We have to map our journey from the inside
I know too well that words can be painful, so we need to find alternatives. Any form of creativity can contribute to bringing awareness to the surface
Els Messelis, Belgian gerontologist and author
Unbeknown to psychologists, there must be some underground “tunnels” that connect unconsciousness and rationality, allowing a silent stream to bring concepts to the surface. I make this hypothesis because I unexpectedly bumped into some poetry. Actually, my mind tossed it at me when I sat down to write this story. The poetry is “Don’t ask us the word” by the Italian Nobel Prize laureate Eugenio Montale. It belongs to the collection Cuttlefish Bones where it appeared some ninety years ago. It’s an iconic line impressed in the memory of any student who crossed the threshold of an Italian high school. What surprises me though is not this casual encounter, but the last lines which I had completely forgotten about, “All we can tell you today is this: what we aren’t, and what we don’t wish for.” I feel these words perfectly frame the challenge of aging in a culture that, by overvaluing being young, obliges the rest of the population to navigate its identity by comparison.
The story of the Belgian gerontologist Els Messelis plays a part in my recollection. I’ve been touched by the description of the powerlessness she witnessed in her aging mother and how this, in turn, propelled her to help adults who face some sort of midlife crisis or deal with the prospect of retirement. Leveraging the power of creativity—from narrative to forest bathing—Els accompanies adults on the verge of change to embrace their past, frame their lives, and chart a new direction for their future. As she pointed out, many times words don’t come easily and then it is necessary to find a way to weave silences into the discourse. When it comes to listening, I can perceive her ability to create a welcoming space from our first “hello.”
It’s probably because of her longstanding experience in paying attention to what is unspoken that, more recently, she began to venture into the hushed topic of sex and intimacy in residential aged care facilities. Together with Professor Michael Bauer, Honorary Research Fellow at La Trobe University, in Melbourne, Els sent a questionnaire to 750 care facilities in Flanders, Belgium. Invited to express their opinions on the 69 items of the “Sexuality Assessment Tool”, a survey designed to measure the support for the expression of sexuality of residents, only 9.2% of the facilities responded. A figure that mirrors the marginal status accorded to sexuality in aged care settings, compared with other measures of wellbeing. Undeterred, Els embarked herself on a new journey, training professionals to bridge the gap and respond to unsaid needs.
Where does your interest for older citizens come from?
It is a combination of reasons. Some are personal and some derive from my profession. When I was a child, I was very interested in the wise words of my grandparents. As they became older and older, I realized they grew progressively invisible in the society. I observed how they became dependent on others. I was touched by seeing how my mother supported her parents and her parents-in-law during their later years.
When I was nine years old, my parents got divorced. At that time, my mother was 48 and my father 45. While my father remarried, my mother didn’t and looked after us four children. Upon retirement, she had a very small pension. This realization pushed me to become a feminist: I wanted to fight for equal rights for older women and for women who never had chances to build a professional career.
Because of the relational and sexual problems of my parents, I witnessed first hand their impact on my mother’s life in the form of sexual and emotional burdens and loneliness. I wanted to contribute to breaking that cycle.
How are you achieving this goal?
I became a social worker, a gerontologist, a writer and a life coach. I teach older adults at the Department of Advanced Education in the University College Odisee, in Brussels. My courses aim to boost people facing midlife crisis and retirement. I founded Lebensverhalen Lab, a name that translates into Lifestory Lab, to access workshops in narrative and art therapy. The goal is to help people on the verge of change to share life stories in an intimate setting, and to help professionals interested in learning more about narrative care for the older and vulnerable adults they work with.
Why did you decide to become a gerontologist, in particular?
Because of my tremendous interest in older citizens and the story mentioned above. As a young student social worker, in my twenties I did my internship in a psychiatric hospital where I worked with mainly depressed and regressive older citizens. I realized that all people – young and old – could become a psychiatric patient if the psychosocial burdens in their lives overwhelmed them. Later on, working as coordinator in a day care center for dependent older people suffering from cerebro-vascular accidents and dementia, I felt the need to know more about gerontology and geriatrics to better empower and support the older people in my care, their families and our staff.
How does narrative gerontology work and what role does it play in aging and in care?
I am not a therapist. I facilitate the communication. Every person is different and there are different paths. Sometimes, the path is writing, sometimes it is talking with another person, sometimes it is painting or walking in nature. As a social worker I know too well that words can be painful and so we have to find alternatives. That’s why I began to add a creative element to life stories narrative, as I explained in my 2018 book Wanneer woorden tekort schieten. Creatief op zoek naar het doorleefde levensverhaal (When words fail. Creative ways to look for lived life stories).
Storytelling is a way to see one’s self as the protagonist of one’s life. By processing the memories there’s a sort of recalibration of the life course and personal growth. Any form of creativity can contribute to bring awareness to the surface. Many people are not used to seeing a coach, to talk about what they want, and to explore the concerns they have for their future. They feel they are caught in the middle of a transformation and need tools and guidance to navigate the challenge. I help them to formulate the questions to make their answers emerge.
I know you’ve been giving lectures on “The art of becoming older” for quite some time. What is your perspective on this subject?
I started to give lectures 34 years ago. My first interest was retirement, but with time the perspective broadened to include social aspects of growing old and the social roles that older people can perform after their retirement. The goal as social gerontologist is to help and support them to improve their interactions and communications with others, to enjoy active and independent lifestyles.
Because of my childhood experiences, I turned out to be a feminist gerontologist. My lectures are grounded in feminist theory and critical gerontology and focus on power relations and the intersecting oppressions across the life course. Many older people have burdens, are invisible, lonely, poor, or are victims of elderly abuse.
The art of becoming older is about solidarity and equality, but also about connection with one’s self, one’s family, social network, spiritual life and nature.
From the feedback you are receiving, what are the most unexplored topics in this time of life?
After retirement, people want to live their own lives, but for many this desire remains unmet. Especially for women, the demands by their parents, partners, children, and grandchildren are often too taxing. Women spend a life saying “yes” and this prevents them from setting limits, to be assertive. Many struggle with this challenge. They do not feel they have the right to say “no,” to set some me-time aside.
Men, especially if they are single, are afraid of loneliness. In general, older adults have difficulties in coming to terms with aging and to accept that death is a part of life.
When we are young, some of us spend a lot of time looking back at our history with the help of a psychologist. Why is it important to look back at our story and make sense of the past while we age?
People can add value to their lives by creating and maintaining a personal narrative. But a narrative is not limited to the past. By talking about experiences, emotions, connections with one’s self, with family and friends, we have a chance to look ahead, to include goals and dreams for a meaningful life.
There are no signposts, no milestone when you age. You have to map your own territory. At first, retirees think that they want to sit on the terrace, looking at the sunset while sipping a cocktail. We factor their life expectancy into the equation and the need for a second or third career, for personal growth, for meaning to begin to emerge.
One of your books is dedicated to gender identity and sexual diversity in elder care. Sexuality is an overlooked subject for older citizens, what can you tell us about this hushed topic when it comes to residential care?
Sexuality and intimacy in older age are a taboo. Although we live in a country that has legal respect for LGBTQ people, gender identity and sexual diversity in elder care are even more a taboo. In order to challenge the culture, together with an illustrator, we created drawings to discuss homosexuality and transgender in residential aged care facilities. By providing scientific information, questions and quotes, I train professionals to communicate with the staff, the patients and their families about these hushed topics in their organization.
You are the creator of “The Sexual Suitcase.” What is it?
More than fifty years after the advent of the “Disengagement theory” formulated by the social scientists Elaine Cumming and William Henry—one of the major psychosocial theories to describe how people develop in old age—it is still rare for health care providers to discuss sexual issues and intimacy with their older patients. The Sex Suitcase is a psycho-educational tool designed to break this taboo.
Old age and sexuality are not just the sum of the parts of one’s past and in 2005, during the United Nations Commission on the Status of Women in New York, I explored the impact of sexual taboos on the health and wellbeing of older women. The recommendations from this workshop included the need for more quantitative and qualitative research on this topic, and more educational training, and tools for the general public as well as for professionals who work with older adults. We wished for more training for medical and non-medical students to address and handle these issues with older patients in their care. Hence the idea of The Sex Suitcase as a conversation-starter, which I presented to the Belgian Association for Gerontology and Geriatrics in 2014.
I have designed a small and a big suitcase. Both contain a DVD, guidelines, sex toys, information on sex and intimacy and a “do not disturb” sign. The suitcase can be used by professionals and carers to ask questions, and to discuss needs and desires with the residents. The goal is to talk about sexuality in a positive way. I also lead workshops to train professionals on how to become a trusted person to ease the conversation with staff, residents and families, and to design protocols that respect and take sexual desires and sexual diversity into account.
My latest project builds on these themes and includes the concept of “skin hunger,” a basic need that accompanies us since we are born. My focus is on people particularly at risk of contact-deprivation: single older persons without a family, older persons in a care facility, homeless and inmates. They all can benefit from pet therapy, wellness and professional hug workshops.
We are having a longer life expectancy, but sometimes it feels difficult to make plans and imagine our future. What is your take?
We cannot wait until we are in our eighties to make plans and to imagine our future. If we embrace our mortality, we can create transcendency in our lives, a fusion of the biological, social and psychological aspects of our lives.
