It manifested as a series of slow and muddy setbacks—nothing as straightforward as, say, a psychotic break—but Sean’s* Problem followed him for most of his life, flaring up in quiet moments, barely perceptible behind his affable Midwestern boyishness. These days, he’s starting to think the Problem began around the third grade. He lays it all out plainly. After all, Sean is used to telling his life story. He’s been doing it constantly for more than a year.
At Yellowbrick Treatment Center in Evanston, Illinois, the country’s preeminent facility dedicated to addressing the various demons that prevent “emerging adults” from growing up, they call this the Narrative. Upon arrival at Yellowbrick, where Sean had been living, you recount your Narrative for a group of psychologists, from start to finish. A few times a week, you share your Narrative or listen to the Narratives of others. And once discharged from Yellowbrick, according to one former patient, you may listen to a robotic recording of your Narrative, transcribed into a computer program in the third person, with heart-rate monitors affixed to your body. So it’s no surprise that Sean’s got the Narrative thing down pat.
It goes something like this: He grew up in a leafy “bubble” of a suburb, the oldest child of an orthopedic surgeon and an accountant turned stay-at-home mom. Sean was a gifted kid, a good kid, until around the age of eight or nine, when long division and more complicated phonics came around. It didn’t come as naturally to him; his parents were not pleased; he gave up on being the smart one. It’s easy to imagine Sean, cruising through public school, taking on the role of a lovable wayward goofball as the years go by. Even now, at 30, in basketball shorts and a backward baby blue cap, he looks like a kid who transcends high school hierarchies—an open-faced, unassuming guy, into sports without the bravado, a “sweetheart” according to his friends. He’s run with many of the same guys since he was in diapers.
But Sean found during his sophomore year of high school that being a solid dude only gets you so far. He failed out and his parents shipped him off to one of those therapeutic boarding schools on the East Coast, a place that promised to turn around “bright but underachieving kids.” There, he had teachers with barely a bachelor’s degree waking him up at dawn, picking him apart. After a year Sean got to go home, held back a grade. But everything, he says, changed after that. So maybe that’s when the Problem started to attach itself more firmly to his psyche.
A full year behind his friends, he still staggered half-asleep through the whole leafy suburban thing: high school, graduation, college. He followed his friends to school, but never declared a major and dropped out right before his final year. And then he landed back at his parents’ house, where he would live for the next seven years: delivering pizzas, drinking beer with his buddies, watching them move from career to marriage without him—and along the way, progressing through a number of disconcerting solitary habits, from nightly drinking to nightly benzos to railing nightly lines of heroin.
Mental health disorders are real; so are the forces that create the vast chasm between what we expect and what we get; so is the crushing, universal defeat of aging into the person you’re going to be forever.
“At the end of the day, I just wanted to relax,” he says, “and not have to think about the fact that I didn’t know how to do anything in life.”
Shortly before Sean’s 26th birthday, a large charge from a Suboxone clinic in the city appeared on his parents’ credit card statement, splaying out the side effects of his Problem for them to see. Having dried up his savings and been laid off from his job, he’d Googled around to see where he could procure the drug, which occupies the same receptors as heroin but doesn’t get you high, staving off the symptoms of physical withdrawal indefinitely. He quit heroin on the spot. But Sean’s parents—simple people, he says, who “live life and trust the assembly line” that turns out well-adjusted adults—were understandably freaked.
Which is how Sean ended up in therapy, seeing a guy who kept suggesting this place called Yellowbrick. “I was like, ‘No way, I’m not going to some booby hatch,’” he says. But then a couple more years passed, a blur of pizza deliveries and nights watching movies alone. Sean was nearing his 29th birthday, and the boredom of sobriety was excruciating. He was still at his parents’ house and his buddies, many of them settled down, weren’t even going out anymore.
Sean knew something had to change. “So I just went for it,” he says. He’d spend the next year living at Yellowbrick, a program that costs around $27,500 a month and is aimed at people roughly between the ages of 18 and 30, some of whom suffer from a Problem only recently attributed to American youth: the failure to launch from childhood onto the shores of something recognizably, functionally adult.
Somewhere between Obama’s election and the economy’s hobble out of the recession, the “millennial” predicament—the basic premise of which remains fashionable today—was brought into sharp focus by anxious Boomers armed with Pew studies and dire anecdotal evidence. The media agreed: Rather than acting like sensible adults, young people were spending their post-collegiate years “finding themselves.” They were marrying later, shacking up with roommates, unable or unwilling to lock themselves into stable careers or even a permanent home. They “boomeranged” back to mom and dad’s, as captured in a New Yorker cover where a kid hangs his PhD on the wall of his childhood bedroom, parents gazing on in anguish.
The existential angst, driven by parents who’d thrown every conceivable resource at their offspring only to find them unable to advance, resulted in a mass hallucination that the only young people alive in America are young people with resources. Material barriers to upward mobility like college debt and stagnant job markets remained, at best, footnotes in an endless train of trend pieces about the baffling flightiness of American youth.
Every moral panic has its favored experts. In the early 2010s, in Time magazine’s “Me Me Generation” cover story and in the widely shared The New York Times Magazine piece, “What Is It About 20-Somethings?” that expert was a psychologist named Jeffrey Jensen Arnett.
A decade ago, Arnett and colleague Jennifer Lynn Tanner published a book, Emerging Adults in America: Coming of Age in the 21st Century, which popularized the idea of a discrete developmental life stage, one in which young people were not yet roped into the comfortable institutions of long-term employment or marriage yet remained unloosed from many forms of parental control. In “What Is It About 20-Somethings?,” which ran while I was in college, the writer Robin Marantz Henig, a parent of an emerging adult herself, stress-tests the theory: She visits a live-in treatment facility called Yellowbrick, where Arnett sits on the board.
The article, with little irony, describes a treatment center fostering independence in college-age youth through the 24-hour availability of staff who instruct residents in basic life skills: scheduling, cleaning, “showing up.” It mentions a boy so stuck he couldn’t bring himself to turn in a final paper at an Ivy League school.
Maybe it was my sense that at 22 I was a full-fledged adult (a certainty that has diminished every year since) but at the time I found the article infantilizing and absurd. The Yellowbrick model struck me as an extension of the institutions, like private colleges, that stunt the development of the privileged by treating them like children—a symptom of the affliction rather than its cure.
Growing up is horrifying, no matter your tax bracket. When someone I know is paralyzed by the cognitive dissonance between their ambitions and their prospects, spiraling into a deep suicidal depression, there isn’t much that seems “emerging” to me about their adulthood. Mental health disorders are real; so are the forces that create the vast chasm between what we expect and what we get; so is the crushing, universal defeat of aging into the person you’re going to be forever. How could any facility, no matter how cutting-edge, hope to address all that?
In few fields are culture and science as intertwined as in psychiatry. When I met with one of Yellowbrick’s specialists, he spoke to me of “complex trauma,” which occurs when hurtful experiences—for example, a child’s parents deriding them—are repeated over a period of years, creating symptoms similar to PTSD. Some historians have catalogued as many as 80 different names for post-traumatic stress, from combat stress to nostalgia to “disorderly action of the heart.”
To give one example: In the ‘60s, an Army psychiatrist named William Menninger believed PTSD was the product not of war but a weak society in which weak men were raised. A culture, he wrote, at “the immature stage of development, characterized by, ‘I want what I want when I want it, and to hell with the rest of the world.’” Many of Yellowbrick’s patients have spent time at the Menninger Clinic, a Texas mental hospital co-founded by that doctor. Their stance on what constitutes trauma is now significantly more complex.
For most of the day, five days a week, patients receive treatment, they sit in small rooms with therapists, they debrief, they gossip, they repeat.
The “emerging adult” theory of the brain has become a popular one in recent years—a couple of teacher friends tell me they’ve been briefed on it—but it isn’t universally admired. When I reach Steven Mintz, a University of Texas professor who has published extensively on the history of adulthood, he describes the life stage between adolescence and adulthood as “circumstantial, and situational, but not psychological.”
“There are great challenges” for the 20-something age group, he says, particularly those who don’t come from affluent families. It is a period where many young people’s lives are completely derailed, particularly if they have children, fail to graduate, or are incarcerated.
“The manifestation of depression and anxiety is not disconnected,” he says. “But that doesn’t mean that this stage of life is pathological.”
Yellowbrick was founded a decade ago specifically to treat “emerging adult” brains. It helps its patients navigate the extended period between childhood and adulthood by fostering habits vaguely existential in nature: the realistic setting of life goals, the formation of an adult relationship to one’s family, “identity consolidation” and self-esteem.
The center’s staff of 33 ministers to a live-in population that hovers around 15, as well as a number of outpatients—though in recent years it has been expanding more aggressively. Yellowbrick’s psychologists are nationally recognized. They run the conference circuit and publish their own (non-peer reviewed) research journal. Their approach is holistic in the most extreme sense of the word. Some of the neurological treatments Yellowbrick draws on are still being research-tested; it complements them with yoga and meditation, massage, dramatic role-play, and art therapy.
Yellowbrick describes its emerging adult patients as “troubled.” It treats, among other things, mood and anxiety disorders, PTSD, psychosis, avoidant personalities, substance abuse, eating disorders, and “failure to launch.” Like other forward-looking residential facilities of its kind, it rarely issues a single diagnosis, preferring to treat patients for a handful of behaviors at a time.
Patients live in a building of four communal apartments (“the Res”) on a quiet suburban street in Evanston, 14 miles north of Chicago. Every day they travel by car or foot the half mile downtown to Yellowbrick’s treatment center, a labyrinth of rooms with dark wood desks and soft carpeting, which mutes patient’s clatter as they migrate between sessions. For most of the day, five days a week, they receive treatment, they sit in small rooms with therapists, they debrief, they gossip, they repeat.
Everything at the facility has a name. Assigned individual therapists are Advocates; lunch is referred to as Connections; rules are Community Agreements. When those Agreements are broken, they turn into Public Behaviors. Intense relationships—romantic, sexual, platonically conspiratorial—are called Coupling, and when you engage in them, there’s a worksheet to fill out (sample question: “How does being part of a couple affect your engagement in your treatment?”) and a protocol to follow. In twice-weekly community meetings, patients and doctors alike air grievances (see: Public Behavior) and tell each other how much they’ve transformed.
Yellowbrick’s reception area is indistinguishable from that of any other high-end medical office but for the blown-up copy of “What Is It About 20-Somethings?” strategically framed on the wall. Dr. Viner motions to it within seconds of my arrival.
Dr. Jesse Viner, simply Viner to his patients, is a well-dressed, square-faced man, a master of the micro-gesture. His voice is soft and deliberate, like it’s being rendered in HD. I’m warned before I meet him that he will probably ask about my dreams. He doesn’t, but I get it. When I sit in his cool, dim corner office, I can’t quite figure out what to do with my hands. A couple of days later, he will casually ask if I’m angry with him, and I will have absolutely no idea what to say.
Yellowbrick is Dr. Viner’s brainchild. Ivy-educated and fantastically accomplished, he is trained both as a psychiatrist and a psychoanalyst; before founding Yellowbrick, he served as the director of adult psychiatry at Northwestern’s medical school and as the medical director of Four Winds, a now-shuttered rehab clinic. Dr. Viner’s references are appropriately acrobatic for the kind of work he does; he speaks with equal, measured passion about re-regulating brain activity and shepherding healing relationships through the development of self-esteem. “Self definition,” he tells me, “is the engine of experience.”
Google Dr. Viner’s practice and you will find a polarized customer base. “If it weren’t for Dr. Viner and the Yellowbrick staff,” reads one online review, “I wouldn’t have come out of my shell and become my authentic self.” On the other hand: “Dr. Viner will take all the money he can get from your family, convince you [you’re] worse in the process to in the end get more money, and when the cash runs out, kick you to the curb.”
Residential treatment is expensive, its success rates opaque. As many as 80% of people who take a stab at rehab will relapse, but being rehabilitated into functional adulthood doesn’t come with metrics as straightforward as a 30-day chip. There are at least several hundred private facilities in the United States treating mental health and substance issues; the array of choices, from private detox bungalows in Malibu to tough-love wilderness retreats, can be so overwhelming there’s a parallel cottage industry to help families decide where to send their troubled loved ones. Generally, residential treatment costs between $800 and $1,500 a day, depending on a center’s amenities and its level of clinical care. But as Dr. Viner notes, there are centers on the West Coast that cost double what his does.
Prominently on its website, in bold, Yellowbrick reminds the parents of prospective patients of its minimum financial commitment (10 weeks) and the insurance situation (private pay). Estimated costs per month come in around $27,500, which depending on an individual diagnosis could include daily rates of $295 for room and board; $675 for a day of group and individual therapies; $450 for trauma, substance abuse, and eating disorder treatments; $50 to $100 for half an hour of life skills coaching; or $325 for deep transcranial magnetic stimulation. Dr. Viner tells me at Yellowbrick there is really no typical length of stay.
The initial mental health assessment—cost: $7,950—lasts three full days. Dr. Laura Viner, Jesse’s wife, oversees the process. An Actiheart monitor, placed on the chest, is used to gauge the patient’s psychical reaction to various stimuli. Technicians perform QEEG (quantitative electroencephalography) brain scans. During the session, a patient and their family recall at great length the patient’s family life, their academic histories, their medical records. At the end of those three days, a diagnosis: a list of afflictions recognized by the Diagnostic and Statistical Manual of Mental Disorders, with percentages. And, if the patient is continuing treatment, a plan.
About five years ago, Yellowbrick founded its Center for Clinical Neuroscience. It includes services like pharmacogenomic testing, which analyzes DNA, and deep transcranial magnetic stimulation, a treatment that battles medication-resistant depression with battery-sized zaps to the brain. During my tour of the small, converted office where such equipment is held, I asked if there was anything I could try. The center’s neurofeedback machine feels like an arcade game, but it’s technically a kind of brain calisthenics, translating brainwave activity onto a screen and rewarding meditative focus. Sensors were attached to my forehead and earlobes. With Dr. Viner and a technician standing behind me, I was told to quiet my mind until my avatar, a neon jaguar, raced ahead. The jaguar stalled; I blame performance anxiety.
The staff at Yellowbrick—the nutritionist and the therapists and the yoga teachers—they’re all such nice people. Their faces are capable of the most extreme contortions, cartoon-level pictures of concern and empathy. During my visit, I ask nearly all of them whether the Yellowbrick model would look the same for kids with different incomes, and they all tell me absolutely, without a doubt, this is it, the best. If only we could. Perhaps, some admit, with a different population the specific shape of the treatment would naturally shift: No discussion groups about privilege. Abandonment issues of a different flavor. Less time spent excavating the “pressure to be exceptional.”
Dr. Viner says he has given significant aid on a case-by-case basis to patients he describes as honest, collaborative, and “willing to do the work” of Yellowbrick. That said, there’s still payroll every two weeks. “When people argue about or object to paying for a service in healthcare,” he says, “you forget they’re also demanding, you know, the highest level of quality in that care.”
The apartments in the Res look like the empty set of a roommate-drama sitcom—breezy and neat, if a little bland; communal but with lots of room to fight over whose turn it is to clean the bathroom. A whiteboard assigns chores. There’s an Intro to Psychology textbook on the coffee table in the basement-level apartment.
“Jesse would kill you if you called it the basement,” Pam Sheffer, Yellowbrick’s outreach director, tells me. (Yellowbrick prefers “garden apartment.”) I am helpless with Pam; she is so awesome. At 69, she reminds me of the matriarchs in the Irish Catholic families I grew up around in the outskirts of Boston, right down to the makeup applied to the outer corners of her eyes and the geometric shapes that dangle from her ears. If Dr. Viner is sensitive to the point of self-caricature, Pam is the compassionate, matter-of-fact cynic.
As Pam leads me up the stairs, she recounts a rare altercation between two residents: She called the police. Less immediately threatening forms of rule-breaking (Coupling, skipping too many Groups, bullying) are considered opportunities to grow. You fill out a worksheet, you discuss during a Community Meeting, you come to understand the offending behavior as a symptom of your “core enactment,” the center’s shorthand for all the bad habits and destructive patterns and childhood neurosis that keep good people down.
So nearly no one at Yellowbrick is on lockdown—though if you come home drunk or are judged a danger to yourself, there’s a quiet room with soft chairs and a white noise machine on the first floor for you. Curfew is at 11 PM, unless you call to say you’ll be late. Chimes go off in the staff office when a door to one of the Res apartments open, a different tone for every floor.
A binder full of job and volunteer opportunities printed out from the internet sits on a table in the house’s common room. The paid jobs are mostly panini-making and dishwashing (the very jobs, I can’t help but think, you’re supposed to be able to dodge by being an effective, well-adjusted college graduate). Pam says some of these kids have never even run a dishwasher before. She shows me across the cool, secluded cobblestone patio to a renovated garage, where an art project dries on the floor.
There isn’t much to do at Yellowbrick at night. In the evening, after therapy, you could join an AA meeting or smoke cigarettes in the covered garden next to the Res. I hear that at one point watching the rehab reality show Intervention on the apartment’s flat-screen was a popular pastime.
Yellowbrick works hard to ensure its patients’ privacy: no photos, no social media posts, certainly no names in articles written about the center. I’m shown a lot of empty rooms during my tour but see few of the people who inhabit them. The starkness of this absence, in tangent with the staff’s narration of vivid personal transformations, leaves me with the unsettling feeling that there’s some life-defining event happening just behind every closed door.
“If you’re not just trying to clean up a mess, but you’re trying to paint a painting, you go to Yellowbrick.”- Sean, former patient
I am permitted to visit Individual Rounds, the backbone of Yellowbrick’s model. During the session, Yellowbrick’s entire professional staff files into a room. A patient’s Advocate briefs the assembled on what progress has thus been made. One patient, I hear, wavers rapidly between extreme anxiety (“I’ll never get a job”) and illusions of overcompensation (“I could run my father’s business better”). Another’s guilt makes him afraid of metaphorically killing his dad, Dr. Viner thinks. Struggling with parents who don’t believe in mental illness is a regular concern.
After the briefing, the patient is brought in and the entire staff takes them on, 14-to-1. They’re asked how they think their treatment is going. “Is there a more feelingful way to express that anger?” they’re asked. Every interaction they’ve had recently, at mealtime and in therapy and in the evening with roommates, is folded into a single continuum of behavior, broken down and prodded.
There’s a lot of pregnant silence. One guy in his early twenties wearing cargo shorts mumbles and balks. He’s not sure what it will feel like not to be the problem child. He admits he’s a little afraid of going home, of leaving this place that’s been so transformative, where all this progress has been made.
Later, in an interview with one long-time staff member, I mention my initial frustration with The New York Times Magazine article proudly plastered on Yellowbrick’s walls. Thanks to what I imagine to be a very professional game of telephone, I find myself in Dr. Viner’s office several hours later, asked about my comment. “I want to get this out of the way,” Dr. Viner says before we sit. “Robbie said you might be angry with me.” The sudden intimacy of the question renders me momentarily speechless.
There are actually two Yellowbricks. One is the Yellowbrick the doctors show me, a forward-looking facility for the life-threateningly troubled. The other is the friendly halfway house for finding yourself, the one Sean describes like this: “If you’re not just trying to clean up a mess, but you’re trying to paint a painting, you go to Yellowbrick.” Occasionally, complications arise from the institution’s split personality.
Bethany was 22 when she first arrived at Yellowbrick, referred there from Menninger, a clinical setting—more hospital, less Crate & Barrel—where Dr. Viner is a member of the foundation’s board. She was living in the South when her parents told her to get help with her eating disorder or she’d be cut off. She describes it as a “surrender”; it wasn’t like she was in a good place to support herself, and her anorexia was getting worse. But it didn’t get better at Menninger, and her doctors told her if she wasn’t going to eat, her meds wouldn’t work. There wasn’t anything they could do. So they recommended a place with “a more intense eating disorder program,” though Yellowbrick’s program didn’t so much increase the care for her illness as try to tackle its underlying causes.
A lot of kids get referred by Menninger, and if they exhaust Yellowbrick’s capacities, say by dropping below a certain BMI or exhibiting signs of intense drug addiction, they’re sent to one of the more extensive local rehab centers. Pam tells me this rarely happens, but Bethany says she was discharged from Yellowbrick twice, both times for falling below the required weight. “It’s kind of rough,” she says, “considering that was the main reason I went to Yellowbrick, to get help with this.”
Bethany describes Yellowbrick as fun; it felt like a family. Her time there was “a really gradual breakdown, of cutting the layers of the onion.” She stayed seven months before they discharged her the first time. The day I speak to her, months later, on the phone from her home town, she’d recently spent a night locked up at the mandate of her current therapist, who considered her a danger to herself.
But when Isaac, a mop-headed 22-year-old arrived for Yellowbrick’s initial session, he remembers them telling his mom: “This program was designed for people like Isaac. He has a lot of abilities, but just can’t get it all to connect.” Direct and unselfconscious, Isaac was probably the smartest kid in your AP history class. He arrived at Yellowbrick straight from a psych ward in Detroit.
His three main diagnoses were major depression, major anxiety, and panic disorder in remission. His Narrative, he tells me not far from his apartment in Chicago, was all about the lying.
He’s the oldest son—“In an Arabic culture,” says Isaac, who is half Syrian, “it’s very prince-esque.” A few years ago, he was in community college, having failed to make it work at the school his parents preferred. Working as a dishwasher, living at his mom’s house, he struggled with depression and saw a therapist a few times a week. The therapist didn’t want him using drugs, and the lying sort of started there—a few “binges” of LSD, cocaine at a party every once in awhile, but mostly alcohol and lots and lots of weed.
“That’s Viner’s dream—to be that person who took in the lost of the lost, and saved them, and turned them around.”- Isaac, former patient
Isaac was doing OK in school, but during the second semester at community college he got “complacent,” in his words. “I felt really bad about where I’d fallen from,” he says. “It’s kind of conceited, but at the same time, my suburb is so, ‘Look at you, where are you now,’ that kind of thing. It’s a bubble.” But between living with his folks and working at the restaurant, he had more than enough money to keep coasting; plus he had a girlfriend and buddies at a college nearby to hang with on the weekends. So first, when Isaac got a C in English, he lied to his mom, and said he got an A.
“I was like ‘Whoa,’” he says, “I can just lie about the grades.” Isaac soon realized he could lie about other things: going to class, for one, and in a couple of months, whether he still had a job. Until, that is, his mother sent a friend to the restaurant to confirm her suspicions about her son’s employment status. Isaac panicked and found his grandfather’s painkillers the same day.
Upon arrival at Yellowbrick, Isaac continued his anti-anxiety meds. It was recommended he participate in the addiction recovery and the trauma group—the latter, he says, he declined until a few months down the road, when he started to feel like he was in a rut, and needed “to work some stuff out with my dad.” Additionally, he was prescribed what he says they called nutraceuticals, or “brain vitamins.” Regular sleep cycles, visits to the gym, and square meals are understood as “brain hygiene” at Yellowbrick.
Dr. Viner tells me in his soft, reflective tone that about half of Yellowbrick’s residents come with one serious attempt at suicide; half of those have made numerous attempts at their own life. He cites research demonstrating that people with psychotic illnesses tend to die 20 years earlier than the general population—not because of suicide, mind you, but because they have poor self-care. From Dr. Viner and the rest of the staff’s perspective, the career counseling, the life skills instruction, the pre-loaded credit cards meant to teach healthy budgeting practices, aren’t self-indulgent: They’re a rational response to a public health crisis. Most of the people who come to Yellowbrick, Dr. Viner says, come because treatment in their own community has failed.
But it’s difficult for me to gauge the overall character of the patients currently residing in the Yellowbrick house, because I’m not allowed to talk to them.
On the phone, weeks before I land in Illinois, I’m told it’s an ethical issue, which isn’t about “whether or not [the patients] agree” to an interview, though nearly all of them are well above age. “It’s whether they can give informed consent,” Dr. Viner says. “It becomes part of their relationship with us. They want to please us…We know it’s really not the right thing for them.”
Some people at Yellowbrick, says Isaac, couldn’t function well because they were “on the spectrum,” others “were just very, very entitled.” He thinks that at times the center holds on to patients longer than it should, particularly if they aren’t getting better—an opinion Dr. Viner rejects, noting that treatment is voluntary and collaborative, and that both patients and families are “informed consumers” making their own choices. Anger could be a symptom of the emotional and financial burden patients have placed on their parents, he says: “Scapegoating us is an easy way to dodge that bullet for themselves.” Plus, “when someone has been living in their basement for seven years, smoking dope and watching video games and yelling at their parents, to say we kept them an extra six weeks—that’s a little disingenuous.”
During my conversation with Isaac, he goes a little bug-eyed when I mention the impression I’m getting from some members of the staff, that Yellowbrick is something of a last hope for patients whose other treatments have failed. “That’s Viner’s dream,” he says, “to be that person who took in the lost of the lost, and saved them, and turned them around.”
Some simply don’t get turned around all the way, and leaving a small world that emphasizes self-esteem and community can be hard, after several months or a year. Lauren, a producer in her early thirties who lived in Yellowbrick following a work-related collapse and a worsening eating disorder, went through a “dark couple months” when she left to live in a Chicago apartment with another alum—she ended up back in the Res. Now, she’s out, but she still misses it. Sometimes she wishes she could go back.
Lauren is grateful—nearly everyone is. The former patients, like the doctors and the prominent psychologists offering testimonials on Yellowbrick’s website, tell me Yellowbrick is the best of the best. Even the ones who bounced out and back or into other programs, still struggling. Even Bethany, who tells me the same morning that another alum called her “barred out” on Xanax, high as hell, babbling about some girl he was in love with: “I don’t know anyone who went to Yellowbrick who’s like, ‘I’m doing awesome!’” Still, she’s thankful for the breakthroughs the staff facilitated. She realized during her tenure at Yellowbrick, excruciating as it was, that her parents “speak a different language” than she does, that “they’re never going to understand” her struggles.
At Yellowbrick, being the best means being on the cutting edge, which is surely reassuring to parents who prefer brain scans to talk therapy and art classes. But state-of-the-art, in the rapidly changing landscape of brain science, can mean unproven. Recently I spoke to Carrie Bearden, of UCLA’s Brain Research Institute, who directs a research clinic for adolescents at high risk for developing psychosis. “It’s a shame how these things are being presented,” she says. “They call it a center for clinical neuroscience, as if this is [all] scientifically founded.”
Some things on the Yellowbrick menu, Bearden told me, are currently being used in research centers—the diagnostic interviews, for example: “There’s nothing wrong with giving user-friendly reports.” But she refers to transcranial magnetic stimulation as something of an experimental treatment, and says that using QEEG brain scans and genetically informed psychopharmacology—the process using DNA analysis to inform medication—to diagnose and treat individuals is, at this stage, functionally impossible.
Stability is rare and fleeting. It’s not the reality for most people I know.
Bearden is most troubled by the ethical implications of Yellowbrick’s model. “It’s fine if people want to collect data or do research on these phenomena,” she says. “But really it all comes down to how this is being paid for. And if patients are being told that this is a state-of-the-art treatment facility and this is part of the treatment, and they’re paying for these services? That’s really not OK.”
In a phone call a few months later, Dr. Viner says the techniques Yellowbrick uses are not unique or rare; moreso, they inspire hope. The center works with people for whom standard care has been ineffective, he says, and many patients are at significant risk of death or disability. “So not to employ everything that might have a research base but may not be totally mainstream? That would feel negligent on our part.”
At times, in my conversations with former Yellowbrick patients, my notebook seemed like the only thing separating me from the people I was interviewing. A month after I visited, I dreamt I returned for a follow-up interview, knocked back a few too many IPAs, lost my job, and stayed.
Which isn’t to say that Bethany—who says in a text message weeks after my visit that she “obviously has issues”—and I are dealing with anything remotely similar. It’s just that pairing pathology with emerging adulthood, finding the symptoms of a treatable illness in years of dead-end jobs or overwhelming performance anxiety as much as in violent acts of self-harm, is confounding and humbling territory.
We tend to soothe the awful messiness of human experience with countermeasures that reflect our basic understanding of the world.
Who hasn’t considered, in their darkest moments, that their poor life choices might be an indication of something inside them that’s deeply and irrevocably damaged? How much do you have to fuck up your life in young adulthood to never recover? Stability is rare and fleeting. It’s not the reality for most people I know.
The stories the affluent tell about their lives, the neuroses they stoke, trickle down and become the standard for everyone else. On some level, everyone in their twenties is waiting for the Big One to come: the final mistake that can’t be corrected, the thing that keeps a promising young person from turning into whatever passes these days for an actualized adult.
After eight months of treatment and the shock of his re-entry into Planet Adult’s orbit, Isaac has a great appreciation for the staff individually, but has complex feelings about the effectiveness of Yellowbrick’s treatment. He’s on “thin ice” with his mother since he “slipped up” and lied about a grade again recently.
In the fallout, he made an appointment with a member of the Yellowbrick staff “and I had to ask him…do I have to pay for this?” (He didn’t.) The question didn’t come out of nowhere—his stepfather is of the opinion that some of Yellowbrick’s practices “seem like a money grab.” During Isaac’s relatively short tenure, there was a conflict over housing; overcrowding was an issue. ”The group mentality feels very churn ‘em out, onto the next one,” at times, Isaac says.
Dr. Viner says the housing issue was a singular misunderstanding in a decade of practice. He has compassion for the parents of Yellowbrick’s patients and all the suffering they’ve experienced at the hands of mental illness. But the center has a clear guarantor agreement, with mutual responsibilities and obligations. People enter into it out of their own free will. The prices, he reiterates, are fair.
And Sean, for his part, feels fine about the cost-benefit ratio; he turned his life around at Yellowbrick. He’s off the Suboxone, happy, enrolled in a college class (philosophy, he tells me, with an ironic laugh). Together, he and his parents decided it was time for him to leave the Res. It’s a tapered process—when I met him in July, he was still going to the Community Meetings, seeing his Advocate, attending Group.
“Shit,” he said, “I just had a Public Behavior, I drank last weekend, but I’m on the way out.” Mostly, his decision to leave came out of some quick math: His parents said they’d never pay this rent, but rent is surely cheaper than Yellowbrick. Now that he’s doing better, they got him an apartment not far from the center.
A few years ago, the sociologist Jennifer Silva coined the term “mood economy,” to describe the appropriation of therapeutic language among working-class 20-somethings. In extensive interviews with this demographic, she found that rather than telling the story of their ascension to adulthood though traditional markers like marriage or career progression, they told “their coming of age stories as a struggle to triumph over demons of their pasts.” These narratives, she writes, “grounded their adult identities in their personal quests to transform their wounded selves”—usually in terms of overcoming the pain of earlier relationships, the turmoil of mental disorders, or an addiction of some kind.
“It’s a chicken and an egg kind of thing, the failure to launch,” admits Isaac, between pulls of a cigarette on a warm day in Chicago, sun catching his glasses. “Is it people constantly saying, ‘It’s okay, you failed to launch, we’ll catch you?’ Or is it, ‘Hey, you really do need some help putting this all together?’” He knows it isn’t fair, but he sometimes thinks about the people he’s known who got it together—whatever “it” could possibly be—without the 24-hour support, the communal apartments, the months-long dedication to self-definition.
It’s in the contract I signed with Yellowbrick, a contract that was still being negotiated as I drove from O’Hare to Evanston, that I would “capture the essence of humanity” in the people struggling with mental illness I observed. Like a lot of Yellowbrick’s language, the clause expresses sober ideas (in this case, respect for patient privacy) in lofty, existential terms. I suppose that’s part of the territory when you’re in the business of teaching young people how to rewire their brains.
I thought about that humanity line a lot. Even with all the privilege required to spend time in a 15-person therapeutic community tailored to the common anxieties of one’s class, it would be wrong to suggest the people I spoke to didn’t need some kind of help, or that their mental illnesses were less real than others. That said, we tend to soothe the awful messiness of human experience with countermeasures that reflect our basic understanding of the world. As one former patient told me, laughing, during one of my first interviews for this story: Her family liked to joke they didn’t have God. They had therapy.
*Fusion changed the names and some identifying details of patients, which was a condition for access to Yellowbrick’s facility.