Counselling & Psychotherapy
Central London, Camden, Kings Cross, London NW1
Glen Gibson - Dip. Counselling, MA Psychotherapy, Dip. Psychotherapy
UKCP & mBACP Accredited Male Therapist, Counsellor & Psychotherapist

Counselling For Older People - Counselling London

Attitudes Of Society & Of Us James Hillman described ageing as a process for which character reveals itself - that it takes courage to let go of useless negative ideas about ageing and to cultivate curiosity about this process, finding its value. He insisted we need to keep our eyes open for both fading light and the blaze of a beautiful sunset. Yet society's attitude often seems to value & even obsess with youth, valuing how we look (the body beautiful), youthfulness & age (whatever this may subjectively be), more than people's humanity, intrinsic worth, who and how we are, all our qualities - whatever our age. At its worst (where ageism may also have an impact), the person behind the label e.g. "pensioner" can be marginalised, written off, disenfranchised, ignored, segregated or unseen. Work advertisement may be focused on ambitious, dynamic, energetic people, which may be an euphemism for seeking younger applicants, yet be overlooking the value of experience and skills. And what people close to us, our own family think or expect of older adults, people's beliefs, behaviours - what they say & how they relate, alongside our own personal attitude, narrative of what we tell ourself, our own expectations affects us. Society can also put people (e.g. teenagers, pensioners) into homogeneous groups, as if each "group" behaves stereotypically, without personal differences (where we too may have absorbed some of these disempowering beliefs, attitudes and behaviours, so growing old becomes something to fear, rather than embracing being an older, maturer adult, valuing and enjoying our life as it is now as an elder). Ageing is a natural process, our body declines. We all have fragile & subtle bodies whatever our age. We may believe that everything is in the past, or that we have nothing to look forward to. Some may be in touch with the emptiness of life, having a feared image of ageing, as if we are at the mercy of it, have to passively cope with ageing, and may be a little depressed. Fear of ageing may be something we experience. We may have genuine concerns & fears, e.g. over our own elderly parents needing care, our health, aloneness, loneliness, dying, reduced capacities and may be questioning what quality of life means for us. Yet others may be in touch with the fullness of life, whatever our age, responding to engaging with life, living successfully as our own personal journey of growth continues. And it may be important for us not to lose our sense of self in the process, our beingness and want to age on our own terms with an open mind, also being both future-focused and reflective. These considerations can also be discussed in the therapy. Life experience, wisdom, contribution as an elder can be undervalued.

Counselling For Retirement Concerns Adjusting our life - the transition from working to no longer working - can be challenging for some, especially if we experience or fear a vacuum in our life. Some of us may struggle how to embrace the fullness of our own identity. At a loss or mourning, grieving the work-life we've had, we may need to replace, create and make a different life for ourself, different roles, doing what brings us joy - enjoying each day, being in the moment other than our familiar work identity (see also Identity Crisis, Who Am I). What motivates me now, what nourishes me as a human being? These questions can bring us up against existential issues. The impact of letting go of our work & employment can be enormous for some. Anxiety, fear & relief may be present. We may need to develop different, new strategies in our life, being involved in things that give us satisfaction. The counselling for retirement can explore concrete ways we organise, plan our retirement over periods of time, e.g. 1, 5, 10 years. Others may want to consider phased retirement. It may be important for our body and mind to remain active in ways, which are meaningful for us, support our health, vitality. Therapy for retirement, counselling for retirement can be a place to talk about what this means for us.

Our Changing Role Our roles and how we see ourselves evolve and are a natural process throughout our life. Counselling & psychotherapy can be used to explore what roles now are important to us, even yet to be discovered roles (maybe as an elder). Some people may also want to discuss their changing role in the family and personal sense of identity.

Ageing Process & Transitioning, Embracing Our Maturity As An Elder Elders have been termed as "grand" parents of the world. As an elder - for all its ills and benefits, with plenty of positive role models, we don't have to ingest any negative stereotypes of "the elderly", "old age". We may want to share, explore, what happens within us around our ageing process, and do so without sugar-coating it. There is a Viktor Frankl quote "Everything can be taken from a man but one thing: the last of the human freedoms—to choose one's attitude in any given set of circumstances, to choose one's own way. When we are no longer able to change a situation, we are challenged to change ourselves." And embracing our emotional maturity, compassion, may be important to us. Each stage of life offers fresh opportunities. In the first phase of our life, we are busy building a platform as a container, questioning how we can support ourself. Our sexuality, gender are important to us as we establish our own identity, a home, friendships, relationships, community, a sense of security. Alongside pursuing pleasure, it may have been important to honour family, cultural loyalties, conventions, have respect for authority, value the importance of our ethnicity, religion, country (see also The "Should", "Shouldn't", "Ought", "Must", "Never", "Always" Beliefs). We may have enjoyed all these props around us, maybe giving us a false sense of control, safety. Yet as we age, these containers may also have been a protective fence around us and may still exist, yet some of these, alongside unhelpful, redundant, inhibiting rules, loyalties, oaths, sacred cows, obligations, duties, taboos, cultural conventions, may now be experienced as fencing us in. (As the Dalai Lama said, "Learn and obey the rules very well, so you will know how to break them properly".) Restless inside, longing and yearning for something, we may have an intuitive sense that our old agenda is less important, no longer works, is redundant, as if the old show is over. (C.S.Lewis in "Shadowlands" refers to the Bible Corinthians 13:11 "When I was a child, I spoke as a child, I understood as a child, I thought as a child: but when I became a man, I put away childish things.") As our priorities in life shift, just keeping going may no longer be enough - preventing us evolving, maturing. We may be questioning "Is that all?" (see also Existential Concerns - Our Direction). We may want to talk about a creeping sense that simply entertaining ourselves and obtaining enlightened self-interest no longer gives our life meaning. This may indicate we are ready to gather our years, ripen in ourself, incorporate the lived, subjective experiences of our self and transition, adjusting towards this evolving time in our life. (It was Carl Jung who introduced his understanding of the two halves if life, "We cannot live the afternoon of life according to the program of life's morning, for what was great in the morning will be little at evening and what in the morning was true, at evening will have become a lie." He also acknowledged "that death is psychologically as important as birth" and that shrinking away from the importance of death is unhelpful and abnormal, which robs the second part of life of its purpose.) There are things we couldn't see when we were younger and in this second half of our life, rather than all or nothing thinking, either/or, we see wholes, as our life now becomes replaced with dilemmas of life's predicaments, priorities, paradoxes, contradictions, conflicts, contrasts, ambivalence. Belonging and making space for ourself, truly valuing what we are doing, enjoying a simpler life may now be considerations.

Our Journey As An Elder Some of us may never have acknowledged, experienced the complexity, disturbances and necessity of suffering and love. This may include acknowledging our achievement, yet recognising what has been is no longer, that we are no longer young, sitting with this (which can be experienced as a fallow period), digesting this - where our life is now. (As Nietzsche said, "One must still have chaos in oneself to be able to give birth to a dancing star".) Without any rites of passage, we may be struggling with moving into the second phase of our life, having been on our own path and now it can be as if Maslov's hierarchy of needs (higher up the triangle) are calling us. As we enter into later life, our false self may dissolve, our very soul, spiritual qualities may be driving the calling and some of us may be connected to, seeking a spiritual path. And in our own integrity, less full of ourselves - we may drop our ego beyond our small and petty self, alongside our masks, old dramas. We may no longer have final and strong opinions about anything, nor fight what's unnecessary any more (e.g. maybe that of our status, wealth, place in life, religion, ethnicity, being superior, having to be right, winning). The tennis champion Arthur Ashe reminded us "You've got to get to the stage in life, where going for it is more important than winning or losing". Independent in our true self, true nature, we may no longer need to change others, just be happy in ourselves. And from this more evolved place inside as we move into our "being", in our "doing", we are ironically more in a place to change others, yet we don't need to do so. Incorporating this second phase of our life, lightness through the darkness and a sense of "OKness", as we embrace mystery, participate in life, become more discerning, we may invariably experience both sadness and joy (even "mad, crazy" moments for as Nikos Kazantzakis points out "A man needs a little madness, or else he never dares cut the rope and be free"). We may also become more in tune with ourselves, community and the wider world, our interdependence, interconnectedness, oneness, unity, harmony. Switching from having what we love, to loving what we have, being in the moment, appreciating the gifts of our life, serenity, we may no longer want to collect material goods and choose more to give for the benefit of others - to serve rather than be served (see also Wellbeing Of Others - Generosity Of Spirit, Being In Service Towards Others, Acts Of Service). At this stage of our life, we may experience the world in broad, yet challenging ways of a different nature - see also Emotional Resilience, Emotional Strength, Emotional Stability & Being Powerful. (James Hollis stated, "The world is more magical, less predictable, more autonomous, less controllable, more varied, less simple, more infinite, less knowable, more wonderfully troubling than we could have imagined being able to tolerate when we were young".) And Sandy Denny questions, "Who knows where the time goes". We too may have a growing sense of spaciousness, maybe timelessness, infinity (not just out there but also internally, as if the inner and outer become one). It was the psychoanalyst Donald Winnicott who said of ageing that: "People are not just their own age; they are to some extent every age, or no age".

The Impact Of Ageing We may no longer feel the same about having endless time ahead of us. Age is no barrier to an active life and as we enter, or are already in, a later phase of life, we may well need to make adjustments. For some, this may involve being flexible, challenging our own views about ageing, for others, maybe adjusting to a more relaxed pace of life (Bob Dylan wrote "I was so much older then, I'm younger than that now"), reviewing what illness, pain, vitality & wellbeing, alongside death, mean for us. As if going along with George Bernard Shaw's comments "Youth is wasted on the young", some of us may embrace our longevity. Others, like Hemingway, fight it "The world is a fine place and worth the fighting for and I hate very much to leave it" (and Paul Robeson sings in Old Man River "I gets weary, Sick of trying, I'm tired of living, Feared of dying, But ol' man river, He's rolling along"). A challenge may be whether to harden, fighting against our ageing process (as if we view it as tragic, failing or illness), or soften (see also Soft Living, Living A Soft Life Powerfully), opening to the ripening of our maturity and what it brings. Our perspective of what matters, what's important and what we value may evolve. As we become maturer as an elder and reflect, we may often come up against existential concerns, existential grief or regrets, meaninglessness - questioning what has meaning & what doesn't. This may include being in the dark at times, maybe struggling as if living in a world which seems out of synchronisation, maybe alienating of the soul. We may be grieving what was, might have been (or what we might be). Some of us may struggle socialising, meeting others, have slowly become a prisoner in our own home. What we do with our aloneness, loneliness, may be a challenge. Companionship & being with others may be important to us. Living to our full potential may take on new meaning for us now. And the therapy for ageing contrasts what ageing does to us and what we do with ageing towards growth and development, living adventurously.

Ageing Concerns The impact of ageing can be emotive for many of us. Physically, as our bodies change, our quality of sleep may decline. We may lose some other healthy physical (see also Responding To ill Health) or mental functions (see also Our Brain & Memory), that we once took for granted. (Ageing might not scare us, yet experiencing incontinence, Alzheimer's, having a stroke may, as might being in pain, dying.) Valuing our independence, comfort, security, we may fear getting older, loneliness, or have our own personal fears, anxieties. We may see or experience the world around us as reducing, e.g. friends, socialising, mobility, etc. We may be grieving or letting go of a stage of life - what was or might have been, for thing we wished we had said, done more. Self-acceptance, forgiveness may be in short supply. The counselling and psychotherapy can offer a space to reflect and talk about our own concerns around ageing. This for some may include reflecting on the losses of old age, injustice of life and our own mortality, making sense of life, handling adversity when setbacks happen. Alongside involvement in the community and relationship with friends, we may need something else that calls us, challenges, stretching us to make certain commitments or have a role, contributing in life being in service of others, needed by them. Others may be on a quest to explore our purpose, truth, spiritual orientation, what life is about. Counselling for ageing, therapy for ageing can support our life-transition, healthy ageing and wellbeing and making sense of things.

Our Brain & Memory For some our brain and memory may not operate as well. We may be struggling to find the right words, language at times, yet our spirit is still alive. (This may also be true if we experience Alzheimer's Disease, Dementia.) Counselling can be a space to just be ourselves, without having to put pressure on ourselves to remember things.

Responding To ill Health We may become more vulnerable to health problems as we age. We may experience declining physical health, pain or illness. One of us may have taken on an extensive caring role for the other. It can be very challenging to find our way to learn to live with our symptoms, health condition, terminal illness. Each of us respond, engage with pain & illness differently & come up against personal challenges & responses. Challenges may include remaining empowered, focusing on the positive, the now, activities that engage us in life.

Living With Alzheimer's, Dementia If we are (or know someone) now living with dementia, our life changes and it can be puzzling to make sense of things. Each person's experience with dementia is different. We may at times feel bewildered, confused, afraid, frustrated, angry, anxious. And the therapy for dementia, counselling for Alzheimer's can be a place to speak candidly about whatever is going on for us and find our own ways to live with Alzheimer's, dementia.

Compassionately Managing Endings, Loss & Grief We may be caught in unhelpful habitual thinking patterns, unproductive, negative thoughts. Positive thinking - "just get on with it" (see also Optimism, Pessimism & Discounting The Positive), exclusively thinking about what we can do may not be enough unless we compassionately acknowledge our losses, grieve them, process them in order to heal, let go of what we need to. Losing friends, a loved one (see also Grief & Bereavement Counselling London) or if our partner has dementia, may take its toll. Living with and adapting to any loss and new beginnings, opportunities, can be a real challenge - the loss of control we used to have, loss of our looks, our mobility, certain faculties, our independence, maybe our memory. Loss of being valued, loss of our career, status, the plans we had for life, maybe a loss of the independence we once had, or mental, physical capabilities may also have an impact on us. As years pass, events in life, losses stack up. Acknowledging these different losses little deaths through transformation, yet being in touch with our qualities within, intrinsic self-worth, alongside what's now emerging for us (see also Living Our Life Now & Looking Ahead), may be important for us, as we nurture our mind, imagination, which can unlock us from being frozen, stuck in time. (See also Grieving, Mourning Our Losses)

Life Reflection We may have spent time on looking inside ourself and reflecting upon what we find. (T.S.Eliot writes of "We shall not cease from exploration, and the end of all our exploring will be to arrive where we started and know the place for the first time.") We have made imprints in the world and much water has flowed under the bridge. We may be nostalgic about the past, maybe having deep love, value some treasured memories, have some unfulfilled aspirations, dreams or regrets and mourn a future we could have, didn't have. (Common regrets may include wishing we had the courage to live our life true to ourself - not the life others expect from us, wishing we hadn't worked so hard, had the courage to express our feelings, stayed in touch with friends, a regret that we hadn't allowed ourselves to be happier.) We may have had missed opportunities, knowing what we do now. (For some, pursued by time or believing we don't have enough time, our image of who we were & who we are now may be in conflict - see also Concept Of Time, Time Passing.) Reflecting upon our own consciousness, we may have existential concerns, grieve many things in our life, need to mourn our losses, integrating our shadow side (for none of us have led a perfect life), alongside extracting simple happy memories, cherished heartfelt people in our life, moments we created, times of wisdom. (Henry Wadsworth Longfellow writes of "Look not mournfully into the past. It comes not back again. Wisely improve the present. It is thine. Go forth to meet the shadowy future, without fear.") Some of us may stay focused on what we don't have, struggling to embrace what we do. Others may be challenged by softer, yet powerful living and the precious commodity of time. Beyond our achievements, we may reflect on our past experiences, achievements, learnings, our meaningful relationships, those we have loved, appreciating the precious moments alongside the big events in our life and the small things - even ones we took for granted. We may also want to turn to therapy in order to reflect upon what life means for us (see also Contemplation, Creating Space & Quiet Time, Taking Pauses - Self-Awareness, Observation & Reflection). Some of us may also be drawn to a spiritual realm or religious faith. (See also Reassessing The Present & Looking Ahead)

Reflecting Upon Our Mortality We may want to die in peace with how we've lived our life, what we've left behind and explore what we think happens after death, if anything. We may want to talk about, prepare for our own death. Death is a great teacher, especially when we acknowledge all the little deaths through transformation. It can teach us to accept our vulnerability, our dependence on each other, bring awareness to the fragility of life. At a certain stage of life, we may be aware of our own mortality, especially around times of loneliness, aloneness, transition, or our body declining. We may be experiencing a phase in life when some of our dearest friends, relatives, die (see also Grief & Bereavement Counselling London). Questioning what really matters to us, we may have some anxieties about our own mortality, fragility, life's impermanence and this can sit on our shoulder throughout our life. Our own mortality, death anxiety or fear of dying may also point to an existential anxiety. (Paradoxically, sometimes some of us too can't wait to die, yet other times value life and would miss others in it.) Some of us may or have believed that death won't come to us - it is something that happens to others, not us. Believing we are immortal we may have been sleepwalking through life. (There are only a finite number of experiences, sunsets, and the evolutionary process of energetic nature teaches us how life rejuvenates through its seasons, rhythms, ongoing cycles of birth, life, growth, letting go, death, rebirths (I am reminded of the Tennyson quote "Every moment dies a man, Every moment one is born."). Our sense of self may struggle to assimilate death, contemplate the world continuing without us. Contradictory for some, when we allow our awareness of life being finite, it can be easier to face death and actually feel more vitality, give our life meaning, make our life a good story. Some may wonder about the footprint and legacy we would like to leave behind. This may include creating a rich tapestry for people to remember us by. Being kind, forgiving, similar to Ho'oponopono, some people wait to the very end of their life to say very important things, like "I love you", "I forgive you", "Please forgive me", "Goodbye". And we may want to also utilise the therapy to make sense of our life, celebrate it, continue to leave it - going forward in the way we can. (Soren Kierkagaard writes of "Life can only be understood by looking backward;, but it must be lived looking forward".)

Counselling For Death Anxiety, Fear Of Death Or Dying, Thanatophobia Counselling We may have awakened awareness of both our aliveness and ultimate death. Counter-intuitively, accepting the fact of death can free us up to live more fully, freely. The rational mind can't process death. We may fear our own death or others close to us dying and want to approach death with more openness. (By preparing for our own death in emotional and practical ways, we are more able to assist others in their own dying process - see also End Of Life Treatments, Assisted Dying & Legal Matters Currently In The UK.) Yet, most of us at some point in our life feared being dead, death or dying - what some people label death anxiety, fear of dying, which is natural, healthy, and normal. (When our death anxiety becomes acute, it can turn into thanatophobia and we may seek counselling for thanatophobia, to talk about what death and dying personally means for us.) We can go to great lengths to avoid our fear of death, have affairs, procreate to carry on our name, strive to be more youthful, have cosmetic surgery, a midlife crisis, obsessively exercise, accumulate material possessions. Simply pursuing happiness may not work for us, nor may resigning ourself to slowly crawling our way to the grave. Is it dying we fear, or more dying alone? Do we fear no one being there holding our hand when we pass, when we die? It may be important for us to die with dignity. Accompanying ourself in life and death is something we may want to explore. Health anxiety, loneliness, aloneness in our life, grieving others dying, can trigger our own fear of dying. Someone in our life may have died prematurely and we may fear this could happen to us. (Some of us may worry or speculate who attends or what is said at our own funeral.) For others, our anxiety may not be about death, but about fearing terminal illness, a stroke, Alzheimer's, dementia, physical pain or how fragile we are as human beings, that life is temporary, uncertain, unpredictable and often unknown - something we are out of control of. Often fear of death may come from a belief that when we die, we will be punished for our sins, that God is judgemental. We may be afraid to die and the therapy may explore our fears, anxiety, whether it is actually about fear of dying, or being helpless, dependent on others, a burden, yet we are not a burden, unless we choose to believe this. We can allow ourselves to receive and be lovingly cared for. This takes dignity of spirit, grace, to accept this. We may wonder what happens when we die or more about not being at all - disappearance, non-being, nothingness, a void. This may terrify some of us, and as if in shock we can be in a dreamlike state. Others may protest "How can it all end?". We may have uncomfortable (or comfortable) thoughts about the concept of time - how much of our life has gone by, and how much time there is to go (see also Soft Living, Living A Soft Life Powerfully). Death is a given, yet we may be so preoccupied that we will die at any time or sometime, that we struggle to value the preciousness of life, the uniqueness of each moment, our and others' aliveness especially if we hold nihilistic beliefs, fear living, as if wasting our time until we die. The counselling for death anxiety also takes into consideration what's going on for us - our concerns about when, how we die and the certainties and mysteries of death. Questioning our own eternity, some of us may fear death so much, that we withdraw, avoid risking things, live routinely or habitually. Yet for others, our responses & reactions to fears, grief, anger may reduce how we live and feel alive in the world now. (Counter-intuitively for some, we may want to volunteer in a hospice - being with the dying, attending to and listening to them, recounting their private moments, loves, losses, memories, regrets, really hearing them. This can help us come to terms with our feelings, rooting our journey to that of a wider human context and love.) Alongside being curious about death, we may want to rediscover spontaneity, new things and embrace surprises, our aliveness, live for today, be happy now, enjoy ourself, express our heart's desire.

Talking about death, dying is not contagious - it doesn't tempt fate. We don't always have to deny or fight death. The Japanese principle of Bushido is to keep death in mind at all time - "A samurai shall always be prepared for death, whether his own or someone else's". And we may want to talk about what death, dying, means for us personally. Our culture and those around us may fear death and it can be taboo to talk about it. Feeling impotent, some of us may have avoided the realities of death, which can render us silent or passive. (Some may feel rageful as the Dylan Thomas quote expresses: "Do not go gentle into that good night, Old age should burn and rave at close of day; Rage, rage against the dying of the light.") We can understandably feel vulnerable talking about death, dying, yet need permission to talk about it, share our experiences, ideas, fears - these may reveal regrets, a painful or secret past, traumas, wounds that need healing alongside our hopes, acceptance, reconciliation, grace. However, some of us can't quite believe we (or others) are going to die and feel traumatised by this. Denying the reality of death leaves us in the dark. Consciously facing it allows us to live in the light. And this doesn't just have to happen in the final moments. If we start now, we can transform the quality, depth, and beauty of the moments we have left on this Earth, so our life overflows with meaning and purpose, as does our death. And with guidance, we may want to realign with both the physical and spiritual world in empowering ways, live fully in the blessings and richness of the here and now - which is all we ever have. How we die and whether we will be in pain, alone, and what we may leave behind may be understandable concerns for some and wonder if we will be forgotten. We may struggle so much to embrace this doorway into the unknown, let go of control, reassure ourselves, that it inhibits moving towards issues of life and living. The therapy can supportively explore the reality of death, nature's intrinsically linked re-birthing, cycles of life and death, which can remind us that we are part of life itself (see also In Tune With Us, Community & The Wider World, Our Interdependence, Interconnectedness, Oneness, Unity, Harmony).

Terminally Ill, Terminal Diagnosis When we receive this news, we may have a range of reactions, emotions, thoughts, and beliefs (see also Counselling For Death Anxiety, Fear Of Death Or Dying, Thanatophobia Counselling). Facing our own mortality, we may have good days, bad days, maybe taking on different perspectives, clearing the clutter in our life and value what's really important, the good things. We may no longer (or never did) view success as monetary wealth. We may no longer worry so much about what others think about us and become more authentic, radically honest - through self-trust. Valuing simplicity (including small goals as well as bigger goals), quality over quantity, accepting just "what is" (and that we are enough, present in the moment) and releasing old regrets may come easier to us. We may shift the way we see the world, ourself and others, no longer "sweating the small stuff", valuing, appreciating grace, what's sacred, what really matters in our life (this may include sharing feelings, emotional connection). Managing our energy, we may also value the simple things in life - even small movements/achievements, gratitude, beauty, love, joy, kindness, humility, creativity. For some, this news can deepen our relationships (or counter-intuitively accepting the fact of our death can enable us to live freer, more fully). We may question life meaning, purpose, bringing us up against existential issues. We may also be exploring our religious, spiritual world.

Planning Ahead - Attending To, Preparing For Our Own Death, Our Own Dying Process, Death Wishes - Bringing Death Into Our Life Carl Jung writes "Death is psychologically just as important as birth and, like this, is an integral part of life." Talking about death and dying may help. We may want to prepare now for a good end of life, have end of life plans, accepting that we are going to die, experience peace of mind, knowing that preparing for the end of life can be our last great gift to ourself and our loved ones. When we embrace death into our awareness, it helps us appreciate what's good in life, where to focus our energies. Preparing for our death and all that it entails can be daunting for many of us. There can be a lot of impending doom and gloom, a sense of dread, depressed attitudes towards dying and for many of us we may not know how to leave the world. Facing our own mortality, we may wonder: "Is it possible to have a good death?" We may desire a good death at home and want to state how we wish to be cared for. On a practical level, we may not want to leave a mess behind us. We may want to attend to certain important issues, like having an up to date will, maybe power of attorney, define how we want our body to be taken care of through end of life care, so we specify our wishes to people close to us and also legally. Feeling right about death may be a need for some and we may want to include our faith, any spiritual or religious preferences (see also Spiritual Framework Of Death). Everybody's idea about a good death is different. We may want to proactively prepare for our own graceful passing, to feel right about death, how we leave the world, have kind conversations about our wishes to others, so they are informed, prepared about these. This may include whether we donate our body and organs (see also NHS Organ Donation), where we would like to die. We may prefer spending our final days at home. Others may prefer being cared for inside a hospital or hospice, yet this can seem remote, more clinical for others. We may want to specify how we want our body to be prepared, whether and how it should be shown on our death. Some may not want a funeral - preferring a quiet exit. Others may have funeral wishes, want to have funeral plans. These may include: arrangements for the location and type of service we would like, who we want to arrange the funeral, officiate the service, whether someone religious, humanistic, etc. and whether we want the service to be formal, solemn or more towards celebration of our life, also whether we would like the service to be long or simple, what rituals are important to us, what in-season flowers, and/or charity to receive any collection are important to us. We may want certain music, writings, poetry to be played or read. We may want to consider where and whether we want a natural, environmentally friendly or green burial e.g. what our body is wrapped in, whether in a coffin and who we would like the bearers to be, or a casket, etc., maybe have a traditional burial, with a gravestone, or a cremation with our ashes kept, interred (if so, the type of container, urn we would like and where we would like them to be), scattered. Whether we would like a reception may be another consideration. We may also want to take care of our feelings, emotions, needs, transforming the quality of our life now. This may include resolving and celebrating our present life - the things we regretted, our pain, celebrating what we've learnt, being kinder and present now, making heartfelt connections with ourself and others, letting go of what we need to, being ready to leave things behind and feeling it's all right to do so, opening to the unknown, our life and death, grounding our Self in the sacred journey of our dying. Alongside making financial arrangements and passing on our objects, we may also want to consider the legacy we would like to leave behind, that continues beyond our physical death - maybe something meaningful, life-affirming and the connections we've made with others, maybe what we value, the gems, treasured memories from our life experience, any guidance we would like to impart, our character traits, virtues and any comforting messages we want to pass on (we may want to consider suggesting rituals, that people will remember us by). By passing on our legacy, this can make our remaining time meaningful. Counselling & psychotherapy can offer a supportive space to talk about our anxiety, fears, concerns, our hopes, thoughts and wishes about our own death, where dying can change what life means for us. As best we can, we can take charge of these matters, affirm our life, give us a sense of purpose to leave behind meaningful legacies, which continue beyond our death (not just the external items, finance, etc., but also our internal legacy - being kind, keeping our heart open, our life experience, character traits, virtues, values, inner wisdom, guidance, our compassion, love and marking the connections we've made with others).

What Happens After Physical Death? - Nothing? Afterlife? Reincarnation? Pre-life? Death is poignant - and we may want to be more at ease around what happens after our physical death. Death and mortality are necessary for the evolutionary process. We may wonder whether our non-physical life continues as our dying becomes arising and want to talk about what mortality and immortality means for us. We may be questioning what's earthly, what's eternal and our notions of time (and space). Some of us believe that once we die we disappear, there is nothing else - a void and are certain that when we die that is it, we are just a brain in a body. Some may be in a "don't know" camp or have thoughts, feelings, about dying physically, yet want to explore the spiritual nature of dying. Others believe that following our physical death we pass over, that the soul's journey continues into unconditional love - a space of loving, wise, benevolent energy, that consciousness beyond time and space goes right on living, that the psyche lives on as our soul essence cannot die. We may also question whether death is the end, that consciousness extinguishes with death of the physical body or if there is an evolution of consciousness, other forms of reality, conscious experience (people who have encountered near-death experiences recount forms of transition), that is immortal, infinite, and whether this is connected to karma? We may be curious about this and have many questions: "Given energy can't be destroyed yet can be transformed, do we pass from this dimension to another, re-emerging into source energy of a spiritual nature?", "Are we resurrected?", "Do we transition, pass through something, transform to the non-physical and does our soul live as spirit?", "Do we reincarnate, is there life after death, past lives, future lives?" - the more eastern perspective and in Buddhism. Being curious, open-minded, and gaining knowledge may reassure those parts of our mind that are intellectually suspicious of these metaphysical and spiritual notions, which can sometimes sabotage our confidence and development.

Spiritual Framework Of Death "That's it when we die, there is nothing - a void, emptiness" may be our belief. We may hold a humanist faith that as soon as we die, it's the end. Without denying suffering, illness, grief, pain and loss, death is often viewed as unpleasant and bad news. Yet a wider framework for some is that we all die and move into other consciousness and welcoming states, which form a part of most major religions - that there is a recognition of spiritual transition - part of a universal narrative (see also Eternal Presence Diagram). Therefore some people view the body, mind, ego as separate from us and is our physical home while we are incarnated in this body on this planet, yet it is not us, that physical death as the evolutionary emergence of the transcendent soul - the soul's journey and death as a steppingstone into another place, so we can be more at ease with death. Alongside any sombre, painful, or dark aspects around death and without minimising our personal challenges, bringing the dying experience back into the light may be part of our bigger journey, where death can be experienced as the most profound, important transition in our lives, adjusting to the new vibrations of our surroundings. A metaphor for some is that death can also be like going to bed after a long, long tiring journey, sinking down into the bed as we shift dimensions, towards the other side as part of a spiritual cosmic context of extraordinary benevolence. Science is about knowledge stating that when the body dies, so does the psyche. Spiritual and many indigenous wisdoms say when the body dies, our experience of sensation will stop, yet we will continue to experience imagination - see also Evolving Consciousness - The Meanings We Make. Narratives of afterlife, that emergence of the dimension of soul continuing to evolve after the body's material death - a transcendent level of reality - our immortal psyche, are time immemorial and worldwide, found in most spiritual traditions. We may want to rigorously research the evidence of consciousness beyond death from neuroscientists, doctors, medics in hospices, palliative carers, after-death communications, past life memories or spiritual traditions across all cultures and times. Many other classical spiritual traditions, religions (e.g. Hinduism acknowledges, that never in our life did we ceased to exist, that we are eternal, spiritual beings) and view death as a profound adventure, suggesting concepts and strategies for harmoniously approaching and passing through this transition, where consciousness lifts from the physical body transforming into the universal field, other subtle energies (see also Eternal Presence Diagram). The momentum of this purposeful energy is variously described as benevolent, loving, a wise consciousness, moving towards clear light. This for some can bring contentment where there was previously fear. We may wonder "What happens when we die, pass away, pass over?", "Do we transition into the non-physical world and understand there is no lapse of consciousness, separation between what is physical and the non-physical?", "Does personal consciousness merge closer with universal consciousness?". We may want to share our feelings, hopes, beliefs in the therapy.

End Of Life Treatments, Assisted Dying & Legal Matters Currently In The UK Some of us may wonder how we can help a loved one, friend, when they are dying, others - how we can help ourselves (see also Planning Ahead - Attending To, Preparing For Our Own Death, Our Own Dying Process, Death Wishes - Bringing Death Into Our Life). We may also wonder what happens after physical death? - nothing? afterlife? reincarnation? pre-life?. Being told we are dying must bring up so much in us. We may not know how long we've got. We are living life with the knowledge that our time is limited, we are dying. This may disorientate us, challenge us to live our death. Some of us may experience a type of anticipatory grief and another complexity is how to live, knowing we're dying. And being open to living can be very challenging - staying in the present moment, connected with family and friends, embracing ordinary things that may matter to us. Others may withdraw from socialising. Small talk may no longer matter to us. Before we make any decisions about such complex matters as end-of-life treatments or researching assisted dying, we need to check the current legality, as things change in this field. Some people consider making advance decisions to refuse treatment (ADRT), as part of their end-of-life care. This needs to be written down, signed by ourself and a witness and comply with the Mental Capacity Act. It is advisable to discuss this with our family and carers, health, and social care professionals, so a copy can also be kept in our medical records. This is sometimes called a "living will", but an advanced decision can be different to that of advanced statement. We can refuse life sustaining treatments (sometimes known as life-saving treatments), interventions which replace or support our ailing bodily functions (these may include: ventilation, CPR, antibiotics, treatment for infections, no intervention if chocking), which can potentially keep us alive. Again, it may be best to discuss this with family and friends. Assisted dying - enabling us, others with terminal illness to end life at a time of our own choosing is a complex area. However much we feel compassionate towards someone, whether or not permission is given by the individual, assisted suicide and euthanasia administered by friends, family, doctors is illegal. Safeguards around this area are important. It is also complex area, because a vulnerable person being cared for at the end of life may not want to feel a burden and coercive controlling, manipulative behaviour or harassment can occur. The therapy can be a space to talk about our personal dilemmas, feelings about assisted dying. We may be faced with an easy right or hard right. There is no easy solution or panacea for everyone. Some of us believe in both palliative care and assisted dying, rather than an either/or approach. Counselling can be a space to share how we feel about this and what we want for ourselves if we are terminally ill, in the phase of dying, receiving palliative care. And there are strong views, issues to consider in both the "For" and "Against" camp of assisted death and the therapy can explore both:

Against Assisted Dying Therapy (see also Dying Well)

• We may have very strong moral, ethical views or beliefs, a religious faith about the sanctity of human life, to not "kill", no matter what
• Doctors need to uphold & maintain their Hippocratic Oath - having the utmost respect for human life, no matter what
• Who has the right to conclude we are better off dead. It is not our job to help people to an "easier" death. Playing "God" in distinguishing who has the right to die is not our business.
• Abdication of life may replace resilience
• It is illegal to take someone's life, help them to commit suicide & if ever assisted suicide become legal
• Any law would be unsafe
• The right to die may slip & slide into a duty to die, as threshold becomes lower & criteria expands & there could be a slow, slippery slope towards death on demand
• There could be a slippery slope expanding to ever-widening criteria
• Suffering & intolerability are subjective
• Doctors also apply subjective judgement
• People, especially those vulnerable who have certain conditions, may not be in a fit state, with all their faculties, to consciously choose to end their life. We can be suggested to, persuaded, manipulated, coerced subtly, covertly or overtly by relatives, friends or indeed some professionals (e.g. placing in someone's mind "have you ever thought of assisted dying as an option and taking this option up?", "You don't have to be burden any more", "Care package costs are expensive, unaffordable". It can be suggested that because of our condition - being worn out, depressed, disabled, mentally ill, that these are valid reasons for ending life). Inheritance can also be a hidden agenda.
• If we are disadvantaged in society, or have no financial means, it is life-giving options that needs addressing, not our life ending. If there is no appropriate care & support (or funding for this) it is not a justification to change attitude towards assisted dying.
• Towards the end of life, a terrible, agonising death doesn't have to happen, suffering can be eased, with other options to help ease our symptoms, without being assisted through dying
• Suicide prevention teams maybe sidelined
• Assisted death may not go smoothly & there can be terrible, agonising deaths, which don't need to happen
• Palliative care, which has immeasurably improved, can be a humane alternative to assisted dying

For Assisted Dying Therapy (see also Dignity In Dying)

• As a part of the Hippocratic Oath, the limitations of always having the utmost respect of human life if these means keeping us alive at all costs. The outdated medical model to save lives at all costs is inhumane & no longer fit for purpose. It takes away a person's right to choose to die.
• The individual has the right to choose this
• Palliative care is not a panacea for everyone & doesn't meet everyone's needs and nor it is our choice
• There is no cure for certain conditions & pain cannot always be alleviated
• We can't understand another's pain & there is a human rights issue regarding the levels & degrees of unbearable suffering - whether they be physical or mental health conditions
• Our quality of life has gone & we desire a good quality of dying
• Where there is no prospect of relief, it is a humane way to relieve our utter distress, total pain (especially if we can't breathe or eat naturally, have lost our basic faculties), agony, anguish, suffering, or have lost dignity, joy in life, and we want to be able to choose this option with awareness, consciousness, free will. This choice also needs to be available to those of us stuck long-term depression, without a cure
• Assisted dying when done well enables us to embrace our death, rather than mourning it
• Where the aim is to provide a pain-free death, with dignity, in comfort
• Medically assisted dying (medical assistance in dying) is already in place in certain states of the US, Canada, Netherlands, Belgium, Australia, New Zealand
• It is a compassionate form of medicine
• Valuing the medical assistance in dying
• It allows for autonomy and choice for each individual - that we know best amp; can make this decision for ourself
• That we are burden to others and life is no longer worth living
• We can be personally empowered in a peaceful assisted death on our own terms, through self-administration or through a doctor
• As part of our self-determination we can choose to be surrounded by loved ones
• Opinion polls show support for assisted dying

Living Our Life Now & Looking Ahead

Change & Transformation Mourning what was in our life, and allowing "what is", may support us in being in touch with what might be transforming in our life, what we value and what's important, as we live our life through a current stage of existence. We may for example no longer get excited as we did in our youth, yet being in the moment, relishing moments, gaining a different depth & quality to how we relate with others, making the most of what's important, may matter to us. What motivates us may change. Valuing life's changes, transitions, little deaths, adjusting, being in touch with and experiencing our desire, what there is to do in our life, joys however small, encountering and embracing new challenges may be our task.

Reassessing The Present & Looking Ahead We have had a lifetime of experience and where we are now is where we are at - see also Concept Of Time, Time Passing. (Yet some of us may not quite know how we've got here - see also Existential Therapy London). We may be re-evaluating our life - questioning, or curious about our past, present, future - for it can seem as if all three at times conflate into one. Integrating this, accepting the life we have led, challenging our narratives now may be important for us. We may want to heal our relationships & manage any unfinished business, have peace of mind or more excitement, speaking our mind without fear. We may question what we are going to do with the rest of our life. (The Chinese proverb speaks of this "The best time to plant a tree was 20 years ago. The second-best time is now".) We may also want to rejuvenate ourselves or rediscover what we enjoy or are good at, address our aspirations, hopes, dreams and what is in the way of expressing love and finding peace. We may want to feel valued, give something back, have more control over our life. As we evolve, so too may our interests, interactions, companionship & what matters to us, alongside getting our changing needs met. Developing and building existing and new relationships, engaging deeply, in life including with our peers, younger people, grandchildren, students, etc, and supporting others may be important for us. Celebrating growing older maybe our challenge. Our routines may be important to us, yet at times limit us (as may holding on to some limiting beliefs, e.g. "It's too late"), where changing some of them may benefit us. Accepting our ever-changing body and the ageing process may be important to experience with ease and grace. Taking new risks, making deeper or fresh connections, being curious, having good nutrition, with a love of learning, in touch with what we enjoy, our desire, passions, discovering and developing our hidden talents, being in touch with our life energy, being present, getting the most out of our life, doing new or different things, having structures and bringing positive energy to all we do, continuing with our personal growth, may be considerations. What we do with our wealth of experience, creativity, wisdom, insight, softened edges & compassion, evolving consciousness, longing and yearning, facing and engaging in life with dignity and courage, may be further challenges, as may living a soft, yet powerful life, to our full potential. (See also Life Reflection)

Relationships, Marriage, Sex, Companionship Being firmly connected to supportive friends and family may be important to us. And many of us may not only want to continue enjoying sexual union, but also the ties that bind us to our partner, valuing the companionship, intimacy, care & love over the years. (See also Maturity As A Couple)

In the counselling & psychotherapy for ageing we may simply want to come along and be heard, reflect, "become who we are" as Carl Jung put it. We may also want to address specific complexities, challenges in order to navigate later life:

• Aloneness, Loneliness, Emptiness, Alienation
• Flexibly responding to the inevitable adjustments of becoming older in this period of transition
• How to be vulnerable without being ashamed
• Remaining empowered, so decisions & lifestyle are in our hands
• Developing new relationships & skills
• Re-invigoration - what boosts our curiosity, vitality, creativity & inspires us, seeking fresh challenges
• What we need to learn
• Utilising our own knowledge, wisdom, light-heartedness, playfulness, carefreeness, laughter, fun, our sense of humour & resources, gained throughout our life
• Re-visiting or re-connecting to what's important & what matters
• Thanatophobia counselling - what is counselling for thanatophobia?
• Connecting in all different ways
• Engaging with life, living it to our full potential