by Edith (Edie) G. Boxer, M.S.W, BCD, PSY.D.
As a child, my one area of freedom from my mother’s control would be to ride my beloved blue and white Shelby bicycle. Pedaling back and forth on Rowland Avenue, which stretched across the top of our street and beyond to several others, allowed me to expand my geographic space ever so slightly. Now, many years after moving across the country from Canton, Ohio to Los Angeles, California, I am facing into the later-in-life issues that we, hopefully, all experience. My analyst and I talk about where am I going to pedal to now. This paper is a look at one of the next places to explore.
“No one likes to admit they’re old. The most they will cop to is that they’re older or oldish.” This witty quote from Nora Ephron reminds me of the time I shuddered buying a ticket at a discounted price, quietly announcing to my friend that I had just uttered the S word for the first time at the movie box office.
Topics such as physical health, sexual activity, and mental acuity ~~ and special bargain prices for a certain age range~~are among the issues to be addressed by the “older or oldish” sector of the population. Front and center is Appearance with a capital A. We spend time and money to slow down the accumulation of fine facial wrinkles, bulging stomachs, and waist lines.
The list of topics to consider appears to be endless. Attitude is a specific area of concern: an email announcing an upcoming talk on aging noted it will be an uplifting talk. Who wants to consider spending time getting depressed about the inevitability of one’s own momentum toward death? Think instead about several women who were commenting on the death of a well known actress. One of the group mentioned that this woman who enjoyed a long and illustrious career, had died at the age of 92, and then began counting – noting with a long sigh she herself had at least fifteen years until reaching that august age.
Inevitably, thankfully, another birthday, and shortly after, I read about the chance to write a paper to present at IFPE. The provocative brochure provides a challenge to what I come to think of as my sound barrier. An unconsciously self-created mechanism to protect myself from what I instinctively cannot bear.
However, and perhaps because I want to attend the conference and return to the pleasure of being in the company of this amazing group of attendees and possibly present a paper, I “hear” my internal voice record my first thought for a topic. NO SUSTAINABILITY/DEATH AND THEN A NEW THOUGHT: THE NOTION OF AGING – ALL IN CAPITAL LETTERS. And subsequently as I allow myself to think: “I am struck with the idea that previously, in analytic sessions and in a paper I have been working on for awhile, I have spent a considerable amount of time focusing on my fear of death, neglecting my aging process. I am curious to understand how it is I “forgot” about this developmental part of life.”
Perhaps, not paying attention to my aging has to do in part with the choices I think I must make, whether consciously or unconsciously, to avoid thinking about the passage of time. However, it does not take much of an external prompt such as reading or hearing about the death of someone in my life or even in the larger world to give me the slight nudge I need to return to my brain’s state of preoccupation. I am attracted to Nora Ephron’s words: “Why do people say it’s better to be older than to be younger? It’s not better…” And “Death doesn’t really feel eventual or inevitable. It still feels…avoidable somehow. But it’s not. We know in one part of our brains that we are all going to die, but on some level we don’t quite believe it.” I notice I can avoid thinking about aging because I am vigilant about the reality of death. That is where my brain unhesitatingly gravitates.
At first, I attempt to focus on the “avoidable somehow” part. I have certainly heard colleagues, friends, and patients tell me their fear as they age is being sick, and unable to enjoy an acceptable quality of life. That is, how are they going to sustain themselves if their health makes life even more difficult? I have a suspicion that I heard, but did not incorporate their worries, as a way for me to convince myself that my life is, and will continue to be, sustainable in the same satisfactory manner, as it has been to date. That feels more manageable. Death can then feel more “avoidable somehow.”
I have lived my life to date based on what I have come to know for myself. I like, for the most part, how I spend my time professionally and personally. So, unlike many of my friends and a few colleagues, I work full time in private practice integrating, over the last two years, my role as co-president of my analytic training institute. The other part of the equation for me, is participating in life sustaining relationships and pursuing a variety of intellectually intriguing interests. This description of what fulfills me noticeably defines the choices I make, but I am beginning to realize that my choices are also about erecting that sound barrier I mentioned earlier, which might preclude myself hearing myself talking to me about what I don’t quite believe, and all that has slowly emerged and continues to do so.
My initial reaction is to keep unpleasant and scary thoughts out of sight and mind. Orchestrated by myself from the time I was a child, I have learned to protect myself from descending into despair. Sensing I need protection from any one of a myriad of perceived threats, I must not let myself “know” so that everything that is threatening can seem under control, manageable, as perfect as possible. While writing this paper, I am beginning to think aging is one of those threats.
I first allowed the thought of aging into my consciousness when, several years ago, my analyst wondered aloud what could have happened to make me think about death so consistently both in sessions and in my daily life. The actual event prompting his question resurfaced at that moment from a time when I was ten years old. I had asked my mother if I could use the baby clothes I found in a closet to dress my doll and she told me from another room, “No.” I remember asking her a few questions – all the time not being able to see each other – such as “whom did the clothes belong to?” It was then I was told her first child, a boy, had died.
“How old was he?’
“What was wrong with him?”
“Where is he buried? “
“In the cemetery.”
That was the last time information about the baby was ever exchanged. The topic was never discussed in our family that included my father and my brother who was two and a half years older than myself. Since they have all died, my questions will remain unanswered: what was it like to lose a child? How did it affect my brother, their second child? There is no other to hear these questions or answer them.
This is what I do know from my experience and from what my analyst recently conveyed to me. Perhaps, this is, at least, how my mother’s information answered from another room, and without any follow-up processing or being with, affected me. I was not helped to live. Instead I lived in an ambience of the ending of life. Given the stifling atmosphere I breathed, I existed with the unknowable: that dying— everything stopping – was a terrifying and utterly lonely concept for a sensitive and impressionable child. Now, I hypothesize, I did not even, understandably, consider the attendant process of growing old. That would be additionally overwhelming. In my adult years breathing new air, cultivated with the help of others’ capacity to be expansive, my analyst remarked I am discovering “a contemporary reality”: a creative, exhilarating trip toward living. Through this journey of coming to know what I think and feel about aging and death, no matter how old I am, I can live in a conscious way despite the lingering and sometime present threat and fear.
Ultimately when I “sorta” begin to know, I work on knowing – My process is one of pausing as I begin to consider fleeting ideas, a point of view; then allowing myself to accept what is going on in my mind and then, perhaps, to write. – All this in order to manage my sense of uncertainty. I must put a poles–apart-from-my-childhood plan into motion such as the German philosopher Martin Heidegger proposed: “Being-true…taking entities out of their hiddeness and letting them be seen in their unhiddenness.”
Over the years, I came to know that the connection between my mother and I often suffered from physical and emotional distance. When I found the box containing baby clothes, there was an aborted exchange with my mother. This time, it was about the traumatic loss she experienced and I stumbled across. I never was able to capture her attention to help me deal with all that I did not know nor understand about the death of my parents’ first baby/ my brother. I now understand that my mother could not be with her grief. If she could have helped both of us to manage that which felt unmanageable— profound sorrow as a part of life to be shared and not forgotten. If she could have embraced moments between us, I believe our relationship would have had the potential to grow. I would not have felt so alone and unheard.
But, she could not. Instead, she said to her eight year old daughter: I am going to make you as perfect as I can. I quickly learned children were to be seen and not heard and that I had to figure out things for myself. At the same time as my mother continued her physical and emotional control my father maintained a stance of “I work and your mother takes care of the house and your brother and you.”
Now, as an aging adult, I need to discover and implement my own path. I did not have positive role models pointing out the way ahead in life who could have helped me deal with the early death of my father at the age of 56 and my mother’s question to me near the end of her life: “ What is to become of me?” I did not have an answer for her. I realized while writing this paper I have no idea how she felt about aging except she could not have been too fond of it as she would never tell her age. At the time of her impending death, I was not sure I even knew what she meant by her question. Now, twenty plus years later, I am in the process of figuring out questions and answers for myself.
While writing my first paper for IFPE which I presented in Pasadena, California in November, 2006, my then writing mentor noted that I was a “gatherer…”my way of learning was to collect books, quotes, facts, thoughts, feelings, and experiences, which in a way seemed random and unconscious, yet far more purposeful, eventually gathering together to form into my clearer, clinical, and theoretical insight.” Several years and now three presentations later, I am gathering again.
This time, I think it is helping me to organize myself leading to a self-state of regulation as I address a very difficult topic, not only for me but also for many who have taken even a minute to consider their own aging. After all, we are all talking about a word I just discovered in my gathering: senescence defined as the condition or process of deterioration with age. But, this conference’s title “Sustainable Psychoanalysis: Embracing Our Future, Preserving Our Past” presents the concepts of entertaining the capacity to endure. The opportunity for vitality provided by this organization allows each of us/allows me to create a sense of exhilaration bringing me to a place of living even as I write in my abstract of this paper titled “The Non-Sustainable Self: Aging, Self-Regulation, and the Work of the Psychoanalyst” that “In the midst of a new journey for me – thinking about my aging – I am compelled to write about this stage of life leading ultimately to loss of self and other. I wonder could I be embracing both concepts? I realize, as I write in my first paragraph of my abstract, “in any given moment, I am confronted with the fact that no matter how I take care of myself, I cannot sustain my existence beyond a point where my physical body ceases to survive.” And—I am also now choosing to be with my aging process even though sometimes I am also kicking and screaming.
This is a choice, I believe, that offers the possibility of sustaining the liveliness of a thirty-year practice as both a social worker and psychoanalyst. The fact is the patients age as does the therapist and, if the patient stays in therapy long enough, questions and concerns will surface about each person in the dyad as well as how time might affect the relationship. I am occasionally asked if I am considering retiring. I am not, but it is a reasonable question. If the time comes that I have to make that plan, I will to the best of my ability. In fact, my three office mates and I tentatively consider the next lease option in 2014. What are we are going to do individually and as a group who have worked together in harmony and collegiality since 1994? Frankly, I do not like the thought that my office I come to five days a week will no longer be a destination point for me. Of course, still true to my familiar style, I think about it in terms of what will I do with the still in good condition furniture and the wonderful art work I bought all those years ago that is still vibrant and engaging? I do note I have a hard time beyond those questions. Colleagues who will admit in hushed tones that we are in the same age bracket wonder if and how they will retire. What are my plans, they ask? To date, none of us is talking about forming a support group for analysts who come to the end of their career. Yet, a conversation between myself and one good friend and colleague could be the launching pad for a co-created holding environment if either one of us wanted to go beyond this initial interchange. Just one week younger than myself, she recently asked me if I was having the same experience. She told me that last year as we both entered a new decade, she did not have any particular reaction to her age. But, she definitely did this year as a one was added to our ages. She wondered what I thought. I paused and said I always take awhile to get accustomed to my new age, and last year was no exception. However, now that she had mentioned it, I thought just as I was getting used to the beginning of the decade number, we both added a number one, and that was even harder to reconcile in my mind. She agreed and thought that the realization may have hit her a year later than she had anticipated. Clearly and upon reflection, this could be the beginning of an important dialogue that neither one of us has pursued.
The fact is that this is a career that one can continue to practice well beyond the time other professionals stop working. Still, I hear more often than I like: Are you still working? On the other hand, my experience is that those who have ended the work part of their lives communicate with each other (and often within the range of my hearing) on such topics as it is the best thing they have ever done, they should have stopped working even earlier, they are so busy and are surprised how the time flies, go on and on about the lack of stress and the ability to do pretty much what ever they want to do when they want to and, of course, there is always time for the grandchildren! I am aware their proclamations irritate me—I am probably a bit envious about their “freedom” and I am also aware that discussions with colleagues about aging seem to go nowhere other than whether or not they have a plan and that we really look young and still have our intellectual properties in working order! When my younger mates say they are going to work maybe five to ten more years, I feel what I can term a jolt. I want to believe I will continue to be in good shape and vibrant and engaging. But, who knows how I will be over the next few years?
Thinking again about my choice to be with my aging led to my reflecting on the beginning of my career. I am certain the issue of my aging did not arise when I began my training as a social worker even though I had, in an internship I volunteered for before applying to Social Work school, often worked with senior citizens. I do remember at about age 45 I was struck with the realization I was older than many of my colleagues who were also mental health fellows at a year long program I was accepted into following graduation from my master’s program. Perhaps that was an early stage in recognizing I was aging, but the thought never developed beyond that point. From time to time, as my birthday approached, I allowed my thoughts to surface and realize I was getting older: the numbers of my age were definitely increasing.
Certainly I have worked with individuals older than me, but they rarely discussed aging.
In fact, most of the older, usually women, I have seen over the years have come not to talk about their aging other than to mention it, but, in one instance, wanted to be heard by an objective other about the pain of a philandering husband’s betrayals for much of their long marriage. Another woman married to her husband, then in his mid-eighties, needed to confirm what she knew when we began sessions, that he was not going to change; deciding as she terminated she just needed to stop expecting anything from him. Both of these women made casual and very infrequent comments about their stage of life. One of the two thought at 76 that, although she is in good health, she probably would not live to be very old. She thought she had no particular reason for this thought other than the fact her parents both died in their seventies. She also related details of her and her husband’s friends and her husband’s siblings who either recently died or were experiencing the fears and tribulations that can characterize one aspect of this part of life. I did not, at the time of her comments, do much exploring with her with regard to her prediction. However, I think if I had felt more comfortable with my own thoughts that I am now exploring, I might (and still can since we continue to work together) continue the conversation. Writing this paper is giving me the opportunity to experience a growing sense of comfort and confidence.
I can see my capacity to discuss the patients’ introduction of their aging concerns grow and develop. As one patient in her late 40’s and experiencing several treatable but concerning medical conditions wondered: “How do I own my aging?” She moved quickly to other material, but I am thinking I am just trying to figure out my answer to that question.
In fact, I remember I had an internal reaction to her statement delivered in a questioning tone, but I did not explore it with her. I think at the time I really could not hear it. Since we are still working together, I /we may have another chance. I hope I can engage with her so we can think together about the meaning of her pronouncement.
So, it did not seem to me there was a case I could make use of as an illustration of working with the aging process. However, as I have been giving a great deal of thought to how to consider my words again in my abstract, “ But, it is the many who are young enough to be my children, even grandchildren, who come into my consulting space both heightening my consciousness and highlighting the years and experiences separating us but also providing the opportunity to impact each other no matter the chronological age,” I have been hearing my patients who range in age from 18 to 76 talk about their lives in a way that is also stirring up feelings I am struggling with.
The group of men and women in their mid twenties to mid thirties talk about possible career moves, potential partners—the whole dating scene and the massive, depressing disappointments over failed relationships. But, when they come to session with conflicted feelings about potential avenues in career and geographical relocations, I am able to encourage our processing their options while realizing my own opportunities are restricted by several factors, which include age. This often means I am endeavoring to be an understanding partner in their investigation and I am also envious of their possibilities. I also know if I am unable to recognize and “own” my feelings and thoughts while working with the patient, my behavior will almost certainly be characterized by enactments and dissociation on my part. I am sure my age is not the only limiting factor because I know myself well enough to recognize I am not sure I would be able to make some of the choices they ultimately generate. The good news in this is I am eager to help them find their way and not let my feeling more limited stop their travels both physically and emotionally.
There is also another group of people in my consultation room who speak more directly about aging and I am listening differently. Ruth, in her early forties, talked about her mother turning seventy and realizing as her mother ages, and my patient parents her daughter in the early years of elementary school, that she is in the middle of these two generations. Ruth is experiencing some degree of trepidation as to how to balance this specific juggling act of making certain her mother remains able to spend time with her granddaughter. The younger woman is concerned her mother can keep Ruth’s seven-year-old daughter safe so that both of them can enjoy their time together. The not- too- subtle implication is: Is my mother too old to take care of my daughter?
Hal is in his mid sixties and began to talk about his own aging. He is a bright, articulate, and robust man who describes himself as a lifelong good athlete who has always loved being active. In fact, he bicycles to session from his home, which means he traverses hills and busy city streets for about 30 minutes to come to my office.
It was during one of our consultation times he mentioned that his several months old arthroscopic procedure on a torn meniscus in his knee was not healing as quickly or as well as he hoped. Hal stated he had not thought about the recovery from the surgery, as a prior procedure on the other knee had been uncomplicated. Missing a couple of our sessions, he seemed to minimize any discomfort or inconvenience when he returned to our work. I did note to myself he expressed some slight amount of pain from time to time. But, I did not know him when he had the other knee repaired so I had no base line to compare this recuperative time with the former one.
He went on to tell me, and I believe himself, that he was thinking he might not be able to do the kind of exercise he used to do. Loving to play pick up basketball even at this point in his life, Hal made it clear he was “not liking this transition in his life.” “I used to play hard. Am I at that point in my life? What will I do? I don’t like it.” Of course, the session was ending, and the next time I saw him, he was eager to discuss his work at a job that was presenting him with challenges he believed he had difficulty confronting most of his life. Perhaps we will return to the subject of his aging. I feel more able to continue our dialogue. I am also considering my own physical challenges attempting to determine my level of capacity and determination to overcome newly compromised joints.
One woman in her early eighties was increasingly suffering with a series of potentially life threatening medical issues. A former teacher, Mary, still absolutely in love with her career she had left many years before, usually talked about the pleasure of continuing to hear from and often seeing students she taught. She came to treatment, in part, however, to talk about some of the physical limitations she was facing, but terminated services when she felt more limited and not interested in discussing her aging.
However, it was while considering, as my writing mentor suggested,” how my work with patients of any age may help me with either my coming to terms with or thinking through my aging,” that a realization dawned on me. At the beginning of my social work education, I tended to distance myself from those patients I worked with who were older than myself. By that, I mean, I used the self-imposed distance to protect myself from feeling afraid. I told myself I am not their age dealing with infirmity, and thoughts of the end of life and what it will look like. I attempted to protect myself, as I also did when, as a newly licensed social worker, I was making home visits to poverty level families bowing under the weight of a myriad of issues. I told myself I did not have to succumb to the overwhelming list of troubles because I could literally leave the house they were inhabiting for my own, where I could breathe all the while feeling relief and hope. I think, depending on the patient’s age and their narratives, I still can remove myself so I do not have to feel frightened.
Even though I might “disappear” when unconsciously alerted to a situation I envision as frightening, I also attempt to entertain the notion that aging has the potential to be exciting and enlivening. It actually helps to read mass market pop culture articles such as the one in a recent Oprah magazine where the subject of an article about one woman in her early 50’s quoted her as saying: “ Things don’t just come your way and happen; you make them happen,” she says. “Go out and seek adventure, knowledge, wisdom, fun.” I add “If not now, when?”
Reading such authors as the one I am about to highlight also adds to my repertoire of ways to consider this, for me, developing reality. Judith Viorst, prolific author, poet of both books for children and adults, and research psychoanalyst graduated from Washington Psychoanalytic Institute in DC writes about the decades with amusing, but piercingly keen titles such as “Suddenly Sixty And Other Shocks”, “I’m Too Young to Be Seventy: And Other Delusions”, and most recently “Unexpectedly Eighty: And Other Adaptations.” In fact you can read her books describing the decades she chose to highlight beginning with “How Did I Get To Be Forty And Other Atrocities.”
As an example of her wit:
“Instead of “old,”
Let us consider
Or maybe “oldish,”
Or something, anything,
That isn’t always dressed
In sensible shoes
And fading underwear.
Seventy isn’t old.
Ninety is old.
And though eighty
Is probably old,
We needn’t decide that
Until we get there.
In the meantime
Let us consider
And learning a new trick or two
As part of our job description
Among her popular works, Ms. Viorst also writes prose about issues encountered in life. One of her most popular books written in 1986 is still in publication, and although not a volume that would be considered part of psychoanalytic literature, she was clearly influenced by her work as a psychoanalytic research graduate completing her work at WPI in 1981. The book “ Necessary Losses: The Loves, Illusions, Dependencies and Impossible Expectations That All of Us Have to Give Up in Order to Grow” includes the chapter “ I Grow Old…I Grow Old. She talks about the fact that old age can be replete with many losses. However, she reminds us that there is another more optimistic perspective. “It argues that if we truly mourn the losses of old age, mourning can liberate us, can lead us through to “creative freedoms, further development, joy and the ability to embrace life.” Thinking about her idea, I am keenly in touch with the notion that that is a substantial part of my work with my patients and, now, increasingly, with myself and with those I love.
Still searching for comfort in the midst of what can be threatening, I think about how others turn to religion for solace. I know I am not a person who is religious. I actually paused in my writing to check out the dictionary definition of the word religion. I wanted to make sure I was not misspeaking. The word may be defined “as a particular institutionalized or personal system of beliefs and practices relating to the divine.” The next of several definitions was a bit better fit: “A set of strongly-held beliefs, values, and attitudes that somebody lives by.” Maybe the problem was the inclusion of the word institutionalized- So, I wondered, how was it I was drawn to a book I happened to notice in a quaint, old-fashioned bookstore in Eugene, Oregon. My husband and I were visiting my long time friend and her partner. As we were touring Eugene, she began to read to me in the car from a book of poetry written by a new friend of hers. I was entranced and asked where I could get my own copy. Easy, she told me. The next thing I knew we were at the bookstore and she located the poetry found in two volumes. Waiting to pay for them, I turned and, directly at my eye level, I noticed a volume with the title “Aging as a Spiritual Practice: A Contemplative Guide to Growing Older and Wiser” by Lewis Richmond. The inside, back flap of the book, displayed a picture of a kindly looking grey haired man in, perhaps, his sixties, describing him as a Zen Buddhist priest and meditation teacher and author of previous books, who both leads Zen meditation groups and teaches at workshops and retreats. Questioning myself almost immediately, I asked why I would buy it. I wasn’t sure, but thought maybe it would be helpful as I addressed my task of writing this paper, which meant delving into a difficult topic. Clearly, I was gathering, and the idea of a way to think about growing older and wiser intrigued me. I have heard so many patients discuss their spiritual practice, but I never went much beyond thinking that, one day, I would investigate what that all meant, and, if I might want to “become spiritual~~if that was how to say it. Maybe I thought the title and, hopefully, the contents meant there was a port in the storm I might encounter.
I began to read and this is a bit of what I found interesting. Richmond defines spiritual practice as “paying close attention to the things that really matter.” He states that one has to have lived a relatively long life and, hopefully, a full one, to begin to think about what does really matter. It goes almost without saying for me: a deep sense and experience of connection with my loved ones, friends, and colleagues, good health including the gift of tune-ups with doctors and other health professionals, but not requiring extended medical testing, diagnoses, an abundance of anxiety, and potentially dire consequences, using my self within the parameters of my profession to help others, fun, and a way to step back and reflect with calmness and wisdom.
Wisdom as a noun stopped me as I researched two definitions, once again from the dictionary. One possibility: “The knowledge and experience needed to make sensible decisions and judgments, or the good sense shown by the decisions and judgments made.” One other possibility: “Accumulated knowledge of life or in a particular sphere of activity that has been gained through experience.” What struck me is that I want to increase my ability to be calm and feel in control of myself; I want to be different from my mother. I want to be as aware as possible of the contours of aging that bring both joy in my granddaughter calling me to say, “Grandma, I just registered for my high school classes.” or my grandsons coming to visit from back East to share their excitement at the newly opened Cars extravaganza at Disneyland.” Or hearing my five–year-old grandson, Emmett, say to his first cousin, our fourteen-year-old granddaughter, “Lauren, I think I am falling in love with you!” And that is just a tiny smattering of examples. In fact, I cannot leave out 9-year-old Owen explaining Fruit Ninja having the patience to play it with me on my iPad!
I want to be able to tolerate and stay present for the vicissitudes of my life. I may not get my wish to reach an age like 90 without complications and then just go to sleep.
A moment to pause and reflect: I do not know anymore than those of you in the audience what my aging beyond this point today is going to look and feel like. And then, I reread the last part of my abstract: “it is the many who are young enough to be my children, even grandchildren, who come into my consulting space both heightening my consciousness and highlighting the years and experiences separating us, but also providing the opportunity to vitalize each other no matter the chronological age.” As my patients look to me for insight and relationship that assists them in their world, they help me come to terms with mine. They enable me to confront my own non-sustainability as they pose questions and describe thoughts and feelings about their own aging, inviting us to stay present together, working our way through unknown and potentially painful pathways. Their unsuspecting gift to me, in the midst of this journey together, is that of helping me to foster my desire to become wiser and calmer. I am no longer alone.
Now, my self-improving challenge extends to being present for those whose own personal narratives may include their own thinking/feeling about the inevitability of non-sustainability.”
If you would like to contact Edie Boxer, her email address is: firstname.lastname@example.org