difficult," we can take a breath and consider the possibilities for change. Smith refreshingly places these issues solidly in a cultural context, offers myriad examples of different paths these mothers have taken, and provides a solid list of resources. What a helpful book!
As the mother of an adult child with mental illness, I’d been searching for a book like Difficult for too long. The burden of never-ending parenthood requires unfathomable endurance, costs time and money, and promises nothing in return. The journey is full of isolation and despair and judgment. At a certain point, hope itself feels too optimistic—we aim for daily survival instead. But who can sustain the unsustainable alone? Maternal love can feel like a paradoxical trap, where love is both too much and never enough. Difficult is an essential book for parents of difficult adult children. Difficult acknowledges that individual mothers vary in where they’re at, in what they can and cannot tolerate. I imagine many readers, myself included, will wisely revisit this book numerous times along this most difficult of parenting journeys.
As a mother, a mental health educator, and an advocate for people affected by mental illness, I am always excited to see books that are devoted to the topic of improving our lives. Dr. Smith’s book takes on some of the toughest topics out there, which can be packed with emotion and fear. She addresses these topics by including valuable information interspersed with perspectives from people with lived experience. The consistent messages throughout are that you are not alone and you have to take care of yourself to be able to take care of those you love.
As a mother who lived with and lost an adult child with substance use issues, I always felt very alone. Difficult made me realize that so many mothers struggle as I did, and that there is not one right answer for everyone. Parents do so much for their children, but they cannot help them with this. I thought this book was extremely helpful and a must read.
Many people assume that the stress of parenting ends when children reach adulthood. However, research shows that children’s problems can have profound effects on parents’ well-being into their later years. In Difficult, Judith Smith breaks new ground in a compelling, sensitive, and ultimately highly useful portrait of mothers coping with the challenges of their adult offspring. Dr. Smith blends the latest research with rich interviews with mothers, capturing the chronic stress they experience and highlighting where practitioners, and society at large, can help. Any reader interested in families in later life will find this book compelling. More important, parents who currently struggle with adult offspring suffering from mental illness, substance abuse, or other issues will appreciate the concrete advice and tips for coping with and improving their situations.
In this thorough, empathetic account of this important previously-swept-aside issue, Judith R. Smith combines eight years of research and grimly honest stories from mothers of children who have SMI (serious mental illness), addiction, and other issues we never expected to face in our kids. There has never been a book like this. If you’re a mother still inside the journey no one wants to speak about, get this book. You’ll be glad you did.
Reading this very welcome book, I was faced with a barrage of emotions: Terrible sadness at the sacrifices made by so many women to keep their child as safe as they know how; Anger at the expectations and prejudices in the attitudes of others towards mothers giving a home or a helping hand to their adult children; Weary resignation in the knowledge that the public services needed to take over the care still do not exist in sufficient numbers; A smile at the similarities in so much of the book with my own field of child to parent violence and abuse; [and] a shout of joy that the book exists – an answer to so many emails and calls for help that I and others receive each week!
[Smith] offers a nuanced and compassionate portrait of the women engaged in difficult mothering, along with guidance on how to move forward.... “A mother’s self-blame and her internal mandate to protect her children do not disappear as her children age,” Smith writes. Fortunately, Difficult serves as a much-needed source of wisdom, compassion, and practical instruction for women engaged in the task of difficult mothering.
1/18/22, Next Avenue: Judith Smith wrote an article based on the book.
2/10/22, Schizophrenia: Three Moms in the Trenches Podcast: Judith Smith joined Randye Kaye to talk about the book.
2/16/22, The New York Times: Jessica Grose’s On Parenting newsletter centers around the book and interviews author Judith Smith.
2/18/22, Bite Your Tongue Podcast: Judith was interviewed about the book.
3/24/22, Mutha Magazine: Smith was interviewed about the book in this article.
5/15/22, Wall Street Journal: Author Judith Smith and the book were mentioned in an article about adult children returning home due to crisis.
8/19/22, National Alliance on Mental Illness: Judith Smith wrote about the challenges of mothering adult children in this blog post.