Removing prejudices: Counselling the elderly and PWD

Counselling psychology is a broad specialization within professional psychology concerned with using psychological principles to enhance and promote the positive growth, well-being, and mental health of individuals, families, groups, and the broader community. (CPA, 2009) In layman’s terms this means that the mental health professional is not there to give you advice and that the main motive behind it is to help people with typical issues like stress, anxiety, relationship problems, anger-management and sexual problems. Counselling can be deemed as “talking therapy” for the client who might have trouble coping with a particular area. We seldom acknowledge the fact that just like other people, the elderly might also face issues that require professional help. Sigmund Freud, a very important figure in psychology, who developed psychotherapy, considered that people over the age of 50 were uneducable. But we have proof, scientific proof based on years of research, that this is not true.

There are certain misconceptions that makes us associate the elderly with not requiring therapy or even counselling like the fact that they might be too stubborn or too negative towards counselling and therapy. Many also believe that it might be too late for the elderly in terms of requiring the help of a mental health professional. All these misconceptions are based on a prejudice since we have a negative perception towards old age. This perception is ageist at its core- to look at old age as a handicap and to treat the elderly in the same way. We also believe that the elderly only suffer from physiological issues. The elderly in fact suffer from a myriad of issues like depression, anxiety, sexual issues,addiction, low self-esteem etc. These issues stem because of a number of reasons. One of it is “cognitive decline”; to feel as if one is losing his/her mind. The other is dealing with grief and loss. This can be the death of a close one or even the loss of one’s independence. At the same time, dealing with one’s impending death whilst suffering from physical problems is also a strong factor. There are certain issues like sexual issues that are considered taboo for the elderly. Disregarding a certain problem doesn’t banish it but makes the elderly feel more isolated and overwhelmed.

Looking at these issues, it’s no wonder that the elderly are often wary about opening up to a mental health professional. Their stubbornness is a defense mechanism that allows them to cling to their old patterns of behavior. Instead of stubbornness we can equate it with resistance, something that is quite common in all the clients seeking counselling. Empathy and simply listening to what the client has to say are basic counselling skills but they can go a long way. There are case studies on the internet that demonstrate how the elderly exhibit symptoms of mental disorders but through counselling and/or therapy sessions the underlying fears and trauma are exhibited. Thus, we must treat the elderly as any other age group that might require counselling. The problem is not with the client but with our own prejudices.

Persons with Disabilities (PWD) are also dismissed as people who can require counselling. The word disabilities in this context means a physical and or mental limitation that impacts one or more major life activities (Balva, 2020). More often than not, persons with disabilities are deemed as ‘different’. This can often have negative connotations. This impacts how the person perceives himself/herself. Disability based stigma is also quite common in our society wherein disability is perceived as very negatively.  Persons with Disabilities often have trouble with personal freedom, low self-esteem and navigating a world that doesn’t accept them as ‘normal’. Counsellors are often suggested to remove their own internalized bias. When we think of the word ‘disability’ an image pops into our mind. This is our bias which we must remove. Wendell (1996) argued that “a distinctive group consciousness is not held by persons with disabilities, but that there is a diversity of standpoints held by persons with disabilities that collectively can be distinguished from those held by persons without disabilities.” This simply means that disabled people should be considered as individuals who experience life differently than us. They shouldn’t be thought of as a marginalized group that undergoes the same issues.

Whether it’s the elderly or people with disabilities, mental health is as important as physical health. It shouldn’t be neglected and as a society we need to understand and remove the bias that while it might be acceptable for some to seek professional guidance regarding mental health, it’s not for some. Mental health professionals don’t judge who walks through the door but focus on understanding why that person sought the professional out.