Artful Witnessing of the Story: Loss in Aging Adults

The authors examine the concepts of ego integrity life review, and narrative reconstruction as cornerstones of theory that inform counseling practice with aging adults. Contemporary theories of grief reconciliation are proposed as useful models for understanding and creatively addressing the needs of adults who are 60 years and older. ********** Erik Erikson (1963) offered a widely accepted conceptualization of the psychosocial approach to development across the life span. Within this schema, Erikson outlined the issue of ego integrity as the central developmental task of the maturing adult. He described this as the evaluation of one's life contribution as worthy (Erikson, 1963; Levinson, 1978). The literature on contemporary grief research similarly presents adults' need to review life in hopes of making peace with their life story. Robert Butler, a pioneer in gerontology, is the founding director of the National Institute on Aging and the originator of the concept life review. Butler (2002) stated, "the strength of life review lies in its ability to help promote life satisfaction, psychological well-being, and self-esteem" (p. 6). In addition, contemporary models of mourning discussed the process of narrative reconstruction, the story-making and storytelling process of restoring meaning after loss (Neimeyer, 2001). The purpose of this article is threefold. First, in this article, we synthesize the three concepts of ego integrity, life review, and narrative reconstruction to expand theoretical models and counseling practices with aging adults. Second, we suggest that grief reconciliation is a beneficial lens through which an understanding of the work inherent in reviewing life as integrity can be viewed. Third, we discuss narrative reconstruction methodologies as creative interventions for affecting the developmental needs of adults 60 years of age or older when the crisis of integrity versus despair initially emerges at the forefront. INTEGRITY, REVIEW, AND RECONSTRUCTION Synthesizing the concepts of ego integrity, life review, and narrative reconstruction enables counselors to expand their conceptualization of the developmental demands specific to aging adults. When Erikson (1963) described the task of ego integrity, he discussed the individual's perspective on the meaningfulness and worth of the cumulative choices that compose the story of the individual's life. Aging adults who master this developmental crisis are able to reflect on and conclude that their lives are productive, satisfactory, and valuable. "Such a person views his or her own being as congruent with the purpose, rhyme, and reason of life and develops a great deal of ego strength or ego integrity from this awareness" (Salkind, 2004, p. 152). Therefore, ego integrity refers to a successful review of life, a crisis with introspection as the critical foundation. On the other side of Erikson's task of ego integrity is the tragedy experienced if the retrospective look is evaluated as despairing and meaningless. On a developmental level, we counselors hope the individual navigates through the past and finds the accumulated grace, learning, order, and benefit in the creation of the narrative as it is lived and as it is nearing the end. Buder's (2002) concept of life review is predicated on the experience of death unique to this life stage. This perspective on death has its beginnings in midlife when adults "see both the finish and starting lines of their life" (Doka, 2002, p. 25). The increasing sense of mortality often brings a crisis leading to reevaluation, recommitment, and reprioritization as the issue of "time remaining" is felt. For many adults, the awareness of mortality "forces individuals to find or to construct significance and meaning in life" (Doka, 2002, p. 26). In maturing adults, an awareness of finitude (Marshall, 1980) brings to the forefront a life review process wherein individuals seek to affirm the value of their past. …