Relationships: 3 Secrets to Engaging Millennial Patients

Relationships: 3 Secrets to Engaging Millennial Patients

Are you looking for ways to relate with your millennial clients?  Would you like to better understand the hookup culture?

As per Alexandra Solomon’s, Ph.D. talk “Inside Hookup Culture” at the 2016 Psychotherapy Networker Symposium, there are 3 important steps to engaging your younger clients.

1.Be nonjudgmental

2.Meet them where they are

3.Invite them to develop relational self-awareness

Be Nonjudgmental

Being nonjudgmental includes taking an open-minded and curious position towards your younger patients. She suggests asking them questions and minimizing any reactivity.

It involves becoming informed and increasing your awareness about the hookup culture. Please see the Minimalist Guide to Hookup Culture (part one of this article) for a quick overview.

In addition, it may be helpful to read up about millennials’ main issues and concerns. To that end, Solomon recommends reading these books:

  • The Defining Decade: Why Your Twenties Matter And How to Make the Most of Them Now by Meg Jay
  • “Modern Romance” by Aziz Ansari and Eric Klinenberg
  • Reclaiming Conversation: The Power of Talk in a Digital Age” by Sherry Turkle

Briefly, twenty-somethings are facing a very different environment than generation X or boomers. They are digital natives versus those of us who are digital immigrants, (i.e., individuals born before 1983).

One main theme for Millennials is that they “want to get it right.” They have heard from boomers’ stories of them settling down too soon and received the advice that they should get married later. They have also heard from generation X stories of them getting married too late and only having a baby when they were 40-years old. Twenty-somethings want to avoid the mistakes of the boomers and generation X and get it right, but they are not clear on what that means.

As seen in part one, the way most digital natives are setting up their hookups is via various dating apps.

To help your clients stay safe:

  • Encourage them to put very little information on their dating app profiles.
  • Have conversations about how to date and keep professional boundaries.
  • Suggest that they move from online to meeting face to face as soon as possible to avoid SMIAB “soul mate in a box,” someone they feel closest to [online] but never meet or talk to in real life.

Meet Them Where They Are

As per Solomon, the vast majority of college students have never had the chance to talk to an adult about sex other than from a fear-ased place such as birth control and sexually transmitted diseases.

They want to talk about sex and relationships; they want to get it right but are confused. They need wholehearted sex education.

Be prepared to talk to your clients about:

  • What they define as sexy
  • Their relationship to their body
  • How they define pleasure
  • The role of sex in an intimate relationship
  • What were the messages received growing up about sex
  • How did they come to believe what they believe about sex
  • Whether they understand their body
  • What are their constraints to giving and receiving pleasure

Invite Them to Develop Relational Self-Awareness

Solomon defines relational self-awareness as a “brave, deep and intimate relationship with self” and this is the foundation for an intimate relationship with a partner.

To help your clients develop relational self-awareness, it is advised to take a sex-positive stance, rely on science/neuroscience and avoid any tsk, tsk or moralizing.

There are two primary focuses:

  • Encourage your clients to listen to their own gut
  • Support alignment of your clients’ goals, values and behaviors

Talk about how everyone has their own sense of internal wisdom and the importance of trusting and becoming attuned to their own sense of intuition.Invite them to understand the messages they received about closeness, love, conflict and role of sex (all essential pieces of relational self-awareness).

Suggest they talk to the people who raised them and ask about their relationship to bring further clarification on these questions. This will help them better understand their family of origin, integrate past, present and future, and gain insight about themselves and what their love template is.

  • Encourage sober hookingup to keep the connection to gut clear.
  • Explain the science of how one cannot listen to one’s gut under the influence of alcohol. One cannot know if one wants more/less of this or this is enough, or this is one’s boundary. Consent becomes very muddy. One cannot hear one’s gut when one is drunk.
  • 20% of college women have experienced unwanted sex.
  • College women are more likely to be raped if participating in hookup culture. When your partner is drunk, he cannot read his gut’s feedback or your feedback.

When supporting alignment of goals, values and behavior:

  • Be curious about what they perceive as the benefits/fears of having a relationship.
    • Being in a committed relationship can feel smothering. The price of privilege is a lack of anger/envisioning a revolution, perhaps because their parents are looking at them like long-term projects, high-achieving extensions of themselves.
    • Sexual double standards. Men rack up points for having sex with as many women as they like, while women can be labeled a slut.
      • There is lack of clarity over what is slut behavior.
      • Women avoid carrying condoms out of fear of being called a slut.

Figure out what their position/sexual script is and provide them with psychoeducation to normalize their feelings.

  • Many have “I can have this fuss, no muss” sex script and then feel confused afterwards because they are finding that they feel something towards the partner. They may feel jealous or suddenly want clarification of their relationship and then they feel shame because they are not getting the “fuss, no muss” script right.
  • Position self as sex positive while also holding onto sex as sacred. Explain how sex is sacred, old, powerful magic and they have tied their bodies together. Talk about the science: what happens to the body and brain when engaging in acts of sex (how it is normal to start feeling and caring for the person with whom you are making out despite intentions to “careless”). It is natural that they want clarification and experience jealousy.
  • Encourage them to listen to their own internal sense of wisdom/intuition.
    • This will tell them what, when and how to do things in alignment with their goals and values.
    • If client wants a relationship but what they are doing is getting drunk and having sex, you can talk about alignment. How does their behavior align with their goals?
  • Support women getting into driver’s seat. Talk from a position of deconstructive feminism.
    • Talk about right to explore sexuality and honor what’s really hers. What is keeping her from inviting a different conversation? A limiting 180 character conversation is not the answer.
    • Suggest asking “What do I desire?” instead of “How am I desired?”
    • Using science, talk about the difference in sex quality in hook ups vs. relationships.
      • Sex in hookups is of lesser quality for both men and women due to lack of safety. Our bodies are wired to enjoy sex when you feel safe. You can only feel truly safe with someone else whom you know, like and are emotionally connected.
      • Oral sex is equitable in relationships but tends to be highly inequitable in hookups, favoring the male.
  • Lastly, recommend clients spend more time with themselves and others and less time with technology to rewire their brains to increase their ability to empathize. Their relationship with themselves is empathy-bound.
    • Solomon shares that there has been a 40% drop in empathy among young adults over the last twenty years and that is probably a reflection of technology. Our frequent use of technology doesn’t make this problem get any better.
    • This is indicated in the careless behaviors of ghosting, icing and simmering (see relationship accountability graphic for a description of what these terms mean).
    • To combat this decline, suggest [all] clients track itchiness to check smartphone and try to stretch their boundary, whatever their current level is. The smartphone is killing our ability to be alone with ourselves, with our emotions. We need to have some time to daydream.
    • Lastly, talk about the science of mindfulness as a foundation for intimacy.

Solomon gave much food for thought on what to read, think and talk about with our clients! I look forward to her upcoming book in 2017: “Loving Bravely: 20 Lessons of Self-Discovery to Help You Get the Love You Want.”

Click for larger image


Solomon, A. (2016, March 19). Inside hookup culture. 2016 Networker Symposium Session# 7160-427.

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Relationships: 3 Secrets to Engaging Millennial Patients

Dorlee Michaeli, MBA, LCSW

Dorlee Michaeli, MBA, LCSW, a therapist in private practice, is psychoanalytically trained and certified in EMDR. She is passionate about helping individuals heal and thrive. She works as a consultant and is editor of SocialWork.Career. Visit her at


APA Reference
Michaeli, D. (2016). Relationships: 3 Secrets to Engaging Millennial Patients. Psych Central. Retrieved on July 15, 2020, from


Scientifically Reviewed
Last updated: 2 Nov 2016
Last reviewed: By John M. Grohol, Psy.D. on 2 Nov 2016
Published on All rights reserved.