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Aging, Chronic Illness, Stress , End-of-Life Care, Hospice , Soul Injury, Moral Injury

Aging: A Soul → to Sole → to Soul Journey

by Deborah Grassman
“It takes a lot of courage to grow old,” my 90-year-old mother said the last few decades of her life. “Aging is not for sissies,” I’ve heard others say. Indeed, it is so. Rather than cultivating courage, however, we often resist aging – even deny its personal existence.
Could it be possible that aging might have something that we need? What are we missing by not valuing aging? Are we too arrogant or too controlling to think that aging might have something to teach us? Why would we want to be anything other than who we are (which includes the age that we are)?
Conceptually, I describe aging as a Soul → to Sole → to Soul journey. Our soul is born into this world to embark upon what psychologists call an “individuation process,” which manifests as the unique individual that we are. As we age, we complete the tasks of individuation; we start letting go of our sole self and gradually start opening up to our soul self.
The Soul-Sole-Soul process is described much more scientifically in healthcare literature, most notably by Erik Erikson (1,2). Most healthcare professionals have studied Erikson’s developmental tasks for aging. He says that there are maturational crises or critical decision points that require attention and mastery in order for successful aging to occur. They are:
· 0-18 months:Trust vs. Mistrust
· 18 months-3 years: Autonomy vs. Shame
· 3-5 years of age: Initiative vs. Guilt
· 6-12 years old: Industry vs. Inferiority
· 12-18 years old: Identity vs. Role confusion
· 18-35 years old: Intimacy/solidarity vs. Isolation
· Middle age: 35-55: Generativity vs. Self absorption or Stagnation
· Older age:55+: Ego Integrity vs. Despair
It is the last two categories (middle and older ages) that are surrounded with fear and ignorance. Healthcare providers working in pediatrics are well versed in the first five categories. Programs designed for toddlers are vastly different than those designed for school-age children. But something happens after adulthood is reached. The developmental tasks seem to fade from healthcare providers’ practices. At best, the general principles of Erikson are known by clinicians, but most geriatric programs evidently don’t take the principles seriously because the concepts are often ignored. For example, Erikson writes about the value of helping elderly people face the fear of death so that they can gain “ego integrity.” Contemplating death and “the meaning of life” can bring fuel for the soul, expanding consciousness as elderly people face numerous challenges in their lives. Yet, geriatric centers and healthcare facilities seldom have classes on aging and dying; instead, classes focus on fitness, clubs, games, and interests from the past. These are important activities, but the topic of aging and death is also important. Yet, it is seldom broached, much less discussed and contemplated. Personally, I think we miss a lot when this “let’s don’t talk about dying” approach is taken, and in some ways, it’s even more than that. To not have programs that integrate death contemplation and exit strategies could be considered a form of abandonment since research and developmental models (like Erikson’s) demonstrate the value.
I cite my mother’s experience living in an Adult Living Facility (ALF). The ALF staff took good care of Mom. She was bathed twice a week, had numerous activities to choose from, and ate good food in a beautiful dining room. She seldom complained about the many ills she had but rather focused on the gratitude she felt for her many blessings. Over the last six months of her life, I noted that she was sleeping more, losing interest in participating in activities, eating poorly, incontinent, and losing weight. She was treated for depression with no change; I surmised that she probably had a cancer, which later turned out to be the case. The ALF staff had a different idea. They called her doctor and got an order for physical therapy.
“I don’t want to go,” Mom told me.
“It’s your life Mom. If you don’t want to go, tell them ‘no’.” Mom worried about staff getting mad at her if she didn’t go and so she went.
One day, I entered Mom’s room unbeknownst to her or the Physical Therapist. I stood at the doorway witnessing their conversation.
“I’m too tired to go,” Mom complained to him.
“You’re not going to get stronger if you don’t get out of that bed,” the therapist said nicely.
“But I don’t care if I get stronger. I just want to sleep,” Mom argued.
“You can sleep after you do your exercises,” he countered.
I intervened to protect my mother’s interests. “It’s okay,” I told the therapist. “Mom is nearing the end of her life. She doesn’t need therapy. If she wants to sleep, let her sleep. We’re in a mode now of just respecting what she wants.” Then I turned to Mom, “Mom, you don’t have to do anything that you don’t want to do.”
“I keep telling them that, but they don’t listen,” she said.
Her therapy didn’t stop until I called Medicare myself and told them not to pay for it.
I don’t want to imply that the staff were insensitive or incompetent. Their intentions were good. They typify the current geriatric culture with its exclusive focus on rehab and activities. It seems odd that helping people confront death and reckon with its unseemly ramifications is commonly excluded within geriatric communities. Rather than having programs that help people reckon with their approaching death, the focus is on distracting them from death, pretending that death isn’t happening. For example, I always enjoyed sitting on the front porch in the rocking chairs with the residents at my mother’s ALF.
Mom and I are on rocking on the porch swing. “You remember Florence?” Mom asked me.
Yes, I had spoken with her many times in the hallways and dining room.
“She went to the hospital and never came back. I asked what happened to her and the nurse said they’re not allowed to talk to us about other patients. We didn’t find out that she died until we saw her obituary in the paper.”
I could only sigh with my mother at the disrespect that she felt — not only for Florence, but for her own needs to know, honor, and grieve.
Another resident sitting nearby chimed in: “When you die, there’s no public acknowledgment,” he said mater-of-factly. “We’ve been living together and helping each other for years, and one of us dies, and everything goes on as if nothing happened.”
Even the deterioration of aging is squelched. One resident told me how anytime they try to talk about how bad they feel or how hard it is to get through the day, that the staff try to cheer them up and talk them out of their difficulties. “They don’t want to hear us complain.”
I’m thankful that Mom and I had many talks about her death on that porch. She told me about a few things she wanted to do before she died, and we were able to accomplish those. We planned her funeral and I reassured her that her body would be flown back to Indiana and buried with my father. However, even these meaningful conversations were discouraged. Overhearing us, a nurse said, “Don’t be talking like that. You’re going to live another 10 years.”
“Oh, I hope not!” Mom laughed. “Ninety years is long enough!”
Opus Peace focuses on aging and transitions – not by fearing or denying it. We also don’t take the other extreme: ie., looking at aging and dying by only focusing on the positive virtues of aging. Rather, Opus Peace seeks to cultivate honesty, courage, and humility to navigate the later years because these years can be difficult! Let’s look at middle age first.
Middle Age invites us to summon the courage to stop clinging to who we were and open up to who we are. Then, we no longer cling to fame or fortune or the appearance of youth. We are transformed by relinquishing the old ego attachments and affirming our deepening descent into the mystery of the soul. We move from sole to soul and gain our freedom. This is not an easy process. It is normal to feel distress as we age with the undoing of all we have labored to secure. That’s why aging is not for SISSIES!
There is a saying in Hospice: “Those who grieve well, heal well.” This is a paradoxical truth that initially seems counterintuitive. But, grief is the normal, natural emotion that accompanies loss and change. Grief allows us to let go so we can move forward rather than “stagnate” as Erikson called it. So grief is not a destructive process as many think. In fact, it’s just the opposite: it’s a creative process that allows us to be re-formed and opened to something new that will better fit the changing circumstances. So, healthy aging during the middle years usually involves getting honest with the losses we are experiencing and allowing ourselves to humbly grieve the changes so we can open up to who we are becoming rather than clinging to who we used to be.
Older age (55+ according to Erikson) means that the horizon is no longer obscure. Bodily reminders start creeping in to remind us of our destiny. Ultimately, INTEGRITY means getting honest about the reality of approaching death. No matter how much we medically advance technologically, death is still a mystery and good travelers are able to open up to the uncertainty of it with a growing wisdom that the world is broad and doesn’t revolve around us. We start accepting death as the completion of life. Despair, on the other hand, is more narrowly focused around fear of the past (“Was the trip here on Earth worth it?” or “I wish I would have done ______ {regret}) or the future (“What is going to happen to my loved ones after I go” or “I don’t want to let go of what I know to go into the uncertainty of the “great beyond.”) Narrow focus can also be disguised as rather arrogantly denying existing fears or covering them over by pretending that there’s no uncertainty in death. Running or hiding from our fear of death can lead to despair. I have seen it many times in the 10,000 people that I’ve been with as they’ve faced death. At the same time, I will tell you that most of these people were able to reckon with their fears by allowing death to humble them. As one patient told me: “Now, while I’m dying, is no time to be lying to myself.” I applauded his wisdom. And in the space of just a few short days, he mounted the courage to open up to the peace that awaited him beyond his fears.
Carl Jung said that the pain of aging is with those who “content themselves with inadequate or wrong answers to the questions of life.” Aging wisely means asking ourselves tough questions that require non-superficial answers. If we’re honest with ourselves, we discover that much of our thinking and frustration centers on clinging to who we used to be. The questions we ask ourselves are:
· Which facelift surgeon should I use?
· How many pounds can I bench press?
· How can I maintain power and authority?
· What love-object do I need to find?
· How can I stay fixated on what I used to be?
Jung would want us to ask questions that can only be answered beyond our ego-self:
· What HONESTLY empowers me (job, status, muscles, boobs, trophy wife, etc.)?
· What happens when erotic success or social status no longer count?
· Why am I ashamed of the age I am, realizing that it is part of who I am?
· Why have I let commercials brainwash and control how I feel about myself?
· Am I willing to regain my NOW life (which includes the age I am NOW)?
The truth is we have allowed modern advertising to dictate who we are rather than allowing our own imprinted destiny to unfold with grace and dignity. Viktor Frankl puts it this way: “Today’s society is characterized by achievement orientation, and consequently it adores people who are successful and happy and, in particular, it adores the young.” (3)
We allow money and temporary materialism to take us away from the eternal. This leads to ignoring our soul. We cover it up so we can “Buy our product so you don’t have to be you.” This is an archetypal form of prostitution: we sell our current-aged self and buy a younger version of ourselves, losing ourselves in the process. When we stop being unfaithful to ourselves, then we can allow the natural urge to age unfold. This produces luminosity and liberation.
If aging is so fearful that we have to deny it, then it has a lot of power over us. Paradoxically, we then miss the very gift that aging brings; we are robbed of our own Self. In our western culture, the premise is that materialism, narcissism, hedonism will make us happy, yet, it leads to emotional/spiritual bankruptcy. In a society that is afraid of loss, aging and death will appear as the enemy to be conquered. Aging is viewed as a poison that we’re forced to drink. The question then becomes: Is it possible that if aging is a poison, that it might be a healing poison?
In my Aging workshops, I often have participants meet their Interior Elder. I even have their Elder write them a letter. Here’s the letter my Elder wrote me:
Dear Deborah,
I first met you 61 years ago. I was so far away that you could barely see me, yet I was in every beat of that tiny little heart that so bravely decided to come into this world to meet me.
You are no longer so far away. As I have called your name with the lub-dub of each heart beat, you have drawn closer. You sit at my knees now. I long to gaze fully into your eyes, but sometimes you turn your gaze away from my loving arms that await your return to my bosom – a buxom bosom that yearns to hold you and suckle you with breasts filled with the milk of life.
Each day, you are looking more and more like me. You don’t like that do you? You are ashamed of me. You didn’t think I knew that did you? Well, I do, and it hurts each time you hide me or curse me when you look in the mirror or groan with the ache in your bones. Deborah, I am the destiny you were born to fulfill. Do not be afraid of me. Do not be ashamed of me. Every time you say you are “lucky” that you don’t have gray hair, you are turning me away. Whether you know it or not, you need me, and when I come to the hairs of your very head, I hope you won’t cover me up or color me away, but that you will REJOICE and wear me proudly. If you will do that, I can hold you even more tenderly than I already am. Yes, you do have wrinkles. This should be no surprise to you. Yet, you act surprised to see them each and every day. When you pull the loose skin up from the sides of your face to erase the grooves I’ve so lovingly placed there, you make me feel very sad. Not for me, but for you. You see, Deborah, you lose your power when you do that. Yes. You are running away from the very thing that gives you strength and wisdom.
Deborah, it was I who carried you through treacherous days. It was I who suckled you at my breast during the night and gave you dreams to guide your way back home. Deborah, it was I who stood strong by your heart to assure that it would not become crusted over with bitterness.
You are about to launch Opus Peace to help bring peace to the Soul of this broken world. Deborah, I have a secret to tell you about that. You are not going to be its CEO… I AM! So, call on me when you are scared, weary, or feint of heart.
Welcome home! It’s about time that you finally acknowledged me as your roommate.
With love,
Your Soul’s Crone
Footnotes:
1. Erikson, E. H. (1959). Identity and the life cycle: Selected papers. Psychological Issues
2. Erikson, E. H., & Erikson, J. M. (1998). The life cycle completed (extended version). WW Norton & Company.
3. Frankl, V. (1988). The Will to Meaning. NY: Penguin Books.

Other concepts about aging like this one are in Deborah Grassman’s book, The Hero Within: Redeeming the Destiny We Were Born to Fulfill.