The psychological problems of old age usually are associated with the readjustments the person who is growing older has to make to the changes which commonly, or well-nigh inevitably, overtake him. . . . What I should like to do at present is to inquire into the emotional impact and the psychological meaning that readjustments to changed situations have for the aged. It is obvious that when anything disturbs the equilibrium of our adjustment we react in a manner more or less characteristic of our personality. We usually repeat our previously established methods of dealing with conflicts or problems. It is also obvious that the equilibrium of different people will be disturbed to different degrees, by the same changes in situation, and that this disturbance will depend on what the specific change means to the individual involved. In other words, the significance to an aging person of any change in his situation, and his mode of reaction to it, will be directly related to his previous history. His present adjustment is the resultant of his constitutional endowment and his physical and functional growth and development, of his past successes and failures, and of his previous modes of adapting his physical, emotional, and social needs to his inner and outer environmental situations.
The very marked individual variations merely emphasize the fact that the person growing older is still the same person, and that the traces of his infancy and childhood, adolescence and maturity, will, of course, be found in his later years. Though his reactions to the various changes in old age will be directly related to his previous life, we can make some successful attempts at generalizations. . . .
How is he apt to react to [aging]? A man who, throughout his life, has prided himself on his physical prowess and who has constantly, though not necessarily consciously, attempted to protect his bodily self will certainly react much more violently than one who had no strong fears in regard to his physical integrity. So will a woman to whom her beauty and appeal or physical health and capacity were of particular psychological importance. Men or women who have striven throughout their lives from childhood on to balance their feelings of inadequacy by success, will certainly be strongly affected by the realization of their failing capacities. People who have always felt insecure are also likely to have a marked situational reaction at this time. Those who have denied themselves various satisfactions because of feelings of guilt, or other fears, are now likely to become panicky and disturbed and may frantically seek to compensate themselves. Aging, and. all it may imply to them, may be completely rejected by them, at least temporarily. They may attempt to deny the fact of their growing older, refuse to acknowledge any illnesses or give heed to any weaknesses. Not only that, they may over react, affecting manners and clothes of a much younger age, and attempting to achieve successes in their profession, in their social life, and particularly in the sexual sphere, in competition with much younger people. This sort of reaction is quite common. Mild anxiety is quite frequent too, but it may become very marked and show itself in sleeplessness, irritability, or in various fears, especially in regard to health or in regard to the future. Attempts may be made to alleviate these anxieties by excessive care or by almost ritual-like precautions. Depending on their previous modes of reaction, people may extrude the knowledge that they are growing older and their resentment of the younger generations which are making them aware of it, and attach their feelings to others about them. They become suspicious and even paranoid, feeling that they are persecuted and treated unfairly. There may be some truth in this at times, and they make the most of it. Finding satisfactions at their mature level blocked, they may turn to earlier, childish, or even infantile, methods of gaining pleasures. They may act and behave in a helpless, childish manner, unconsciously seeking a return to a more satisfying period of their lives. This may manifest itself in a milder form as an attempt to stop the progress of time by insisting that all things remain as they were, with intolerance for any change or for any new-fangled ideas and with an increased, rigid resistance to any new adaptations. These people may then collect trifles or even trash and store them as if they were something valuable. The realization of being older may be a catastrophe to some, before which they give up the fight and passively submit. They may become markedly depressed in the face of it, further deprecating themselves, being pessimistic, in fact, entirely hopeless about the future, and even committing suicide. Some of these reactions may be relatively mild and transitory. In others they may, however, assume the proportions of a psychosis when the person loses contact with reality to a very considerable extent, or they may become neurotic illnesses often superimposed on a diminished intellectual functioning as a result of some brain damage. These reactions may be temporary and usually are, especially if they occur in association with serious economic, social, or occupational changes, and if the previous adjustment of the person and his previous life satisfactions were adequate. In rarer instances, when the past and present conditions are unfavorable, they may be extremely persistent and even become permanently, incapacitating, in spite of any treatment.