The theory of psychosocial development created by Erik Erikson is perhaps one of the best known personality theories. The theory differs from many others in that it addresses development across the entire lifespan, from birth through death. At each stage, the individual deals with a conflict that serves as a turning point in development. When the conflict is resolved successfully, the person is able to develop the psychosocial quality associated with that particular stage of development (Crain, 2011). Marie is in the eighth and final stage of Erik Erikson’s theory of psychosocial development, integrity versus despair. This stage occurs during late adulthood from age 65 through the end of life. During this period of time, people reflect back on the life they have lived and come away with either a sense of fulfillment from a life well lived or a sense of regret and despair over a life misspent (Niolon, 2009). Those who feel proud of their accomplishments will feel a sense of integrity. Successfully completing this phase means looking back with few regrets and a general feeling of satisfaction. These individuals will attain wisdom, even when confronting death (Niolon, 2009).
Those who are unsuccessful during this phase will feel that their life has been wasted and will experience many regrets. The individual will be left with feelings of bitterness, purposelessness and despair (Niolon, 2009). In the field of addiction counseling, working with Marie would first involve dual diagnosing since she seems to be experiencing memory loss, symptoms of depression, and feelings of anxiousness. Evaluating the entire family and learning more about the family history may also benefit Marie since there are additional issues that seem to be surrounding her family, such as her daughter’s addiction to prescription medication. Problems of external origin that derive from conflicts or internal problems such as depression, denial, and frustration, may hinder the ability to recognize the need for help (Gifford, 2012). Due to Marie’s knee replacement surgery and on-going physical therapy, her feelings of depression may be directly related to her feelings of becoming dependent on her children.
Marie’s refusal to take the prescriptions provided to help manage her pain stems from a fear of dependency, most likely from observing and witnessing her daughter’s dependency on pain medications. The psychosocial crisis that seems to be most present for Marie is integrity verse despair, which involves life review, introspection, and self-evaluation. Contemporary factors, such as health, family relationships, and role loss or role transition are integrated with the assessment of past aspirations and accomplishments (Newman & Newman, 2012). Integrity can be described as the ability to accept the facts of one’s life and face death without fear while reconciling life events. The attainment of integrity is a result of the balance of the psychosocial crisis that came early in life, accompanied by ego strengths and core pathologies that have accumulated throughout the course of one’s life. When a sense of integrity is established, the ability to integrate past history with present circumstances produces contentment with the outcome (Newman & Newman, 1991). It appears that Marie may be lacking feelings of integrity and may have various regrets within her life.
Although Marie has achieved accomplishments through the course of her life, she may be lacking a sense of purpose. This might be directly related to her retirement, feeling dependent on her children, or even the death of her husband. As a result, Marie may have feelings of anxiety and depression, and, no longer having her emotional support system, may not have been able to deal with the grieving process from the loss of her husband. When older adults receive high levels of emotional support from friends and family members, higher levels of life meaning are achieved. Anticipated support can also play a role in the changes that take place in a person’s sense of meaning. When older adults are confident they can count on others, their sense of meaning is strengthened with increasing feelings of trust and hope (Newman & Newman, 2012).
Although Marie moved away from the rural town she lived in most of her life to be closer to her children and the emotional support they provided, the conflict and pressure she feels from her daughter Lisa, who depends on her for childcare, have more than likely contributed to an increase of anxiety and feelings of despair. In order to experience integrity, older adults need to be able to incorporate their self-image with a life-long record of conflicts, failure, disappointments, and accomplishments. They must then come to terms with the fact that some of their hopes for themselves or their children may not be accomplished in their lifetime (Newman & Newman, 2012). Marie’s conflict with her daughter Lisa may provoke feelings of disappointment, which is further aggravated with feelings of disapproval about the fact that Lisa has an addiction to prescription drugs. This may also indicate that Marie may have regrets or feelings of guilt from middle adulthood that may not have been resolved.
During middle adulthood, the psychosocial crisis of generativity verses stagnation is described as the adult to be committed to improving the life conditions of future generations (Newman & Newman, 2012). Although Marie seemed to set goals and achieve accomplishments during middle adulthood, such as running her semi-successful business, she may be experiencing feelings of stagnation that went unresolved during middle adulthood due to the circumstances surrounding her daughter, Lisa. In western societies, the social position and experiences of older persons vary across cultures. Not surprisingly, the greatest differences in the status of older adults are between traditional societies and the modernized world, with its rapidly changing values, norms, and lifestyles. As physical functioning diminishes and levels of independence lessen, discouragement and feelings of low self-worth may become greater (Infeld, 2002). Cultural values also play a role in the way society views death within the later adulthood stages of life.
Death during this stage may not be viewed as a great loss since society views their contributions to society to be completed. These factors are likely to create feelings of regret about the past, a desire to be able to do things differently, or bitterness about how life has turned out (Newman & Newman, 2012). This, combine with unresolved issues from middle adulthood surrounding the psychosocial crisis of generativity verses stagnation, can have a drastic negative affect concerning the feelings of having no purpose that occur during later adulthood. If Marie feels that her contributions to society did not meet societal standards, she may feel depressed and as if her life had no meaning. A recent study that compared older adults in the United States and Holland indicated that within both cultures, attainment of social contact and family goals were the strongest predictors of overall life satisfaction (Newman & Newman, 2012).
As cultural values in western societies emphasize high levels of importance surrounding childrearing and family relationships (especially concerning women), Marie’s feelings of having no purpose, which may stem from the unresolved middle adulthood psychosocial crisis, may be directly related to her conflicting relationship with her daughter Lisa. Marie’s declining levels of life-satisfaction may also involve loosing the sense of belonging to a community after she moved from her home in order to be closer to her daughters. Life satisfaction and resiliency is supported through a sense of belonging, which may have been lost for Marie after being removed from her community. Later in life, social relationships are a primary source of meaning. Loneliness or inadequate social networks are much less satisfied with life than those who perceive themselves as positively connected to a meaningful circle of loved ones and friends.
Negative relationships and ongoing exposure to interpersonal conflict (such as what Marie experienced with her daughter), can disrupt feelings of life-satisfaction (Newman & Newman, 2012). Issues such as memory loss and loss of physical abilities may also be aggravated by cultural and societal views regarding aging and a lack of purpose. Although this may pose as a challenge for older adults as they may feel they have to constantly redefine themselves and prove their levels of self-worth, new patterns of thought that occurs in late adulthood may actually increase levels of resiliency (Newman & Newman, 2012).The limitations of formal operational reasoning can provide new methods of post-formal thought. This can be characterized through a greater reflection of self, values, and emotions, the ability to find solutions based on past experiences, a willingness to include conflicting thoughts and emotions, experiences in finding a solution, flexible integration of cognition and emotion for adaptive, reality-oriented, satisfying solutions, an enthusiasm for seeking new questions, finding new problems, and new frameworks for understanding experiences (Newman & Newman, 2012).
In order for Marie to reach heightened levels of resiliency and wellness, issues or circumstances which may have occurred as early as infancy or early childhood (such as trust verses mistrust) should also be evaluated in order to help Marie better cope with the crisis occurring during later adulthood. Cultural values regarding parenting styles, methods of communication and collaboration, discipline that occurred during early childhood, and feelings of support may all need to be addressed in order to increase Marie’s level of wellness and the ability to cope with life changes. Achieving a sense of heightened integrity requires the ability to introspect about the gradual evolution of life events and appreciate their significance in the formation of the adult personality (Newman & Newman, 1991).
This can be achieved through individual effort, which involves reminiscence of long-term memories and events, which may involve finding closure. Cultural values that may challenge older adults, such as the circumstances surrounding ageism, may also be counteracted with more positive cultural values or ideals, such as high priorities in relation to wisdom and age. This knowledge that reflects sound judgment and a deeper understanding about managing life also links wisdom with high levels of expertise (Newman & Newman, 2012). Through assessing each stage of the psychosocial developmental factors that played a role in shaping Marie’s sense of self, determinations can more effectively be made regarding the methods of treatment beneficial for her during late adulthood. The psychosocial crisis of integrity verses despair that occurs during middle adulthood may stem from a previous psychosocial crisis that was unresolved (Newman & Newman, 2012).
As Marie learns to re-evaluate her accomplishments, cope with life changes, and find closure in unresolved issues, she may then learn to find her place in society, expand her social networks and increase her feelings of contribution to family and society. As Marie gains a more positive reflection of herself, her feelings of integrity and sense of belonging will increase, providing her with a greater sense of self-worth, resiliency, and life-satisfaction. Personal and social resources and the absence of anxiety and depression are of crucial importance for the maintenance of life satisfaction in older adulthood. According to Manfred Beutel, author of “The Aging Male” (2010), life satisfaction is strongly associated with resilience, lack of unemployment, the presence of a partnership, positive self-esteem and a good household income.
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