Helping Our Clients Come to Terms with Impermanence: Aging Isn’t for Wimps!

There are an abundance of articles, Instagram posts and podcasts telling seniors how to “Age Well.” This can be wonderful and empowering information, but it can also create false hopes and unrealistic expectations leading to pain, shame and guilt if we don’t perceive ourselves as aging in the best possible way. 

Let’s face it, there are many normal and natural changes that a person’s body may go through as it ages. And no matter how fabulously we excel at aging, or how many of the good health tips we follow, we will still age and eventually die. Clients may blame themselves and wonder what they did wrong when their bodies don’t respond in an optimal way. They may also be embarrassed and ashamed that they aren’t aging better.

This self-blame and shame frequently come up for clients experiencing depression. They are not only depressed but feel guilty for being depressed because according to social media feeds, happiness is a choice. If we aren’t happy, we must be doing something wrong . . . Maybe it’s our negative thinking?

Sadly, I saw this up close when my mom was diagnosed with cancer. She was embarrassed and didn’t want to tell friends or neighbors about her diagnosis. It was as if cancer was a moral failing. Actually, my mom was the kind of woman who even felt embarrassed if she needed to take a nap. Her self-identity was tied into being a strong woman and naps and cancer didn’t fit with her view of herself.

Judging oneself doesn’t help the depressed client or the senior. And frankly everything isn’t within one’s control. Genetic makeup, environment and many other factors impact health, longevity, and mood.

One way we can help our older clients navigate changes that come with aging is to help them let go of the stigma that there is a gold standard of aging. Your office can be a place where clients can talk about what aging is like for them, and look their reality squarely in the eyes. They can grieve their losses, let go of guilt and begin to see and feel the positive (and not so positive) aspects of aging. 

As the ancient Greek philosopher, Heraclitus, said, “The only constant in life is change.” This is also a key tenant in Buddhist philosophy, accepting that everything is temporary and nothing is certain. Our clients so often suffer because they believe that if they just do this aging thing right their bodies and the universe will cooperate; they will “Age Well” and maybe even be a super-senior.

I don’t want to dash my clients’ hopes of being able to control the aging process. Instead, I want to help them widen their understanding of aging and themselves. I want to help them accept that all may not go according to their plans no matter how well they follow best practices for aging.

Spouses can die prematurely; clients can lose their vision or their hearing or get a devastating diagnosis. Or on a smaller level, the changes may be as simple and as mundane as getting tired earlier or no longer being able to take their daily 4-mile hike. These things won’t happen to everyone as they age, but most likely there will be some changes that are outside of our clients’ control.

As therapists it is important to know how to support our clients when they can’t change their bodies or their circumstances, but instead need to learn to accept their new reality, future uncertainty, and maybe even some diminished capacities.

Some approaches that are helpful in this process are Existential Therapy, Logotherapy, and ACT (Acceptance and Commitment Therapy).

On one level we need to be a companion on this existential journey. We can best serve our client by helping them reflect on the impact that aging is having on their bodies, relationships, and identity. We can help them explore the questions: “Am I the same ‘me’ only older, or has aging changed who I am? Has aging changed my sense of identity and how I see myself? Has aging changed how others see me? These are important and existential questions because so much of how one defines oneself may be changing. For instance, has your client always seen herself as an athlete? Or has his job title been his identity? Helping our clients understand who they are when these labels are stripped away is essential.It can pave the way to help them find a deeper sense of who they are.

Logotherapy, developed by Victor Frankl, can also be useful in helping our clients find meaning in their suffering. Victor Frankl was a holocaust survivor and, in his book, Man’s Search for Meaning, he emphasized that when all is stripped away, we can still choose our attitude.

Neither Existential Therapy nor Logotherapy deny difficult realities. Instead, both therapies focus on looking at the individual realities of aging. They provide ways for our clients to process their thoughts, feelings, hopes and expectations so they can reach a deeper understanding of themselves.

ACT (Acceptance and Commitment Therapy) can also be a useful therapeutic approach to help our clients come to terms with aging and their mortality. ACT starts with encouraging our clients to be mindful of their current realities without judgement . . . then moving towards embracing what is. This approach doesn’t mean giving up on proactive steps toward creating a more fulfilling and comfortable future. Rather as the Serenity Prayer prescribes, it helps our clients accept the things they cannot change. ACT also helps our clients reassess their core values and commit to taking steps that are in alignment with those values. 

In Ezra Bayda’s book, “Aging for Beginners,” he says, “. . . we are all beginners when it comes to the process of aging — none of us has ever done any of this before” and as therapists we can give our older clients a place where they can explore their thoughts, feelings, and fears about the process. We can help our clients feel less alone in this journey of self-discovery.

Kim Scott, LMFT is a licensed marriage, family and child therapist. She has a private practice in Granada Hills where she works with couples and individuals, in-person and via Telehealth. Kim has been licensed for 30 years and has expertise in working with older adults and women issues. To learn more about Kim's practice and to read more of her articles visit her website: www.kimscottmft.com.