Midlife is all about managing change without letting it overwhelm you. Kids leave the nest, parents die, your own health declines or maybe you lose your job in a round of layoffs. It can all leave you feeling at sea. Even positive changes — retirement or the birth of a first grandchild, for example — can be stressful in ways you may not expect. Professional counseling could help you sort it all out, even if you've never considered it before.
"People don't come to see me because everything's going well," says Karen Hague of Ann Arbor, Mich., a social worker who offers therapy and life coaching in her Boomer Solutions practice. Midlife, she says, "can be a wonderful and exciting time, but for some people that transition can be pretty daunting."
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Katherine Green of Chevy Chase, Md., is a career coach whose specialty is advising people over 50. "When life happens to people in their 50s and 60s, it just hits much harder," she says. "It really seems to activate a desire to get meaning out of that event."
Midlife "is like going through adolescence again," says Suzanne Degges-White, an associate professor of counseling at the University of Mississippi and president-elect of the Association for Adult Development and Aging. "You're trying to figure out who you are."
Getting to the Roots of the Matter
Counseling and psychotherapy have never carried the same stigma for the boomer generation as it did for many of their parents. Still, many people in midlife have never imagined they'd need such services and some do think that asking for help is a sign of weakness. But a series of troubling recent studies shows that this generation faces a number of urgent mental-health issues that demand clinical intervention.
One recent federal study found that as many as 1 in 5 Americans age 65 and older has a mental-health or substance-abuse problem — 5.6 million to 8 million people in all — and that the next, and larger, generation of seniors, all of them baby boomers, already has even higher rates of mental illness and drug abuse. A new report from the federal Centers for Disease Control and Prevention confirmed this concern, revealing that from 1999 to 2010, the suicide rate for 35- to 64-year-old Americans rose 28.4 percent over all, to 13.7 per 100,000. The greatest spike occurred among those currently age 50 to 64. Even more disturbing, researchers of suicide rates are confident those numbers are actually even higher because such deaths continue to be widely underreported.
Fortunately, the experiences of older people who have turned to therapy later in life, even in their mid-80s, show that it's never too late to begin counseling. "The talking cure" can have restorative effects for patients who take it seriously at any age, despite Sigmund Freud's belief that psychotherapy would be largely ineffective for subjects older than 50 because their minds lacked "elasticity."
As a recent New York Times feature reported, psychotherapists now believe that past assumptions should be overturned because the problems of older patients are far from intractable — they can be better candidates for therapy than younger adults. "Older patients realize that time is limited and precious and not to be wasted," Dr. Robert C. Abrams, a professor of clinical psychiatry at Weill Cornell Medical College in New York City, told the Times. "They tend to be serious about the discussion and less tolerant of wasted time. They make great patients."
Boomers, especially those who have had successful experiences with therapy earlier in life, can expect positive outcomes if they come to or return to the couch, says Christine Moll, who heads the department of counseling and human services at Canisius College in Buffalo. "There is a great potential for 'aha!' and growth in individuals who are open to seek out counseling after 55 or 60 years of age."
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The inevitable losses and regrets of midlife — the close of a career, the death of a parent, widowhood, divorce or the onset of chronic medical problems — bring their own challenges in part because they "trigger a lot of old stuff that might not have been dealt with," Hague says.
Therapy can help people in midlife access what Swiss psychotherapist Carl Jung described as the "shadow" side, the parts of themselves that have been long repressed or denied. Men might need help bringing out their gentler side when they become grandfathers so they can relate better to youngsters, Degges-White says, while women whose children have grown might benefit from talking about their goals as they seek the fulfillment of new professional challenges.
There's opportunity for growth in those discoveries. "There are so many transitions going on, but there's also gain," she says. "You can gain a new role as a grandparent. You can finally do the work you wanted to do but couldn't because you had to put the kids through college."
Finding a Therapist
What should you look for in a therapist? Above all, someone you feel you can talk to. "I'm not a family member, I'm not a friend," Hague says, adding that patients need to believe that their sessions with her represent "a safe place to open up and talk about whatever."
You can seek references from friends or relatives who've had positive experiences in therapy, or from your primary-care physician. If you are dealing with a specific medical condition, your specialist may know therapists experienced with helping similar patients. If you're coping with divorce or mourning, your family or estate lawyer may have recommendations for you. You can also consult a local university department of psychology or use the American Psychological Association's Psychologist Locator Service.
Many people prefer a therapist with similar life experiences, Green says. "Sometimes, someone in their 50s doesn't want someone in their 30s."
But contrary to popular belief, you won't necessarily have more success with a therapist who's the same gender as you are. Degges-White recalls working with "a man's man" in his 50s who'd lost his daughter in a car accident a decade earlier. The man, recognizing that therapy was a safe place, felt free to spend his sessions raging and sobbing before pulling himself together minutes before his time was up, she says. It's possible he may not have let himself go to that extent with a male therapist.
"Sometimes there's chemistry right away," Degges-White says, "and sometimes it does take a while." Therapists in private practice will often allow you to have a brief, introductory talk without charge, perhaps for 15 minutes. It's not unlike meeting a blind date for a cup of coffee before deciding to go out for dinner, she suggests. And just as you seek a good fit, the therapist will try to judge if he or she has sufficient expertise in your area of need to be of help.
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But no matter how pressing your issues are or how skilled your therapist may be, if you go to a session only because a spouse or child has dragged you kicking and screaming, you might not get much out of it.
"Therapy isn't for everyone," says clinical psychologist Kolleen Martin, who works for Fairfax County Mental Health Services in Virginia and maintains a private practice. "Some people don't feel strong enough to deal with the issues. The research is clear: Nobody makes changes unless they really want to."