Purpose and Aging

I was looking at Paul Fink’s column in the April 2010 Clinical Psychiatry News, one of those newspaper format “journals” that we like to call “throwaway journals” because subscriptions are free and they summarize other journals, as they usually end up in the trash. He writes for other psychiatrists.  It is possible to identify with him if you do this for a living and are sentient enough to know what is going on around you.

I always liked this guy.  Older people have a lot to say when they have practiced long enough to see trends go up and down and know their fate.

If I remember correctly, he is the one who said a while ago something to the effect that psychiatry is like prostitution in that the amateurs think they know as much as the professionals.  Nobody has better nailed the central difficulty of this job.

Now he is rhapsodizing (a privilege of age I have started to collect on) about an article that showed a correlation between cognitive loss and sense of purpose in life.  The Rush Memory and aging project looked at this, and used structured scales, and the source given, for anyone who wants to look it up, is Arch. Gen Psychiatry 2010;67:304-10

AAAUUUUGGGHHH!

I knew a nurse who built a private practice in alternative psychiatry with supplements I would not have administered to the lowliest member of the animal kingdom who told me.

“You don’t need research to prove there is a nose on your face.”

People who have lived through at least the tail end of the era of analysis, like Dr. Fink, know that there are means to approach existential questions when two people are present in an office, with one having at least the intention of helping the other, maybe some training, and enough good comes from this to know that something has been lost when we become pill-pushers.

Study upon study has shown that income or business “success” or whatever is dependent not upon the few IQ points that differentiate most of the masses from, say, most of the masses.  It is more dependent upon that more difficult entity we describe as “motivation.”

“The mass of men lead lives of quiet desperation.” I was not exactly demonstrating in the streets in the 60’s, but still I felt a kinship with Thoreau. I was also born in New England.  I also visited his Walden Pond. I was rhapsodizing even then in the 60’s about getting my status first, then changing the system from within. I am still working on that one.

I know people for whom the sense of goal or purpose is more obscured.  People for whom “change” is the scariest word. People to whom I (and my husband) extend opportunities for contact and potential advancement on all sorts of levels, from interpersonal to professionally-related, things they profess are of interest.  When there is little contact for hours or days let alone weeks, the interest melts like snow in Miami.

I love being a crusader.  The more I do it, the more I love it.  There is a heady, powerful feeling in knowing I am saying things that only I have scraped together the peculiar shards of knowledge that let me be able to say, and in knowing that if people sometimes listen, their lives really could be change.

Sense of purpose is important; it is crucial.  It is on a continuum with inertia.  When inertia wins, you are down for the count, although the count may be slow.

On a physical level, people seem to accept this.  They know if you want to maintain physical attributes, you have to “work out” on some kind of regular basis.

But mental? When I was finishing up medical studies in France, I remember some kind of a national council on aging came up with something touching and gentle.  They said that older folks could do themselves a great deal of good by memorizing their shopping lists. Only one example of how pushing memory further to prevent its degeneration could make daily life more workable and accessible.

In America I hear only political polemics and empty promises.  I do not think Americans are given to the gentle and accessible.

So when somebody comes to me and they are in one of the county clinics and poor, just surviving, and not able to see a purpose in life, I ask them a few things.

1.  I ask about their belief system.  Religion can be an inspiration sometimes, and they should exalt if it is that, but more often it is a trap.  I tell them to decide what is real in their feelings and beliefs, find others who feel the same way, try to grow in belief, as can happen in all ages.

2.  I ask them, when they were kids, what they wanted to do when they grew up, and why.  Getting in touch with those feelings again can imbue purpose.

3.  I tell them to divorce their own goals from the goals of their kids.  There is only trouble as parents expect children to live out their lives as they (the parents) could not. Getting in touch with their own feelings means their own successes and joys.

4.  Get over the idea that you have to be rich, famous, or powerful to be happy.  When Doris Day said she got more of a kick from rescuing an animal in trouble than she did from any of her fame, I may have been the only person who believed her.  The “rescuing an animal” experience is more visceral and more personal.  Lots of people need visceral and personal experiences.

5.  If you can’t get over the rich, famous, and powerful needs, go for it.  With the internet, there are ways where there have never before been ways.

The hardest part is knowing what you want, not doing it. The answer is usually there in your own passionate, emotional memories.  Sometimes you have to go back pretty far in childhood to find them , before socialization or your parents’ goals for you or school or work stifled who you are.  Perhaps the greatest taboo in this life is not money nor sex nor any of the things we claim we do not want to talk about.

I believe the greatest taboo in this life is one against personal identity. In this overpopulated world, plenty of people will tell you what groups you are a member of, and how to spend your money.

Political correctness will work against your understanding of your own racial and ethnic origins.  These are important to understand everything from what kind of medicines work best on you to why you think how you think on many issues.  Mass media will work against you thinking unlike the masses.

Know who you are and then you will know why you are here and you will flourish as unknown parts of you become revealed and grow in joy.