A Relocated Psychoanalyst Reflects on Aging”
By Michael Issacs,MSW, NCPsyA, JD

Like most people in the age group sixty and older I am dealing with and confronting the aging process.

As I age, two thoughts from my earlier years have come to the fore. Previously these images were mere cognitive musings about a period of time that seemed as far away as the stars. The first, from my teen years, was the familiar archetype of an old man with a white beard and a cane. He was traveling around searching for the “fountain of youth”. The second, during my psychoanalytic training, was a statement by a teacher. He was reflecting on the role of loss in depression, but then he went further to say that life is ultimately about loss and how we deal with it.

What are the losses that can impact us in varying degrees as we enter this stage of life? They can be decline in bodily functioning- especially the five senses; loss of sexual interest and capacity; loss of earned income; loss of career satisfactions; loss- or at least decline- of memory capacity;  and loss of independent living. Witnessing the loss of health of others, especially family and friends, and the increasing awareness of one’s mortality have a major impact on out thoughts and feelings.

Among the emotional repercussions from these losses are: fear, anger, sadness, loneliness, anxiety, depression, and despair or denial. From a psychological perspective, how well we cope with these losses has much to do with how successfully we have reduced pathological narcissism by self-growth and life experience. In the Greek myth, Narcissus was a youth who fell in love with his own reflection in a pool. His self esteem was based on his outward self. Imagine the blow to his grandiosity should he look in the pool and see balding hair, a shrunken face, and wrinkles!

Concerns about dying are probably the most formidable issue weighing on the minds and hearts of those dealing with aging. For many, the older we get the more intensely we fear pain, the disfigurement of the body, losing control over one’s own emotions and those of family and friends, increasing dependence, and the uncertainty and mystery of the whole process.

It is strange how little most of us think about and talk about death. In the history of the psychotherapy experience, there was a period when sex was the most difficult subject to talk about. In a later era, issues around money superseded sex as a closed subject on the agenda. Today, I would suspect that the subject of death, even more than sex and money is least brought up in the therapy room and probably in society in general.

It is unfortunate that so few older people do not utilize psychotherapy to talk about emotional issues arising fro aging, especially mortality. Few older people are aware that there are many therapists who as Medicare providers will treat those on Medicare who have supplementary insurance coverage, at no cost to the patient.  Notwithstanding the formidable challenges of aging, this inevitable period may be an auspicious time to achieve inner peace.

For me, the first step is to allow uncomfortable loss feelings to come to the fore. I attempt to remember that they are part of every human’s life journey. As the Buddhists say, we need to accept the process of decay and mortality lest we bring on more suffering. However, if these worrisome thoughts and feelings become excessive, I attempt to shift my mind to a more positive frame. Like many of my peers, I have intuitively done this by lessening the need to change others: moving towards gratitude and forgiveness; resolving past and present shortcomings and regrets; spending more time with family and friends; reconnecting with high school, college, graduate school, and psychoanalytic training; volunteering services; and making more time for exercise and hobbies.

The aging period can allow more time for those who are religiously, spiritually, and philosophically inclined to delve deeper into their studies, contemplation, and value systems.

One mundane aspect of aging has come as a surprise, which is the increasing amount of time and effort for health maintenance and care!  Although I know I should be grateful for my good health and availability of good healthcare, it is discouraging to beat the path to a horde of health professionals for prevention and cure. Also, the annoyance and boredom of increased daily maintenance of the likes of teeth, eyes, ears, quadriceps, hamstrings, bones and so forth!

One step that my wife and I undertook three years ago was to reconnect with our two daughters and families who live in the Bay area of California. We all wanted to live close to each other, but we knew that they were not going to move back to the winters of New Jersey! So four years ago we picked up our tents and did it.

I am happy at the present time with my balance between work and play, although adjusting to our move west and the aging process have been challenging. As to work, I have limited my practice to no more than fifteen sessions a week. In California I am authorized to practice psychotherapy as a research psychoanalyst. Under the statute, no more than one-third of my clinical time can be in the treatment room with the rest devoted to writing, research, and teaching. This is just fine with me. Because I am not an academic, I suspect that my non-clinical time will continue to be focused on research and writing. My special area of interest is the relationship between psychotherapy and spirituality. I am interested in what situations adding a spiritual dimension to therapy can be helpful and how this dimension can be integrated into the aging process.

Play is an increased part of my life as I have more time available to enjoy family, nature, and cultural activities of San Francisco. In high school and college I was a competitive swimmer, but gave it up until the move and now swim a few times a week. I am back to reading and rereading novels, pondering the themes of inner conflict and life goals and how they have played out in my life.

We have totally enjoyed the fruits of reuniting as a close family unit as well as living in the city of San Francisco. This move was made possible by the lessening of the importance of career and financial goals allowed by the process of aging.

Michael S. Isaacs, JD, NCPSYA, MSW, spent the first fourteen years of his professional career practicing law full time in Northern New Jersey before becoming a psychoanalytic psychotherapist, psychoanalytic control analyst, divorce mediator, and teacher of breathing techniques, meditation, t’ai ch chih, and yoga. He taught at the New Jersey Institute of Psychoanalysis and at Ramapo College of New Jersey before moving to San Francisco. He may be contacted at michaelisaacs@ sbcglobal.net or through his website www.michaelisaacs.net



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