the team – another example of ‘joining’ and ‘conjoining’. Melanie: You have, in our conversations, led me to think of older age as an ‘unexplored territory’ for younger people. Curtis and Dixon similarly say they see work with older people as a form of cross-cultural practice where we need to take into account a historical framework and the cultural changes clients have experienced over their lives. Which requires us to be curious about times very different to our own. John: I think that’s exactly right. Again, it’s about crossing the frontier of difference. Melanie: We used to meet a couple in their 70s who had been through traumatic experiences, separately and together. He could behave in an aggressive and controlling way towards his wife who was depressed and had withdrawn from him. He found it very difficult if we asked his wife questions in the sessions, much to her frustration. They felt very stuck and had little positive to say about their marriage. Whilst I felt compassion for both partners, I did rather dread the sessions as I often felt a sense of failure after them. Webb-Peploe and Fredman (2015) suggest emotionally preparing for sessions by ref lecting in advance on positions we take, often without realising it. The idea is that we can make a choice about our ‘emotional postures’ that has a real impact on how we are with clients. My co-therapist and I ref lected with our team on our frustration and hopelessness. We asked each other questions about how this would impact on the sessions and what alternative postures might be more useful. We were all women and conscious of how our beliefs about gender equality were inf luencing how we listened. This helped us to access some optimism and have a different dialogue with the couple. We decided to each take the perspective of the different partners. This got us in touch with the man’s determination to be in charge of


his life and care for his family despite multiple humiliating experiences – and her capacity to keep trying to be heard and to improve the relationship in the face of enormous obstacles. We asked more about how they saw men and women’s roles and how their views had developed over their years of marriage. The wife said at the start of their relationship she appreciated relying on her husband to speak for her but that, at her current age, it now felt silencing and so caused conf lict. The man became more able to listen and be curious about his wife’s experience and the woman to express both her own distress and her understanding of his. John: I like what you did to find your way through that potential minefield, Melanie. Our work is gingerly defusing family ‘minefields’ (or ‘mindfields’ as the ‘Human Givens’ group calls them). To love in ‘sickness and health’ is a challenge, certainly when facing the complex, multiple health and mental health problems many older adults experience. We have spoken about how much family literature has focused on the child and middle years rather than the later stages of the family life cycle, where the emotional issues are definitely about ‘love and care’ as well as ‘hostility and rage’. The promise to love ‘in sickness and health till death do you part’ is a noble sentiment but also a ‘big ask’. Will I stand the challenge all the way through? Hard to say, but I have taken great comfort from the extraordinary experiences of ‘enduring love’ I have listened and been witness to. It is a highly rewarding group to work with, as we both agree. It helps me to ‘grow old’ if not ‘disgracefully’ then at least ‘knowingly’. Melanie: I really enjoyed specialising in working with older adults in my last NHS role. And it was the job where I had most opportunity to use my family therapy skills. I draw on the experience still as I currently see quite a few people over 65 and will soon arrive in that territory myself.


Final refl ections


Old age and ageing are both ‘content’ and ‘process’. To those who are not yet there it can seem an alien land with threats to those most precious and ‘taken-for-granted’ possessions – personal wellbeing, health and independence. We hope from our conversation with one another we have managed to balance some of the anxieties with the many promises it affords too. These include a matured understanding of the complexity of ‘being human’; a compassion towards our life-cycle journeying; and an enlargement of that rarefied human virtue – humility. Above all, ageing intensifies the inborn joy that comes from childhood which is about just being alive and experiencing the fullness of living. As systemic therapists, joining is enhanced if we can respectfully and playfully consider both the threats and the promises, which of course inf luence us as much as the people with whom we work, to explore the territory of older adulthood.


References Curtis, L. & Dixon, M. (2019) Developing cultural humility in work with older people. Context, 165: 2-5. Jenkins, H. (2006) Inside out, or inside in: Meeting with couples. Journal of Family Therapy, 28: 113-135. Jeffery, S. with Jeni & Jayne Webster (2019) Knitting meanings with semantic dementia: A collaborative consideration of family therapy. Context, 165: 15-17. Jorgensen-Taylor, J. (2018) Cognitive connections: Creativity in the reflecting team experience. Context, 159: 33-34. Lee, E., Tsang, A.K.T., Bogo, M., Wilson, G., Johnstone, M. & Herschman, J. (2018) Joining revisited in family therapy: Discourse analysis of cross-cultural encounters between a therapist and an immigrant family. Journal of Family Therapy, 40: 148-179. Minuchin, S. & Fishman, H.C. (1981) Family Therapy Techniques. Cambridge MA: Harvard University Press. Webb-Peploe, H. & Fredman, G. (2015) Systemic empathy with adults affected by intellectual disabilities and their families. Journal of Family Therapy, 37: 228-245.


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Context 169, June 2020


Growing old disgracefully and working with the disgracefully old: Signifi cant landmarks in the ‘unexplored territory’ of older adulthood


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