It is easy to feel stuck at middle age. Looking back one can regret missed opportunities; ahead are the prospects of aging and mortality. Even satisfaction with our present lives involves reckoning with reality that all is not quite what we anticipated. Unless we see the value of relationships, work and social involvement, we can stagnate at midlife.
This challenge can be profound for people with HIV who never imagined living to age fifty or beyond. Decades caring for themselves and others has knocked them off their life course. The magnitude of loss has decimated their social networks, removing the people with whom they expected to grow old. Adjustments to physical and financial challenges, have further diminished circles of social involvement1.
Stagnation was a significant theme in my study of aging with HIV. Hector, age fifty2 said he “got into t.v.” rather than pursue work opportunities. Jamie, 57, acknowledged he, “doesn’t get out much.” Joe, age 64, spoke of losses as he aged with HIV. All of his close friends died of AIDS. Add to that physical challenges, leaving work to care for his health, and financial limitations all coalesce to create what he called, “a shrinking kind of life.”
“Then, the other question – what for? Why should I eat properly, exercise, stay active…” For Joe the threat of stagnation at middle age had serious implications.
The antidote to stagnation is generativity3. In middle age we can stagnate in self-absorption or we can give our lives meaning by sharing our experiences to the next generation. When we are generative we use our strengths creatively to engage others through teaching, mentoring, volunteering, or leading.
Examples of generativity were seen in the narratives of the men I interviewed. Arthur, age 64, talked about his writing as a way to “leave something behind”, Luis, 51 volunteered at an AIDS service organization to “make a difference.” Tim, at 50, described his activism as honoring friends who died of AIDS:
“For my friends that are dead… it’s not for me, it’s for the future as my friends did it for me, I want to do it for them. I want the future better for people.”
I met with Joe often during the eight months of my study. During that period he made significant changes to his life. He continued rigorous health care regimens, engaged therapy and rejoined a support group for older people living with HIV. He even attended a family reunion and was surprised that rather than feel ostracized, he felt included and involved. What motivated Joe to emerge from stagnation? He attributed his adaptation to developing concern for others and desire to stay engaged:
“You have to care about other people, and try to integrate your life with other people.”
In adulthood we continue our psychological development through mastering the challenge of generatively vs. stagnation. For Luis the solution was obvious: “I refuse to be stagnated.” Sometimes the decision to be generative involves subtle choices regards how and with whom we spend our time. This was evident as Patrick, age 55, expressed ambivalence about reconstructing a career at middle age:
“There are those things about 55 that make you want to say, oh just relax…But on the other hand, because that was snatched out of my life in my late 30s and throughout my 40s, I’m scrambling to have those experiences that I should have had when I was younger. You know?. . . so I’m conflicted between being 55 and going, “Well, you’re 55, you know, it’s hard to get out of bed, just relax! Enjoy your life, you know? Don’t . . . don’t work so hard.” And then this other part that’s still hungry.”
Generativity has additional psychological benefits. Generative activities can help people with HIV rebuild social relationships, reclaim goals relinquished to HIV/AIDS, and remind middle aged and older people of what they have to offer.
Here are a few strategies for generativity that emerged from my study of aging with HIV4:
- Teach a class or workshop
- Lead a social group
- Tutor a child
- Provide companionship to a homebound person
- Become politically active
- Be an HIV peer educator
- Serve on a community advisory board
- Join a chorus
- Create an inter-generational art project
- Mentor gay teens
- Join a professional organization
- Start a blog
- Write an editorial on aging with HIV
It’s never too late to pursue a goal, find new interests or positively impact someone’s life. You have a great deal to offer, but you are of no service to anyone, including yourself, if you don’t put yourself out there.
James Masten, PhD, LCSW is the author of Aging with HIV: A Gay Man’s Guide (Oxford University Press, 2011) and a psychotherapist in New York City. To learn more about Dr. Masten’s work go to AHAproject.org.
1Masten, J.E. (2014) A Shrinking Kind of Life: Gay Men’s Experience of Aging with HIV, Journal of Gerontological Social Work. 58(4):319-37; 2All names changed; 3Erikson, E. H. (1963). Childhood and society. New York, NY: W.W. Norton and Company; 4Excerpt from: Masten, J.E. (2011) Aging with HIV: A Gay Man’s Guide. Oxford University Press: New York.