Therapy for the Aging Population

Why does no one speak about healthy sexual activity post-child rearing? Are we unconsciously still a society that views sex as a means for reproduction or are we a culture that is sex positive for pleasure? Healthy sexual activity and release is a natural part of living and does not stop just because our libidos decrease in intensity. However, as a society, we label the aging as non-sexual beings. A lot of couples’/ individual’s identities revolve around their sexual intimacy and when aging makes that more difficult, tensions can increase, causing interpersonal issues. Unhealthy sexual activity, lack of, or difficulties with sexual activity can lead to mental health issues—an issue almost all adults face at one point, but no one seems to be talking about it. It is so important for therapists to not only focus on the sexual dysfunction that services are being sought, but also what the couple/individual wants from their sexual experiences, sexual aspirations, and the use or addition of enhancement products like vibrators, lube, pills, and clothing (Clay, 2012). According to Skultety, in 2007 there were over 1,000 books on Amazon.com regarding old age and sex. This underlines the scale to which this is a problem. Cross-sectional studies showed that older adults maintain positive attitudes towards sex. The study showed that 90 percent of individuals 70-years-old and over disagreed that “sex is only for younger people” (Skultety, 2007). Attitudes seemed consistent amongst older Caucasian individuals expressing, “people should not have sexual relationships if they are not married” might be the root of the issue. It is beneficial to clients to provide psychoeducation on the options available for older adults, especially those involving physical dysfunctions that have alternate treatment options.

An aspect of sexuality that is important when it comes to treatment is knowing that lack of or oversexualization can be a symptom of several disorders and not necessarily the root problem. That is, a clinician who is aware of a client’s current sexuality and expression of sexuality can assist in diagnosing. For example, those experiencing significant life stressors may be experiencing sexual dysfunction or lack of interest in pleasurable activities (including sexual intercourse). When diagnosing, it is always important to establish if symptoms are occurring because of a larger issue or mental illness or if symptoms are because of current life circumstances that are situational (American Psychological Association, 2013). This assists in the ability to improve the interventions modalities used in treatment. If a client’s issues with sexual intimacy in their relationship comes because of work stressors that the client is taking home, then they would not require the same treatment as a diagnosis of depression or anxiety would.

Religion cannot be ignored when discussing the importance of sexuality and its evolution. A lot of cultural perceptions on sex and moral compass surround religious dogma. For example, common ideas from Judeo-Christian religions include: no sex during menstruation, birth control, abortion, same-gender sex, anal sex, sexual fantasy, masturbation, non-monogamy, sex before marriage, marrying outside the religion and no sex outside marriage (Klein, 2010). Much like we speak about the Constitution today, we must remember the context in which religious texts were written in. In 1,200 BCE and 800 CE the population was primarily nomads, had high rates of infant mortality, life expectancy was 40-years-old, no privacy, no electricity or light after dark, very little non-family mixed-gender interactions, no indoor plumbing, rarely bathed, and never traveled over 50 miles (Klein, 2010). These are outdated standards but we continue as a society to perpetuate these ideals, despite knowing the damage they place on non-religious and religious individuals every day.

Where do your views on sexuality come from? How would you treat or inform clients about healthy sexual activities and dysfunction?

References

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th edition). Arlington, VA: Author.

Clay, R.A. (2012). Later-life sex: psychologists are working as part of health-care teams to help older adults keep their sex lives going strong. American Psychological Association, 43(11). Retrieved from https://www.apa.org/monitor/2012/12/later-life-sex.aspx

Klein, M. (2010). Religion & sexuality: Iron age or dark ages. Retrieved from https://www.psychologytoday.com/us/blog/sexual-intelligence/201012/religion-sexuality-iron-age-or-dark-ages

Skultety, K. M. (2007). Addressing issues of sexuality with older couples. Generations, 31(3), 31-37. Retrieved from https://tcsedsystem.idm.oclc.org/login?url=https://search-proquest-com.tcsedsystem.idm.oclc.org/docview/212210397?accountid=34120

Zeiss, A.M. (2003). Aging and Human Sexuality [photo]. Retrieved from https://www.apa.org/pi/aging/resources/guides/sexuality