Therapy Can Help in the Golden Years

I recently met with one of my clients who is 82 and a widower. He loved his wife very much and still misses her. It has been three years since she died but he feels that he “lost” her some time ago due to her dementia. He would like to begin to date and remarry someday but is overwhelmed with the thought of dating again after 62 years of marriage. He is seeking counseling to process his feelings about dating.

This reminds me of an article I read in the New York Times on April 22, 2013. The article discusses the elderly seeking counseling in their later years. Marvin Tolkin was 83 when he decided that the unexamined life wasn’t worth living. Until then, it had never occurred to him that there might be emotional “issues” he wanted to explore with a counselor.

Though he wasn’t clinically depressed, Mr. Tolkin struggled through a lot of things in his life-the demise of a long-term business partnership, the sudden death of his first wife 18 years ago. He worried about his children and grandchildren, and his relationship with his current wife, Carole.

So Mr. Tolkin began seeing a professional therapist. “Dr. Abrams is giving me a perspective that I didn’t think about,” he said. “It’s been making the transition of living at this age in relation to my family much better.”

Mr. Tolkin is one of many seniors who are seeking psychological help late in life. Most never set foot near an analyst’s couch in their younger years. But now, as people are living longer, and the stigma of psychological counseling has diminished, they are recognizing that their golden years might be easier if they alleviate the problems they have been carrying around for decades.

“We’ve been seeing more people in their 80s and older over the past five years, many who have never done therapy before,” said Dolores Gallagher-Thompson, a professor of research in the department of psychiatry at Stanford. “Usually, they’ve tried other resources like their church, or talked to family. They’re realizing that they’re living longer, and if you’ve got another 10 or 15 years, why be miserable if there’s something that can help you?”

Many are grappling with mental health issues unaddressed for decades, as well as contemporary concerns about new living arrangements, finances, chronic health problems, the loss of loved ones and their own mortality.

“It’s never too late, if someone has never dealt with issues,” said Judith Repetur, a clinical social worker in New York who works almost exclusively with older patients, many of whom are seeking help for the first time. “A combination of stresses late in life can bring up problems that weren’t resolved.”

When members of the Greatest Generation would feel comfortable talking to a therapist, or acknowledging psychological distress, it is a significant change. Many grew up in an era when only “crazy” people sought psychiatric help. They would never admit to themselves — and certainly not others — that anything might be wrong.

“For people in their 80s and 90s now, depression was considered almost a moral weakness,” said Dr. Gallagher-Thompson. “Fifty years ago, when they were in their 20s and 30s, people were locked up and someone threw away the key. They had a terrible fear that if they said they were depressed, they were going to end up in an institution. So they learned to look good and cover their problems as best they could.”

Some older patients may feel that they don’t have the time necessary to explore psychotherapy, or that it’s too late to change. But many eagerly embrace talk therapy, particularly cognitive behavioral techniques that focus on altering thought patterns and behaviors affecting their quality of life now.

Experts say that seniors generally have a higher satisfaction rate in therapy than younger people because they are usually more serious about it. Time is critical, and their goals usually are well defined. “Older patients realize that time is limited and precious and not to be wasted,” said Dr. Abrams. “They tend to be serious about the discussion and less tolerant of wasted time. They make great patients.”

Lisa Hansen, MSW

Elder Care Coordinator

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