Active Aging, Book Reviews

Aging Grace

When at 35 my hair began to turn gray, my female friends teased that I better had start coloring it, With a roll of the eyes, my retort was “When it’s completely gray, I’ll want people to know that I’ve made it that far.” Now nearing 60 little of the pepper is left, and I wonder sometimes “How did I get here?”

In “Successful Aging” Daniel Levitin tries to provide all possible answers to that question. You might stop to think about that. The sheer scope of that project is mind-boggling.

Regarding a book on aging written by one with direct experience as well as long study, perhaps the most direct characterization of Levitin’s attitude is a paradoxical “youthfully enthusiastic.” He communicates faith that a better understanding of aging will improve every life. While occasionally technical, Levitin’s treatment is approachable, and won me over to his vision.

That perspective covers sweeping territory. While a blue-collar worker may face decline alone in a room, the erstwhile Secretary of State still guides public service operations. While an unusual centenarian may smoke and drink (moderately), an elderly wife may sell the family home to pay for her husband’s chemotherapy. These barely hint at the variability that Levitin must address – a variability that may leave the reader to plead “But what should I do?”

Levitin sagely begins with the irreducible: What kind of person are you? Regardless of economic or social standing, your personality determines how you approach problem-solving, and thus how you manage aging. Surprisingly, Levitin and his colleagues find only five essential personality traits, each defining a range against its opposite. Against these traits he builds his prognosis for adaptability and longevity.

What controls our personality? Here the picture is impossibly complex: genetics, parenting, culture and opportunity. But upon reaching adulthood, that complexity fades into irrelevance. We are who we are. Here Levitin shares the perspective of Dan Siegel (who in “Mindsight” treats that matter in more detail): the brain continues to adapt even in adulthood, and with diligence we can choose our behavior.

Our capacity to implement those choices requires soundness in our mentality, including memory, perception, intelligence, emotion, and motivation. All change emphasis as we age, losing power in certain aspects (for example, forming memories) while strengthening in others (filling in missing detail). In each area, Levitin offers practices for shoring up declining faculties. The most important of these is social interaction, the essential ingredient in the formation of the personality, and paradoxically the most insidious source of stress (the universal mind-killer) and the most comprehensive stimulant for faculties threatened by aging.

Inevitably, though, aging brings infirmity that leads to illness. Unfortunately, experience has shown that attempting to eliminate illness in the elderly must be balanced against reduced quality of life. Often that reduction is driven by pain that disrupts our mental faculties, robbing us of our sense of self. Levitin surveys the qualities of pain and observes that those perceptions are distributed throughout the brain. I wasn’t surprised by the conclusion that as of today pain medications do less than desired and may cause harm, leaving us with the difficult choice of balancing life span (years alive) against wellness span (years enjoyed).

Against the background of the natural processes for the development of personality, Levitin shines a light on the artificial threats to their stability in the areas of schedule, nutrition, exercise, and sleep. Each threat is developed as a disruption to sensitively balanced biochemical systems that sustained wellness as conditions varied in the natural world. Unfortunately, artificial environments push those variations out of the natural range, and our biochemistry breaks down. Levitin’s illustration of the consequences is a strong motivation for respecting the body’s limits.

Given the gravity of death, of course, hope persists that means will be found to delay (if not reverse) the infirmities of our elder years. While Levitin glories in the scientific acumen that motivates positive expectations in consumers, the book nears its end with chapters that puncture faddish trends in cellular restoration and cognitive enhancement. In the final chapter, then, Levitin offers advice that guides us away from decisions that are likely to squander the mental and social opportunities of later life.

For some the last chapter might be all that matters, but Levitin provides the detailed background because he hopes that science will produce strategies and treatments that allow us to lead youthful lives at ages that today ensure infirmity. After all, 60 is the new 30. Why shouldn’t that first number reach 100? Or 200? As those treatments evolve, the prescriptions of the last chapter should be modified. Levitin does us the service of tracing his deductions back to science, so that when the science changes we can confidently update his guidelines.

If I would mount any criticism of Levitin’s treatment, it would be against his Pollyannaish selection of inspirational case histories, often drawn from privileged lives. A justification might be that, given the complexity of the factors he surveys, only the most sophisticated can apply his lessons.

For me, there’s a broader point to celebrate. In tracing the roots of infirmity, Levitin teaches us a great deal about how we lead the rest of our lives. There the prescriptions are clear, although scattered across 360 pages. Following them will improve our elder years. It is in this realization that I find myself seduced by Levitin’s program, and energized to pursue its implementation as a hypnotherapist.

Active Aging

Hypnotherapy in Later Life: Part 6

Conserving Identity

When we are young, we respond “policeman” or “nurse” or “astronaut” when asked “What do you want to be when you grow up?” For many of us, it’s not until almost mid-life that we might realize that we didn’t understand the question. “Being” is about character. We should have said “intelligent,” “honest,” “respected,” or “caring.”

Character is critical to social connection, which comes with vulnerability to our intimates. Sometimes that vulnerability is physical: after a full day, a construction worker needs food and rest. For an attorney, the needs may be emotional: peace and warmth. When restored, a protector may curl up with a book or knitting, while the adventurer seeks the company of friends at the pub or mall.

Knowing our needs and preferences, our partners can contribute greater variety and depth to our experiences – or disrupt our plans and upset our well-being.

The Ericksons’ Stages of Development map our social development. As success is not guaranteed, each stage represents a psychological crisis. The resolutions (the “Success/Failure” columns in the table) control many aspects of our character. Trust is the foundation of honesty; mistrust foments lies. Autonomy, initiative and industry feed intelligence; shame, guilt and inferiority undermine the search for experience and knowledge.

Age Partner Success Failure
0-1 Mother Trust Mistrust
2-3 Parents Autonomy Shame
4-5 Family Initiative Guilt
6-12 School Industry Inferiority
13-22 Peers/Father Identity Role Confusion
23-35 Lover/Spouse Intimacy Isolation
35-55 Workplace Generativity Stagnation
55-65 Society Integrity Despair

Ideally, we would be allowed to linger in each stage until the crisis was resolved successfully. In reality physiology and social norms push us forward. If we haven’t evolved a stable social identity in our teen years, still we must leave the family home, often necessitating moving in with a lover or friends (intimacy). Any bond will fray as we continue to try out adult personalities, forcing our intimates to adjust to our new preferences and priorities. The alternative is to allow others to make choices for us, swallowing our frustration until we find an opportunity to change our living circumstances.

The problem with the second outcome is suggested by the “organic language.” “Swallowing our frustration” reflects a hesitancy to express our needs to our intimates. The latent psychological conflict is transferred to muscles in the throat and jaw, manifesting in eczema or teeth-grinding. These are often recognized only when the “body syndrome” becomes a recognized medical condition, but in fact most of us carry unresolved crises in our body.

This is the context we carry with us when entering Joan Erickson’s ninth stage of development: what we do, our character, and the physical side-effects of unresolved crises. In that ninth stage of development, the first (what we do) is suddenly undermined, threatening the foundation of our character.

To understand this point, consider an Asian child, eating with chopsticks while kneeling on a mat on the floor. In kneeling parents come down to the child’s level, increasing the sense of connection. Now imagine a move to America and the ridicule of peers who see the child fumbling with a knife and fork. Confidence and self-esteem are undermined, restored every night when eating again with family.

In counseling retirees to continue to learn, experts recognize the danger posed by the interruption of our daily routine. The brain is designed to learn, but also to unlearn. Maintaining neural circuits requires energy, and when our priorities change (for example after a successful dating life results in marriage), underutilized circuitry is slowly dismantled to support circuits that bring success in our new situation. In retirement, continued learning helps us to maintain our identity.

In counseling those diagnosed with dementia, Dr. Dan Nightingale proposed a relationship between doing (outer rectangle) and identity (inner rectangle). To preserve identity, he proposes that we focus learning on activities that support our most valued character traits. The process defines a “Strategic Action Plan” that is negotiated by the patient with caregivers and peers. For a detailed case study, see “A Clinician’s Guide to Non-Pharmacological Dementia Therapies.” The book includes vignettes that describe the resuscitation of lives upended by dementia.

Inevitably, however, the disease progresses. As the social identity and cognition are conditioned on physical survival, the brain’s reduced capacities become focused progressively on bodily functions. The degraded conscious mind no longer accurately explains the environment, driving anxiety and fear. Here hypnotherapy has a special role to play: the trusted therapist takes over the executive functions of the brain, in suggestions explaining how the beloved should act to avoid conflict with their caregivers and community. With positive feedback, fear and anxiety recedes, leaving more resources for socialization and reason.

Still, the circle of engagement continues to narrow, and the stress stored in body syndromes eventually comes to the fore. Rumination on traumas may take place, sadly more pronounced after language skills have declined. A detailed history of life trauma is essential in diagnosing these episodes and providing therapy to relieve them. Again, see Dr. Nightingale’s book.

Part 1 || Part 5

Active Aging, Specializations

Hypnotherapy in Later Life: Part 5

Life in Harmony

Developed in the third quarter of the 20th century, the Ericksons’ Stages of Development end at age 65. Today if we live to 65, we have a 50% chance of living to 90. Given that nearly a third of life can be lived after retirement, we would expect to find stages on that journey into mortality. Indeed, after her husband’s death Joan added a ninth stage of development in which prior successes are challenged as the organism and mind weaken.

Louise Aronson (in “Elderhood”) applies a model arising from the medical community. It aligns with the ninth stage of development but distinguishes social and medical challenges. Retirement, as a social challenge, often occurs while we still have physical and mental vitality. As in Erickson’s model, these “seniors” (as Aronson labels them) are concerned with sustaining the integrity of a personality that slowly is cut off from the pillars that support its expression. It is only among the “old” that accommodation must be made for slacking vitality. Among the “elderly” medical concerns dominate, while the “aged” hope for dignity in the process of dying.

In both cases, of course, we have a sense that the final stage of life is a desperate gripping by the fingernails as the cliff tilts up and back over our heads.

To escape this dread, I add the liberating dimension of spirituality. The practices are:

  • Life review to remove limitations to personal growth.
  • Spiritual deepening as a loving management of the boundaries between “I” and “we.”
  • Inner peace as stillness and sensitivity that guide us into beneficial relationships.

The goal is a life lived in harmony and balance.

Let’s elaborate now on why that is hard. As a child we adapt to the culture defined by our parents. The middle stages of development are driven by conflict between those behaviors and society. To manage that conflict, the conscious mind evolves to engage society and validate experience. The subconscious – the original “naked” mind – continues to operate, but never fully integrates our social experience. Conversely, the conscious mind operates without full access to the physical and spiritual resources managed by the subconscious.

If to live in harmony is to expose those resources, then harmony requires that we heal the divide between the conscious and subconscious minds.

How does hypnotherapy facilitate this process? By helping seniors achieve the Stages of Development in their new living environment, thereby removing resistance to spiritual growth.

I myself began this journey in my adolescence. As a child of the ‘60s entering adulthood in the ‘70s I realized that our society needed to change. I choose love as the fulcrum for that change. In 2005, my exploration of that principle had revealed:

Love dissolves the barriers of time and space, allowing wisdom, understanding and energy to flow between us, and embracing us with the courage, clarity and calm that overcomes obstacles and creates opportunities.

One manifestation of this principle came as my unconscious father clung to life on his last day. I stood at the head of his bed to announce “Dad, a big brain party is waiting for you in heaven.” The hospice nurse, noticing the change in his face, announced “I think that he heard you.”

Seniors have a unique opportunity to cultivate such capabilities. As harmony grows, it becomes palpable to others as a presence of peace. Its effects include dissolving anger and fear, exposing hypocrisy, redirecting resistance, and encouraging collaboration. Those benefits unroll to shape the future. Reaching into the past, peace recovers parts of the personality trapped in sorrow or trauma. Through these gifts, the elder draws to them those less experienced or fortunate. They are beloved not for their ability to entertain, but for their abilities to heal and guide.

In a study of nuns in the Order of Notre Dame, another inexplicable benefit was seen. The academics saw the simplicity of the community as an asset, allowing them to expose the biological preconditions for dementia. As part of the study, the Sisters agreed to be autopsied after their death. The surprise came when the autopsies showed that women in their 90s, fully functional and active, had brains like those suffering from late-stage dementia.

How can this be? My sense is that when life and soul are fully aligned, the brain is no longer necessary to the expression of our intentions. The soul immerses itself directly into the tissues it needs to control. In exploring this new process of living, the soul surrenders fear of separation from the body. When the time comes, it lets go gracefully.

The last post in this series will consider the contrasting outcome – a long, debilitating decline into incoherence – and how hypnotherapy can minimize the associated trauma for both beloved and caregivers.

Part I || Part 4 | Part 6

Active Aging, Specializations

Hypnotherapy in Later Life: Part 4

Inner Peace

What does inner peace look like? To many, it would be a serene spiritual figure – the Virgin Mary, Gandhi, or White Tara.

Can we imagine becoming that?

Probably not, and it’s not what I mean by “inner peace.” Inner peace is not an endpoint, it’s a waypoint. It facilitates our growth be reducing inner resistance to change.

To understand how that works, we’re going to take a round-about journey, first looking at peace in the daily world.

In the daily world, most obviously peace is an end to conflict. From the history books, it doesn’t seem to be a natural condition. When peace is interrupted by conflict, nations restore it only by dominance – one side wins the war, and the loser submits to regulation.

But is the loser at peace? “Free will” is often argued against by scientists, but in the original political sense it recognized that the loser’s mind was not restricted from turning toward liberation. You might force a man to work for you, but you could expect him to seek freedom at the first opportunity.

Sometimes that liberation appears in unusual ways. MLK Jr. spoke of being “taken up to the mountain” and having “seen the promised land.” This echoes the testimony of African American theologians born in the early 1900’s. They said that their grandparents had everything taken from them – even the flesh of their flesh – and so turned inward in prayer, discovered a presence of infinite love. That knowledge gave them the psychological strength to turn the tables on their tormenters.

Is this a strange way to start a search for inner peace? Considering the world’s religions, perhaps not. The antics of pagan deities reflect the turmoil present in human nature and thus the individual mind. That private conflict was recognized in monotheistic religions, with adherents cautioned to follow the Golden Rule. (“Do unto others as you would have them do unto you.”) From there it was carried into the theory of psychiatry, with the mentally ill often seen as being at war with themselves. As documented by Anne Harrington (“The Mind Fixers”), psychiatrists were thus given dispensation to wage war against the demented part using isolation, labor, self-recrimination, surgery, and drugs.

We should naturally reject all such models in our search for inner peace.

A more suitable model is the family home. When conflict arises and dialog fails, we send the parties to their rooms. Mature members remain to craft a plan of reunion, while their wards contemplate the cost of isolation.

Taking the home as our example, inner peace only separates conflicting thoughts until they are ready for reconciliation. This is what I mean by inner peace: to recognize when mental conflict originates from tension in our thoughts, and to have the patience and discipline to reorganize our thinking so that the conflict is relieved.

Creating inner peace is difficult in the combative arena of the working world. That is why philosophers and religious seekers are often described as “retiring from the world.” But it also suggests that retirement is a great time to take up this goal.

The journey begins by learning to monitor and manage our level of physical agitation. The body exists to serve the mind, and when the mind is agitated, that comes with elevated blood pressure, restlessness, and even twitching. When we learn to calm those reactions, we can use them to monitor our progress in reducing mental conflict.

Hypnosis is an invaluable aid in that journey because it removes reaction delay. Common techniques include methods that improve tolerance and resilience, and specific types of discovery journeys.

As described thus far, inner peace seems to be mostly an intellectual journey. For those seeking spiritual deepening, however, it is an essential gateway. Spirituality, the negotiation of boundaries between “I” and “we,” begins in community. In group sessions, personal inner peace is extended to others.

Eventually inner peace does lead to profound spiritual awakening. Only those with the discipline to smother conflict are allowed entry to the parts of the spiritual landscape cultivated by our religious avatars. The elements of those landscapes have been shaped, honed, and precisely joined. The avatar’s will squeezes out dissonance.

Fortunately, the goal of every religious avatar is to see flowers bloom in their garden. Step softly and their realm thrills to the addition of the notes of your personality.

Part 1 || Part 3 | Part 5

Active Aging

Hypnotherapy in Later Life: Part 3

Spiritual Deepening

The conscious mind serves to protect our personality from accepting harmful judgments. Sometimes those judgments are positive, such as when a caregiver is told “but you’re doing a great job” when a request for help is refused. Sometimes judgments are opportunistic, such as up-selling by a car dealer. But mostly they are negative. “Children should be seen and not heard,” “You’re not pretty,” or “Nobody will ever love you like I do.”

While the protection of the conscious mind is admirable, it comes with consequences. The most potent negative messages program our body to ignore its needs. Whether we’re overweight or simply robust, “you’re fat” implies that we should eat less. To avoid weakening of the organism, the subconscious must suppress the influence of the conscious mind on the body. We become divorced from ourselves.

The power of hypnotherapy is in re-establishing those lost connections. That is possible only upon a grant of trust by the client that allows the hypnotherapist to bear witness to their subconscious landscape.

The figure presents the main features of that landscape. The conscious, reasoning mind explores the world, systematically building experience. When transitioning through sleep or during dangerous situations, that information is passed through to the subconscious mind that is concerned with doing and being. “Doing” is expressed through the body; “being” is the province of the soul.

While I introduced the conscious mind as the gateway to the world, that does not mean that it is the most direct route to the subconscious. This is evident when confronted with a trauma. While some among us will try to analyze the situation, others will act immediately to control the physical environment, or we may turn first to a higher spiritual source for strength and guidance.

These tendencies account for the richness of the wellness industry. Therapists and life coaches cater to those that analyze; doctors and chiropractors cater to those that seek a physical control; faith healers and reiki masters cater to the spiritual. Working in the gaps between these disciplines we find acupuncture (body and soul), psychiatry (mind and body) and organized religion (mind and soul). But as the figure illustrates, the subconscious mind links all aspects of the self, and so a multidisciplinary approach may be most effective.

For emphasis: in the modern era the virtue of the analytical disciplines is in creating a bulwark against harmful messages from society. Comparing hypnotherapy and psychotherapy, psychotherapy has the cachet of science. For those seeking spiritual depth, however, that comes with a prejudice against spiritual experience. Modern physics has no model for the soul (a problem that I have tried to solve elsewhere). This is a 20th century insanity driven largely by the terror of industrialized warfare. With psychology resistant to direct engagement, hypnotherapy is the best discipline for those seeking to deepen their spirituality. Hypnotherapy is also accommodating of religious orientation: It doesn’t seek to guide, but only to bear witness as the client seeks harmony.

Given that the modern world drives us to analyze and do, how do we know when we have reached the soul, the fundament of being? A survey of the great theologies reveals these precepts: a receding of concern with concrete outcomes and a growing seeking after harmony between the mind and body; a sense of the world entering into us rather than the projection of the self into the world; and a growing confidence that limitless love is the foundation of reality.

These principles have a long track record in supporting people seeking healing. Spiritual deepening facilitates life review.

In our modern society the greatest obstacle is overcoming materialism that encourages most of us to ignore spirituality – even if “scientific thinking” does not cause us to reject it outright. The strategies for overcoming such resistance are subtle, beginning with a survey of moments of inexplicably deep connection to the self and others. To protect against identity confusion, those experiences must be anchored with love. Love preserves and amplifies virtues in us witnessed by others and protects us from corruption. In Cheryl O’Neil’s Therapeutic Imagery, those truths are established as a foundation before undertaking any hypnotic work.

But the end goal of spiritual deepening? That is informed by a simple precept: spirituality is the negotiation of the boundaries between “I” and “we.” It is a process that can occur only in community, ideally among those seeking similar aims. When that condition is lacking, conflict arises. As a core principle, then, spiritual deepening requires inner peace, our next topic.

Part 1 || Part 2 | Part 4