Sexual dissatisfaction is a theme I encounter in therapy often enough that I wanted to organize some basic perspectives on the topic for those struggling with this issue. First, let us debunk some commonly held beliefs about sexual functioning that may be limiting connection and opportunities to have a healthy sex life.


MYTH: You must have a predictable, routine number of times a week. 

Having sex regularly nourishes a relationship, sure, but don’t get too caught up in the counting. Most happy couples don’t have sex two or three times a week (see below). What’s important is that you both are satisfied with the frequency. If that’s not the case, start a discussion outside the bedroom by saying something like, “We don’t have sex as often anymore, and it worries me.” And remember: There’s more to a healthy sex life than just sex, don’t forget cuddling, holding hands, and spontaneously hugging and kissing.

MYTH: You both need to be in the mood.

It’s normal for sex to be a little ho-hum for one or both spouses up to 15% of the time. Any number of factors can throw things a bit off-kilter: timing, your mood or his, the amount of foreplay, life stresses, you name it. Rather than postponing until the planets align, have sex when you can—and don’t interpret an off night as a sign of a failing relationship. If your partner seems disengaged, just be affectionate and look forward to next time. To keep things exciting, make a point of venturing out of your comfort zone occasionally with new positions, locations, and sexy videos.

MYTH: If you’re not having spontaneous sex, it must mean your sex life is over. 

When you were first together, you had sex on your mind for hours, maybe even days, leading up to the experience. In many cases, you set the date, thought about it, planned the evening –even what to wear. It may have seemed spontaneous, but it wasn’t. Good sex is planned sex and in order to keep having it the more elaborate and integrated two people’s lives become, it must stay planned. Think date night, pencil it onto your calendar, and take time to talk about your sexual frequency, your needs, your fantasies, and what is missing and what is there for each of you.

MYTH: If a couple is having less sex, it’s her fault.

In men, low sex drive is often related to health problems or medications he may be on, many of which are known to create some sexual functioning challenges. Men aren’t used to needing stimulation, and it can be troubling. Sometimes he’ll just avoid it, causing the woman to think he’s no longer attracted to her –which results in a sexual Catch-22. Also, pressuring partners for sex can actually decrease sexual desire, particularly for women since historically sex has been viewed as a right by many men. The freedom to choose sexual activity can be a difficult paradox for a partner interested in increasing sexual activity with a female partner: the very thing often required to increase female desire is not feeling like you HAVE to put out to keep your mate.

MYTH: Good sex is long and slow.

Few of us can afford the luxury of leisurely sex. (Frankly, most of us secretly think it sounds like more work after an exhausting day.) And holding out for the ideal moment can lead to infrequent or, even worse, vacation-only sex. The solution? Embrace the quickie. Think of it like a sex snack, sure to boost your energy and put you back in the mood. For extra excitement, break out of the bedroom: Five-minute romps are perfect for unusual locations, even if that just means your shower or sofa.

Sex expectations can be changed but you may want to know where you fit in  terms of common sexual functioning, which may be best understood with a review of some basic statistical facts–although it must be said that what is to be deemed normal sexual functioning is subject to much debate.


FREQUENCY: Age is an important factor in predicting frequency of sexual activity. Some interpretations of this are hormone surges and better health for the young, more obligations and less energy for the middle aged, and health concerns and partner loss for the aged.

  • 18-29 year olds have sex an average of 112 times per year (Kinsey Institute)
  •  30-39 year olds an average of 86 times per year (Kinsey Institute)
  • 40-49 year olds an average of 69 times per year (Kinsey Institute)
  • Between 2004 and 2009, the percentage of people in their 50s who say they have sex at least once a week took about a 10-point plunge for both sexes (women dropped from 43 to 32 percent, and men from 49 to 41 percent) (AARP survey)


COUPLE STATUS: Whether or not a couple is married also interacts with frequency of sexual activity. Some interpretations of this are feeling obligated, financial worries, and/ or stress. 

  • Unmarried couples living together have reported having the most sex, averaging 146 times per year  (Durex Survey, 2003)
  • Married couples may have the greatest range of sexual frequency, having reported having sex approximately 98 times per year  (Durex Survey, 2003), which may be distributed a variety of ways in a given month:  once-a-week, 26% (David Schnarch’s survey), a few times per month 45% (Kinsey Institute), twice a month or less (David Schnarch’s survey). On the higher end, 34%  have reported 2-3 times per week (Kinsey Institute), and 7%  4 or more times per week (Kinsey Institute). On the lower end, 13% of couples have reported only a few times per year (Kinsey Institute),
  • Single folks appear to have the least sex, reporting sex an average of 49 times a year  (Durex Survey, 2003)


GEOGRAPHY/NATIONALITY: Cultural norms play a role in the frequency of sex and this may be due to a variety of factors, including norms, religion, and/or family-career dynamics.

· Global average: 127 times a year (Durex Survey, 2003)
· Eastern Europeans (Hungarians, Bulgarians, and Russians) are the most sexually active (150 times a year) (Durex Survey, 2003)
· Americans were low on the frequency list in 2003 at 118 times per year (Durex Survey, 2003)


GENDER: Men and women seem to differ in sex drive, sexual exploration, and expression of sexual interests, which can influence sex frequency of same and opposite sex partnering. 

  • Among women 48% admitted to faking an orgasm; 22% men (different survey) have gone on record as faking
  • 25% of men reported visiting a pornographic site in the previous 30 days while only 4% of women reported visiting pornographic sites in the same timeframe.
  • 12% of females and 22% of males reported erotic response when told a SM story.
  • 55% of females and 50% of males reported having responded erotically to being bitten
  • 14% of men and 11% of women have had some sexual experience with sadomasochism.
  • 11% of men and 17% of women reported trying bondage.
  • Men’s sexual fantasies tend to be more sexually explicit than women’s; women’s fantasies tend to be more emotional and romantic.
  • In one study, men’s fantasies mentioned a partner’s sexual desire and pleasure more frequently than did women’s fantasies
  • 54% of men think about sex everyday or several times a day, 43% a few times per month or a few times per week, and 4% less than once a month, while 19% of women think about sex everyday or several times a day, 67% a few times per month or a few times per week, and 14% less than once a month


NEEDS: Regardless of sex frequency, the majority of people are underwhelmed with their sex lives, and interestingly enough, it is not the frequency of sex that tops the list of unmet sexual needs.

  • Only 44% of people surveyed are fully satisfied with their sex lives  (Durex Survey, 2010)
  • 39 % of those dissatisfied are looking for more love and romance (Durex Survey, 2010)
  • 36% would like more quality time alone with their partner (Durex Survey, 2010)
  • 31% would like more fun and better communication and intimacy with their partner (Durex Survey, 2010)
  • 37% want to feel less stressed out and tired” (Durex Survey, 2010)
  • 29% desire a higher sex drive (Durex Survey, 2010)
  • 82% who are sexually satisfied say they feel respected by partner during sex (Durex Survey, 2010)


Examination of sexual functioning for emotional healthiness may be the difference between sexual satisfaction and dissatisfaction. So what are some of the markers of emotional health in sexual functioning?

10 major differences between emotionally Healthy and Unhealthy Sex:

1. Healthy Sex leads to feelings of well-being while unhealthy sex often leads to feelings of guilt and shame.

2. Healthy Sex is sensual with emotional connection to the current partner in the present moment while unhealthy sex is seeking surrogate intimacy with connection to the past, often unresolved emotional or sexual trauma, or unresolved relationships.

3. Healthy Sex is inspired, intuitive, and passionate while unhealthy sex is empty of these qualities and more about “chasing an orgasm” and satisfying a “need.”

4. Healthy Sex is nurturing of both physical and emotional connection while unhealthy sex is about getting high, numbing out, or escaping to fantasy.

5. Healthy Sex is loving of yourself and your partner while unhealthy sex is exploitive and selfish.

6. Healthy Sex is being emotionally vulnerable while unhealthy sex lacks emotional investment, vulnerability, or intimate connection.

7. Healthy Sex is respecting and honoring healthy sexual boundaries while unhealthy sex is often boundaryless and offensive.

8. Healthy Sex is moderate and feels safe to both partners while unhealthy sex is about intensity and requires escalation to achieve arousal.

9. Healthy Sex is being curious and caring about your partner while unhealthy sex is selfish and self seeking, often leaving your partner feeling used.

10. Healthy Sex is learning to trust, being vulnerable, accepting that anxiety and awkwardness are okay, and risking being known while unhealthy sex is avoidant of emotional intimacy, about power and control, and disembodied

If these areas are concerning for you, you may wish to seek mental health counseling or therapy to understand your internal processes related to sexual functioning and satisfaction. While this may not always preserve the relationship you are currently in, it can have lifelong benefits for present and future relationships.

SOURCES,,20411243,00.html   Jennifer Berman, MD, is the director of the Berman Women’s Wellness Center and the author of For Women Only    | Best of Everything After 50 |


 Ever wonder what it feels like to be gifted?   

The truly creative mind in any field is no more than this:

A human creature born abnormally, inhumanly sensitive.
To him…
a touch is a blow,
a sound is a noise,
a misfortune is a tragedy,
a joy is an ecstasy,
a friend is a lover,
a lover is a god,
and failure is death.

Pearl Buck

you may benefit from gifted therapy, which targets overexcitibilites and issues associated with gifted traits. Please contact me for an initial appointment and assessment.

Lavelda Naylor, MA, LMFT

4230 Gardendale
Suite 502
San Antonio, Tx 78229
(210) 460-0442



Defining Giftedness

Gifted” means (As defined in the Texas Education Code) those who perform at or shows the potential for performing at a remarkably high level of accomplishment when compared to others of the same age, experience or environment and who:

  1. exhibits high performance capability in an intellectual, creative or artistic area;
  2. possesses an unusual capacity for leadership; or
  3. excels in a specific academic field.



out in crowd

Gifted Adults

When looking at Giftedness in adulthood, it is critical to note the word “potential” in the definition above; potential does not necessitate outward markers of achievement  to be present for giftedness to exist later in life. In fact, many of the positive traits associated with Giftedness in youth have costs that can be incurred. Often these costs intensifying across development and create significant problems for gifted adults. They can even become deterrents to social and occupational success, and contribute to poor psychological functioning with higher incidence of anxiety and depression.

Traits Possible Problems
1. Acquires/retains information quickly 1. Impatient with others; dislikes repetition; irritable; may mistakenly assume that others can function similarly to the gifted or not accept themselves as gifted
2. Inquisitive; searches for significance 2. Asks embarrassing questions, can be dismissive of new ideas from others, search for meaning may lead to cynicism and hopelessness
3. Intrinsic motivation 3. Strong-willed; resists direction; not driven by money or reward (particularly in matters related to occupational identity)
4. Enjoys problem solving; able to use abstract reasoning 4. Resists routine practice; questions use of abstract reasoning procedures; may find themselves in conflict when faced with dilemmas that have no clear choice and be unable to make decisions in these moments
5. Seeks cause-effect relations 5. Dislikes unclear/illogical areas (such as traditions or feelings), may rationalize to avoid feelings, may struggle with existential matters (morality, life/death, etc.)
6. Emphasizes truth, equity, and fair play, strong moral code 6. Worries about humanitarian concerns, may be unforgiving to self and others for moral transgressions; may have difficulty not relating to human error as the norm
7. Seeks to organize things and people 7. Constructs complicated rules; often seen as bossy; may develop or seek out labyrinthine hobbies/games
8. Large vocabulary; advanced, broad information 8. May use words to manipulate; bored with school/occupation and age-peers; may seek novel stimulation to ward of boredom
9. High expectations of self and others 9. Intolerant, perfectionist; may become depressed and/or anxious; highly critical of self and others
10. Creative/inventive; likes new ways of doing things 10. May be seen as disruptive and out of step, may feel asynchronous (out of step with the times)
11. Intense concentration; long attention span; persistence in areas of interest 11. Neglects duties/people during periods of focus; seen as stubborn; can get swept away by passionate thinking which can inccur high relational costs
12. Sensitivity, empathy, desire to be accepted 12. Sensitivity to criticism or peer rejection may make living with giftedness difficult to tolerate; high need for belongingness but often does not feel a sense of belonging
13. High energy, alertness, eagerness 13. Frustration with inactivity, may be seen as hyperactive or viewed as a distraction
14. Independent; prefers working solo; self-reliant 14. May reject parent or peer input; nonconformity, may have difficulty working with others particularly if not in a leadership role
15. Diverse interests and abilities; versatility 15. May appear disorganized or scattered; frustrated over lack of time; may have difficulty settling on identity due to constantly changing or plethora of interests
16. Strong sense of humor 16. Peers may misunderstand humor; may become “class clown” for attention; may use sarcasm or derisive humor at inappropriate times




When To Seek Help

If you have felt misunderstood for years; or struggle with persistent bored, or feel plagued by self-doubt; or struggle with loneliness, you may want to seek help. In addition, if you feel subjected to persistent and uninvited commentary about your difference, support may be an important part of your personal growth.  Other problems associated with giftedness in adulthood that benefit from treatment are identity confusion and distorted self concept. The best description of these problems comes from a reknowned author on adult giftedness —Mary-Elaine Jacobsen, PsyD:

Identity formation occurs gradually and becomes a central task during adolescence. Teens


1. Books
Living With Intensity
The Gifted Adult
 Gifted Grownups: The Mixed Blessings of Extraordinary Potential
 “Living Out the Promise of High Potential: Perceptions of 100 Gifted Women,” provides many insights about gifted girls and women
2. Websites:
3. Articles: 
4. Therapy:
If you live in the San Antonio area, please contact me if you are interested in therapy services for the gifted. 
Lavelda Naylor, MA, LMFTA
The Key Counseling Services of SA
4230 Gardendale
Suite 502
San Antonio, Tx 78229


Video games are a good tool to extend play therapy into adolescence (Ceranoglu, 2010) since this medium is the preferred form of play for this age group; 97% of American teens ages 12-17 report gaming (Lenhart et al., 2008). In addition to being in the language most preferred by teens, it is well-known that teens are notoriously apathetic to talk therapy. Playing games allows for a kind of parallel activity that can help them open up about deeply personal issues they may not otherwise discuss.

Here are some other aspects of gaming therapy that may be interesting to you:

1. Gaming can impact development in positive ways;

  • Action games that require fast response are causally related to increases in many faucets of spatial cognition (Spence & Feng, 2010), such as:
  • contrast sensitivity
  • spatial resolution
  • attentional visual field
  • enumeration
  • multiple object tracking
  • visuomotor coordination
  • speed
  • mental rotation
  • affect regulation
  • reaction time
  • inhibitory control
  • Prosocial games have been found to improve social cognition (Greitemeyer, Osswald, & Brauer, 2010). 

xbox layout

2. Different types of games elicit different types of play (Hamlen, 2011):

• Active play= high cognitive load and fast paced (Call of Duty, Left For Dead, Halo)

• Strategic play= manipulation of game resources (Civilization 2, Star Wars Lego Games)

• Creative play= can modify the game environment (Animal Crossing, SIMS)

• Explorative play= discover new things and solve problems in the gaming field (Legend of Zelda)

• Boys favor Active and Strategic play while girls favor Creative and Explorative play

kids gaming

3. Games can be used in therapy to understand many psychological aspects of kids (Ceranoglu, 2010; Spence and Fang, 2010):

• Explore weaknesses/strengths

• Temperament

• Exercise moral judgment

Role play

Build self-esteem

• Establish rapport with therapist

• Increase social cognition

• Engage in playful fighting behaviour

• Regulate affect

• Explore autonomy and decision-making

Down's and Gaming


4. Research has found video Games to be an effective therapy tool for these special populations (Goh, Ang, & Tan, 2008):

• ADHD (Tahiroglu et al., 2010)

• Anxiety disorders (Jordan, 2009)

• Autism spectrum (Parsons, Mitchell, & Leonard, 2004)

• Depression (Ferguson & Rueda, 2010)

Neuropsychological rehabilitation (González-Fernández, Gil-Gómez, Alcañiz, Noé, & Colomer, 2010)

• Down’s (Wuang, Chiang, Su, & Wang, 2011)



Ceranoglu, T. A. (2010). Star Wars in psychotherapy: Video games in the office. Academic Psychiatry, 34(3), 233-236.

Ferguson, C. J., & Rueda, S. M. (2010). The Hitman study: Violent video game exposure effects on aggressive behavior, hostile feelings, and depression. European Psychologist, 15(2), 99-108. Goh,

D. H., Ang, R. P., & Tan, H. C. (2008). Strategies for designing effective psychotherapeutic gaming interventions for children and adolescents. Computers in Human Behavior, 24(5), 2217-2235.

González-Fernández, M., Gil-Gómez, J.-A., Alcañiz, M., Noé, E., & Colomer, C. (2010). eBa ViR, easy balance virtual rehabilitation system: A study with patients. Annual Review of CyberTherapy and Telemedicine, 8, 49-53.

Greitemeyer, T., Osswald, S., & Brauer, M. (2010). Playing prosocial video games increases empathy and decreases schadenfreude. Emotion, 10(6), 796-802.

Hamlen, K. R. (2011). Children’s choices and strategies in video games. Computers in Human Behavior, 27(1), 532-539. doi: 10.1016/j.chb.2010.10.001

Jordan, N. A. (2009). This is why we play the game: A quantitative study of attachment style and social anxiety’s impact on participation in online gaming relationships. Syracuse University Ph.D. Retrieved from ProQuest Dissertations & Theses (PQDT) database.

Lenhart, A., Kahne, J., Middaugh, E., Macgill, A. R., Evans, C., & Vitak, J. (2008). Teens, video games, and civics Retrieved from Pew Internet & American Life Project. Retrieved from doi:

Parsons, S., Mitchell, P., & Leonard, A. (2004). The Use and Understanding of Virtual Environments by Adolescents with Autistic Spectrum Disorders. Journal of Autism and Developmental Disorders, 34(4), 449-466.

Spence, I., & Feng, J. (2010). Video games and spatial cognition. Review of General Psychology, 14(2), 92-104.

Tahiroglu, A. Y., Celik, G. G., Avci, A., Seydaoglu, G., Uzel, M., & Altunbas, H. (2010). Short-Term Effects of Playing Computer Games on Attention. Journal of Attention Disorders, 13(6), 668-676. doi: 10.1177/1087054709347205

Wuang, Y.-P., Chiang, C.-S., Su, C.-Y., & Wang, C.-C. (2011). Effectiveness of virtual reality using Wii gaming technology in children with Down syndrome. Research in Developmental Disabilities, 32(1), 312-321.



I find that clients benefit from normalizing many of the issues they struggle with. Letting them know that certain aspects of life’s challenges are shared by others is often comforting. Using life cycle development stages, we can reframe some issues as part of life, and move away from strictly problem solving in session to gaining insight into what it is like for them to be going through what they are facing, which is truly the unique part of life–personal experiencing.

Life Cycle Stages of Development:

  1. Independence: This generally occurs in adolescence/young adulthood. Markers of the beginning of the family life cycle in an individual are supporting yourself emotionally, physically, socially, and financially, development of unique qualities and characteristics that define your individual identity. As noted, Intimacy is a vital skill to develop during your independent, young adult years. Good intimacy helps you maintain family relationships while building new relationships that lead to starting your own family.

Specific goals of the stage:

  • Learn to see yourself as a separate person in relation to your original family-parents, siblings, and extended family members.
  • Develop intimate peer relationships outside the family.
  • Establish yourself in your work or career.
  • Establish your Identity, or who you are in the world.

Some of the challenges of this stage include:

  • Desiring more autonomy but not getting it
  • Struggling with sexual and personal identity
  • Finding a sense of belonging in the world
  • Retaining a relationship with your family of origin as independence is fostered
  • Lacking good models for making the move to a healthy fulfilling adult life

2. Coupling: The next stage is when a partner is selected for an extended period of time that tests your ability to commit to a new family and a new way of life. When you join families through a marriage or committed union, you form a new family system, which includes both partner’s personal ideas, expectations, and values that have been shaped by the relationships and experiences from the family of origin. In the most functional relationships, partners have the ability to take two different points of view and create an option that neither person had considered. It differs from a compromise in that it is not giving up something. Rather, it is creating a third, better option.

You may find that some of the ideas or expectations that you held in the past are not realistic at this stage. Some common areas of adjustment include:

Specific goals for this stage of the family life cycle are:

  • Forming a new family with your partner.
  • Make adjustments to unrealistic expectations
  • Learn advanced interpersonal communication.
  • Improve problem-solving skills.
  • Develop common spiritual and emotional development goals.
  • Set and manage boundaries in relationships.
  • Learn when to place the needs or importance of the other person above your own.
  • Realigning your relationships with your family of origin and your friends to now include your spouse

Some of the challenges of this stage include:

  • Transitioning into the new family system.
  • Including your spouse or partner in your relationships with friends and family members.
  • Being committed to making your marriage work.
  • Putting the needs of another ahead of your own.
  • You and your partner will have less stress if the transition into a new family system is smooth, and less stress often means better health.

3. Parenting: this is one of the most challenging phases of the family life cycle. The decision to have children is one that affects your individual development, the identity of your family, and your relationship. Divorce rates peak during the parenting stage. Children are so time-consuming that skills not learned in previous stages will be difficult to pick up at this stage. Your ability to communicate well, maintain your relationships, and solve problems will be tested. And if you have not learned compromise and commitment in the previous stage, you may not have the skills you need to transition well.

Specific goals when young children join your family are:

  • Adjusting your marital system to make space for children.
  • Taking on parenting roles.
  • Realigning your relationships with your extended family to include parenting and grandparenting roles.

Specific goals during the stage of parenting adolescents include:

  • Shifting parent-child relationships to allow the child to move in and out of the family system.
  • Shifting focus back to your midlife relationship and career issues.
  • Beginning a shift toward concern for older generations in your extended family.

Some of the challenges of this stage include:

  • Mismatched parenting values between biological parents
  • Setting positive boundaries with family of origin
  • Unrealistic expectations regarding child-rearing
  • Gender disparities in the home and at work regarding caregiving
  • Securing good, affordable , safe childcare

4. Launching: this begins when your first child leaves home and ends with the “empty nest.” When older children leave home, there are both positive and negative consequences. If your family has developed significant skills through the family life cycle and their own childhood development, your children will be ready to leave home and handle life’s challenges.

Specific Goals are:

  • Strengthen your partner relationship
  • Re-evaluate your career goals
  • Developing adult relationships with your children
  • Accept new members into your family through your children’s relationships
  • Reassessing your beliefs about life
  • Self-examination, education, and counseling can enhance your life and help ensure a healthy transition to the next phase

Some of the challenges of this stage include:

  • You may not have moved through the phases with the appropriate tools and attitudes
  • You may not have taught your children the skills they need to live well on their own.
  • If you and your partner have not transitioned together, you may no longer feel compatible with each other.
  • Some parents, women in particular, may feel a lack of purpose
  • Your health and energy levels may decline
  • You may also be caring for aging parents in this phase, which can be stressful and affect your own health.

5. Retirement: Welcoming new family members or seeing others leave your family is often a large part of this stage as your children marry or divorce or you become a grandparent.

This stage can be a great adventure where you are free from the responsibilities of raising your children and can simply enjoy the fruits of your life’s work. Retirement can be a fulfilling and happy time. Becoming a grandparent can bring you great joy without the responsibility of raising a child. Those who are without adequate support systems or not well off financially, though, may have a more difficult time in this phase of life.

Specific goals to reach for at this final stage of your family life cycle include:

  • Maintaining your own interests and physical functioning, along with those of your partner, as your body ages.
  • Exploring new family and social roles.
  • Providing emotional support for your adult children and extended family members.
  • Making room in the family system for the wisdom and experience of older adults.
  • Providing support for the older generation without doing too much for them.
  • Dealing with the loss of a partner, siblings, and other peers, and preparing for your own death.
  • Reviewing your life and reflecting on all you have learned and experienced during your life cycle.

Some of the challenges of this stage include:

  • Being able to support other family members as you explore your own
  • Maintaining your relationships
  • Caring for elderly parents
  • Changes in your financial or social statusLate Life: this stage is relatively new and necessary since many people live past the fifth stage and development marches on. The key emotional

6. Late Life: this stage is relatively new and necessary since many people live past the fifth stage and development marches on. The key emotional principle is accepting the shifting of generational roles. Couples in the sixth stage tend to be maritally rather than parentally oriented. The marriage is likely to become more egalitarian. The couple may continue to have an active and meaningful sex life. And marital satisfaction is likely to be at its highest point since the couple’s early years together. Family relationships are still important. Contact with children tends to be frequent. Strains may result if adult children move back into the home, however.

Women are far more likely than men to experience the death of a spouse. Both men and women whose spouses die face a difficult period of adjustment. There is a loss of identity and a variety of physical and emotional consequences of bereavement. Those who talk over various matters with the dying spouse make a better adjustment to the death than do others. Many eventually remarry, although widows are less likely to do so than are widowers. Companionship is one of the most common reasons that both men and women remarry after the death of a spouse.

Goals of this stage are:

  • Maintain our own interests and functioning as a couple in face of physiological decline
  • Shift focus onto the middle generation (the children who are still in stage five) and support them as they launch their own children.
  • Deal with the loss of our spouse, siblings, and peers and the preparation for our own death and the end of our generation.
  • Make meaning and retain a sense of being valuable

Some of the challenges of this stage include:

  • Declining physical and mental abilities
  • Possible death of other family members and friends
  • Normal aging such as wrinkles, aches, pains, illness, and loss of bone density
  • The chances of having a mental or chronic physical illness does increase with age.
  • Loss of meaning in life and/or increased death anxiety



I am graduating! This is an important time in my life and I notice that it comes with many complex feelings; I feel happy, excited, scared, nervous, sad, proud, etc. When asked by classmates and interested others “Will you walk the stage?” I answer without hesitation, “Yes! I wouldn’t miss it!”

Rituals and rites of passage, like walking a stage, are an important part of human experience and they traditionally mark hellos and goodbyes; birthday parties are hello reminders, weddings are hellos, funerals are goodbyes, and graduation walks are goodbyes and hellos. Of course we can engage in rituals privately, but sharing our joys and sorrows with others is an important part of applauding our experiences. In fact, rituals are framed as requiring both events and cognitive processes of the event. Through connection around an event  we solidify memories, we temporarily make the past real again, and we get courage from those who believe in us to head toward the future.

The importance of the familial and community systems viewpoints of the ritual experience have been noted as highly influential on whether a rite of passage becomes a healthy or unhealthy transformative experience (Blumenkrantz and Wasserman 1998). Thus, if one’s cultural view holds a transition in contempt (e.g., “Miss College fancy pants thinks she is better than us”), the ritual might provoke anxiety and despair, which can influence people to withdraw from sharing transitions,  hellos, and goodbyes with one another. The most positive rituals seek to celebrate achievements, note an emergent identity, and foster a sense of belonging.  When joining a ritual party, it would be wise to frame the experience with these ideals in mind.

Even when a ritual marks a particularly sad goodbye, the elements of success remain the same. It is important to the grief process for a ritual to review the good that has been lost. Not only does this help participants make meaning , it fosters solidarity and joining. It is also important to note the changing roles that goodbyes leave behind. In funeral ceremonies, this can often be seen in people bringing food for grieving spouses, offering childcare for children mourning the loss of a parent, and in friends agreeing to congregate yearly for a lost buddy. Other sad rituals, like moves, work best when goodbyes are marked and plans are made to allow for contact, illustrating the same principles at work. Even breakups, which can be particularly painful, need a ritual for healing. These are often done more privately, or even in therapy, but perhaps connecting with a trusted friend or family member to review, make meaning, and honor a new role might help smooth the transition to being single.

What motivated me to write this post is how disconnected our culture seems to have gotten from rituals; we have forgotten what is gained and have become focused on what must be spent. Sometimes I hear people say they will not attend a ritual because they dont have time, or talk about how much it costs, or even more frightening, they say there is no meaning in the ritual. Pageantry and distance aside, the meaning comes from participating with an intention to make something happen in connection with others. Perhaps if we refocused on that part of the experience, the barriers of competition, feeling obligated to spend money, and choosing to go it alone or not mark the transition at all would abate. The next time you are tempted to avoid celebration, examine what is underneath. Perhaps joining an event is exactly what is needed to help make meaning out of the absurdity that is life.

In conclusion, although I am weary, low on money, and feel pressed for time, I will participate in my graduation ceremony. I want to feel the moment, see others taking the walk, look out in the crowd for my family and friend’s faces, and explore this monumental transition period in my life to the fullest. It is time to say goodbye to the role I have had for so long and hello to my new life. In such a big moment, I choose to not go it alone, so thanks to all of those who will be joining me in my ritual. I did not get here alone, I will not get where I am going alone.

For Therapy Services: The Key Counseling of SA

Iceberg LJN

The Personal Iceberg is a Satir technique used as a transformational tool to explore the self. The tool utilizes the metaphor of an iceberg to represent human experiencing; the small tip represents visible behaviors, which is often what we focus on as we move through life because it is so easily accessible to us. But as the Iceberg metaphor illustrates, the observable is only the tip of human experiencing. Each layer under the water represents a part of personal experiencing that is unique to each individual, and if explored, gets us closer to who we each are in the world.

Behavior is objective occurrence  which means it is observable and measurable. Behavior is also normative: this is the domain of right and wrong, of justice, of morality. What we say, do, what happens, or does not happen, can be just or unjust, but below the water’s surface, there is no need for judgement, there is not a right or wrong thought, feeling, etc. As we journey down the Iceberg, release the need to judge what you find.

Example: I am having an argument (behavior) with my wife about money I spent on video games.

Thoughts are  intellectual activity involving an individual’s subjective consciousness. This can include reasoning, ruminating, remembering, problem solving, deciding, evaluating, etc.  The key to understanding how your thoughts relate to an observable phenomenon using the Iceberg is to examine what present thoughts you are having about what has been observed in the self or others, or the environment, via introspection (a quiet kind of internal listening). Some find it helpful to write these thoughts down. Thoughts can serve as the gateway to deeper levels of experiencing so they are important to notice and not discount as right or wrong.

Example: She is such a controlling idiot!


Feelings, for some, are more challenging to discern. In part, this is because we can feel multiple feelings simultaneously. Also,  feelings occur in a region of the brain thought to have difficulty accessing temporal information, which is why sometimes a feeling that occurred long ago can be re-experienced as if it is happening right now.  And to top it all off, we may not have been taught how to identify and talk about how experiences feel. Sometimes this is evidenced by confusing a thought with a feeling; you don’t feel like someone is an idiot, you think that. What you feel is…

Example: I feel angry and I feel unhappy with the way I am being talked to about money, like a child. Oh! I feel belittled. 


Expectations often are built from our collection of behaviors, thoughts, and feelings that have already occurred in our environment   Some sources of expectations are personal experience, family, friends, media, legends, stories, religion, myth, culture, race, gender, caste, etc. Interestingly, violated expectations are rarely voiced in conflict although they are playing a large role in how the experience unfolds (notice how the base of the iceberg widens as we go down the layers). Sometimes our expectations even predict our behaviors directly! Check this out…

Example: I expect to be yelled at -because she always does- for buying a new video game so I will just not tell her about it for a few weeks. 

Values are the ideas we have that make life worth living, the ideas that we believe are fundamentally true. It is from our values that we judge our self and others. The interesting thing about values is that we can have behaviors, thoughts,  feelings, and expectations that do not match up with what we hold to be true about life. When reflecting on how your values are activated by a particular behavior, allow for any noted contradictions as they emerge.

Example: I value keeping it real (being authentic). 

Yearnings are our needs, wants, hopes, dreams, and desires. This aspect of experiencing is closest to our true self and often leaves us feeling feeling vulnerable when exposed. Perhaps this is why we know so little about the role they are playing in how we go through the world unless life gets really bad –when we must function for long periods of time with high levels of unmet need, or always put our own hopes and dreams aside  living can become intolerable.

Example: I need to relax after work, playing games helps me have fun and when I was younger, I used to imagine being a game designer. I wish she would learn how to play so we could play together!


The Self is who we are, who we have always been, and who we will always be. This is not to say the Self is static, or unchanging, it is more like the entirety of your existence from birth to death. It is, existentially speaking, being you. This is your core, it is the base from which all the other layers are born. The self has a concept that is formed through all the other layers over time. This concept colors how we form current thoughts, feelings, etc. Poor self concept can be a result of low self esteem. To exact true and lasting change, the self concept must be accessed and explored.

Example: No one that I love appreciates me.

What good is the method? When you can know your self, you can better communicate who you are to others and become more congruent. Being congruent allows you to choose behaviors that reflect more of your authentic internal experiencing.

Example: Honey, when you criticize me for buying video games, I feel small and unappreciated. What I need you to know  is that what may seem like a waste of money to you is important to me. It is a way that I relax after work, and a way that I get in touch with myself. You know, when I was a kid, I used to fantasize that I would design games. What did you fantasize about when you were a kid?

touching icebergs

Etc. … Now the Icebergs at least have a chance of connecting -notice that where the Icebergs touch is at the level of self. When people are in conflict, it is often over a difference in values, yearnings, and self concept. Yet, we often only talk about behavior (then the lists come out). But when the partners have truly heard each other, they can problem solve more effectively. But more on problem solving later…

For Therapy Services: The Key Counseling of SA