Life Review Therapy—How Talking About Our Past Can Help Us Cope with Change, Old Age and Death
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“Old age is becoming increasingly important all over the world; the ever-increasing population of the elderly is one of the most challenging issues in the domains of health and welfare. The growth of the elderly population has been so important that it has come to be described as the silent revolution.”
(Effectiveness of Life Review Therapy on Quality of Life in the Late Life at Daycare Centers of Shiraz, Iran: A Randomized Controlled Trial by Farkhondeh Sharif, Ph.D., Iran Jahanbin, MS, and Mahboobeh Hosseini Moghadam, MS, April 2018, International Journal of Community Based Nursing and Midwifery, ncbi.nlm.nih.gov)
While it is obvious to most that seniors face many physical challenges and illnesses that require increasing amounts of medical and occupational interventions, what is less discussed and understood is the incredible mental health challenges seniors face. “The World Health Organization (WHO) states that many older adults face special physical and psychological challenges, reporting that 20% of adults age 60 or older suffer from neurological and mental disorders with 6.6% of all disability attributed to psychological disorders. Older adults who live in nursing homes deal with comparatively poorer quality of life than those of normal aging elderly. Psychological interventions and activities within nursing home environments to increase life satisfaction are oftentimes undervalued.” (Effect of Life Review in Quality of Life for Older Adults Living in Nursing Homes by Rene’ Wren, University of St. Augustine for Health Services, Spring 1-23-2017) Additionally, coping with a terminal diagnosis can be extremely difficult for patients. Health practitioners need to have effective treatments for people struggling with facing their death. Close friends and family also need assistance in dealing with a loved one’s terminal diagnosis. Lastly, when we face significant upheavals and change, we often struggle immensely and can suffer from anxiety and depression. Changes like the loss of a parent, divorce, or even moving out of a house you had for a long time are times when a therapeutic intervention could prove helpful or even invaluable.
The discoveries of two renowned psychologists, Butler and Erikson, helped create what is now referred to as life review therapy. Butler would be the first to coin the term and write extensively on his belief that by encouraging and therapeutically guiding an older adult as they reviewed their life, the older adult often found a renewed sense of happiness and fulfillment. “Butler believed that the depressive symptoms of his patients stemmed from the aimless way they remembered their pasts. He devised a procedure for helping people conduct ‘life reviews’ that highlighted the key purposes they had pursued successfully in their prior stages of life. By finding positive benefits in all earlier experiences—even ones that appeared unfortunate at the time—people can affirm the values of their lives and chart a hopeful path forward.” (Purpose and the Life Review by William Damon, Ph.D., July 28, 2021, psychologytoday.com) As Butler continued to research the life review as a therapy, he came to see that people, regardless of age, facing a terminal diagnosis also benefitted greatly from life review therapy. Additionally, further studies on the practice also found that life review therapy was helpful for the mourners. Now, many Hospice nurses will offer life review therapy for both the patient and their loved ones.
The other key figure is Erikson. Erikson is famous for defining human developmental stages. Erikson proved that we continued to develop throughout our lives, including the final years of our life. “Erikson [1902-1994] was also the first psychologist to see old age as an active developmental stage of life. Erikson’s stage 8 is Integrity Versus Despair, which generally affects persons over 65 years of age. This is the crisis seniors face and must resolve.” (How a Life Review Comforts the Elderly and Prevents Late Life Depression by Joy Intriago, May 4, 2021, seniorsmatter.com) Life review therapy can help a person transform the despair of feeling like there is not enough time to fix their mistakes or accomplish something of significance to seeing themselves as an integral whole. Hence, like the challenge of adolescence is becoming separate, individuated beings apart from our parents, the challenge of Erikson’s stage 8 is to transform our despair into integrity.
What is life review therapy, and how is it different from ordinary thinking about our past? “A subtle difference between reminiscence and review must be addressed. Reminiscing is giving an account of what is remembered. Review is more systematic.” (Life Review with the Terminally Ill by Mimi Jenko, MN, RN, CHPN, Leah Gonzales, MSN, RN, Mary Jane Seymour, MS, RNC, Journal of Hospice and Palliative Nursing, Vol. 9, No.3, May/June 2007) Life review therapy usually follows the natural developmental stages of life. Additionally, themes are highlighted and represented like marriage, children, social status, and career. Special attention is paid to moments when the patient experienced defeat, heartache, betrayal, or guilt. The patient is then encouraged to review the incident logically and forgive themselves or others. Additionally, seeing how a negative turned out positive in the long run is encouraged.
Research has proven that life review therapy can be beneficial for seniors finding purpose and joy, the terminally ill finding peace, and courage and hope for people facing a major life change. “Especially in times of change, reflecting on the past may help people to maintain or to flexibly adjust their identity. Similarly, problem-solving functions go beyond the mere recollection of memories, as the recollection of earlier coping strategies may help people deal with current problems.” (Life Review and Life-Story Work by Gerben J. Westerhof, June 19, 2015, The Encyclopedia of Adulthood and Aging, onlinelibrary.wiley.com) Life review therapy can even be practiced on oneself. Or in the case of a terminally ill loved one or elderly relative, a friend or family member can help them do a life review. It is crucial, however, to research the practice and follow the guidelines as best as possible. In my research on the subject, I found several workbooks and manuals online on how to conduct a therapeutic life review. Two warnings: life reviews are not appropriate for anyone who has suffered from a significant trauma. Those people need careful professional treatment. Additionally, it is never okay to push a person to share more than they are willing to share. Research suggests that cross-generational life reviews, like a grandchild conducting one with their grandparent, can be very healing and helpful for the broader community.
The life review is a wonderful way we can find resolution, healing, and purpose in our lives. For seniors or people facing death, it can transform despair into integrity, and for people facing a significant change, a life review can reveal effective coping strategies. “A life review offers us a way to look back and connect the dots, starting with our first glimmers of purpose in adolescence. It can help us recall the purposes we’ve had in our lives, integrate them with our present circumstances, and envision opportunities for further purposeful work.” (Purpose and the Life Review by William Daman, Ph.D., July 28, 2021, psychologytoday.com)
Jennifer Barnick is a painter and writer. She studied painting at the San Francisco Art Institute. She founded Twenty-two Twenty-eight. “One of the most exciting aspects of Twenty-two Twenty-eight is building a channel for artists and writers to share their work with the world.” You can follow Jennifer on her Instagram here.
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