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Aging with Integrity

by Su Russell, M.Ed., RCC


Recently, I decided to retire from my work as a Registered Clinical Counsellor. I began the process of reducing my practice by referring clients on to other practitioners. At 76 years of age I had, in the natural order of things, accumulated a number of clients who were older women.

I soon discovered that those clients were having difficulty finding the support they needed, as many older female therapists in Victoria had either retired or had a full practice. Seeing an older counsellor was very important to them; they were unanimous in feeling that the counsellor’s age would enhance the ability to honour the client’s years of life experience and to empathise with the challenges they faced.

As a result of these shared sentiments, I began to reflect on how my work had served this population of clients and, more importantly, to notice how that work varied from the time spent in sessions with clients ten to thirty years younger. As a result of these reflections I realised that I wanted to continue my practice, but to shift my focus to work with clients over 60 years of age.

The Journey

Our North American culture does not honor the elderly. Little of social consequence is offered to support the exploration of the deeper fears and reflections which preoccupy the aging as they look at the latter third of their lives. Resources are often limited to superficial entertainment, spiritually bland volunteerism and organised group exercise or activities.

Erik Erikson’s stages of development, as described in Childhood and Society (1950) identifies a series of stages that an individual should pass through from infancy to late adulthood to achieve a healthy psychosocial outcome. In his work, Erikson described introspection as the existential conflict of the eighth and final developmental stage. He described the years beyond sixty-five as the time when a personal review of one’s life and accomplishments take place. Erikson noted that the outcome of this review could be a perspective full of integrity, or one fraught with despair. The result depended on one’s personal sense of achievement and satisfaction over a lifetime.

The more favourable outcome of the two conflicting forces of the eighth stage of psychosocial crisis – integrity- is often illusive. In this context, integrity is not defined in the usual way, but, as Erikson described it “the acceptance of one’s one and only life cycle as something that had to be” (Erikson, 1950, p 268) or “a sense of coherence and wholeness”(Erikson, 1982, p 65). Success in this stage leads to the wisdom to look back on life with a sense of closure and to accept death with grace.

The journey however is not a smooth one; frequently, there is a desperate attempt to hold the alternative, despair, at bay. Wisdom is not a solid state. It is transient and fickle, particularly to the aging. At times, self-doubt, fear and confusion mar its reputation; it is a continuous process of re-evaluation and searching for answers, often propelling the client into despair.

As we age, we face the challenges of retirement and the resulting financial adjustments. We are further distressed by health, beauty and body changes. We experience relationship shifts with partners, family and friends. We suffer the loss of parents and family members through illness and through death. The invisibility that accompanies aging in our culture is rampant and instances of being ignored or patronised commonly occur, often daily. Being called “dear” by someone of the age of one’s own child is humiliating at best, and an insult at worst. Frequent offers of help can carry with them the insinuation that, on some level, we are not able to manage physically or mentally, magnifying the fear that this will some day likely be a fact. Grief becomes a frequent reality, summoned by losses on all levels, not just the physical.

There is a recurrent need – no, urge, for the client to attain clarity about their person and place in their present day lives. Paramount is the search for connecting with their authentic self. Building a sense of community around what matters most to them becomes essential. A life of “spirit”, self defined, becomes more and more important, as regular connections with people and significant activities are less and less a part of their lives.

Members of this gender and age grew into young women in the tumultuous years of the fifties and sixties. Raised by mothers who were restricted by outdated ideals at a time when women’s roles were beginning to undergo radical changes, they have spent a lifetime attempting to define their identity and sense of purpose. They have had few older female models as guides and consequently may be left with a tenuous sense of self.

Frequently, experience and wisdom are words used to describe the years beyond sixty. While it may be that we have achieved sometimes great things in the past and developed valuable insights to share with those who are younger, our personal experience in the present moment is feeling neither wise nor experienced. Often the life skills we have acquired seem to have no meaning in the present circumstances.

Aging is a day to day task of accepting the inevitability of our future. Loneliness and apprehension about what lie ahead dominate our thoughts. Sharing these, often despairing, feelings with others who have similar concerns and who are willing to listen is frequently a challenge. Inevitably, the repair of historical and developmental trauma will surface, but that which surfaces most frequently at this juncture, is a need to make peace with the present, and to move toward a more deeply satisfying way of living into the immediate future. The journey consists of examining everything we know and have experienced to create a new context for living the remaining years of our life.

Shared Conversations

As we age, I have noted that support systems thin out, often due to limited capacity, isolation, decline, and illness. While individual support, when available from a counsellor, is critical at critical times, I have also become acutely aware of the need for meaningful community for aging clients.

Women express enthusiasm for groups with other women, where they can talk openly about the lived experiences which define their present-day perspectives. Clients are explicit in stating that they do not want to do group process work, but that the groups be small, intimate gatherings focused on conversation. Mentored by a respected elder capable of creating a safe space where sensitive and sometimes painful present-day stories can be shared, is important. Airing reflections on current experiences of coping take place; women muse that humour is not an uncommon resource! They express excitement about reviewing film, literature and media material relevant to the group and creative activity is encouraged. There is an interest in expanding on themes related to the spiritual aspect of aging.

Questions generating a shared conversation might include:

What, at this moment in your life, carries the most meaning for you?

How will (that) significant experience influence how you approach the next year of your life?

What do you notice is your richest connection at this period in your life?

Clients express the desire, the urgent need, for a place to reflect and express their ideas and perspectives frankly and honestly. They are also willing, in fact enthusiastic, about sharing the experience of their journey with other older women.


Final Thoughts

My clients’ challenge is no longer work around their past, but conspicuously about being present to the experience of aging. They do not require motivation to do this work. They are driven to do it by the mere awareness of their mortality. They want to create a meaningful and integrous perspective as they age by reframing the awareness and knowledge gained from years of life experience to suit this new, and final, stage of their lives. They want to navigate the journey in community with others, and in refreshing, fruitful and peaceful ways.



Childhood and Society. Erik H. Erikson. New York: Norton, 1950.

The Life Cycle Completed. Erik H. Erikson. New York: Norton, 1982.



Your grief for what you’ve lost lifts a mirror

up to where you’re bravely working.

Expecting the worst, you look, and instead,

here’s the joyful face you’ve been wanting to see.

Your hand opens and closes and opens and closes.

If it were always a fist or always stretched open,

you would be paralyzed.

Your deepest presence is in every small contracting and expanding,

the two as beautifully balanced and coordinated

as birdwings.

– Rumi

The Essential Rumi as translated by Coleman Barks, 1995


Su Russell BA, MEd (counselling) has a private practice in Victoria focused on a client population of women over 60 years of age. She looks forward to participating in mentoring individual and group conversations which will enhance the lived experience of aging for her clients. For more information on