Saturday, January 19, 2019


I am 76 years old and still growing psychologically and as a psychotherapist. Many of my patients are in their 60's and 70's and are also still experiencing themselves as growing psychologically. Including some who are experiencing profound shifts in their way-of-being-in-the-world. I and my patients also do acknowledge the physical and cognitive changes of the aging process and the full spectrum of feelings that those changes evoke. And. We feel more open to the potential for continuing to grow psychologically and spiritually until we die.
One day, a year and a half ago I was in robust health. Suddenly - without any warning - within six hours I was riding in an ambulance heading for the emergency room where I was diagnosed with pneumonia and septic shock. If my wife Jeanne had arrived home an hour later - which would have been her usual time - she probably would have found her beloved husband dead. Before this episode I was already very conscious of my aging process. Yet, this sudden physical and psychological trauma still is affecting me every day. I have become even more acutely aware of the preciousness of every day of life. I have become more conscious of how certain behavior patterns and ego attachments to some ways-of-being-in-the-world have blocked me from being more open to the flow of life. I have become more open to the flow of love between myself and others including my patients. My life is feeling fuller and richer.
One of my patients started psychotherapy at 87 at the insistence of his girlfriend who stated that their relationship would end unless he addressed his anger issues. In the initial sessions he was able to acknowledge that his lifelong pattern of explosions of anger had been so destructive to all his relationships. In subsequent sessions he was to look at his tendency toward self-sabotage that had blocked him from being more successful and really enjoying the many accomplishments of his life. As our work progressed he was able to internalize my repeated reminder, "time is running out" and has worked hard to make changes. Now at 89 his frequent refrain is "I am a lucky man." This expresses his deep appreciation for the richness of his life - the people who love him, the accomplishments (which are still happening) and his own personhood. His relationship is thriving.
Another patient, who had initiated therapy at 68 because of anxiety, was, after a year in therapy, diagnosed with early onset dementia. Because of the dementia he became unable to work and to perform many of the fix-it chores around his home. These had been his primary ways of defining himself. Initially these losses increased his anxiety, made him feel useless and diminished his already low self-worth. Gradually, as he increasingly accepted his "condition" - his Buddhist meditation practice was very helpful in that process - I and his wife witnessed significant psychological and spiritual growth. In contrast to before, when his demeanor was more serious and guarded, he seemed "softer" with a sense of lightness of being. He became more able to feel that his wife loved him for who he was not for what he did for her or their home. He trusted more the solid foundation of their love built through all the struggles they had weathered together. As they reflected upon these changes, both of them felt that somehow the memory loss and cognitive diminishments of dementia were helping the process of letting go of old ways of viewing himself and others and creating a more flexible way of being.
Another patient had initiated therapy because of the psychospiritual crisis evoked by becoming 70. Several of his close friends had recently died. Several weeks before our first session, two of his other friends had been diagnosed with early onset dementia. Early in our therapy he realized that although he had been in therapy twice before some core issues had not changed in any significant way. He wanted to delve more deeply. I have witnessed this phenomenon repeatedly with my aging patients especially when they connect to the phrase "time is running out." He was amazed when I said that I experienced him as a "very sensitive soul" and that he had probably been that way all his life. It became clear that he was still experiencing life through the lens of a very sensitive boy who grew up in the everyday atmosphere of the complex trauma of a highly dysfunctional family. It was especially helpful when I labelled that part of himself as "Little Paulie" who was very fearful and still filled with family shame. We then used the name "Big Paul" for the adult part of himself that was witnessing with compassion "Little Paulie" and protectively encouraging him to grow up. "Big Paul" conveyed the attitude, "It's safe now. I'm here for you. You're not alone anymore." He was profoundly grateful that with a lot of hard work both during and between sessions he was gradually able - even at 70 - to significantly shift his perspective on life and himself.
I feel moved to tell these stories about myself and my patients because they are hopeful and are counter to our cultural narrative. Our cultural stereotype is that old people sit around talking about their litany of body pains and aches, their cognitive and memory losses and the deaths of their friends. There is a partial truth in that stereotype. When I gather with friends those issues are often brought up first. However, someone usually changes that narrative. When one of my friends asks me "How are you?" my usual response is some version of "A year and a half ago I almost died suddenly. Because of that I am more aware of the preciousness of every day and I am grateful for and more open to the richness of my life."
As psychotherapists and counsellors we can help change the inner narratives of our aging patients/clients and the cultural narrative about the aging process. Yes, it is important for us and our clients to be able to acknowledge the full spectrum of feelings evoked by all the losses. And. It is also essential to look at and be open to the ongoing opportunity for more psychospiritual growth. Perhaps it will be helpful for your clients to internalize the mantra "time is running out" not with a sense of fear and dread, but with a sense of deep awareness of the preciousness of each day. A question for each of us to be asking is, "If my time is limited what do I want to do with it, who do I want to share it with, and how do I want to be with these people?" This means looking at how we may be blocking deeper intimacy with the people in our lives. This means looking at how some old ways-of-being-in-the world, ways of viewing myself and others that may no longer be useful in this stage of life. This means looking at whether my thought processes are too focused on projecting into the future and upon the losses, that I am missing out on the present moments of everyday life. These are the questions we can help our aging clients to address.

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