Beyond Halfway

The Reluctant Caregiver and Agape

Posted on March 30, 2013 by Bob Ritzema

Picture courtesy of imagerymajestic/freedigitalphotos.net

Several weeks ago, Paula Span of the New Old Age blog wrote about “The Reluctant Caregiver.” She’s referring to someone who is providing care for someone in need of help but provides the care grudgingly rather than willingly. She cites the example of “Mrs. A,” who provides assistance for her mother-in-law. Mrs A “doesn’t have much affection for this increasingly frail 90something or enjoy her company; her efforts bring no emotional reward.” Her mother-in-law expresses gratitude, but that only makes Mrs. A feel guilty. She feels ashamed when she compares herself to other adult children who willingly provide care. She continues to help out of a sense of obligation.

I became one of my father’s caregivers last year, joining the ranks of thousands who help an elderly relative or friend. I wasn’t hesitant to take on that role, since my dad and I have always had a close relationship. In my work as a psychologist, though, I have provided therapy to many reluctant caregivers. Reluctant caregivers are conflicted, having both reasons to pull back but also reasons to help. Here are what I consider the types of reluctant caregivers—often a reluctant caregiver falls in multiple categories:

The Injured Caregiver, who bears wounds inflicted by the needy elder. The injury may have ended many decades ago, or it may be continuing into the present.
The Resentful Caregiver, who bears a grudge against the needy elder, usually due to some conflict.
The Misunderstood Caregiver, who helps the best he or she can but whose efforts or intentions are misconstrued by the needy elder.
The Discouraged Caregiver, who yearns for a closer relationship with the needy elder but is saddened because such a relationship seems unavailable.
The Detached Caregiver, who neither has nor wants a close relationship with the needy elder.
The Guilty Caregiver, who is helping out of a sense of obligation and feels that her or his efforts are never sufficient
The Overwhelmed Caregiver, whose willingness to help is compromised by the stress of other obligations.
The Used Caregiver, who perceives other family members as having dumped the needs of the elder on him or her.

Span thinks that the reluctant caregiver deserves credit for persisting at the hard work of caregiving despite not getting much back in terms of warmth, closeness, or appreciation. She cites the advice of a geriatric social worker who advises such caregivers to sign up early for community services that could lighten the load and to join support groups. Of course, there may not be a group of like-minded caregivers available, so talking to anyone who is sympathetic or supportive can help. Pastoral care is often useful, and psychotherapy is advisable if the relationship with the needy elder brings up significant unresolved emotional issues. It’s also important for reluctant caregivers to set boundaries to keep from being emotionally damaged or used while they are in the helping role.

Reluctant caregivers often experience guilt because they don’t feel toward the needy elder as they think they should. They don’t have either what the ancient Greeks called storge (affectionate or family love) or phila (the love between friends). However, the Greeks also had another term for love, agape, a sacrificial love based not on feelings but on commitment to the welfare of the other. Christ and his followers regarded this as the highest form of love. In seeing the elder’s needs and helping despite the lack of rewards and often at considerable personal cost, reluctant caregivers can be bearers of agape love. That’s nothing to be ashamed of!

Posted in Psyche, Relationships, Uncategorized | Tagged agape, aging, caregiving, older adults, parents, relationships | Leave a comment

Depression in Older Adults: Symptoms

Posted on March 27, 2013 by Bob Ritzema

Sally was feeling sad. This wasn’t a new experience for her; depression had been a frequent visitor throughout life. Having grown up with an alcoholic, physically abusive father and a mother who provided little care and blamed her for the family turmoil, she had little basis for positive feelings about herself. Her mother had spent weeks doing little more than lie on the couch; years later, Sally realized her mother had been depressed. Sally had had some successes in life—a career as a nurse and several long-lasting friendships, for example—but she also had some major disappointments, such as two failed marriages and chronic financial problems. She struggled with self-blame and thoughts of herself as a failure. Medication had been helpful, as had therapy. Now age 70, Sally had done well for a number of years. However, she felt a loss of meaning in her life when she retired last year, and felt more lonely after her brother, her only sibling, died and she moved away from friends. Her mood gradually got worse, she lacked energy, and her appetite diminished. She was even thinking that death might be welcome. She recognized that she was slipping back into depression.

I recently was asked to write an article on depression in older adults for a local paper. I’m going to post exerpts from that article here. The first is on the nature of depression in the elderly.

Here’s a good thing about depression in the elderly: Most older adults never develop clinically significant depression. In fact, depression is less frequent in the elderly than in the general population.

Here are some bad things about depression in the elderly: depressive symptoms (just not full-fledged cases) are more common, rates are elevated in some groups of elderly, and depression often goes unrecognized in late life.

As many as 20% of elderly people experience depression at some point. Rates among those living in the community are relatively low—anywhere from 1 to 5 percent. Rates increase to 10-15 percent among community residents needing assistance in living, and are as high as 30 percent among those confined to nursing homes.

Symptoms of depression can include feelings of sadness, lack of energy, decreased interest in things that would normally spark interest, weight loss or loss of appetite, sleep difficulties, withdrawal from others, feelings of worthlessness, preoccupation with death, or suicidal thoughts. More so than younger individuals who are depressed, the depressed elderly may have problems with confusion or impaired memory. Additional features common in the elderly can include increased physical complaints, deterioration in hygiene, irritability, and hopelessness. A person with several of these characteristics may well be depressed even if he or she denies feelings of sadness.

Sometimes it is difficult for physicians or mental health providers to diagnose depression because certain behaviors can be either signs of depression or signs of normal aging—for example, feelings of detachment, loss of interest in some activities, or a decrease in social involvement are characteristic of both. It is also difficult to distinguish depression from other medical conditions. Are increased somatic complaints due to depression or actual illness? Are problems with memory, concentration, and sleep due to depression or to early signs of dementia? It’s important to consult someone with expertise in the mental health problems of the elderly to make the dianosis.

I’ll post next week on causes of depression in older adults.

Posted in Psyche | Tagged aging, depression, elderly, older adults | 2 Comments

“I Am Enjoying Dying”

Posted on March 23, 2013 by Bob Ritzema

Gordon Cosby, by Kevin Clark/The Washington Post

I recently read a eulogy of Gordon Cosby, founder of Washington D.C.’s Church of the Savior, by Jim Wallis. Cosby died Wednesday at age 94. I was struck by something Cosby recently said to Wallis: “I am enjoying dying.” What did he mean by that? How could anyone enjoy dying?

I knew a little about the ministries that the Church of the Savior had sponsored, but wasn’t aware of how extensive their activities were. Cosby and his church were certainly active. What was particularly interesting, though, was Wallis’ account of what Cosby hadn’t done:

“Gordon Cosby never needed or wanted to be out front or become a famous public figure. He could have spoken across the country, and was often invited to do so. But he instead decided that his own vocation was to stay with a relatively small group of people trying to “be the church” in Washington, D.C.: the Church of the Savior, which has produced more missions and ministries, especially with the poor, than any church I know of anywhere in the country — even the huge mega-churches who capture all the fame. He never wrote a book, went on television, talked to presidents, planted more churches, built national movements, or traveled around the world. He just inspired everybody else to do all those things and much more.”

So perhaps he was able to say that he was enjoying dying because he had been dying all along—dying to fame, to success, to self-aggrandizement. That’s pretty much what Cosby told Amy Frykholm of Christian Century that all followers of Christ should do:

“We must die to our own egos and open up to a new reality. That new being is what Christ was after. He wanted me to be a new being. He wanted the old self, the old ego, to die. God wants all of us to move into that new being of love for which we were created. Therefore, personally, I should be moving into love and embodying love. Not just doing loving things, but becoming love. That’s what it means to surrender, to give one’s life to God—who is love—to the one who planted the seed of His/Her own being in our deepest being.”

The distinction between doing loving things and becoming love seems important when it comes to death. If what I’m all about is doing loving things, I’d be interested in staying alive so that I can do more good (and perhaps also feel proud of myself for what I did). If I’m becoming love, though, I’m giving up my life, my plans, everything, for the sake of love. Wouldn’t it be wonderful to, like Cosby, reach the end of life enjoying dying—enjoying surrendering yourself to God and His love?

Posted in Death, Spirit | Tagged aging, Christ, Christianity, Church of the Savior, death, dying, Gordon Cosby, love | 10 Comments

Posted on March 21, 2013 by Bob Ritzema

Here is a beautiful piece by Harold Knight on J.S. Bach, inviting our souls, and why some music can best be played by the old.

Me, senescent

On March 21 nearly every year I give my students a quiz of one question. “Why is today the most important day of the year?”

Almost never does a student pass the quiz.

And I’ll bet I’m safe in assuming that almost no one who might be reading this today can guess why this is the most important day of the year.

It’s obvious.

Today is the 328th anniversary of the birth of Johann Sebastian Bach.

But for the birth of J. S. Bach, music would not exist as we know it.

Music purists and historians and better-musicologists-than-I can (and may) dispute that assertion. Of course it’s not true. Or is it? The harmonies, the contrapuntal designs, the musical forms both great and small perfected by J. S. Bach are the touchstone for all of music since 1685. The Beatles, Beyonce, John Cage, Madonna, Arthur Sullivan, and Arnold Schönberg notwithstanding.

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Posted in Spirit | Tagged aging, Bach, music, organ music, Whitman | 2 Comments

The Day of Darkness: Bring in the Candles

Posted on March 19, 2013 by Bob Ritzema

On May 19, 1780, the sky over New England turned dark during what should have been daylight hours. The darkness was observed as far south as New Jersey and as far north as Portland, Maine. It took several hours for the gloom to pass; in many places it persisted until night. Candles were needed to conduct normal activities. According to the Wikipedia account, the darkness is thought to have been the result of forest fires, fog, and cloud cover. Many people thought the world was ending.

Abraham Davenport

In Connecticut, a member of the legislature, Abraham Davenport, became famous for his response to his colleagues’ fears that the Day of Judgment had arrived. When they proposed adjourning the legislature, Davenport answered as follows:

“I am against adjournment. The day of judgment is either approaching, or it is not. If it is not, there is no cause for adjournment; if it is, I choose to be found doing my duty. I wish therefore that candles may be brought.”

Davenport’s response can be taken as inspiration for all of us to persist despite obstacles. I also take the Day of Darkness as a metaphor for the decline that we will all face if we live long enough. There will be a time when sight darkens, hearing fades, and limbs weaken. We will have difficulty doing what we have always been accustomed to do, and will increasingly need assistance. Should we give up, choosing to adjourn from what we had hoped to accomplish? Not if there are candles—external aids—available! I see my 87-year-old mother as someone who persists at what she feels called to do—manage her household and provide care for my dad as his mental abilities worsen—despite significant health issues. I hope that in my own Day of Darkness, I’ll have the same courage as both she and Abraham Davenport, doing what I believe I should be doing as best I can.

Posted in Body, Spirit | Tagged Abraham Davenport, aging, Connecticut history, Day of Darkness, persistence, purpose | Leave a comment

What Matters Most to Assisted Living Residents

Posted on March 13, 2013 by Bob Ritzema

The National Center for Assisted Living reports that the average age of individuals in assisted living facilities in the US is 86.9 years. The average length of stay is about 28 months. Martin Bayne is an exception to the typical assisted living patient, both because of his age (he’s only 63), and, most remarkably, because of the time he has spent in assisted living. Bayne, whose movements are severely limited by early-onset Parkinson’s Disease, recently completed his 10th year in an assisted living facility.

Martin Bayne

According to an article by ChangingAging.org editor Kevan Peterson, Bayne has recently been reflecting on what matters most for residents of assisted living facilities. For him, it isn’t the reputation of the facility, the dedication of the staff, or the excellence of the programs. What matters most is whether residents find a purpose for their lives. As he put it in a phone conversation with Peterson, “Without purpose, nothing gets done, everything stays the same. People don’t move, they don’t have new ideas, they don’t grow and eventually they just give up and die.”

Bayne’s point was made decades earlier by another observer of people living in institutions. Victor Frankl wrote about his experiences in a German concentration camp during World War II. He observed that the key factor determining whether prisoners survived was whether they had a reason to struggle for survival, some purpose outside themselves giving meaning to their lives. Though concentration camps and assisted living facilities are vastly different institutions, both are highly structured systems that exert control over their residents. It is easy to see how each could sap the will to live of those inhabiting them. Though all humans wither in the absence of purpose, the withering may be especially rapid and severe in residents of tightly organized institutions.

Bayne thinks that one of the things that assisted living facilities do that interferes with a sense of purpose is that they encourage selfishness among the residents. Specifically, the focus is on entertaining residents, not on challenging them. He told Peterson, “We put people here and give them no responsibilities an [sic] that is a big mistake. It leads people to only think of themselves.” Bayne wants residents to be interested in the welfare of the community they are a part of, not just in their own comfort. He suggests the way to foster this change is to expose residents to “incremental compassion.”

I looked at Bayne’s blog for more information about incremental compassion, but didn’t find anything. I like the idea of it, though. I suspect that he’s referring to experiences that would evoke feelings of compassion for others. The Eden Alternative, which changes the culture of nursing homes to reduce loneliness, helplessness, and boredom, does this in part by providing “close and continuing contact with plants, animals, and children.” Some assisted living residents have a sense of purpose having to do with family, friends, or community. It can be as simple as praying for a troubled grandchild or sending birthday cards to friends. For those who haven’t found a purpose via such connections, though, watering a plant or feeding a puppy may be sufficient motivation to redirect attention from self to the world outside one’s skin. It can be reason enough to look forward to the next day.

Posted in Culture, Psyche | Tagged aging, assisted living, compassion, Martin Bayne, meaning, purpose | Leave a comment

Boomer Health

Posted on March 6, 2013 by Bob Ritzema

A recent segment on National Public Radio describes the poor health of the Baby Boomer generation. Boomers were born between 1946 and 1964, so they are now in their late 40s to mid-60s. A group of researchers led by Dana King, a physician and chairperson of the Department of Family Practice at West Virginia University, compared the health of boomers with the health of similarly aged individuals two decades ago (data came from the National Health and Nutrition Examination Survey). The stereotype of Boomers is that they are active and fit, and the researchers’ comparison did identify some areas in which Boomers were more healthy than the earlier cohort—they are less likely to smoke, get emphysema, or have heart attacks. In many ways, though, Boomer health is poorer. They are more likely to have high blood pressure or diabetes. They are more likely to be obese or have a disability. According to King, “Only 13 percent of people said they were in excellent health compared with 33 percent a generation ago, and twice as many said they were in poor health.” This is quite a change from 20 years earlier. Perhaps part of the difference comes from Boomers having higher standards for what constitutes excellent health. Still it is surprising that about seven out of eight Boomers don’t think their health is excellent.

Obesity appears to be an important factor in Boomers’ poor health, contributing as it does to diabetes, high blood pressure, heart disease, and the joint problems that can impair mobility. So, why are Boomers more likely than the previous generation to be obese? External factors such as our toxic food environment play a role. Soft drinks and fast foods are heavily marketed, and the prices of sugar, sweets, and carbonated drinks have declined relative to the prices of healthier foods such as fruits and vegetables. Though fast food restaurants predated the birth of the first Boomer, the industry grew along with us, and I suspect we are more inclined to go through the drive-thru to pick up a tasty but fat- and calorie-laden meal than were members of the generation that preceded us.

Boomers (my sister and brother-in-law) exercising.

Exercise (or lack thereof) also plays a role in both obesity and poor health. It turns out that boomers are doing a dismal job of getting to the gym. According to King, “About half of people 20 years ago said they exercised regularly, which meant three times a week, and that rate now is only about 18 percent.” What’s responsible for the huge decline? The title of the NPR segment suggests that not taking care of our health is an act of Boomer rebellion, but that’s hard to believe. Who would we be rebelling against by becoming couch potatoes? Perhaps a more likely explanation is how we define ourselves. Thinking of ourselves as athletic, energetic, and perpetually young, we may take such qualities so much for granted that we don’t see the need of actually doing things that would maintain our fitness and vitality. It’s similar to our attitude towards savings; we’ve been told that collectively we are the most asset-rich generation in history, so many of us have decided that, being proclaimed wealthy, we don’t have to bother with actually saving for retirement.

In my psychological practice, not many clients initially come to therapy primarily to address concerns about health. They are usually more focused on emotional or interpersonal problems. Physical, emotional, and relational health are all intertwined, though, so I’m sensitive to the person’s health status and habits. We often focus on improving these. Though I’m not a physician, nurse, or dietitian, I have something to contribute to helping people meet health goals. Physicians are good at telling people how they should eat or how much they should exercise, but usually don’t know how to motivate people to make needed changes. Psychologists are experts in behavioral change, though, and thus are good at helping people stop activities that harm health and start activities that enhance it. Psychologists are also aware of how easy it is to relapse, and offer help in overcoming the discouragement and hopelessness that lapsed dieters and exercisers often experience. Even we Boomers can be healthier if given a little help!

Posted in Body, Psyche | Tagged aging, baby boomers, exercise, health | Leave a comment

Looking Ahead

Posted on February 26, 2013 by Bob Ritzema

Middle age tends to be a time of focusing not only on oneself and, if married, one’s mate, but also attending to maturing children and aging parents. Those generations—one on ahead, the other trailing—not only are sources of concern and joy, but also serve as reflections of the self. More than others in their age cohort, they prompt us to think of who we were and who we will be.

In a recent post in the Opinionator site at the New York Times, cartoonist and essayist Tim Kreider, age 45, writes of his mother’s plan to enter a retirement community. He is troubled not only by the immediate effects this move will have, but by what it intimates for his future. The emotion that her decision provokes in him is sadness.

Kreider is sad, first of all, because her move from the family homestead means for him the end of one of the great constancies in his life. His parents purchased their house 37 years ago, making it the place he has viewed as home for nearly all of his remembered life. He describes its meaning as follows:

“However infrequently I go there, it is the place on earth that feels like home to me, the place I’ll always have to go back to in case adulthood falls through. I hadn’t realized, until I was forcibly divested of it, that I’d been harboring the idea that someday, when this whole crazy adventure was over, I would at some point be nine again, sitting around the dinner table with Mom and Dad and my sister.”

My family homestead.

My parents have lived in the same house since 1956. I can remember our family living elsewhere, but only dimly. I spend most of my time in their house now; I’m writing this in their family room. My presence enables them to remain for a little longer, but I know that their time of possessing this place—this house on the hill that I have been coming home to ever since elementary school–is nearing an end. I fully understand Kreider’s sense that losing the place one has always thought of as home produces feelings of rootlessness and dispossession.Kreider also takes his mother’s move as a foreshadowing of her—and his—eventual death. He laments the segregation of the elderly from the rest of us, largely because providing separate living facilities for them creates for us an illusionary world in which senescence doesn’t exist.

“Segregating the old and the sick enables a fantasy, as baseless as the fantasy of capitalism’s endless expansion, of youth and health as eternal, in which old age can seem to be an inexplicably bad lifestyle choice, like eating junk food or buying a minivan, that you can avoid if you’re well-educated or hip enough. So that when through absolutely no fault of your own your eyesight begins to blur and you can no longer eat whatever you want without consequence and the hangovers start lasting for days, you feel somehow ripped off, lied to.”

Kreider shudders not only at the indignities of aging and its accompanying maladies, but at the indignity of life ending. For him, the loss of control that occurs as health departs and death approaches is particularly frightening:

“Another illusion we can’t seem to relinquish, partly because large and moneyed industries thrive on sustaining it, is that with enough money and information we’ll be able to control how we age and die. But one of the main aspects of aging is the loss of control. Even people with the money to arrange to age in comfort can die in agony and indignity, gabbling like infants, forgetting their own children, sans everything. Death is a lot like birth (which people also gird themselves for with books and courses and experts) — everyone’s is different, some are relatively quick and painless and some are prolonged and traumatic, but they’re all pretty messy and unpleasant and there’s not a lot you can do to prepare yourself.”

But is there no way we can prepare ourselves? Isn’t our entire life in one sense preparation for decrepitude and death? As I described in my previous post, psychoanalytic theorist Erik Erikson saw our psychic life as a series of psychosocial stages or tasks; successful resolution of each stage helps prepare us to deal adaptively with the next stage. The final stage of life faces us with the dilemma of “ego integrity vs. despair.” Each of us reviews the course of our life; if it has been a meaningful one in which we have made lasting contributions to the welfare of others, we have prepared ourselves to have a sense of integrity even though we are descending progressively into the vortex of death.

A life of faith also serves as preparation for our last days. The loss of control is nothing new for those who trust that God’s providential care, not their effort, determines the most important life outcomes. Faith communities provide reminders of the inevitability of death in the form of rituals and sacred texts. Consider the imposition of ashes on Ash Wednesday, for example, or this passage from the Psalms:

“You turn us back to dust,
and say, ‘Turn back, you mortals.’
For a thousand years in your sight
are like yesterday when it is past,
or like a watch in the night.
You sweep them away; they are like a dream,
like grass that is renewed in the morning;
in the morning it flourishes and is renewed;
in the evening it fades and withers.
. . . .
“So teach us to count our days
That we may gain a wise heart.” (Psalm 90: 3-6. 12)

The unknown realm entered through the grave is not frightening to those who trust that God waits for them with open arms. We may not avoid deaths of “agony and indignity” that Kreider dreads. More importantly, though, we can avoid deaths of despair and terror. That’s worth remembering as we look to what lies ahead of us.

Posted in Psyche, Spirit | Tagged death, elderly parents | Leave a comment

Nursing Home Ratings

Posted on February 26, 2013 by Bob Ritzema

U.S. News and World Report recently released its ratings of nursing homes in the U.S. The ratings are based on data from the federal Center for Medicare and Medicaid Services and consist of an overall score plus scores in three areas: results of state-conducted health inspections, adequacy of staffing by nursing personnel, and performance on several quality measures that assess the health status of all Medicare or Medicaid recipients in the facility. Overall scores and scores in each area range from one to five stars. There are nearly 16,000 nursing homes in the U.S.; 3036 of them received an overall rating of five stars. The ratings, sorted by geographic region, can be found at this site. The scores have to do primarily with adequacy of the health care provided by the facilities. Though health care is essential, those looking for a nursing home for a family member may also want to consider such aspects of a facility as social climate, recreational activities, and emotional well being of residents. Still, the U.S. News ratings are a good place to start the research process.

Posted in Resources | Tagged nursing homes | Leave a comment

Dealing With the Regrets of Late Adulthood

Posted on February 20, 2013 by Bob Ritzema

As a psychologist who provides services for older adults, I’ve noticed that, though my older clients have a variety of reasons for seeking help, their underlying issues often coalesce around common themes. Specifically, those deeper issues often entail concerns over what they’ve done with their lives.

Here are a few reasons that clients have come for help, along with underlying issues that then emerged in the course of therapy (some details have been changed to protect confidentiality):

A woman in her late 70s sought help for depression evoked by a highly critical husband. An underlying issue was her disgust with herself for having spent over 40 years with someone who consistently tore her down.
A woman in her early 70s sought help for anxiety related to finances. She and her husband had built a successful business, but, after her husband’s death 15 years earlier, a son had mismanaged the business, and it failed. An underlying issue was whether it had made sense to spend her life building something that didn’t last.
A man in his mid 60s sought help for suicidal thoughts that occurred after years of being berated by a bullying boss. An underlying issue was dissatisfaction with having spent his whole life trying to please others who mistreated him, beginning with his irate, drunken father.
A man in his late 50s sought help for obsessions and compulsions centered on cleanliness and order. An underlying issue was that he had always wanted a lifelong, intimate relationship, but his desire for control over his surroundings had driven away prospective mates.

Erik Erikson

Though these people had each been coping for years with the problem they first described to me, what had changed for each of them was that they had become increasingly dissatisfied with how they had lived their lives. This in turn led all of them to be critical of themselves for not having lived differently. A psychological perspective that helps explain what had happened in each case is psychoanalyst Erik Erikson’s theory of psychosocial development. He proposed that a person’s sense of self and of his or her relationship to the social world develops through a series of eight stages. In each stage, events challenge the self in some way. There is a resulting conflict between developing some psychological characteristic (for example, a sense of trust) or failing to develop that characteristic (e.g., being mistrustful). In the last of these stages, occurring in late adulthood, the conflict is between ego integrity and despair. The person reflects back on the life he or she has lived and comes away either satisfied or dissatisfied with that life. If one feels content with decisions made and proud of accomplishments, there is a sense of integrity and wholeness. On the other hand, if one regrets what he or she has done or failed to do, there is emptiness and despair. Each of the clients mentioned above had some degree of this despair.

What’s to be done with the despair of late adulthood? No matter how much we may wish to, none of us can go back and take the road we passed by long ago. Dwelling on what might have been only intensifies the misery. Often, a change in perspective is needed. Here are some thoughts I’ve found could be helpful for those experiencing regret late in life:

Be aware that the best choice may seem clear now, but probably wasn’t clear at the time. It may be a cliché to say that hindsight is 20-20, but it is true. At one point, that marriage or business or career seemed rife with promise, and there probably was much to recommend it. Conversely, there may have been good reasons for avoiding what now seems to have been the better option.
Explore the positives that occurred as a result of the path chosen. Who benefited? What good thing wouldn’t have occurred had you chosen differently? The woman whose business failed was consoled when she realized that the business had both allowed her time to build a close relationship with her children and provided ample income for their educations.
Remember that each day provides a new opportunity to make more satisfying choices. I can’t do anything about having cowered before a bullying boss in years past, but I can learn how not to cower today, and perhaps can find a way to change or leave that and other destructive relationships.
Each day also is an opportunity to take care of myself rather than to berate myself. Rather than living in the past, I can put emphasis on what provides joy and comfort in the present—good friends, grandchildren, digging in the garden, reading a good book, a cup of soup on a cold day, a glass of lemonade on a hot one.
Think of how you would act toward someone else who made choices similar to yours. If you wouldn’t condemn them, it doesn’t make sense to condemn yourself. Be as compassionate toward yourself as you would be toward others.
Some bad outcomes or missed opportunities need to be grieved. Name the sadness and let yourself feel it. Recognize the loss as loss, but DON’T ruminate on what could have been done differently. Dwelling on what you think you should have done can keep you from completing the grieving process.
Focus not on ego but on spirit. Despair is a reaction of the ego to perceived inadequacies. “ I made bad decisions, I should have known better.” Life is about much more than building up one’s ego, though. We are spirit, and that spirit thrives when we surrender our ego to God, whose majesty dwarfs both our successes and our failures. Surrendering our ego to Him, we can recognize that He often brought good even out of our most wretched decisions. Even more, we recognize that we are enfolded in His love; from the shelter of His arms, neither accomplishments nor failings loom as large as they do from the perspective of our egos.

If you’re experiencing regret over how you’ve lived your life, consider how these points might apply to you. Often, facing regrets is the first step to making peace with them.

Posted in Psyche, Spirit | Tagged aging, despair, ego integrity, Erik Erikson, regret | 2 Comments