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Forever young

"May your heart always be joyful,

May your song always be sung,

May you stay forever young"

Bob Dylan

I’ve written a lot about the mental health of young people, an issue which has garnered an enormous amount of attention over the past year – and rightly so. I want to take a few moments to reflect on another issue which is largely going without comment at the moment. Whenever we discuss the elderly at the moment it is in terms of their vulnerability to infection, illness and death due to Covid. This is of course important, but the impact of a year of isolation and worry on the mental health of this massive proportion of our population has barely been considered. To make it worse, there are regularly messages, implicit or explicit, in the media telling older people that their lives, mostly lived, are now less important than those of others. I wonder how many older members of our society fear that if they do become infected; their medical needs will be considered less important than those of others?

Studies have shown that people can internalise the representations of them as weak, vulnerable and less important and thee can become self-fulfilling prophecies. As a result, their physical health, and emotional wellbeing can suffer leading in some cases to shortened lifespans. It could also be argued that as relatives, neighbours, friends and fellow citizens, we too internalise these ideas and lower our expectations of the physical and mental health of older people.

When I was reading a letter to The Lancet on this topic the other day (I know how to live!) I recalled my first experience, a while ago, of counselling an elderly client. I listened as she recounted stories of rationing and the empty eyes of men returning from war. She described how society had changed. She reflected on emotional constriction which came from growing up in a culture where suffering in silence was the norm. She told me about upbringing and the growth and eventual dispersal of her own family. All of these things, you may like me, have expected.

But she then began to reflect on the frustration of missed opportunities and being directed to a particular role in society, of feeling overlooked and patronised by older siblings, of finding herself in a transactional marriage as a young woman. Perhaps most profoundly of all, she talked about the moment when she realised that her relationship roles with her children had been reversed. The moment when she realised that they were no longer holding her hand, rather, she was holding theirs. How it felt to be replaced at the top of the family hierarchy. How this brought a sense that your time had passed.

All of this was interspersed with comments like ‘that was just how it was’ and, somewhat ironically, ‘there’s no point living in the past’. The tendency to dismiss and minimise emotional pain was there, but these sentiments and phrases came from a person who had sought help and one who felt compelled to describe her emotional journey. There was a real sense of conflict between feeling pain and acknowledging its origin. Even when pain was acknowledged, there was a real awareness that others might be too preoccupied to worry about the emotional wellbeing of an ‘old woman lost in her memories.’

What was also there was humour. Silly, cheeky, irreverent humour, reflecting a need to keep everyone happy…even me, culminating in the mischievous farewell of ‘I hope it hasn’t been too boring for you!’

I’m never sure whether I’m supposed to enjoy my job. When your whole purpose is to walk alongside someone whilst they explore their emotional discomfort, it feels somehow inappropriate to experience pleasure. At the end of our time I thought ‘I've learned a hell of a lot about life and how one person has experienced it.’ I also thought ‘Did I ever listen, truly listen, to my mother for an hour?

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