Saturday was World Suicide Prevention Day. We remember those who took their own lives, and we support and mourn with family members who lost their loved ones prematurely.
We've done fairly well creating suicide prevention programs for teenagers and college students. Yesterday, for instance, WBUR described AWARE (Asian Women's Action for Resilience and Empowerment), a program designed at Wellesley College to provide support for Asian-American university students. AWARE stemmed from research that states Asian American women have the highest rate of suicide among women of that age group. Samaritans Hope hosts SafePlace, a support group on Thursdays in Quincy for people who have lost loved ones.
We haven't done so well with the elderly population. While people 65+ makes up for only 12% of our national population, they commit 18% of reported suicides. Researchers believe that suicide in elder populations is underreported by up to 40% due to deaths by self-starvation, overdose, and refusal to take medication. As our nation's number of elderly people increases, we must have more productive conversations about improving late-life care.
Carla Perissinnotto, a professor at the University of California at San Francisco, writes that 43% of elderly adults (65+) reported feeling lonely, regardless of their relationship status (only 18% of the 1600 assessed lived alone) or access to social activities. Late-life suicide is complicated by the experience of health issues and physical pain. However, loneliness--the feeling of emptiness and lack of belonging--seems to play a significant factor in late-life suicide.
As Katie Hafner wrote last Monday in the New York Times: "Researchers have found mounting evidence linking loneliness to physical illness and to functional and cognitive decline. As a predictor of early death, loneliness eclipses obesity." (Links are also used in the article.) In the United States, approximately half of everyone over the age of 85 lives alone. If these men and women have lost faculties, mobility, and other forms of independence, this means they are much more likely to lack daily affection and conversation, relational activities that keep us alive and motivated.
The American Association of Marriage and Family Therapy has a list of warning signs for family members to watch for, including the reduction of self-care and grooming, the halting of medical and exercise regiments, making sudden changes to legal affairs, such as wills and property, and a preoccupation with death.
Marriage Counseling and Intimacy
Healthy intimate relationships are often antidotes to feelings of loneliness for elderly folks as well. Sara Moorman, a professor at Boston College, recently surveyed almost 800 couples aged 65+, and discovered that partners who receive criticism and blame are much more likely to experience loneliness, which makes sense.
Interestingly, Moorman discovered that partners who criticized and blamed more felt much less loneliness, a pattern that isn't replicated in younger couples. Criticism and blame seem to be functional in older couples in this way: if I criticize you for your lack of caring for yourself, I'm trying to communicate that I care about you, even if my process draws out the negatives. I'm also taking care of my own sense of loneliness by overfunctioning for my partner.
The problem, of course, is that criticism often leads to defensiveness, an increased sense of loneliness for the person being criticized, and a negative interaction cycle.
Couples therapy can be helpful for all demographics, including elderly couples and couples with 35+ years of marriage.
For instance, Perrissinotto mentions that 36% of married persons feel loneliness because of factors outside of the relationship, such as the loss of a close friend or sibling, or the loss of a physical ability. Often, we feel like a partner's loneliness has to do with us, and we may poke and prod to try to help (it usually doesn't) and to absolve ourselves from culpability (even though, according to this study, your partner's loneliness probably isn't your fault). We may also blame our partners for something that has nothing to do with them. Couples therapy could be a safe place to learn about and connect with your partner's vulnerabilities of loss and loneliness.
Couples therapy could also help you improve your sexual relationship, and sense of connectedness. We can help you find ways to accept the abilities and mobility that your and your partner's bodies currently have, and to communicate about the needs of our ever-changing bodies. Our partner's acceptance and celebration of our bodies, particularly if they are affected by disability, often parallels an acceptance and sharing of our emotional worlds.
For more information about couples therapy, check out my (Jeremiah's) bio page and the bio pages of my colleagues, or read our description of couples therapy. You can set up a session with us online, or by calling us at 617-750-0183.