HE.S.T.A.F.T.A. - Scientific Society of Mental Health Professionals


  • Katia CharalabakiPsychiatrist – Systemic Therapist

I kindly thank my colleagues George Gournas, Dimitris Kokkalis, Kia Thanopoulou, Athanasia Kati for the literature they forwarded to me.

"The object that sparked particular curiosity was a nineteenth-century jade screen, with a Chinese character representing longevity."



While beginning to write the paper on "old age", I was wondering whether it would be better for an old person or a young person to write it. And the answer was an ambiguous one. In the case of the old person, there is the presence of personal experience, but not only that. At the same time there is also their experience of living as a young person (with grandparents and parents). As for the young person, there is this exact experience along with images as visions of the future.

Historical references

When one reads on the history of old age they will find out how rich it is, as it dwells on what every era’s societies’, classes’ and people’s attitude towards old age were… From primitive societies to modern ones, from the Middle Ages, Renaissance, Europe, America, the entire world… Similarly the stance/attitude of literature and its great representatives around the world and throughout history, from Plato and Heraclitus to Shakespeare, Hugo, Beckett, Ionesco and many others, even in more modern times. Scientific literature on old age is also very rich ("Croesal" one could say) in information. Yet, there is one problem: It remains mainly accumulative, and very rarely – or never at all – experiential… Very few accounts focus on the existential aspect of old age, which constitutes the heart, the essence for its analysis and understanding.

I will very briefly, and as concisely as possible (which probably is not possible at all) discuss the ethnological dimension of the subject, mainly for the reason I mentioned above; I would like to mostly focus on its experiential aspect, setting the foundation for a discussion and an exchange of emotions, thoughts and personal or collective experiences. This is what we have been talking about when saying that along with history and "findings", experientiality must also emerge (same as for the therapist), which is in essence the double existence…

First of all, the biological aspect of the matter has proven that old animals receive the respect of younger ones and offer their valid opinion regarding the elements of life and nature in general.

On a human level too, in several eras and civilisations there are similar accounts. Yet, there are completely opposite events as well, or more accurately, the coexistence of contradictory situations. For example, in primitive societies (i.e. in regions of Africa) the chief would be considered as the embodiment of a deity. Yet, when he grew older and had passed his prime they would execute him, they would kill him… In some cases (like in the Dinka of South Sudan), they would even bury him alive.

In Ancient Greece, the ruler of the city would rule with the assistance of the council of elders. Thus, in Homer we see Nestor, the supreme councillor, representing the personification of wisdom. Odysseus, however, does not cease to be much more powerful and effective than the wise Nestor in dealing with the Trojan War problems that arise in the Iliad. 

In ancient Sparta, too, the elderly were very respected and were selected as members of the Senate. The predominance of people of advanced age as decision-makers constituted a regime of gerontocracy. Here also, there were cruel customs for the adjustment of young people to this kind of regime, i.e. the "whipping ritual". This was the ritualistic whipping of adolescent boys, on the altar of the Sanctuary of Artemis Orthia in Sparta.

In Athens, as well, old men constituted the Areopagus Council as per Solon’s laws. However, there are conflicting opinions regarding old age in Greek antiquity. These are depicted in myths, like the one of the old god Cronus (son of Uranus and Gaia), who would eat his children.

From Ancient Rome we have inherited the term "pater familias" that refers to the concept of the limitless power that the oldest member enjoyed within the family.

What is interesting here is the conflict (battle to the death in certain cases) between generations. Seneca, the Roman stoic and humanitarian philosopher, becomes the tutor of future Roman Emperor Nero. When Nero ascends the throne, Seneca continues for several years to positively council him. But Nero becomes a tyrant (possibly as a result of a psychiatric diagnosis that would place him in the families of the very severe psychiatric disorders) and cuts off communication with Seneca. Seneca retires and is ultimately accused of participating in a conspiracy against the emperor. His former pupil, Nero, then commands him to kill himself by severing his veins, which is what ultimately transpired.

From the Christian religion, we have the example of a grandfather, Noah, saving the world. According to the Book of Genesis in the Old Testament, Noah, being the only just and pious man of his era, constructed the Ark as instructed by God. He would survive the flood that God sent to punish the human race in the Ark (when it was washed ashore on Mount Ararat). With him were saved the members of his family and a couple of every animal that existed on the earth. Finally, Noah died at the age of 950 (as was God’s will), meaning that not even he – the saviour of mankind and everything living – could avoid the "final farewell". He was even surpassed by Methuselah, who lived to be 969… And let us not forget that Dracula, who drank blood, lived for 400 years… (And there are modern scientific procedures that give blood to old people in order to extend their lives)…

Middle Ages: The old age of civilisation and of old age as well. Especially during the early Middle Ages, the elderly where gradually more excluded from public life, as it was mostly younger people that were in power (with Popes even being elected at a young age), because they could travel, fight etc. Simultaneously, in folklore the old woman is seen as the deceitful and enforced witch. Here, one can mention the Shakespearian story of King Lear, as an exception, that portrays a common medieval reality regarding the relationship between generations. Regarding this subject, Simone de Beauvoir mentions that only Venice constituted an exception as an old person was elected doge. Dandolo, albeit blind and having been elected doge at the age of 84, managed to win an epic victory over Constantinople.

Renaissance: It was termed revitalisation and was considered as civilisation’s escape of death. However, here too, the position of the elderly was ambiguous. A floundering between circumstances (poverty included) that did not allow for a more favourable treatment of the elderly, and of an authoritarianism of the elders against youth (whippings of children and adolescents were also carried out in France). Yet, at the same time the concept of "care for the elderly" emerged, and such systems were implemented. In England, for instance, Queen Elizabeth I introduced poorhouses (which also housed the needy elderly), and the Church started support movements like fundraisers and charities. Simultaneously, the newly emerged puritanism gave old age a new value, with the unrelenting strictness it ought to reserve against children/youths that would reach or even exceed the limits of authoritarianism. It is an era where the conflict of generations reached its peak. Characteristic of this is 16th century Italian comedy (commedia dell arte): Pahlaço is a hideous, repulsive, degenerate old man. But as years went by and socio-political changes, revolutions etc. occurred, the middle class rose to the surface. As a result, the elderly had a better, more humane fortune.

Yet, in the 19th century, with the explosion of the industrial revolution, urbanisation and social upheavals, the position of some of the elderly became intolerable. It is here that class differences emerged between elderly people; the gap between the elderly aristocracy, the middle class and the proletariat. The situation for the elderly poor became deplorable, in the upper classes a "positive gerontocracy" emerged, and in the bourgeoisie an "age balance" began to form. This meant that for the average family, the grandfather did no longer hold an authoritarian power, but still deserved the respect of the younger members.

And of course the eradication of patriarchy in society and family highlighted new aspects of the position and the experiential substance of old age. At the same time, the life expectancy of the population increased, which expanded both the field of observation of relationships with others, and with themselves. And certainly, we cannot disregard the imposing theories of Freud (the "Oedipal Complex") and Jung (the "Electra Complex"), that place the son-father and daughter-mother couples in a murderous relationship, while putting the son-mother and daughter-father couples in an incestuous one. Simultaneously, socio-economic progresses coloured the evolution of the position of old age. Bowen and Bateson’s systemic concept of "Leaving Home", which refers to the separation of children from their parents when they reach adulthood, the concept of pensions for the formerly employed elderly (and of benefits for those without social security) that ensures financial independence, as well as the creation of "Nursing Homes" (or, in a best case scenario, the employment of a caregiver), have given birth to new concerns, both positive and negative, for this phase of life.

I will discuss these further, mainly on an experiential basis.

Many studies and reports (positive and negative) have been performed by scientist (mainly psychiatrists, psychologists and psychoanalysts), but also by writers and artists regarding the sex life of the third phase of life (even from the simple popular jargon referring to "dirty old men"). I will not address this subject, but rather save it for a future paper.

I will principally focus on a description of the social situation and the relationships and experiences of this phase.

But before we move on to the experiential references, let us discuss Freud a little further.

Freud’s references

As is widely known, Freud delved into the subject of old age and death for his entire career. From the Goddess of Death or Ancient Egyptian religion, to the death drive, sexuality and death, fear of death, taboos of death.

His first mention, and its connection to his psychoanalytic thinking, occurs in 1894. In a letter in the first issue of "Neuro-psychoses of Defence", he mentions old age as a "normal element of advanced age", along with Degeneracy, Conflict and Destruction, which are the main elements of Neuroses. The same year, in an outline of a paper he mentions the "transformation of physical excitation into anxiety because of old age" as an element of "anxiety of their decreasing potency or insufficient libido".

Freud’s final mention of the great subject of old age is in his last extensive paper that was published during his lifetime in 1937, "Analysis Terminable and Interminable". It is impressive that in this subject he involves Ancient Greek civilisation, and the great philosopher Empedocles of Acragas in Sicily in particular, "one of the grandest and most remarkable figures in the history of Greek civilisation". "The two fundamental principles of Empedocles – φιλία (love) and νείκος (strife) – are, both in name and function, the same as our two primal instincts, Eros and destructiveness, the first of which endeavours to combine what exists into ever greater unities, while the second endeavours to dissolve those combinations and to destroy the structures to which they have given rise… Moreover, we have provided some sort of biological basis for the principle of "strife" by tracking back our instincts of destruction to the death instinct, to the urge of what is living to return to an inanimate state".

Freud, an old man, two years before his death, at the age of 83 turns to one of the most inspired Greek philosophers, in order to discuss old age and the death drive. Empedocles, an old man himself at 60 years of age for the standards of his time, having completed his writings and dressed, as always, in an extremely impressive and eccentric manner, leaves Acragas, hikes and throws himself into the volcano of Aetna. A short while later, his fellow citizens find one of his golden sandals in a piece of quenched lava.

Old age, then and now. And afterwards, Death.

Present conditions

I will now return to the socio-economic condition of the elderly. The concept of pension, of the existence of income beyond the time of employment, constitutes an element of the modern financial and social reality. Theoretically, it offers the elderly substance, problems (relating to class, ethnological, spatial etc.) notwithstanding. Yet, even though superannuation has helped, partially at least, the financial and living standards of the elderly, the psychological result of retirement is still prevalent. Let us mention here another one of Freud’s remarks on the subject: "I cannot face with comfort the idea of life without work; work and free play of the imagination are for me the same thing, I take no pleasure in anything else… Hence, in spite of the acceptance of fate which is appropriate to an honest man, I have one quite secret prayer: that I may be spared any wasting away and crippling of my ability to work because of physical deterioration. In the words of King Macbeth, let us die in harness" (Sigmund Freud in a letter of Oskar Pfister, March 6 1910, Freud Museum, London).

One other modern (20th and 21st century) subject that is worth discussing is the emergence of "Nursing Homes" or, in more common terms, "Old people’s Homes". I will begin my discussion of this subject with descriptions that were made of the practical implementation of these institutions. Nursing Home in Attica (according to the newspapers): The elderly were found in a state of total neglect, dehydrated and locked inside a room. Members of staff would bind patients, either to their beds or to radiators, with their hands behind their backs, would leave them for hours in their own excrement. Every time someone died (and there could be two deaths in a single day), the coffins were brought at night so that it would go unnoticed. Generally speaking, "inmates" were living in deplorable conditions, malnourished and oftentimes without the necessary medication treatment. The conclusion to be drawn here, is that abandoning elderly parents in "homes" is equivalent to handing them over to what we used to call "common homes". Here, I will cite a story from my time as a member of staff at the Attica Psychiatric Hospital. There was a psychogeriatric department there. It was well-organised and had a good director, and (for the psychiatric standards of the time) it operated positively. HOWEVER: Very often, when we were on duty, we examined elderly patients and decided on whether they would be admitted to the psychogeriatric department in question. Yet that was not possible as there was no available bed. Why did this happen? Because hospital employees had "parked" their parents there, and with no psychiatric diagnosis at that. It was common practice among employees to "take advantage" of the department for their own benefit, instead of allowing it to be used by the general public. I remember becoming revolutionarily outraged and a pioneering militant activist against this situation. As I look back on it now, though, I have entered a different perspective. They may have been depriving patients of hospital beds, but for their parents it was a suitable solution. They kept them close to them, saw them, and could check their living conditions, so that none of the things that were recently described in the newspapers about the Nursing Home in Attica would occur. The elderly parents were close to their children in conditions that the children could control. Thus, it was a wise solution… A place of coexistence for the two generations, a place that transformed into a safe haven. Not the unwanted "asylum", just a safe harbour…

What would Ana Aslan, the monumental Rumanian gerontologist, have to say about this? But I will conclude this line of thought with a final mention of this former colleague that treated and resurrected frail old ladies and men. She herself died having just turned 90… This is the global event, the general final END…

Associations concerning old age

The "third life" (the autumn of life) is a bearer of many elements of life, both positive and negative (or contradictory), the evaluation of which, apart from scientific or social, is also personal. On a corporal level, the changes that occur with the passage of time have been described both scientifically and experientially. But as I mentioned earlier, I will not dwell on these. I will focus more on the psycho-mental aspect of old age. First of all it contains a wealth of experiences and knowledge: "I lived through this and that". "I experienced". "I know". Some people miss the forest for the trees. With the passage of time it is the forest that stands in the foreground.

It was Plutarch that termed old age autumn. Winter is imminent, and it might by a hard one – the leaves and trees are dry, snow is falling… But spring is not expected… The resurrection of nature is not expected… Arbuzov’s "Autumn Story"… Is it the sweet chestnuts from the chestnut vendor’s cart, or the unhospitable snowy White Mountains of Chania in Crete? It is here that the accumulation of losses emerges (in contrast with the Spring of life, where there is an accumulation of acquisitions). As the leaves turn yellow, fall, are lost and (alas) no new ones emerge, the loss (losses) becomes an element of the present environment. Marquez’s One hundred years of solitude. This solitude, however, strengthens "existence" in the heart and in the mind, meaning that there are moments of reversal: You gaze at the sunset from the balcony of your house, the sun has set and only its sweet red resplendence remains; and this goodbye (for just one day, one evening, one night) sooths you and turns your gaze into a painter… It snowed… Everything is white… We stayed locked inside the house. Oh, how I enjoyed it! Because it was not just me, but everybody relaxing in their homes. The disease of internalisation (due to the weather) was not a "privilege" of old age, but a general phenomenon, a countrywide (maybe even) worldwide characteristic!

And as mentioned before, there is loss. A basic element of old age. It started with the loss of the parents and people of their generation, and it was the first turning point for crossing over to the "next phase". And it is in this next phase that the loss of peers – relatives, friends, acquaintances – comes. And these are now natural elements of this period of life (as opposed to special losses, of mainly young people, due to acute illnesses, accidents or as victims of earthquakes war etc.). The image of "ploughing a lonely furrow" begins to emerge. Solitude… I use to host dinner parties. For relatives, cousins and also colleagues and friends. I cooked Cretan dishes (i.e. pie from Sfakia, staka, a Corfiot fish-soup that a nurse from Corfu had taught me to cook…). Now all these are memories (is the corona virus to blame too, and we should not blame it all on age?). Maybe some similarities in life and relationships exist, but there are also major changes. I even noticed a change in the crosswords puzzles I loved to solve. I gave them up and began to solve different ones, equally enthusiastically. That’s life… As we grow older, we will keep seeing/experiencing such changes… Great changes in life not only due to age, but also due to (changes) in history…

There is also forgetfulness: Memory loss, with or without dementia, for familiar faces (out of sight is out of mind). All these cause sorrow. HOWEVER! There is another side to it: Elderly people with Parkinson’s or Multiple Sclerosis call up their old classmate and comrade with revolutionary ideas: to create a resistance movement, organise events etc. These things cause stimulation and rejuvenation… A return to youth, psychically and emotionally… An elixir of youth was what the alchemists sought…

When we learn of the deaths of famous people (actors, directors, writers etc.) we immediately pose scientific and historical questions. And the questions are followed by answers/information. When was did Liz die? Or Brigitte, or Lenon, or Edith Piaf, the "little sparrow" of French music? How and why? Why then? And Emily Bronte that I used to read as a teenager, died of tuberculosis at age 30. I only just learned this… And this Greek actress that committed suicide by jumping off her balcony at 35, suffering from postpartum depression…What did Liz feel really when she was about to bid the last farewell to the world that singled her out as a famous being? How can we connect a humble ending with the glamorous stardom that we came to know in the movie theatres; how can we accept the levelling humanisation of our great idols? And also: every time we see a person in the news, in the newspapers, in magazines, we rush to the internet to search their date of birth… And for some (very few) the result of the subtraction, date A –date B, shows that they have reached 104 or 106! Then we stop, we (mentally) smoke the peace (or longevity) pipe and sigh, relaxed by the beauty of life and history… Time is time, simply time and not money…

Furthermore, this is a time period where by remembering and reflecting everyone makes their own "will and testament". What do I give? What do I take? What do I deserve? What am I deprived of (and why)? At the same time, everyone makes a confession to their inner priest (the "Superego") that judges, condemns, forgives and promises heaven or hell, or hell or heaven as per the will of God (that is one’s self). With recollections comes self-criticism. I.e. my jealousy (as I recall Hera was one of the contenders for the apple of Eris…) Because I was happy to hear that other people didn’t fare too well in a certain vote… why is it comforting to think of that? Gazing at life, politics, relationships, people around, I judge others and myself through different eyes – gazing deep, seeing the innermost and more essential elements… Self-reference and self-criticism. The mistakes I made in my lifetime, especially in choosing people (friends, associates). Even though I used to brag that I was perfect in selecting people and incorporating them, I recently discovered the quality, moral, or even criminal mistakes I have made… None is without sin… Still, it is not like that the people around us, relatives, friends, acquaintances have not been judged as belonging to the cells of hell. What do the bitter recollections of life bring to the surface? Quotes like "Woe to the vanquished"… Images of the "bitter waves of the sea"… Recollections bring forth the questions: "how did I live, and how did I (supposedly) fight alongside these clowns"? When I realise this, through specific examples, I bring to my mind the colleague and friend that at the time of tension and financial crisis - when Schäuble would send his minions to repossess the houses of Greeks with outstanding debts - would say "we live in an era where ‘let him who saves himself be saved’ is quite true". But there is also a reverse side: After bitter quarrels or even aggressive relationships, comes the making-up of warm relationships, where like the Achaeans we recognise the good qualities of the Trojans… And at the same time, the soft gaze for our own self returns, bringing the gift of rest, reducing anxiety and softening the hard Superego…

After all, we realise that to an extent (and no further than that) narcissism is a feature of the human substance, an element of all beings. It is sometimes normal and sometimes pathological. Yet its increase with age makes it more normal, brings it closer to life, in contrast with the narcissism of youth who’s enlargement leads to moral criminality or self-destruction… (Normal) narcissism of old age is, perhaps, the force of survival of the elderly. That is why it is common (mostly for women) to hide their years and why the Greek proverb that "it is the old hen that makes good broth" is acceptable.

This is also the time for Compromise: Compromise with one’s wrinkles, pimples, white hair, with the quote "fear old age, for it never comes alone", even if we wish for a second chance at youth. For Heraclitus "Everything flows" and for others "life is a fairy tale"… For Yannis Ritsos we seek "the fourth dimension". We are finally old enough to know better than others… There is a reduction of the control power of the strict "Superego", and thus life becomes simpler, more relaxed and more poetic… I will live until I cease to live… I will live until I die, even though the anxiety, the fear of death will always lurk and intensify with the emergence of physical (and often mental) helplessness


I will conclude with the narration of two events, two comic strips and a Freudian epilogue…

The first narration:

Simon de Beauvoir mentions the following narration by professor Delors: A 100 year-old woman walked to the hospital and requested a bed to lie in and die because she felt very tired. She actually did die the next day, and her autopsy did not show anything pathological. It was what is termed a "natural death", as opposed to that which is brought on by organ failure or an accident. I have a very similar story: The mother of a colleague and friend would say when she was around 90: "I will reach 100, I feel very well"… One morning she woke up and said: "I don’t want to reach 100, I’m bored". That same night, in her sleep she departed from this world, or in simpler terms she died. In these stories there is the concept of compromise with natural processes, and also the propulsion of these processes by individual will…

And the second narration:

It’s the umpteenth birthday of an older gentleman in a village in Chania Crete. A young fellow sees him and tells him: "may you live to be 100", to which the old man replied "why only 100 son, do I rob you of your food?" In this situation 100 years-old sounded so little it was almost offensive…

The two comic strips:

  1. A lady tells her friend: "After being married for 40 years my husband ran off with a 22-year-old. Every day shudder at the thought that he might come back!"

  2. "Grandma if I’m young only once, how many chances do I get at being old?"

And the epilogue:

Sigmund Freud, towards the end of his carrier is in analysis with a woman. At some point, he asks her "Do you have erotic feelings towards me, as you did towards your father when you were young, in the context of the Oedipal complex?" "No, not at all" the woman replies. "It is because I am old" Freud concludes in his psychoanalytic interpretation…


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Jean-Marc Talpin, «Quand le corps envahit la scène: Corps et vieillissement dans Un homme de Philip Roth», Champ psychosomatique 2008/2 (n° 50), p. 37-50. DOI 10.3917/cpsy.050.0037.

Jean-Marc Talpin, «Le vieillissement en institution», in Yves Jeanne, Vieillir handicapé, ERES «Connaissances de la diversité», 2011 (), p. 67-79. DOI 10.3917/eres.jeann.2011.01.0067.

Film: Amour. Directed by Michael Haneke, with Jean Luis Trintignant, Emmanuelle Riva, Isabelle Huppert.

Film: Nebraska. Directed by Alexander Payne, with Bruce Dern, Will Forte, June Squibb, Stacy Keach, Bob Odenkirk.

Film: Straight Story. Directed by David Lynch, with Richard Farnsworth, Sissy Spacek, Jane Galloway Heitz.

Film: The Father. Directed by Florian Zeller, with Antony Hopkins, Olivia Colman, Mark Gatiss, Imogen Poots, Rufus Sewell, Olivia Williams.

Film: Tokyo Story. Directed by Jasujiro Ozu.


  1. Suggested reading, not exhaustively used for this paper.

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ARTICLE 6/ ISSUE 22, April 2023

Psychiatry and the refugee condition: fragmented services, fragmented relationships, fragmented people

Lycourgos Karatzaferis, Psychiatrist/Hearing Voices Network (HVN), Athens, Greece
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