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How Older Clients Help Us Grow

Older people have often been overlooked in psychotherapy literature, and Freud even went so far as to state that people over 50 could not benefit from psychoanalysis. For Helen Kewell, this is a huge loss, both for an aging population that needs support, and for the therapy profession itself. The author of a new book of case studies focused on older clients, here she explains why such work is not just necessary and meaningful, but helps us grow as therapists.

 

We are living in a rapidly ageing society. It is predicted that the number of people over 80 will double by 2037 and the number of people over 90 will triple. Despite studies showing that they are more content than the younger population, there remains within this growing demographic a propensity for poor mental health: depression affects around a quarter of people over the age of 65. Supporting the mental health of those in their final few decades is something we will all need to care about, no matter how uncomfortable we feel about it. For me it is challenging, rewarding work – and I hope this blog will inspire more people to do the same.

1. It is subversive!

Contemporary society often groups ‘the elderly’ into an amorphous, vulnerable mass, a far cry from the ‘elder’ culture of previous centuries and other cultures. However, the person before you, who may look frail, with whitened hair or poor vision or posture, has an identity and life that transcends what you immediately see. Our job is to find and experience the unique identity of the person before us, in all its glory. And in doing so, offer the possibility of a different way of relating. We can be an antidote to objectification, and wonderfully, subversively so!

2. It engages us fully with the idea of death

Working in any supportive capacity with people near the end of life necessitates a courageous attitude to death. We may think that talking about death will be painful for the ageing or dying person, but it can be incredibly isolating if those around avoid or try to minimise it… think of poor Ivan Ilyich in Tolstoy’s famous tale! Research shows that when people who are close to death are actively encouraged to explore it, they in fact live longer. However, this requires us to admit to ourselves that all life will end, which means we must face our own death. As an existential therapist this is somewhat of an occupational requirement, but I absolutely find it life affirming to do so, through supervision, reflective practice and my own therapy I find my connection to life feels stronger and more meaningful as a result.

3. It debunks the idea of vulnerability

It is difficult not to subconsciously assume the role of a rescuer when someone appears to be physically or emotionally frail. Every time I have assumed, or made allowances for, a vulnerability with an elderly client without checking it out, I have been proved wrong, or our work has been derailed. We are all vulnerable, we all close the door on our counselling room and confront the stark realities of our life. Once you find and nurture the purpose, capability and resilience in even the most seemingly dependent and frail client, you can feel hope for whatever life then throws at you.

4. We get to journey through the stories of others’ lives

As we age, we face almost constant change; logistically, biologically, neurologically and psychologically. One way of protecting and evolving our identity as we age is to recount the stories of our lives. Short-term memory can suffer but long-term memories can still be vibrant, and reassuring. One of the absolute privileges of working with older and profoundly old clients is witnessing this telling and retelling of life stories. Far from a sentimental exercise, it is a powerful way for clients to find meaning and acceptance. As ever, our job is to be curious, notice inconsistency, gently reach for narratives that are hidden or reluctant to come forward. For anyone with even a mild curiosity about life and its meaning, this process is irresistibly rewarding.

Living Well and Dying Well: Tales of Counselling Older People, by Helen Kewell, is published by PCCS Books.

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Helen Kewell

Helen Kewell is a humanistic counsellor with a private counselling practice in Sussex, and volunteers as a counsellor and supervisor for Cruse Bereavement Care. During her training, Helen became profoundly influenced by existential and experiential approaches to therapy and, almost inadvertently, became fascinated and inspired by working with older adults. She considers this area of psychotherapeutic work to be underrepresented in literature and under-resourced and hopes to continue to promote a wider dialogue on it and prompt others to do the same.

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