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 2

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 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