From Despair to Integrity: Using Narrative Therapy for Older Individuals in Erikson’s Last Stage of Identity Development

Adults aged 65 and over are a growing population in the United States today. This population is underrepresented in the mental health literature despite the high rates of depression and suicide. Additionally, the newest generation of older individuals is more likely to seek therapy than past generations, furthering the need for mental health professionals to be prepared for treating older individuals. Erikson in Childhood and society, Norton, New York, (1950) describes this time period as being critical in terms of the final identity crisis, integrity versus despair. Integrity is marked by a positive evaluation of the individual’s entire life, less anxiety about death, and a feeling of gaining wisdom. Individuals who do not resolve this crisis can manifest despair in a number of ways, including depression, anger, and regret. This model proposes utilizing Narrative therapy (White in Maps of narrative practice, Norton, New York, 2007) to understand how elderly individuals evaluate their lives in reference to their environment. The model utilizes externalization, unique outcomes, and re-membering conversations to unlock subjugated stories and promote integrity.     

Dyadic Traumatic Reenactment: An Integration of Psychoanalytic Approaches to Working with Negative Interaction Cycles in Couple Therapy with Childhood Sexual Abuse Survivors

Childhood sexual abuse (CSA) survivors often face difficulties in their intimate relationships and struggle to engage in the process of couple therapy. Recent research has demonstrated that the negative interaction cycles of CSA survivors are more complex and entrenched than those of couples who do not present with a history of trauma (MacIntosh in J Couple Fam Psychoanal 3(2):188–207, 2013). This paper integrates the psychoanalytic concepts of repetition and enactment into the concept of the negative interaction cycle as articulated by Emotionally Focused Therapy (EFT), to provide an expanded understanding of these deeply entrenched dynamics in which the traumas of the past are embedded. The complex repetitions of early traumas in the negative interaction cycle of the couple are referred to as Dyadic Traumatic Reenactments (DTR). Two contrasting case studies are used to illustrate these concepts.     

Gender and Performance Capital among Local Musicians

This article extends Bourdieu’s field theory to explain how learning spaces in the Toronto folk and metal scenes create gendered access to a field-specific form of cultural capital: performance capital, or the instrumental and interpersonal skills required to perform music. Folk musicians develop performance capital in open-access spaces, such as workshops and open stages at local folk clubs, while metal musicians learn in private spaces such as garages, basements, and rented rehearsal rooms. Folk’s learning spaces are open to all aspiring musicians, while access to heavy metal’s learning spaces relies on social networks from which women are often excluded. These different processes of capital development can lead to greater or lesser opportunities for women to become cultural producers: In Toronto, women make up approximately five percent of heavy metal musicians, but almost half of practicing folk musicians.     

How Does Occupational Access for Older Workers Differ by Education?

To assess the employment opportunities of older job-changers in the years prior to retirement, this study examines the how the breadth of occupations in which they find employment narrows as they age past their prime working years and how this differs by gender and educational attainment. The results indicate that workers who change jobs in their early 50s find employment in a reasonably similar set of occupations as prime-age workers, with opportunities narrowing at older ages. They also indicate that job opportunities broadened significantly for better-educated older workers since the late 1990s. While job opportunities now narrow significantly for less-educated men in their late 50s, this narrowing primarily occurs in the early 60s for women and better-educated men. In contrast to previous research, the study finds that employer policies that emphasize hiring from within are less important barriers to the hiring of older job-seekers. The study also finds that the narrowing of job opportunities is associated with a general decline in job quality as measured by median occupational earnings, a decline associated with differences in occupational skill requirements and the underlying economic environment. These results suggest that older hiring is not as limited to a select few occupations as it had been in previous decades, and that policy reforms aimed at increasing opportunities and improving labor market fluidity might best be served if they focused on less-educated men.     

Performance Pay,the Gender Gap,and Specialization within Marriage

We show that the large gender earnings gap at the top of the distribution (the glass ceiling) and the motherhood penalty are associated with each other and that both are uniquely associated with performance pay. These patterns appear consistent with specialization by gender. We show that among married couples with children, the hours worked by wives are strongly and persistently negatively correlated with earnings of the husbands only when those husbands work in performance pay jobs. There is no correlation between husbands’ hours and wives’ earnings.     

Cigarette Smoking and All-Cause and Cause-Specific Adult Mortality in the United States

This study illuminates the association between cigarette smoking and adult mortality in the contemporary United States. Recent studies have estimated smoking-attributable mortality using indirect approaches or with sample data that are not nationally representative and that lack key confounders. We use the 1990–2011 National Health Interview Survey Linked Mortality Files to estimate relative risks of all-cause and cause-specific mortality for current and former smokers compared with never smokers. We examine causes of death established as attributable to smoking as well as additional causes that appear to be linked to smoking but have not yet been declared by the U.S. Surgeon General to be caused by smoking. Mortality risk is substantially elevated among smokers for established causes and moderately elevated for additional causes. We also decompose the mortality disadvantage among smokers by cause of death and estimate the number of smoking-attributable deaths for the U.S. adult population ages 35+, net of sociodemographic and behavioral confounders. The elevated risks translate to 481,887 excess deaths per year among current and former smokers compared with never smokers, 14 % to 15 % of which are due to the additional causes. The additional causes of death contribute to the health burden of smoking and should be considered in future studies of smoking-attributable mortality. This study demonstrates that smoking-attributable mortality must remain a top population health priority in the United States and makes several contributions to further underscore the human costs of this tragedy that has ravaged American society for more than a century.     

Destroyed by Slavery? Slavery and African American Family Formation Following Emancipation

This study introduces a new sample that links people and families across 1860, 1880, and 1900 census data to explore the intergenerational impact of slavery on black families in the United States. Slaveholding—the number of slaves owned by a single farmer or planter—is used as a proxy for experiences during slavery. Slave family structures varied systematically with slaveholding sizes. Enslaved children on smaller holdings were more likely to be members of single-parent or divided families. On larger holdings, however, children tended to reside in nuclear families. In 1880, a child whose mother had been on a farm with five slaves was 49 % more likely to live in a single-parent household than a child whose mother had been on a farm with 15 slaves. By 1900, slaveholding no longer had an impact. However, children whose parents lived in single-parent households were themselves more likely to live in single-parent households and to have been born outside marriage.     

Growing Wealth Gaps in Education

Prior research on trends in educational inequality has focused chiefly on changing gaps in educational attainment by family income or parental occupation. In contrast, this contribution provides the first assessment of trends in educational attainment by family wealth and suggests that we should be at least as concerned about growing wealth gaps in education. Despite overall growth in educational attainment and some signs of decreasing wealth gaps in high school attainment and college access, I find a large and rapidly increasing wealth gap in college attainment between cohorts born in the 1970s and 1980s, respectively. This growing wealth gap in higher educational attainment co-occurred with a rise in inequality in children’s wealth backgrounds, although the analyses also suggest that the latter does not fully account for the former. Nevertheless, the results reported here raise concerns about the distribution of educational opportunity among today’s children who grow up in a context of particularly extreme wealth inequality.     

Cohort Differences in Parental Financial Help to Adult Children

In this article, we examine birth cohort differences in parents’ provision of monetary help to adult children with particular focus on the extent to which cohort differences in family structure and the transition to adulthood influence these changes. Using data from the Health and Retirement Study from 1994 to 2010, we compare financial help to children of three respondent cohorts as the parents in these birth cohorts from ages 53–58 to 57–62. We find that transfers to children have increased among more recent cohorts. Two trends—declining family size and children’s delay in marriage—account for part of the increase across cohorts. However, other trends, such as the increase in the number of stepchildren and increasing child’s income level, tend to decrease the observed cohort trend.