Ageism, death denial, and wisdom

What is the role of the wise elder in our contemporary society? There is a difference between growing old and growing up. Growing old is inevitable, and growing up is optional.

The youth culture idolizes immortality foolishly. As one grows up one comes to terms with limits, failure, and death. In growing up a person can come to face their demise with equanimity and the peace that comes from the satisfaction and fulfillment of completion.

Age discrimination is based on the denial of death in our culture. We don't want to think about it, understand it, respect it, let alone welcome it. We avoid it, deny it,  and discriminate against anything that reminds us of it.

Age discrimination fundamentally is death discrimination which is crazy and mentally unhealthy. Wisdom comes from knowing that all things die. It is part of the life cycle. The concern should not be about death because death is natural. The concern is how to do it well and honor it and welcome it because of a life well lived. This wisdom is something that a youth idolizing society denigrates, dismisses, marginalizes and thereby creates unnecessary anxiety and social tension.

As elders who have come to terms with the downside of our life cycle and learned how to enjoy it and value it, we have much to offer to the younger members of our society. We, as elderly psychotherapists, have much to offer a society which is very much in need of our wisdom developed from thoughtful lives productively lived.

What are the three most important lessons you have learned so far inyour life that enlighten you and may be of help to others?

Major cause of perinatal maternal death is behavioral health problems

 

The major cause of maternal mortality in the US are behavioral health conditions accounting for almost 23% of all perinatal deaths.

Mental health care for pregnant women can be life saving. It also seems the SSRI antidepressant medications are safe in general and the benefits outweigh any risks.

For more click here and here.

Differentiation of self as an indicator of functioning

Question: Have you experienced/observed age discrimination in our field? In what ways? I am giving a CE training on the topic and would love to hear more about people's lived experiences with this!

Answer: Interestingly in my 56 year career as a Psychiatric Social Worker I have never experienced what I would consider "age" discrimination, but I have encountered often what could be called "experience" discrimination especially when I was over 50 looking for higher level positions when the people interviewing me had less experience, competence, and skills that I did. They were usually courteous and somewhat dismissive and I knew they were never going to hire me because I could easily do their jobs. It is very interesting how many mediocre people are threatened by competence.

Further answer:

Another factor even less talked about than experience is the level of differentiation in a hierarchical emotional system. Using Bowen's concept of differentiation of self (DOS) as applied to emotional systems having a subordinate more differentiated than a superordinate in an emotional system is toxic ground for all kinds of dysfunction.

This perverse hierarchy caused me much distress until I learned about emotional systems and had names for the dynamics being played out. The strain was still there but I became much better at managing it.  However, over the course of my 56 year career I resigned from three jobs because of my lack of satisfaction with the incompetence of my supervisor.

We don't have many words for this phenomenon but the one that often comes to mind is being "underemployed" or "overemployed" or years ago it was known as the "the Peter Principle." when a person is promoted to their level of incompetence.

Question: Is a national government an emotional system?

Answer: Yes, a national government is an emotional system. Of course, we have three branches of government and so we can consider the emotional system of the executive branch, the legislative branch, and the judicial branch.

A symptom of the perverse hierarchies based on differentiation based on differentiation of self is the resignations on principle. Of particular note is the number of resignations of very competent people in Trump's cabinet in his first term. Can you imagine Rex Tillerson the CEO of Exxon working successfully for Donald Trump just as one example?

In congress there have been a number of resignations because of incompetence of the leadership, notably, Liz Cheney, Adam Kinzinger and many others.

We could reflect on this dynamic much more extensively, but  I am not sure if it is necessary and I don't want to turn this into a political discussion. The focus of attention is on how emotional systems function at all levels of society.

As an exercise when I was learning about Bowen theory, in one class we discussed the level of differentiation of the various presidents and the success of their administrations. While highly speculative, it was very informative about the theory.

When you observe any organization and you attempt to ascertain the level of differentiation of the leaders at various organizational levels I find the concept extremely helpful. I also have used the concept in hiring and promoting people in the organizations I managed when I had hiring and firing authority. Facilitating the enhancement of a person's level of differentiation is one of the most important purposes of psychotherapy and supervision. This presumes that the therapist and supervisor are at a higher level of differentiation than the client or the supervisee. Enhancing the therapist's level of differentiation is one of the reasons that psychotherapists should engage in their own therapy. Self awareness and understanding of what makes one tick is an important factor in an effective therapist and supervisor.

A good book that deals with this concept is Edwin Friedman's book, Generation To Generation, in which Friedman applies Bowenian concepts to church organizations. Another of Friedman's books that address organizational and societal dynamics from a Bowenian perspective is Failure Of Nerve which was published posthumously after his death.

Bibliotherapy - Object lessons by Anna Quindlen

Anna Quindlen's Object Lessons is a coming-of-age novel set in suburban New York City during the 1960s. It tells the story of twelve-year-old Maggie Scanlan as she navigates a pivotal summer marked by significant changes within her large, Irish-Catholic family and in her own life.

Summary of Object Lessons

The novel centers on the Scanlan family, dominated by the wealthy and imposing patriarch, John Scanlan. Maggie is particularly close to her grandfather, who attempts to impart "object lessons" – life lessons – to her. However, Maggie's world is in flux. Her family dynamic is strained by her Italian-American mother, Connie, who feels like an outsider within the Irish clan and struggles with isolation and a distant relationship with her husband, Tommy (John Scanlan's son).

As the summer progresses, several events challenge Maggie's perception of her seemingly stable world. Her powerful grandfather suffers a stroke, leading to his eventual death, which deeply impacts the family's hierarchy and emotional landscape. Maggie witnesses her parents' struggles, discovers uncomfortable truths about her own conception, and grapples with the unraveling of her friendship with her best friend, Debbie, as they drift into different social circles and confront challenging adolescent experiences, including peer pressure and even a brush with delinquency. Through these experiences, Maggie begins to shed her childhood innocence and gain a more complex understanding of family, identity, and the adult world.

Therapeutic Benefits of Reading Object Lessons

Reading Object Lessons can offer several therapeutic benefits, particularly for those reflecting on their own coming-of-age or family dynamics:

• Validation of Adolescent Experiences: The novel realistically portrays the often confusing and emotionally charged period of adolescence. Readers, especially those who experienced similar transitions, can find validation in Maggie's struggles with identity, shifting friendships, and the growing awareness of adult complexities. This can foster a sense of "I am not alone," which, as Anna Quindlen herself has noted, is a significant benefit of reading.

• Exploration of Family Dynamics: Quindlen's keen observation of family relationships, particularly the complexities of a multi-generational, somewhat dysfunctional family, can be cathartic. Readers might recognize echoes of their own family challenges, power struggles, and unspoken tensions. This can lead to greater understanding and empathy for their own family members and their past.

• Processing Change and Loss: A central theme is the impact of change and loss, particularly with the grandfather's illness and death. The novel demonstrates how individuals and families cope with grief, shifts in power, and the redefinition of relationships. This can be beneficial for readers who are experiencing or have experienced similar losses, offering a fictional space to process these emotions.

• Understanding Intergenerational Conflict and Cultural Differences: The novel subtly explores the tensions between Irish and Italian cultural backgrounds, particularly through Connie's experience as an outsider. This can provide insight into the challenges of navigating different cultural expectations within a family and the impact of prejudice, even within seemingly homogenous communities.

• Empathy and Perspective-Taking: By immersing themselves in Maggie's perspective, readers develop empathy for the characters and their struggles. Seeing events through a young girl's eyes, while simultaneously understanding the adult world around her, can broaden one's perspective on human behavior and motivations.

Reflection on Personal Growth and Resilience: Maggie's journey is one of self-discovery and resilience. Despite the unsettling changes, she finds her voice and begins to forge her own identity. This can inspire readers to reflect on their own journeys of growth and the strength they've found in overcoming challenges.

This book might be of help to parents of adolescents and to people interested in and working with family systems.

Coming - Mental health warnings on social media

 Minnesota will require mental health warnings on social media next year and other states may follow.

"I think the evidence is very clear that social media use is linked with depression, anxiety, loneliness, self-harm, suicidal ideation, eating disorders, all sorts of terrible mental health conditions," says Democratic state Rep. Zack Stephenson, the main sponsor of the law. "You'll see a message telling you that prolonged use of social media can lead to those outcomes."

Stephenson says the labels, while not yet written, will be like warnings for tobacco products or alcohol, and it's up to the Minnesota Department of Health to decide what they say.

"If you had expected big tobacco to make cigarettes less addictive in the '50s and '60s, you would have been sorely mistaken," Stephenson says. "Addiction was their business model. And the same thing is true for big tech."

For more click here.

While the primary concern is the negative impact of social media on youth, it also has negative impacts on adults as well. The primary impact on adults is the scamming that occurs with lonely adult males who get sweet talked out of their money by posers who promise love and affection. I have seen this occur numerous times in my psychotherapy practice.

Book review - Never Change by Elizabeth Berg

Elizabeth Berg's novel "Never Change" tells the bittersweet story of Myra Lipinski, a 51-year-old visiting nurse who considers herself a contented spinster, living quietly with her dog, Frank. Her ordered life is upended when she is assigned to care for Chip Reardon, the "golden boy" she secretly adored in high school. Chip, once the popular and handsome athlete, has returned to his hometown to die from an incurable brain tumor, having chosen to forgo further treatment.

Their reunion forces Myra and Chip into a poignant redefinition of their past roles. Myra, who always felt like an outsider in high school, now finds herself in a position of intimacy and care with the man she once worshipped from afar. As Chip's health declines, their relationship deepens, exploring themes of memory, longing, and second chances, even in the face of imminent loss. The arrival of Chip's former girlfriend, Diann, adds another layer of complexity, but ultimately, Myra finds herself in a loving connection, albeit with a man whose time is running out.

Therapeutic Benefits of Reading "Never Change":

Reading "Never Change" can offer several therapeutic benefits, particularly for those grappling with themes of:

Grief and Loss: The novel directly confronts the reality of terminal illness and impending death. It can help readers process emotions related to loss, both for themselves and for loved ones, by offering a sensitive portrayal of a character facing the end of life and those caring for them.

Acceptance and Letting Go: The story highlights the importance of accepting life's unpredictable nature and finding peace even in difficult circumstances. Chip's decision to forgo treatment and Myra's journey to accept their limited time together can be a powerful lesson in letting go of what cannot be changed.

Second Chances and Unconventional Love: For those who feel they've missed out on love or connection, the novel offers a hopeful message about finding profound relationships in unexpected places and at unexpected times, even in the twilight of life. It challenges conventional notions of romance and happiness.

Empathy and Compassion: Myra's role as a visiting nurse and her deep care for her patients, including Chip, fosters empathy in the reader. The book delves into the emotional complexities of caregiving and the human desire for connection, encouraging readers to consider the perspectives of both the ill and those who care for them.

Self-Discovery and Identity: Myra's journey allows her to shed old insecurities and embrace a more authentic version of herself. The novel can encourage readers to reflect on their own identities, past regrets, and the potential for personal growth at any stage of life.

Living Fully: Despite the somber backdrop of terminal illness, "Never Change" celebrates the richness of human connection and the importance of living fully, even when faced with limited time. It reminds readers to cherish moments and find joy in the present.

This book can be used to facilitate discussions about caregiving for human service professionals in all disciplines.

Crisis Intervention and Conflict Resolution

 This podcast discusses crisis intervention, focusing on the natural restorative process of systems and the limitations of crisis counseling. It emphasizes the importance of "environmental manipulation" or external controls to manage crises, particularly in power struggles. David G. Markham, LCSWR highlights the role of incentives in conflict resolution and the necessity of a safe, structured environment for productive discussions, advocating against "cancel culture" and promoting differentiated leadership. The email uses examples from various fields, including behavioral economics and family systems theory, to support its points. Ultimately, Markham stresses the importance of creating a supportive space for professional growth and development.

Subscribe to David G. Markham’s Behavioral Health in the upper right corner. 

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