What therapy can offer the older adult

Good therapy can help older adult clients relate positively to their emotions, especially when they want to move on from the past and face new challenges confidently. At the same time, it can help with recognising that well-established patterns of behaviours may not be serving them as well as they once did.

Whilst older adults often experience many losses and disappointments in their lives, they may not have learnt how to express their feelings when they experience loss, such as death, divorce, moving/leaving home, health, identity and self. And, when adult clients have spent many years in the role of 'helper' or 'carer', asking for help can seem impossible. To do so can lead to feeling a failure, shame or being 'less than'.

Whatever our age and stage in life, connecting with others in meaningful ways tends to make people happier and helps with self-esteem. Studies have shown that one of the best things older adults can do to help with their mental well-being is talking and listening. Since good therapy is about both, the therapeutic experience can provide a useful model for clients to practise outside the therapy room. 

Contrary to popular belief, studies have shown that the ability to focus on whatever we are engaging with can actually improve with age. And what better way to demonstrate this than in the therapy room?

Joan* needed to talk. And to keep talking until she had felt she had said all she wanted to say. My job was to actively listen so I could understand how she was experiencing her own situation. It seemed she had not felt ready to re-engage in the world following the loss of her husband two years previously. Working through her losses and disappointments, the need to talk to someone who was not emotionally involved and was not going to push their own agenda, would remain non-judgemental and 'just' accept what Joan had to say felt like the opportunity for which she had been waiting.

Listening to her story, I noticed the artwork which was on display and I was not surprised to hear that her 'creative streak' seemed to have deserted her. She yearned to pick up a paintbrush again. The importance of self-expression seemed a life force for Joan. It provided an escape, a focus and time for self - all of which seemed to have been unavailable to her. Her story suggested she had felt responsible for much of her life - an important and necessary role, yet tiring and stressful at the same time.

She came over as a woman who was full of life with an agile mind which reflected the bright colours of her art. Therapy, I thought, could help her reconnect with herself. Hopefully, this would provide a way for her to move on to the next chapter of her life. She could come to realise she had now reached a stage in her life when she could access her own inner resources. She just needed help in finding that much-needed space in her head to do so. We needed to do some decluttering!

Donna*, recently divorced after decades of marriage, needed to explore the reasons why she had stayed for so long. As someone who worked in the care sector, she found it hard to understand how she had allowed herself to remain in such an unhealthy relationship.

The immediate aftermath of the divorce felt like freedom, however, it wasn't long until she was off sick from work, unable to focus, felt lonely and at a loss as to how she could find a way out of the continual spiral of negative thinking which seemed a daily preoccupation. We talked about how a divorce can feel like a bereavement - the grief needs to be worked through and finding a therapeutic breathing space for herself could help her move on.

For the older adult, the passage of time can feel both slow and quick as thoughts of mortality become more prominent, options shrink and a nagging feeling that it may be too late to find happiness. Often, older adults reflect on their 'wasted years'. For Donna, therapy provided her with an opportunity to consider and take time to work through her feelings; it offered her an opportunity to get some perspective whilst she focused on her own needs.

Having cared for her family and her ex-husband for so long, now it was time to learn to care for herself. She would need to do this if she was going to give herself a chance of finding a new relationship (which she wanted). To have a good chance of achieving this outcome required a different way of thinking, and letting go of old habits which were no longer considered useful.

It can take some time to achieve this if we find ourselves resistant to change. It can feel risky, scary even. However, the rewards for unlearning empty habits can be empowering and well worth the effort.

Good therapy offers change and hope if it takes place in the context of a safe, supportive therapeutic relationship.

Steve* accessed therapy having lost his brother three years ago. He clearly found it hard to express how he felt. However, having offered reassurance that therapy was a safe place to talk, he acknowledged he needed to tell someone how it felt to lose his brother. It had been a sudden death and, therefore, a shock that had left him struggling to make sense of life itself.

He felt lonely and isolated in his grief and making the decision to seek help was probably a very hard thing to do. He had been the older brother who looked after his younger sibling. With the loss of this key responsibility, it seemed his purpose in life had disappeared. He seemed baffled - why was it that his parents seemed to have dealt with the loss whilst he continued to struggle?

Therapy provided a safe space to express his feelings, to be compassionate towards himself and recognise he had the right to feel the way he did. Talking about his feelings was not easy for Steve, yet he stuck with therapy because, as he said, he realised he needed to let his feelings go in his own way and in a place where he felt it was safe to share, and above all, to be heard.

It seemed to me, working with these older adult clients, a common thread running through the work was they had learnt to keep their feelings to themselves; that life went on regardless, to accept 'their lot' - until that is, they reached a breaking point. Then, a realisation took place when they needed to seek help from themselves.

However, before they could truly access the help on hand, they needed to find space in their own minds to process their thoughts. We would need to clear out the clutter first which frequently included negative self-belief and a sense of worthlessness.  When they could do this, they discovered they had learnt a lifelong skill of 'letting go' and could face the future with more confidence.

In my experience, older adults who come for therapy have often focused on taking care of others for years, usually at a detriment to meeting their own needs. This becomes embedded over time and can come to feel like it is the only way to survive. We can become stuck in our ways which has an impact not only on the individual but on those around them. 

Good therapy for the older adult provides a space in which they can give themselves permission to take care of themselves and their physical and psychological well-being. This, in turn, helps them to connect with themselves and others which is so vital to well-being and a sense of purpose in the later years.

* Names have been changed.