Older adults tend to experience anxiety, irritability, hypochondria, and depression, due to increased physical and cognitive dysfunction and physical illness. Effective psychotherapy for older adults can provide advice on their daily activities and lifestyle, while listening carefully to their everyday experience in a way that pays attention not only to symptoms but also to the unavoidable "four pains": living, aging, suffering, and dying.
 Living engages the light and shadow of older adults' life stories. It is important to listen carefully to the shadow side of each story, and not just to notice the bright side. As for aging, older adults are nowadays "younger", when it comes to their physical, cognitive, and social abilities, compared to older adults of earlier generations. However, their lives can be disrupted by an obsession with youthfulness. In the presence of an expectation to be "youthful and active forever," it will be hard for the elderly to accept their state of life. In this case, the therapist's guidance should aim to remind older adults that aging is a natural process, and they do not have to oppose it. Regarding suffering, when an elderly patient shows signs of hypochondria and complains of a variety of symptoms, if there are no abnormalities in their medical examination, then a therapist should tell them that they cannot do the impossible to find the true cause of a symptom. In that case, older adults should be reminded instead that they have no other choice but to accept their mind and body as they are. They should be advised to stay active and keep in shape, even when they are experiencing anxiety. In addition, the therapist should inquire not only about elderly patients' (negative) symptoms or anxieties but also about (positive) instances of health and personality, and direct patients to the physical feeling that is undermined by symptoms. Finally, when it comes to death and dying, it is important to approach topics like fear of death and what will happen after death, and to allow older adults to inquire into the therapist's own view of life and death; after all, it is important to have an honest discussion with the therapist.
 When facing a crisis in the second half of life, i.e. a deadlock such as conflict or depression, self-transformation remains possible if one recognizes one's limitations by sharing his/her life experiences, and if one lets go, to some extent, of the obsession with his/her own symptoms. An elderly person's daily life reveals their nature. Hence, as an observer of older adults' daily existence, the therapist should support a way of life not opposed to living, aging, suffering, and dying, while allowing them to enjoy fundamental desires that are natural and healthy.
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