Our Aging Families

Over the last 30 years, interactions between adult children and their aging parents have been changing in ways that have brought about a fundamental shift in what they want from therapy, and need from each other. As adult children craft their own lives—experiencing new vulnerability as they grapple with the hard demands of work, love, and having or not having kids—their parents are experiencing a parallel process of vulnerability and change. They’re growing older, and must wrestle with the challenges that aging brings, including a shifting sense of identity and sometimes physical and cognitive decline.

This phenomenon might seem timeworn, but these days, adult children are having kids significantly later than generations past. This, of course, means that their parents are older by the time this parallel process occurs. So when elder parents and adult children, alone or together, come to us for therapy, they often feel a sense of urgency that their time for healing family rifts is running out.

In March 2020, that anxiety went into overdrive. I’ve spent decades as a director of a large psychotherapy institute in New York City and a private practitioner working with parents and children, and I’ve never seen such a sudden shift in family dynamics as when the pandemic hit. When lockdowns and the specter of illness exposed already existing fault lines and threw our relationships and communities into disarray, it made us think harder about our connections and disconnections. The reality that any of us could suddenly succumb to COVID’s deadly effects—especially senior citizens, who comprised 75 percent of fatalities—caused many elder parents and their adult children to turn toward each other out of an intense and sometimes conflicted mutual concern. In my clinical work with them, I’ve developed a renewed sense that these relationships carry the pressures of time and an impermanence that deserve more attention from our field.

Baby Boomers, Gen Xers, and older Millennials make up approximately 60 percent of the U.S. population, and they represent the largest grouping of adult kids and parents. What this means for clinicians is that we’ll be hearing a lot more from these clients, who are feeling increasing anxiety about seeing each other grow older. Fortunately, I’ve learned that hard conversations around aging and death often lead to transformational insights that can increase closeness between elder parents and adult children. To better approach relationships between two parties at such different stages of life, I’ve found it helpful to address several paradoxes of growing older together.

Invisibility amid Specialness

For the most part, we revere our elder family members. After all, they’re living testaments to a family’s history, anchors who provide time-tested guidance and support to children and grandchildren. But despite this, I’ve found that many elder parents struggle with an increasing sense that they’re invisible. This invisibility can occur in the most innocuous of ways.

One of my clients, Martha, in her late 60s and a mother of three adult children, returned from a family gathering feeling depressed. “I know my kids love me,” she lamented, “but they were all talking so fast I couldn’t get a word in edgewise! When they’re not chatting, they’re on their phones. And now that they’re older, they’re the culinary masters, not me. I’m rarely even allowed to cook or assert my views. I just don’t know how to stay relevant.”

The common feeling of being marginalized too often leads elder parents to intrude in their children’s lives in an attempt to remain relevant, or withdrawing and secluding out of depression or resignation.

In clinical training, we rarely discuss how the overlapping challenges of emerging adulthood and the decline of elder parents contributes to feelings of invisibility for the older generation. But one of the goals of psychotherapy is to question assumptions, to turn misattuned concern and reflexive defensiveness into empathy. In working toward this goal, we can increase parents’ and children’s mutual visibility.

So where do we begin? Often with this pairing, there have been ruptures in the child-parent relationship, and these can be exacerbated by aging parents’ not-unrealistic anxiety that time to address the rupture is in short supply. Decades of unintended parenting errors, disconnection, and trauma may be part of the story. Respecting their anxiety and history, I stress the importance of moving slowly in treatment. For parents who are eager to become visible once again, I emphasize that rushing things can often lead to profound disappointment for all family members involved. “With so much time having passed,” I tell them, “hope can be a wonderful but dangerous thing to feel!”

Then I shift the focus from helping parents and children resolve old ruptures (reconciling different memories takes considerable time) to helping them learn to see each other more clearly in the present. I find that this almost always dissipates their combustible mixture of anticipation, hope, and fear, creating a safer space to process feelings more calmly, even as the clock ticks away for both generations.

Since reconnection doesn’t just happen on its own, I help my clients reawaken parent–child bonding activities that they once found mutually enjoyable, or create new ones. I focus on an elder parent’s perhaps forgotten, but embedded, life skills. These attributes are the therapist’s allies, highly valued by parents and often children. For example, Martha had once been an excellent piano player and had enjoyed playing music, in particular with one of her daughters, Caren, when Caren was a child. Now in her early 30s, Caren has been struggling to hold down a job, and she and her mother argue about this often.

Seeing them in session together, I focused on their history of struggles around control, but I also helped them schedule an agreed-upon time to play music together. Predictably, they bickered about the correct tuning and which songs to play, but this activity immediately addressed Martha’s feelings of marginalization and their parallel experiences of inadequacy. In a later session, Martha reported that after playing music with Caren, she felt more positively seen by her daughter, and appreciated that the two of them were beginning to find new ways to connect.

The Worried Aging Parent

Over the years, I’ve observed the subtle but devastating impact of ageism, and how it’s even directed toward those we love. One ageist stereotype is the perception that when young adults get older, they mature; when older adults get older, they age. This can make it especially difficult for parents in a later stage of life to open up about the weaknesses and frailties associated with aging, whether cognitive or physical. For many, it represents a real loss of interpersonal power, independent living, and admiration.

One elder mother who came to me for therapy admitted that despite her feminist and sex-positive beliefs, she desperately wanted to hide her aging body from her kids. And an elder father I work with, who’d recently suffered a near-fatal heart attack, admitted that before the event he’d been living with a sense of invincibility, something he’d desperately wanted to project to his children.

For some parents, the symptoms of aging also trigger deep anxieties and guilt about how their adult kids will fare without them, especially if they’re not successfully launched. Barbara, a 65-year-old single mother to 32-year-old Aiden, was a strong, compassionate woman, but had never opened up to her son about her fears of growing older as he continued to act out with substances and floundered from job to job. She didn’t want to seem rattled, guilt him, or lose any of his remaining respect.

Shortly after begrudgingly admitting in an individual session to the ways in which she’d aged, something unexpected happened. One night, when Aiden casually sauntered through the front door at 3 a.m. after ignoring her numerous texts, she spontaneously screamed, “I’m older now! Don’t you realize that?! I can’t keep worrying about you like this!” Aiden, taken aback, replied incredulously, “You? Get old? You’re way too tough! You can’t.” “Of course I can,” she replied, “and as I get older, I’m only worrying about you more.”

When Barbara told me about this in our next session, I was amazed at her directness and how it had managed to shock Aiden out of his paralysis. Their subsequent talk that night was the first tender exchange they’d had in a long time, and it marked a turning point in their relationship that allowed them to speak more openly about their life challenges and hopes for the future. This is the kind of dialogue that’s almost impossible to have when parents and children are younger and the clock isn’t ticking quite as loudly. For Aiden, it jumpstarted his journey to recovery.

The Worried Aging Child

It’s not just elder parents who fear what growing old means for the family. Adult children, too, worry about the passing of time and grow scared for their aging parents. Although they might speak about “age sightings” with siblings, friends, and therapists, they’re often afraid to talk about aging directly with mom and dad. Instead, they may lovingly, patronizingly, or symptomatically express their fears.

“How could you forget to buy ice cream, Mom?!” one of my usually empathic 30-year-old clients asked his mother at the end of an otherwise wonderful dinner. Another client, in his late 20s, told me he’d never obsessed about his own health until his father’s Parkinson’s began advancing.

My 38-year-old client Dave worried often about his father’s health. Even though his father, Paul, prided himself on staying active, Dave knew that his death was, of course, inevitable, and worried about what life would look like without his father’s emotional and financial support, though he never said as much out loud to him. When Paul’s 80th birthday rolled around and he continued to insist that he was a paragon of health, Dave’s anxiety intensified into depressive ruminations about his father and his own stalled life.

In a session with Dave, I reframed his father’s strident insistence that he was perfectly healthy as perhaps a growing recognition of the opposite—of mortality. “He’s frightened about the end of his life,” I told Dave. “He’s also afraid of leaving you and your relationship in an unfinished state.” Dave was silent, but that week, he called his father and they arranged a time to meet up and go for a walk.

In our next session, Dave told me that his father had finally expressed bewilderment about how old he’d become, and had disclosed some of the physical limitations he’d been trying to hide. And for the first time, Dave opened up about his own anxieties and fear of losing his father. Over the next few weeks, this newfound openness allowed them to talk in our sessions about the deaths of several relatives that had remained undiscussed for decades. I wasn’t surprised: recognition of life’s impermanence has a way of loosening stuck relationships.

Since we psychotherapists have mostly overlooked parents’ and adult children’s concerns about aging, in my work with them, I focus on elder parents’ vulnerabilities—without omitting their strengths. This dual lens almost always strengthens the parent–child relationship and uncovers unaddressed trauma. I regularly ask parents things like, “How do you see your getting on in years, and how do you deal with time passing and the non-negotiability of death?” I want to emphasize that it’s safe and necessary for both generations to discuss existential frailty. At a minimum, talking about it at this stage is preferable to just waiting for decline to happen.

Self-Care for the Aging Parent

Another important aspect of my work is to encourage aging parents to focus on self-care. Baby Boomers and Gen Xers are an extremely child-centered cohort, which makes it difficult for many Boomer parents today to prioritize taking care of themselves before their children. I’ve had to drive home the importance of this with nearly every elder parent I’ve worked with in therapy, especially as it relates to their caregiving tendencies with their now-adult children.

My client Maddie, in her 70s, is the mother of an adventurous daughter, Ali, in her mid-30s, who enjoys hiking in new places and travels for work whenever she can. When her son, Henry, entered toddlerhood, Ali began scheduling trips again and regularly asked Maddie to babysit.

Maddie loved being a grandmother and treasured spending time with Henry, but she began to resent that Ali just expected her to be a primary caretaker so she could travel. Every time Ali dropped Henry off, she’d come with a new list of parenting techniques she expected Maddie to follow, many of which seemed ridiculous to Maddie. Maddie, however, was frightened to confront Ali about it, despite her partner, Charlene, insisting that they never had enough time alone together anymore. In my session with Maddie and Charlene, I suggested that they each talk to Ali about how her trips were affecting them at this stage in their lives.

They balked at the notion of bringing up age, but a few weeks later, Maddie injured her back picking up Henry. It was a wakeup call, and she phoned Ali the next day. “I can’t believe I’m saying this,” she told her daughter. “I love you and Henry to death, but taking care of him so often so you can enjoy yourself isn’t how I want to spend these years. I’m happy to babysit when I can, but you need to find other arrangements when you go for longer trips.”

Ali was shocked to hear this at first, but after subsequent painful discussions about the divorce a decade earlier, Ali started reaching out to Henry’s father to increase his caregiving responsibilities. In the end, she said to Maddie, “Mom, I’m glad you’re taking care of yourself. You did an awesome job parenting me, but I can’t expect you to parent Henry. This needs to be your time, too.”

We hear talk about “aging gracefully” in terms of dieting, exercising, and taking general steps to increase our emotional and physical wellbeing, but rarely do we consider the relational aspect of what it means to age gracefully, how growing older affects the state of our relationships, and the importance of leaning into hard conversations about aging and loss with those we love. Helping parents and children remain present in each other’s lives, practice vulnerability, reconnect and repair hurts, and take better care of themselves and each other may seem like business as usual for us therapists, but I believe there’s something special about doing this work right now. The pandemic made even more plain, for therapists and nontherapists alike, what had been there all along: the fragility of life. It forced us to again take stock of what we have, what we’ve lost, and what might be renewed.

After three decades of working with families, I’m still encountering surprising new twists in the parent–child relationship. I’ve learned that much of psychotherapy with adult children and elder parents is about addressing our relationship to the passage of time. During this journey, I’ve found renewed passion to help family members, at a time of unique challenges and relational dynamics, move through life together as fellow guides—more collaboratively, honestly, and lovingly. If we therapists can accomplish that, we’ll have done our duty well.

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