Effective Clinical Supervision

A new paradigm for growing old

Effective Clinical Supervision

This article first appeared in the September/October 2007 issue.

Q: I now have many older clients. How can I help them make the most out of their lives as they age?

A: More people are living into very old age than ever before. Centenarians are commonplace today, with more than 70,000 in the United States alone. Assuming that longevity trends hold, most of us can expect to live well into our eighth or ninth decade. In fact, if you ask a typical person how long he or she expects to live, the likely answer will be 85 years almost a decade beyond our current average life expectancy.

The question of interest in the 21st century has turned from “How long will I live?” to “If I’m going to live a long time, how can I be happy in the process?” To be sure, the pitfalls to happiness and contentment loom large as the average person finds him- or herself living beyond the 80-year mark, when diseases of dementia including Alzheimer’s are more threatening than ever. Even if you’re lucky enough to avoid these dreadful conditions, no one escapes the diminution of memory, physical health, and day-to-day functioning that are part of advanced aging. Included in this collection of trials are the inevitability of caregiving and the loss of loved ones to death. From a practical point of view, it would seem that growing old portends misery, not happiness. However, in spite of the harsh realities of aging, most of us believe that old age is still worthwhile.

This optimistic attitude has been fueled by the Positive Psychology movement, which champions the idea that how we think about our day-to-day living shapes what it means to be happy. Now the principles of Positive Psychology are captured in a new term specific to later life–namely, “positive aging.” The idea behind positive aging is that there are sources of happiness in our later years that are inherent in the processes of growing old. In other words, positive aging is not how well we’re able to dodge our infirmities, but rather, our ability to focus on what makes life worthwhile in our later years in spite of the physical or mental challenges that may arise. We all have known people who were born with the type of attitude that allowed them to grow old gracefully and get the most out of life right up to the end. For the rest of us, however, there are specific actions and habits of mind that we can learn, which, with focus and practice, can help the process of aging become a more positive experience. To grow old with a positive frame of mind, it’s important to learn to take four basic actions:

Mobilize Your Resources

To make the most of your resources as you age, it’s helpful to learn to be selective, optimize, and compensate. Older adults who are better at adapting to the aging process limit their options or life choices in order to optimize functioning as their faculties decline. They regularly practice the behaviors that they want to remain intact and seek the types of support they require or use other compensation techniques to be able to carry out the activities they wish to continue doing. As an example, at 80, the renowned concert pianist Arthur Rubenstein was still able to maintain a high level of performance by playing fewer pieces (selectivity), practicing those pieces more often (optimization), and masking his loss of motor speed by learning to slow the overall tempo of the piece, allowing him to contrast its fast and slow segments (compensation).

Make Affirmative Lifestyle Choices

The challenge in life isn’t to avoid all bad choices, but to tip the scale of choices in favor of good ones. To increase the frequency of good choices and enhance your enjoyment of life as you age, it’s important to understand what your life goals are and then make decisions based on those ideals. Other qualities that can help you lead a self-directed and fulfilling life as you age are: – Knowing how to help or do for others and receive help in return. – Appreciating your place in the world and then choosing to make your contribution, however small, in that place. – Knowing how to approach life with the hope of self-improvement or self-actualization, with an ongoing desire to learn new things and have new experiences.

Cultivate Flexibility

Thinking outside the box isn’t just for youngsters. In fact, the science of aging has suggested that older adults may do this better than younger individuals. The cultivation of flexibility involves lifelong strategies of thinking and feeling in ways that counteract maladaptive patterns. People who age positively have learned to move beyond maladaptive patterns of thinking embedded in regret, rigidity, self-absorption, chronic worry, and negativity, and have cultivated flexibility by practicing life-enhancing skills, such as gratitude, forgiveness, and altruism.

Emphasize the Positives

Positive aging is a way of perceiving life that construes growing old as meaningful and worthwhile, regardless of the challenges that that old age inevitably presents. In a sense, positive aging is as much a state of mind as it is any specific physical or mental condition. The essence of what it means to be happy and healthy in old age is to discipline yourself to reframe perceptions and cultivate positive emotions as you cope with the dilemmas of old age. The science of aging has made great strides in understanding that older persons can be happy in their later years. Findings in neuroscience suggest that there may be specific neurobiological pathways for happiness that are activated as older persons practice positive aging skills. The challenge for therapists is to find ways to teach positive aging principles to their older clientele and, in the process, help them discover how to be happy as the years pass.

Robert Taibbi

Robert Taibbi, LCSW, is a Licensed Clinical Social Worker with over 40 years of experience primarily in community mental health working with couples and families as a clinician, supervisor and clinical director. Bob is the author of Clinical Supervision: A Four-Stage Process of Growth and Discovery and Clinical Social Work Supervision; Doing Couples Therapy: Craft and Creativity in Work with Intimate Partners; Doing Family Therapy: Craft and Creativity in Clinical Practice; Boot Camp Therapy: Action-Oriented Brief Treatment of Anxiety, Anger & Depression; and The Art of the First Session.