Category: Specializations

Active Aging, Specializations

Hypnotherapy in Later Life: Part 5

Brian Balke

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

Brian Balke

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, Specializations

Hypnotherapy in Later Life: Part 2

Brian Balke

Life Review

While philosophers make much of reason, the most complex parts of the mind evolved to help us create communities.

Community starts with the family – we look at our parents’ faces and find comfort or distress. Sometimes those responses are instinctive: when we smile, blood is forced into the brain and we feel happy. Perhaps intuitively we understand then that it is good when our parents smile. They are happy and reward us with their attention.

But other expressions seem arbitrary. Why make a raspberry, for example?

Well it turns out that not everybody does. Thus comes the problem of community: we wander away from the family and encounter other ways of relating. Rather than a raspberry, another person may snort to show disdain. It is the social center of the brain that allows us to see past the differences to build trust.

Eric and Joan Erickson studied personal growth to social maturity. Their “Stages of Development” recognize that what we learn at an earlier stage supports our success at later stages. In the early stages, however, society expects us to accomplish each stage by a certain age. That means that even if we have not mastered an earlier stage, we will be forced to move into the larger social setting as shown in the table. It’s expected of us.

Age Partner Issue Success
0-1 Mother Will the world provide for me? Trust
2-3 Parents Can I control myself? Autonomy
4-5 Family Can I control my environment? Initiative
6-12 School Can I succeed? Industry
13-22 Peers/Father Will society accept me? Identity
23-35 Lover/Spouse Can I be emotionally responsible? Intimacy
35-55 Workplace Can I be socially responsible? Generativity
55-65 Society Does life have meaning? Integrity

When the shift to larger concerns occurs too soon, we can feel like an alien, like we “don’t fit in.” Sometimes that’s not bad. We’ve all heard of children that were “precocious” – mature beyond their years. But most often it’s a problem for us – we say and do things that are inappropriate, making others uncomfortable and suffering their rejection.

The fulfilled life closes without regrets. Most of us muddle through, surrounding ourselves with people that don’t mind our quirks. At every step we do the best that we can and often find friends at hand when we need help. When that doesn’t happen, we are left with a trauma – and the regret that comes with it.

A good way to think about trauma is a muscle cramp. We strain against some force (like a heavy weight) and the muscle contracts until it gets tired and stops. If we are forced to hold the muscle at that position (perhaps by our own stubbornness), eventually it begins to cramp. Because the muscle tissue tears during a cramp, the effects can last for weeks or even years. During that time, we shift its burdens to other muscles. Those muscles become stronger, but that very strength can cause twisting of the posture that can itself become disabling.

I had several muscle injuries when I started yoga in my fifties, and posture problems to go with them it. While it was painful and frustrating, with discipline and patience they have healed. I learned to relax the compensating muscles so that my posture straightened, and then stretched and strengthened the original muscle.

Having done this work, I find that I move with greater grace and dignity. People stop to tell me how wonderful my posture is.

I spend all this time on muscle cramps because as regards social growth a similar opportunity is available to seniors after retirement. With the pressures of daily life behind them, they can revisit painful experiences in the past and apply their adult wisdom to heal them.

This is the opportunity of life review. The first goal is to prevent social trauma from affecting the choices we make in the present. But as the earliest social traumas ripple down through the rest of our lives, they affect our intimates as well. Our traumas infect others, and theirs infect us. Life review branches out to encompass others. Guided by the Stages of Development and other frameworks for personal growth, we attain insight that leads us toward forgiveness.

On my own journey, I eventually realized that all the people who hurt me were “doing as was done unto them,” looking all the while for someone strong enough to show them how to heal.

Retirement living also drives social change. We leave work and search for new ways to serve our community. Friends and partners retire, move away to be with family, or leave us behind when they die. No longer finding satisfaction is maintaining a large residence, we seek to simplify. One side-effect is to find ourselves in close contact with others in facilities designed to stimulate the formation of new friendships and romantic interests.

In recognition of these facts, Joan Erickson suggested a ninth stage of development in which all the earlier stages were revisited. That occurs in retirement. What better opportunity to revisit old wounds and gaps to heal and strengthen our spirits? And find deeper fulfillment in the years that remain! A sensitive and compassionate therapist bears witness to those capacities, ensuring that we recognize and celebrate new growth.

The power of hypnotherapy is always to give courage to the subconscious mind that seeks safety. With gentle and persistent encouragement, it comes forward to reveal depths of experience that are known to few, as we’ll consider in our next post

Part 1 | Part 3

Active Aging, Specializations

Hypnotherapy in Later Life: Part 1

Brian Balke

Marvelous Opportunity

Most clients seek hypnotherapy to correct behaviors that limit success. In later years, that motivation shrinks – we don’t have to stand up in front of an audience or look good in a bikini. So why would a senior client seek hypnotherapy?

Certain reasons still apply. Smoking cessation therapy comes up often. Hypnosis for medical recovery is also common. But while many other conditions become less pressing with age, benefits arise that are only available to those with the time to invest in themselves. These include life review, deepening spirituality, and cultivation of inner peace. These bring the elder a new kind of power – the power to guide others toward those same goals.

Sadly for the growing number of Americans pioneering life with cognitive decline, those opportunities gradually slip away. Recent studies indicate that better nutrition and sound sleep can slow that loss. Sleep is particularly important, and here hypnotherapy can help by reducing anxiety as the pioneer begins to lose control over their world. We understand language before we speak and interpret expressions and gestures even earlier. Those capacities remain until the end and can be used in hypnosis to encourage change even when the rational mind has succumbed to confusion.

In this series we’ll consider the benefits of hypnotherapy in each of the areas outlined above. In this first post, however, I’d like to emphasize how hypnotherapy changes when working with seniors.

As aging progresses, we become more vulnerable and thus more sensitive to unfamiliar settings. For this reason, elderly clients may prefer at-home sessions or sessions over Skype. Remaining in the comforts of home, their energies are also preserved for the important work done in the mind.

That work must include exercise of the mind’s capacities. The brain is designed to continually adapt to a changing world, and that includes clearing away unused circuitry. For this reason, deafness is followed by loss of speech comprehension. Conversely, reading of novels appears to help preserve long-term memory better than reading of magazines. Rather than simply moving from one experience to the next, then, activities should be planned to ensure that all sensory and thinking processes are exercised.

The crux of the matter, however, is that life does simplify with age. Retirement not only relieves us of challenge but also orphans the thinking patterns that were unique to the workplace community. Conserving those patterns requires rechanneling into new experiences, and such channeling is always done in dreams. Hypnotherapy can help to focus dream process. With elderly clients, dream therapy is therefore an emphasis.

Along with a shift in attention to these needs particular to elders, the hypnotic process often must be adjusted. Arm-raisings favored by 20th century pioneers may be uncomfortable to seniors. The usual fallback is visual focus, but declining eyesight may frustrate that as well. For elderly clients, then, the hypnotist will use conversational methods: confusion, pacing and leading, and imagery. When deafness or failing comprehension frustrates even that, still the language of expression and gesture remains – and that is sufficient for hypnosis.

Once the therapist enters trance with the client, of course, the magic of hypnosis is that new channels of communication open as trust is solidified. We’ll see that cropping up again and again as we consider in detail the unique benefits of hypnotherapy in later life.

Part 2

Book Reviews, Specializations

A Geriatrician Advocates for the Elderly

Brian Balke

When I reached 50, friends began advising me to color my hair. I laughed – given what I’d been through in my 40s, I was proud of the evidence that I’d made it that far.

In “Elderhood,” Louise Aronson reflects on a career in gerontology (the medical specialty that focuses on the elderly) to expose the cultural disease of opportunism that infects our experience of aging – both within medicine and the larger culture.

The challenge of caring for the elderly is that normal aging changes body chemistry, making invalid many of the strategies pursued when caring for adults. Since all medications and medical procedures are proven for adults, gerontologists must understand the entire body when planning care. The liver and kidneys no longer may be able to eliminate drugs before harmful side-effects occur. As conditions accumulate, physical therapy requirements may overwhelm the patient’s decreased stamina. And procedures designed to restore full functioning in younger patients may instead cut short the life of a less resilient senior.

Paradoxically, the complexity of caring for a senior created the opportunity for Aronson to operate for most of her career as a dying breed: the home-calling general practitioner. Financial limits meant that radical treatments were often out of reach to her patients, and so common-sense behavioral and environmental adaptations were acceptable options. Perhaps not surprisingly, many seniors report greater satisfaction with their care when offered options that preserve their social setting, whereas hospitalization would have left them isolated for long periods – if not permanently.

Unfortunately, Aronson’s written contribution to this public debate was triggered by burn-out. Systemic factors – medical specialization, rigorous reimbursement policies, and profit-conscious administrators – generated resistance to providing the kinds of care that were best for her patients. To illuminate those factors, Aronson’s writing develops two themes in parallel: how medical care should evolve as a patient ages, and then the professional history that finally drove her to collapse in frustration when praised for her outstanding performance. While laudable in intent, the mixing of these two stories dilutes the focus of the book. In the end, only the most careful reader can form an independent judgment about Aronson’s views.

To a degree, Aronson seems to have accepted this outcome. Her afterward opens with a quote in which another author describes his work as a polemic – as intended to stimulate emotions that would drive political change. Taking this as Aronson’s goal, “Elderhood” builds a strong case: 50% of doctors “burn out” as Aronson did, and leave medical practice. More desperately, young and heavily indebted doctors choose suicide at rates far higher than the general public. It is only the narrowly qualified specialists that thrive, and they are precisely those unable to deal with the complexity of aging. Aronson takes the point further, believing that myopia extends even to treatment of “normal” adults – precisely because there is no “normal” adult. The inability of the specialist to anticipate the side-effects of their treatments eventually traps patients in the medical system as the treatment of side-effects creates further side-effects until the patient runs out of financial resources.

From the perspective of hypnotherapy, however, it is the first thread (the evolution of care with age) that is most important – and specifically to those of us seeking to serve the senior population. Aronson draws upon her clinical experience to illustrate the shifting goals of aging patients. To distinguish them, she proposes that we consider the stages of senior, old, elderly, and aged. These are wrapped in life’s third act – elderhood (the first two acts being childhood and adulthood). Aronson’s purpose is to hone our sensitivity to the opportunities and challenges of growing old.

Most of society relates to growing old as the loss of youth. Those visible changes – wrinkled skin, gray hair, and decreased vitality – appear long before we lose our creative potential. Seniors, therefore, are those still seeking opportunities after leaving their adult career. Their unique gifts are discernment, patience, and a surrender of financial ambition that allows them to prioritize options that benefit their community.

Medically the principle concern for the senior is decreased recuperative capacity. Senior illness and injury can trigger a debilitating cascade that speeds decline. This is therefore the stage to begin defining preferences for managing the inevitable decline. Aronson sets the two poles of the spectrum as “breathing at all costs” and non-intervention. Aronson’s illustrations tend to support “comfortable longevity” as the best compromise.

As aging continues activity begins to match the expectations generated by appearance. We become “old.” In planning gatherings and outings, compromises are made for reduced stamina. This transfers to medication – “adult” prescriptions should be screened for new or enhanced side-effects. With conditions that require surgery, discomfort may best be managed with lifestyle changes.

“Old” is also the stage where social changes begin to cascade. This follows naturally as life-long friends relocate and die. While still fairly active, this may be the best time to move to a dedicated retirement community, simplifying lifestyle while developing new friendships. Aronson emphasizes, however, the benefits of multi-generational households – once a necessity but now an overlooked option that enriches the lives of both youngest and eldest family members.

“Elderly” follows when management of medical complaints begins to dominate our days. Aronson dwells on the challenges posed by America’s utilitarian ethic. Cab drivers speed away from elderly fares, and private and public spaces become inhospitable – both physically and socially. Aronson warns that our failure to accommodate the elderly condemns us to suffering in our elderly years and denies us the opportunity to reap the insights gained from their lived experience.

In treating the elderly, Aronson condemns our modern “disease management” system. Essential practical needs are not recognized as medical expenses, creating “penny-wise and pound-foolish” practices that allow minor inconveniences (such as nutritional deficits and hearing loss) to evolve into serious conditions before services are provided. Worse, when those conditions arise, the influence of medical specialists means that the course of treatment often depends on which doctor is available first.

Ultimately, of course, the principle concern is managing the decline of the “aged” to death. Even here, Aronson offers inspirational tales – a bed-ridden grandfather who became tutor to the neighborhood’s school children. She argues for advanced planning and hospice over the isolating and desperate institution of the nursing home.

While I only outline the changes that define the transitions between the stages of elderhood. Aronson’s monumental work draws upon her experience in geriatric practice to illuminate the psychological needs that evolve from reinvention (seniors), to isolation (old) to wellness (elderly), and finally into mortality (aged). While somewhat diluted by her indictment of the medical establishment, Elderhood is rich with insight for those seeking to support each of these distinct communities.