Therapeutic Practice with Older Adults:

Smith, G., & Pearson, M. (2011). Counselling clients from an older generation. Psychotherapy in Australia, Vol.17 (3), 12-18.

This peer-reviewed bit by Smith and Pearson begins by pointing out a few key things:

1. We’re living longer, and finding that differences between generations could be viewed as a cultural issue.
2. There’s a research gap in the area of generational difference between counsellor and client; what do we understand about the dynamics between vastly different ages in the therapeutic setting, and what are the questions we should be asking in our future research?
3. This is a qualitative study, and it met some expectations from prior data in some cases that are implied to be rather sober, but with this new study, they did find some happy news. The relationships that therapists are building with significantly older clients than themselves are bringing forth personal rewards for counsellors, as reported by the counsellors. These are, namely, self-awareness, personal insight, and empowerment to live well in the present and into their own future.

The study aimed to “explore the challenges and rewards for counsellors who work with client from an older generation”. When reviewing the evidence in play up til this 2011 work, the authors noted that despite a mention by Beutler, Gastonguay and Follette (2006) that there may be poorer outcomes for clients more than ten years older than their counsellor, there otherwise stands very little evidence that a difference in age between counsellor and client has any impact on outcomes.

I was writing on the class discussion board earlier today that while the material for this week seems to be working on assumptions supported by the literature about the attitudes of younger therapists having to work with older clients, I’m a bit of an outlier because for the longest time, I’ve actually preferred to work with either very young people or much older people. This is reflected in my social life; not so much with the younger people as friends, but with people who are at least 15 years older than myself. For a few years there, it also reflected my dating preferences!

I am now happily married to someone who’s only a year older than myself, but in his own words, he’s pretty much a 78 year old in a 43 year old’s body. I suppose we both break the rules a little.

After a couple of days worth of reading on this topic I can see that where counsellors are concerned, they’re not too keen to load up their books with older folks, but once they actually gain some experience, they’re finding it actually very rewarding and the misconception about older people being a drag to counsel is actually working against their own professional and personal development. So if you’re a counsellor or psychotherapist or psychologist reading this, chew on that for a little more food for thought today! Older people rock and I actually choose them above people my own age as my friends. I have done this since I was 16 years old, and I really believe that as a result I’ve become a stronger, wiser person.

Culture and Diversity in Therapeutic Practice

Gosh it’s super-duper back to basics with this class, and I’m really getting a lot out of being prompted to revise those very basic fundamentals of social psychology and sociology. I’ve done a shit-tonne of sociology classes, and only a tiny fraction were actually recognised by my current university, pretty much because my first university was a bit shit. Still, I did have a handful of really great lecturers there. I’ve even done HR (ugh, never do summer school unless you’re a young bounder with no dependents!). I really don’t see the unrecognised units as a loss, because you really can’t do too many sociology classes, as far as I’m concerned. I wish everyone could have the opportunities that I’ve had to expand my learning on sociology and social psychology. I will have a psychology degree next year, but I’ve probably one 30% more units than I needed to in order to be awarded it. And I remain glad and grateful for those “unnecessary” classes.

This week’s reading for this class is from all the way back in 1959! It’s a chapter called “The Promise”, out of a book by Penguin titled The Sociological Imagination. C. Wright Mills wrote this when he only had a few years left of life on earth. I love these words from the very first page:

“When society is industrialised, a peasant becomes a worker, a feudal lord is liquidated or becomes a businessman. When classes rise or fall, a man is employed or unemployed; when the rate of investment goes up or down, a man takes new heart or goes broke. When wars happen, an insurance salesman becomes a rocket launcher; a store clerk, a radar man; a wife lives alone; a child grows up without a father. Neither the life of an individual nor the history of a society can be understood without understanding both.”

The author’s annoying insistence on the default “men” descriptor (and the assumption that kids are lost without a father, coming from a dude who kept having babies with women and then leaving them for another woman) aside, it’s such an interesting and also a kinda bleak reading from a very comfortable white bloke living in a decade that really did not feel the real pinch of devastation and fragility we’re feeling in 2022. However, there’s a lot of prophecy in it, too. He predicts that “political colonies are freed; new and less visible forms of imperialism installed”, as if to be gazing through a crystal ball directly at 2022’s Western sociopolitical landscape.

C. Wright Mills continues on to talk about how society is now awash with information and yet it’s kinda totally illiterate if it doesn’t have a sociological imagination (I’m paraphrasing his more detailed take, but that’s basically it).

“The first fruit of this [sociological] imagination – and the first lessons of the social science that embodies it – is the idea that the individual can understand his own experience and gauge his own fate only by locating himself within his period, that he can know his own chances in life only by becoming aware of those of all individuals in his circumstances. In many ways it is a terrible lesson; in many ways a magnificent one.”

This passage tells me that maybe the author knew a little something about suffering early in life; if something was trauma-informed in 1959, maybe that’s what it sounded like. The whole idea of someone being quite afraid of the world around him, feeling it’s a series of traps that wants him to fail. It makes me reflect on my own trauma. I have only just begun to start really unpacking the learnings by myself, after recently drawing to a close my continuous trauma therapy, which I’ve been receiving for over ten years. Before that, I’d had stints with psychologists and counsellors sort of as a “PRN” mental health medication to deal with childhood and adolescent trauma. Something you come to realise is that during the ongoing trauma, you really only pull apart the actual trauma itself, with perhaps some sessions devoted to trying to remember who you were before DV totally destroyed your sense of self. It’s only after the offender is removed from the picture and can’t continue reoffending that you realise that you’re now free to finally look forward.

I’ve mindfully ended the continuous appointments because I felt it had run its course for the time being, and I wanted to have some time to really let my reflections echo within the bounds of my own daily life, without living week to week between psychologist appointments. It’s really done me some good, and my husband really deserves credit for it, too, because without him, I’d still be living with the daily trauma of poverty. We’re not wealthy, but we’re not hungry anymore. I haven’t skipped a meal in more than a year. (It shows.)

I feel I now have the headspace to write the book in a committed way. But it does take consistent work on oneself, and all the readings you get from uni are useful in terms of training for the future, but the odd reading or viewing you’re prescribed by a lecturer also invites you to go back into the past and re-organise and re-pack it, if that makes sense. That revisiting and honesty about ourselves of course has to be primarily about dealing with trauma so that we can live a healthy, functional life, but it does indirectly safeguard our future clients, too. You have to deal with your trauma before you can truly be in command of the therapeutic space others are trusting you to provide. There’s no delaying it and there’s no sweeping it under the rug. And it’s ongoing. You don’t just deal with it once; you have to deal with it every single day.

Once the ongoing trauma has ended (as it did for me last December), you have the grateful release of the trauma vacuum. It’s a hard process and a hard feeling to describe to the uninitiated. After over eight years of ongoing trauma, I have to be careful I don’t over-analyse everything too quickly, or I’m going to become overwhelmed all over again in a different fashion. I think the first six months for me has just been about learning anew how to spend time with myself, how to rest, how to sleep without nightmares, and how to set new goals. I also fell prey to a trauma response that not many people talk about; a pathological need to stay busy every single day, in a sort of panicked rush which serves the function of “I am far too busy to sit still and allow painful trauma flashbacks to commandeer my brain”. This dysfunctional habit of setting myself up with too much community work also served the purpose of keeping me from hope; blinding me from trying to see too far into the future. Like countless survivors of PTSD before me, I have long found it very difficult to imagine successfully setting long-range goals, let alone reaching them. I had continually tried to access education and a working life, hitting impassable barriers, and then I was judged or exiled for my failure to overcome the barriers, rather than having people judge the barriers themselves. The war veteran who is diagnosed with PTSD receives a hero’s welcome. The domestic violence survivor who is diagnosed with PTSD is judged, even when she’s doing all she can to help her children and herself. This is why trauma continues so long after the last punch is thrown. Society lacks the sociological imagination to see the wider picture, choosing instead to judge the individual in their immediate view. It’s not just memories of being abused and controlled that haunt you. It’s the memories of the people who failed you in the years which follow; the abuse begets continued abuse from other people while you are still so injured and vulnerable, opening the door for things like religious coercion and abuse from family members or institutional abuse when your children need to access police protection, social workers, charity help or other welfare services.

One of the big things that happens to traumatised people is that you cease being able to see a future for yourself; you become convinced that you’re probably not long for this earth. It’s the brain’s way of trying to process the unimaginably horrific; trying to accept its fate… that you will die soon, probably traumatically, without anyone to love and house and feed your babies for you, and without anyone who even cares you’re gone. The traumatised mind, I suppose, is attempting to process the unprocessable. It’s trying to make sense of cruelty and horror which should never make sense to anyone. Yet, here we are.

The way that C. Wright Mills writes about sociological imagination, you can see that he might’ve been the child who once looked around him and saw only a minefield. In the same way the traumatised mind attempts to make sense of horror, the sociological imagination attempts to manifest context and the possibility of healing in a world where there are others with your same experiences. Without it, I’m not sure I would have survived domestic violence.

Reference:

Mills, C.W. (1959). The Promise. The Sociological Imagination (pp. 9-32). Great Britain: Penguin Books.