Thursday, October 13, 2016


At this time in my lifework as a psychotherapist I am seeing an increased number of clients in their 60's and 70's. Recently - in the same week - I started work with a man who is 87 and had a final session with a long time client who was 86 and dying. I am 74 and have my own personal experience with the aging process that I was able to bring into the conversations. As an elder in the field of psychotherapy with over 40 years of experience in private practice I would like to share my insights in the hope that they will help you with your clients who are aging.
For many of my patients in this stage of life there is an awareness - at some level of consciousness - that "their time is running out." For each of them there has been some life event that has begun that awakening. For some,like myself, it is a medical crisis that has triggered the process. Twelve years ago I had a very aggressive lymphoma which took thirty pounds from my tall and lean body. My very enlarged spleen was surgically removed followed by five months of chemotherapy. I was then and still are now very grateful to still be alive. At that time I became more acutely aware than ever before of the preciousness of time. The way I describe it to others,including my patients, is that "I now have two companions Aging and Death who walk with me every day. I have befriended them and are grateful for them because my awareness of them affects my decisions every day."
Every day there are multiple moments in which we make decisions about how to spend our time. A small example: one day while I was writing this blog I was really struggling about how to describe some notions. I stopped and asked myself,"What's going on?" Quickly the answer came. "I don't want to be doing this today." Years ago I would have just kept going and slogged through. At this time my two companions helped me to frame the question,"What do you want to do with your time today?" And the answer came back, "I want to continue that book about coyotes." I stopped and read with pleasure and peace of mind. The next day the writing flowed easily.
For others there is a minimization or denial of the aging process. One client initiated therapy at 71 saying,"For the first time in my life I wake up in the morning anxious and I don't know why." Another patient at 66 after looking forward to retirement for so many years was losing weight and feeling quite depressed and confused regarding these unexpected feelings that were showing up after he stopped working. For these clients my initial therapeutic task was to bring into awareness their underneath feelings about aging and dying. For them the phrase that I used that that most deeply resonated was "MY TIME IS RUNNING OUT."

As we age there are inevitable changes in our bodies and minds. Each of us in this stage of life to varying degrees is experiencing losses or diminishments in what our bodies are able to do. Also our brains are experiencing difficulties in accessing memories and feeling diminishments in our cognitive processing. In this brief blog it is not necessary for me to list the myriad possibilities. What is important is how we psychologically deal with these changes. It is essential for us to do the difficult task of acknowledging, grieving and accepting these losses. But it is also key not to over focus on them. Yet, probably because our culture overemphasizes the externals of physical appearance and fast efficient mental processing, many people frequently give a litany of these physical and cognitive diminishments. It is vital to acknowledge and honor that something else is also happening which from my perspective is the MAIN EVENT of aging. COEXISTING with the body losses and diminishments are the increased needs of our souls. As time in this body form is "running out" there is important, exciting and scary soul work to be done. We need to help our clients pay more attention to that process.
What are the core needs of our soul at this time? One of the primary needs of our soul is to be able to look back at our selves at earlier stages of our life with compassion, loving kindness and forgiveness.
It is a very human tendency for most of us to look back and see the mistakes we made, the pain we caused, our failure to do more for loved ones... Usually we look backward through a critical or judgmental or guilt-filled lens. My approach is to say to my clients,"You are looking from the perspective of your now self. You have evolved into a more developed person. At those earlier times in your life you were a less evolved person and you made those choices from your stage of development at that time. I would encourage you at this stage of your life to begin to look at those earlier versions of yourself with compassion and loving kindness." During the therapy process I will repeat that multiple times. Gradually my patients internalize my compassionate voice and then do it more for themselves. The way I theoretically conceptualize this process is that the source of that self-compassion is their personal Higher Self and that I am embodying that inner aspect for a while until they re able to access it themselves.
When talking about the needs of the soul I often use the metaphor of a jewel with many facets. When we arrive at this stage of life some of those facets(or aspects of our essential being) have been highly developed; others have been suppressed because of the need to support ourselves and raise a family; others are underdeveloped because they have never received any nurturance; others are deeply damaged by how others in the past have treated them; still others are so hidden that we have no awareness of their existence. From my perspective it is our task at this stage of life to reawaken and resurface those aspects of our soul to be honored and nourished in the time we have left. One example of this is the retired 70 year old furniture maker who had been a political activist in his early twenties who now wanted as a result of his therapy to find ways of doing service in his community. Through the assistance of his pastor he befriended an older couple in his community and he visited them regularly providing companionship especially for the husband whose wife was showing some early signs of dementia. Another example is the 65 year old successful businesswoman. who after selling her business decided to write songs, reawakening her long neglected passions of writing poetry and singing.


Our culture does not provide pathways of honoring the role of elders. Of course there are exceptions wherein some public figures and some members of our local communities are respected and valued for what they can offer to younger generations. From my perspective, however, every aging person has something to offer, some area(s) of accumulated knowledge and experience. They too should be respected as elders. In our culture, however, people past a certain age are expected to step aside- some are tossed out - for the next generation and then to go away into some state called "retirement." What is not done is to honor and provide for the role of elder and encourage younger people to seek them out as a source of guidance. That leaves many of us aging people in the position of having to personally claim the status of elder and offer ourselves to those younger people who are open. That is what I have done with my book(Working From the Heart: A Therapist's Guide to Heart-Centered Psychotherapy), my blog, Twitter accounts and Youtube videos. What I say in each of those vehicles is "At 74 years old with over 40 years of experience as a psychotherapist I want to pass on what I've learned." I encourage my aging patients to think of themselves as elders who have something to offer and find ways to offer it. Most of them have never thought of themselves as elders and are reluctant to acknowledge it because they question what is it that they have to offer. Gradually,though, they grow into the notion of being an elder and like it. One example: A patient who was involved with computers long before they became an essential tool for everyone has many years of experience in adapting to all the changes and solving the problems that inevitably arise. He decided to offer himself as a "computer pastor" who would make "house calls" for people who were struggling with computer problems He found an important and fulfilling niche in our community especially with people post 40 years of age who were really struggling with this now essential tool.
I know that the topic of aging is complex and a blog of a few pages cannot discuss everything. My hope is that some of these notions that I have offered are evocative to you and helpful in your work with your clients.