boomers
The Three P’s: Pride, Pleasure & Purpose
The Three P’s: Pride, Pleasure and Purpose
A Simple Guide for How to Avoid Chronic Depression in Older Life
Recently a colleague told me about the “three P’s” which she teaches in workshops to older people. It’s such a simple yet helpful mantra to guide you in finding balance. Finding balance is one of your key developmental tasks in life, and especially so in older anastrozole years. Balance can help you avoid falling into chronic depression.
Older people are balancing provimed the combination of all of the life lessons they’ve been through, hopefully getting to some “wisdom” on and off at this point. Wisdom meaning, according to Joan Erikson PhD’s research a few years ago, “to know how to”.
They are balancing their anabolicstation.com growing needs for exercise, healthy eating, enough sleep, enough friends, enough mental stimulation, enough fun of various sorts that feeds their souls, enough contribution to the greater good, etc.
Which brings me back around to the “three P’s”. I would say that the Pride part is something a lot of my clients feel pretty good about. They are oftentimes proud of their careers or their families, or their contribution to others. The Pleasure part is, on the other hand, something they are figuring out and beginning to understand they need more of. That pleasure is critical in helping them find enjoyment in older years because it helps balance out the increasing number of challenges inherent in aging. Sometimes we brainstorm about what used to give them pleasure, what gives them pleasure now, and what they might like to try in the future given their capabilities at this point in their lives.
Pleasure is usually connoted by something that feels good visually, sound-wise, smell-wise, taste-wise and touch-wise. It also encompasses doing new things because the brain loves novelty.
The trick is to find “just enough” like in the Goldilocks story – not too much, not too, not too scary, not too bland. You get the gist.
That brings up the other “P” which is Purpose. This I see as one of the most difficult challenges for older people. Many of my clients have felt clear purpose in their earlier years – e.g. raising their children, helping with their grandchildren, serving on Boards in their communities or doing other volunteer work, working at their careers, being successful in a whole manner of ways.
Now, though, they may not be working their last paying careers. They may not be needed to watch grandchildren who are getting older and more independent. They may not feel able to commit to structured schedules in a volunteer or paid part-time job. They also may feel that they have offered to share their lifetime of accumulated, and valuable knowledge with groups, businesses, organizations, schools, etc. and felt that they were ignored or rebuffed. They feel “adrift”
This brings up the subject, then, of grief. Loss of earlier identities, loss of income, loss of value by others for their wisdom, loss of a clear path, and loss of groups of friends one makes in work-related settings.
However, the way through this, is to first acknowledge this grief. To also acknowledge that we live in an ageist society that does not typically value our elders. Our older people’s voices are too often not sought out, and not listened to, and not respected.
As they educate ourselves about ageism in our society and get support for the grief that all of these aspects engender, they begin to be able to lift their heads up above this and take a look around for where they might have purpose now in their lives.
Often they come around to asking the questions: Where am I helping someone? Who is in worse or different shape than I am that I can help and who would appreciate some attention? Can I volunteer in a hospital holding preemies, can I volunteer in an assisted living community, how about in a library or a nonprofit thrift shop? Can I volunteer taking care of a pet for someone? Can I visit a home-bound neighbor who is lonely? There are so many people in need in our country and so many understaffed nonprofits trying to help.
The point is not *what* you do, but it’s about your sense of purpose. When you are thanked from the heart by
someone for something you do, you get more from the interchange than they do! This is something many volunteers say to be true – that they get more from being volunteers, they think, than the people they help.
So, Pride, Pleasure, Purpose. A simple equation, so beautiful in its simplicity and truth.
Taking a News Fast for Mental Health
Mental Health and the News
Something I see more and more recently is how troubled and even distraught many of my clients are about the state of our country. When I ask them about how much they are watching the national news, many of them say, “Every morning and every evening.” What I ask them how it makes them feel they report “Terrible! I’m so upset (angry, frustrated, disappointed, fearful) about what is going on!”
These folks may be rimobolan Republicans, they may be Democrats or no party affiliation. It’s not about political leanings as much as it is about their memories of how various politicians they admired were once able to communicate across party lines to “put country first and get things done”. It greatly 
concerns my clients that this bipartisan spirit does not seem to be happening anymore. They get so mad about it that their blood pressure and overall stress levels are not healthy. This is the situation for many Americans now, young or old or in-between.
My senior clients, many of whom are retired, are educated, hard-working, middle class Americans who care about our country. They are also facing plenty of issues related to aging, illness, having less energy, figuring out their relationships with adult kids and grandkids, their identities and value in their older years, the big existential questions of life, and yes, oftentimes depression and anxiety. The news media these days can make them sick!
So, we have been experimenting with various ways they can try taking a “news fast”. One woman in her 80’s reported that she stopped watching the news on television where the sound bothered her so much – the music, the strident tones of the the newscasters voices and the video graphics. She has found that, for her, *reading* the news in small, manageable bites is fine. She stays current with anything important and can read the words without the over-stimulation of noise.
Others have stopped watching or reading altogether for a few days at a time to see how this impacts their spirit of well-being and mood. Another client is being creative by playing around with getting her news through the late night comedy shows and via short comedic clips on YouTube. She reports that she feels much calmer and that laughing more feel great!
The point is that constant drumbeat of 24/7 cable news shows, along with media hungry politicians and pundits, can seriously contribute negatively to people’s emotional health. Take a break from it to see if you sleep better or just feel a little less down. Finding some balance that works for you may not be the same as what works for your friend or family member. The important thing is to find that balance and to remember that the good things that happen in life tend not to be reported in the media and that focusing on the good things all around you is a great help to your mental health.
So… consider taking a “News Fast” from time to time and see how you feel! The news will still be there when (if) you come back to it!
Broad Band – Raising Women Up Out of Invisibility
This week we saw the release of a new book chronicling a hidden segment of the female population who made important contributions to our world without most people ever realizing it. Similar to Hidden Figures, although perhaps not as dramatic as a WWII story, the women in Claire Evans’ Broad Band were creatives, science geeks, pragmatists, entrepreneurs, activists, visionaries and householders trying to make a living. They were some of the very few pioneering women who pushed out the boundaries and succeeded in the vastly male-dominated world of science and computing.
Claire takes on the daunting task of sifting through so many many stories and voices to feature just a few spanning over 100 years. She begins with ground-breakers like Ava Lovelace, Grace Hopper and the “two Betty’s” (Betty Jean Jennings and Betty Snyder). She spins the tales of “A Girl Named Jake” and tracks the women leaders through the days of the ARPANET, the early BBS’s, the dial-up’s, the emergence of the web and the world of gamers. As Claire poignently writes at the end of her book, there are hundreds of more stories to tell and women to feature – she hopes others will take up on the torch and keep giving voice to women’s contributions and stories.
I am so honored to have a few of my own stories told in Claire’s chronicle. It was a blast of a ride 
to launch the first women-focused online site Women’s Wire to entice women to try out this new medium which would change our world. There were so few women online in the beginning. It was clear to me that we needed more diversity and more different kinds of voices involved in this new medium. Trying to teach women how to use computers was great fun – I was able to move from our mighty band of 1500 initial Women’s Wire subscribers to launch and mange a huge new “women’s channel” of 7,000,000 female subscribers at AOL. Once the doors opened to the Net for women, they flooded online and have never looked back.
As a lifelong activist and feminist, I find myself working every day now to bring my own version of justice and fairness and kindness to this population I am entering – seniors. This population too – especially senior *women* – needs to become more visible and have their voices heard. They all have rich stories – adventures, failures, successes, lessons learned that can be passed on. And this is time in our country when we can really use those voices sharing what they have learned, often the hard way, and what they have accomplished through plowing hard ground – accomplishments that often are simply taken for granted in the present time.
Although I have not yet finished Claire’s book, I look forward to reading more pages every day and learning about the amazing women who invented and contributed (and led!) in the field of computing. Some of the women are renowned to me and some I am just learning about. Again, such an honor to have a small place in this book amongst so many amazing women and kudos to Claire for taking on this challenge and giving VOICE to so many whose stories are fascinating and worthy of being told.
Successful Aging Takes a Team!
Successful Aging Takes A Team!
Let’s talk about why it’s critical to their quality of life to have a strong support team around seniors who are growing older.
Why?
Because I see so many older people in my private practice who face, for example, situations where they are grappling with:
- family members or loved ones with very strong opinions about what is best for them – opinions danabol that may or may not be informed and wise
- *no* family members or close friends at all to advocate for them
- a primary care physician who is prescribing medications but not following them in after-care. What is known as the “diagnose and adios” routine.
- a specialist or two who is also prescribing – say for instance a cardiologist or endocrinologist – but who is not tracking the interaction of *all* of the medications involved
- a psychiatrist who may be also be treating and prescribing psychiatric medications
- possibly a nutritionist, alternative health practitioner or two prescribing supplements, vitamins and minerals which may all be fine but which also carry side effects that can contribute to mood problems.
Way more often than not, there is very little, if any, communication and coordination amongst the health professionals. This coordinator function may have been done in the past by the primary care doc who managed the broad perspective overview of how each of his patients were doing. But nowadays primary docs are under so much time pressure in their practices that they just do not have time take on this role.
In order to build that coordinated team which will support an individual’s successful aging, it takes someone stepping into the role of being a skilled ADVOCATE. A person who knows how to coordinate effective communication amongst team members and who is in charge of reaching out on behalf of the patient to represent their concerns. Someone who can help the patient communicate their concerns and questions to other team members, and who also helps the patient remember the answers and instructions of doctors. Team members need to work in concert with each other, supporting the various lens through which each patient is viewed.
All of this process needs to be done with the utmost RESPECT for each patient where the patient has TRUST in the advocate that he or she is representing the wishes of the patient towards the goal of the best possible quality of life at any stage.
Gerontologists and mental health professionals who understand the importance of building good communication and coordination amongst care teams can be invaluable to the patient and family. Sometimes, it is care managers who provide this role, sometimes it’s an adult child, and sometimes it’s gerontological counselor.
Whoever it is that takes the lead in this role, a support team that is identified, built, coordinated and in good communication, will result in a patient who is much more likely to thrive and much less likely to fall through the cracks.
This is the health care situation for older people in our country today. Just the facts. And totally doable to navigate through it successfully. With help. With a solid, caring team.
Octogenarians Worrying About America
I am finding, as I continue my counseling work with older clients – those in their 80’s in particular – that there is a concern they express about the state of our U.S. government. These people have been raised with a sense of decorum, a respect for one’s character, integrity and good manners. My clients are a small pool so I don’t have a large study going on, however, their views make sense to me. That is, that the way our government behavior seems to be devolving into an angry, polarized, rude, dishonest style of treating each other and that this is something they have not seen to this degree in our country.
They express concern about this, yes. They worry about where the government is headed. They remember times when Democrats and Republicans disagreed heartily yet were able to work together, spend time together, even be friends despite policy differences.
The anger and polarization leads them to wonder whether our democracy can survive this. My octogenarian clients also talk about other major issues like climate change and health care and tax reform. They don’t all agree on what is to be done about these things – but they watch the behavior of America’s government and shake their heads.
They watch our president’s behavior towards leaders of other countries. Again, they were raised with the values of being courteous, polite and kind as well as strong. They are embarassed and sad that America is losing its standing in the world. Remember, this is the World War II generation – the “greatest generation” as Tom Brokaw labeled them. They have been through many years of watching American men and women fight and give their lives for these values, these truths that we hold as being “self-evident”. These are people who have studied *and lived* history. There are veterans amongst them as well.
Many of the baby boomer clients I see – in their 60’s and 70’s – are also afraid and worried. They tend, in general, to still be busy, though, with working, watching grandkids, traveling, hobbies and other distractions which take up much of their contemplative time. It is the older generation I find that is expressing the most grave and deep concern about our country.
Others may say “it was ever thus”, i.e. that older generations worry about younger generations. Although my older clients did report concern about issues during the previous administration, they are much more worried at this point.
Shouldn’t we be listening to our elders more? They remember the autocratic regimes of Hitler, Stalin, Mussolini and others. They remember the warning signs, the lead-up to widespread wars. They are heartened that Dan Rather, Carl Bernstein, many historians and people who served during the Watergate hearings are being brought out to educate and remind about those times, and to share their experiences and perspectives. Much more of that is needed.
Solutions to The Problem That Has No Name
Here are, as promised, some tools that boomers are using to help keep their spirits afloat as they navigate the transition from their 60’s into their 70’s. They are simple and we mostly know about them. Putting them into regular practice is the key towards feeling better.
- Mindfulness, contemplation and loving kindness practices
Sitting still and paying attention. Daily. That is the gist of mindfulness practice. It doesn’t have to be for a set length of time. One minute is fine. What tends to happen is that if you can stop the momentum treadmill of everyday life even for a moment by stopping, sitting up with good posture and paying attention to your breath for one minute, you might find yourself sitting for more than one minute. The hardest thing is simply to make the effort to stop. This can be pulling over on the side of the road, in a parking lot, in your office, at your home, wherever. The word for mindfulness in an Japanese is also the word for heartfulness. This is where loving kindness practice comes in. Sitting quietly with awake presence includes paying attention to our feelings and not judging them. Letting them be, and pass by. This is a big long topic but keeping it simple, it’s about being kind towards yourself before you can begin to be truly kind to others. Repeating the simple Metta Loving Kindness mantras can be a place to start: “May I be safe, May I be happy, May I be healthy, May my heart be filled with loving kindess.”
- Exercise – aerobic; Yoga
Exercise is key, we all know that. Again, even a few minutes can make a big difference both in physical health and in mental health too. A short walk around the block. A few minutes on a stationary bike. Dancing to some music on the radio. A Youtube gentle yoga video to help build muscle but also to stretch your muscles out. Most people find the most challenging part of this is getting started. So, starting by just committing to 5 or 10 minutes a day is a great way to get yourself going. Don’t start with too much of a commitment so that you give up!
- Understanding the link between nutrition and mental health
More and more research is coming out about the links between good nutrition and good mental health. We are what we eat, it’s true. So many of the neurotransmitters that govern our moods are produced in the “gut”. Paying attention to what we eat – backing down the processed carbs and the white sugar is paramount to good health. Complex carbs, protein, vegetables and fruit. Simple. Fortunately we live in a day and age when good quality organic foods are available. Counting calories is an important thing to watch too. You can eat good quality foods but eat too much of them. Paying attention to your weight and aiming for a strong body are things many of our grandparents and parents knew. We need to pay attention to them too as we get older.
- Giving back to your community; volunteering
It’s not a surprise that helping others makes us feel good. People that survey volunteers at various causes always say that people report that they feel better than the people they help! As we get older and probably are retiring when we can :), people sometimes feel like now what? Traveling and doing hobbies and socializing are great – but so is having purpose and helping out our friends, family and community.
- Consciousness raising support groups
Since we are talking about a “problem that has no name”, being in a supportive peer group where we can compare notes, commiserate, exchange ideas, and yes, laugh!, can be sooo healing. There are meditation groups where people have discussions afterwards, support groups for caregivers, church/temple groups, groups that have to do with aging such as AgeSong in the Bay Area, and more. Many agencies that serve older people offer groups of various kinds, as do community centers. You might have to try one or two before you find one that feels just right.
- Nature – renewing a commitment to spending time outdoors
There is a term in Japanese that translates as “forest bathing”. It turns out that trees release not only oxygen but also chemicals that contribute to the overall health of the forest. And, it turns out, these chemicals are very good for us humans! So, try to get out in nature, in the forest, or on the mountain, or by the ocean or river, or in the park. Anywhere where you can “forest bath” – meaning to simply stop and immerse yourself in the beauty of natural surroundings.
- Counseling
Going to see a therapist who understands the journey of being in middle age and older years can be so healing and supportive. Any therapist might be helpful but particularly someone who understands that the challenges and opportunities and transitions we encounter in this adventure of growing older – can be very helpful in terms of you being able to understand what is common and normal in this part of your life. Understanding that you are not alone – you’re not doing something wrong most of the time – can feel like an unburdening. Yes you still have to figure things out and there are challenges. But the self-criticism, self-blame, and shaming can be *greatly* reduced with the power of a little education about what are called the “developmental tasks” of this age and the common landmarks of this territory. Plus, of course, learning about the many ways people like you are successfully dealing with a variety of issues is a huge help.
- Using the Arts to reconnect with Self
Re-exploring one’s love of the Arts can be so healing at this time in your life. Reading, writing, journaling, reading and writing poetry, playing a beloved instrument, learning how to play an instrument for the first time, taking a 
class, learning to dance, going to art exhibits, singing in a group, going to concerts, enjoying doing crafts, arranging flowers… – all of these feed the soul and, now that you may have more time on your hands, are a good way to relax and keep your mind engaged in beauty rather than on problems. Winston Churchill, for instance, suffered greatly from depression – what he called the Black Dog. Painting, for him, was a tremendously helpful therapy.
Please feel free to email me if you have questions or comment below.
Not Enough Geriatricians or Geriatric Psychotherapists Either
One of our old friends Katie Hafner just wrote an important article for the NY Times entitled “As Population Ages, Where Are the Geriatricians?”. Katie eloquently explains the situation which is that this country is woefully underserved when it comes to doctors who understand the myriad complexity of symptoms that older people encounter. Docs are under-reimbursed by Medicare and so many choose not to go into this field. Others find it too complicated, too difficult, maybe too sad for them. At any rate, treating older people is NOT the same as treating younger people – whether it involves the medical field or the mental health field! Here’s a top-notch quote from Katie’s article that speaks to that fact:
Dr. Eckstrom was a general internist who practiced in primary care for nine years before returning to Oregon Health and Science University to complete a geriatrics fellowship. “I thought I was doing a good job caring for my patients,” she said. “But oral trenbolone for sale I wanted to do more geriatrics teaching and research.” The fellowship opened her eyes. “I had no idea what I didn’t know,” she said.
I hope there will be more articles and education for the public about this critical lack of informed care for the rapidly growing aging population. Someone commented that the government should increase Medicare reimbursement rates for doctors – and I think for mental health professionals too – to encourage more people to go into this field. Someone even suggested the government should pay the student debt for medical students going into geriatrics. We have to do something!
A New Year & A New Perspective
A New Year & A New Perspective
Dear friends and colleagues in the healing arts,
2015 presented me with some interesting challenges. After the death of my beloved mother and the near death and continued illness of my husband, I wondered how we healers can continue to serve our patients when we ourselves are in the midst of tough times. Maybe some of you have come up against this question too.
What I discovered is, as songwriter Leonard Cohen writes, “The birds they sang at the break of day. Start again I heard them say. Don’t dwell on what has passed away or what is yet to be. Ring the bells that still can ring. Forget your perfect offering. There is a crack in everything. That’s how the light gets in.”
It’s this last part that has surprised me. What an unexpected gift is the grace and light that can emerge out of adversity. What I am learned continually deepens both my work and my home life.
As we get older, we find ourselves adding to our toolkit of life skills. Mindfulness tools have reentered my life and work in a big way. And so has my intention to reach a much wider audience through teaching nationally about conscious aging. The need and demand for navigation help is so great as the boomer generation enters the unfamiliar terrain of older life.
If you have friends, family or patients in these populations below who you think I might be able to help or if you have questions yourself, please feel free to reach out anytime:
- People in their 50’s, 60’s and 70’s waking up to their own sense of aging – often through illness or other changes in themselves or their loved ones. They seek answers, solutions, and guidance.
- Adult children of aging parents who feel confounded and frustrated about how to best help their parents through a myriad of difficult circumstances. They are the sandwich generation with aging parents, children and often grandchildren too.
- Families where adult children and aging parents need to and want to come to some new understandings and find a closeness now to the extent they can while they can still can.
- People in their 80’s and early 90’s who are facing their last years with all that that entails – memories, regrets, fears, peace and contemplation – all healthy parts of this stage of life. Having a genuinely caring nonjudgmental skilled listener is so valuable.
You might already know that there are very few psychotherapists in Marin who have advance training in gerontology. With my expertise in the fields of aging, communication, business, medicine and psychology, I am uniquely qualified to help your midlife and older patients, friends and family.
My offices are in Mill Valley and San Anselmo. Telephone appointments are also available for people who do not live close by. I provide a free initial phone consultation. And if I can’t help, I can often steer people to other beneficial resources.
With warm wishes for a peaceful 2016,
Nancy Rhine, MS, LMFT, CPG
415-378-6577
nrhine@gmail.com