LEARNING NOT TO AGE:

The Link Between Belief and Biology

Although awareness gets programmed in thousands of ways, the most convincing are what we call beliefs. A belief is something you hold on to because you think it is true. But unlike a thought, which actively forms words or images in your brain, a belief is generally silent. A person suffering from claustrophobia doesn’t need to think, “This room is too small,” or, “There are too many people in this crowd.” Put into a small, crowded room, his body reacts automatically. Somewhere in his awareness is a hidden belief that generates all the physical symptoms of fear without his having to think about it. The flow of adrenaline that causes his pounding heart, sweaty palms, panting breath, and dizziness is triggered at a level deeper than the thinking mind.

People with phobias struggle desperately to use thoughts to thwart their fear, but to no avail. The habit of fear has sunk so deep that the body remembers to carry it out, even when the mind is resisting with all its might. The thoughts of a claustrophobic—“There’s no reason to be afraid”; “Small rooms aren’t dangerous”; “Everyone else looks perfectly normal, why can’t I get over this?”—are rational objections, but the body acts on commands that override thought.

Our beliefs in aging hold just this kind of power over us. Let me give an example: For the past twenty years, gerontologists have performed experiments to prove that remaining active throughout life, even up to one’s late seventies, would halt the loss of muscle and skeletal tissue. The news spread among retired people that they should continue to walk, jog, swim, and keep up their housework; under the slogan “Use it or lose it,” millions of people now expect to remain strong in old age. With this new belief in place, something once considered impossible happened.

Daring gerontologists at Tufts University visited a nursing home, selected a group of the frailest residents, and put them on a weight-training regimen. One might fear that a sudden introduction to exercise would exhaust or kill these fragile people, but in fact they thrived. Within eight weeks, wasted muscles had come back by 300 percent, coordination and balance improved, and overall a sense of active life returned. Some of the subjects who had not been able to walk unaided could now get up and go to the bathroom in the middle of the night by themselves, an act of reclaimed dignity that is by no means trivial. What makes this accomplishment truly wondrous, however, is that the youngest subject in the group was 87 and the oldest 96.

These results were always possible; nothing new was added here to the capacity of the human body. All that happened was that a belief changed, and when that happened, aging changed. If you are 96 years old and afraid to move your body, it will waste away. To go into a weight-training room at that age, you have to believe that it will do your body good; you have to be free of fear; and you have to believe in yourself. When I say that aging is the result of a belief, I’m not implying that a person can simply think aging away. Exactly the opposite—the stronger the belief, the more rooted in the body it is and the more immune to conscious control.

According to the belief system you and I adhere to, Nature has trapped us in bodies that grow old against our will. The tradition of aging extends as far back as recorded history and even prehistory. Animals and plants grow old, fulfilling a universal law of Nature. It is hard to imagine that aging is the result of learned behavior, for biology cannot be denied.

Yet the core belief that aging is a fixed, mechanical process—something that just happens to us—is only a belief. As such, it blinds us to all kinds of facts that don’t fit the belief system we cling to. How many of the following statements do you believe are facts?

a)  Aging is natural—all organisms grow old and die.

b)  Aging is inevitable—it can’t be prevented.

c)  Aging is normal—it affects everyone about the same.

d)  Aging is genetic—I’ll probably live about as long as my parents and grandparents did.

e)  Aging is painful—it causes physical and mental suffering.

f)  Aging is universal—the law of entropy makes all orderly systems run down and decay.

g)  Aging is fatal—we’re all growing old and dying.

If you take any or all of these to be statements of fact, you are under the influence of beliefs that do not match reality. Each statement contains a little objective truth, but each can be refuted, too.

a)  Aging is natural, but there are organisms that never age, such as one-celled amoebas, algae, and protozoa. Parts of you also do not age—your emotions, ego, personality type, I.Q., and other mental characteristics, for example, as well as vast portions of your DNA. Physically, it makes no sense to say that the water and minerals in your body are aging, for what is “old water” or “old salt”? These components alone make up 70 percent of your body.

b)  Aging is inevitable, but the honeybee at certain times of the year can shift its hormones and completely reverse its age. In the human body, shifts in hormones may not be as dramatic, but there is enough latitude so that on any given day your hormonal profile may be younger than the day, month, or year before.

c)  Aging is normal; however, there is no normal curve of aging that applies to everyone. Some people entirely escape certain aging symptoms, while others are afflicted with them long before old age sets in.

d)  Aging has a genetic component that affects everyone, but not to the degree usually supposed. Having two parents who survived into their eighties adds only about three years to a child’s life expectancy; less than 5 percent of the population has such good or bad genes that their life span will turn out to be significantly longer or shorter. By comparison, by adopting a healthy lifestyle, you can delay symptoms of aging by as much as thirty years.

e)  Aging is often painful, both physically and mentally, but this is the result not of aging itself but of the many diseases that afflict the elderly; much of that disease can be prevented.

f)  Aging seems to be universal, because all orderly systems break down over time, but our bodies resist this decay extremely well. Without negative influences from within and without, our tissues and organs could easily last 115 to 130 years before sheer age caused them to stop functioning.

g)  Finally, aging is fatal, because everyone has to die, but in the vast majority of cases, perhaps as much as 99 percent, the cause of death is not old age but cancer, heart attack, stroke, pneumonia, and other illnesses.

It is extremely difficult to ascertain what it would be like to watch the body age per se. Two cars left out in the rain will rust at about the same rate; the process of oxidation attacks them equally, turning their iron and steel into ferrous oxide according to one easily explained law of chemistry. The aging process obeys no such simple laws. For some of us, aging is steady, uniform, and slow, like a tortoise crawling toward its destination. For others, aging is like approaching an unseen cliff—there is a long, secure plateau of health, followed by a sharp decline in the last year or two of life. And for still others, most of the body will remain healthy except for a weak link, such as the heart, which fails much faster than do the other organs. You would have to follow a person for most of his adult life before you figured out how he was aging, and by then it would be too late.

The fact that aging is so personal has proved very frustrating for medicine, which finds it extremely difficult to predict and treat many of the major conditions associated with old age. Two young women can ingest the same amount of calcium, display equally healthy hormone levels, and yet one will develop crippling osteoporosis after menopause while the other won’t. Twin brothers with identical genes will go through life with remarkably similar medical histories, yet only one will develop Alzheimer’s or arthritis or cancer. Two of the most common conditions in old age, rising blood pressure and elevated cholesterol, are just as unpredictable. The aging body refuses to behave according to mechanical laws and rules.

After decades of intense investigation, there is no adequate theory of human aging. Even our attempts to explain how animals age have resulted in more than three hundred separate theories, many of them contradictory. Our notions of aging have been drastically modified over the last two decades. In the early 1970s, doctors began to notice patients in their sixties and seventies whose bodies still functioned with the vigor and health of middle age. These people ate sensibly and looked after their bodies. Most did not smoke, having given up the habit sometime after the Surgeon General’s original warnings about lung cancer in the early 1960s. They had never suffered heart attacks. Although they exhibited some of the accepted signs of old age—higher blood pressure and cholesterol, and tendencies to put on body fat, to become farsighted, and to lose the top range of their hearing—there was nothing elderly about these people. The “new old age,” as it came to be called, was born.

The “old old age” had been marked by irreversible declines on all fronts—physical, mental, and social. For untold centuries people expected to reach old age—if they reached it at all—feeble, senile, socially useless, sick, and poor. To reinforce this grim expectation there were grim facts: Only one out of ten people lived to the age of 65 before this century.

For centuries in the past, the human body was exposed to the killing influence of a harsh environment: Inadequate nutrition, a lifetime spent in physical labor, and uncontrollable epidemics of disease created conditions that accelerated aging. Leaf through the accounts of immigrants passing through Ellis Island at the turn of the century; some of the photographs will horrify you. The faces of 40-year-old women look haggard and drawn, literally as if they were 70—and an old 70 at that. Adolescent boys look like battered middle-aged men. Under the surgeon’s scalpel their hearts, lungs, kidneys, and livers would have looked identical to those of a modern person twice their age. Aging is the body’s response to conditions imposed upon it, both inner and outer. The sands of age shift under our feet, adapting to how we live and who we are.

The new old age arrived on the scene after more than half a century of improved living conditions and intensive medical progress. The average American life span of 49 years in 1900 jumped to 75 in 1990. To put this huge increase in perspective, the years of life we have gained in less than a century are equal to the total life span that individuals enjoyed for more than four thousand years; from prehistoric times to the dawn of the Industrial Revolution, the average life span remained below 45. Only 10 percent of the general population used to make it to 65, but today 80 percent of the population lives at least that long.

The Mystery of Aging

Despite this evidence that aging is a shifting, fluid phenomenon, we still find ourselves operating under the belief that aging can be understood strictly as a biological process. When you look at your body and notice how much it has changed physically since you were young, aging seems an obvious phenomenon. In fact, it is anything but.

Twenty years ago I was a young resident working in a vast and dreary veterans hospital outside Boston. In a typical day I ran physicals on dozens of patients, mostly old soldiers who had served in two world wars. The passing years had taken a toll that was all too obvious. Even when I had my eyes closed, the sound and touch of their bodies were unmistakable. Their hands trembled while I took their pulse, and their lungs wheezed under the stethoscope. The pounding lub-dub of young hearts had given way to feebler, threadier rhythms.

I knew that unseen destruction was taking place beneath the thin veil of their dry, wrinkled skin. Blood vessels were hardening and blood pressure was rising. If I could reach in to touch the three coronary arteries, one or more would almost certainly be engorged with fatty plaque. The body’s main artery, the aorta, might have turned as hard as a lead pipe, stiffened by calcium deposits, while the delicate arterioles in the head were likely to be so tissue-thin that the slightest contact would make them crumble, triggering a stroke. Vertebrae and hip bones would be getting thin and brittle too, waiting to crack if the person slipped on the stairs. All over the body, hidden tumors would be held in check only by the slowed metabolism of the elderly, which mercifully retards the spread of cancer.

All this may sound like an accurate, if grim, description of the aging process, but in fact I wasn’t seeing old people at all; I was seeing sick people. All over America doctors were making the same mistake. Caught up in treating various diseases, we forgot what aging is like when disease is not present. Moreover, the few medical researchers who took an interest in the aging process tended to work in veterans hospitals like the one in which I practiced. By definition, the “normal” aging they observed was abnormal, because a normal person isn’t hospitalized. No one would dream of defining childhood by studying patients in a children’s hospital ward, yet old age was largely defined that way.

Across the general population, only 5 percent of people over 65 are institutionalized, in either hospitals, nursing homes, or mental institutions. Surprisingly, this figure is not significantly higher than for younger age groups. Obviously, there are many reasons besides old age why someone might wind up in an institution. Such places are dumping grounds for the widowed, homeless, alcoholic, mentally incompetent, and destitute. A doctor can’t spend a day in a typical big-city hospital without seeing a police car pull up with a load of hapless derelicts swept off the street to become the faceless statistics that researchers use to define aging.

“Fear old age,” Plato cautioned over two thousand years ago, “for it does not come alone.” He spoke the truth. As we grow older, the things that bother us most are often not aging itself but the ills that accompany it. In the wild, few animals die simply because they have grown too old. Other factors, such as sickness, starvation, exposure to the elements, and ever-vigilant predators, kill off most creatures long before they reach their potential life span. Gaze at a flock of sparrows outside your window this spring; by next spring, half will have died from various causes. So, for all practical purposes, it is irrelevant that sparrows can live over a decade if kept safe in a cage.

Long life spans are possible among birds (in captivity, eagles can survive for fifty years and parrots for more than seventy years), which seems strange considering their fast metabolisms and racing heartbeat. But very little about the aging process is logical. The evolutionary purpose of aging is itself a puzzle to biologists, given that Nature has so many other ways of ending an animal’s life. For example, mortality is built into the system of competition for food. Some animals have to die in order for others to live; otherwise survival of the fittest would have no meaning. Among bears and deer, for example, the males fight for territory during breeding season; when the strongest males win the right to breed with the females, they also win the prime territory—land that is rich in food—while the losers must settle for much poorer foraging grounds, where many struggle on the verge of starvation and quickly die.

If a wild animal is fortunate enough to survive to its natural life span, its body will not just be old, it will be riddled with disease. Cancer, heart disease, hardened arteries, arthritis, and strokes are rampant among old creatures. Aged lions suffer coronaries and old eagles get cataracts. Aging is so mixed in with other factors that it is extremely hard to separate it out.

The same blurring occurs in humans. Although we pride ourselves on having escaped the trials of the wild, modern people still rarely die of old age. In 1938 the British medical journal The Lancet carried the report of a senior pathologist who maintained that he had never examined a deceased body that had succumbed to age alone. The closest candidate was a 94-year-old man who had died just by fading away without overt disease. But appearances were deceiving: At autopsy it was found that he had been suffering from an undiagnosed case of lobar pneumonia, one of the most common causes of fatality among old people.

Although it appeals to common sense that we grow old because we simply wear out, no wear-and-tear theory of aging has ever held up under close scrutiny. Aging bodies only seem to wear out like overworked washing machines and tractors. “How’s the old ticker?” a doctor will ask an elderly patient, as if her heart were a clock winding down on its spring. Unlike machines, however, which run down with too much use, the human body is capable of getting better the more it is used. A well-exercised bicep doesn’t deteriorate; rather, it gets stronger. Leg bones gain mass in proportion to how much weight is put on them, which is why osteoporosis is practically unknown in tribal societies where lifelong physical activity is the norm. Moreover, if wearing out were the true cause of aging, it would be a good strategy to rest in bed all your life. In fact, prolonged rest is disastrous for the physiology—a hospital patient confined to complete bed rest for a few weeks will suffer as much muscle and skeletal wasting as someone who has aged a decade.

Any purely physical theory of aging cannot help but be incomplete. Consider arthritis, one of the most common symptoms of age. In medical school we were taught that common arthritis (or osteoarthritis) is a degenerative disorder. This means that its cause is simple wear and tear. After a lifetime of hard use, the cushioning cartilage in large weight-bearing joints deteriorates, which explains why the knee and hip joints, which carry the burden of supporting the body, tend to be favored sites for arthritis. The synovium, the smooth lining that cushions the bones where they meet, also becomes inflamed or deteriorated, leading to the pain, swelling, and burning of arthritis. Sometimes the synovial fluid dries up, and the bones grind against each other, creating pits or bone spurs. This kind of degeneration has plagued mankind since the Stone Age. The familiar image of prehistoric man walking hunched over from the shoulders is now thought to be a distortion of what healthy cavemen really looked like. Archaeologists, it seems, were misled because so many of the intact skeletons they found in their digs were deformed from arthritis of the spine.

As the cause of arthritis, wear and tear appeals to common sense, but it fails to explain several things. Some people never become arthritic, even though they subject their joints to extreme stress. Other people develop arthritis after a lifetime of sedentary desk work, not to mention that certain favorite spots for the disease, such as the fingers, are not called upon to bear weight at all. Newer theories of arthritis look to hormones, genetics, autoimmune breakdown, diet, and other factors; in the end, no clear cause is known.

However, emotional factors have been strongly linked to another major type of arthritis, rheumatoid arthritis. This disorder seems to favor women who have a marked tendency to repress emotion, who adopt passivity and depression as a mode of coping with stress rather than getting angry or confronting serious emotional issues. The disease can get worse under stress, and, for inexplicable reasons, it can also disappear, perhaps in obedience to a deeper current of change.

Three Ages of Man

The complexity of the forces operating inside an aging body becomes even more obvious when you ask a seemingly easy question: How old are you?

Before you rush to reply, consider that there are three distinct and separate ways to measure someone’s age:

Chronological age—how old you are by the calendar

Biological age—how old your body is in terms of critical life signs and cellular processes

Psychological age—how old you feel you are

Only the first of these is fixed, yet chronological age is also the most unreliable of the three. One 50-year-old may be nearly as healthy as he was at 25, while another may already have the body of a 60- or even a 70-year-old. To really know how old you are, the second measure—biological age—comes into play; it tells us how time has affected your organs and tissues compared to other people of your chronological age.

Time doesn’t affect your body uniformly, however; practically every cell, tissue, and organ is aging on its own timetable, which makes biological age much more complex than chronological age. A middle-aged marathon runner may have the leg muscles, heart, and lungs of someone half his age, but his knees and kidneys may be aging rapidly due to excessive stress, and his eyesight and hearing could be declining on their own idiosyncratic paths. You become unique as the years pass. At 20, when muscle development, reflexes, sexual drive, and many other primary functions are reaching their peak, most people look alike to a physiologist. Young hearts, brains, kidneys, and lungs all exhibit healthy color and firmness; evidence of malformed, diseased, or dying tissue is scanty or nonexistent. But by age 70, no two bodies are remotely alike. At that age, your body will be like no one else’s in the world; its age changes will mirror your unique life.

Biological age also has its limits as a measurement tool. Considered purely as biology, the aging process moves at such a slow rate that its fatal effects rarely match those of faster-moving diseases. Most critical organs can function well at 30 percent of peak capacity. Thus if our bodies are losing 1 percent of their functioning per year after age 30, it would take 70 years, or age 100, before aging per se threatens a particular organ with imminent breakdown. But social and psychological influences are ever at work, our lifestyles subject us to various conditions, and the differences in how we age show up much earlier in life.

Two stroke patients in their midfifties with identical medical conditions can, and often do, display wildly different outcomes—one may recover from his attack quickly, respond well to physical therapy, and easily regain lost speech and movement, eventually returning to normal life. The other may respond poorly to treatment, be overcome with depression, and give up all active pursuits; in short order he may grow old and die. The determining factor is psychological age, which is the most personal and mysterious of the three measurements but also the one that holds the most promise for reversing the aging process.

Biological age is known to be changeable—regular physical exercise, for example, can reverse ten of the most typical effects of biological age, including high blood pressure, excess body fat, improper sugar balance, and decreased muscle mass. Gerontologists have found that elderly people who agree to adopt better lifestyle habits improve their life expectancy on average by ten years. Thus, the arrow of time can move forward quickly or slowly, stop in its tracks, or even turn around. Your body becomes younger or older biologically depending on how you treat it.

Yet your third age, psychological age, is even more flexible. Like biological age, psychological age is completely personal—no two people have exactly the same psychological age because no two people have exactly the same experiences. Listen to the voice of Anna Lundgren, age 101, who made a very important observation as a child that influenced how she aged for the next eighty or ninety years. “Back in Norway where I was a little girl, when people got to be 55 or 65, they just sat. I never felt that old. That’s old. I don’t feel that old today.” How old you feel you are has no boundaries and can reverse in a split second. An old woman recalling her first love can suddenly look and sound as if she has turned 18 again; a middle-aged man who hears that his beloved wife has died can wither into lonely senescence in a matter of weeks.

Instead of coming up with a fixed number to answer the question “How old are you?” we need to arrive at a sliding scale that shows how fast our three ages are moving in relation to one another. Take two 50-year-olds:

A, who was recently divorced, suffers from acute depression, with a history of heart disease and overweight; B, who is happily married, healthy, optimistic, and satisfied with his job.

Because of the various factors at work, the true age of A and B is best expressed by a three-tiered graph:

The arrows point in the direction of aging and their length indicates how fast the process is taking place. Although A and B are both chronologically 50, A is under so many negative influences that his body is 10 years older biologically and is aging quickly; in terms of psychological age he is about par with his calendar years, but he is aging fairly rapidly there, too. The picture is very different for B, who is younger on both the biological and psychological scales. His good physical and mental health indicate that he is aging slowly biologically and actually getting younger psychologically.

Overall, A is in much worse shape than B. Depending on how severe his depression and heart condition are, his composite age might be as high as 60, but this figure is artificial. It ignores the fact that all the factors that make him so much older than his chronological age are reversible. Ten years from now, he could be as happy, optimistic, and fit as B, in which case his composite age would decline.

When gerontologists try to predict longevity, all of the following psychosocial factors must be taken into account to accurately determine if the aging process is being accelerated or retarded.

NEGATIVE FACTORS THAT ACCELERATE AGING

    Asterisk (*) denotes major factors

*  Depression

    Inability to express emotions

    Feeling helpless to change oneself and others

    Living alone

    Loneliness, absence of close friends

*  Lack of regular daily routine

*  Lack of regular work routine

*  Job dissatisfaction

    Having to work more than 40 hours per week

    Financial burdens, being in debt

    Habitual or excessive worry

    Regret for sacrifices made in the past

    Irritability, getting angry easily, or being unable to express anger

    Criticism of self and others

POSITIVE FACTORS THAT RETARD AGING

*  Happy marriage (or satisfying long-term relationship)

*  Job satisfaction

*  Feeling of personal happiness

    Ability to laugh easily

    Satisfactory sex life

    Ability to make and keep close friends

*  Regular daily routine

*  Regular work routine

    Taking at least one week’s vacation every year

    Feeling in control of personal life

    Enjoyable leisure time, satisfying hobbies

    Ability to express feelings easily

    Optimistic about the future

    Feeling financially secure, living within means

As you can see, there is much more to psychological age than the cliché “You’re only as old as you think you are,” and changing your psychological age involves interweaving personal and social factors. Among the major factors are several we have touched upon. The importance of a regular daily and work routine is emphasized by almost every longevity study. Job satisfaction emerges as the most reliable indicator that a person is at low risk for a heart attack, while being dissatisfied with one’s job puts one at extremely high risk. Living alone is precarious, while being happily married indicates that one will age slowly.

The combinations of these factors become extremely complex, mirroring the complexity of one’s personal life. Gerontologists have gone to great lengths to try to quantify some of these factors, with plausible results. Someone who has lived alone for four years, for example, would have a slightly different psychological age from someone who has lived alone for eight years. The relative value assigned to having a regular daily routine is considered three times more important than having a satisfying sex life, while being optimistic about the future cancels out, point for point, the negative trait of not having a hobby.

But I have personal reservations about any attempt to quantify someone’s personal makeup; despite the general accuracy of these factors, they lose the essence of personal life, which is its ability to shift and transform itself, to touch many chords both happy and sad, to undergo sudden reversals and abrupt illuminations. When I think of myself, my image is not of a fixed collection of attributes—things are always changing inside, sometimes drastically.

The list cannot quantify intangible qualities such as being able to give of oneself and having regard for others. In general, this is a limitation of modern psychology, with its overreliance on numbers and impersonal data. One unusual study bridged the gap rather neatly, however. Larry Scherwitz, a University of California psychologist, taped the conversations of nearly six hundred men, a third of whom were suffering from heart disease, the rest of whom were healthy. Listening to the tapes, he counted how often each man used the words I, me, and mine. Comparing his results with the frequency of heart disease, Scherwitz found that men who used the first-person pronoun most often had the highest risk of heart trouble. In addition, by following his subjects for several years, he found that the more a man habitually talked about himself, the greater the chance he would actually have a coronary.

Counting the times a person said “I” was an ingenious way to quantify self-absorption, and to me, there’s something very fitting in the fact that the less you open your heart to others, the more your heart suffers. The antidote, Scherwitz concluded, was to be more giving: “Listen with regard when others talk. Give your time and energy to others; let others have their way; do things for reasons other than furthering your own needs.” In those words, he goes beyond the quantifiable data to issues of love and compassion, which appeal very much to our intuitive sense that an open, loving person should age well.

One thing the quantified research has shown so far is very valuable: Biological age responds to psychological age. If you look over the list of positive psychosocial influences, subjective words such as happy, satisfied, and enjoyable indicate how completely personal these factors really are. By nurturing your inner life, you are using the power of awareness to defeat aging at its source. On the other hand, changes of awareness in the direction of apathy, helplessness, and dissatisfaction push the body into rapid decline.

The Value of Adaptability

It is very frightening to watch an old person give up his desire for life, and it is extremely difficult to show him what he is doing. When life becomes meaningless, the body’s sustaining energy seems to drain silently away like a leaky battery. But if we look closer, we can prove that this draining away of vitality, curiosity, and the will to live is controllable and in fact has nothing to do with normal aging. The body is self-replenishing; it renews its energies automatically after times of depletion. No matter how severe the stress, once the body has responded, it returns to a state of balance. This tendency to remain in balance is completely necessary to life and proves to be a key survival mechanism.

In 1957, Flanders Dunbar, a professor of medicine at Columbia University, reported on a study of centenarians and “nimble nonagenarians.” She found that psychological adaptability in the face of stress was dominant among these people. This trait more than any other set them aside from the general population. Although everyone has occasions for grief, shock, sadness, and disappointment, some of us spring back much better than others. Dunbar went on to compile six traits that in her opinion were shared by “precentenarians,” people who have the best chance of living to be 100:

  1.  Responding creatively to change. More than any other, this trait made precentenarians stand out from ordinary people.

  2.  Freedom from anxiety. Anxiety is a great enemy of our ability to improvise and create.

  3.  The continued ability to create and invent.

  4.  High levels of adaptive energy.

  5.  A capacity to integrate new things into one’s existence.

  6.  Wanting to stay alive.

As with all predictive models, this one is flawed. It must be conceded that some people vegetate and still live to be 100, as do some who are rigid and uncreative, who couldn’t care less whether they stay alive. But positive qualities are far more common in centenarians, and as a description of the kind of old age that is most desirable, Dunbar’s list is extremely helpful. Her precentenarians are special because they reveal that just as people have strong or weak immune systems, we all vary in how well we adapt mentally. For some, the journey of life, however harsh on the outside, is met with resilience instead of brittleness; they are the reeds who bend in the storm, not the oaks who stand stiff and break.

Adaptability can be most simply defined as freedom from conditioned response. To remain open to change, to accept the new and welcome the unknown, is a choice that involves definite personal skills; for left to inertia, the mind tends to reinforce its old habits and increasingly to fall prey to its conditioning.

ADAPTABILITY QUESTIONNAIRE

If you want to see whether you have learned the skills that make someone adaptable, answer the following questions as they apply to you, assigning the following points:

Almost never applies	0 points
Sometimes applies	1 point
Usually applies	2 points
Almost always applies	3 points

  1.  When I am first confronted with a problem and have no idea how it can be solved, I take the attitude that the right answer will emerge.

  2.  Events in my life happen with their own right timing.

  3.  I feel optimistic about my future.

  4.  When someone rejects me, I feel hurt, but I accept that the decision was theirs to make.

  5.  I feel the loss of family and friends who have died, but the grief resolves itself and I move on—I don’t try to bring back what cannot be brought back.

  6.  I feel committed to ideals larger than myself.

  7.  When I’m arguing with someone, I defend my position, but I also find it easy to acknowledge the rightness in the other side.

  8.  I vote the man, not the party.

  9.  I donate time to worthwhile causes, even if they are unpopular.

10.  I am considered a good listener. I don’t interrupt others when they talk.

11.  If someone has a lot of emotion at stake in something, I will hear them out without expressing my views.

12.  Given a choice between a high-salaried job that is fairly boring and a job I like doing at half the pay, I’ll take the job I love to do.

13.  My style of managing other people is to allow them to do what they want rather than try to control them. I interfere as little as possible.

14.  I find it easy to trust others.

15.  I am not prone to worry; the ups and downs of difficult situations affect me less than most other people.

16.  In a competitive situation, I am a good loser—I will say, “Good game,” not, “I wasn’t at my best.”

17.  Being right in every situation isn’t all that important to me.

18.  I feel comfortable playing with young children; I enter their world easily.

19.  I don’t think about my moods very much.

20.  I can easily feel what someone else is feeling.

21.  Quiet people make me feel comfortable. Nervous people don’t make me nervous.

Total score: ______

Evaluating your score:

50 points or over:

You are an exceptionally adaptable person who has spent a long time on personal growth. Others seek you for guidance and advice. You place a high priority on your ability to remain comfortable under pressure and readily accept new challenges. You pride yourself on being able to resolve conflicts well.

30–50 points:

You are reasonably adaptable to everyday challenges, but the amount of work you have put into this area has probably been limited. You are the kind of person that others consider easygoing, but you are likely to have more worries and regrets that you haven’t faced up to. Conflicts upset you, and you tend to fall under the influence of people with stronger emotions than yours.

20–30 points:

You have definite ideas of right and wrong behavior and put a high priority on defending your point of view. Working on personal growth has not been a high priority in your life so far. You are likely to be well organized and decidedly goal oriented. If you find yourself in a situation of conflict or competition, you really want to be on the winning side.

Under 20 points:

Your sense of self needs considerable work. Dominated by one or both parents as a child, you fear rejection and become upset or critical when others disagree with you. You have your way of doing things and do not like surprises. You are likely to be obsessively orderly, with lots of hidden worry, or else very disorganized, reacting strongly to one external event after another.

The purpose of this test is not to make anyone feel superior or inferior but to spur conscious growth. The common denominator of all adaptable people is that they actually work, on a daily basis, at keeping their awareness open. Most of this book is devoted to that work, and I feel that there is no higher life purpose than trying to open your awareness until the full impact of reality—in all its beauty, truth, wonder, and sacredness—is consciously experienced. Reduced awareness occurs when life is not consciously lived and appreciated. This tendency is often so subtle that it may take months or years before the damaging results are evident, but the trail of clues is very obvious for anyone who cares to look. The age changes that develop in mind and body are the end products of thoughtlessly giving in to rigid assumptions, beliefs, and opinions. Some people, for instance, have absorbed the notion that they are going to lose their memory in old age, an expectation frequently reinforced by those who believe in the “old” old age.

As soon as they are 55 or 60, such people begin to worry about every tiny memory lapse, despite the fact that occasional memory lapses occur to everyone, young and old. Memory is a funny thing. You can’t make yourself remember anything, but you can make yourself forget. One way to do this is to block a memory with anxiety. Remember that last time you were in an emergency and had to call home? You rushed to a pay phone in a state of anxiety, and as you picked up the receiver, the thought flashed through your mind, “What’s my number? I’ve forgotten my number!” This thought doesn’t go away until you calm down and allow the fog of anxiety to withdraw, which then permits memory to arise spontaneously.

Some people are so anxious about growing old that they cannot help but leak that anxiety into every situation that calls for them to remember something—a friend’s name, someone’s address, the place where they left their keys. They start trying to monitor their memory (“Okay, am I about to forget this?”), which only makes matters worse, until they get caught up in a vicious circle: They are so persuaded of encroaching senility that they force themselves into memory loss by not allowing enough relaxation for memory to work.

The development of any character trait starts early in life and begins to display itself by middle age. The best way to ensure that you will be adaptable in old age is to work on being that way when you are still young. This was demonstrated in a classic study started fifty years ago by Harvard psychologist George Vaillant. He took 185 young men, students at Harvard during World War II, and monitored their health for almost forty years. Vaillant found that even if someone appeared perfectly healthy in youth, he was very likely to die prematurely if he reacted poorly to stress, fell prey to depression, or was psychologically unstable. Of the men who had the best mental health, only 2 became chronically ill or died by age 53. Of the 48 men with the poorest mental health, however, 18—almost ten times as many—were chronically ill or dead by that age.

Vaillant concluded that early aging—defined as irreversible physical decline—was retarded by good mental health and accelerated by poor mental health. The most formative years for establishing these conditions, he found, were between ages 21 and 46, because those are the years when a person generally succeeds or fails in establishing a secure sense of self, regardless of even the most terrible childhood traumas and abuse. Once the seed is planted, the results of mental health show up physically in one’s fifties. Late middle age is the perilous decade often called “the danger zone,” because it is then that premature heart attacks, runaway hypertension, and many types of cancer first show up in great number.

To put it more generally, Vaillant found that the aging process is learned. People with good mental health teach their bodies to age well; depressed, insecure, and unhappy people teach their bodies to age badly. Although Vaillant observed that increased stress was often found in the lives of those who became chronically ill and died young, he had the insight to realize that stress doesn’t make people sick; giving up their inner adaptability to stress does. The greatest threat to life and health is having nothing to live for. Children display tremendous vitality and rush at each day with open arms. This is natural to them and remains natural unless they learn the dulling habits and attitudes that smother spontaneous curiosity and wonder.

Vaillant was among the first researchers to establish that being depressed often leads to premature aging, chronic illness, and early death. Generally, at the root of depression is a kind of emotional numbness; the person feels he has no laughter or joy inside because these positive emotions have been blocked by unhappy memories. Old traumas lurk inside, and when new feelings try to bubble up, they are filtered through the traumas. Even the most beautiful experience, such as having a baby, cannot survive if it has to be filtered through preexisting hopelessness. Giving birth generates a flood of powerful hormones, generating a surge of energy pouring through the body. In a woman with healthy memories of her early childhood, this surging energy is experienced as a strong bond to her child; at the same time, the body renews its energy after the exhaustion of going into labor. Within a few days, the whole mind-body system has been returned to express the joy and power of motherhood. However, in a woman whose memories associated early childhood with sadness and emotional hurt, the flood of new energy during childbirth triggers the old programming instead. The joy and power are transformed into apathy and fatigue. Postpartum depression is the result of outworn memories seizing a new lease on life.

Although the vast majority of depressed people are treated with antidepressant drugs, such medications do not cure the underlying sadness, trauma, and numbness that are the true cause of the disorder. When the drug is taken away, the depression flowers again. Even though it takes longer and requires more insight and courage, a more effective way to treat depression is through psychotherapy. Classic “couch psychiatry” is often scorned, but counseling a depressed patient, uncovering the inner hurt and releasing it, sometimes accomplishes a lasting cure, which no drug can claim. This implies that premature aging, which Vaillant so closely linked to depression and mental instability, might also be treatable in a similar way. In fact, all of us are learning and unlearning to age, we just haven’t looked at ourselves that way.