For a happy life, focus on what’s left, not on what’s lost

Building resilience as we grow older is about deep connections - and laughter.

Professor Gordon Parker. Picture: John Appleyard

If you’re going through hell, keep going.

– Winston Churchill

Old age is not for sissies.

– Bette Davis

There is always a margin within which life can be lived with meaning … despite illness.

– Norman Cousins

When we were young our resilience was quantified by simple markers. We adapted (or didn’t) to a new school, we stood up (or didn’t) to the school bully, we did (or didn’t) accept the challenge to not cry after losing a tooth to that bully. In our older years our resilience is tested by the markers of ageing. We each can perform an “organ recital” of our medical problems, and our medical chart has as many pages as our CV once did.

Social hardships – the loss of our partner, loneliness, cluster about. Our previous life-defining roles have disappeared. We chant a litany of “I used to …” observations. And gradually our independence and commonly our dignity begin to erode. To struggle against such stressors is part of the human condition. Psychologist Erik Erikson termed older age as a stage marked by integrity, where people age with grace; or despair, where the focus is on the losses and the burden of regret.

The word resilience comes from the Latin resilere (“to spring back”). Resilience is viewed as an individual’s ability to bend but not break. It is thought to have genetic underpinnings but there is a complex interaction with personality traits and environment that fashions the defining robust outlook. The resilient individual has a positive sense of themselves, an ability to confront adversity and the capacity to find hope and meaning in life. With resilience comes strength and action; without it comes weakness and victimhood.

Resilient people face realities with vigour, make meaning of hardship and improvise solutions. They more readily tap into hope, are more optimistic and eschew negativity. Even when under pressure, they are distinguished by a continuing curiosity about life’s events and changes. A key marker is that they keep moving forward.

Some people are born resilient. Early on they show signals of meeting the world on their own terms and judge that they control matters rather than events being determined by luck or fate. However, more people acquire resilience than have it innately, most usually following exposure to major stressors and being strengthened by them. Hence the aphorism “What doesn’t kill you makes you stronger” is absolutely valid.

As we know, ageing is associated with numerous changes – with many weighted to self-protection: not many 90-year-olds slide down banisters or do the splits. And we do less. Summary joke: “My wife asked, ‘What are you doing today?’ I told her, ‘Nothing.’ She said ‘You did that yesterday.’ I said, ‘I wasn’t finished.’ ”

We tend to socialise less and cut back on tasks. We can think ourselves old – which predictably compromises our resilience.

A wonderful illustration (and its capacity to cause us to give up) is the experiment where elderly people were asked how many lines they could read on an optician’s eye chart. If they started (per usual) on the largest font line, they averaged three fewer lines than if they started at their selected smallest font line.

So, can we improve resilience by thinking ourselves young? BBC documentary The Young Ones is informative. Six celebrities from the 1970s and ’80s spent a week in a country retreat refashioned to conform to their heyday and to encourage them to the view they were reliving their youth.

The group effectively became younger, both physically (evident in improved hearing, grip strength and manual dexterity) and psychologically (with improved memory and IQ).

The wellbeing literature offers models and strategies for considering resilience. It informs us that about 20 per cent of people are “flourishers”, 20 per cent are “languishers” and the rest of us cluster in the middle.

Flourishers wake up each morning bright-eyed and ready for action. They are engaging and enthusiastic, lighting up others. Their ongoing mode radiates positive thoughts and behaviours, conferring engagement, fulfilment, contentment and wellbeing on others. They affirm the key question testing a high level of wellbeing: “If I could live my life over, I would change almost nothing.” When faced with adversity they show true resilience: motivating others in the face of setbacks, finding positives in the challenges they face and often rendering adversity transformative. Remember Paralympian Dylan Alcott’s speech when he was awarded Australian of the Year. An excerpt: “I love my disability. It’s the best thing that ever happened to me.”

For us in the middle, resilience is not so innate.

We can seek to improve our resilience. The wellness literature argues for people to be curious, creative, open-minded, kind, hopeful, able to forgive others and show gratitude and humour, able to appreciate beauty and be spiritual (in a formal or informal way), have the capacity to advance relationships, find meaning in life, engage in exercise, develop focused interests and succeed in optimisation – finding positive meaning in ordinary events, or even in adversity itself, undertaking acts of kindness and interpreting events positively. Biological strategies such as meditation, relaxation, yoga and mindfulness, in particular, can inhibit negative signals from the amygdala – our threat and fear centre in the brain.

I offer four books for your consideration.

First, Anne Deveson’s 2003 book titled Resilience. Deveson had a son with schizophrenia and lived through years of extreme stress as she tried to assist him through psychotic periods, and then faced the enormity of his suicide. This was succeeded by the death from cancer of her husband and later her partner. She concluded: “Resilience is learning how to absorb sadness and how to live with it.” She observed that, initially, shock cushions sadness, but then a range of emotions crowds in, among them fear, anger, outrage, pity, denial, but ultimately and hopefully acceptance wins out.

She noted four human qualities detailed by psychiatrist George Vaillant as assisting people to become the “happy well”: an orientation to the future, to enable anticipation, plans and hope; the capacity for gratitude and forgiveness; the capacity to love and have empathy for others; and the ability to connect with others and not cast oneself as the victim.

Aristotle observed that “Happiness is the consequence of a deed.” Conceiving of and delivering such deeds is one marker of resilience.

Deveson also placed emphasis on maintaining socialisation and advancing your “relational competence”. This is more than making and keeping friends: it involves seeking a “deep connection” with people. She also observed that when resilience flags we may benefit from a kick up the bum from a loving friend.

A second book is Anatomy of an Illness by Norman Cousins, a distinguished editor who developed a crippling and seemingly irreversible connective tissue disease causing great pain, limited mobility and jaw locking. I note just three of his suggested strategies.

First, working with your medical practitioner in a collaborative partnership model rather than being a passive receiver of advice – not always easy. Cousins didn’t accept the illness verdict, and thus he avoided feeling trapped in a cycle of fear and depression. Second, he advises, never underestimate the capacity of the human mind and body to regenerate. Third, he advocates laughter, induced mainly for him by Candid Camera excerpts and Marx Brothers films. Ten minutes of genuine belly laughter would give Cousins two hours of pain-free sleep.

Quest for Life chief executive Petrea King detailed her life story in a 2017 book, Up Until Now. Her childhood years were dogged with medical problems and lengthy hospitalisations, the brother she sought to protect committed suicide in his 20s, her husband left her stranded with young children and no money in another country, and then King was diagnosed with myeloid leukaemia. She elected to take refuge in a cave in a monastery in Assisi, where she wept and wept, and then meditated. On return to Australia her leukaemia had remitted. She has a range of strategies for dealing with life’s curve balls. Her approach emphasises a healthy lifestyle, living a meaningful life, and finding joy in the present via passions and pastimes and in relationships with people – optimally feeling valued or loved by the people with whom we share our life.

Finally, psychiatrist Viktor Frankl’s book Man’s Search for Meaning. During World War II Frankl, being Jewish, was sent to four concentration camps, where his parents and brother died, while his wife died shortly after his release. After working through the scarifying impact, he not only learned to let fate take its course but also developed a philosophy: to live is to suffer, suffering is an integral part of life, and to survive it is necessary to find meaning in the suffering. He faced each camp day as a challenge, never ceasing to try to define life’s meaning but also seeking to find or invent one humorous story each day and at least one positive within each day.

Frankl developed logotherapy (from logos, or meaning), which reflected what he judged as man’s primary task – searching for meaning. This could involve creating a work or doing a deed; giving love to another; and developing an attitude that if fate cannot be changed, the aim is to evolve beyond oneself so that suffering becomes a growth experience. He argued for a focus on what is left, not on what is lost.

As observed by American educator Yasmin Mogahed: “Resilience means you experience, you feel, you fail, you hurt. You fall. But you keep going.”

Gordon Parker is Scientia professor of psychiatry at the University of NSW. This piece is adapted from a talk at the Positive Ageing Forum held on October 26 under the auspices of Prince of Wales Hospital’s Older Persons’ Mental Health Service.