The Poetics of Aging and Dementia
Nader Robert Shabahangi
This article suggests a unique way of viewing aging. Focusing on the process of aging, the author examines the manner in which we age and the meaning(s) we create while we go through the various stages of life. A literal and metaphorical analysis of aging is explored in great depth. Utilizing poetry as a vehicle for meaning making in aging, this article brings to light how we can apply ourselves creatively, and author our life story, as we age.
The Starting Point: Our Mainstream View of Aging and Dementia Today
A core tenet of humanistic psychology and philosophy is the belief that human life is intrinsically significant. This meaningfulness extends to all we do and are in life. It is evident in our creative expressions, in our work, in the choices we make, in the way we keep writing and rewriting our life stories. It is also evident in the way we age, that we age. Though this seems an obvious insight to many, we need to remember only the intense cultural opposition to aging that shows itself not only in promotion of anti-, and “successful aging” campaigns but, perhaps most poignantly, in the publications by more and more members of the scientific establishment. Those writings, in the name of modern science, tend to bio-medicalize aging i.e. look at aging from a standpoint of biology only. Such a limited viewpoint can create the impression that aging is a disease ignoring the many other dimensions of human development and growth associated with growing older. This is not the place to cite the innumerous literature attesting to this conception and movement. Rather, I would like to point out the fact that not only popular culture but, increasingly also, members of our own and of other research and professional communities are proposing that aging, phrased succinctly, is something to be overcome, can be cured or fixed.
Of course, this perspective raises a host of questions that have us enter into quite sensitive and risky territory: at what point or age, do we start treating and curing aging? What do we do with those who do not respond to treatment? What about those who do not want treatment? How do we know when treatment is successful? What measures do we use: those of biology, psychology, anthropology?
From a humanistic, poetic point of view, life and aging have meaning. The very processes of life and aging cannot be separated. Without aging there is no life, without life there is no aging. As absurd as this sounds, to propose anti-aging is to propose antilife, to believe that aging is a disease is to state that life is a disease.
It is tempting to ask the question and explore further how it is we humans managed to create such a life-negating, one might even say, absurd viewpoint. This questioning must remain, however, the subject of a separate inquiry. Here I would li e to focus on the possibility of creating a different attitude towards aging, one I would like to call the poetics of aging.
In conjunction with the poetics of aging, I would like to address also the mainstream conception of dementia, often linked to the process of aging. Dementia or Alzheimer’s, in much of today’s scientific and popular publications, is understood principally as a dreadful disease with little, if any, redeeming value. This understanding goes against the experiences many care partners make in working with those showing signs of dementia or Alzheimer’s. In contrast to those speaking about a dreadful disease, they tell a different story reporting that people with dementia – given a loving environment and care – can be content and happy individuals who are spontaneous, funny and wise. This is a rarely spoken poem or story of dementia and Alzheimer’s to which I would like to give voice in this paper as well.
Poetry and the Creative Process
In speaking of the poetics of aging I would like to remind the reader of the very meaning of the word poesis. With poesis the ancient Greeks referred to the act of making, of creating. To speak of the poetics of aging, then, is to speak – expressed quite literally – of creating aging, of being actively engaged in the aging process. Given the inseparability of life and aging, to speak of the poetics of aging is to speak thus also of the poetics of life.
The poetics of aging views our existence as a creative process of making a life. It is based on the belief that we humans possess an innate desire and will to deepen our understanding of who we are, of our purpose and meaning. It is interesting to note that when we are in our youth the process of aging is synonymous with growing up, with learning, with becoming more aware, more of an adult.
The process of aging is equivalent to the process of changing. We might even go as far as to replace the word “aging” with the word “changing”, a substitution that does not alter the conceptual meaning of aging. The expression “I am changing” captures the same essence as the statement “I am aging”. Yet, the latter contains more often than not a burdened meaning showing the degree to which we have given the word aging a biased, derogatory meaning. This bias begins sometime around middle adulthood – though there are signs in popular culture that such bias is entering even early adulthood.
A New Phenomenon: Living Older
Only in our recent generations have we humans enjoyed a longer life-span, that is the ability to grow in ever greater numbers to an age far beyond our socially instituted retirement age. In the last hundred years those living in so-called developed countries have nearly doubled their life expectancy. Even more dramatic is the fact that for much of recorded human history the average life expectancy did not exceed that of late youth.
This exponential increase in our average life-span confronts us today with the need to come to terms with this phenomenon called Old Age. And coming to terms with it we must. For some reason we do not think, yet, of later adulthood as a time for learning and growth. Though we have images of wise elders in our history, such images seem to us to belong to mostly exceptional human beings, not to who we are.
This is the challenge that confronts us now. In order to accept Old Age as another phase of learning and growing, we need to exit from the attitude that literally devalues our aging process. This devaluing takes place because we do not yet see the value of aging and old age for us and society. This devaluation, especially of the aging that occurs in our later years, not only has the effect of creating an anti-aging sentiment in our culture, but also diminishes the human values or virtues that most often are present only in old age.
The Role of Eldership and Timeless Human Virtues
In the last centuries we have seen a gradual deconstruction of universal belief systems, what Nietzsche called the transvaluation of all values. Those earlier belief systems did not require of the individual an introspection of his or her own deeply held values and convictions. On the contrary, adaptation to commonly held beliefs was understood as the hallmark of good citizenry and required of most of us.
The 20th century, especially, saw a further erosion and abandonment of universal systems of faith. This process, now and then, has increasingly left individuals to search for guidance themselves as to the principles with which to live their lives. Today many of us derive our guidance from observing individuals who have managed to live a life we admire. They possess qualities such as patience, humility, courage, and compassion. They also seem to accept others, value human experience and have an understanding of the limits of knowledge and of being human. Again, because these qualities are rarely obtained at a young age through schooling or other forms of education, but rather take a lifetime of experience and learning to achieve and practice, those people are often referred to as elders. Even though it is not necessary to have entered Old Age to be an elder, more often than not this is the case. Conversely, being in Old Age does not make an elder. Rather, it is exactly those who have made the effort throughout their lives to grow and deepen themselves, have made a commitment to become aware and accept the struggles and sufferings alongside the joys and pleasures of life, who can be regarded elders in our society.
Toward a Poetics of Aging
Many cultures possess a role called eldership as a way to honor those who have attained culturally cherished virtues through a life-time of learning, growing and experiencing. But more than honor the achievement of elderhood, many of our cultures understood the value such persons held for counsel and guidance of its people.
The poetics of aging and life, then, is not a process that understands its completion somewhere in the middle of life, a place where our dominant paradigm places it with expressions such as being in the prime of life, at the highpoint of a career, at the peak of one’s power. Rather, the poetics of aging wants to express that the poem called ‘my life’ finds its final stanza, its completion, only at the very end of life. To look at a poem half or two-thirds completed is to look at a fragment, is to misunderstand the meaning of the whole.
From this vantage point we might understand the nonsensicality of looking at our later and last years as declining years, years that are supposedly less valuable than those before. This decline-metaphor permeates much of our culture, often visible to us, at other times entering our awareness in more subtle ways. It is a metaphor that derives its understanding principally from looking at aging and life from the outside; that is by looking at our bodies. In so doing, this metaphor of decline upholds a certain image of the body as more desirable than another.
Besides evaluating our bodies, this decline-metaphor also evaluates our cognitive abilities in order to judge our up or down trajectory in the world. For example, do we remember quickly or at all, do we speak a language coherently or not, do we meet normative standards of social engagement or don’t we? These measures alongside the perception of our bodies form a way of how we continue to judge a person’s value to us and to our culture today.
Towards a Different Understanding of Life
No doubt, as a culture and people we are ready to establish a new, more complex and rich understanding of life and aging. This understanding will move beyond the superficial, surface layers of what we perceive of as optimal, bio-medically measured functioning to a more comprehensive view of the human being. This view pays equal attention to the socio-psycho-spiritual-somatic dimensions of a human life and will regard the attainment of what have proven to be timeless human virtues to be the measure of a person’s standing in the world. From this new point of view we will start to look at life as a complete poem, one that has its highpoint with a human being’s last stanza or verse. Aging understood as such is an active process of becoming, learning and growing. We do not get old but grow old.
role we grow into as we age is that of the elder. The final stanza of our life poem is that of eldership, the apex of a lifetime of learning and experiencing, of struggle and concern, of being courageous and creative. From the point of view of an elder, young and middle age are seen as the time we wrote important parts of our poem that would lay the groundwork for the final verses written in our eldership years. The struggles of middle age, for example, focused on the dynamic between our inner and outer lives, a struggle that centered around the balance to grow our inner capacities as human beings as well as developing further our standing in the world. The challenge of eldership is to give back to our human community the depth we have gained through the joys and toils of a lived life. From the poetics of aging point of view, all the years of life are understood as important and necessary building blocks for our final, climactic years of eldership.
Writing Our Poem
We have learned in the last few hundred years, thanks to science and philosophy, that human perception co-creates reality. Since each of us has their own unique perception, we have as many realities as we have individual perceptions – no one person sees the colors red and blue, for example, quite the same way, looks at a dog or cat with quite the same eyes and feelings. This awareness that perception equals each person’s reality has fundamental implications, one of which states that there does not exist one universal truth, that truth does not exist outside of us. In contrast, we humans create our own truth, a truth that is ever changing, shifting, and transforming with time, with our learning, experiencing and growing. This awareness thus leads us to conclude that truth is always of a personal nature and such truth is told through the story or poem we tell to ourselves and others.
How we tell our poem can have a large impact on us. Imagine if you feel fortunate about how you grew up or you feel that your upbringing might have precluded you from being all you wanted to be in life. One poem uplifts, the other can depress you.
A case in point is melancholia, a condition we now call depression. In the time of the Greek Empire, melancholic people who moped around the house, sat all day at some table or in some chair with their head leaning heavy on one of the hands, was considered a gift by the Olympian Gods. For, so the poem of that time told, melancholic people have the god-given luxury of contemplating the plight of the earth, of thinking about the weight of being human, the burden of being alive. Today we treat people who are melancholic, now called depressed, with anti-depressants, call it a disease. In a culture that is based on productivity and efficiency, based on activity and achievement, sitting around moping and reflecting on the complexity and depth of the world must invariably be considered as abnormal, a disease.
The Poem called Dementia
The power of a poem is also evident in how we “see”, for example, a symptom of aging we call dementia or Alzheimer’s disease. In calling it a disease I have already given the conclusion of the poem: I prejudge this phenomenon as undesirable. In labeling something as a disease I state that it does not belong to me, that it has, in fact, no meaning for me and for my life.
What we label dementia is a poem written largely by people who believe in the myth called objective science. I say myth because there is no objectivity, as stated above, and there is not a uniform understanding about what we mean by science. Both concepts, that of objectivity and that of science, are part of a poem that has been written and re-told innumerous times in the last few hundred years, to the point that many of us equate those stories written with objective truth. However, just as the many religions, as the theory of the big bang, of creationism, of evolution, of objective science, are stories, form mythologies of some kind or another, so the poem of dementia, of Alzheimer’s disease, forms part of a myth, of a story told.
Enter the world of dementia, of no-mind. Never mind that we humans have yet to understand the nature of mind, that mind is a concept we invented in order to explain something for which we have no answer yet, that in some cultures a state of no-mind is considered the highest possible state of enlightenment. Never mind all that. In creating the myth of dementia, the poem of no-mind, we impose our sense of normality on those who are different from us. In a cognitively oriented society such as ours, anyone who does not talk and think and remember as fast and efficient as the mainstream must be abnormal, must be wrong, diseased.
Poem of Forgetting
We can also write a different poem. This is the poem of forgetting, a poem of traveling to a different planet, to new and exciting worlds of which most of us earthlings and mainstreamers know little, as of yet.
Imagine this different world, explore it. If you consider your life a poem you are in the process of creating, then the adventure that awaits you on the journey to a different planet might feel exciting to you. After all, such a journey provides you with new material for writing your poem, can help you create a whole new verse. As in the story of The Little Prince who lives on planet B612, we travel to other planets in order to discover what the rest of the world is like. On those planets we meet people who possess different ways of viewing themselves and the planet on which they live. Through these travels we recognize how each of us writes their own poem, some of which we can comprehend, others which we can’t.
In The Little Prince, for example, the fox expresses what the protagonist of the story, the little Prince, learns through his travels, that is through his openness to other worlds: “On ne voit pas bien qu’avec le coeur, l’essentiel est invisible pour les yeux.” (One cannot see well except with the heart, the essential is invisible to the eyes). There is another point spoken by the fox that is important understanding for the little Prince: “It is the time you have spent with your rose that makes your rose so important.”
This, indeed, is a different poem from the one many of us know, most of us write. This poem brings us to a different region, the region of the invisible, what other stories might refer to as soul. If the essential is invisible to the eyes and the essential can be called soul, then what might lie ahead of us if we undertake a journey to the soul? On what planet does a person who forgets, who has no-mind, live? What if we saw forgetfulness not as a disease but as an entryway to soulfulness?
The Question of Identity
We humans have become accustomed to think of ourselves in a modern scientific way. This means that we identify with what we can recognize with our senses and measure in our biographies such as the way our bodies look and feel, how we experience others and the world, notice where we come from, what we have accomplished, perhaps still want to achieve. Few of us think in terms of our essential self, that part we experience not with our senses but in a different way. This essential self some call soul, sometimes also the spirit that resides within. We know of this through that inner voice that speaks in the middle of the night, through the hunches we have as we walk through life, through what guides us inexplicably hither or thither, moves us in ways we will often only understand much later in life. This essence or soul forms part of our identity. It does not leave us just because our body ages, our cognitive abilities change. On the contrary, more often than not it is because our bodies move less fast and our minds less quickly that our essential selves can even emerge and become visible through the haste of the day and the noise of the mind. Understood as such what is called dementia can be seen as a gift rather than a curse in a person’s life.
A New Poem for the Future
The discussion about a new way of looking at aging as maturing, as a deepening of who we are as a human being, and the different way of looking at dementia as an entering into our soulfulness, are both grounded in a dialogue about a fundamentally different attitude toward life itself. This attitude is one that is curious about our differences as people and attentive to our tendency to judge and reject what does not fit our sense of normality. It is aware that there is no fixed, immutable reality and that any truth is always connected to the individual perception of the human being. And this new attitude understands that human relationship as it expresses itself in the care and love for our fellow human being is the primary force behind a life worth living. This applies especially to the way we care for those amongst us who are dependent on our care, whatever form that care may take and wherever it may take place. For whether we speak of emergency medical care, emotional care, or care for our elders at home and/or in communities, it is the personal, human relationship which has shown again and again to be a central agent for a healthful life.
I am emphasizing this point for in the care of the aged and the care for those with symptoms of forgetfulness increasingly attention and resources are placed in the medical treatment model. The latter stresses medication management and thinks too little of the importance of human connection. The quality of this connection is often less determined by doing than by being present with the other. Being present is a state of being not governed by time and outcome but rather by allowing whatever is taking place between two people to take place. This implies being with a person without judgment, a quality of presence that continually challenges one’s commonly held personal and cultural assumptions, ideas, and preferences. Such a disposition to the other challenges each one of us to a larger understanding of ourselves and the world within which we live. Foremost it teaches us acceptance of what is rather than displeasure of what is not. As importantly, it teaches us acceptance of our own aging process which might include a dosage of forgetfulness or not. For the more we can accept what is outside of us, the more we can accept all that we are as individuals. Seeing the beauty of elders in front of us, glancing lovingly at them, will make it easier, no doubt, to look into the mirror in the morning and accept and love ourselves as we change into our own elderhood. Similarly, as we become appreciative of the world that opens up to us through people with forgetfulness and their different ways of communicating, so we, too, become more accepting of our own changes, physically and mentally, as we move along our aging process. The new poem of the future, then, will be one that understands our human differences no longer as a phenomenon to be normalized or cured but rather as an opportunity to deepen our awareness of our amazing diversity and purposes. This new poem will not only accept but celebrate our differences in the world as we become ever more curious about how we keep changing and diverging from known ways. Such a stance relates to being more open and cognizant of our soul dimension, an awareness that remembers the mystery of life alongside our advances in manipulating it. This new poem also remembers that the core of human, perhaps of all earthly life, is based on our ability to give and receive care, to give and receive love – especially with respect to what is not so easily cared for and loved. As the great sages and mystics have reiterated throughout the millennia, this kind of service might be one of the more fundamental meanings of our life.