Aging and mortality

This is a review of three books each from different perspectives pointing to the value of learning to be less fearful of aging and more accepting of death, and suggesting ways to do this, in order to make the most of life while it’s ours.

The first book is a tour of the physical aspects of aging focused on the brain and how changes show up throughout the body as well as the mind.  The second looks at the social world and the potentially devastating impact that fear of death can exert on human affairs.  The third is a personal meditation on life and all that is lost when it ends. It’s a reminder that our ordinary hours are much richer and more amazing than we appreciate when in the midst of things.

The Aging Mind: An owner’s manual by Patrick Rabbitt, Routledge, 2015. 242 pages.

Professor Rabbitt, a UK cognitive gerontologist, is a delightful and encouraging companion in the exploration of ‘normal’ aging of the brain and its effect on the mind and body.  Now in his 70s he continues to work and write on this topic drawing on over 50 years of research and on his own experiences of the aging process.

He sets the tone of his book saying that what we find out through research may not always be comforting but “there is always excitement and dignity in understanding our situation as clearly as we possibly can” (pg 4) and this book is replete with information to help understand and make the most of the longer lives many of us can expect.

Aging affects the whole brain and this affects our senses and all our abilities. Consequently how well our brain is aging shows up in our hearing, sight, touch and gait; with grip and balance being key markers.  He discusses why and how our brain ages, how fast it happens (quite slowly over a long period from mid 30s to late 60s then quite rapidly with decision speed and IQ declining more rapidly than memory) and how with reducing bandwidth it becomes increasingly hard to do, remember or perceive more than one thing at a time.

On the plus side he says that with motivation, engagement and revision we can still learn very effectively “even when we are very old indeed” (pg 97) which is encouraging for both therapists and clients.

While most body cells reproduce themselves anything from 40 to 120 times before reaching a limit controlled by telomeres (for longevity you really have to hope for good ones) our brain cells are mostly those we were born with, slowly diminishing in number.  We can’t stop this happening but we may be able to slow it down.

The rate of brain cell loss depends on blood supply and the best way to increase this is through 20 mins walking every day which has a “measurable effect on survival and on keeping our wits” (pg 242).  Something for therapists to take note of given all the ‘lethal sitting’ we do. Just moving briskly around between clients will make a useful difference.  In contrast, Rabbitt says there is no convincing evidence that brain training, crosswords etc help much.

Despite the losses and challenges that come with aging, studies show young people are more depressed by the experience of pain and illness perhaps because poor health is less common in youth while older people are more likely to know others in the same boat, and may be more accepting and grateful for what they still have.

On death, Rabbitt notes that those who appear most contented “seem to live in tighter boundaries of the present” (pg 186) and that studies from different countries and cultures all report a reduction in fear about death as age advances.

I found this book enlightening and useful in understanding the changes I’m experiencing and those that my older clients are also experiencing.  Memory lapses and moments of confusion often prompt anxiety about dementia for the over 60s but Rabbitt shows that for most of us they are just signs of normal aging.

 

The Worm at the Core: On the Role of Death in Life by Sheldon Solomon, Jeff Greenberg and Tom Pyszczynski. Penguin, 2016. 288 pages

“The worm at the core of all our usual springs of delight” is a quotation from William James’ book The Varieties of Religious Experience.

Inspired by the earlier work of Ernest Becker who claimed in The Denial of Death that human activity is driven largely by unconscious efforts to deny and transcend death, the authors who are American experimental social psychology professors have been collaborating on research for 25 years to test this hypothesis and explore its implications in our lives.

Through over 500 published studies they found that fear of death does indeed have a profound and persuasive effect on human affairs at all levels and in all areas, driving our behaviour far more than we realise.  Their ‘terror management theory’ posits two main ways we try to protect ourselves against the prospect of annihilation.  These are through maintaining a cultural world view that confers a sense of order, meaning and permanence; and through strong self esteem to give us a sense of personal significance in a meaningful world.

Their approach in each study was to take two groups and prompt one to think about their mortality and the other, control group, to think about something worrying but less alarming and then to compare attitudes immediately afterwards. They did this over a range of people and topics including crime and punishment, sex and physicality, war and violence, anxiety and phobias.

They repeatedly found that reminders of death did indeed alter beliefs and intended actions compared with the control groups.  For example, after being reminded of their mortality, judges imposed more severe punishments than they might otherwise have done, arachnophobes  reported spiders to be more dangerous and attack-prone, religious people and atheists became more inclined to proselytizing.

Significantly, they found that death reminders generally elicited kinder attitudes to ‘people like us’ and harsher more aggressive attitudes to ‘others’, sometimes murderously so.

Their worthy but extremely ambitious hope is that their work will help us realise the role mortal terror plays in causing conflict and wars so that we will “find ways of counteracting the destructive potential our fears can, and do, unleash” (pg 149).

In their final chapter ‘Living with death’ they suggest ways we can explore our own attitude to mortality and how to live more creatively with this.  They invoke the advice of philosophers ancient and modern to face and accept the reality of death and use it as a spur to appreciate life and be more compassionate to others and concerned for future generations.

There is much here that is familiar territory to a therapist, especially an existential one, and indeed they refer particularly to Yalom and to existential psychotherapy as a way to shore up our terror management resources.

The Black Mirror: Fragments of an Obituary for Life by Raymond Tallis.  Atlantic Books, 2016. 352 pages

Tallis, philosopher and retired professor of geriatric medicine, approaches the topic of mortality from the perspective of viewing his own corpse, using its inert Nothingness to illuminate the Everything of human existence. His focus is on the basic elements of life, to remind himself and us of the everyday richness and wonders of being alive and the necessity to remember and be grateful more often.

This book is a hymn to life, to be fully awake and make the most of it, to avoid dissipating what we have in order not to look at what we will lose.  He describes and celebrates all the amazing aspects of embodiment (those facilities we take for granted until, as Rabbit describes, they gradually fade with age). We die because we are ‘improbable’, our wonderful highly structured bodies are at odds with the general tendency of things to entropy.

He begins by looking unflinchingly as his imagined corpse. He suggests that seeing life from this perspective brings us to the heart of the philosophical impulse, making us onlookers into the strangeness of our being in the world. He ‘sees’ his corpse being laid out, mourned over by those whose memories of him will constitute whatever afterlife he can hope for, heading into the crematorium fire which he has chosen over the worms. Then he steps back to consider the living body: pumping heart, lungs, bowels, kidneys and so on, “a constellation of miracles” (Pg 39).

He then widens out to look at the elements we are made of and intimately connected to, and our senses which transform the world around us. He remembers the smell of a newly mown lawn, wood smoke, singed hair, urine in public toilets; and so on through sights, sounds and touch describing some of the things that have intrigued, repulsed and delighted him.

Then he moves to the world with others.  Relationships, modes of behaviour and dress, the social mores of his community and the cultivation of a carefully constructed identity. His world of work, the ‘tools’ of his trade, his hobbies, all the things that had interested and enthralled him, constituting a full and busy life.

He recalls his hoard of possessions, his ’empire’ (the stuff we all accumulate that marks stages and events in our lives and bolsters our sense of a substantial self) poignantly contrasted with the few possessions (a rubber bone, basket and blanket) of his long-deceased dog, blissfully content with so little.  Then the experience of moving from a house long inhabited and felt as ‘home’  and seeing how when empty it was disturbingly revealed as a temporary stage set, a premonition of a world carrying on without him.

Tallis is a kindly and thoughtful companion in this exploration of the view through the black mirror, a journey that is hard to contemplate with eyes wide open, but he makes it possible and worth the effort.  He uses himself as an exemplar but of course it’s about us all.

“Then awakened by death … relish that it is still possible to put the kettle on, look out of the window, and exchange smiles with another human being” (pg 344).