How a “Life Review” Consoles the Elderly and Counteracts Late Life Depression

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Erik Erikson, a psychologist born in Germany who lived from 1902 to 1994, said there are eight stages of human psycho-social development. He later revised this to nine. Each stage has an issue or “crisis” attached that people must resolve in order to “graduate” to the next level of emotional and mental health. Erikson introduced the commonly accepted term “identity crisis” to connote the issues of adolescence.

Erikson was also the first psychologist to see old age as an active developmental stage of life. Erikson’s Stage 8 is “Integrity Versus Despair,” which generally affects persons over 65 years of age. This is the crisis seniors face and must resolve.

Erikson’s stages spanned the lifetime. For example, an infant must resolve the issue of trust versus mistrust of the world and of caretakers. Toddlers must confront autonomy, or of being capable and independent as opposed to feeling shame and doubt about their abilities. As the life span proceeds, persons go through stages such as the adolescent identity crisis to that of establishing a meaningful and intimate relationship with someone of the opposite sex, all the way to nurturing others of younger generations by being a parent, mentor, etc., until late adulthood. At that level, Stage 8, a person feels that his or her life has been well-lived, makes sense and brings a sense of peace and satisfaction (integrity). If he or she does not feel this, the person will experience a sense of despair characterized by depression, anger, feelings of failure, worthlessness, uselessness and having wasted one’s life.

What is to be done if an elder person regards his or her life with a sense of failure, defeat and waste, leading to fear about death? It is too late to start over. Most of one’s life is past. What can be done for an older person who is not experiencing a sense of integrity?

Since many elderly people experience depression, we may surmise that they are experiencing despair rather than integrity. Researcher David Haber said depression is the most common emotional malady of the elderly and the most overlooked. Haber equates depression in the elderly with Erikson’s “despair.”

What should be done if an elderly person regards his or her life with a sense of failure, defeat and waste, leading to fear about death? It is too late to start over. Most of one’s life is past. What can be done for an older person who is not experiencing a sense of integrity?

Fortunately, there is something elderly persons can do or be helped to do. They may conduct a life review, which is a more formalized method of engaging in the reminiscences that elderly people so naturally do.

As death nears, gerontologist Robert Butler, a pioneer in the importance of reminiscence in the lives of older people, said that older people have a tendency toward self-reflection. Memories resurface, as well as unresolved dilemmas and conflicts. This is part of preparing for death. It can be an exercise to create meaning and a way of integrating the personality and accepting the inevitable with grace and equanimity.

A life review uses the past to come to peace with the present. It also helps put the past to rest.

Haber found that life reviews are easily administered and may be self-administered. He said older people enjoy doing them. Haber cites studies showing that life reviews increase life satisfaction in those who complete them as opposed to elderly people who have no interventions. Thus, life reviews can be therapeutic and allow older people to feel better about their lives in lasting ways.

A thorough life review brings forward successes and disappointments…

A life review is an evaluative process that should include looking at and resolving old conflicts. It can cover basic questions such as where one was born and when, where one grew up, what it was like in one’s home, community, and in the schools one attended. It covers relationships with parents, step parents, siblings, friends, and the different phases of life, including childhood, adolescence, young adulthood, marriage, career, and raising one’s children. A life review includes friends, influential people in one’s life, and feelings about retirement and health as well as descriptions of a typical day now, and what kinds of things make the person happy. A thorough life review brings forward successes and disappointments and lets the older person reflect on what he or she would do differently and what turning points were experienced. It covers a person’s philosophy of life, and his or her concerns and hopes for the future.

Sharon Kaufman, author of The Ageless Self: Sources of Meaning in Late Life, sees people as organizing their life reviews into themes. These themes help integrate the disparate pieces of life into a meaningful whole with which the person may be psychologically at peace. Examples of these themes may be relationships, service to others, financial pursuits, achievements, marriage and family, and spiritual or religious pursuits. Emerging themes can help the elderly person put the pieces of the puzzle of life together into a picture that can provide satisfaction and peace. This helps the elderly person achieve integrity instead of despair.

 

Sources

Clark University. Life Review Interview Manual. Available online at www.clarku.edu/faculty/dmerrill/soc180/manual.doc. Retrieved 12/08/2016.

Haber, David. (2006). Life Review: Implementation, Theory, Research, and Therapy. International Journal on Aging and Human Development, 63(2): 153-171. Available at http://jshellman-reminiscence.wiki.uml.edu/file/view/Haber_LR_Rem_200.pdf. Retrieved 12/08/2016.

Shippensburg University of Pennsylvania. Personality Theories, Erik Erikson. Available at http://webspace.ship.edu/cgboer/erikson.html. Retrieved 12/08/2016.

 

 

 

 

 

 

 

 

 

 

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