Negotiating existential conflicts in later life: an empirically informed analysis of gender and age in psychotherapy with older adults

This article explores the intersection between age and gender in a psychotherapeutic context with older adults through an existential lens. While awareness of gender- and age-related biases in mental health care is growing, their combined effects and the normative implications for clinical practice remain underexplored. The existential perspective allows psychological symptoms and personal struggles to be understood in relation to the fundamental conditions of human existence, against the backdrop of this intersection and broader structural conditions. A secondary qualitative analysis of written psychotherapeutic session protocols from 13 patients aged 60–80 years in psychiatric care was conducted using Kuckartz’s qualitative content analysis. The analysis examined case-based and cross-case patterns to explore potential links between gendered experiences and the negotiation of existential conflicts in later life, thereby generating gender-sensitive hypotheses that may be relevant for clinical practice. The analysis suggests that structurally gendered conditions, such as economic dependency, the role of professional identity, the amount of involvement in care work, or masculine norms of strength and decisiveness, are linked to how existential conflicts are experienced and negotiated in later life. It offers a basis for hypotheses about how gendered experiences shape encounters with mortality, dependency, and guilt, as well as the resources available for addressing them. Existential conflicts in later life can be shaped by gendered patterns of experience that influence both the challenges older patients face and the resources they have for engaging with them. An existential perspective complements intersectional approaches by illuminating how structural and fundamentally human dimensions can coalesce in shaping such experiences. This perspective is clinically significant because it draws clinicians’ attention to often overlooked but important patient concerns and supports self-awareness and the development of authentic coping strategies that promote personal growth. The study was registered with the German Clinical Trials Register (DRKS00023139, 16th November 2020).