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A Social Version of Gero-Transcendence: Case Study

Published in Journal of Aging and Identity, 6, 2, 105-114, 2001

Dr. Tova Gamliel

Department of Sociology and Anthropology

Bar-Ilan University

Ramat Gan, 5290002 Israel

E-mail: tova.gamliel@biu.ac.il

Abstract

This article presents an analytic attempt to reexamine the concept of

Gerotranscendence in the light of anthropological findings. Particular social patterns

in a nursing-home have testified to a unique reality, communal to its tenants. The

researcher assumes that the tenants’ spontaneous patterns of social gathering construct

a collective death consciousness, which is spiritual in its nature. Tornstam’s term

“another paradigm”, seems suitable not only for a developmental shift in old age but

for the situational shift in the daily life of the subjects. Anthropological concepts, as

well as contextual and inter-subjective parameters, join to indicate that some

Gerotranscendence dimensions are experienced in what the researcher terms as

“sitting” and “giving” episodes.

KEY WORDS: gerotranscendence, social gathering, nursing home, death

consciousness

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Gero-transcendence, in its essence, is a psychological concept used to understand

aging processes. In Tornstam’s creative innovation, gero-transcendence represents a

special state of mind, “a shift in meta-perspective from a materialistic and pragmatic

view of the world to a more cosmic and transcendent one”(Tornstam, 1997, p. 143).

Along with this psycho-spiritual definition, Tornstam states that culture and social

gerontologists have an obstructive effect on gero-transcendence because culture and

its observers are guided by the same basic and irrelevant assumptions about elderly

people and their expected disengagement. The hidden theoretical strength of

disengagement theory (Cumming and Henry, 1961) has been shown to have diverted

its traditional claims from social to developmental issues (p. 204–205). Specifically,

the intrinsic drive to disengage is presented as an explanatory principle—a substitute

for the simplification derived from the “social-breakdown” description (Kuypers and

Bengtson, 1973). In this personal and subjective respect, Tornstam follows,

honorably, classical theoreticians such as Jung (1933) and Erik H. Erikson (1950,

1982). He is also inspired by Gutman’s phenomenological description of the

disengagement pattern, that refers to “passive and magic mastery (Gutman, 1976)”.

Even though the current article presents an anthropological view, its purpose is not

simply to challenge the foregoing notion. On the contrary: it aims to strengthen the

validity of gero-transcendence (Tornstam, 1994, 1997b,c), by relating it to a

contextual parameter. Even if the following analysis offers “reaction” of sorts to

Tornstam’s writings, the reader should treat it as a sequel.

The “context” variable should not be foreign to the developmental dimension of gero-

transcendence. If we look closely at the developmental debate in psychology, we may

find a theoretical distinction between biological and environmental or contextual

effects (Lerner, 1985; Sarbin, 1977). Taking the “environmental” view into

consideration, I propose to examine the totality of nursing-home conditions as an ex

post resource for the acceleration of gero-transcendence. This examination will place

the two sides of the disengagement coin—the social and the personal perspectives—in

a new and moderate equilibrium. My assumption is that the key for understanding this

idea is the set of social characteristics of the institutional reality. Thus, this article will

show that a nursing-home subculture—a counterculture relative to the general

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society—is a suitable environment for the efflorescence of unique perspectives on life

and death (Gamliel, 2000).

Tornstam describes life crisis as a crucial variable that has connection with cosmic

transcendence (1997c). He also finds that the correlation between the two decreases

with age, and explains it by ascribing less power to crises to induce cosmic

transcendence in old age. In a similar fashion, it should be indicated that gerontology

literature has convincingly identified relocation to an institutional environment as a

crisis event (Haight, 1995; Adams, 1992). This kind of crisis, however, does not seem

long-lasting and it arouses severe emotional reactions instead of setting a psycho-

spiritual journey in motion. This may strengthen Tornstam’s conclusion that “aging

itself becomes more important for the development of cosmic transcendence (1997c,

p.130)”. But there is another side to the coin; in view of the rapid improvements in the

service conceptions of old-age homes (Shtarkshall, 1988), we may find that the

outside world and institutional arenas occupy a continuum. This continuity facilitates

the crisis experience, but more importantly, despite social segregation, it encourages

central modern values—individuality, mastery, independence, autonomy, competition,

and activity, to name only a few—to persist within the institutional borders (Gamliel,

2000). Leder (1996) attributes these values to recent social models, the “Producer”

and the “Consumerist”, while Tornstam refers to them as guidelines for a regular

paradigm of life (1994, p. 207). In either formulation, these values are opposed to

specific cultural patterns – the Zen Buddhist for example. We may conclude that even

as old-age homes attempt to circumvent emotional obstacles occasioned by the

ramifications of relocation, their strategies have a crucial by-product concerning gero-

transcendence: they deprive tenants, the old aged “candidates”, of suitable atmosphere

for the development of a new “paradigm.”

The setting I investigated, a traditional nursing home with characteristics of the “total

institution” (Goffman, 1961), stands outside this inclusion. My doctoral dissertation

traces the residents’ behavioral patterns to the institutional policy and describes this

policy as one of dispossession and “colonization.” Examples of its manifestations are

the lack of clear borders between public and private spheres of life and an exaggerated

focus on medical-treatment procedures. It is not hard to imagine the stressful

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implications of this policy, especially for people who spend several years in a nursing

home and are deprived of personal possessions, space, and time. Ethnography

gradually exposes their consequent behavioral patterns—those that have been

described as “self-death.” Three internal phenomena have been identified with this

kind of death: a deep state of indifference, a low level of death anxiety, and death

discourse. Intensive implementation of the participant-observation method over a

thirteen-month period exposed a rare shared reality that corresponds to the label

“death culture.” The accumulated data gave rise to the following biaxial model of

analysis, which posits four fields of interaction between “self” and “other,” “life” and

“death”:

Self-alive

2 1

Other-dead Other-alive

4 3

Self-dead

The constructionist approach is a fundamental guideline in ethnography. Accordingly,

we may regard every interaction among the four fields as a field of reality. The scope

of this article does not suffice to describe the whole picture. For our purposes, we will

focus on one extraordinary option, the fourth one. A brief discussion may enhance our

identification with the other three realities; with reference to relative degrees of

vitality, we may recall situations in which we felt equal, superior, or inferior to others.

In joyful common situations we expect, perhaps unconsciously, to experience social

equality, but in competitive ones, when we are more ready to use defensive

mechanisms, we expect interpersonal discrepancy. Does Reality 4 elicit a similar

retrieval reaction? Is it an accessible reality in daily life? I assume that it is not. Most

people, except from chronic patients, prisoners on death row, and inmates in

concentration camps, are not acknowledged to have a common reality of death or

weakness. Thus, a reality of interpersonal death that is cultivated by elders should be

deemed an aberrant phenomenon. To the best of my knowledge, gerontological

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discussions that deal with increased acceptance of death (Neimeyer, 1994; Mullins

and Lopez, 1982), on the one hand, and community life surrounded by institutional

borders (Keith, 1982; Shield, 1988; Gubrium, 1975), on the other hand, have not

converged to create a comprehensive socio-existential analysis. This ethnographical

and theoretical void illuminates the innovative aspect of the present effort, which

draws a parallel between subjects’ collective patterns and some components of gero-

transcendence (Tornstam, 1994, 1997a), while the claim of ‘defense mechanisms’ is

excluded.

Before we proceed to the next section, let us consider some of the subjects’ general

characteristics, and the research method. At the time of the study (1998–1999), the

subjects’ average age was eighty-five. Most subjects belonged to the lower-middle

socioeconomic class and did not perceive themselves as religious. The vast majority

had immigrated to Israel from Europe during World War II. Two-thirds were

considered “independent,” i.e., in command of five physical functions. The “feeble”

subjects, who resided in a special ward, were only partly independent because they

needed assistance in two functions. In opposition to Tornstam and Tornqvist’s

research in a nursing home (Tornstam & Tornqvist, 2000), data relies on observations

and random conversations with tenants themselves and the interpretation presents

them as collective members.

Gero-Transcendence Theory

Tornstam’s illuminating description of gero-transcendence is based on intensive

interviews with fifty Swedish individuals aged 52–79. It is divided into three

dimensions; the cosmic, the self, and social and personal relations. A concise

quotation of that description, to be discussed later, follows:

…[A] common response was that ordinary language is sometimes preventing

us from insight and understanding. Transcending the barriers of language gives

rise to new forms of awareness [….]

The experience of nature evokes the feeling of being at one with universe,

which is called “at one ment” in the Eastern tradition. The increasing

significance of these small everyday experiences could therefore be interpreted

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as a way in which the barrier between the self and the universe is transcended

(Tornstam, 1997a, p. 148–149).

...The increasing feeling of a cosmic communion with the spirit of the

universe can be experienced as a being a part of a flow of energy which is

coursing through the universe. Feelings of communion with the oceans, nature

and the starry sky are aspects of this cosmic communion.

The perception of time can change from our normal linear view. Not only

the perception of the velocity of time, but also the perception of past, present

and future can change. Specifically the past, even back to the old Greeks, may

come alive in a way never experienced before (Tornstam, 1994, p. 209).

...The theory of gero-transcendence assumes that the individual’s self is

gradually changing and developing. It is partly dependent on the degree to

which we discover the hidden aspects of our personality, what Jung calls—the

shadow.

The change in the perception of objects can include an elimination of the

borders between self and others. An impression of being One all together

appears instead. As a consequence of this, the degree of self-centeredness will

decrease. To a certain extent the enclosed self is disaggregated and substituated

with a cosmic self. Individuals no longer look upon themselves as especially

important. Maybe they perceive themselves as part of a cosmic flow of energy,

where the flow of energy, not its individual parts, is the important thing. This

also involves a redefinition of the perception of life and death. It is not

individual life, but rather the total flow of life that is important. With such

changes in the definitions of the meta-world, it is understandable that the fear

of death decreases. (Tornstam, 1994, p. 209).

The individual might also experience…a greater need for solitary

“meditation” (1994).

…[T]he theory of gero-transcendence … [implies] changes in point of

view, shifts of emphasis and redefinitions of the meaning of social relations.

One theme was an almost roguish delight in breaking away from the role

expectations that earlier seen as compelling… A new kind of innocence and

spontaneity is added to adult judgment and rationality. People can admit that

they don’t know about something, without feeling embarrassed.

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The need and search for a positive solitude is not the same as loneliness

and disengagement. Rather, it’s part of a development where one has become

more selective (Tornstam, 1997a, p. 152).

...With all these changes in the definitions of the meta-world, from a

restricted perspective to what we have termed a gero-transcendence

perspective, it is easy to understand the decreasing interest in superfluous

social relations and material goods. The individual … may look with pity on

many younger people, who are over invested in “social engagement,” seeing

this as a neurotic focusing on social contacts (Tornstam, 1994, p. 209).

An anthropological view of spiritual processes would differentiate from these

psychological expressions but would not invalidate them in any way. The four-field

model actually describes four realities in interpersonal encounters. As noted above,

Field 4 describes a special and perhaps unknown reality—an encounter between “self”

and “other,” both characterized by a “dead” identity. The very occurrence of an

interpersonal encounter may be essential in viewing gero-transcendence. This is not to

say that each dimension of gero-transcendence, including “social relations,” “needs” a

compatible interpretation; rather, a possible and partial compatibility is indicated. As

we will see, the conversion of a subjective perspective into an inter-subjective one

entails a selection among the components of the theory and some modifications of its

content.

The Significance of the Other

In the ethnography, “self” and “other” represent two residents who interact verbally

and non-verbally. Most of the time they are aware of each other’s presence and react

accordingly. In the constructionist view, “reality” is situated between the two persons

and among three or more, who construct it continually by means of reciprocal gestures

and attitudes. A shared reality, then, is a negotiable entity, drawn from the subjective

experiences of each participant (McCarthy, 1996). The institutional circumstances that

govern the residents’ lives converge to separate them from the outside world and

intensify their own social constructs. The lack of clear borders between spheres of life,

dispossession, and considerable bodily frailties shape the residents’ minds. They live

within a closed and separate world that forces them to face imminent death and,

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concurrently, to note the frequent disappearance of others. The subjects are like

voluntary prisoners who have been sentenced to a natural death. Robbed of their

individuality, privacy, intimacy, and capacity to control inner and outer environments,

they are partners in fate. This existential reality serves as a unique prism by which the

significance of the Other is magnified. Beyond its mere noticed participation, the

Other has been viewed as an essential validating mirror of the self (Mead, 1934) and a

projected expansion of the self (Freud, 1961; Rank, 1958). In view of the mentality of

survivors in extreme situations, i.e., their tendency to interdependency and unification

(Cohen, 1994; Davidson, 1992), the residents’ collectivity is an integral part of their

residual existence. The manifestations of the Other in the elderly residents’ reference

group are the only remnants of “the world” that they still possess shortly before they

close their eyes forever. The social reality in the nursing home serves this final

denouement.

Togetherness in the ward is an ambivalent situation. On the one hand, residents are so

dispossessed that they embrace each other’s presence to escape boredom; on the other

hand, this is precisely the right direction in acknowledging others’ death. This trap has

several implications, but for the moment let us focus on one—the collective

consciousness. The residents have to encounter each other daily and do so at least

three times a day in the dining room. There, seated in their regular places, they reveal

their deep distress by habitually taking quick notice of others’ absence. This, in turn,

leads to the cultivation of wild rumors about hospitalization and death. This critical

situation is the largest contributor to the death discourse that residents conduct by

means of an impressive “death vocabulary” that they have developed and use in

various contexts, relevant or not. The death theme even surfaces in replies to

questions like “How are you?” and in descriptions of simple matters. Death is present

among residents most of the time. In view of the residents’ behavioral patterns,

attitudes, and emotional manifestations, I have reached the conclusion that their

discourse, in addition to being one dimension of a unique culture, is only a surface

manifestation of a collective death consciousness.

Let us return to the Other, an old man or woman who has gone through socialization,

is well versed in the extraordinary discourse, and resembles other members of the

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reference group. This Other is an essential player in the individual’s factor thoughts,

feelings, and actions. More than anyone else, including staff members and one’s own

children, the Other shares the individual’s sufferings and need not learn the meaning

of real empathy. Even if he or she is not one’s friend or acquaintance, his or her

presence is supportive. More than that, the Other’s presence is considered an

accessible and valuable resource in completing one’s coping with imminent death.

There is no need to disengage from approximately two hundred “significant Others”

of this kind. On the contrary: there is a tendency to participate, albeit passively, in

spontaneous gatherings.

Phenomena of Togetherness

Two unique phenomena appear as major elements in the residents’ death culture.

Prolonged observations and personal participation were needed to elucidate several

behavioral patterns and to allow me, the researcher, to overcome strangeness. Many

informants repeated reminded me, “You are too young to understand our condition,”

or “To understand old age you have to get into it.” I was able to ignore such comments

and to rely on the well- known advantages of empathy only until confusion took place.

I also experienced situations that challenged my previous knowledge and, for this

reason, justified what my subjects have said. This is especially pertinent in regard to

residents’ group manifestations of togetherness and their habitual altruism. When I

observed these two phenomena, I felt attracted to participate and was most willing to

solve the “disengagement” mystery.

Sitting

Residents expressed their wish to be together in several ways. “ “I’m not lonely here,

said “Y.” “After all, I came here to avoid loneliness.” A woman in the ward for the

feeble, who shared one room with two additional women, answered my question:

“Well, when I was ‘independent’ I had my own room. The staff brought me here, and

I didn’t refuse. On the contrary: it’s good to be with somebody. It’s really good.” “S”

expressed the same preference in the dining room when she asserted, “I’m happy to

take my meals with other people…. No, no, no, I don’t need room service. I don’t

want to stay alone. I want to meet people.” These attitudes underlie several

extraordinary episodes that came to light later.

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About half an hour before dinner, residents regularly gathered in front of the dining-

room doors. They tugged chairs into a face-to-face arrangement along two imaginary

rows. Each resident who arrived later joined the others by adding his/her chair to the

rows. Every evening there were about fifty men and women, sitting silently, looking

ahead and into each other’s faces. In the background of this scene, the sights and

sounds of nature were visible through a large window. Rain, sunset, a cloudy sky, and,

sometimes, the whistle of the wind joined the residents’ deep silence. The residents

looked like people in a waiting room, listening carefully to a staff member. When I

saw them for the first time, I automatically looked for a hidden speaker and was

shocked to realize that they were sitting by themselves. For more than fifteen minutes,

they “merely” sat there and gazed vacantly. Finally, I pulled up a chair, too, seated

myself among them, and did my best to imitate their few gestures. I tried to imagine

myself as one of them—as an old woman with a short future. “What is the

significance of sitting here? Do I get something out of this?” I asked myself as I

looked around and relaxed. It took me some minutes until a sense of intimacy with my

acquaintances spread inside me and alleviated my anxieties. To use a metaphor, it was

a “sauna of silence,” shared by peers who felt a powerful mutual acceptance. When

dinner time arrived, several residents stood up unwillingly, as if forced to tear

themselves from an unseen beneficent reality. Still influenced by that solidarity, some

tried to be helpful—one hurried to open the doors, another offered his arm to a frail

woman, and a third extended a hand to push another’s heavy walker.

The same atmosphere prevailed in other occasions, e.g., when some of the women

crowded around a table on a Friday afternoon and made strenuous efforts to light

Sabbath candles. Their trembling hands, busily crossing each other, caused the candles

to fall repeatedly. Unexpectedly, feelings of frustration did not breach the silence. For

lengthy moments, the weaker women were not alone and miserable but enveloped in

motherly care. The women left the table only after each of them completed the

religious task successfully.

Despite or, perhaps, because of the residents’ death anxiety, a mystical unity with

others was created. Such experiences transcend the borders of body and self that are

cultivated by individualistic being (Walter, 1994). Spiritual views in gerontology

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attribute the shift towards the Other to a return to impersonal condition of

consciousness. The spontaneous formation of residents’ inter-subjectiveness has clear

spatial and temporal borders that correspond to Thibault’s (1996) “natural monastery”

metaphor. Undoubtedly, the amorphous nature of spiritual experiences limits the use

of metaphors, and no detailed description is available. Martin Buber encountered a

similar difficulty in describing the authentic “I–Thou” affinity. He described a

dialogue of silence in which, although no word is spoken and no gesture is made;

communication streams unreservedly and silence carries the messages to the neighbor,

who receives them unreservedly. “He will be able to tell no one, not even himself,

what he has experienced. What does he ‘know’ of the Other? No more knowing is

needed” (Moore, 1996, p. 104).

Giving

The residents carried out many small and spontaneous interactions daily. They

expressed limitless concern for each other’s state of health and mood. Sometimes they

intervened actively in each other’s affairs, advising each other how better to handle

problems. On a few occasions they called the other’s attention to defects in his or her

appearance, e.g., in matters of clothing, shoes, walker, or other objects. Moreover,

with their relative advantages they enhanced others’ feeble eyes, ears, and hands to

facilitate dignified communication. Those who were confused were treated as

“normal”; their strange comments elicited listeners’ efforts to follow and understand.

A few looked relatively unkempt and made unexpected movements. Even though they

loitered freely, they were neither avoided nor driven away; “independent” residents

treated them patiently and even warmly. Not knowing where they were standing and

unable to recognize others’ faces, the confused represented the inevitable fate that

awaited everyone. One man entered the lobby panting. It was a great effort for him to

return from his room after lunchtime; he had left his orange on the table and rushed

back to “save” it. A woman who had shared the same table called him over and gave

him his orange, explaining that she had noticed what happened and had taken the fruit

to keep it for him. The old man smiled, kissed her hand, and expressed his gratitude.

This kind of motherly attitude characterized as many episodes as the state of old age

entailed.

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These small interactions suggest an implicit relationship between “dignity,” as a

human need, and the means to fulfill it—impression management. Goffman’s (1963)

analysis of “deference” elucidates this relationship by defining demonstrations of

courtesy or disregard as ways in which one can attain proper public appearance. It

seems that residents achieved good functioning impressions by means of these

interactions. Exposed to manifestations of mental frailty and bodily disabilities, the

residents helped each other to repair whatever could be repaired and to overcome

losses. By engaging in reciprocal favors, they attested to their concern for dignity.

Gero-Transcendence among Peers

The word “transcendence” is used to describe a mystical feeling of ascendancy beyond

constraints, a sense of the ineffable, a flood of joy, or a peak experience. The

transcendence of loss is often accompanied by such feelings. Weenolsen (1988)

describes three modes of transcendence: situational, dispositional, and general. The

first is external in nature; it involves dealing with a specific situation, rituals, and

other activities. The second is mainly internal and comprises defense mechanisms as

well as personality traits that may be defensive. The third mode is often used to

minimize the effect of everyday losses or to escape; it includes meditation, athletics,

travel, or religious experience, to name only a few. Csikszentmihalyi (1975) refers to

these examples as “flow activities,” by which one tends to lose one’s sense of time

and forget one’s problems. According to these definitions, gero-transcendence should

be classed as “dispositional” only because it implies internal and developmental

changes of self. In contrast, the subjects’ ritualistic practices, as described above, seem

to correspond to the other two modes of transcendence, “situational” and “general.”

The Other is an essential entity in spontaneous dramas played out by dispossessed

selves. These dramas reflect a collective “solution” or a shared situational struggle to

transcend imminent death. Nevertheless, we may see that this associates well with

Tornstam’s theorizing of the relation between social activity and gerotrancendence; he

claims that “gerotrancendence correlates positively with social activity at the same

time as a greater need for solitary “philosophizing” is experienced (1996, p. 47)”.

The current effort to invest gero-transcendence with contextual and group relevance

resembles Turner’s (1982) comparison of the qualities of “flow experience” with

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“communitas.” The similarity exists not only because “flow” is experienced within an

individual whereas communitas is between or among individuals, but also because

these two notions are compatible in their contents with subjects’ overt experiences. In

Turner’s words, communitas is “what all of us believe we share and its outputs

emerge from dialogue, using both words and non-verbal means of communication,

such as understanding smiles, jerks of the head, and so on between us (p. 58).”

Following Csikszentmihalyi (1975), he summarizes the “six qualities” of flow

experience as follows:

1. an experience that combines action and awareness;

2. centering of attention on a limited stimulus field;

3. loss of ego;

4. control of one’s action and environment;

5. non-contradictory demands for action;

6. autotelia—in which no goals or rewards outside the action itself are needed;

Further research may elicit similarities between the flow experience and dimensions

of gero-transcendence. Turner’s discussion alludes to the first as mentally “another

paradigm” by exposing the connection between flow and Zen experience. Turner

contends that flow reaches out to nature and to other people in what Csikszentmihalyi

calls ”intuitions of unity, solidarity, repletion and acceptance.”

This analytic precedent, which implies a social dimension of flow, illuminates the

relevance of gero-transcendence for the ethnographical findings. The parallel between

residents’ rituals and gero-transcendence is partial but contains essential elements. It

is worth repeating that the company of the Other was all that the subjects had. Sitting

together silently, they transcended the borders of past and future time to live in a

“sacred present” (Kearl, 1989) or a “limbo time” (Hazan, 1980). By ignoring

movements and sounds around them, they also transcended space. They seemed

disengaged from the institutional context, seeing themselves and others as one unity.

The Other’s presence represented the universe and served as a source of collective

meditation. Unique rhetoric about death attests to group strength against fear of death.

Moments of spontaneous but initiated meditation indicate a decrease in self-centrality.

The silence transcends the barriers of language, probably yielding to new insights.

Ring (1980) contends that life in the shadow of death may arouse a person’s spiritual

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sensitivity in that pettiness and egoistic tendencies disappear and are replaced with

love and affection. In addition to death imminence, the residents experienced acute

dispossession. These two factors encouraged them to transcend self-constraints by

over-identifying with the Other’s misery and helplessness. Dignified appearance was a

by-product of weakened self-orientation and a shift from egoism to altruism. The

Other as a projected extension of the self proved to be an essential player in exploring

the world, striving for ego-integration, and, of course, abandoning roles and social

masks. Thus, social circumstances at the micro level of an old-age home anchor a

context parameter in gero-transcendence theory.

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