Column: It’s Never too Late: Therapy and Aging

By Donna C. Henderson

The Dalles Ore., January 2, 2024 — As we approach and pass yet another January 1, many of us will be taking the opportunity of the symbolic “fresh start” of the new calendar year to contemplate and commit to behaviors meant to promote and improve our health and well-being.

For some of us, starting (or resuming) behavioral health therapy is one of those.

For many older adults, however (as well as those who care for and about them), misconceptions about mental health and aging include the idea that we can become “too old” for therapy to be of any benefit, as though we were a piece of petrified wood someone was trying to water back to life! For others, it is the misconception that therapy is for people who “can’t solve their problems” (in fact, people who cope well and are good at problem-solving generally benefit much more from therapy than those who don’t).

In addition, physicians are more likely to miss the presence of depression (and other treatable mental health conditions) in older adult patients than in younger ones, often assuming that mood symptoms, energy levels, and cognitive changes (the kinds that would be an instant “red alert” if exhibited by a younger person) are simply an indication of normal aging, and so they are less likely to suggest treatment.

And if health care professionals don’t see these symptoms as a reason for older adults to seek therapy, writes geriatric psychiatrist Daniel Plotkin, MD in the AARP Bulletin,

then it’s no surprise that much of the general population holds the same prejudice. One study of people ages 60-79 found that the greatest barrier to seeking help was the belief that a decline in mental health was a normal part of aging.(It’s not.).

So it’s worth noting that research studies on the effectiveness of therapy by age have found (as I have observed, in my thirty years of experience as a therapist with people of all ages bears) that older adults often benefit more —and more quickly— from therapy than younger people do.

Why? As Dr. Plotkin explains it,

If we look at the ingredients for successful therapy, some key factors that emerge include the ability to form a good working (therapeutic) relationship, the motivation to change, ability to reflect. It turns out that all of these factors are associated with normal aging. Older adults are more oriented towards people and relationships than in younger years […] and they have a natural inclination to reflect and review their life (there is even a type of therapy based on this, called ‘life review’ or ‘reminiscence therapy’).

The reality is that our capacity for learning and changing continues throughout our lives, as we engage in new experiences while integrating what we’ve learned from the old. For older adults in particular, this learning and changing inevitably includes the challenges of adapting to the limitations and losses that are increasingly a part of our lives as we age. But it is precisely in meeting, greeting, and engaging with the challenges and changes that come with aging that we continue to refresh and deepen our vitality; challenges that the conversation of therapy can help to navigate and integrate.

My own mother’s experience of receiving therapy as an older adult is a case in point.

About a year after she joined A.A. and stopped drinking at age 70 (on New Year’s Day, as it happened), mom sought out a therapist to address the long-standing depression that she had begun, in her early twenties, to use alcohol to self-treat. Over the ten years that followed her last drink (before her death from cancer at 80) I had the privilege of watching her transform into a confident, creative, engaged, and joyfully alive older woman. By way of the self-understanding she had gained in the process of therapy, she was that much more able to realize and share the gifts of her life experience with her children and grandchildren, as well as with the older adults she later became trained to peer-counsel, and the medical students she was invited to guest- lecture.

Before the Covid pandemic, distance and the sparseness of regional resources were major obstacles for many in locating and accessing a therapist. But teletherapy (like other forms of telemedicine) has come into its own over the past four years and is now a covered benefit by Medicare, as well as most other health insurance policies. This makes therapy much more convenient for many older people (since transportation is not an obstacle), and also opens up the geographic range of potential resources to include any therapist licensed to practice in the state in which the client resides (or in which he/she is physically present when receiving services). And because most licensed therapists have both their websites and a listing in the nationwide Psychology Today Therapist Directory, it is easy to screen and filter for all kinds of parameters from “treatment approaches” to “training and experience” to “insurance taken” to “populations served,” and more. And, if you want to see someone in person, just type in your zip code for the nearest local matches.

As Dr. Plotkin writes, therapy is ultimately “a journey of self-discovery,” appropriate for any age. Why not begin 2024 by starting your journey now?