The 5 Most Common Issues People Bring Up In Therapy As They Get Older

As we age, past concerns may go to the wayside as new problems pop up. Maybe you feel more stable in your relationships, for example, but you also can’t drink as much because you feel extra anxious the morning after. In other words, each stage has its own joys and struggles.

While we’re all unique in some way, you’re probably less alone than you may think when it comes to those problems. Additionally, a multitude of coping skills can help you handle them, even as tough and emotional as they often feel.

Below, therapists share some of the topics they hear about the most from older clients, as well as how they help or advise clients to handle that distress.

A lot of changes happen as you age, and grieving what had been is normal and understandable.

“I hear a lot about how difficult it is to start transitioning to retirement or getting older physically and mentally,” said Holly Humphreys, a licensed professional counselor with Thriveworks in Roanoke, Virginia, who works extensively with adults transitioning into retirement and who are 65 and older.

While this goes for losing loved ones, that’s not the only type of grief experienced. “Older adults can also go through the grieving process when they retire from their careers that they have been in for decades,” she continued. “They can also go through the grieving process when they start to notice a decline in either their or their significant other’s mental and physical health.”

What to do: Humphreys encourages her clients to feel their feelings, and she supports them along the way.

“I also assist with providing coping strategies to help older adults to better manage these feelings of anxiety and depression,” she said. “Likewise, I help with problem-solving to make sure they have all of the resources that they may need during this time in their life. Lastly, I provide supportive reflection to allow them a safe space to process their life up to this point and what they want out of their remaining time with their loved ones.”

While having a therapist who can help with this is a smart move, it may not be as accessible for everyone. If that’s the case for you, think of friends and family, and let them know what you need.

As you age, your child does, too, which leads to a change in relationship dynamics.

“One of the most common topics I encounter in counseling with older adults is their relationship with an adult child,” said Alicea Ardito, a therapist with Choosing Therapy who specializes in working with older clients. “Patterns are often established in childhood and adolescence, and it can be a difficult adjustment for older adults to learn how to be the parent of an adult.”

What to do: It all comes down to communication and working together.

“We will often explore ways to improve communication, find connection and establish healthy boundaries in the relationship,” Ardito said. This might look like asking open-ended questions or engaging in activities you both enjoy, for starters.

Kelsey Latimer, a clinical psychologist who has worked with older people, has heard many clients pick themselves apart, especially during times of change, transition and stress.

“The change can trigger a deep sense of instability, loss of control and fear of the unknown,” she explained. “Our mind can disconnect from those underlying things and tend to settle on thinking our bodies are the problem or the wrinkles on our face are why we feel a certain way.”

And, of course, societal beliefs don’t help. “The fact we live in a culture where the aging process is not one seen to be embraced places unrealistic expectations on people and can reinforce these feelings of instability during change,” she added.

What to do: If you struggle with this, Latimer encouraged dealing with your emotions directly, ideally with a professional or friends who are going through similar changes.

“Try to do the best you can to realize this is not about your body, sagging skin or wrinkles on your face — it’s a lot deeper than that,” she said. “Don’t suffer in silence — talk it through and find space for those emotions.”

Aging often comes with reflection, as evidenced by psychoanalyst Erik Erikson. According to his work on stages of psychosocial development, older adults often spend time trying to contribute to the world and looking back on their lives. Did they fulfill their purpose and live life the way they wanted?

This is another commonly discussed topic in therapy. “Clients may reminisce about fond times and regrets, depending on their mood and thoughts during the present session,” said Joel Frank, a licensed psychologist in Los Angeles.

What to do: The three key words here are “validation,” “acceptance” and “change” — usually in that order. “For individuals reflecting on their past, especially their regrets, I typically validate their thoughts and emotions on the topic and work with them on moving toward a perspective of acceptance,” Frank said. While the past can’t be changed, he said, learning from it is crucial.

One aspect you can learn more about is who you are, focusing on your values and desires. “It is also the recognition that there is still time to develop new traits and hobbies, should they wish,” he said. This might look like being more kind, trying an art class or becoming more involved in your place of worship, though those examples only scratch the surface of all the possibilities.

Similar to grief, the aging process is full of loss, unfortunately. “This is a nonfinite loss that does not involve physical death, but there is a sense that the loss is enduring in nature,” said Venetia Leonidaki, a clinical psychologist who’s worked with clients across the lifespan. “For older clients, such a loss could involve having to let go of treasured habits, feeling nostalgic about an important time in life, or coming to terms with a drop in physical or mental strength.”

Another type of loss that encompasses many of the others: a sense of losing your identity.

What to do: Let yourself feel those emotions and try to move forward in positive ways, according to Leonidaki. She validated that even if the loss isn’t clearly visible, it’s valid and significant.

After coming to terms with that, what helps? “As a part of active coping, I’d also get them to focus on the things that they can do instead of those that they can’t,” she said. “Practicing gratitude for the significant things that continue to be present in their lives could also help them counteract feelings of loss.”