by Melody Anderson and Leora Magler
In midlife. according to the Harvard Medical School Mental Health Letter, women experience more personal change than at any other time in their lives. “Middle-aged women are at risk for illness or death of a husband, divorce, separation, midlife crisis of a husband, unemployment, death of parents, caring for frail elders, children leaving home, a move to a new neighborhood, and loss of social supports.” To this list should be added the increasing social invisibility of women as they age.
Because society views women as essentially biological sexual beings, once a woman goes through menopause she becomes devalued and is no longer viewed as sexual or desirable. She is, therefore, of low social status and of little interest to most people, including psychotherapists. Due to age and sex discrimination, a mature woman faces tremendous obstacles in entering the job market or even changing a job during a successful career. She is very often shunned by the social world. Even men of her own age who, 20 years prior, were interested in her as a potential partner, no longer see her as acceptable, treating her almost as if she is not there, as if she were – invisible.
This invisibility involves three pivotal issues: deprivation, discrimination and dependency.
All little girls are brought up in an environment that teaches, encourages and reinforces them to deprive themselves. Little boys on the other hand are encouraged to initiate and explore. Girls are taught and told not to: not to climb trees, not to talk too loud, not to get dirty, not to have sex, not to enjoy their bodies. Many are taught that menstruation is a curse and that it is feminine to deprive themselves of food and nurturance. In essence, mothers teach their little girls to be satisfied with less because that is what they learned from their own mothers.
“Invisible” older women are even more deprived for they are not seen or heard. For example, feminists may not approve of the way young women are often portrayed on TV and in films, but at least they have visible images. Older women rarely see themselves portrayed by the media, popular literature, and fine arts at all. Being an older woman means being invisible. It means rarely, if ever, finding your own reflection in the popular culture. Even more difficult is the pressure put on older women to accept all this gracefully.
Although the modern women’s movement has helped to create new and exciting opportunities for younger women, this often can result in a heightened sense of loss for older women. It reminds them of what they could have had and of what they most likely will never have. They see younger women, their daughters and granddaughters, have some choice about how to lead their lives. Choices they never had. While many women truly enjoy seeing their daughters achieve – very often the joy is tinged with bitterness and colored by feelings of deprivation, frustration and loss.
Barnett and Baruch have pointed out in their landmark study of the psychological well-being of women in their mid years that women’s “culturally determined and psychologically internalized marginality seems to be what makes their historical experiences essentially different from that of men.”
Man has named, classified, and interpreted the meaning of the universe and, in so doing, has left out the experience of women. In every area of knowledge, a male view of the world has been taught conditioned and internalized by both women and men. In every area of discovery, men have investigated and reinterpreted the world’s events by a particular logic and language, always assuming, without inquiring, that their view of the world was pertinent, meaningful and real to women.
Women are now questioning the validity of male experience as the only true and objective reality. As Mary Daly describes in Beyond God the Father:”… women are beginning to recognize that the value system which has been thrust upon us by the various cultural institutions of patriarchy has amounted to a kind of gang rape of minds as well as bodies.”
Theory and subsequent research concerning the psychological development of both women and men rarely explore mid and-later life. There is an assumption that personality is finalized early and that significant growth cannot occur later in life. American culture views personality as static and unchanging. Theorists have also neglected to investigate the full experience of women as they age, focusing only on isolated events, such as menopause and bereavement, which are seen as pathological disorders rather than common events in the lives of aging women.
When older women turn to existing mental health services, they are all too often confronted by ageist and sexist beliefs, by a system that in its design and delivery cannot possibly respond to their needs. Women are often reticent about seeking help, fearing stereotypic negative attitudes such as “women are really childlike adults, submissive, compliant, who. because of age, are unable to learn or change”; or even worse, being viewed as crazy and domineering mothers or grandmothers. These attitudes keep women dependent, reinforce feelings of deprivation, and deny the impact of age and sex discrimination on their daily lives.
Dependency, often fostered and considered charming in young girls, results in economic and emotional devastation in older women. Traditional psychotherapy cannot respond to the needs of women because of the false assumption it still makes about appropriate roles for women of all ages, particularly the older woman. Also, it does not recognize that discrimination is an aggressive and annihilating attack on a woman’s sense of self and her reality.
Only recently have we begun to develop alternative ways of thinking about women and only very recently have we begun to recognize the development of women as they age. The works of Carol Gilligan and others reveal that women’s moral development has not only been misunderstood but also labeled inferior and pathological. Research is beginning to provide evidence that women’s development and life cycle differs from that of men. Just as theorists have conceptualized women’s moral development as less, simply because it differs from men’s, so too have practitioners misunderstood women’s “symptoms” as pathology.
Women who failed to adhere to sex role expectations were seen as problematic and this often created symptoms where none existed. Women’s low self-esteem, their depression and other behaviors often seen as inappropriate, are in fact accommodations to sex discrimination, second-class citizenship, unmet dependency needs, and an accurate appraisal of a depriving environment. These “symptoms” express both the rebellion and accommodation that have been, unfortunately, necessary to their survival.
The concept of the midlife transition as a “crisis” for women is derived from traditional psychoanalytic and psychological theories that have always considered woman’s reproductive functions and resulting biological events as central to her sense of self. Biological markers, such as menstruation and menopause, are used to assess a woman’s mental state and her sense of well-being. In this medical model, a woman’s biology is seen as directly affecting her mental condition. Hence, we get involutional melancholia – “menopausal blues” and the “emptynest syndrome”.
“Menopausal blues” has unfailingly been used to explain a variety of problems experienced by midlife and older women despite the fact that no evidence has been found to link menopause and increased depression. Studies have concluded that only post-partum depression can be linked to hormonal changes, i.e., the endocrine system, and that it can’t be concluded that hormones are primarily responsible for women’s higher rate of depression.
In response to these studies, researchers have begun to explore external causes. In Learned Helplessness and the Depressed Housewife, the authors interpret related research and conclude that there is strong indication that depression in women can be mainly accounted for by the special characteristics of the life style of housewives in the context of the male-dominated, sexist society. These characteristics include limited intellectual and social stimulation, emotional dependence on relationship with husband, low social status due to sex discrimination and resulting low self-image. Contrary to myth, younger women at home with children have been found to be more depressed than older women.
Another misinterpreted biologically related event is the so called “empty-nest syndrome”. Because of the supposed centrality of reproduction to women’s lives, the loss of child rearing responsibilities is considered a devastating event.
The term “empty nest” is used to describe the state of emptiness, sterility and despondency that women are thought to experience after their children grow up and leave home. Interestingly, current studies show that while many women miss their children after they leave home, they also experience this transition as an opportunity to grow and develop in many ways. This is not to deny that some women feel sadness when their children depart, but depression among this group, if it exists, may be more a reflection of the lack of other forms of stimulation and fulfillment, or a result of earlier unresolved conflicts or feelings.
Because most existing mental health services and practitioners believe the misconceptions on ageism and sexism, they confirm what older women have internalized and the myths are brought into the treatment room, where they are dealt with as facts. Obviously, if women are to reverse these myths, an effective alternative model must be found.
So here is the challenge for the clinician. In response to the unique needs of this population, what does an effective alternative model look like? How do you structure support groups that directly address the deprivation, discrimination, and dependency issues of this current generation of older women? We believe that we must begin by developing therapeutically oriented groups that encourage expression of angry feelings created by the discrimination and exclusion women have experienced; not only as women but as older women. Many women are greatly relieved when they understand that their agony is real and they are neither crazy nor stupid.
Groups should be led by sensitized professionals, mostly older women, and structured to allow each woman 15-20 minutes to share her concerns with the leader, thereby limiting interaction and competition among members. This is important because it responds to a personal dynamic wherein women care for others at the expense of caring for themselves and getting cared for by others. It also encourages women to feel entitled to their own time and space, and assures that each member will be given something at each session. Learning to acknowledge needs and to get them met is essential. Guilt feelings which naturally arise from getting cared for within this structure, are both revealed and can be addressed.
As Ohrbach and Echenbaum suggest (Understanding Women: A Feminist PsychoAnalytic Approach) that because society devalues women, mothers communicate a sense of low self-worth to their daughters. “For that reason, women come to seek validation from their fathers and then from other men.” But our practice suggests that the search for validation relates to difficulties in the mother/daughter relationship, and that what women really want is validation from other women. In a woman’s therapy group a woman has a chance to re-direct her search for validation through her relationship with other women. Listening to other women, they begin to take each woman’s experience seriously and thereby to take their own the same way. Thus, they begin to reverse deeply internalized feelings of low self-worth.
It’s been our experience that this population, as a result of their deprivation and the continual losses they experience, are easily threatened by the slightest external change, both in their environment and in the group structure. Thus, the security of the group structure, the time limits, and the focus on self rather than others, create the safety necessary for trust, disclosure and risk-taking.
This is an exciting time for feminist theorists and clinicians. We are on the verge of developing a conceptual framework for femininity and the development of new treatment models that will perhaps for the very first time understand the experience of women and address their needs.
Psychotherapist Melody Anderson. M.A.. M.S.W.. C.S.W. and Attorney Leora Magier. M.S.W.. C.S.W. are Co-Directors of RESOURCES, the first nonprofit social service agency in the country dedicated to serving the needs of midlife and older women.