From the instructor notes this week:
Erikson’s wife, Joan Erikson worked closely with her husband Erik and continued on with their work after his death in 1994. In 1997, Joan added a new chapter on the ninth stage of development, “very old age”. Joan Erikson wrote of the challenges faced by people in their eighties and nineties, such as autonomy over life choices and one’s own body, and discusses faith, hope and wisdom in very old age.
Erik Erikson collaborated with his wife Joan throughout their lives. Erik noted that he could not remember what parts of his theory were from him and which were from Joan. When they were in their eighties, they realized that eight stages were not enough, and conducted interviews of the very old.
Erik passed away in 1994, and Joan published the ninth stage based on Erik's notes and her own work. The ninth stage can be characterized as "trust vs. mistrust" - the same stage encountered in infancy! These questions of trust revolve around your physical world and body - do you trust that your leg will still work today? Your heart? Do you trust that your caretakers will treat you well? Despair and resentment are very easy to fall into in this stage.
Gerotranscendence is a theory developed by Lars Tornstam, a Swedish sociologist. He describes it as "a shift in meta perspective, from a materialistic and rational view of the world to a more cosmic and transcendent one, normally accompanied by an increase in life satisfaction." He uses Erikson as a starting point, and considers gerotranscendence - if achieved - to be the final stage of developing towards wisdom. In his view, a frail 89-year-old who is withdrawing from activities and socialization isn't deteriorating - she is evolving.
Take, for instance, the apparent tendency of some elderly people to confuse the past and present. “People sometimes describe their perspective on time changing,” Dr. Tornstam said. “They feel they can be children, middle-aged and old at the same time.” If an 80-year-old describes this sensation to a contemporary neurologist, the doctor might jot in his notes that the patient seems improperly oriented in time and place.
But Dr. Tornstam describes the characteristic as “a transcendence of the borders of time” and argues that old people who experience these changes (including greater spontaneity and playfulness, less self-absorption, and feelings of “cosmic transcendence”) take greater satisfaction in their lives.
(from an excellent NY Times article linked here, about Tornstam - Tornstam has also written a concise description of his theory, linked here)
I find this fascinating. Joan Erikson describes an almost complete regression at the end of life, and Tornstam describes an ascension - and they're keying off the same symptoms. Tornstam cautions caregivers to not treat their clients as victims of aging, though he does distinguish 'gerotranscendence' from dementia. He is saying, do not pathologize - be in awe of these people.
I really enjoyed reading your blog this week. I have worked with a lot of long-term care residents, many of them very old . While working with the very old above eighties up to 104 years old and I have often wondered what was really going on in their minds. Some of them will tell you exactly what is on their mind, some have dementia and if blessed are pleasantly confuse, others don't respond much and those are the ones I wonder about most. Many very old people will respond to touch and sound and are often sleeping but some just watch and listen and are in their own little world it seems.
ReplyDeleteIt think the Erickson's may have been describing the 9th stage more in terms of physical adaptations and being unable to care for themselves anymore, trusting others to care for them, definitely a physical regression.
Tornstam's ascention is genius. What a cool way to look at those final days. I always thought it so sad that people work hard all of their lives to attain material possessions and in their final days all they have left are some clothes and a few nick-knacks at their bedside table. When you talked about Tornstam's gerotrancendance and the evolving of the final stage it made a lot of sense to me, a peaceful happiness of a life well-lived would be a great way to go out. Thanks for sharing.
Thank you so much, Marci! And thank you for your perspective on it. It seems like gerotranscendence is not a theory with broad acceptance, and I can see how it might sound like wishful thinking. But when we evaluate the very-old, it's about the ways they couldn't fit into a modern, rational, productive society. Isn't it showing our prejudice to say that OUR way of doing things should be the standard to judge people against?
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