When anti-wrinkle cream begins to outprice gold, it is hard to focus on the benefits of aging. Paradoxically, increasing numbers of people are living longer into their nineties while age is devalued and the quest for eternal youth intensifies. With this shift in priorities, the world will lose the accumulated wisdom of many lifetimes. It will be comparable to throwing every known map into a great bonfire, then expecting the next generation to find its way in an uncharted world. It is time for us to age consciously, defining the meaning of our lives well past the wrinkle-free years.

Sophisticated society is living an oxymoron. We speak of the “veneration of youth,” forgetting that by definitionHI, veneration is reserved for the wisdom and dignity that come with age. Where there are strong oral traditions, people eagerly harvest the wisdom of their elders. Most respected are the sages, those with the ability to learn from past mistakes and successes, and pass this experience on to the young lions they teach. But our society is so tied up in technology and the written word, that we neglect the importance of listening and tend to dismiss any idea that isn’t “cutting edge.” In the process, we are losing sight of the “sage-ing” process.

Young people aren’t the only ones caught up in youth worship, older people fall for it, too. Rarely do elders take the time to enjoy a chorus of well versed inner voices that can give vision and meaning to elderlife. It’s like ignoring a the wisdom of a panel of experts. It doesn’t make sense, but we do it. These experienced voices can open our minds to our own personal histories, teach us to learn from past mistakes, help us engage in the freeing work of forgiveness, find our place in the universe, and accept, even value our own mortality.

The goal of eternal youth is so alluring that many retirees don’t retire: instead, they pursue a most un-sage second adolescence or extend careers that distract them from serious contemplation of their lives. Increasingly, we view physical exercise not as a way to prepare for healthy aging, but to preserve the appearance of youth. Yet focusing on the physicality of life — a youthful body, a cure for every ill –inevitably forces mental and spiritual strengths into the back seat. Research shows that maintaining a balance of physical, spiritual and mental strength has a significant effect on the length and quality of life.

Living longer should not mean continuing to act and think as you have always done. It should mean appreciating a greater opportunity to be a sage: to conduct life review and life repair and to prepare for mortality with a sense of the wisdom others will inherit from you. By viewing the elder years as a time to consciously slow down, people step more easily into their elder years. And in the last the last stage of life, they can accept with grace the help of others.

Ethical wills are an excellent tool for conscious aging, and like traditional wills they are a work in progress that can be started at any time. They are highly individualized documents, but always seek to pass on accumulated wisdom. Your ethical will would state your beliefs and might re-tell the stories that taught you right from wrong, important from unimportant. They provide a tool for children and grandchildren who might never meet their elders, or listen at leisure when they are together. For fragmented, widely scattered families. ethical wills are creating relationships that will extend through many generations.

Writing an ethical will gives many people a comfortable knowledge, even anonymously, they will be the sages of future generations. And by reminding the writer of the importance of bequeathing spiritual wisdom along with the family china, they add dignity to life. Teaching always puts values to the test and can lend perspective to any subject matter. When you are the subject matter, a well-constructed lesson becomes paramount.

Life repair is a blend of life review and forgiveness. By taking the time to look back over our lives, we can examine our successes and failures. We find places we hurt others, and where we were hurt. But in these painful events are the most powerful teachers of what we come to value in ourselves and others. By looking them squarely in the eye, we extract the positive aspects and let go of the exhausting anger that lingers from hurt. New energy comes from that release, and of course, a new stage of wisdom.

As we enter the second half of life in larger numbers, it becomes more compelling that ever to find the meaning in living beyond the child bearing and child rearing years. As people age, entering perhaps the empty nest stage of their life, they have more time to focus on themselves. Without the demands of family and career building, they can find a part of themselves that they put aside after adolescence. This often included a sense of excitement, a determination to DO something important, to change the world! By reconnecting with that sense of excitement and locking into it, spiritual growth continues With this renewed sense of purpose, many people find they can increase their contribution tothe enrichment of self, community, even the planet. This will be their legacy.

Dr. Turin holds a doctorate, and is a licensed psychologist with offices in Lawrenceville. She was a facilitator of the Grief Support Group at the Princeton YWCA. Kate O’Neill collaborated with Dr. Turin on this article.

Demystifying Psychotherapy and how to Choose a Therapist

by Arnold A. Lazarus, Ph.D. & Clifford N. Lazarus, Ph.D.

In recent years there has been considerable change in the mental health marketplace. One of the major shifts has been to make the process of therapy less complicated and less mysterious.

Many therapists now regard their work as that of problem solving. They help their clients find solutions and develop healthy habits in the here-and-now. Thus, the old fashioned idea of digging deeply into the past has been replaced, in many circles, by resolving present-day problems and misfortunes. The modern and well-informed therapist uses active means to help people overcome their fears, miseries, uncertainties, and relationship difficulties. Moreover, this outlook lends itself very well to developing self-help procedures, and many clients are asked to practice various activities in-between sessions to give them self-mastery.

When you are faced with a psychological or emotional difficulty, we suggest that you take the following approach: First, try to define the problem. Attempt to be very specific. Next, accept the fact that for the most part you learned to act, think, and feel this way, and therefore you can unlearn it.

Devise a way of measuring the problem to see how often it occurs or to what degree it occurs. For example, if you are bothered by disturbing thoughts, keep a notebook and make a check mark every time you catch yourself thinking in that way. Or, let’s say you want to stop over-eating. Write down the exact foods you eat. Often, the very act of keeping a record tends to lessen the frequency of unwanted habits.

Problems are fully overcome only when we make a determined effort to solve them. If you do not get results, it may mean that you did not work hard enough at it, or that you are getting more advantages from staying the way you are. But it does not mean that you are hopeless. There are very few free rides in life and effort is required to bring about change. Basically, effective psychotherapy, whether it be self-help or professionally assisted, uses a combination of scientifically established psychological principles and “common sense” to enable people to live happier and more productive lives.

Of course self-help can only go so far. Often people are troubled by difficulties that transcend problems of everyday living and require expert assistance. For example those who suffer from severe anxiety, significant depression, obsessive-compulsive behavior, panic attacks, or extreme problems with stress are best advised to seek professional help. BUT, how does one find a good therapist? For starters, we suggest that you consider the Latin dictum: CAVEAT EMPTOR — let the buyer beware. Choosing a therapist can be a difficult and even dangerous task.

There are a staggering number of psychotherapies and psychotherapists. According to a recent survey, no less than 500 distinct therapeutic approaches currently exist. Not only does the psychotherapeutic marketplace offer a bewildering array of therapies and therapists, but finding one’s way through the maze-like corridors of the mental health system is difficult and often confusing. Because all therapies and therapists are not alike, people can end up in the hands of poorly skilled and inadequately trained professionals, and may even get hurt or harmed in the process.

But what is a consumer to do? Ask a friend? A family doctor? Consult the Yellow Pages? Here are some useful tips for the modern mental health consumer. In our view, the first step is to establish that the therapist is a licensed mental health provider. This can be done by contacting your state’s Department of Law and Public Safety — Division of Consumer Affairs, or by simply asking the therapist directly. We strongly recommend phone-interviewing the prospective therapist to ask questions about her or his experience, theoretical approach, areas of expertise, fees, insurance billing, and any other issues that seem appropriate.

Any therapist who won’t agree to a 5-10 minute introductory discussion over the phone may be too rigid or too busy to provide quality service and we recommend continuing to shop around. When you meet with a therapist, determine whether the counselor is warm, accepting, and non-judgmental. Does he or she provide feedback and answer questions directly? Does she or he seem flexible with time and scheduling? Is the therapist interested in solving current problems and not just concerned with exploring and understanding the past? If you can’t give a definite YES to all these questions, perhaps it would be a good idea to look for another therapist.

It is most important to emerge with a sense of hope after meeting with a therapist. If your morale is lowered rather than raised, we recommend that you look elsewhere. After all, it is your life and happiness that are at stake.

Love, like all emotions, changes and evolves over time. When they first “fall in love,” a couple feels euphoric. Their mutual fascination transforms their most trivial activities into meaningful moments. After one or two years, when the initial euphoria tapers off, couples usually settle into a deeper, more intimate relationship. Sometimes, however, when people sense the cool-down, they fear their partners no longer love them. Or they may believe that the lessening of desire means they have fallen out of love. If a couple is not familiar with the normal course of love, they may run into difficulty. But if they recognize that the cooling of sexual passion is almost universal, they can prevent the next stage: a pattern of rejection, anger and resentment. Unfortunately many formerly loving relationships end when the dysfunctional pattern spreads to other levels.

As the magic wears off, one partner, usually (but not always) the man, feels rejected, angry and sexually frustrated. The other partner becomes angry at the constant demands, while feeling shameful and inadequate. The safest course can be a retreat into separate emotional or physical worlds. The retreat may even take the extreme course of having an affair to avoid confronting problems at home.

In our world, passion is a popular topic. We see it and hear about it everywhere. It is one of Hollywood’s favorite subjects. Yet until recently, little was known about the actual causes for the crazy, intense feelings that accompany new love. Certainly, we do not generally think of it as a scientific topic. Yet it is useful to know that the euphoria of falling in love may stem from the temporary interaction of neurotransmitters in the brain. Phenylethylamine (PEA), an amphetamine-like neurotransmitter, combines with other biochemicals, including dopamine, to create the wild attraction between people falling in love. Later, when the PEA activity stops, Cupid’s love potion dries up. Many couples feel lost without it.

In addition to a chemical change in brain activity, science also explains the biological gap between the sexes. For their libido, or sex drive, both males and females rely on the male hormone, testosterone. Women have a ten-times lower level of the hormone, making them more sensitive to its fluctuations. Once PEA levels drop, many women experience a sharper decrease in sexual desire than their male partners do. This discrepancy should not be a source of ridicule, shame or anger. Learning the scientific basis for these discrepancies helps many couples accept one other, so they can begin to move out of the pattern of recrimination.

A cooling of the “in love” experience is different from loss of desire for other reasons. The former is universal: it is the nature of our biochemistry. The latter is not. A loss of desire for intimacy may stem from physiological or psychological factors including fatigue, depression, aging, stress, illness or the effect of drugs. Other factors might be shame, sexual exploitation, abandonment, date rape, acquired attitudes about sex, or bitter memories of a past love. Body image problems often spring from constant exposure to media prototypes of “perfection,” and the insecurity they cause can seriously taint a relationship.

During the initial phase of falling in love, the PEA euphoria masks the concerns of one’s inner world. It is not unusual for people to experience inner feelings such as loneliness, emptiness, or a lack of meaning in life. When they fall in love, every moment together is joyful. But once the haze lifts, inner issues erupt, affecting trust and sexual desire.

Loving relationships stem from both the inner and outer worlds, so exploring one and not the other does work. Often a psychologist can help a couple examine and interconnect the two levels of their lives. Generally, we speak easily about the events of our outer worlds: jobs, current events and daily routines. But our inner worlds are vast, obscure, and far more difficult to discuss. After the first phase of love, we are again aware of our old feelings. Yet, we are unable to discuss them, fearing shame and vulnerability. We might not even understand our inner turmoil, let alone dare to speak openly about it.

Communicating about sexual feelings can be even more difficult. In our world, sex is omnipresent, but how comfortably do most of us discuss sexuality and intimacy? And what vocabulary can we use? The strongest insults in our language have sexual connotations. Whether we want to mention a problem with intimacy or share a joyful moment, the lexicon of sex seems loaded with a coarseness that degrades the feeling.

A couple who have endlessly declared their attraction for one another may find it awkward or impossible to bring up their changing feelings and doubts.

In psychotherapy, people find the words they need to communicate constructively on this most sensitive topic, so they feel safe, heard and understood. They learn that their experience is neither unique nor shameful, and that they are not inadequate. Both men and women need to feel respected, listened to and openly appreciated, a goal of successful psychotherapy. Once they appreciate their normal differences [and similarities] they will probably be able to manage relationship more easily.

Despite feelings of vulnerability, a couple in counseling often feels safer exploring these issues, learning what each finds important and arriving at an appreciation of their differences. In their mutual acceptance, the couple can find an enduring form of love that is filled with desire, trust and respect. It should more than compensate for the loss of their early, passionate relationship.

Dr. Sofair-Fisch is a licensed psychologist, specializing in family and couples therapy. She has offices in Lawrenceville and West Orange.

Death, loss, and grief are normal parts of life and living. Yet, we make every effort to avoid them. We view death as the enemy, and we recoil from the pain of grief, attempting to avoid or curtail it at all costs. In our society, there is barely any place we can turn to learn the value of being touched by the strong and loving hand of sorrow.

By entering grief fully and allowing it to shape us as an artist shapes a masterpiece, we are transformed into something more magnificent than before. As the intensity of the pain dissipates, we resume our lives with new understanding, greater wisdom, and deeper compassion for all living things, including ourselves. These are unexpected treasures.

We commonly associate grieving with loss through death, but grief can spring from the ending of any meaningful relationship. A divorce, the loss or change of a job, home or lifestyle, illness and disability are some of the many events that can leave us mourning our losses. Even changes for the better often involve releasing something cherished to make space for the new. And, often, people do not understand the depth of anguish that springs from certain types of death such as suicide, miscarriage, or the death of a pet.

Throughout life, our losses accumulate. It is important to meet and experience each of these losses. Like a physical wound, a psychic or emotional wound left unattended, will not heal or will heal in a way that interferes with functioning.

Grief naturally ebbs and flows. We may be surprised months or even years later by a sudden, intense “grief reaction.” These are natural feelings that seem to accompany an emotional experience of closeness with the lost loved one. With that understanding, we might savor, rather than avoid these feelings.

Every loss is different, every mourner unique. Short term and moderate alterations in appetite, sleep, level of energy, mood and concentration are natural effects of this life event. Sadness, anger, fear and disorientation are common. Sometimes people feel they are actually “going crazy.” The bereft may experience guilt, believing they did not do enough in the life of the deceased or that they could have averted the death. For others, the death can feel like a release. Our response to significant loss will depend on a variety of factors, such as personality, family beliefs about death and emotions–especially the darker ones–our relationship with the deceased, our history of loss, and the cause of death.

In fact, it is not the presence or expression of emotions that is problematic. Rather, it is the effort to freeze them. It is only when sadness is frozen in us that it congeals into the diagnosable problem we label depression. When we allow our sadness to have its full voice, it flows through us and leaves us feeling more refreshed and free. If there are significant unremitting changes in mood and behavior, or if the mourner is still in acute mourning after six months or a year, professional intervention may be appropriate.

Having a ritual in which to express feelings and engage with family, friends, and community is very helpful in connecting with our grief. Funerals, memorial services and practices such as wakes or sitting shiva are designed to acknowledge and support the mourner’s path. Support should not be confused with distraction. Mourners will benefit by having friends and family who are available and not afraid to help them experience and express their feelings.

Children also need opportunities to talk about or play out their thoughts, ideas, and feelings about the death. We should try to answer all their questions as simply and honestly as possible. They need reassurance that death comes when someone is “very, very sick, old, or hurt.” Children need to know that they are not at risk.

Death, loss and grief, when allowed to have their rightful and honored places in our lives, are great teachers and guides to our inner selves. They help us to remember that life is a treasure, which is loaned to us. Through awareness we can enjoy it, and when the time comes, we should relinquish it with grace. The extent to which we accomplish this is the extent to which we open our hearts and experience joy, meaning and success in our lives.

Dr. Turin holds a doctorate is a licensed psychologist with offices in Lawrenceville. She was a facilitator of the Grief Support Group at the Princeton YWCA.

Kate O’Neill collaborated with Dr. Turin on this article.

“What a perfectionist!” We often use this statement to single out those who demand and achieve excellence. Yet true perfectionists are trapped in an unenviable web of contradictions. They appear to pursue excellence but constantly dodge the perception of failure. They seem programmed for success, but their goals elude them. They want praise but reject it as unfounded or insincere. And although we tend to put them on pedestals, perfectionists often cause misery to themselves and to the people they live and work with.

How can you recognize perfectionism in yourself or someone else? Above all, it is exhausting both to be a perfectionist and to be with one. They are dominated by a nagging, sadistic inner voice that is critical and judgmental. They fear making errors and they need to feel in perfect control. So, perfectionists live with constant anxiety, thinking that nothing they do is good enough.

The typical perfectionist makes lists upon lists. List-making can itself become a goal. Perfectionists also focus on technicalities, always seeing some minor “imperfect” detail rather than the overall success of a project. Nothing is ever right: a new chair is marred by a loose thread, prices are too high, a game should have been played better, reports cards are inadequate, gifts are flawed, or clothes fit poorly. There is no respite from the criticism and tension.

Perfectionists do not like to spend money or time, particularly on themselves. They do not like risks. They avoid change, they tend to worry and ruminate. On vacation, they would be uncomfortable stopping impulsively overnight. Instead of relaxing and making new discoveries, they would insist on following each step of the itinerary.

Perfectionistic behavior can hurt colleagues, but it is particularly damaging in loving relationships. Since closeness implies vulnerability, perfectionists often project an image of arrogance and tend to avoid meaningful friendships. Fearing that every decision is irrevocable, they feel mistrustful and emotionally guarded. Intimacy and long-term commitments are very difficult.

The stress of perfectionism can create physical ills. Anorexia, for example, is a life-threatening embodiment of the perfectionist’s belief that “nothing is ever good enough.” Also aches and pains result from the constant tension as do various gastro-intestinal problems. The condition may be non-specific, so a physician cannot diagnose any physical disease, but the misery of the patient will continue as long as the perfectionistic behavior persists.

Perfectionism can start early in life. Children may learn the behavior in a perfectionistic household where praise tends to be scarce. Or it can begin in a home that is simply too chaotic to meet their emotional needs. Children do not understand that they are not responsible for the turmoil caused by a parent’s alcoholism or the anger surrounding a divorce. Instead they convince themselves: “If I work harder, I can make things better. Then I’ll please my parents and make them pay attention to me.”

Although they may deny needing help, perfectionists usually need and benefit from psychological counseling. A therapist will attempt to help the client recognize the negative characteristics of perfectionism, understand its unhealthy effects, and find bearable ways to change. At first, perfectionists might suspicious of treatment since the therapist does not offer an ideal solution or promise to understand their situation “perfectly.” A perfectionist may also fear that any change in behavior could lead to failure or that the therapist will be critical.

Perfectionists can learn to develop realistic priorities and see that perceived failures are not shameful. They can modify their reactions to people and events, reducing impatience and alleviating stress. They can learn that letting go does not mean becoming sloppy or worthless. Moreover, a qualified therapist can help the patient see the ripple effect of perfectionistic behavior.

In treatment, recognition is the first successful step and comes as the perfectionist separates fact from illusion. Two types of psychotherapy may lead to this stage. Cognitive therapy helps perfectionists change their way of thinking, undoing, or unlearning traits that perpetuate it. Alternatively, in psychodynamic therapy, the therapist helps the patient explore the origins of perfectionistic behavior. In the process, they discover together the positive aspects of the patient’s personality.

Therapy will not create a complete metamorphosis. Perfectionist parents may never become more patient with themselves, but they can learn to change their attitude toward their children. They can begin to demonstrate affection without linking it to specific achievements. Without this support, children do not recognize their strengths. They become their own most unforgiving critics and may perpetuate the perfectionistic pattern.

For everyone’s sake, it is important for perfectionists to acknowledge the anxiety that motivates their behavior. Then they can take the first step. They can learn to appreciate themselves more than any product they can achieve. With less fear of making a mistake or being seen as a failure, the perfectionist can escape the tangling web and learn to make their lives worthwhile.

Marta Aizenman has a doctorate in counseling. She is the director of the Cook College Counseling Center at Rutgers University and also has a private practice.

(If you are looking for a therapist and would like a referral, you can find help through a friend or through your family physician.

You may also call the referral service at the New Jersey Psychological Association: 1-800-281-6572.)