Aging isn’t easy. From the physical effects to the mental toll, even the smallest of issues can pile up and create an overwhelming experience. In addition to all this, trying to get help can also be a frustrating and confusing process—in our current world of information overload, it can be hard to pick out what’s really important. And, as an older adult, you may have been brought up in a society that looked down on expressing your emotional struggles, treating it as a taboo subject.
Luckily, our societies have steadily become more aware and open about mental health and the impact it can have on your life. Through this, it’s become much more accepted to take care of your emotional wellbeing. As a result, there are thousands of resources, counseling opportunities, and studies on how emotional health ties into other areas of life—so many, in fact, that it can get overwhelming. In this article, we have gathered advice on when to start looking at therapy, how to find a well-fitting therapist, and the different kinds of therapy that you may encounter. This is in no way an exhaustive list, but our hope is that by collecting key bits of advice on these topics, it will make your path forward a bit clearer.
Why Emotional Health is Important
To start, it’s a good idea to understand why exactly you should be taking care of your emotional health. While it’s easy enough to see how taking care of your physical health improves your quality of life—through mobility retention, reduced risks of diseases, and more—it can be a bit harder to see the impacts of poor mental and emotional health, since unlike a broken bone or scraped knee, they often don’t have any outwardly visible signs.
While the terms “mental health” and “emotional health” are used interchangeably, it’s also important to understand the distinctions between the two. “Mental health” refers to your health in terms of your emotional, social, and psychological state. It’s an umbrella term that also includes our second term, “emotional health,” which refers specifically to one’s ability to identify, manage, and express emotions. As an example, you can think of it in terms of how your mind might deal with the information of losing a job offer; your mental health determines how you will process this information overall, while your emotional health specifically determines how well you manage and express the sadness and other emotions that arise. In other words, your emotional health is one factor that influences your overall mental health.
Since your emotional health is so closely related to your overall mental health, having poor emotional health can directly lead to the development of mental health conditions. According to the World Health Organization (WHO), a mental disorder is “characterized by a clinically significant disturbance in an individual’s cognition, emotional regulation, or behaviour,” meaning that improving your emotional health can, in some cases, help to prevent mental health conditions or alleviate some of their symptoms. This is very important for your quality of life, as most mental health conditions are quite difficult to live with, and should be avoided as much as possible. Having strong emotional health is also crucial in maintaining a positive sense of self-worth, as well as keeping good relationships with those around you—which, again, are both critical components of a happy and healthy life.
Building and Maintaining Strong Emotional Health
Now that you understand the importance of your emotional health, we’ll take a look at some strategies to build and maintain strong emotional health. To start, there are several things that you can do without any external help. As seen in the NIH’s Emotional Wellness Toolkit, these strategies can be broadly summarized into being mindful, getting enough sleep, strengthening social connection, building resilience, reducing stress, and coping with loss.
The first three can reliably be achieved on your own. To become more mindful, for example, you can try meditating or doing a mindful form of exercise like yoga or tai chi. Getting enough sleep might mean making changes to your nighttime routine, investing in a comfortable pillow or mattress, and avoiding caffeine intake before bed. In the case of strengthening social connections, you might make an increased effort to get out and meet new people, or spend some more time hanging out with existing friends and loved ones.
For the last three—building resilience, reducing stress, and coping with loss—it can be helpful to have someone there to guide you. Especially in instances where your stress or grief has become overwhelming, talking to a licensed professional like a therapist can make the process significantly less daunting. Depending on your concerns and needs, you may benefit more from one type of therapy than another, or have more success with a therapist specializing in one area of emotional wellbeing.
Types of Therapy
So, what might going to therapy entail? Depending on the type of therapy, your therapist, and your reasons for going to therapy, your experience will vary. However, there are some general things that you can probably expect, based on the type of therapy you receive.
A commonly practiced form of therapy is Cognitive Behavioural Therapy, also known as CBT. As per Healthline, CBT focuses on taking “an active role alongside your therapist to change unhelpful patterns of thoughts and behavior.” In other words, the main goal of CBT is to work through the patterns of thought that can lead to negative emotions and behaviours, and to work on dismantling these patterns whilst learning positive coping mechanisms. As one of the most studied forms of therapy, this method is often used in the treatment of mental health conditions such as depression, bipolar disorder, anxiety, OCD, trauma disorders like PTSD, and substance misuse. However, the benefits of CBT are not limited to people with diagnosed mental health conditions; you can also benefit from this type of therapy if you’re struggling with things like grief, chronic pain, low self esteem, life transitions, insomnia, and general stress. Treatment itself involves lots of reflection on your negative thought patterns, goal setting, and engaging in positive activities. Over time, you’ll learn to dismantle overwhelming negative thoughts and lead yourself back towards more realistic neutral or positive thoughts. Your therapist may assign homework, such as journaling or practicing the process of restructuring negative thoughts.
CBT also has several subtypes, one of which is Dialectical Behavioural Therapy (DBT). According to Healthline, this form of therapy was first developed to treat those with borderline personality disorder (BPD), but it is now also used to treat those with eating disorders, depression, and those who self-harm. In fact, according to one study, DBT is highly effective in treating depression in older adults when combined with the use of antidepressants. Like CBT, DBT is a form of talk therapy that aims to help you understand and regulate your thoughts. However, DBT places more emphasis on your emotional health and helps you to better manage your emotions; this is done through the four core skills of DBT, which are mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation. These skills are built across several sessions involving one-on-one talks with your therapist and skills training group sessions, in which you’ll learn about, practice, and talk through a particular skill. For those who find themselves regularly struggling with high degrees of emotional distress, DBT is a fantastic option.
Another subtype of CBT is exposure therapy. While DBT is used for patients who struggle with emotional volatility, exposure therapy is commonly used for those with anxiety disorders, such as generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), phobias, and post-traumatic stress disorder (PTSD). This form of therapy works by exposing you to an object, situation, or idea that causes you anxiety while in a safe environment. This is usually done in a gradual way, to avoid throwing you “into the deep end” of your fear—instead, a therapist may first guide you through simply imagining a feared scenario, and then work up to confronting it in person in later sessions. By repeating this desensitization process over and over, you’ll gradually begin to unlearn the fear surrounding this stimulus and start noticing your ability to overcome it. Research has shown this to be a highly effective method for treating anxiety disorders, including in older adults; in a review of past studies, it was found that most older adults who received exposure therapy—in some cases, in combination with other forms of therapy—benefited highly from receiving treatment. This makes it a great option if you struggle with anxiety.
CBT and its subtypes are generally short-term treatment methods which take around 6 ~ 20 sessions, or roughly 2 ~ 5 months of weekly sessions. Of course, this can vary by person and situation, but these are the average lengths. Comparatively, other therapy forms like psychodynamic therapy can take much longer—the process of traditional psychoanalysis usually takes multiple years. Generally with this kind of treatment, you’ll stay with one therapist for the duration of treatment and work together to unpack everything from your childhood and past to any recurring dreams or fantasies that you presently have. This type of therapy operates on the belief that your past unconsciously influences and causes your current problems, and works to help you identify the root causes of present issues. Those who live with mental health conditions like depression, anxiety, PTSD, BPD, and persistent isolation / loneliness can often benefit from psychodynamic therapy.
It is important to note that a therapist will usually use a combination of several types of therapy, and will tailor their approach to each individual patient. If you go to therapy and find that one treatment works well, or find that something isn’t working for you, it’s very important that you communicate this to your therapist. Most therapists greatly appreciate feedback! And, if they create pushback or don’t take your input seriously, they’re likely not a good fit.
Finding a Therapist
Now, how do you find a therapist that is a good fit for you? First, it’s a good idea to start with the basics and get a feel for what you’re looking for in a therapist. Take some time to ask yourself questions and get a general idea of who your “ideal therapist” is. Would you want them to be a particular age, gender, or sexuality? Are you looking for a therapist who is from the same culture as you, or does that not really play a role in your decision? What areas—such as specific mental health conditions, grief and loss, body image, and more—would you like them to have experience in? If you have prior experience in therapy or have an idea of what methods would work best for you, it’s a good idea to add that to your list of criteria as well. Depending on what area you live in, your choices may be a bit limited, so it can help to rank your criteria from most to least important.
Another important thing to consider is the cost. Therapy can be quite expensive, with the average price per session being $100 ~ $200. Because of this, it’s a good idea to explore your options in terms of insurance—which is often a headache, both for providers and for you as the patient. One strategy to make this process easier is to ask your insurance company directly which providers are covered under your insurance; this will save you the hassle of having to look through each option on your own. If your insurance doesn’t cover therapy, or you need to pay out of pocket for any other reason, local universities often offer sessions with their doctoral students at a reduced rate. As mentioned in The Guardian, these students are “very senior in their training, and (are) supervised every step of the way.” If your budget is a limiting factor, this is a great option.
Once you have a list of criteria that you’d like your therapist to meet, you can start your search. What options are there in your area? What about online, through video or audio calls? According to The Guardian’s interview with Dr. Marnie Shanbhag—the senior director of independent practice at the APA—you shouldn’t be afraid to google for things like “psychotherapists in my area” as a starting point. Therapists will often have introductory sections on their websites that outline their experience, as well as the forms of therapy that they practice. In some areas, you may be able to find online databases of therapists that allow you to easily filter by gender, type of therapy, specialization, cost, and more to narrow your search automatically. After filtering your results, you’ll hopefully be left with a few solid matches.
Things to Consider
After your initial search has (hopefully) given you a few options, it’s now time to see whether they’re truly the right fit for you. Most therapists will offer free consultations of 15 ~ 30 minutes, in which you can get to know them a little before deciding to start treatment. This is your time to ask any questions about their approach, experience, costs, or anything else that you may want to know more about. Pay attention also to how they make you feel, and what you like / dislike about their approach.
You may not know straight away if you like a particular therapist, and that’s completely normal! Choosing a therapist should not be a rushed process. While your therapist won’t be able to magically tell you the exact path you should take to feel better, therapy should still feel comfortable, helpful, and supportive. After two, three, or even more sessions, if something doesn’t feel quite right, it’s perfectly fine to move on to someone else. Therapy is for your benefit, so you should always look for someone who you feel is truly helping you.
