Dealing with the FInal Psychosocial Stages of Life

In my last post, I talked about stages and tasks of adulthood.

Today I am going to focus on the last part of life, beginning around age 65, with what has traditionally been retirement age.

The question is: Is this really a stage?  Erickson saw it to be so.  Jung talked about the last half of life--a much broader concept.

I will use two of Erickson's concepts; Generativity versus Stagnation and Ego Integrity versus Despair.

Generativity begins around age 45 and lasts until around age 65.  However, I would argue that one of the ways of having a successful retirement is to stretch this period into as late in life as possible.

I am going to borrow liberally here from the Verywellmind.com website

( https://www.verywellmind.com/generativity-versus-stagnation-2795734 )

What Are Generativity and Stagnation?

Generativity refers to "making your mark" on the world by caring for others as well as creating and accomplishing things that make the world a better place. Key characteristics of generativity include:

Making commitments to other people
Developing relationships with family
Mentoring others
Contributing to the next generation

Stagnation refers to the failure to find a way to contribute. These individuals may feel disconnected or uninvolved with their community and with society as a whole. Some characteristics of stagnation include:

Being self-centered
Failing to get involved with others
Not taking an interest in productivity
No efforts to improve the self
Placing one's concerns over above all else

Those who fail to attain this skill will feel unproductive and uninvolved in the world.

Benefits of Generativity
Better health
More positive relationships

Greater productivity (including mentoring, and volunteering)

Greater feeling of fulfillment

There is no reason that Generativity needs to stop at age 65, although the form it takes may change when we retire from our occupation.

I believe that there has been a major flaw with the way we have conceptualized retirement, at least among some parts of our society.  It has been seen as a prize, duriing which time we can lean back and take it easy.  For some people, the earlier retirement starts, the greater the prize.  However, many people discover that it is not so great a prize after all if they are not contributing.

The Concept of Being Plugged In

The concept of being :pluged in" refers to people needing something from us. That may not sound like an ideal retirement. However I feel that the definition of hell is for no one to need anything from us. I have two hobbies, jazz piano and painting. One of the problems with being a painter is that unless you're really good no one wants to buy your paintings or even hang them on their wall. In this particular age of our American society it is harder and harder for a professional artist to make a living because paintings are not sought after. It doesn't make any difference how good you are, if you cannot sell your paintings then it's not only hard to make a living but there is a lack of affirmation. One of the worst things for a painter to experience is to have 100 paintings stacked up in a back room.  Similarly I have a piano teacher. During the pandemic it has been hard for her to have an audience except online. For a musician not to have an audience is not to be plugged in. For an artist not to have a buyer is not to be plugged in. For a politician not to have an audience is not to be plugged in. But for the average of us to have a role to play we heed someone who needs us to play that function is to be plugged in, whether it is as a grandparent or a part time worker, or a mentor, or a volunteer. Now the dilemma of old age is that we need to be needed but not as much as we used to do it. There needs to be more rest--more time for recuperation. I have used this concept with my patients and I haveI found that it resonates with them. The ways that they used to be needed are not available to them anymore. The ways they used to contribute may not be supported by their level of physical or even their brain function anymore. But the need to be needed still is there.

Ego Integrity Versus Despair

Erickson talked about the last stage of life as Ego Integrity versus Despair

What Are Integrity and Despair?

Integrity refers to a person's ability to look back on their life with a sense of accomplishment and fulfillment. Characteristics of integrity include:

Acceptance
A sense of wholeness
Lack of regret
Feeling at peace
A sense of success
Feelings of wisdom and acceptance

Despair refers to looking back on life with feelings of regret, shame, or disappointment. Characteristics of despair include:

Bitterness
Regret
Ruminating over mistakes
Feeling that life was wasted
Feeling unproductive
Depression
Hopelessness

The integrity versus despair stage begins as the aging adult begins to tackle the problem of his or her mortality. The onset of this stage is often triggered by life events such as retirement, the loss of a spouse, the loss of friends and acquaintances, facing a terminal illness, and other changes to major roles in life.

During the integrity versus despair stage, people reflect back on the life they have lived and come away with either a sense of fulfillment from a life well lived or a sense of regret and despair over a life misspent.

Benefits of Integrity

There are a number of benefits to successfully achieving feelings of integrity at this stage of life. These benefits include:

Ego integrity: Successfully resolving the crisis at this stage leads to the development of what Erikson referred to as ego integrity.

Peace and fulfillment: People are able to look back at their life with a sense of contentment and face the end of life with a sense of wisdom and no regrets.

Wisdom: Erikson defined this wisdom as an "informed and detached concern with life itself even in the face of death itself."

Those who feel proud of their accomplishments will feel a sense of integrity. Successfully completing this phase means looking back with few regrets and a general feeling of satisfaction. These individuals will attain wisdom, even when confronting death.

Causes

There are a number of different factors that can influence the integrity versus despair stage of psychosocial development. Some factors that influence the outcome of this stage include:

Family: Having supportive relationships is an important aspect of the development of integrity and wisdom.

Work: People who feel a sense of pride in their work and accomplishments are more likely to experience feelings of fulfillment at this stage of life. 

Contributions: Those who reach this stage feeling that they have made valuable contributions to the world are more likely to achieve a sense of integrity. This often involves contributing to things that will outlast them through their children, friendships, mentorships, work, or community involvement.

Consequences of Despair

Despair can have serious consequences for a person's health and well-being as they face the end of life. Research suggests that ego integrity and despair are important life-space development indicators of well-being.3

Some of the consequences of despair include:

Increased depressive symptoms: Feelings of despair at this stage of life can be marked by feelings of low mood, hopelessness, sadness, and feelings of worthlessness, which are also symptoms of depression.

Increased regret: People who look back on their life with despair are more likely to ruminate over mistakes and feel regret for the life they have lived. 

Decreased life satisfaction: When people feel despair at this stage, they are also less likely to feel satisfied with their lives going forward. This can have an effect on their ability to cope with stress and decrease their resilience.3

Those who are unsuccessful during this phase will feel that their life has been wasted and will experience many regrets. The individual will be left with feelings of bitterness and despair.

How to Improve Integrity

This stage of psychosocial development often depends on many of the events that occurred during earlier periods of life. However, there are things that you can do to help develop a greater sense of ego integrity as you age.4

Start early: The things you do during middle age will play a role in your feelings about life as you age. Focus on doing things that will support your emotional wellness as you grow older, such as getting involved in your community and strengthening relationships to ensure you have a strong social support network.

Seek meaningful relationships: High-quality relationships with people you care about and who care about you are important. Focus on those relationships and work on making peace with relationships that may not be as strong.

Reframe your thinking: Rather than ruminating over regrets or wishing you can change the past, focus on reframing how you think about those events. For example, you might focus on what you learned from those experiences rather than dwelling on what you wish you could do differently.

Practice gratitude: Focus on the positive aspects of your life rather than paying excessive attention to the negative. 

If you find yourself experiencing a sense of despair as you age, there are steps that you can take to improve your well-being. Some of the steps you can take include:

Reach out to others: Focus on building social support. Discussing your feelings with friends and family can help, or look for new connections by participating in community groups or organizations.

Focus on the positive: Think about the memories and events that brought you feelings of pride and happiness.

Explore new experiences: Seek out activities that bring you pleasure and joy in the here-and-now.

Engage in spiritual practice: Find ways to explore your spirituality, which may help bring feelings of peace and well-being.

Get help: If you continue to struggle with feelings of despair, consider talking to your doctor or mental health professional. You may be experiencing symptoms of a condition such as depression or anxiety. Your doctor can recommend treatments that will help.

A Word From Verywell

According to Erikson's theory, individuals don't experience integrity or despair all the time. Instead, most healthy individuals experience a balance between each as they begin to make sense of their lives.

I would also add, if you are feeling a sense of despair, focus on what you did right in life, not what you did wrong or what went wrong.

Special issue:  Are older people more depressed?

Depression is less prevalent among older adults than among younger adults.  However, because of suicide it can have serious consequences.

Suicide rates in the elderly are declining, but they are still higher than in younger adults.

Depressed older adults are less likely to endorse affective symptoms and more likely to display cognitive changes, somatic symptoms, and loss of interest than are younger adults. 

What helps geriatric depression?  Research says: 

cognitive behavioral therapy

problem-solving therapy

brief psychodynamic therapyl

ife review/reminiscence therapy

group support