PSYCHOTHERAPY NETWORKER: Do you think that your experience as a therapist has given you any special insight into the challenges of aging?
KLAGSBRUN: I’m aware of how lucky we are as therapists to have a front-row seat to watch the theater of life unfold. Even early in our careers, we get to interact deeply with people of all ages and at all stages of the life cycle. We get to step into their experience of what moves them, how they see the world, how they struggle. And with older clients, we bear witness to how they cope with aging and illness—some with bitterness and regret, others with integrity, dignity, and courage. We can learn from their struggles and their resilience. Several of my clients have been role models for me in facing illness and dying.
PN: Do any particular lessons stand out?
KLAGSBRUN: I had a middle-aged client, with teenaged children at home, who was critically ill and didn’t know how much longer he’d have to live. He said one day, “Feeling good about the life you’ve led really helps you face death, even when you’re dying before you thought you would.” That was a wake-up call to me—that living authentically and well could be a prelude to accepting our dying.
Another client, the head of a big company, was aware that everyone who worked for her was witnessing how she was handling her illness and her dying, and that she’d become a mentor for them in facing this final chapter. She reminded me how we’re all teachers for friends and family when facing illness and death. Remembering that imbues the last chapters of our journey with even more meaning.
Unlike many other professionals, older therapists are often viewed as having acquired more wisdom, as opposed to having become obsolete. Over the years, I’ve never had a client come in and say, “Oh, I’d rather work with somebody younger.” My husband sees a therapist who’s 89. My niece’s therapist is 86.
We’re lucky to be in a profession where most people tend to work a lot longer than they would in the business world. In fact, I can’t think of many therapist friends who are ready to fully retire, although some now work only two or three days a week so they can spend more time with grandchildren or do volunteer work or political activism. Overall, they feel that being older, and all the experience that comes with it, creates a sense of confidence and comfort for their clients.
PN: Not everyone has such an easy time with growing old. What have you noticed about people who really struggle with the aging process?
KLAGSBRUN: For many people, the biggest struggle is letting go of who they were and accepting who they are now. A lot of the stress of growing older involves living in the past or fearing the future. I see the struggle elders have with retirement, with finding a new purpose for their lives, with accommodating new physical conditions and illnesses. It’s challenging to be slower in body and mind, to hear and see and remember less well, and to accept these limitations gracefully. People who can’t do that really struggle.
I had a friend who played basketball through his 60s. As a younger man, he was so identified with being a basketball player who played for hours every week. But now that he’s in his 70s, he can’t do that anymore, and it’s a big adjustment for him. I think aging is a lot about letting go of old identities so you can discover new ones.
PN: What have you learned about how to help people make the kind of transition you’re describing?
KLAGSBRUN: As we age, I think it’s important to find contemplative practices that help us slow down in a way that feels positive. It could be meditation, qigong, breathing practices, Focusing, gratitude practices, or using guided imagery. Any practice that helps us settle the mind and accept what is will help us to better tolerate the losses that come with aging and appreciate all that’s still there to be enjoyed. Whether we’re facing hip replacement surgery or dealing with Parkinson’s disease or cancer or any of the myriad challenges that often come with growing older, mindful practices can help us cultivate acceptance and resilience. We all need to have tools that help us be with things as they are, even when they’re unpleasant or painful or simply uncertain.
PN: Can you tell me more about the role models who’ve helped you as you’ve gone through your own aging process?
KLAGSBRUN: I’m thinking about a client of mine who came to understand that there were important lessons to learn in the illness phase of his life. He was a natural helper in his congregation, but he was really terrible at receiving help himself. Then he was diagnosed with cancer and saw it not as a tragedy, but as a graduate course in learning to receive from others. He told me, “Sometimes I’ll be sitting with people for hours, waiting for chemo or during chemo, and we’ll have these profound conversations, where it’s hard to tell who’s giving and who’s receiving.” He felt like he’d finally learned how to take in love.
Before the illness, taking in help and love felt like a present he just couldn’t open, but over time, he learned that opening it would deepen not only his life, but also the lives of the people who offered it to him. That was an important lesson for me because, like most therapists I know, I’m more comfortable with giving and helping than receiving. But aging kind of demands that we learn how to get comfortable receiving help from others.
PN: Do you think that men and women have different ways of experiencing the aging process?
KLAGSBRUN: As a woman, what makes aging positive is not doing it alone. The fact that I have a wide circle of women friends my age is enormously helpful. We bring humor and comfort to each other, and there’s a sense that I’m gonna be there for them and they’re gonna be there for me. In contrast, men don’t always have that ready resource of intimate relationships where they can share their vulnerabilities, and talk about worries and joys.
Having said that, I think men are just as open to sharing if the opportunity presents itself. A colleague of mine offered to facilitate a men’s retirement group in his church, focusing on what’s brought meaning to their lives. He thought he’d get a handful of the more reflective men in the community, but 30 men showed up and come regularly.
One other difference in gender around aging that I’ve noticed—though of course this certainly doesn’t describe everyone—is that generally, when women are thinking about aging, downsizing, dealing with illness, or even when they’re dying, they’re acutely conscious of how it will affect their adult children. Nurturing is so intrinsic to women that they think relationally at every stage. By contrast, some men in this same stage of life feel that their role as parents is less relevant than when they were younger. They tend to see their adult children as launched and involved in their own lives. Therefore, they’re less aware of the profound effect of their aging and illnesses on their children.
PN: What do you think are the biggest pitfalls people experience in the aging process?
KLAGSBRUN: One pitfall is holding on too tightly to what’s familiar and habitual, and not moving toward what’s new, fresh, and beckoning now. The former could mean not letting go of long-term friendships that feel obligatory but aren’t nourishing anymore, or continuing work that’s no longer meaningful, or not taking the opportunity to mend fractured relationships with family members where forgiveness may now be possible.
Another pitfall is staying in denial about the changes that are here or coming soon. Sometimes that shows itself on a physical level, where people end up getting injured because they overdid an activity. Sometimes it’s a reluctance to plan for the future, thinking, Oh, that’s so depressing, let’s not deal with that. But talking about both the fears and the gifts of aging can be rewarding if we do it together.
A new role for therapists that I think is exciting is to facilitate groups for aging, both for individuals and for couples. Participants can hear how others are dealing with the challenges of downsizing and retirement, and they can articulate the gifts, highlights, and even the regrets of their lives. These groups also offer an opportunity for people to talk frankly about their fears of getting old, as well as to share their hopes and plans for facing death as best they can.
I think it’s important to see where the aliveness is in the aging process, to find the positivity even as we lose some of our physical and cognitive capacities. Stasis is really the basic pitfall, doing the same thing rather than saying, “I need to transition to this new phase. So what are the practices I need to have? And what are new interests that will enrich my life? And how can I include others during this transition in a meaningful way?”
As I mentioned before, I’ve been impressed with the idea that we all become teachers for each other as we age. My mother was very courageous in the way she faced her death, and I learned a lot from her.
PN: Courageous in what way?
KLAGSBRUN: Well, she had advanced ovarian cancer and was in a lot of pain, and she knew she didn’t have much longer to live. So she asked her family for our permission for her to end her own life. She chose how and when she wanted to die. It was very inspiring that she knew the right time—when she was very sick and there was no more hope of recovery. She didn’t want the process to go on and on because she saw that my father was suffering, as was the rest of the family. She was an amazing teacher for me in that moment. When I went to visit her one of the last times, she said, “Ask me anything you want to ask me. Tell me anything you want to say.” It was such a precious moment of her being able to complete her life while also being tuned in to my needs.
It really is a testimony to the shift that can happen when you no longer approach death as a kind of secret shrouded in shame. It can change your outlook on the whole experience. As we’re talking, I keep having this odd thought: What a fun conversation. Who would know we’re talking about aging and dying?
This blog is excerpted from "Occupational Wisdom," by Marian Sandmaier and Psychotherapy Networker. The full version is available in the March/April 2018 issue, A Gift of Time? Facing the Challenges and New Possibilities of Aging.
Photo © Joan Klagsbrun