The Case for the Older Therapist

Five Therapeutic Lessons That Only Come with Age and Practice

Walter Lowe

Even in the field of therapy—where emotional maturity and wisdom supposedly count for something—the enthusiasm, bravado, and pure physical energy of youth sometimes trump the sobriety, skepticism, caution, and, well, fatigue afflicting those of us who'll never see 40—or 50, or 60, or even 70—again. Sometimes, brash young Turks instinctively do brilliant therapy that their older teachers and mentors couldn't or wouldn't dare to do, even after four cups of coffee and two shots of ginseng extract. That said, there's nothing like experience—the slow, steady accretion of millions of new neural connections—for teaching us how to do something well, and that can only come with time and age.

Time and practice, practice, practice count as much or more than formal instruction in becoming an expert at therapy or just about anything else—medicine, law, carpentry, fire-fighting, or violin-playing. The longer you've been at it, the more deeply knowledgeable and skilled at the work you're likely to be.

So, first in line of Lowe's Laws for Codger Therapists is:

Our Age and Life Experiences Allow Us to Understand a Wider Range of Clients.

All the major life passages that older therapists have experienced—marriage, perhaps divorce, rearing children, juggling two jobs or working rotating shifts, coping with economic stress, illness, aging parents, death—means that they're likely to know with firsthand knowledge what their clients are feeling. The older you get, the less shocked or thrown for a loop you're likely to be by a client's dilemma, having handled quite a few of your own dilemmas. In the very best sense, you've already been there, done that.

Given that you have, or have worked to attain, a fairly well-balanced psyche of your own, your familiarity with life's conundrums breeds, not contempt, but a certain confident unflappability. If you've taken charge of your own life, your own marriage, your own teenagers, chances are you'll be better able to exert compassionate control in the therapy room with angry spouses, defiant adolescents, and families in which everybody talks furiously over everybody else and all at once. You're no longer afraid, as young therapists sometimes are, to give orders—tell the overbearing husband to be quiet or the teenager to quit cursing her mother—and make it happen. And, with clients who are going through particularly tough times—a death or other severe loss—simply the fact that you've no doubt suffered your own losses enables you to convey the understanding and comfort of one who really does know what they're going through.

This painfully acquired lesson inspires Lowe's Second Law:

We Don't Confuse What Clients Want Us to Do With What We Can Do.

Let me illustrate. Elizabeth, 45, a part-time waitress at a truck-stop restaurant, and Frank, 50, a sheet-metal worker, came in to therapy to get help for their 19-year-old daughter, Francine, who'd recently dropped out of college and, according to Frank, "gone completely out of control and moved in with a 25-year-old, Negro, drug dealer."

Elizabeth objected to this description of their daughter, saying that Frank had no proof that the Negro in question was a drug dealer, and furthermore that the young man had a steady job at Auto Zone, a local auto parts store. "I seriously doubt that a drug dealer would keep a 40-hour-a-week job. Don't you agree?" she asked me. Before I could respond, Frank said, "Listen, Elizabeth. You see the way the boy dresses? The baggy pants, the gold chains? The neighborhood he's from is full of drugs and gang-bangers. You're living in a fantasy world." Then, turning to me, he said, "You know what I'm talking about, right? My wife's always trying to be a good Christian, thinking the best of everybody. I try to be a good Christian, too, but I'm also realistic. You know what I mean?"

I knew that somewhere down the line we might have to deal with religious, gender, and racial issues. But when you're an older therapist, one of the lessons you've learned is to break down therapy into digestible bites—morsels that you and your clients can chew on for a while without either of you getting psychic indigestion. You can more easily set your own personal and political views aside, at least temporarily, and, as you were taught many years before, focus on process rather than content.

I asked Frank only one question in regard to their daughter's boyfriend. "Frank, what's the young man's name?"

"Who?" asked Frank, somewhat puzzled.

"Your daughter's boyfriend."

"Marcus," replied Frank.

"Marcus," I repeated. Frank and Elizabeth nodded.

Having thus moved this young man from the general categories of "Negro" and "drug dealer" into the realm of a human being with a name, I was ready to put into effect the next Lowe's Law:

Older Therapists Aren't Afraid to Perturb Clients with Demands or Limitations That, in the Long Run, Will Help Us Do Better Therapy.

I told Frank and Elizabeth that I couldn't complete an assessment of their daughter unless their daughter came into therapy. "If you can't get her to come in," I said, "there's no point in continuing. I can't help her if I can't talk to her. Can you two somehow convince her to come for your next session?"

When I told Frank and Elizabeth there was no point in continuing therapy if they couldn't bring their daughter in, I was risking the possibility that they wouldn't come back. But I believed, with the intuition that a therapist gains over the long run, that Frank and Elizabeth knew they needed help and would probably return. And I was right.

At our next session, Frank and Elizabeth brought in their daughter. It wasn't lost on me that Francine's name was a feminine version of her father's name, and I could have hypothesized quite a number of things from this: he saw her as a female extension of himself; there was a battle between Frank and Elizabeth over whom Francine "belonged" to more.

"Francine," I said, "I've heard a little bit about what your parents want for you. What do you want for yourself?"

"She doesn't know what she wants," Frank interrupted.

"Let her answer the question, Frank," Elizabeth interjected.

I might have tried to block Frank and Elizabeth's bickering and repeat my question to Francine, putting her at center stage. From a narrative point of view, I'd be restricting her parents' dominant stories and empowering her subjugated story. From the Milan System's point of view, I'd be demonstrating my neutrality in preparation for a round of circular questioning. From a structural point of view, it would have been a potentially powerful unbalancing move. It also might begin to bring the family's racial issues into bas relief, if not high resolution.

Or I might have directed the question I'd asked Francine to her mother. Giving Elizabeth center stage would also have been an unbalancing move, possibly opening the door to her transgenerational issues, while at the same time being a proactive way to counteract the apparently unequal division of power in her relationship with Frank.

In any event, if my small list of approaches didn't work, I'd have felt sunk—my repertoire was still pretty limited in those days. This leads us to another of Lowe's Laws:

Older Therapists Can Sift Through More Options in 30 Seconds than Younger Therapists Can in 30 Minutes.

No sooner had these three options flashed through my mind than they set off a whole new chain of possibilities that I never would have thought of 25 years ago.

I quickly decided to do the exact opposite of what I'd have done as a young guy, and address the question first to Frank. "Frank," I said, "When you were Francine's age, what would you have wanted from your life if everything you wanted was miraculously guaranteed to turn out to your complete satisfaction?"

I didn't ask this particular question because it made obvious theoretical sense, or because I was following some clinical guideline, or because I had some structural, strategic, or narrative goal in mind. I asked this question mainly because it fascinated me and I was personally very curious to know how he'd answer. As young therapists, we play pretty strictly by the rules, following the clinical narratives we were taught to follow, afraid that if we don't, we'll be cornered by something unexpected for which we don't have a response. As older therapists, however, many of us have the confidence that we'll be ready for just about anything that happens.

Frank briefly contemplated my question, and then replied with a chuckle, "I think all I wanted out of life was a really great tattoo, and to make enough money to buy a brand new Harley, and to marry Elizabeth."

What I decided to try was, I think, unexpected for all of them. But then, that's another advantage of being an older therapist:

There's More Than One Way to Skin a Cat: We Aren't Afraid to Act on Our Hunches (as Informed by Accumulated Wisdom).

We sometimes act on hunches based not upon on our emotional identification with an individual case, but rather upon our previous experiences with other, similar, clients. I call that accumulated wisdom.

"Elizabeth, Francine," I said, "I'd like to talk with Frank alone for a few minutes if you don't mind." The two women looked at each other and then at Frank, who shifted uneasily in his seat and frowned at me.

"What do you want to talk to me about?" he asked.

"Just something between you and me," I said mysteriously. "Something private."

This was an interesting moment, because, in a peculiar way, I think Frank saw this invitation to talk to me alone as both a potential threat and a challenge to his courage. I think his wife and daughter also felt this. Glancing sharply at him, Elizabeth said, "It's fine with me. Come on, Francine." As mother and daughter left the room, I sensed that a shift had already taken place in the family dynamic. For one thing, Elizabeth had always pretended to side with her husband while being secretly in alliance with her daughter. By sending her out with her daughter and keeping Frank with me, I had, by implication, made her alliance with her daughter overt instead of covert, and at the same time made Frank's sense of isolation from his wife and daughter overt.

As Frank sat before me with his arms folded across his chest and his knees crossed in a protective posture, I moved my chair closer to him and said, "This is no big deal, but I just wanted to ask you about the tattoo you wanted. Did you ever get it?"

"The tattoo?" he asked, seeming somewhat confused.

"You said that when you were 19, one of the things you wanted most was a really great tattoo. Do you remember saying that?"

"Yeah," he said, smiling slightly for the first time since coming to therapy. "I'm surprised you remembered that."

"Well, did you ever get it?"

Frank leaned forward, clasped his hands together and chuckled. "Yeah, I got it. I got more than one, as a matter of fact."

"Did you get it at Rob Boy's?" I asked, mentioning the name of a prominent local tattoo parlor.

"Yeah," he said with a surprised smile, "How do you know about Rob Boy's?"

I shrugged. "Everybody knows they're the best in this area. Did Rob do it or his wife?"

"His wife. Damn, I never expected that you...," he now looked truly amazed. I shrugged again.

"I've had other clients who got tattoos from Rob Boy's," I said, which was both true and an excellent example of how having seen hundreds of clients multiplies the reference points for an older therapist and a new client. "It's a beautiful art form, but I think that a lot of people don't recognize it as such."

"You're damn right it is," he said forcefully. "A great art form. It's like your whole body becomes a canvas, you know?"

For the next 20 minutes, we talked about the art of tattooing, Tattoo magazine, and even Ray Bradbury's famous short story "The Illustrated Man," which Frank and I had both read when we were teenagers.

His body language was entirely different. He leaned toward me as I leaned toward him. He continued to smile and make eye contact, as if with a friend, a supporter. I told him that I'd leave it up to him if he, his wife, and daughter would be back for another session.

"Well, I can't speak for them," he said, "but I'll be back even if they don't want to come in. I just gotta learn how to talk to Francine better, so she doesn't tune me out." I told him that was a fine goal.

At that moment, it suddenly seemed to me that we'd passed a critical fork on the therapeutic road. For the first time, I could see the general form of the next few sessions: how the family would change, and what I needed to do to help them change. As an old-fashioned structural therapist, I could see Frank's softening leading to a stronger alliance with his wife, more permeability in the boundary between his daughter and himself, and, overall, greater inclusion for him in the family system. And I knew that I'd need to encourage him to be vulnerable, and also that he'd keep trying because he trusted me as a man with whom he'd shared the supernatural destinies of the saved and the damned etched upon his flesh. And Frank, I felt deeply, wanted to be among the saved.

***

Maybe there's a fork in the road for experienced therapists, a point at which they either begin to truly grow old, both intellectually and spiritually (and by old, I mean tired, bored, uncreative, and perhaps even jaded), or somehow find a way to renew their fascination with the art of therapy and the vigor to do it not only well, but even better than before.

It's the older therapists in that second group, however they got there, that I've come to praise.

***

This blog is excerpted from "In Praise of the Older Therapist" by Walter Lowe. The full version is available in the January/February 2005 issue, Leaving the Comfort Zone: Growing Older with Open Eyes.

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Photo © Katarzyna Bialasiewicz/Dreamstime

Topic: Challenging Clients & Treatment Populations | Professional Development

Tags: 2005 | Children | Children & Adolescents | clinical creativity | creative | creative counseling | creative counseling techniques | creative therapy | creativity | getting old | old age | Parenting | parenting issues | parenting techniques | Professional Development | race | race in therapy | race relations | relationship | relationship issues

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1 Comment

Tuesday, October 17, 2017 10:53:36 AM | posted by Rick Foster
Thanks...from an older therapist!