Mid-life “Crises”: How Should Therapists Think About Them?

“I don’t know what’s wrong with me,” the client confides. “I’m at the top of my game in my job, my marriage is going ok, and I am healthy. I have achieved a lot of my goals, but my life suddenly feels like it doesn’t fit me anymore.” The client continues, describing a wild desire to quit everything and leave town – or maybe take up drinking to excess as a nightly sport. You perceive anxiety, depression, and something more. What’s clear from the client’s tale of angst is that what seems meaningful and purposive has somehow shifted, and now in the middle years there is an urgent need for re-assessment of what matters. Welcome to mid-life, you think.

But what, exactly, do we mean when we refer to “mid-life” or to a “mid-life crisis”? What years do we mean, what tells us that it is a crisis, and how should we be thinking about this sort of angst in order to best help the client?

Definition and a few stats

Elliott Jaques coined the term “midlife crisis” way back in 1965 (Capetta, 2017): over 50 years ago. 100 years ago, according to the U.S. Census Bureau, the average life expectancy was just 50 years of age; living past that, a person was deemed to be lucky. Advances in healthcare, education, and overall quality of life have meant that the average life expectancy worldwide is now over 70 years, with countries such as the United States getting to almost 80 years, Australia at about 82.5 years, and Japan and Singapore reaching toward 85 (AIHW, 2017; Dundon, 2018; ).

Thus the years which are the middle of life have shifted upward. Beyond that, there are claims that the timeline for reaching mid-life angst is different for women than for men, with women reaching it earlier: say, between 35 and 39 (Rothman, 2018) or 36 and 45 (Saiisha, n.d.), whereas men typically experience it around 45 to 50 (Rothman, 2018; O’Connor, n.d.). Ron Levant, professor of psychology at the University of Akron in Ohio and former president of the American Psychological Association, notes that mid-life crises typically happen between the ages of 45 and 64, but can happen at any time after a person establishes their adult life structure: that is, they have a partner, a career, possibly children, and a comfortable home (Braff, 2017).

Janis Morris, a Texas-based psychologist, notes that, while difficult life changes – illness or death of a loved one, loss of a job, or a divorce – can cause a crisis at any time, often people experience turbulence in their 30s and 40s because their world view is suddenly shown not to bring them the sense of satisfaction they expected (Braff, 2017). A mid-life crisis, Morris claims, refers to “an emotional reaction to the realisation that life has time limits. It involves anxiety or fear that the ways we have spent our time, along with the choices we have made, are not important enough, enjoyable enough, or consistent with some ideal sense of self”. The reason we have mid-life crises is to try to fulfil unmet needs and garner a better relationship with ourselves, thus attracting different choices (Braff, 2017).

We should also acknowledge that the whole idea is a “luxury of the privileged”, in that a person normally needs to be at least middle class in order to have the bandwidth to worry about what they want from their lives, as opposed to using all available energies merely to survive (Braff, 2017).

Although experts disagree somewhat on the “bookend” years that define mid-life crises, they tend to describe the symptoms similarly.

Signs the client may be having a mid-life “crisis”

While each person’s experience is unique, note that the typical symptoms largely revolve around a loss of meaning and purpose. Life transitions occur regularly throughout our years as we re-evaluate what is important to us and move into ever-deeper understanding of ourselves. That said, mid-life is often an intense passage. Here are the typical symptoms.

Asking deep, probing questions

There is a tendency to question whether we are on the right track, to wonder whether the “rules” we have been living by (values often given to us by our parents) are the right ones for us. Even though we may acknowledge that we created the life we are living, we may suddenly find that it doesn’t “fit” us anymore. This symptom, like most of them, has a silver lining, even though it is uncomfortable, because through this self-reflection we come to eliminate those aspects that no longer relate to who we see that we are.

Feeling apathetic or like life is “blah”/dreading getting out of bed

Feeling like life is boring or that we are stuck in a routine can come upon us suddenly, rendering us passionless. Somehow, the idea of doing things for fun gets lost.

There is success, but not satisfaction

Many people in mid-life have highly successful careers that they have been doing for years; they are good at what they do. However, when we combine a strength (what we are good at) with a need (that others have for us to do a certain thing), but do it without passion, we only get a “chore”. Strength, need, and passion must come together (again) in order to feel fulfilled.

There is a strong desire to leave a legacy

We don’t want to waste our energy on unimportant things, and there is a strong sense of wanting to give back, even if we aren’t sure how to do that.

Running life on autopilot, with a dismal-looking future and overwhelming sense of loss

We lose our optimism, sensing that our best years have already been lived. We fear that our dreams can never come true. We begin to move robotically, with no goals in sight, and despair of ever being able to create them. This, then, engenders the next symptom.

Making rash decision/changes that aren’t “who we are”

The stereotypical response here is the normally stable mid-life fellow who buys a sexy red sports car, writes a note to his wife, and leaves town with the mistress half his age. We may be fantasising about leaving our job/family/community, abandoning the rat race, and living out our days on a sun-drenched tropical island. Most people will never act out such fantasies, but it makes sense to pay attention to them, as they – and the dreams that whisper ever more loudly to us – speak to unmet needs, unresolved issues.

Leaving stagnant or stifling relationships

Despite many people having fantasies about new relationships, some people go further, actually leaving their relationship of many years, seeking more equal partnerships to fit an evolving sense of self (Rosenfeld, 2015).

Intensifying signs of ageing/concern (or loss of concern) with appearance

Many people have been blessed with good health up to mid-life; thus, signs of an ageing body are doubly disconcerting as we face not only the inevitable signs of greying, thinning hair and wrinkles, but also diminished physical strength and vigour. Many become preoccupied with appearance (witness the popularity of Botox and “filler” treatments for wrinkles). Alternatively, some may “give up” on their appearance, feeling like they cannot do anything about the ageing, so why even bother trying to look nice? Changing hormone levels can cause sleeping problems, mood swings (especially for women going through menopause), and decreased libido, as sex suddenly seems less important.

Overwhelm with the ticking clock

For some, mid-life arrives as a panic, in the form of: “I haven’t accomplished any spectacular achievements”. Whether the intense feelings are a sense that we must hurry if there is ever to be achievement or a sense that it is already too late and we are on a slippery slope to total decline, time is suddenly measured differently, uncomfortably. Life is no longer an open field, extending seemingly “forever”.

Lost sense of purpose or meaning

And this, the most disturbing symptom of all: we lose our sense of purpose. Whether it comes as a sense of having no purpose or that there is a purpose, but it is bigger than what we can experience in day-to-day life, the entire mid-life (or any) transition can revolve around re-establishing a daily rhythm which feels purposive and meaningful. We want to know that we are making a difference, and we want to do that in a way that is significant to us personally. The problem, of course, is that in crises, what is personally significant has shifted; the old activities, values, interests, and beliefs no longer qualify as meaningful or full of purpose. We have a sense of being in the centre of a storm with energies swirling around us, and we need to re-ground ourselves in that which will be workable in the new phase. How do we do it? (Symptoms adapted from Capetta, 2017; Forbes Coaches Council, 2017.)

Strategies for dealing with the mid-life quest for identity

We will identify several strategies here for you to tap in your work with any clients in the throes of mid-life. They emanate from at least four different modalities, but notice first that we have labelled this section as strategies for dealing, not with the mid-life crisis, but with the mid-life quest for identity. Viewed from a transpersonal perspective, we can talk about the disenchantment that arises in mid-life being a prompting from our inner wisdom. It is about life putting us into crisis mode in order to bring about an inner awakening. Saiisha, of Doyouyoga Company, prefers to call this time a “soul crisis” or an “identity crisis”, as we do the work of making contact with deeper, emerging aspects of ourselves. It is, says, Saiisha, a “sacred rite of passage toward spiritual maturity” (Saiisha, n.d.). With that in mind, here are strategies recommended by writers familiar with the mid-life transition.

Respect the fantasies and the dreams

Fantasies and dreams signal a need to stop, take stock, and re-evaluate what we want to have in our lives, and how we can meet our needs in real life without psychologically harming ourselves and those around us. A pivotal intervention here might be, “If your fantasy is totally, completely realised, what does it give you?” The desire to escape to the tropical island, for instance, might represent freedom, release from the drudgery of a now meaningless job, or even an opportunity to live with less of the responsibility currently weighing the person down. Then, because running away to an island “paradise” – or anywhere – is not only unrealistic but also generally unwise – we help the client find a way to gain more freedom, create life rhythms with less drudgery, or to examine current responsibilities to see if they are still appropriate. Dreams are said to be “uncontaminated by ego”, so they can be good aids to self-reflection: a means of understanding ourselves more at depth (O’Connor, n.d.). Psychodynamic theorists are particularly adept at working with dreams and fantasies.

Change the language; reframe!

As therapists, it is second nature for us to reframe, especially for those working primarily in cognitive and cognitive-behavioural modalities. We can help clients at mid-life examine how the language they use helps or hinders their attempts to move through the transition. So being 50 is no longer about being “over the hill”. Rather, it is an intense spiritual experience of disillusionment leading to deeper connection with our most inclusive sense of ourselves. We are not somehow “lost in space”, but travelling the path of the hero’s journey as we move to more profound understandings of ourselves and our place in life. We can feel “dragged” to the next life stage or “pulled with excitement along the path of unlimited possibility” (Dundon, 2018; Reynolds, 2011). Clients get to choose how they regard their time in “the void”, which is at once empty and also pregnant with possibility.

Slow down, re-assess goals, cultivate mindfulness

The tendency is to want to run away, hide, or engage in reckless behaviour to avoid facing the changes occurring to us, but if we can simply do the opposite — slow down and give the needed space for reflection – we find that the inner direction we seek eventually makes its way to our consciousness. Of great value to clients for this are practices of mindfulness, meditation, yoga, and journalling. Time in solitude, perhaps in nature, helps (Saiisha, n.d.). Transpersonal therapies are invaluable in helping clients gain insight from a spiritual perspective.

Learn new skills to re-charge and re-awaken passion

Some mid-life “coaches” suggest creating a fresh outlook by taking up new and valued learning to help get a sense of nourishing self and re-awakening enthusiasm for life (Douglas, in Forbes Coaches Council, 2017). Learning at this stage can be what we really wish to know more about, as opposed to what someone told us we should study when we were younger. Solution-focused approaches seem to be especially efficient at helping clients tap into what they already know works for them in terms of experiencing positivity toward life and learning.

Consider the alternatives: both staying the same and changing

For some clients experiencing the deepest angst of a mid-life quest for identity, a potent intervention may be along the lines of twin motivational interviewing questions: “What happens if you stay on this course (i.e., disenchanted with life, work, relationships, etc.)?” and “What do you see happening if you change (Greenwade, in Forbes Coaches Council, 2017)?” Counsellors are excellent choices for help with moving through transitions such as occur at mid-life, but other possible helpers could include mentors and life coaches. Clients need to be both supported and challenged.


As those who are middle-aged or older can attest, the life transition called the “mid-life crisis” is an intense period of disillusionment, typically with many, if not most aspects of life. However, if handled wisely, it heralds an unprecedented opportunity to deepen our connections with ourselves, our relationships, and life. We prefer to think of it as a mid-life quest for (deeper) identity.


  • AIHW. (2017). Deaths. Australian Institute of Health and Welfare. Retrieved on 11 June, 2018, from: Hyperlink.
  • Braff, D. (2017). Why your mid-life crisis could actually be a good thing. Executive Style. Retrieved on 5 June, 2018, from: Hyperlink.
  • Capetta, A. (2017). 13 signs you’re having a midlife crisis. Woman’s Day. Retrieved on 5 June, 2018, from: Hyperlink.
  • Dundon, E. (2018). Onward and upward: Replacing “over the hill” with a new path. Psychology Today. Retrieved on 5 June, 2018, from: Hyperlink.
  • Forbes Coaches Council. (2017). 15 signs you’ve hit your mid-life crisis (and what to do about it). Forbes. Retrieved on 5 June, 2018, from: Hyperlink.
  • O’Connor, P. (n.d.). The midlife crisis. SBS. Retrieved on 5 June, 2018, from: Hyperlink.
  • Reynolds, M. (2011). What a female md-life crisis looks like. Psychology Today. Retrieved on 5 June, 2018, from: Hyperlink.
  • Rothman, J. (2018). The philosophy of the midlife crisis. The New Yorker. Retrieved on 5 June, 2018, from: Hyperlink.
  • Saiisha. (n.d.). The yogini’s way of facing a female midlife crisis. Doyouyoga. Retrieved on 5 June, 2018, from: Hyperlink.