Couples Counseling with Older Adults with Dr. Erlene Rosowsky

Welcome to the Living to 100 Club Podcast. Here's our host, Dr. Joseph Casciani.

Well, hello to everyone joining us today on our podcast. You're listening to one of our Successful Aging episodes this month on the Living to 100 Club program, and I'm your host, Joe Casciani. Each week, our conversations educate and inspire, helping you get the best out of all the years we're given, regardless of what obstacles come our way. This is a non-corp appearance for a second time by Dr. Arlene Rosowski, a friend and colleague who's returning to the Living to 100 podcast. On this occasion, we discuss couples therapy with older adult couples, those in long-term committed relationships, whether married or not. We explore the many positives of marriage in older couples, including companionship, support, and health benefits, and we discuss some of the ex— expected challenges that may occur in later life, such as family, financial, sexual, and health factors, and why they may be stress-related. Is couples counseling a smart decision? And if so, what are the main issues that may surface? This is an in-depth conversation with an experienced mental health professional about an important subject. Be sure to join us. Just a little bio first. Arlene Rosowski PsyD, P-S-Y-D, is professor in the clinical psychology department at William James College. Prior to her retirement, she served as director of the concentration in geropsychology and the founding director of the WJC Alliance for Aging. She is a teaching associate in the department of psychiatry at Harvard Medical School. Dr. Rosowski has achieved an international recognition as an expert on late-life personality disorders. She's well-published in the professional literature and has authored 3 books, numerous chapters, articles, and columns. In 2011, 2012, and 2017, Dr. Rosowski was a Fulbright Specialist Scholar in Global and Public Health, visiting the Netherlands, Belgium, and China. In 2012, Dr. Rosowski received the American Society on Aging Award for outstanding contributions to the field of aging. In 2020, Dr. Rosowski was the recipient of the first annual Michael Duffy, PhD Award for outstanding contributions to training and mentorship of psychology in long-term care. Dr. Rosowski, welcome to our program today.

Thank you, and thank you for inviting me again. This is— yeah. Happy.

You're most welcome. Most welcome. I always like to again ask our guests to tell us about maybe the highlights of what took you to where you are today. What along the way in your journey brought you to where you are today?

Okay. I think the brief or the Reader's Digest version is that I started as a speech pathologist, speech therapist, and went on to graduate school in audiology. Interested in that. And then from there, I progressed to a PhD program in language development, and more fittingly, what happened when in older age, primarily when language sometimes gets challenged and people become— have an aphasia. And that's important vis-à-vis our topic today, in that most people with aphasia, it's a sudden event, usually a a cerebral accident, a stroke. And so the people that I was working with in my research and my clinical work in graduate school were older adults. And then going forward from there, I finished the clinical experience and all the research work. And I also love talking with couples when one of them became compromised linguistically. So that ties in with today's program. And at some point, right at the end, when I was just starting my dissertation, I became very, very ill. And for a year and a half, I was in and out of the hospital and experiencing all sorts of existential issues and had a lot of time on my hands. And it really interrupted my just being on the treadmill of going forward one step in front of another. And when I thought about it, I really felt that the best part of my work was working with older adults, and I liked their narratives, and I liked to understand more about how people, some of them cope better with the vicissitudes of aging, and in this case with language loss, and others didn't, and how they relied on their support network, their spouses, their family, their faith. And so I did what any reasonable person would do, um, I started all over again and became a psychologist. That only took up another 5 years of my life, but I was well and restored by that point and, and knew where I was going, or at least I thought I did. And as I said when I was with you, um, talking about, um, personality disorders in old age. That came out of my postdoctoral work at Harvard and with the Positive Aging Unit. And that became, and still is, my major research topic. But I know you're probably interested in how I got from there to older couples, uh, topic today.

Yeah. Well, I know you've, you've really specialized, uh, so much in personality disorders in older adults and certainly your background in linguistics and speech counseling, speech therapy, plus the PhD in psychology. I mean, that's a really well-rounded kind of foundation for someone like yourself. So how did you—

Yeah.

How did you happen to focus on couples counseling?

Very simply, I spoke up maybe when I shouldn't have or should have. Every year, Harvard has a very wonderful program, a continuing education program. Program at a nice hotel with lunch and the whole business. And every so often, every few years, they had it on couples therapy. And I went to some, got my obligatory continuing ed units, which, you know, we need to have. And they were good programs. But the problem was that they stopped with couples in like middle age. And so being a neuropsychologist at this point, I protested. And I must have protested enough that it got somebody's attention who was conducting it. And then they said, you know, essentially, all right, lady, you do it. So, I began to do the couples in older life piece of this. And I did that for a number of years. And, you know, that kept my academic chops up, you know, looking up what was actually researched and done. And I loved it. That was on my academic side. Concurrently, I was practicing as a clinician, and I had a— in fact, I was the head of a very substantially big research clinical group, and I had a number of couples that came into therapy with me, and I love doing that. So it's my second passion and delight to be able to have an opportunity to talk about it. So here I am.

Well, that's great. That's great. So glad you could join us today. I know we'll learn a lot. So I know you have a short passage you'd like to share with our listeners, and why don't you go ahead and read it for us?

Okay, this will be my theatrical chops. Yeah, it comes from a compendium of short stories by Richard Bausch, B-A-U-S-C-H, if If any of your listeners haven't found him, I strongly recommend him. He's lovely. And it's called A Letter to the Lady of the House. The voice of this— it's about a 3-minute piece. It's humorous, it's touching, and I never not get to the end of it without being very moved by it. So I want to share it with you. The person, the voice in this is a man, a married man who is just turning 70, cusp of old age. And he and his wife had been, I guess, before he writes this letter, preparing the house for the kids who are gonna be coming and the family, et cetera. And things, you know, were a little tense with them. And so I'll let, his letter, but it was written on the eve of his 70th birthday. Tonight we had one of those long silent evenings after an argument. Do you remember? Over pepper? We'd been bickering all day really, but at dinner I put pepper on my potatoes and you said that about I shouldn't have put pepper because it always upset my stomach. And I bothered to remark that I used to eat chili peppers for breakfast, and if I wanted to put plain old black pepper on my potatoes, As I'd been doing for more than 60 years while it was my privilege. Writing this now, it sounds far more testy than I meant it, but that isn't really the point. In any case, you chose to overlook my tone. You simply said, "John, you were up all night the last time you had pepper with your dinner." And I said, "I was up all night because I ate green peppers, not black pepper, but green peppers." "A pepper is a pepper, isn't it?" you said. And then I started in on you. I got, as you called it, legal with you, pointing out that Green peppers are not black pepper. And from there we moved on to an evening of mutual disregard for each other that ended with your decision to go to bed early. And then grandchildren will make you really tired and there's still the house of the dew and you have every reason to want to get some rest. And yet I felt that you were also making a point of getting yourself out of proximity with me and leaving me to my displeasure with another ridiculous argument settling between us like a fog. The fact is, we aren't the people we were even then, a year ago. I know that. I know that things have been eroding between us for a long time. We're a little tired of each other. There are annoyances. There are old scars that won't be obliterated with a letter, even a long one written in the middle of the night, desperately sincere, under the influence, admittedly, of a considerable portion of bourbon whiskey, but nevertheless with the best intention and hope and hope that you might know over the course of this night how I came to the end of needing an explanation for our difficulty. We've reached this place. Everything we say seems rather aggravatingly mindless and automatic, like something one stranger might say to another in any of the thousand circumstances where strangers are thrown together for a time, and then the silence begins to grow heavy, and well, someone has to say something. My darling, we go so long these days without having anything else to do with each other, and the children are arriving tomorrow, and once more we'll be in position of making all the gestures that give them back their parents as they think their parents are. And what I wanted to say to you, what came to me, was that even the harsh things that have happened to us, even the struggles, the anger, the silence, the disappointments, the bitterness, the wanting not to be in the same room anymore, Even all that must be worth it, but such loveliness that we have. At least I'm here at 70 years old now, hoping so. Tonight I went back to our room again and stood gazing at you asleep dreaming whatever you were dreaming, and I had the moment of thinking how we were always friends too. And what I wanted finally to say was that I remember well our own sweet times, our own old loveliness. And I'd like to think that even if at the very beginning of our lives together, if I had somehow been shown that we'd end up here with this longing to be away from each other, this feeling of being trapped together, of being tied to each other in a way that makes us wish for other times, some other place, that I would have known enough to accept it all freely for the chance at our love. Because if I could, I would do it all again, all of it, even the sorrow. My sweet, my dear adversary, for everything, for everything that I remember.

Wow, such a inside over a little black pepper.

Yes, right. Yeah, so that happens with most marriages and unions over time, that it, that evolves. And the nostalgia and the revisiting of life, as you know, we do when we get older, and our clients and patients do as well. It goes toward a lot of existential issues, including, you know, have I mattered? Has the marriage mattered? And who's going to be with me toward the end of my life? So yeah, it's really interesting.

Yeah. So it's, you know, in my thinking, we each— each of us goes through our own development and unfolding new sides, new dimensions. And so one person's changing, the second person is changing, And that means the relationship is changing, which is infinitely complex because each of us is already complex. But when you add the pair, the duo, that makes it so much more, um, just kind of, uh, hard to get our arms around, literally. Yeah, yeah. So, um, that was great, that was great. I agree. Thank you, thank you for sharing that.

Well, you mentioned the concept of change. And sometimes with couples, there is one of the couple that are very proactive with people who go into assisted living facilities or continuing care retirement communities, are anticipating probable changes that they're going to need and want to plan ahead to accommodate that. And sometimes the friction with couples is other Other people are more resistant to change. The other spouse— I'll use the word spouse, but that's the committed partner— and want to change or need to change only on an ad need basis as opposed to proactively. And then the third, beside the people who are proactive and reactive, there are people who are resistors, you know, who even resist the most obvious need for change. When you have some disparities between the two partners, in those kind of relationship to change, sometimes that's some reason why they have some grief in the marriage and some time where couples work could help when there's that kind of thing. The most important part is to normalize change. Folks always think of people, older adults, as old fuddy-duddies and resist change. It's an awful time to resist change because there's a lot of change that goes on as we get older. And midlife, it's not always talked about. So people go into it, even deeply intimate couples go into it with that as an enormous topic that had been not discussed or only minimally discussed.

Yeah. Well, I, I agree. Of course, uh, successful aging to me is all about change and knowing how to adapt and I call it opening new doors. Um, you know, the whole notion of, um, being resistant to change is just building more walls and being protected, you know. Maybe the old coping style worked in the past, but it doesn't work anymore.

And it doesn't— but marriage, I mean, there's some benefits to marriage, and the research tells us about a lot of benefits not only in physical health, but also mental and emotional health too. There's a caveat for that, and there's a little gender shift with a caveat too. And that is, if marriage is good, let alone excellent, but just plain old okay, it does seem to benefit versus being not in a committed relationship. However, if it is a negative hurtful or even toxic relationship, people, very older adults, are better off not being in that relationship because they don't have— And men seem to be more tolerant of mediocre, I was going to say meh, or a little sub-me relationships. Women seem to be a little more fussy. If the marriage is good, it's helpful. If it's not good, it really is— they'd better off without it. It's, it's, it shows up in the literature too in terms of physical health and mental health as well.

I, I know it's, we don't want to generalize, but that's interesting to say that men are, tend to be more satisfied with kind of the status quo.

Yes, and they're quicker to remarry after widowhood. Yeah, right, because of that, because, because they, I think They need the spouse, they need a woman to help with— we know they're more, they help more with the socialization in marriage usually. You know, so, and we know increasingly that socialization is a hugely important part of older adults.

For sure.

Yeah.

The whole notion of staying engaged, staying connected.

Absolutely.

Absolutely. Being involved. Yeah. That engagement is really proven to be one of the most important factors in longevity and aging well.

I can tell you a little bit about what the research and the clinical work, which I can speak to directly, what are the functions of marriage? What does it do? What does it do? Again, I restate what you said at the outset. We're not talking about necessarily marriage by some legal document, but a long-term committed relationship. And the literature in marriage in old age tends to mean committed relationship over 40 years, some of it over 45 years, that those are the benchmarks for. So, these are— we're talking about really older, older people who have been together a very long time, really long time. So, what good is it? People say, what do I need it for? What does marriage help? Old age. I mean, you're not making babies and good things like that. So you already bought the house and went to graduate school or got your job. So what good is it? So I do have a list of 7 reasons why, and in no particular order.

Sure, please share them.

And I could have even alphabetized them, but I didn't. One is collaboration. This is really true of mutual interdependence. If you were to— people who are real, real independent people, really independent. That's not a good thing to be when you get older. You have to be able to tolerate and even recruit interdependence when you're older. You know, and that we see, you know, rugged individualism does not work. Collaboration, if you've watched typically older adults parking, couples parking a car, one is steering and the other one is saying a little bit, you go, go, turn to the right. You're not getting near the curb. And it takes two people to do things. And they, over the years, come to be very visibly interdependent. It's lovely sometimes. So that's the collaboration that these long-married people have. Another one is companionship, just plain companionship without having to recruit it outside of the house. You know, they're there. To share the day in and day out of our lives. And very often that's the most missed with the loss of a spouse. You know, the world will, after somebody dies, will remember to talk to the widow or the widower at Christmas time. They'll bring something or, you know, remember their anniversary or the special things like that. You must be very sad this day. And I was thinking the other day Mother's Day and that kind of thing. What I hear, what I've heard is, remember one woman came into the office in my clinic and was saying, you know what I miss most about? I came home and I didn't see the tulips along the wall. And I said, okay. She said, Harold always planted the tulips. And this year he wasn't here to plant them. And I missed the tulips along the walk this time when it was probably this time of year, Joe, too. There's no card for that. There's no Hallmark card for that. Nobody's going to bring a casserole or a glass of wine for that. But this is when the loss of the day-by-day companion, it is. Another one is what I call continuity and cohesion. And write about it as the The connection, the interdependence comes from a shared history. What, you know, sometimes historical books will talk about fellow travelers, you know. It's not arbitrary that remarriages— I had mentioned remarriages— often occur with former long-term friends, you know, who have— they've gone out together over the years. They know the family, maybe in the same church, in the same community. Or those they've known earlier in life who happen to both be widows, you know, or unmarried, maybe through divorce. And they line up and find each other. And I thought sometimes, well, that's lazy. This was before the, you can have it on an app with dating sites, but just kind of call in. And then I realized that there's something very delightful and supportive of continuity of yourself by having a shared history where somebody has known your wife or your kids or what they've done or things that, you know, you experience together at town hall meetings or whatever. And it's respected. It's not— as opposed to meeting someone to recommit so late in life with the illusion of a blank slate, you know, we're starting now and we have to fill them in on everything. So I think this shared history becomes very, very rich and important to us. With that collaboration, you have— sometimes you hear people, older couples, one will start some story about something and the other will fill in with the details. It's very handy. When memory isn't quite what it was and the speed of memory retrieval. I don't know about you, Joe, but I'm there. Sometimes it takes me a little while to remember either a name or a date or a word, et cetera. It's good to have somebody around that can kind of help you out with that.

Filling the gaps.

Yeah. Nice.

I agree.

Nice. And another one is affirmation in successful older marriages and people who say their marriage has been successful. Each partner is able to affirm the other as having been chosen and committed to, you know, and as not just, you know, at anniversaries with the roses and the card or whatever, but just, you hear it deliciously. And an older man or woman will say, "Oh, she's the same sweetheart that I knew when she was 20 and I was 22." And they're now 92. She's not, and it's not a delusion. It's just that I fell in love with her then, and I'm in love with her now. I think that's the essence of that famous quote of— in Robert Browning's poem, "Grow old along with me. The best is yet to be. The last of life for which the first was made." I think there's something Can I jump in here with just a comment?

There's a line that I like. Yeah, that relates to this, this point of affirmation. It says the best relationships are where each person thinks they got the better deal.

Yeah, yeah, that, that's, yeah, that's true. And there, there are, there are studies that talk about that too. And most, um, because women, uh, are more responsible to the success of the marriage during certain times and work harder at it and both agree on what times of life that is. It's interesting. Yeah, absolutely. That's true. A lot of the research— and there's only 3 more elements— depend on support, instrumental support and emotional support. And I was kind of giving a teaser to that before, Joe, and men tend to specialize certainly in traditional marriages in the more instrumental and the women in the more social and emotional. So what that means with widowhood is often an older woman, again, it's a different cohort now, but the older women now wouldn't know how to do things that her husband had done for 60 years, you know, when, and there's a big loss. And you can generally hire that in if you have, you know, you're able to support upbringing. But the emotional, social-emotional, the one that the woman was in charge of more, is harder for a man to recruit. You can't, you know, look online and find someone to call in. So that tends to be a different— but the final thing is, again, the research says is that the paired status, the paired status, it serves, it seems to serve to protect the individual from needing to go it alone in all the ways I was talking about. And we see it, or the family members will see it, when one partner seemingly comes to serve as a buffer or a liaison, a connection to the world. And then, and they mask the spouse's limitations. You see, they kind of segue in as the spouse started segueing out emotionally and only comes to attention after the loss of the protecting spouse. And then you hear the middle-aged kids saying, I didn't know Mama was so, or I didn't know Dad was so, whatever, fill in. There is some real protection in the world. It helps. It just helps to have a partner.

It really—

Yeah. Yeah.

Well, so there are a few more.

Yeah, no, I, I think this, uh, the sum of all this is that marriage or partnership appears to be more positive in older age. It just plain is more positive.

Yeah, there's a refinement, there's a polishing, there's a kind of recognition, tolerance, acceptance, and continuing to grow with each other.

I think more need for one another, more identified need for one another. I hesitate to say that because I don't think anybody's ever come in and said that to me. That might be from the outside looking in. You know, I don't think anybody has come in and said, "Well, now that I'm older, I need him more." Sometimes through the rearview mirror, they say, "I have come to need her more. I've come to need him more since my stroke." I've come to need her more since this happened to me. But since I can't drive anymore, I've come to need— But I don't think anybody identifies that. I've not heard it identified in advance or wondering how that need is going to feel. You know, I don't. But I have some understanding of why it might be more positive in older age and less negative. And there's some great research that says older people don't fight as much, you know, when they, they report being more satisfied than younger couples, same couple.

So yeah, that's the tolerance I was touching on. We may not articulate that appreciation in advance. We see it afterwards, but We may have it before as well, but we may not articulate it or share it with one another.

I've come to some understanding of why this is true, and I think we heard a little bit about it in the letter that I read, the story. I think one reason is, you know, when we get older, There's a need for energy conservation, and conflict takes energy. And that's lessened in old age. We don't have— I sure as heck don't have the energy that I did when I was 20s and in my 30s. And having and bickering and fighting and carrying on takes energy, which is lessened. I think there's also a narrowing of extreme emotions, both positive and negative. You know, sometimes people will say, middle-aged children will say, my mom seems a little flat. You know, I called her up and I was hysterical because the car didn't start. There was a line at the grocery store. I finally got there. And then I get a call from the kids at school. And then And you can hear where I'm going with that, really escalating. And Mom saying, "You'll be all right, dear. It'll be okay. Take a deep breath." You know, what the heck is going on here? But I think, and you know, the peak emotionality is like in teenagers. If you've ever worked or raised teenagers, you know, if they have their skin break out the night of a prom, it's definitely comparable to, you know, World War II. You know, it's a horrible thing. But when we get older, they— so that in the marriage too, been there, done that, survived that. In fact, sometimes in old couples, it's kind of sweet. They— if their little spats become routinized, you know, they're like little triggers and it's actually the same script. Oh, she said that. There she goes again. There he goes again. And then it's done. It's kind of minimized. I think also there's sometimes a truce to old conflicts with the passage of enough time, Joe, a kind of a burning out. Again, it might be the energy or, you know, without getting into the spiritual kind of existential stuff, toward a more universal position of letting go of old hurts and injustices. Just, I've experienced that with my patients and with myself, that just there's a moment of it gets behind you. It doesn't hurt you at this point. You know, with the end of life, with increased spiritual growth, or at least rapprochement with getting older, what matters significantly before may no longer matter so much. The last one that I think is most also important is there's a growing awareness, if not able to articulate it, of one's spouse as the one with whom you're going to share the passage through old age. And you're going to, if you do, you're going to need to rely on that person. You know, there's some intuitive sense that whatever, this is the one that's going to be there.

Yeah, I think holding on to a lot of the grievances or, you know, grudges or experiences, that, that has a bit of a protective, you know, value. It allows us to stay stuck— not stuck, that's too strong— but allows us to focus on that, dwell on that in the past, and not be open to change and growth and, you know, new opportunity, new experience. So there's a certain protective mechanism that comes from that kind of grievance nature. What do you think? Right.

No, I do. I think, but I don't think it's— I've not heard it actually clarified and, you know, it's conceptualized, but it just seems to happen with time and age and staying power, I think. But That is the kind of thing that you work on in counseling and therapy too, without labeling it that way.

Sure, sure. Yeah. So for these long-term relationships, and one of the, the major events of course is the loss of a spouse, the death of a spouse, and the person, you know, may benefit from some individual counseling support. What does that support look like? How would you— I know it's hard to put it into a simple explanation. What does that grieving process look like?

Well, I can talk about the grieving process a little bit, but I would tell you that most people, as far as grieving the loss of a partner, that they don't need to come into therapy. You're talking about the death of a spouse, is that what you were asking? Yes.

Uh-huh. Yeah.

Fortunately, not what you see very often, and it's one reason why people come into therapy. But certainly most people, grief is a normal response to a major loss. And most people do not have what we call a complicated bereavement. There are people who get in, who do have a complicated bereavement, and that's a clinical situation. Very briefly, because I don't think this is the regular bereavement, people who have had a history of depression and high reactivity to loss in the past need to be watched for really going into a major depression, you know, a functional downward spiral, because that requires and can be helped by therapy and sometimes medication, or sometimes just counseling by itself. There's also, again, in the clinical domain, I'll just mention one minute. There are some conditions that are so devastating and such a difficult trajectory where the caregiving spouse, or the, the non-impaired, the non-ill spouse, has an anticipatory distinct grief reaction defined not by the final loss, which is what you were asking, I think, Joe, but by the ongoing progressive loss of the person. And you see that sometimes with the spouse of a dementia patient, especially the, the fast and hard types of dementia. Also some with Parkinson's disease or amyotrophic lateral sclerosis. And that has to be addressed in the hidden patient, which is the spouse, because it's associated with depression and severe anxiety, a lot of anger, a lot of despair. It's a loss of a person before the person dies, and it really, really is a major situation. It actually— the findings in, in the research say that the spouse's death in this is increased by the partner inducing this kind of chronic sorrow by about 20%. This is a big deal. In fact, cancer— being a caregiver for a cancer patient was relatively harmless to the partners in this. And, you know, one can understand that, but without getting into great detail, primarily it's the loss of personhood where the partner is no longer able to express partnership and appreciation and be with that person, it makes the burden of caregiving much, much harder.

Yeah.

But I'd be happy to talk about the more usual presentations in therapy that we have in couples.

Well, I'm noticing the time, you know. I think we, you know, you've done such a great job kind of looking at the richness of relationships and, you know, all the benefits that come from a long-term committed relationship and, you know, the upsides and the downsides. And the reality is that's, you know, that's our life existence. We do experience pleasure and we do experience sadness and loss and sorrow. So I think you've done a great job articulating Really, I love the upsides and the benefits of these marriages. And let me ask, what would you, what would you like our listeners to take away from this conversation today, Arlene? What, what do you hope they leave this conversation with?

Well, that's a good question. Um, I guess I could refer to a couple of metaphors that would be helpful, that I found useful in working with couples.

Sure.

And that may— your listeners may resonate with any of these. I always explore what are the elephants beneath their carpet, what topics have they avoided and now need to address, and what are the eggshells, what are the topics that have become very carefully broached and glossed over, and What are the— what's in their small boat on choppy waters, which is my image of aging, and what can they lighten from those choppy waters? What can they at this point together throw over the edge of the boat? And so it's easier for them to go through that. I think what's at the end of life is most important for them, or us, the partners, and is, what do I need to say to you? What do I need to hear from you? And that toward the end of therapy becomes an extremely— becomes an exquisite, exquisite moment. To have heard what they need to say and have told them what you need to hear. At the end, couple therapy in late life is to both look back on the ride and to survive the bumps along the road ahead, and to— for each spouse to feel known and valued and believe that their life together has mattered. And at the end, like in the little story I read, to be able to say, it's been a good ride and I'd choose us all over again.

Yeah.

I want them to know.

I'm glad I took the ride with you. Yeah, I like that. Well, this has been great. That's so much good content to hear and process and digest and hold on to. I really appreciate this. Earlene, it looks like we're out of time for today though, but before we wrap up, I just wanna remind my listeners to visit my website, livingto100.club, and sign up for my email list. Download a free copy of my 9 Tips to Make Living Longer Enjoyable. You'll also see an option to contact me with your questions and comments. I welcome your feedback. Earlene, thanks so much for being a guest on our show. For those who might wanna contact you, how can they do that?

Thank you for inviting me again. My website is erlenepsyd.com, E-R-L-E-N-E-P-S-Y-D dot com, or LinkedIn, my name. You can reach me through that as well. And I hope to be invited back again. It was lovely to have a chance to talk with you, Joe.

Oh, it's great. It's great. Yeah, our friendship goes back a long ways. Our collegial work together goes back a long way, so I've always valued that. Yeah, and I'd love to have you back. I really do appreciate your, your presentation, your ability to touch on these very poignant topics. So thank you again, and thanks to all of our listeners for tuning in. Hope to see you next time.

Okay, great.

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