Demonstrating Resilience as Older Adults

On April 20, ASA publishes a Generations Journal on Mental Health, Aging, and Resilience. The below piece serves as an appetizer for that issue, from someone working on the frontlines of mental health care.

When I was a boy of 14, my father was so ignorant I could hardly stand to have the old man around. But when I got to be 21, I was astonished at how much the old man had learned in seven years.

—Mark Twain

I have worked in the field of aging for 36 years, and not a week goes by when I don’t reflect on this quote from Mark Twain. At age 19 and working in my first job on a mobile mental health team for older adults (or “geriatric homebound team” in the parlance of the time), I considered myself an expert on aging—and I definitely thought I knew more about life than the older adults I was assigned to help.

With each passing year, however, I have gained deeper respect for the life experience and wisdom of the older adults in my life, as well as a greater sense of humility and gratitude for being able to play a small role in the important work of supporting adults as they grow older.

As chief program officer at the Service Program for Older People (SPOP), I oversee community-based behavioral and mental healthcare programs for adults ages 55 and older in New York City. We are the only agency of our kind in the region, and we offer individual and group psychotherapy, psychiatry, medication management, assessments, group-based psychiatric rehabilitation services for adults with serious mental illness, bereavement support, and links to other programs and services that support aging in place.

Our overarching goal is to enable all older people in our communities—neighbors, friends and relatives to live independently for as long as possible, working in partnership with hospitals, older adult centers and dozens of other providers to ensure our clients get the support they need.

One of the most profound lessons I have learned—and continue to be reminded of every day—is that there is nothing “generic” about aging. Our client population spans at least four decades and reflects New York City’s economic, ethnic, racial and gender diversity. Each client brings a long and complicated history to the process, and we aspire to listen without any preconceptions about aging, race, ethnicity, sexual orientation, gender expression or financial status.

‘Each client brings a long and complicated history to the process, and we aspire to listen without any preconceptions.’

The most common diagnoses we see in our clinic are depression and anxiety, though we also treat clients for a multitude of other presenting issues. Social isolation, economic insecurity, caregiver distress, chronic illness and alcohol or substance misuse have always been contributing factors to our clients’ well-being, and all of these issues intensified during the pandemic.

Our team of mental and behavioral health professionals have deep expertise working with adults older than age 55, and many identify as LGBTQA+, people of color/multiracial, bilingual, or as having lived experience as an older person or mental health consumer. To a person, they bring an extraordinary dedication to their work, which translates to a 97% satisfaction rate among our clients.

Resilience is the word that comes to mind when I think about the SPOP community. Yes, each client becomes older while they are at SPOP, but they also learn, grown, and change as they work toward treatment goals. During my years at SPOP I have seen dozens of clients in their 70s, 80s and 90s who have achieved sobriety after decades of alcohol or substance misuse; learned to understand and resolve grief after the loss of a partner; acquired self-regulation skills to manage symptoms of anxiety or depression; found ways to define and celebrate holidays in meaningful and joyous ways; acknowledged the challenges of chronic illness and learned how to accept assistance; and resolved deep-seated emotions rooted in trauma or abuse.

Our clients—and our therapists, psychiatrists, schedulers, receptionists and intake staff—are an unending inspiration to me.

This year I crossed a threshold and am now at an age where I am eligible for SPOP services. As I look around our office, I feel a new resonance with the challenges that many of our clients have faced in life, and a tremendous respect for their ability to articulate and work toward new goals.

The SPOP community is reminder to me that this chapter is what psychologist Sherry Ruth Anderson calls “a season of ripening”—a time to chart a pathway that braids together decades of life experience with opportunities to work toward new goals. It is a time to draw upon a deep well of knowledge and strengths, accept the help we need, and, like the young Mark Twain, continue to be open to the growth and deepening that continues across our lifespans.

Catherine Thurston, LCSW, is the chief program officer at SPOP, where she oversees the SPOP Clinic, PROS/Personalized Recovery Oriented Services Program, Bereavement Support, community outreach and other program initiatives at SPOP. She has three decades of experience in geriatrics, which includes serving as chief services officer at SAGE/Service & Advocacy for LGBTQ+ Elders and as director of Alzheimer’s Programs at the Cobble Hill Health Center.

Photo credit: Shutterstock/Carlos Calretas