As a therapist in New York working with older adults, it seems that just about every psychological issue has its roots in a lack of feeling safe, included or trusted. Generally people develop severe mental illness when accidents of heredity or persistent trauma are added to that equation. Sexual abuse can be the most crippling. Parental abandonment is right up there, too. Healing in traumatic situations like these requires much more than the “pain relief” pills provide. Instead, I believe it requires the proactive introduction of pleasure into the individual’s life. This pleasure is not just for fun. It is to attempt to see if pleasure can be learned and applied to the affairs of daily living. It is also an attempt to see if the endocrine system can reverse the physical damage caused by long-term stress or trauma.
What would happen if a program of treatment included increased human touch, along with social engagement, personal validation, and group activities instead of pharmacological interventions? Of course, there will always be those who require medication, but we should only provide pharmaceuticals when a caring environment and efforts of a healing community have failed. I want to see if having masseuses, therapists, sex surrogates, nutritionists and personal trainers working as something of a “personal crisis team” can help older adults improve their sense of well-being.
The reason I mention all this is that, too often, as people get older, their opportunities for pleasure diminish. Older adults deserve to feel good and that includes having physical intimacy with others or themselves. The fact that people who are uncomfortable with sexual activity–whether adult children, institutional caregivers or administrators–restrict older adults’ opportunity for privacy, intimacy and pleasurable activity is both ageist and contemptible.
As you can probably guess by now, I’m a big believer in talk therapy in general and the therapeutic value of human touch in particular. I won’t go into the research comparing the act of hugging favorably with drugs for reported relief from distress. But I believe we should treat pain and distress by finding ways to increase the amount of pleasure a person is experiencing rather than simply trying to reduce their pain.