In my experience with psychotherapy with the elderly client in family settings, I've found that the ability to help bring about a good outcome after years of family conflict involves two main factors: 1) the client's emotional constitution (i.e. their ability to accept the fact that "unhealthy" behavior exists) and 2) the client's willingness to take the emotional risk of making amends. A third factor is the adult child's ability to understand the parent's life journey.
In the course of my work with a 96-year-old woman, "Lilly", who had recently lost her third husband and her older daughter (aged 70) within six months of each other, it had become clear that I had the task of not only helping her through her bereavement, but also of trying to repair sixty-plus years of pent-up feelings of shame, embarrassment and guilt. These feelings had resulted from the years of routine abuse - mostly emotional but periodically physical - that she had inflicted on her younger 66-year-old-daughter , "Dina". (The actual names of mother and daughter have been changed.)
Dina had contacted me to serve as almost a stand-in "hand-holder" for her legally blind mother, to relieve Dina of the weekly barrage of complaints she received from her mom about the caregivers obtained from a variety of homecare agencies. Lilly later admitted to me, jokingly, that she had caused her daughter's ulcers.
My weekly home visits with Lilly soon revealed her hunger for emotionally reconnecting with her surviving daughter, as well as her deep re-awakened feelings of abandonment and emotional deprivation from her own painful childhood. At first, Dina reported that Lilly did not want to talk about her past, that it was too painful and I should stick to discussions of the present. However, I gently prodded Lilly, as I saw that she was resilient enough to face her past. It was possible to actually do psychotherapy with this sharp 96-year-old, rather than just supportive counseling.
In reviewing Lilly's difficult past with her, I began to draw a parallel to Dina's emotional deprivation. It was this growing understanding that motivated Lilly to have the courage to risk her daughter's impatience and anger and forthrightly approach her about their long-standing rift.
During and after the period in which we had improved Lilly's homecare situation, Dina and I had exchanged e-mails. I could see that her extreme anger towards her mother for the years of abuse had blocked any understanding of the underlying cause of her mother's nagging about home attendants and other routine matters. Lilly's complaints and various requests reinforced Dina's impatience with her. Anger at mom - particularly at taking her stepfather's side when it came to Dina's choices of careers and friends - prevented her from clearly seeing Lilly's own fears of her strict Austrian-born husband leaving her if she took her daughter's side. In further understanding her mom's horrendous childhood, failed marriages and disappointments, Dina gradually began to look at their relationship differently. She came to understand how Lilly's own emotional deprivation as a child and her yearning for greater closeness with Dina led to her pattern of constant complaining.
After Lilly's initial expression of remorse to her daughter, Dina felt relieved but that it was still "sixty years too late". She sent me an email about this and when I responded I helped Dina understand the immense pain that her mother felt. Dina then was able to see Lilly's apology as "extraordinary". She wrote, "If she was brave enough to face herself and give me what she owed me, I felt I could take the plunge too". She told her mother that "the past was in the past" and described a long embrace with her. "It was touching and difficult but also easy".
When mother and daughter both realized the similarities of the emotional betrayals that they had each suffered, they saw each other more clearly and both were willing and able to give each other the gift of a new beginning. It was a great achievement for these two very strong-willed women.
Of course these issues were not completely resolved, but an important breakthrough was achieved a few months before Lilly's passing at 98. At any stage of life - even old age - when two people reach a point of understanding of their own motivations, as well as the other's, healing is possible. A true bond of caring and reassurance can be re-established. Dina wrote me, "I can't get my life back, but I've always been amazed at the fine job I've made of it, given what I started with". Dina had forgiven herself for her own feelings of shame and inadequacy that she had felt as a victim.
The bond that was re-established between Lilly and Dina made Lilly's final months and battle with cancer a little easier for both of them. Dina invited me to a memorial service that she held for her mother several weeks after her death. When she eulogized her mother she spoke about their reconciliation and how much that had brought some peace of mind to her own life.
But what about adult children who are not as fortunate as Dina was to reach an understanding with her mother and receive the apology that she had always needed? We can only do our best to understand our own parents' painful lives, allow ourselves the time and space to mourn both what we lost and never had, then forgive ourselves and know that we did the best we could for our parents and ourselves under very difficult circumstances.