Book Review – Ageless Body, Timeless Mind: The Quantum Alternative to Growing Old

By Deepak Chopra

Deepak Chopra is a practicing endocrinologist who was born in India. He combines Eastern spirituality, traditional medicine, and physics to provide a holistic view of health and aging. He demonstrates the true connectedness of nature by combining physical science and spirituality. Who would have seen these two seemingly separate topics as one package complimentary knowledge?

We humans have always sought to unravel the secrets of aging. According to Chopra, we’ve spent most of our collective planet time looking in the wrong places. Scientists have long pried and examined the body seeking answers to eternal questions about the mystery of aging. Chopra suggests that the answers lie in our consciousness, not in our bodies. Teacher comment: Excellent point. Like Dorothy in the Wizard of Oz, we’ve had the power and the answers within us all the time. It’s empowering just to imagine the power over our physical and spiritual lives within us.

Dr. Chopra combines mind-body medicine with current anti-aging studies to demonstrate how aging’s negative effects can be prevented. Over the last thirty years, hundreds of research findings have verified the fact that aging is very individual and that there’s no definite line between psychology and biology. He says we can learn to redirect how are bodies metabolize time. If we want to intervene in aging process, we must do it “at the level where belief becomes biology,” here, we can attain our “unbounded potential.” Teacher comment: Interesting position.  The secret to diminishing the signs and symptoms of aging lies simply in our perception.

It’s our social conditioning, our collective worldview, “the old paradigm,” (3) our way of seeing things that he calls, “’the hypnosis of social conditioning’, an induced fiction in which we have collectively agreed to participate.”(3). Our bodies are aging as we have programmed them through our collective conditioning. We can actually rewrite our own developmental software and by reprogramming our perceptions of reality.

“Our cells are constantly eavesdropping on our thoughts and being changed by them.”(5). Falling in love can boost the immune system. Our immunity can be destroyed by depression. Teacher comment: True. Despair increases the risk for a heart attack or getting cancer, where as, joy keeps us healthy and extends life. Just the act of remembering a past  stressful event stimulates the flow of destructive hormones, the same reaction caused by the stressful event itself. We have the ability to speed up, slow down, or even reverse aging with our minds.

Your entire world can change, including your body, by a simple adjustment in your perception. Teacher comment:  Yes.  Mandatory retirement can be deadly for many men. The day before your sixty five you’re valued and seen as socially useful, the very next day  your a societal dependent. The incidence of heart attacks, cancer, and early death in previously healthy men soars within the first few years after retirement. On the other hand, in societies where old age is accepted and valued, elders stay vigorous.  Teacher comment: No doubt.

Our current assumptions about aging don’t define our reality, they were interventions of the human mind that we converted into rules. If we’re going to challenge aging we have to change our worldview because nothing holds more power over our physicality than our beliefs. The underlying reason that old people feel marginal, devalued, and cut off from mainstream activity is because they lack positive images of aging.

Quantum physicists, like Einstein, have known for almost a hundred years that our perception of the physical world is wrong. It reminds me of the very old belief that we clung to for so long, the belief that the world was flat. It took a very long time for the human race to evolve away from that false belief. Our worldview creates our individual world that’s unlike anyone else’s. We are squeezed into a body and a lifetime, by the rules of cause and effect that we accept.

In actuality, life is unbounded. At the deepest level our bodies are ageless, our minds are timeless. Einstein realized that time and space were products of our senses. He and his colleges were able to see beyond this mirage. They reassembled time and space into a new geometry without beginning, end, edges, or solidity. They discovered that every solid particle was a bundle of energy vibrating in a huge void. The advantage of this worldview is that it is infinitely creative.

Chopra thinks that it’s liberating to know that you can change your world and your body via a perceptual adjustment. Old cells serve as maps of your experience, your suffering gets imprinted on your cellular memory  along with your joy. Stresses you forgot about consciously still send signals like imbedded microchips that make you anxious, tense, or fatigued because they cross the mind-body barrier – they become a part of you. By seventy, experiences processed and metabolized by your tissues and organs are seen externally in cellular changes.  Teacher comment: Interesting concept.

The act of paying attention to your body’s functions, instead of leaving them on autopilot, will change how you age. When we love the miracle of who we are beyond social classifications we create health for our mind and body. One example is biofeedback and meditation that has been used to teach people to lower their blood pressure or their stomach acids. Teacher comment: Good point.

Quantum physics tells us that our atoms are 99.9999 percent empty space. Our subatomic particles are just bundles of vibrating energy that carry information, not solid matter. Since the Big Bang the quantum field holds the universe in unexpressed form, similar to how are we hold thousands of words silently in our memories. All the essential stuff of the universe, all that we can see, feel, and hear, including our bodies, is actually non-stuff. It’s not ordinary non-stuff, it’s thinking non-stuff.

The basic emotion fear, isn’t just an abstract feeling, it’s also a tangible molecule of adrenaline. Teacher comment: True. Without the hormone there’s no feeling, without the feeling there’s no hormone. Transmitting pain works the same way, there won’t be any pain without nerve signals to transmit the pain. There’s no pain relief without endorphins to block the signals. Mind-body medicine was based on the discovery that where ever a thought goes, a chemical goes with it. This helps to explain why a recently widowed woman is twice as likely to develop breast cancer and why people who are chronically depressed are four times as likely to develop physical illnesses. Both examples illustrate how psychological pain can be converted into the biochemicals that lead to dis-ease. This knowledge points to the vitalness of our work as counselors in helping our clients feel better emotionally, we are also helping them maintain healthy bodies.  Teacher comment: Yes.

The placebo effect allows a sugar pill to relieve pain the same way a real narcotic does. The same thing has been done with chemotherapy for cancer patients. Patients with advanced malignancies have gone into remission after receiving only sterile saline solutions, but were told it was a powerful anti-cancer drug. Our bodies are capable of producing any biochemical response if the mind is given the correct suggestion. The power of the placebo is in the suggestion that is converted into the body’s intention to cure itself. Chopra suggest, why not skip the sugar pill and go directly to the intention?

We could trigger the intention not to age and the body would carry it automatically. Intention is actively partnered with attention, which can enable us to convert automatic processes into conscious ones. We age the way we do because we all expect to do so. We’ve unwittingly set up a self-defeating intention with our unwavering belief that our mind-body automatically carries out. These intentions have created obsolete programming in us, but we can reprogram our intentions consciously.

The image of our bodies in Western medicine is that they’re mindless machines, despite unquestionable evidence that this is not true. It has been proven that death rates from cancer and heart disease are higher in people with psychological distress. A Yale study found that breast cancer spread fastest among women with repressed personalities, felt hopeless, and were unable to express negative emotions. There have been similar findings with asthma, arthritis, intractable pain and other disorders. A Stanford psychiatrist studied eighty six women with advanced breast cancer. Half received weekly psychotherapy and lessons in self-hypnosis. It had been thought, what could a woman do to combat a fatal disease in an hour’s therapy a week, shared with other patients? After following these women for ten years Dr. Spiegel was stunned to learn that the group receiving therapy survived on average twice as long as those without therapy. Doubly telling was the fact that only three of the women were still alive – all had been in the therapy group. This study is amazing because the researcher didn’t expect any effect at all. Over the last decade many other researchers have come up with similar findings.  Teacher comment: Unquestionable evidence.

Medical journals overwhelmingly preach about the inherent biology of disease, thoughts, feelings and attitudes are just along for the ride. The new paradigm teaches us that emotions aren’t just fleeting events isolated in mental space, they’re expressions of awareness – the fundamental stuff  of life. All religions teach that the breath of life is spirit. To raise or lower one’s spirits means something fundamental that the body must reflect.

Perception is a learned phenomenon. Our bodies are the physical results of all the interpretations we’ve learned to make since birth. Transplant patients describe participation in donors memories. One woman who received a heart/lung transplant awoke craving beer and Chicken McNuggets that she had never craved before. She also dreamed a man named Timmy would come to her. She tracked down the donor’s family and learned that he was killed in a traffic accident on his way home from McDonalds. He was also very fond of beer. Our experience becomes our bodies. This women that Chopra spoke about was on the Oprah Winfrey show. They referred to this phenomenon that happens to many transplant recipients as cellular memory.

Defiant of medical science which says that growth hormone is preprogrammed in DNA, children who have felt unloved have stopped developing. A condition called, psychological dwarfism. Severely abused kids convert lack of love into a growth hormone deficiency. The cure – loving foster parents who transform the child’s beliefs which can produce bursts of the hormone. Learning to see themselves differently is reflected in their bodies. Teacher comment:  Yes.

Awareness can heal and destroy depending on how it’s trained. We have been conditioned to think that we have no choice to see aging differently. Our bodies conform to unconscious messages in our heads that say, “I must age”. We grow old and die because that’s what we see others do. This physical process is so universal it appears to be inevitable. Aging is how our bodies respond to social conditioning. If aging is something that’s happening to you then you’re a victim of it, but if aging is learned, then we can unlearn this behavior.

Many different kinds of studies have shown that the support of family and friends can make a difference in our health at times of stress.  Teacher comment:  Yes. Auto workers who received support were less likely to develop physical or mental symptoms. Pregnant women experience ninety one percent less serious complications of pregnancy when they have support. Gerontologists put a group of elderly nursing home residents, ages eighty seven to ninety six, on a weight training program. Within eight weeks wasted muscles came back three hundred percent, coordination and balance improved and their overall sense of an active returned. Beyond the physical, they regained dignity.

A Harvard psychologist studied one hundred eighty five men (students at Harvard during WWII) and monitored their health for forty years. Those who reacted poorly to stress (i.e. depression) were more likely to die prematurely. Aging was retarded by good mental health and accelerated by poor mental health. The results of mental health show up in the fifties, a perilous time when premature heart attacks, high blood pressure and cancer show up. Teacher comment: Yes.

Giving birth generates a flood of powerful hormones that provide a surge of energy through the body. If a woman has healthy memories of childhood this energy is used in establishing a strong bond to the baby. Sad childhood memories triggers old programming which changes the joy into apathy and fatigue. Postpartum depression is the result of outworn memories seizing a new lease on life. Chopra doesn’t recommend anti-depressant drugs because when the drugs are taken away the depression returns. He suggests psychotherapy even though it takes longer and requires more insight and courage.  Teacher comment: Interesting point.

A US study tested female runners to see if hard exercise prevented osteoporosis. The best prevention is not calcium or hormone replacement, but building bone density with exercise in the younger years with exercise. A study of runners also showed increased bone density in their arms. At the quantum level, the whole skeleton got the message to deposit more calcium to the bones. The whole body knew exercise was happening.

A scientist named Backster found that cells removed from the body and placed in another room react to the same stimuli that the person does. He applied a polygraph on cells scraped from the inside of the mouth and they reacted in the same way as the person did in another room. At the source of intelligence, there’s little difference between thoughts and molecules. Another demonstration of cellular memory!  Teacher comment: Really?

Words, unlike the promise of childhood songs, can and do hurt us because they cause hormones to be secreted in response. Words of love transform us. Child psychologists have learned that children are more deeply influenced by ascriptive statements such as, You’re a bad boy”, or “You’re a liar”, than prescriptive ones such as, “Wash your hands before eating.” Telling her what she is, makes a deeper impression than telling her what to do. The mind-body system is actually organized around such verbal experiences. Wounds delivered can create for more permanent effects than physical trauma, for we literally create ourselves out of these words. Teacher comment: True.      

Words have the power to program awareness, so it’s important to avoid passively accepting negative connotations that the word old  carries. (I might add words and phrases like: faggot, dumb blonde, girl talk, nigger, kike, bull dyke, whop, polock, all the societal images that harm some aspect of humanity).

Chopra thinks that nothing makes people age more than fear, second only to grief. Every doctor has witnessed the appalling deterioration of a spouse that has been widowed. It’s not that death is a fiction, but that our belief in it creates limitations where none need exist. Teacher comment: I agree.

Meditation’s use for stress held little appeal for Western medicine until the early seventies when physiologists at UCLA proved that along with its spiritual implications, it had profound effects on the body and creates changes in breathing, heartbeat and blood pressure. This researcher also showed that long term practice of meditation actually reversed the effects of aging.

Psychologists are beginning to verify that human development extends into old age through higher states of awareness, such as wisdom.  Many believe the notion that any decline in the brain’s physicality with age is offset be new mental accomplishments. Creativity researchers say artists can come up with more ideas in their sixties and seventies than in their twenties and the later you take up the creative pursuit the more likely you are to pursue it into old age. PET scans show increased blood flow to the brain during periods of creative thought illustrating that creative experience may enhance brain structure itself. Julia Child came to television when she was past mid-life.

A Harvard psychologist studied the physiology of love. A group of people viewed a movie of Mother Teresa doing her work among the sick and poor which displayed a profound outpouring of love. While they watched, their immune systems increased, SIgA or a salivary immunoglobulin antigen which indicates a high level of immune response. (Also characteristic of people who have recently fallen in love). Teacher comment: The philosophy of emotion.  Despite the fact that all audience members had this positive immune response, some expressed objections centering on differences such as religious or being disturbed by the sight of starving children. Their physical response to love was more powerful than their rational attitudes. It brings to my mind the question, what effect does racism, sexism, homophobia and violence have on our immune system? What are the effects on aging to those us who life in a culture separated by stratifications that include issues such as gender, race, and class? Surely these separations in our humanity lack an outpouring of love.  Teacher comment: Good questions.

When we accept our parents belief system about aging, we agree to fear death, because its thought of as the end. But, perhaps there is no ending. Birth and death are time-space events, existence is not. If we look inside us, we find a faint but certain memory that we have always been. No one remembers not existing. The deepest questions about who we are and what life means are wrapped up in our notion of existence. It’s fear reaches much further into our lives than our conscious minds are willing to admit. When you say you fear death, you’re saying you fear you haven’t lived your true life, which cloaks the world in silent suffering. When the spell of mortality is broken we can release the fear that gives death it’s power. Seeing ourselves in terms of timeless, deathless Beings, has the power to awaken every cell to a new existence.

This new paradigm provides us with a concept that connects body, mind, and spirit into a unity. The later years should be a time when life becomes whole. The circle closes and life’s purpose is fulfilled. In that regard, active mastery is not just a way to survive extreme old age—it’s the road to freedom.  Teacher comment:  I like that!  

Aging can also be said to be a self-fulfilling prophecy. You expect to be withdrawn, isolated, and useless when you age and you create the very conditions to justify these beliefs.  Teacher comment:  Yes! Our deepest assumptions are triggers for the physical changes we know so well.

He wrote the book with the hope of taking the subject so fraught with fear – aging, and turning it into a vehicle for fulfillment. Humans aren’t really trapped in time, squeezed into the volume of a body and the span of a lifetime, we’re voyagers on the infinite river of life. He recommends using love as our mirror of timelessness, letting it nurture our certainty that we are beyond change, beyond memory of yesterday and the dream of tomorrow.

Chopra’s ideas give me hope for humanity. I’m hopeful that if aging is a product of social learning, then it’s also possible that concepts such as racial, gender and sexual inequality are learned myths that can also be reconceived in ways that will prevent them from artificially separating humanity. Surely the wisps of intelligence that Chopra envisions harbor true global family values, such as tolerance, non-violence, acceptance, egalitarism, altruism, values that offer hope to heal all of humanity. If we can come to see ourselves differently, surely we can also see others differently than we do. I believe that his ideas about the possibilities of human development will find ways to overcome man’s inhumanity to man.

We  Must Discard These Ten Assumptions:

1.   There is an objective world independent of the observer, our bodies are an aspect of this objective world.

2.    The body is composed of clumps of matter separated from one another in time and space.

3.   Mind and body are separate and independent from each other.

4.   Materialism is primary, consciousness is secondary.  In other words, we are physical machines that have learned to         think. 

5.   Human awareness can be completely explained as the product of biochemistry.

6.   As individuals, we are disconnected, self-contained entities.

7.   Our perception of the world is automatic and gives us an accurate picture of how things really are.

8.   Time exists as an absolute, and we are captives of that absolute. No one escapes the ravages of time.

9.   Our true nature is totally defines by the body, ego, and personality. We are wisps of memories and desires enclosed        in packages of flesh and bones.

10.   Suffering is necessary—it is part of reality. We are inevitable victims of sickness, aging, and death.

Ten New Assumptions:

1.   The physical world, including our bodies, is a response of the observer. We create our bodies as we create the experience of our world.

2.   In their essential state, our bodies are composed of energy and information, not solid matter. This energy and information is an outcropping of infinite fields of energy and information spanning the universe.

3.   The mind and body are inseparably one. The unity that is “me” separates into two streams of experience. I experience the subjective stream as thoughts, feelings and desires. I experience the objective stream as my body. At a deeper level, however, the two streams meet at a single creative source. It’s from this source that we are meant to live.

4.   The biochemistry of the body is a product of awareness. Beliefs, thoughts and emotions create the chemical reactions that uphold life in every cell. An aging cell is the end product of awareness that has forgotten how to remain new.

5.   Perception appears to be automatic, but in fact it is a learned phenomenon. The world you live in, including the experience of your body, is completely dictated by how you learned to perceive it. If you change your perception, you change the experience of your body and your world.

6.   Impulses of intelligence create your body in new forms every second. What you are is the sum total of these impulses, and by changing their patterns, you will change.

7.   Although each person seems separate and independent, all of us are connected to patterns of intelligence that govern the whole cosmos. Our bodies are part of a universal body, our minds an aspect of a universal mind.   

8.   Time does not exist as an absolute, but only eternity. Time is quantified eternity, timelessness chopped up into bits and pieces (seconds, hours, days, years) by us. What we call linear time is a reflection of how we perceive change. If we could perceive the changeless, time would cease to exist as we know it. We can learn to start metabolizing non-change, eternity, the absolute. By doing that, we will be ready to create the physiology of immortality.

9.   Each of us inhabits a reality lying beyond all change. Deep inside us, unknown to the five senses, is an inner-most core of being, a field of non-change that creates personality, ego, and body. This being is our essential state—it is who we really are.

10.   We are not victims of aging, sickness, and death. These are part of the scenery, not the seer, who is immune to any form of change. This seer is the spirit, the expression of eternal being. 

Ten Keys to Active Mastery:

1.  Listen to your bodies wisdom, which expresses itself through signals of comfort and discomfort. When choosing a certain behavior, ask your body, “How do you feel about this?” If your body sends a signal of physical or emotional distress, watch out. If it sends a message of comfort and eagerness, proceed.

2.  Live in the present, it’s the only moment you have. Keep your attention on what is here and now. looking for the fullness in every moment. Accept what comes to you totally and completely so you can appreciate it, learn from it, and then let it go. The present is as it should be. It reflects infinite laws of Nature that have brought you this exact thought, this exact physical response. This moment is as it is because the universe is as it is. Don’t struggle against the infinite scheme of things; instead, be at one with it.

3.  Take time to be silent, to meditate, to quiet the internal dialogue. In moments of silence, realize that you are recontacting your source of pure awareness. Pay attention to your inner life so you can be guided by intuition rather than externally imposed interpretations of what is or isn’t good for you.

4. Relinquish your need for external approval. You alone are the judge of your worth, and your goal is to discover infinite worth in yourself, no matter what anyone else think. There is great freedom in this realization.

5.  When you find yourself reacting with anger or opposition to any personal circumstances, realize that you are only struggling with yourself. Putting up resistance is the response of defenses created by old hurts. When you relinquish this anger, you will be healing yourself and cooperating with the flow of the universe.

6.  Know that the world “out there” reflects your reality “in here.” The people you react to most strongly, whether with love or hate, are projections of your inner world. What you most hate is what you deny in yourself. What you most love is what you wish for yourself. Use the mirror of relationships to guide your evolution. The goal is total self-knowledge. When you achieve that, what you  most want will automatically be there, and what you most dislike will disappear.

7.  Shed the burden of judgment—you will feel much lighter. Judgment imposes right and wrong on situations that just are. Everything can be understood and forgiven., but when you judge, you cut off understanding and shut down the process of learning to love. In judging others, you reflect your lack of self-acceptance. Remember that every person you forgive adds to your self-love.

8.  Don’t contaminate your body with toxins, either through food, drink, or toxic emotions. Your body is more than a life support system. It is the vehicle that will carry your on the journey to your evolution. The health of every cell directly contributes to your state of well being, because every cell is a point of awareness within the field of awareness that is you.

9.  Replace fear-motivated behavior with love-motivated behavior. Fear is the product of memory, which dwells in the past. Remembering what hurt us before, we direct our energies toward making certain that our old hurt will not repeat itself. But trying to impose the past on the present will never wipe out the threat of being hurt. That happens only when you find the security of your own being, which is love. Motivated by the truth inside you, you can face any threat because your inner strength is invulnerable to fear.

10.  Understand that the physical world is just a mirror of a deeper intelligence. Intelligence is the invisible organizer of all matter and energy, and since a portion of this intelligence resides in you, you share in the organizing power of the cosmos. Because you are inseparably linked to everything, you cannot afford to foul the planet’s air and water. But at a deeper level, you cannot afford to live with a toxic mind, because every thought makes an impression on the whole field of intelligence. Living in balance and purity is the highest good for you and the Earth.

Taken From:

*Chopra, Deepak. (1993). Ageless Body, Timeless Mind: The Quantum Alternative to Growing Old. New York: Harmony  Books, pp. 4, 5-7, & 258-260.

Work Cited

Chopra, Deepak. (1993). Ageless Body, Timeless Mind: The Quantum Alternative to Growing Old.  New York: Harmony  Books.

Viagra: What Does the Future Hold for the Relationships of Older Americans?

National Louis University

Research Evaluation & Methodology

Summer 1998

Dr. Christopher Clemmer

Group project by: Joyce Sweeney, Trish Anderson, Linda Israel, Marissa Green, Debbie Anthony

Introduction

The problem:  will Viagra have a negative impact on the emotional relationships of older Americans? AARP discourages the use of the term elderly and uses, instead, the term older Americans, young seniors, and older seniors. This concept is also supported by Journals on Gerontology. This project has taken us into some old and new territory. We chose this topic because of its challenge, and our belief in the value of working collaboratively to mirror an actual research project.  We were not disappointed.

Sex in the “golden year” has been a mystery, if not a surprise. Today’s older Americans grew up in a time when sex, at any age, was a secret. As gerontologist Ruth Weg states, “Anyone can be sexually responsive given adequate stimulation, but genital response is only one measure of the total sexual experience” (1). In other words, physiologically aging need not hamper sexual activity, more sexually significant may be one’s feelings about one’s self and one’s mate, one’s expectations, general physical condition, alcohol and drug intake, mood, living situation, ability to communicate about sex, and whether one has a partner.

“Sexuality is very much tied to the rest of the culture,” states anthropologist Jay Sokoowski, of the University of Maryland, “Among the Asisataic Indians, where women are repressed, sex represents male domination and women embrace menopause as an excuse not to engage in sex. On the other hand, he states, in socially equalition cultures, such as the South Pacific Islands, sex is openly discussed from childhood, it is engaged in for pleasure as well as procreation, and it continues, for both men and women throughout life” (2).

In our society, sexuality, in older people, has been the object of ridicule and pity. The underlying assumption is that continued sexual desire is pathetic and inappropriate, since sexual function, we have assumed, is diminished and unsatisfactory. In the late 1940’s Kinsey blew this myth wide open and opened the door to questioning this concept, through his Kinsey Report. In 1970, Masters and Johnson, emotional issues rather than organic problems are the main cause of impotence. Their treatment programs focused on appropriate sex information and facilitating verbal, emotional, and physical communication with the older sex partners. Health problems of older individuals have often been dismissed as unavoidable by products of aging, or treated with drugs that have had a negative impact on the psyche or have led to impotence – generally considered insignificant in older people by the medical professions.

Our paper will explore the available research on Viagra and the theoretical underpinnings of our question, “will Viagra have an impact on the emotional relations of older people?” Our research, via a review of the literature, and interviews with people in the medical field, has provided us with a historical sketch of Viagra since it became available to Americans in March of 1998.  We find that our research has raised more questions than it has answered and strongly indicate a need for additional study. As time progresses, and we have the opportunity for analysis of further research, we will have more credible statistics to support or disprove our hypotheses, that Viagra does have emotional consequences for older Americans. The data, available at this time, indicates that some harm is apparent and is consistent with the need for supplemental investigation.

Literature Review

Myths & Taboos

Meredith E. Drench and Rita H. Losee (1996) explored sexuality, psychosocial issues, and sexual capacities of older adults (sixty five and older) in connection with the rehabilitation nurse’s role in providing sexual counseling. Despite many deeply ingrained stereotypes, many elders can and do have sexual enjoyment (Drench & Losee 1996; Richardson 1995). Our society has internalized images of older adults as slow moving and sweet (Drench & Losee 1996).  Joan P. Byers (1983) discussed a survey of health professionals in which they used the following phrases to describe sex among the elderly: hard to imagine, nonexistent, discouraged by society, normal, impossible, slow, healthy, and, not very often. People erroneously assume that older adults: don’t desire sex, couldn’t do it if they wanted to, are too fragile physically and might hurt themselves, are unattractive and undesirable sexually, and the thought of older adults being sexual is perverse (Byers 1983). Elderly men are the blunt of jokes and often referred to as dirty old men (Byers 1983; Semmens 2 1997). Women who were once considered attractive girls, and mature interesting women are cast into sexual oblivion after fifty (Byers 1983; Richardson 1995).

Older adults who deviate from internalized taboos against their having a continuing appetite for and ability to maintain sexual relations are seen as abnormal or foolish (Drench & Losee 1996). This lack of understanding and insensitivity can lead to frustration and conflict among older people (Drench & Losee 1996). The notion that aging automatically means a loss of sexuality distorts our attitudes, norms, and values and can cause older adults to miss out on the physical contact they need (Drench & Losee 1996). Some older adults may repress their sexual feelings simply to avoid the disapproval and rejection as a result of taboos and stereotypes (Drench & Losee 1996).

In the nineteen sixties and early seventies, many long term care facilities actually restricted contact between the sexes to public areas so they could be monitored by staff (Byers 1983). Even married older adults were separated and if a spouse visited they were seldom allowed privacy (Byers 1983). These practices were unjust and required older adults to conform, give out their sexuality, and suffer with feelings of guilt because of remaining sexual feelings (Byers 1983).

Medicare guidelines now require nursing homes to provide private spaces for married couples (Drench & Losee 1996; Byers 1983). Some long term care facilities provide privacy for men and women whether they’re married or not (Drench & Losee 1996). Despite this progress, the sexuality of older clients still sometimes conflicts with attitudes of healthcare workers (Drench & Losee 1996).

Women’s Physical Changes

Aging brings a gradual decrease in the duration and intensity of physiological responses to sexual stimulation requiring more and longer stimulation during intercourse (Byers 1983; Richardson 1995). However, all four phases (excitement, plateau, orgasm and resolution) of sexual response still occur (Byers 1983). Orgasms may be shorter, less intense and might take longer to accomplish (Drench & Losee 1996; Richardson 1995). Unlike the male refractory period which increases, women can become aroused again without delay (Drench & Losee 1996).

Masters and Johnson’s studies showed that the main physical changes that aging females experience is due to losses of estrogen (Byers 1983; Semmens 1 1997). With age vaginal mucosa thins, lubrication diminishes, the vagina loses some elasticity and expansion, and shrinks in length and width (Drench & Losee 1996; Byers 1983). If intercourse is infrequent it could be uncomfortable (Drench & Losee 1996). Hence use it or lose it does apply here.

To continue sexual activity one needs to maintain regularity, be interested, and have emotional involvement among the partners (Drench & Losee 1996). Maintaining sexual relations also has some positive physical effects for older women: it helps maintain muscle tone, reduces the incidence of mild urinary incontinence, and regular sexual experience helps to retain their ability for multiple orgasms (Drench & Losee 1996). 

Men’s Physical Changes

Although the decrease in testosterone is slight compared to women’s great drop in estrogen, reduced secretions from the seminal vesicles and the prostate gland causes the semen to thin and reduces the amount of ejaculate (Drench & Losee 1996). Sperm remain active and can still be present in advanced age (Drench & Losee 1996). Older males have less ejaculatory tension, sexual flush, and perspiration which may lessen the intensity of pleasure, but doesn’t prevent sexual function even to age ninety (Drench & Losee 1996).

Older males need increased physical stimulation and time to get an erection (Drench & Losee 1996; Richardson 1995). After sixty, men are slower to get an erection, in penetrating a partner, and in ejaculating (Byers 1983). Erection is also lost faster after orgasm (Drench & Losee 1996. There is a greater time delay for recovery (hours or days) before older males are able to become erection again (Drench & Losee 1996; Richardson 1995). As men age there’s a greater frequency of intercourse without ejaculation along with less powerful ejaculation (Drench & Losee 1996).

According to the National Institutes of Health, erectile dysfunction is a myth of aging (Drench & Losee 1996). Potency is measured by erection not ejaculation and males don’t loose this ability solely through aging (Drench & Losee 1996). Men without partners are more likely to experience potency problems, many widowers regain their erectile function when they remarry (Drench & Losee 1996). Masters and Johnson found that the changes in aging males are quantitative rather than qualitative when compared to younger males (Byers 1983). The advantages are that older men can have better control of ejaculation and because arousal is slower, foreplay can be more leisurely (Byers 1983; Richardson 1995). From a partner’s point of view this can be a positive change. Men’s sexual responsiveness does decline, but the availability of partners and retention of youthful attitudes are significant factors in maintaining interest and activity (Drench & Losee 1996).

Psycho/Social Factors

Psychological factors in decreasing potency include: guilt or feelings of inadequacy, self-doubt, lack of knowledge, worries about masturbation or infidelity, fear of failure, fatigue, depression, boredom, worry over money, and the pressure to conform with cultural taboos about sex and aging may impact potency (Drench & Losee 1996). The mistaken notion about sexual activity being harmful after a heart attack, a hysterectomy, or a prostatectomy may also put a damper on one’s sex life (Byers 1983; Semmens 2 1997; Carter 1997).

Sexuality isn’t only about the physical act itself, it’s about love, caring, sharing and warmth expressed from one person to another; it helps us feel secure and comfortable (Byers 1983). Sexual appeal isn’t just about physical attraction, it’s includes assurance of one’s worth, validity, and ability to be loved (Drench & Losee 1996). These feelings can be extremely meaningful to older adults who have experienced many losses (Byers 1983).

A older adult experiencing depression is likely to have a decline in sexual interest and potency, but may erroneously attribute these symptoms as a natural part of the aging process (Drench & Losee 1996). For others, the nearness of or the risk of death may actually heighten sexual desire, which can then lead to guilt and shame (Drench & Losee 1996). A common cause of stopping sexual activity is the loss of a partner (Drench & Losee 1996). Enduring grief can preclude the pursuit of a new partner combined with the loss of confidence and familiarity, making new relationships threatening (Drench & Losee 1996). Many widows and widowers might not have been sexually active with their deceased partner for a long time, making it that much harder to start a new sexual relationship (Drench & Losee 1996). Older adults have had long experience with sexual taboos which can make it hard for them to talk about their sexual desires (Drench & Losee 1996). However, older men have had time to overcome inhibitions and have gained experience with lovemaking skills (Byers 1983).

Many factors can be involved in erectile dysfunction: lack of practice, unfamiliarity with a new partner, guilt, performance anxiety, diminished vascular flow, or delayed neurological reflexes which can then result in decreased self esteem and confidence (Drench & Losee 1996). Older widows have less sex after the loss of their partner than younger widows, but the sexual desire doesn’t differ by the age when one is widowed (Drench & Losee 1996).

Within our youth focused culture, older adults, especially women, are perceived as having lost sex appeal and are labeled as asexual (Drench & Losee 1996). Thus older women become self-conscious about their bodies which makes them avoid sexual contact (Drench & Losee 1996). Our society has focused on older adults who are sick and poor, rather than on the majority who are productive and healthy (Byers 1983). Youth oriented culture scorns signs of aging, seeing it as pathological rather than natural process, with hope that they can somehow prevent it in themselves (Byers 1983).

Drench and Losee (1996) assert that rehabilitation nurses play an important role in helping clients cope with age related changes. Sexual counseling provided for younger clients also needs to be provided for older adults (Drench & Losee 1996; Byers 1983). The rehabilitation nurse needs to be knowledgeable about sexual physiology, sexual needs, myths about elderly sexuality and be aware of their own and their older client attitudes and values around sexuality because older adults can be influenced by the attitudes of health professionals (Drench & Losee 1996; Byers 1983). (An implication for counseling is easily seen in this regard.) Patient education in a psychologically safe atmosphere is vital to discuss intimate issues such as fantasies, masturbation, and homosexuality which may need to be dealt with (Drench & Losee 1996; Byers 1983). A major role of the health professional may be in dispelling myths (Drench & Losee 1996) and assuaging guilt or moral apprehension (Byers 1983). Sexuality and its expression can enhance quality of life and is beginning to be recognized as an important part of the interpersonal relationships among older citizens (Drench & Losee 1996).

Studies

Byers (1983) discussed research done by Kinsey and others at the Center for the Study of Aging at Duke University. Although the elderly were only a small part of Kinsey’s study, they found that at sixty most males were capable sexually and women weren’t found to decline sexually until very late in life (Byers 1983). Longitudinal studies at Duke examined two hundred and fifty people age sixty to ninety four every three years over more than twenty years (Byers 1983). Fifteen percent of these people actually increased their sexual activity and interest as they aged (Byers 1983). Masters and Johnson’s research included interviews and observation of sexual acts (Byers 1983). Both researchers found that people in good health were able to enjoy sex beyond their seventies (Byers 1983). An older couple with a history of a good sex life is more likely to maintain vigor and interest, and is more likely to continue sexual activity with aging (Drench & Losee 1996; Byers 1983; Richardson 1995).

When a problem of sexual functioning does occur its cause usually fits within the following categories:

       -monotony in a repetitious sexual relationship

       -mental or physical fatigue

       -overindulgence in food or drink

       -preoccupation with career or economic pressure

       -physical or mental issues with one of the partners

       -performance anxiety relating to any of the above (Byers 1983).

One episode of impotence can alarm an older man so much that it discourages further attempts (Byers 1983). A prolonged illness of either partner can contribute to impotency (Byers 1983). Widowers may feel too guilty to remarry after the loss of their wife which may cause sexual difficulties (Byers 1983).

Although there are only a few studies of sexuality among older adults, one interesting study was done in nineteen eighty eight among upper middle class residents in ten California life-care communities (Richardson 1995). To be eligible for the study respondents couldn’t be on any regular medications or have daily medical or nursing needs (Richardson 1995). Although the average age of participants was eighty six, seventy percent of the males and fifty percent of the females thought often or very often about being close to or intimate with the opposite sex (Richardson 1995). Despite the fact that twenty nine percent of the men and fourteen percent of the women were married, fifty three percent of men and twenty five percent of women had regular sex partners (Richardson 1995).

Another study, with two hundred and fifty residents in fifteen nursing homes, found that although ninety one percent of the residents hadn’t been sexually active in the previous month, seventeen percent wanted to be, if they had a partner and the privacy to be active (Richardson 1995).  Despite some physical changes, older adults can and do continue, sexual interest and capacity even into the their nineties (Drench & Losee 1996).

The Meaning of Life

Patricia M. Burbank’s nineteen ninety two exploratory study explored the meaning of life among older adults. Most of us think of the meaning of life as an important, but elusive concept from the  domains of philosophy and theology (Burbank 1992). However, the meaning of life is a major concern to many nurses. Burbank (1992) cites J. Fitzpatrick (1983), “Those who have no meaning do not continue to live” (3) and posited that the meaning of life is intimately connected to our health. Studies have found a positive connection between depression and the loss of meaning in life which the authors view as a mental construct and a primary motivational life force (Burbank 1992).

The theoretical framework that guided Burbank’s (1992) study was symbolic interaction, which is a broad perspective within social psychology, useful in understanding people’s behavior in society. Meaning is seen as the central notion in symbolic interaction and refers to the meaning of symbols and situations (Burbank 1992). Rather than simply responding to events and situations, people give them meaning, and our responses are based on those meanings (Burbank 1992).

Burbank (1992) administered a questionnaire to eighty one older adults over sixty two (most respondents were White females in their mid seventies) who were affiliated with a senior center, some were home bound and required assistance to complete the questionnaire (The Fulfillment of Meaning Scale which is a likert type scale) (Burbank 1988). The study found that within a symbolic interaction perspective relationships are vital (Burbank 1992). Interaction with others is how we define situations and our meanings stem out of these situations, thus making relationships and interaction crucial to how we give and maintain meaning to situations (Burbank 1992). The majority of participants said relationships were what gave meaning to their lives (Burbank 1992). Burbank (1992) recommends that nurses become more aware of what’s meaningful to older adult clients and plan nursing interventions in ways that support or improve meaning for their clients (Burbank 1992). If life holds meaning through relationships, what happens when Viagra is added to the relationships of older adults?

And Then There Was Viagra …

Viagra, whose chemical name is sildenafil citrate is manufactured by Pfizer Labs, Inc (Pfizer 1998). Viagra is indicated for erectile dysfunction (Pfizer 1998). At recommended doses, Viagra has no effect without sexual stimulation (Pfizer  1998). It’s metabolized by the liver and is excreted mostly as metabolite in feces (Pfizer 1998). It’s absorbed orally with maximum plasma concentrations in thirty to one hundred twenty minutes (Pfizer 1998). If taken with a high fat meal absorption is slower (Pfizer Labs 1998). In eight double blind, placebo controlled crossover studies with patients with organic and psychogenic erectile dysfunction, sexual stimulation resulted in improved erectile ability as assessed by penile plethysmography after Viagra compared to placebo (Pfizer 1998). Most studies tested after sixty minutes (Pfizer 1998). Single doses of up to one hundred milligrams failed to produce electrocardiographic changes in normal male volunteers (Pfizer 1998).

Clinical studies assessed its effect on the abilities on men with erectile dysfunction to engage in sex and in many cases specifically to achieve and maintain an erection sufficient to perform satisfactory sexual activity (Pfizer 1998). Clients using Viagra demonstrated statistically significant improvement when compared to placebo in all twenty one studies (Pfizer 1998). At the end of the long term study (one year) eighty eight percent reported improved erections (Pfizer 1998). A review of the population subgroups showed efficacy regardless of baseline severity, etiology, race, or age (Pfizer 1998). Viagra was effective in patients with histories of coronary artery disease, coronary artery by pass surgery, high blood pressure, peripheral vascular disease, diabetes, radical prostatectomy, prostatic trans-urethral resection, depression and antidepressant or antipsychotic drugs, spinal cord injury, and antihypertensive, or diuretic drugs (Pfizer 1998).

A thorough medical history with physical exam are recommended to diagnose erectile dysfunction, determine its cause, and identify appropriate treatment before prescribing (Pfizer 1998). There is a degree of cardiac risk involved in sexual activity, thus it is suggested that physicians consider cardiovascular status prior to prescribing Viagra (Pfizer 1998). The most common side effects were reported from long term (over one year) studies in order of frequency are: headache, flushing, dyspepsia, nasal congestion, and urinary tract infection (Pfizer 1998). 

For most patients the recommended dose is fifty milligrams, taken as needed, one hour before sexual activity, but may also be taken from thirty minutes to four hours before sex (Pfizer 1998). Dosage may be increased up to one hundred milligrams or decreased to twenty five milligrams (Pfizer 1998). The maximum dosage frequency is once a day (Pfizer 1998). 

Popular Media Coverage

Popular magazines, newspapers, television, and talk radio shows abound with information and articles on Viagra. A New York Times article (May 1998), suggested that marriage and sex counselors are uneasy about men overhauling their sex lives without any guidelines regarding the potential earthquake they may be introducing into their emotional lives (Nordheimer 1998).

A Washington Post article (May, 1998) suggested that Viagra may have a downside for some couples (Wee 1998). One woman said she and her husband had sex five nights a week in their twenties, but after thirty three years of marriage, they might have sex on Saturday nights if they’re not too tired (Wee 1998). Although they may go weeks without sex, they still enjoy it once they get going (Wee 1998). They now have a deep and comfortable relationship without the sex (Wee 1998). The article relates the view of urologist, Myron Murdock, National Medical Director of the Impotence Institute of America (involved in Viagra clinical trials), who warns, that as time passes, we’re going to see some complex psychological things happening in the relationships of patients using Viagra (Wee 1998). Murdock predicts that some impotent men will discontinue Viagra due to the increased stress and anxiety that sex adds to their relationships, stress and anxiety they’re not able to cope with (Wee 1998).

A Chicago Tribune (May 1998) article questions what effect the “Viagra frenzy” (4) might have in marital bedrooms where sleep has been the primary activity for years (Condor & Black 1998). For the men Viagra has helped and for Pfizer stockholders, Viagra is a sweet miracle (Condor & Black 1998). But the article asks, as we do, what issues about aging and sexuality in our American culture is Viagra bringing out and how will it effect our senior’s relationships (Condor & Black 1998)? Which brings us to the kinds of questions we would like to ask about Viagra’s effect on the relationships of our grandparents, parents, our future sexual selves, and to our children. 

Hypothesis

The main object of our exploratory study is to determine the psychological effects that taking Viagra would have on relationships in elderly couples. The hypothesis is that taking Viagra will have psychological effects on older Americans’ ages 65 and older. Up to date there have been many studies done on the medical and or physical side effects of Viagra. In many of the articles we read the researchers talked about possible physical side effects such as heart problems and possible side effects of taking Viagra in combination with other medicines. From what we found however there has been very little research done on the possible psychological effects Viagra could have on older Americans’ relationships. The psychological effects of a drug are just as important as the physical ones are.

The aging process can be difficult for both men and women, but research has shown that men generally have a more difficult time adjusting to these changes.  Men are conditioned throughout their lives to be strong, in control and independent.  Men can be particularly devastated by the losses associated with aging, especially their capacity to have a sexual relationship.

Prior to the development of Viagra, older couples just took it for granted that they would no longer have that youthful, passionate sexual experience.  Now, Viagra offers these couples a “new lease on life,” or at least some of that lost passion. There are some concerns in the elderly community with regard to health risks as well as mental health risks and taking Viagra.

Dr. Steven Lamm, a teacher at the New York University School of Medicine and is author of The Virility Solution states, “this drug touches the core of malehood” (5).  He also states that “some couples are going to be disappointed that this hasn’t enhanced their intimacy, and for many that will throw their relationships out of synch” (5).

There are many possible psychological  effects that could take place after taking Viagra. Couples that have not been able to perform sexually for years many times learn to be intimate in other ways other than just sex. In many of the articles we read the couples referred to their relationship as a strong companionship that they have grown to love on a new level. Putting Viagra on the market adds a pressure to one or both partners about having sex again. Many women may also feel pressure to abide by this because of a fear that their husbands may stray from the marriage and have an affair. Another possible psychological outcome could be a great disappointment on the actual effects Viagra will have on a couple.

Another words many people may think that by taking this “magic” pill many of their intimacy and or sexual “issues” will just vanish. Unfortunately a pill can not do that, any underlying intimacy or communication problems that were there prior to taking Viagra will still be there after the fact. If these types of issues are not addressed to couples prior to taking this drug it could potentially cause great anxieties and new “issues” in the relationship.

It does seem hopeful that the psychological effects of Viagra on relationships could in fact be the next step. In one of the articles we read it talked about this being the next step in research. For individuals to truly benefit from this drug the psychological as well as the physical effects should be studied

Our approach is a holistic one that would place equal importance on the mind and body working together. Couples who are thinking of taking this drug need to be aware of the potential negative effects it could have on their relationship if they are taking it for the wrong reasons. For instance if they think that it will help underlying sexual issues of any kind, it won’t. Couples should have a realistic understanding of what Viagra will and won’t do for their marriage. That is not to say that Viagra’s effects are all negative. In fact it is quite the opposite as long as couples know the possible effects. Many experts agree that taking Viagra could in fact be magical, for committed caring couples whose sex life has been put on hold for many years.  A way to test our hypothesis would be to give confidential questionnaires to older Americans after taking Viagra. We have documented how we would go about doing this in the next section.

Methodology

We have selected the use of questionnaires as our form of research and data collection. We feel the nature of our questions are very sensitive and people might feel less threatened and more prone to giving accurate information. We will request the medical professional administering the Viagra give an open-end form of the questionnaire to the patient upon initial prescription of Viagra. This will be used as a pretest to form the more closed-end questions we will be using on the research questionnaire. We will request the health professional follow up with the research questionnaire approximately six months to a year after the treatment begins and request their cooperation. They would be accompanied by a post-paid, addressed envelope for return. This would help insure patient confidentiality and anonymity. We will be using two identical questionnaires, one to be completed by the male prescribed Viagra and one completed by his partner. They will be consecutively numbered 1a, 1b, 2a, 2b, etc, so that information can be tracked by couple. By using this split-ballot type questionnaire, we hope to get an accurate picture of the relationship changes, if any, from both perspectives.

Questions will be both closed-ended and open-ended, with a comment section provided at the end of the questionnaire for elaboration. Information requested will include relationship and general health problems prior to Viagra use, and relationship and specific health problems after Viagra use. We will also request information regarding any new effects on health or relationship since Viagra. Questionnaire respondents will be asked if they would be willing to participate in any future interviews conducted. A representative sample of the questionnaire is included at the end of this paper.

SONG

What goes up must come down

If I take Viagra will my life turn around

Talkin bout my troubles is a crying shame

That’s why this Viagra gonna give me some fame

You got no passion … you got no hope

Praying for a miracle so I can cope

Talkin bout my troubles and I never learn

Give me some Viagra, let my maleness return

Chorus:

What if my wife tells me not tonight

When I finally get this erection

What if I can’t perform tonight

I’ll end up in a deep depression …………

Someone is waiting just for me

If it’s not my spouse I’ll pay a fee

Could be a problem, don’t you see

Research for Viagra should include psychology …..…

This is my story, I wanted you to know

What can happen if it starts to grow

I hope and I pray there’ll come a day

When Viagra gonna work for me in every way

Chorus:

What if my wife tells me not tonight

When I finally get this erection

What if I can’t perform tonight

I’ll end up in a deep depression …………

What goes up must come down

If I take Viagra will my life turn around

Talkin bout my troubles is a crying shame

That’s why this Viagra gonna give me some fame

End Notes

1     Weg, Ruth (1989, Sept/Oct).  The Biological Facts: Myth Versus Reality. Geriatric Nursing. p. 305.

2     Sokolowski, Jay. (1982, July/Aug). Sexual Behavior of the Aged.  Gerontologic Review. vol. 15, pp. 214-215.

3     Burbank, Patricia M.  (1992, Sept). An Exploratory Study: Assessing the Meaning of Life Among Older Adult Clients.  Journal of Gerontological Nursing. pp. 19.

4     Condor, Bob. & Black, Lisa. (1998, May 3). Couples Adjusting to Life with Viagra. Chicago Tribune. Sec 1, p.5, col 5.

5     Berkowitz, Harry., Vincent, Stuart., & Talan, Jamie. (1998, May 3). Little Pill Big Stir: As Demand for Potent Viagra Grows, So Do Concerns. Newsday, Internet.

Work Cited

Burbank, Patricia M. (1992, Sept). An Exploratory Study: Assessing the Meaning of Life Among Older Adult Clients. Journal of Gerontological Nursing. pp. 19-28.

Byers, Joan P. (1983, Sept/Oct). Sexuality and the Elderly. Geriatric Nursing. pp. 293-297.  

Carter, Ann, M.D. (1997). Sexuality and Age: How Does Age Affect Sexuality? First Search: HealthRefCtr. Clinical Reference Systems Ltd, p. 2235.

Condor, Bob & Black, Lisa. (1998, May 3). Couples Adjusting to Life with Viagra. Chicago Tribune. Sec 1, p.1, col 5.

Drench, Meredith E. & Losee, Rita H. (1996, May/June). Sexuality and Sexual Capacities of Elderly People. Rehabilitation Nursing. vol. 21, n 3, pp. 118-123.

Nordheimer, Jon. (1998, May 10). Some Couples May Find Viagra a Home Wrecker. New York Times. sec 9, p.2, col 1.  

Pfizer Labs, Inc. (1998, May). Viagra  (sildenafil citrate) tablets. Drug Information Insert. Description, Clinical Pharmacology, Indications and Uses, Contraindications, Precautions, Adverse Reactions,        Overdosage, Dosage and Administration, and How Supplied.

Richardson, James P. (1995). Sexuality in the Nursing Home Patient. American Family Physician. v 51, n 1, pp. 121 (4).

1-Semmens, P. James, M.D. (1997, Dec). Older Adults and Problems with Sexuality. First Search: HealthRefCtr. Clinical Reference Systems Ltd., p. 2153.

2-Semmens, P. James, M.D. (1997, Dec). Psychological and Social Problems of Midlife Sexuality. First Search: HealthRefCtr. Clinical Reference Systems Ltd, p. 2624.

Sokolowski, Jay. (1982, July/Aug). Sexual Behavior of the Aged. Gerontologic Review. vol. 5, pp.  214-215.

Wee, Eric, L. (1998, May 6). Viagra? Not Tonight, Dear. For Some Couples, the Anti-impotence Drug Has a Downside.  Washington Post.  Sec D, p. 1, col 3.

Weg, Ruth (1989, Sept/Oct). The Biological Facts: Myth Versus Reality. Geriatric Nursing. p. 305