When you're younger, you think: someday. Then you realize, there is no someday. -- Rose, aged 65
It went on for 40 years -- the anger, the blame, the misery of an unhappy marriage. But they were raised in the Depression years: They toughed it out, they endured, they couldn't -- shouldn't -- expect to be happy.
That's all changed now, because Bill and Rose are two of increasing numbers of men and women choosing to change themselves in the second half of life by seeking psychotherapy, a process that used to be reserved for the young.
Their therapist is one of increasing numbers of professionals helping older adults because of a belief in their capacity for change, change every bit as satisfying -- even dramatic -- as is possible in the first half of life.
It used to be thought that childhood was the crucible in which all our lifelong patterns of response were forged. The long years of later adulthood -- today as long as 40 to 50 years -- were one long unbroken period consigned to the dustbin of rigidity, as though emotional rigor mortis set in. It was just too late.
Who hasn't heard the term "too old to change"?
Sigmund Freud wrote that he regarded people over 50 as too old for therapy. He said their minds lacked the "elasticity" needed to grow, and besides, they had so much to think and talk about -- having lived so many years -- the therapy would go on forever.
"That is archaic," says Dr. Nathan Billig, associate professor of psychiatry at Georgetown University Medical Center. "Any individual can change at any age, depending on his capacity and own interest in doing so.
"It even seems ludicrous to have to say it now, that older people can and do benefit from therapy," says Billig, author of To Be Old and Sad: Understanding Depression in the Elderly.
Consider Rose and Bill:
The Bethesda couple married at 18 and 25, had two children and lived together miserably for four decades. After a trial separation, "we both decided to try a last-gasp effort at change," says Ruth, who was 55 at the time.
Bill: "It was a matter of desperation -- do or die. We saw a lot of friends' 40-year marriages break up."
Rose had spent her life "always blaming someone for everything; it was either my mother or my husband's fault. I wanted someone else to do everything for me."
Bill had worked continuously since he was 10 when his father abandoned his family during the Depression. "Those were hard years. I became the father in the family and dropped out of high school to support the family. I had enormous feelings of abandonment. I felt my teen-age years had been robbed from me, but I didn't realize any of this when I was young. Instead, I covered everything up by being the greatest Mr. Nice Guy in the whole world.
"Underneath, I was full of rage and resentment. I took this out on my family by withdrawing, not communicating, not sharing anything," Bill, now 72, recalls.
It took a decade of treatment, a lot of courage and a lot of struggle on the part of Bill and Rose. "Looking at myself has been the hardest job in the world," he says, "but after a while the dividends started to come in," one such dividend being their sex life. It's far better today than it ever was in their youth. "And when it isn't good," notes Bill, "I can usually figure out why. Sometimes it has to do with unexpressed anger."
"We share the pain and the joy now," says Bill.
"I'm very grateful we have the friendship we have," adds Rose. "We talk, joke and laugh with each other. We face our problems together. There's comfort and closeness.
"If we still had the anger and the bitterness, we couldn't have done it," she concludes.
Surprisingly little is known about the course of emotional life and its vicissitudes beyond the age of 50. Scientists are only now studying the normal ordering of development in mid- and late life.
According to Dr. Gene Cohen, chief of the Center for Studies of the Mental Health of the Aging at the National Institute of Mental Health, "We know remarkably little about how individuals change in the second half of life.
"We've put children under a microscope for a long time," says Cohen. "Now it is time to do the same for adults." Cohen currently is conducting a long-term intensive study of 50 adults between the ages of 65 and 103 to learn in detail just what happens to them emotionally as the years go by.
"One thing we do know," he says, "is that there is a great deal of confusion about the capacity to change."
Jean, 63, housewife and mother of three grown children, suffered years of "not liking how I was feeling," years of unhappiness, depression, anger.
Then she met a woman at a party, an older social worker. "We started to chat and I knew this was someone I could really talk to," says Jean.
Therapy has led her to examine many parts of her life:
Lack of self-esteem, which she discovered stemmed from her reactions to her mother, now 89 and "very self-centered and critical." I still get a lot of put-downs from her," Jean says. "She doesn't really approve of things I do, even now.
"But I don't get so angry anymore. I have better ways of answering her back, whereas for all those years I was totally deflated by her."
Lack of close friendships. "I had plenty of acquaintances but almost no real friends to go through life with," she discovered. "Now I find my friendships go two ways. I feel I've taken a lesson on how to have a friend," she says.
A big change in Jean's life was the realization that, "If I have something I wanted to do, what was I waiting for?" She was able to persuade her husband to sell their home in Bethesda and move into the fashionable house she had eyed for 10 years.
Inevitably, regrets must surface in examining a life of many decades. "Sometimes you look back and ask, 'Did all those things really happen to me?' For so long I kept everything bottled up inside," recalls Jean, who says that "talking about intimate things is still very hard. I think it's much more difficult than for young people, who seem to talk about everything. In my day, for instance, I never knew what menstruation was until it hit me, and we never talked about money or sex."
The second half of life used to be viewed as a series of losses: loss of strength, power, prestige, physical ability, sexual opportunity, while the loss of possibility seemed to be the worst one of all.
"But," says Cohen, "focusing so exclusively on loss is only doing half the job."
The importance of parenthood, grandparenthood, family, friendships, personal interests and generational cycles are increasingly acknowledged as powerful forces in generating continuous growth throughout life.
In their just-published book, Race Against Time: Psychotherapy and Psychoanalysis in the Second Half of Life, Drs. Robert Nemiroff and Calvin Colarusso write that "adulthood is not static; the adult is in a constant state of dynamic change and flux, always 'becoming' or 'finding the way.' "
The University of California, San Diego, psychiatrists also write: "Changes in psychic structure that occur in adults are analogous to gutting the inside of a building and retaining the facade for historical purposes; the interior becomes very different but the same face is presented to the external world."
They suggest that the paramount issue, the guiding force, in life after 50 is the growing awareness of death. "Physical signs of aging," they write, "the deaths of parents and friends, the maturing of children, and the growing understanding that not all one's life goals will be realized force upon the adult in middle age an unwanted awareness" that our days are finite.
"Suddenly," they maintain, "it is clear that life itself is half over and the race against time cannot be stopped."
Paradoxically, that very race can be a powerful motivating force. "The motivation for change can be great in the older years," says Elma Wolf, a licensed clinical social worker in Bethesda, with 30 years of private practice behind her. "After 50, you know you have limited time, you are aware of your mortality."
"Sometimes I am amazed at the rapidity of insight in this age group," says Wolf, who was treating men and women in their sixties and seventies for years before it was widely done.
Cora was 69 when she knew she had to end the relationship with the minister of her church. He was an alcoholic and had become increasingly belligerent over the course of 3 1/2 years. "But I had really loved that guy," says the long-divorced mother of four. She consulted a social worker at a senior counseling center who gave her the support she needed to break it off.
In the course of therapy, Cora learned a lot about her almost seven decades of life. "I had often set myself up to have problems so there could be no happy endings," she says. Eventually she was able to tie up some of the painful loose ends of her life. She discovered, for example, that she was still grieving for one of her sons who died at age 9.
Also, she was not as close with two of her children as she had wished. "I began to see how much I had thought that I had gone willy-nilly through life like a leaf on a current," she says. "Now I see how much I chose without realizing it."
Cora, who now lives in Rockville, found it very hard to go through therapy. "If you're not ready to hear it, you will argue, deny, or sometimes listen on the outside but deny it on the inside, and think, 'Well, only I know me.'
"But eventually you realize that what you don't want to think and listen to can be what ultimately makes you feel better," she says.
She recalls how much she cried when she sold her house, until one day she realized, "I've lived in this great big house with decay all around me; I had all those clinging connections to the past, even where it had not been a good past; it freed me to do something new."
"I think we grow," she now believes, "till we stop living."
"After 50 is a time when people can actually redo some of their development, things they didn't do when they were younger," says Betty Thayer, a social worker in private practice who also works at the Community Psychiatric Clinic's Senior Counseling Program in Bethesda.
Thayer points out that current generations over 50 were raised in the Depression years, a time of great hardship and dislocation for most families. "The effect of family tragedies during the Depression was delayed," she notes. "Now, as this generation matures and starts to retire, there may be a sense of completion. You can do what you didn't do earlier."
Yet, says Thayer, this age group was not raised in the psychologically sophisticated era of today. "When this group was young, only 'crazy' people entered therapy, while today psychotherapy is seen as a developmental process to enhance the quality of life," notes Thayer.
"It's also a generation not raised to speak about certain topics," says Dr. George Pollock, Chicago psychiatrist who has pioneered theory on adult development. "There were forbidden topics for this age group, such as sex, but also other sources of shame and humiliation, for instance a child born out of wedlock, or hanky-panky in a family, or the fact that the family had to go on relief during the Depression."
"Yet," says Pollock, "for such men and women, it can be a great relief to realize that they do not have to just shrug their shoulders and endure, that in the process of intimate talking, problems become all right, part of being human.
"The key to successful aging," he says, "is the ability to recognize that the past is the past. We can then go on to invest in the present and the future."
Carol Hausman, a psychologist who also treats many people over 50, suggests that many more crises occur in the older decades than are generally acknowledged. Retirement, for instance, can cause serious difficulties for men unprepared to handle time, and unused to looking to social relationships as sources of satisfaction. Meanwhile, "the wife in her sixties may have embarked on a satisfying career she took up after the children grew up, and be unable to share that with her husband," says Hausman.
"They are not in the same life stages, and serious marital difficulties may emerge," she says, "plus these people may also be facing the care of frail elderly parents."
Cohen says that "people, simply by virtue of having more time to live, have more time to patch up old conflicts, to attend to old nagging life problems."
He notes that for the country as a whole, the big change is the huge number of people in the second half of life. "Today," he points out, "people can expect approximately 20 more years when they hit age 65."
Census data reveal that half of all Americans are now 30 or older. There are 25.5 million people over 65 years of age, 28 percent more than in 1970.
"The sheer numbers of people, better educated and in better health than ever before in history, will mean life experiences different from ever before in history," says Cohen, who says he already sees a shift from the negative stereotyping that reached its peak in the youth-oriented '60s to newer role models of aging, which will be more positive and realistic.
"Now we realize that age itself has nothing to do with whether a person can benefit from therapy," says Dr. Martin Berezin, a Boston psychiatrist who created the Boston Society for Gerontological Psychiatry.
"If you are rigid at 20, you'll be rigid at 60," he says. "No one is really his chronological age. Everyone has a secret, often unconscious, age. That's why at class reunions, others seem to look so much older than we do. The matron with the long hair past her shoulders, for instance, still secretly thinks of herself as a young woman.
"People have the same needs at every age, for love, affection, approval," says Berezin.
"I'll always remember the woman in her seventies whom I saw as a patient for several years. She told me once, 'All I have left is my future.' "