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AGEING, THRESHOLDS AND VULNERABILITY

De
145 pages
Throughout the multitude of life experiences there exist moments of particular vulnerability, or " thresholds ", where personal resources of the individual are tested and give birth to vastly different trajectories of aging. In light of the concepts of " thresholds " and " vulnerability ", the autors demonstrate that one can begin to discriminate in such circumstances the differences between normal and pathological compnents of aging.
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Jean Bouisson Jean-Claude Reinhardt

AGEING, THRESHOLDS AND VULNERABILITY

!Ç)L'Harmattan, ISBN:

2002

2-7475-2267-9

Jean Bouisson Jean-Claude Reinhardt

AGEING, THRESHOLDS VULNERABILITY

AND

L'Harmattan 5-7, rue de l'École-Polytechnique 75005 Paris

FRANCE

L'Harmattan Hongrie Hargita u. 3 1026 Budapest HONGRIE

L'Harmattan ltalia Via Bava, 37 10214 Torino ITALIE

INTRODUCTION

We could begin with a simple riddle: " Who is short in stature, with set routines and personal habits, threatened by dependence and mind blanks, praised for staying young, reprimanded like a child for giving up, all the while menaced by an inexorable fate which desires precisely that he falls back into infancy? " The 'old person' of course, or in less blunt terms (corresponding with the general movement in an era which places a discreet veil over everything evoking old age, sickness, and death), "a person of the third age" that even the Sphinx claimed walked" on three feet in the evening ", but who, today, is not necessarily leaning on a cane, even in very old age. The riddle, then the Sphinx. .. could this book myth of Oedipus? In a certain way, of course, discourse on old age and growing old touches on the destiny', the knots in which the personality of every structured, where future choices are organised, between generations are woven. be linked to the because every 'inevitabilities of human being is where the ties

To speak about ageing, however, we mustn't stop at Oedipus. We also need to summon, amongst others, Cronos, master of the Golden Age and of the first race of man which didn't know old age, then Sisyphus and Orpheus, heroes confronted by the unmercifullaw of death, and also Philemon and Baucis, two elderly folk eternally united in the strength of their love. Yet, what scientific merit is accorded to these imaginary stories whose function was, long ago, to provide answers to the great questions of existence, and to give some sense to it all ? Myths, we

are led to believe, no longer have anything to teach us, and knowledge about old age and growing old is now the domain of clearly identified specialists, notably biologists and doctors. For Birman (1997, p.178), the discovery of 'old age' as a defined concept in occidental history lies between the 18th and 19th centuries: " The scientific ideology of evolutionism brought with it a scientific guarantee which established the biological cycle of human existence in clearly defined age groups. The concept of old age was constituted in the midst of these historical and theoretical circumstances, as a moment of decadence in human existence, characterised by certain particularities of its biological functioning. Such a theoretical criterion, defining the vital periods, was until then non-existent. " In that context, the concept of degeneration was expounded, as was the fundamental conception of medical and biological knowledge, precisely by the fact that human existence was henceforth represented according to the canon of vital development. Thus, degeneration would be a form of abnormal biological development in the organism imposed onto a model constructed according to the organisation of foreseeable biological sequences. " Apart from a few rare and notable exceptions, medical gerontology handbooks (where you'll find a summary of the essential scientific discourse of a given period) will bear witness, until recently, to the influence of this model. They are filled with a long catalogue of losses, alterations, and multiple collapses in physical and psychological capacities, generally followed by administrative texts on the rights of the elderly and how to cope with dependence, or with recommendations for the families of Alzheimer's sufferers. In the same vein, due to a lack of effective therapeutic techniques, doctors are forced to limit their focus to the hygiene and social aspects of their ageing patients. F rom a field of geriatrics which could fairly be labelled impotent, limited principally to the role of observing the deficiencies of old age and often scorned by the other medical disciplines, there nevertheless succeeded sometime in the 90s, a geriatrics discipline which is much more efficient, capable of treating the most dreadful illnesses, and providing the keys to " successful ageing" (Rowe & IZahn, 1987). It appears, however, that we are not yet ready to break 8

away from the model of degeneration and with the concept of growing old that is generally defined as "the complex of transformations affecting the fmal stage of life and constituting a process of decline (characterised by: weakening of vitality, organic modifications through a reduction in exchanges, tissue dehydration, muscular atrophy, slowing down of functions, and general decline in performances), the culmination of which works towards progressively limiting adaptation capacity" (postel & al., 1993, p.601). Our aim here is not to formulate reproaches directed at a geriatrics field where advances are more and more encouraging (and more desirable for us all I). It consists, rather, of contributing to one aspect of scientific knowledge outside the field of biology and its paradigms. Although the psychology of ageing may have been tempted in the beginning by the biological model, particularly with regards to intellectual deterioration, there has been a progressive awareness that the observation and understanding of a person's behaviour as they grow old can only be envisaged with reference to the major objective of all human existence: the development and refinement of the self. \Vith the psychology of ageing being, in this sense, a psychology of development, the interest accorded to its study is not limited only to the twilight years but applies to the totality of a human being' slife. Viewed in this way, old age is understood as a complex process where the interaction of numerous parameters (some known, like a rough life with precarious living conditions, others yet to be specified, like eating habits) operating at different rhythms at both the interindividuallevel (as with the variation from one person to another of up to ten years in age for the f1tst signs of lon'g-sightedness) and the intra-individuallevel (for example, the speeding up of some processes as illustrated by the expression" he turned grey overnight "), according to both hereditary and social factors as well as the psychological dynamics of each person. For us, all aspects of ageing have to be situated in a context (historical, socio-economical, cultural, family, individual), and are to be understood in terms of the developmental history of a person, in the way they manage their personal resources, their modes of

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adjustment context.

to the process of ageing, and their relationship
that we have only ever studied

to the
of

It follows

the expressions

growing old at the level where the process - hence the most visible and to its acme - manifests itself in extremely varied configurations
of all the factors mentioned above. It would seem obvious that today, more so than in the past, we are dealing with a great heterogeneity of conceptions of old age, from that of a person from elevated social circumstances, who has all their life participated in intense intellectual activity and had the possibility of various investments, now enjoying a comfortable retirement surrounded by warm and attentive people, to that of a person who has lived constantly below the 'poverty line' without any real health or social aid, living in constant fear of tomorrow. So many different ways to grow old. So many different configurations of a long path laid out since birth. So many 'passages', each bearing the mark of an individual and their style of ageing. In this multitude of roads winding from the beginning through to the end of life, there are, however, some lines of convergence which are more or less 'determined', and linked to the multiple biopsychosocial dimensions of the human being: weaning, schooling, the teenage years, access into the world of work, couple life, motherhood, fatherhood... to name only some. These are the 'thresholds' which a number of paths necessarily cross. Moments of profound change or simple ruptures in rhythm, they break life up, allowing us to spot the junctions between stages and to grasp, as each person crosses them, a part of that person as they situate themselves in the world and attempt to make sense of their existence. Because they necessitate adjustment to a new situation, these thresholds are often accompanied by a time of crisis. " And 'crisis'
the Greek krinomaz), " J. Guillaumin (1979, was, in the past, the moment of judgement, of " junction imposing a more or less urgent choice on Oedipus at the crossroads ofThebes, opposite (...) (from

p.224) reminds us, decision-making, a the path we're on, (the) Sphinx. "

The 'crisis' is the decisive moment where, more than ever, a person is bound by his choices, and where, from one threshold to the next, his existence 'takes form'. The 'crisis' is also a moment of solitude, face to face with oneself; perhaps provoking anxiety over 10

making the right choice, because forever all the other possibilities"

choosing" (Quinodoz,

amounts to renouncing 1991, p.31).

At any age, a person may realise after a while that their decision has placed them on a road of no return; but some periods in life seem particularly more likely to arouse such awareness. One such period is the" mid-life crisis" (E. Jaques, 1963). This profound identity crisis is characterised by a break with the past and an analysis of the self from a new distance. Using a metaphor, we have ourselves Bouisson, 1997) compared it to the experience of an individual who, fmding himself against his will on top of a huge belvedere, suddenly realises that all the paths he has followed up till now, all his efforts to realise his dreams, come together, in fact, at the same spot, far off on the horizon. Forced to break away, therefore, from his old illusions, he invents other objectives building a path which is more in line with reality and is more coherent with his identity.

a.

A moment of risk for the self - and so of vulnerability crossing the threshold involves as much time putting life forces to the test as the re-uptake for future aspirations. From this moment forth we would see, little by little, the great range of ageing styles, from those who would still be able to challenge life in " the acceptance of elevated pressures and calculated risks" in " opening their mind to the prospect of death" (D. Lagache, 1967), to those who, no longer having the force for personal evolution, would finish by withering up in an anxious search for the immutable and the routine. Progressively, it has become apparent that reflection on old age is bound by the two key notions of 'threshold' and 'vulnerability', notions that constitute the two major sections of this book, notions that we will need first to define, then argue, illustrating the emergence of a clinical view of normal and pathological ageing. Although we don't reject any part of it, the reader will recognise that our approach to the study of ageing doesn't have a lot in common - or if so, in an accidental manner - with the classical publications in this domain. The subject matter is not that of memory, or of cognitive functions; it is not a study of old age divided into particular sections (perception, the nervous system, 11

intelligence, depression.

personality...)

; and it is not about

loss, dependence

or

Instead, in this discussion on ageing, we will follow resolutely our own perspectives, b,ased on work on the psychology of ageing begun some years ago by our research team: "Routine and Creation ", some of which have been the objects of publication, conference communications, symposiums and seminars. All that is left is to invite the reader to wander, company, along some of our pathways in the world of ageing. in our

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I THRESHOLDS
(J.C. REINHARDT)

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