Working with the older couple
After the death of Jack Kennedy - Jacqueline Kennedy wrote:
“Now I think that I should have known that he was magic all along. I did know it , but I should have guessed that it would be too much to ask to grow old with him and see our children grow up together. So now, he is a legend when he would have preferred to be a man.”
This poignant quote by Jaqueline Kennedy highlights the tragedy of not having the chance to grow old together. Her words might serve to remind us, as I explore the older couple relationship, that as difficult as may be, to grow old together, it is also an opportunity in life that is not to be missed.
The inevitable result of engaging in a long-term relationship is to eventually suffer the loss of one’s partner. That’s the deal - unless the couple decides to end it all; and jump off the Forth bridge together.
I am suggesting that if the fear of potential loss is not made conscious or expressed explicitly, then paradoxically, the fear will inform and influence the way we live our lives; as we grow old together.
If we refuse to accept the inevitability of this extraordinary process, this inevitable loss, which will leave one of us alone - we might unconsciously withdraw from our partner, and the interest and the enjoyment of life before death will be diminished.
Alison Lyons and Janet Mattinson in their seminal paper, Individuation and Marriage, ask: whether one person can partner another and at the same time develop his wholeness and capacity for individuation?
There follows several definitions of Jung’s notion of individuation, but for this Paper I would like to define individuation as “becoming one’s own self” and more specifically as “ remaining ones own self”.
As people move into old age, I am suggesting that the tension between the longing for intimacy and the desire to be alone is heightened and that this period is a final opportunity to take on the working through and the struggle to reconcile the opposites, intimacy and autonomy and, in so doing, hold onto our sense of self. In Jungian terms, to individuate.
Often however that struggle for balance is abandoned and there is a collapse into one position or another. The couple either become merged or grow distant from one another. Some couples remain glued to each other in a malignant dependency; unable to act independently. Alternatively, some couples give up all hope of interdependence and go their separate ways, to live in parallel existences.
Like most topics that capture our interest, the subject, of course, finds a reflection in my own stage of life.
I wrote a Paper about four years ago called The Creative Couple, which was also about the older couples. In this Paper I reflected on my feelings one Easter Sunday when my husband was away. I was appreciating having the house to myself but as I was laying the table for lunch for my children and grandchildren, I became aware of an enormous sense of loss. It felt like a forerunner of things to come. I was performing familiar tasks, but I became aware that I was alone. Of course, even if my husband had been there I would have been doing these things by myself but - to use Winnicott’s phrase - I would have been alone whilst in the presence of another and therefore would be “contained”.
I was acutely aware that one day there would not be a couple to greet the family visitors. The feeling quickly passed and I am happy to say that there are still two of us to enjoy Sunday lunch with our family. But sadly, since writing that Paper, a close friend of mine has lost her husband and I think she would now recognize the feelings that I experienced on that Easter Sunday morning.
It is difficult to write about aging and couples without considering the ultimate loss that death will bring. Although this might be implicit in the work that we do with older people in my experience it is rarely spoken about. Not surprisingly; because death is, as today’s teenagers might say, truly awesome.
How to grow old together - is in itself paradoxical, because growing old together successfully might demand a separateness in the relationship that seems contrary to the expectations of ourselves as a couple. We are facing the enormity of old age and death individually, but we are also facing it with each other. Surely this is the biggest challenge of our shared lives?
It seems to me that far from being able to rest on our relationship laurels, as we might reasonably expect, after decades of a good-enough marriage, there might yet be much to be gained in thinking about and understanding our situation.
As I write and think of the work that such a developmental approach requires, I can understand why we might collapse into one position or the other, into separation or into merging. Bringing our love and hate together again, struggling, yet again, into a place where we can love our partner as a separate other, when our marriage is now starkly outlined against the prospect of death, is not for wimps. Who amongst us hasn’t thought of the release that death will bring? Who hasn’t day dreamed about gathering around the graveside weeping about our loss? But what happens to our fantasies when such a prospect is not so far away? For either of us.
Whilst part of us might be pleased to think of our partner coping well and enjoying life after we have gone, our narcissism will surely resist such a notion.
I remember as a young woman; demanding from my husband that he mustn’t die first as I couldn’t bear to be without him. Now, life itself seems more precious and less dependent on him, and although I don’t want him to die first I don’t want him to die last either.
This is a quote from another first lady, Eleanor Roosevelt:
“ Probably the happiest period in life is most frequently in middle age - when the eager passions of youth are cooled and the infirmities of life not yet begun – and then we see that the shadows, which are so large at the morning and evening, almost entirely disappear at midday.”
That might well be true, but perhaps the midday sun is often too bright for us to clearly see the whole picture.
As couple therapists - we can chart the stages of a long relationship and anticipate periods that might create difficulties; such as - the birth of the first child; the death of parents; or, children leaving home. We know that the loss of a job can put intolerable strain on a relationship and that many unconscious forces are at work to undermine the expected, and hoped for, happy life together.
Impossible as some of the presenting problems and ensuing work might seem, it is the case that often the difficulties manifest within a maelstrom of a busy and hectic life. Indeed, it is quite often the maelstrom that is creating the intolerable stress on the couple.
Warren Colman (1993) speaks of marriage as a psychological container, and we therapists find it helpful when thinking with a couple about the process of therapy, to talk about the marriage as a container, which can manage to hold many of the difficulties of life, but which occasionally cracks, when it is overburdened. I think about the therapy, with all of its predictable parameters, as an auxiliary container, rather like an auxiliary heart machine, which can support the patient …whilst the hard work of sorting out the problems is undertaken.
My point here is that, for many of my younger clients, it is life itself which is creating the anxieties and difficulties, which they are experiencing. Life is throwing up problems, and we know that if these problems are reflected in unconscious unresolved conflicts in the past, the couple are in trouble.
As Warren Colman says in his Paper, The Individual and the Couple “The purpose of marriage is not necessarily to remove difference, but to find ways of managing the various struggles that the vicissitudes of life will invariably bring to the couple.”
When a younger couple first tell me about their problems, there is no doubt that they are often experiencing life as completely intolerable; …the affair is devastating, …the loss of a job catastrophic, …the misunderstandings and rows are excruciating …and the lack of communication unbearable. They would not be seeking help if things had not reached an impasse.
Life and the business of living it is all engrossing. …Which school? …Lack of money …parents in law …to have children or not …to try to have children but can’t …to move house or not to move house. The list is endless.
I struggled to put a label on this stage of life. It seems biologically and socially driven and, although the types of problems I have outlined are real and deeply upsetting and obviously find echoes and have roots in history, they are all set against a backcloth of an assumption that life will go on forever. As Eleanor Roosevelt said ‘ in the midday sun’.
At some point it strikes us that life will not go on forever. It might be because of an illness, or the death of a parent, or retirement or a particular birthday, but - whatever the trigger - it is a sobering thought that I, we are going to die.
I am suggesting that the struggle to think about that unpalatable fact, to acknowledge it and continue to live and love, is incredibly demanding. I am also suggesting that whereas in the younger couple, the problems are problems that need to be solved, it could be that the problems and ensuing conflicts in the older couple are a defense against the approaching, larger, inevitable, unavoidable problem …of the death of one’s partner or oneself.
The oedipal struggle with all that that entails remains the same whether we are three, seven or seventy. In order to move on we need to mourn that which we have lost, but surely this last, ultimate working through is the hardest of all. Before late middle age when we accept what we have lost and can’t have - we know we are moving on to something else. But now, we are expected to mourn all that is gone, …all that life, …all those traumas, …all that so called immortality, and move on …to – what?
These days, the certainty of moving on to a life after death is not ubiquitous and what we believe or don’t believe is not under discussion here. What I am proposing we discuss is: when we know death is not so far away - can there be life before death? Can our creativity, the creativity that comes from engaging in the struggle of opposites that a couple represents, be with us …until the day we die?
We often talk about our client as being the couple, the relationship.
The couple, the relationship, might be in their fifties, sixties or seventies, and any number of situations or problems might have precipitated the need for therapy.
I’d like to present the cases of three couples who became aware, during their therapy that they were grappling with the challenge of how to grow old with each other, or, as you will hear later, grappling with the challenge of not being able to grow old together.
The first of the three cases that I have drawn on is …Richard and Maria.
Richard is an academic from North America; Maria a lawyer from South America. I liked them both immediately and, as quickly became apparent, so do many others. Theirs is an open house full of friends and family. They clearly have had a good marriage so far. But, after half an hour of open and frank discussion, the delightfully eloquent and refreshingly honest Maria said “ Well we are sixty and have been married for thirty years and the question is do we now have a party or get divorced?”
Maria went on to say that they didn’t need each other, as they were both financially independent and had their own professional lives. She said all this in a friendly and non-emotional way which was accepted with equanimity by Richard. I was the one who was baffled.
They explained that when they visit Maria’s family in South America - Maria becomes a different person. She is absorbed into the extended family and Richard feels completely excluded.
Maria agrees that she does become integrated and preoccupied with the tribe and they both told me that her family never stops talking - loudly and expressively and, as far as Maria is concerned, that is normal. She thinks that Richard could put up with it, as for the rest of the year they are in academic Oxford, which couldn’t be more different than being with the hot blooded Brazilians.
What initially seemed to me to be an easily resolvable problem ended with an ultimatum from Maria that if they didn’t solve this dilemma - Richard could not possibly go back to Brazil with her.
Richard countered that if Maria did not give him more “air time” when they were with friends, when she didn’t allow him to speak that he would have to end the relationship. He wanted more intimacy and it seemed to him it was impossible to find it with Maria. These delightful people were at their wits end.
Why at this point in life have they have come for therapy? And why have these familiar problems suddenly become unbearable?
They both come from large and lively families and enjoyed their childhood years. However, both had experienced the death of a sibling when they were young. They only have two children, but they reproduce the bustle of their large families by filling their home with students, nieces and nephews and, as far as I can judge, the entire Brazilian population of Oxford.
They are both near retirement. And their children are about to leave for University and to start careers. Their life will soon change and, because they function best in a large group, they might unconsciously feel alarmed at the thought of being left with just the two of them.
What is looming is a smaller world. Most of the older generation in Maria’s family and two of her brothers have now died. Richard’s family are in North America - and they are less inclined to spend much time with them.
They are saying …“We either find our couple and have a party, or fail and get divorced”. In late middle-age, they are recognizing that just to be part of a huge family isn’t enough. Richard is clearly saying that he loses Maria, and himself, when she is with her family …or in a group of friends. Maria insists that they will still visit Brazil. The unconscious metaphor is that they can’t go to a place that isn’t comfortable for them to visit together.
Both realize that they need to grapple with these difficulties in order to happily grow old together.
I am suggesting that in order for this couple to move on they need to accept that life is changing, and mourn the loss of the family bustle they enjoyed.
They could separate, in the hope that in leaving one another they will also be leaving their problems behind, but if they resolve this stage of life, it might enable them to find a deeper intimacy.
But such intimacy could be frightening. Both suffered tragic losses in their childhoods; losses they were unable to mourn. To discover their need for each other now and enjoy a dependence on each other, they will need to deal with the knowledge that one day they will suffer the loss of the beloved other, as they did in childhood.
The title of this Study Day is “Couple Work in Different Contexts - How Far Do We Adapt Our Techniques”.
I am thinking of this in relation to working with older couples and Richard and Maria fall into that category. But they also fall into the category of successful VIP Oxford academics, often travelling to give Papers or, in term time, working from dawn to dusk - teaching or as administrators.
To challenge the sanctity of their regime feels like interrupting the Seven Days of Creation – could it possibly have been done in eight days? With less stress!!!
It is often the case that I go as much with the academic flow as I possibly can, in the interest of continuity, and will see one or other partner alone, if one of them is away. But I feel with Richard and Maria that the challenge will be to only work with them together because their busy, inviolate professional and social lives may be a defense against the intimacy which they both long for.
.Although the content of their sessions is important to understand and give meaning to, I think it will be of most benefit to the progress of the therapy if I challenge the interruptions to the work.
If Richard and Maria can acknowledge that the therapy session is more important than the demands of their careers, I believe much of the therapeutic work will be done. But my counter-transference tells me that this will be no easy task. To challenge their academic work feels like a challenge to life itself.
But it is early days …and our relationship is not yet established enough to encounter head-on the narcissistic aspects of my charming couple.
The second couple I am going to talk about is Sharon and Dave.
Sharon and Dave are struggling to come to terms with loss. They are not old, but they are facing death. Sharon is being treated for secondary cancer and she bears the scars of the previous treatment she has had. She has put on a lot of weight because of the drugs; her hair is thin and her arm swollen.
She limps in to my consulting room and collapses into her chair. But she is a feisty woman, with her own business.
Dave is a quiet man. He has just been made redundant and is determinedly seeking another job, whilst making sure that the home is as comfortable and nurturing as possible for Sharon and their three teenage children.
In the two initial consultations Sharon described the problem as …Dave not caring about her …that she couldn’t talk to him about anything …that she got on very well with all her girl friends …but not with Dave. She described their devotion to their children as unwavering, but their couple relationship as bleak. Dave said that he could never please her …that she was abusive and terribly critical. Many years ago there had been an incident when Dave was violent towards her – but he had never lost his temper like that again – he had co-incidentally at that time been sent on a developmental course by his company and he had used it to understand what had happened to him. The effect was transformational.
Sharon’s cancer was talked about, but not with feeling. She had first had it diagnosed four years ago – now it was back again, but it didn’t stop her working or enjoying the children. Life was hard and they had had to sell their house a couple of years ago, but now they were renting a lovely cottage which they all enjoyed very much.
Sharon displays great energy and vitality in spite of carrying herself with difficulty. Dave is courteous and often calls her “darling”, but his main aim is to try and keep the peace.
I first saw them in November 2009. Every session was explosive. I was regaled with stories of how casually Dave treated Sharon and how rudely Sharon treated Dave. They had had counseling before -- the last time was about five years ago. They had really liked their counselor – Steve- but one day he had rung them to say he wasn’t allowed to carry on seeing them, because they had been coming too long!
I felt that Steve had been a big loss for Sharon and Dave, and suggested they might try to contact him. He might possibly be able to see him again.
They did try, but couldn’t trace him.
Dave pleaded with me to set some homework for them to do. He wanted more structure, some way of being able behaviorally to stop these incredibly debilitating and upsetting fights at home.
I thought with them about the possibility of Cognitive Therapy – I reasoned to myself that this couple had had a lot of counseling, and time was seemingly short for them, so perhaps someone skilled in cognitive behavioral therapy or cognitive analytic therapy would be of more help.
Throughout November we explored these possibilities until finally I realized that they might be continuing with me for a reason, and that might be the hope, albeit unconscious, that someone could contain their terrible situation.
After one particularly aggressive and explosive session, as we were nearing the end of the hour, I addressed the elephant in the room. I said that I thought that much of their fighting was an avoidance of the terribly painful situation they were in. I asked if they talked about the cancer at home. Dave said Sharon wouldn’t talk to him about it …that she talked to her friends, but not to him. Sharon said her friends were helpful and sympathetic, and Dave wasn’t. Dave protested that there was no way in for him.
I said it was quite understandable that they found it difficult to share such a distressing situation, but that it wasn’t only Sharon who had cancer, but the couple also.
The atmosphere in the room instantly changed and they both became very thoughtful and said after a while that of course I was right. Sharon acknowledged how hard it must be for Dave. And Dave said that she was on his mind all the time, but it seemed as if nothing he did was right.
I said it must be difficult for anything to be right when the most important aspect of their lives couldn’t be talked about; that it was understandable that every issue from the undercooked egg to the careless word was seized on and used as evidence that no one cared or understood. The big issue hadn’t been understood, so all the little issues became evidence that something was wrong.
There was a silence that included all our thoughts. My thoughts accompanied a heavy heart, obviously I was caught up in the counter-transference, but I think it was more than that. In speaking to the unspeakable I was acknowledging their frightening world and in doing so, I was creating the container that might allow them to enter that unknown and frightening place together. I was tacitly agreeing to enter it with them, until death do us part and I really didn’t want to go there.
It was only as I was writing this Paper that I realized all my helpful suggestions to them of finding their old counselor or a new cognitive therapist was, at least in part, an attempt to avoid working with them.
The next two sessions, before Christmas, were calmer. But it was still difficult to know how to speak about the unspeakable. There was a delayed return after Christmas because of the snow and, by that time they had returned to the familiar hatefulness; with Sharon feeling neglected and unloved and Dave feeling un-appreciated and abused. But slowly we are again finding moments of real softness.
I stick to my guns and hope that, in speaking of the cancer and acknowledging the tragedy they going through, the container I am offering them will be strong enough to allow them to explore and to bear their horrible situation.
I stay with the here and now. I make little reference to their individual histories and although, of course, I listen to the rows, I do not follow the minutiae of them but regard them as a defense against the knowledge that Sharon is soon to die. When appropriate, I call their attention to the feelings they might both have about the future and their impending loss of life with an interpretation.
My hope is that if they are able to find themselves as a couple and can bear to acknowledge the situation the couple is in if they could weep together this would release them from the constant rows and frustrations. Then perhaps they could get on with their family life, as indeed they are now, but without the hatred of what is happening to them which manifests itself through their endless rows. A tall order!
My third and final case is that of Daisy and Peter.
I decided to present this case because, in many ways, Daisy and Peter have everything to play for. They are in their sixties, have been married for about 30 years, have two children and three grandchildren and, by great good fortune, are about to realize an investment which will mean that they can live comfortably for the rest of their lives.
I have been seeing them for about two years and volumes of therapeutic water have flowed under the bridge.
Their personal histories are important, as is their shared history and, unlike the other two couples I have talked about, their histories are a constant and important part of the therapy. The three of us now have a shared language which allows for short cuts. We are familiar with incidents from the past and can often share an intimacy and understanding of situations that allows me to look forward to seeing them.
The difficulty is to remember that Peter and Daisy are clients such is their easy acceptance of me and my genuine warmth for them. I work very little in the transference, possibly because they are both in individual therapies and I think the emotional edge, as James Fisher would say, lies between them and not between them and me.
Over two years we have come to understand that they have had a deep fear that some terrible catastrophe would befall them if they were to allow themselves to claim their inheritance of talents; and they can now clearly see where the roots of these fears lie. Both individual histories have had more than their fair share of disaster. And it is no wonder that they shared an unconscious, now a conscious fantasy, that to lift one’s head above the parapet meant that it would be knocked off. Between them, there had been a tacit agreement never to let go, never to take the risk of being happy. So, like a weather men on a Swiss cookoo clock, if one came out the other would go in. It was usually Daisy who kept her foot firmly on the brake, but if she should take it off for one minute, then Peter would pull on the hand brake.
For them to come together was to risk being overtaken by a catastrophe that would threaten to destroy the couple, but to be separate, brought the terror of being alone. Both creative artists, their talents were endlessly compromised because of their difficulty in dealing with the tension between their longing for intimacy and their desire to be alone. This tension was endlessly acted out, creating domestic frustration. They could disentangle themselves by sleeping in separate bedrooms or by going to the unnecessary expense of renting outside studios - when they had ample space at home to work in different rooms. Then, they felt isolated and resentful towards each other.
Gradually things began to change. And as if to symbolize their new-found capacity to come together without being overwhelmed, Daisy made a pot that Peter painted for their daughter’s wedding present -- a truly creative gift.
But just last week, something rather curious happened.
From time to time, they have tried to talk about sex. This is a difficult subject, because of Peter’s florid sexual history before he married Daisy, and Daisy’s longing to be loved as a whole person - which she believes Peter doesn’t do.
Peter, who feels rather ashamed of his sexual past, finds himself on unsafe ground when they talk about sex and he becomes defensive, eventually retreating to a place of no-sex - which leaves Daisy feeling unwanted and undesirable. An impasse.
Daisy managed to bring up sex again and they both acknowledged that the lack of sex was a cause for concern and regret. Peter said that he talked often about sex in his individual therapy and, when Daisy asked why he didn’t talk to her about what he had come to understand from his individual work, Peter said that his analyst had told him that the work was like a cauldron that needed to be kept on the boil, and that meant not sharing the thinking he was doing. Suddenly, after years of finding no conflict between their individual therapies and the couple therapy, something in me began to feel outraged. Peter was having intercourse with his therapist whilst intercourse between him and Daisy was nonexistent.
We, the therapists, were an embodiment of the conundrum of how to be both a couple and separate individuals. We were colluding with the belief that it was impossible.
I don’t think this has always been the case. Until very recently it has been helpful for this couple to combine the therapies. But now, as they begin to reconcile the tension between being individuals and being a couple, paradoxically the therapies might collude to stop this development.
I commented that it felt as if the middle-man was being cut out. Daisy said “do you mean you are the middle man?”
Well yes and no! …I thought that their relationship was the middle man and, as it was the relationship that was my client, I was suggesting that the couple was in danger of being overlooked. Once again the intimacy between the two of them was being avoided, and had I somehow colluded with that?
Daisy said she thought sex was the last piece of the jigsaw that they needed to put in place. Right at the end of the session - Daisy had linked intimacy and sex together.
The following week, they told me they had discussed what I said last week.
I said “about sex?” They said “yes and about other things”. It was as if the flood gates had been opened. They talked about how they met, their previous experiences with therapists and of the two abortions Daisy had had; neither of which I knew about. As they talked about their lives together Peter said the trouble was that he and Daisy had different views of their marriage. He thought they had had difficult times, but on the whole the good times outweighed the bad, but Daisy only remembered the painful times. Daisy said rather sweetly, “That’s because your glass is always half full and mine half empty”.
They were reminiscing and I was allowed to be party to the intimate sharing and remembering of a life together. It seemed to me that this was the beginning of a process of thinking together about their disappointments and pleasures. They talked of the time after the affair when sex began to be good, but a blunder and misunderstanding by Peter meant that once again their passion was spoiled.
I thought that this blunder, this spoiling of the moment, reflected all that had been so difficult for them as a couple. They shared such a fear that if they dared to come together in a passionate embrace some terrible catastrophe would befall them. Better to destroy the passion themselves than to take that risk.
I think on reflection that my noticing and speaking to the split that was being acted out by the therapists made it seem that two individual therapists and a couple therapist could co-exist and acknowledge each other. This, which also challenged their defensive system, enabled Peter and Daisy to feel safe enough to really let me into their world. They existed as two individuals, each with their own therapy, and I had spoken up for the couple which also existed and needed to be acknowledged. Whatever it was, it made a difference.
In Conclusion:
I am suggesting that there is an added dimension to our work with the older couple. That is the shared knowledge, either conscious or unconscious, that the relationship will suffer the loss of one of them, in the scheme of things, sooner rather than later.
I have spoken about three couples who have presented with very different problems, but with similar defenses against a fear of catastrophic loss.
Maria and Richard want intimacy, but fear experiencing the loss of each other if they should they embrace it. The fear is intensified by the fact that the loss of their siblings in their youth had never been mourned.
Sharon and Dave are facing the stark reality of loss very soon. I wonder if they can be courageous enough to know what they mean to each other, when death is in sight.
Peter and Daisy have lived all their life trying to avoid the terror of the catastrophe, which they have both already encountered. They have come to understand what we would call their shared phantasy, that if they were to embrace life they would lose what they loved and their shared defense, to never passionately embrace life. They now need to mourn the loss of what might have been, to bear the knowledge that so much has been missed, before they can claim and enjoy the really good things the rest of their life has to offer.
I have often thought that it is the fear of death that stops us from living; for the instant we claim life and truly know we are alive we must simultaneously know we are going to die. It follows that when we accept what our most intimate other means to us, we realize that we will ultimately lose them.
All our lives we are struggling with the tension between dependence and independence, between intimacy and autonomy, but the dynamic takes on a fresh urgency at the later stages of life. I am suggesting, or perhaps hoping, that something creative can be achieved if we continue to hold and sustain that tension of opposites.
It is true that eventually we will lose our constant and much loved other, but if we know, really know what it is like to be a couple and are ultimately able to internalise the creativity that comes from bringing two opposites together; then perhaps we will be able to Let Go and Get On.
© Pauline Hodson