On Narcissism, Loss, and Adaptation in Later Years

As an adolescent I made a promise to myself that I would not follow in the footsteps of my mother, who dedicated her life only to her children. Not that she lived an unhappy life, but to me, as an adolescent, to be just a wife and mother did not seem sufficient. I have been fortunate enough to accomplish most of what I set out to accomplish; I have a husband, children, and I work in a field that has increased my self-esteem and healthy narcissism. I was quite content: I never thought of living my life in any other way—until unexpectedly the lease for the Manhattan office, in which I had practiced for sixteen years, was not being renewed. My stability was shaken, and for the first time the thought of semi-retirement—giving up my practice in Manhattan and continuing to practice in Queens—was up for consideration. But soon that prospect became unpleasant and, to a degree, traumatic. I was no longer simply dealing with the loss of my office but also with the reality of my aging and the aging of important people around me: family, friends and colleagues. I was also dealing with the possible demise, because of decreased membership through illness, death, and the lack of younger members of the organizations that have been a vital part of my profession.

Freud, in Beyond the Pleasure Principle (1920), introduces the complex idea that there are forces within us that work to bring the living being back to the inorganic state, the death instincts opposing the living instincts. From biology we learn that from the moment a cell is born it is on its way to dying. This natural process of aging is also the belief in some Eastern philosophies. What I have been speculating about is why, if this is a psychological and a physiological imprint, was I so in denial of the passage of time until it was thrust upon me? It is as if I was young and then not so young anymore, as if I was not the same person that I was the year before. The integrity that I had experienced was disturbed and felt unrestorable.

In my practice I have three patients older than sixty-five. Each, in different ways, has experienced this disturbance in their sense of integrity. Roy relied on his good looks as a way to seduce women and obtain opportunities for himself. The loss of his youthful appearance and the power it provided destabilized his established sense of security, and he presented what can be described as a “melancholic” state in the old Freudian sense as pertaining to older men. Mary, a divorcee, had depended on the structure of her working week—earning power and socialization—to maintain her emotional stability. Severe arthritis of the knees diminished her ability to get to work in bad weather. At such times the nature of her job allowed her to work from home, but two months before reaching her retirement age her company “downsized,” eliminating her job. In this case lithium has been effective in preventing a serious depression, but she is not anxiety free. Anne, seventy-four, was an aspiring actress married to an actor. She limited her own career in order to give most of her attention to her husband’s and to her two children. She rationalized that it was better that way since she was not such a good actress. Her symptoms at present are an increasing inability to breath and she sometimes has severe claustrophobic episodes. These episodes seem to be centered around the fear that something might happen to her husband,

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who is six years older than she, and that she will be left to face life alone as a non-contributing member of society. My assessment, which has not as yet been shared with her because she is still unconscious of it, is her wish to die first, as well as the fear of her own death, which is symbolized by her claustrophobia.

The connection between our roles at home, at work and in society are a clear component of our developmental well being, but the compounded losses that accompany the aging process makes it more difficult to maintain a stable self identity. Freud, in Mourning and Melancholy (1917), identifies the fear of the loss of the loved one (the object), the fear of the loss of love, and the fear of loss of self-esteem as three areas of psychological danger. In aging, as the adaptive defenses become less effective, the dangers become intensified. In Childhood and Society (1950) Erik Erickson addresses the tasks of this period as identity vs. despair, where the more developed the individual is, the more integrated is the sense of identity and the less the despair.

For myself, I recovered my sense of stability. The regression that I experienced in the moment of crisis contributed to a mobilization of my psychological resources and to realistic solutions that, rather than debilitating me, have made me feel stronger. This has worked for patients as well. Roy found a part-time job at a mental health clinic counseling clients as to how to improve their skills in their fields of work. Being appreciated for the skills and emotional resources he gives to them has shifted his criteria for self-worth. Mary, who finds driving soothing, has placed her car and her energies into providing her elderly friends and neighbors with needed transportation. Anne has come to the realization that she is walking, “living history;” and that in passing on her knowledge of historical, political and artistic events during her life span to her grandchildren, their friends or any young person who will listen, she is making a contribution.

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