Pedro Paulo Monteiro

Foreword

Old age had left deep imprints in the corporeal structure of elders under my care; beyond my grasp and ordinary procedures, there were undercurrents veiled to the eyes.

This book issued from a master’s thesis in Gerontology at PUC-SP and attempts to examine how lying deep within and irrespective of age is the potential for transformation of one’s life story in the fulfillment of a more rewarding universe.

The first part of the book comprises a systemic overview of life, of how all living organisms self organize dynamically in rhythmic movements comprising networks of cells, and systems of interacting, self-organizing organs. The human organism is a complex and dynamic system in constant shifts, there is no stability in the living world. As it ages, it allows for ever-newer structures to mature and specialize in an evolutionary process.

We will see how beliefs, negative clichés and stigma affect elders´ identity, leads to guidelines depriving them of familiar settings, jeopardizing their social relations and undermining their freedom.

The second part of the book, presents an insight into how negative clichés associated with old age influence biology and day-to-day life, how mental images construe a worldview and our place in it. Moment-to-moment, through physical sensations, external objects are apprehended and transformed into mental images which, associate with other existing images, build up the global image of ourselves as individuals. This mental image--corporeal image--is a representation of our body leading to the understanding of who we are and how the body presents itself to us. Thus, old age, loss, exclusion and isolation create a vacuum distorting this image, constricting movements causing the ensuing loss of one's body as a reference.

We will see how a sense of touch can reclaim sensitivity in the bodies of elders wrecked by sensorial deprivation. Through touch we manifest care and closeness giving rise to a more reliable, less segregated and forlorn corporeal image. We are social beings dependent on one another for our personal emancipation; hence, the power of encounter for those partaking of the relationship is an essential aspect of corporeal transformation.

The third and last part, comprises an encounter with three physically handicapped old women facing the paradoxes of life who found new paths for their journeys through familiarity with their own bodies which had long been anesthetized by a life of submission and strict boundaries. At the time I was confronted with the challenges of our partnership and was crucial to my own ageing process. Later I would understand how the flow of the river of life, the great master, unveiled mysteries of my own life story.

The metaphor of a river is to be found throughout the book attempting to bypass our linear and rational thought processes and shine a new light on the ways of nature to express itself. It acknowledges the interconnectedness of all living tissue--not as separate entities, as deemed by many--but as the only means of understanding living nature. It points out how our human life is, indeed, a flowing river, an on-going process, made of singular rhythms, obstacles, whirlpools eddies, uncertain destinies and relentless might.

To speak of life is to speak of ageing for ageing and living are one. A network of relationships is built with the lore we collect and weave as we journey through life. We have been ageing from the time of conception, ageing and living, living and ageing, forever changing, for ageing is the coming into being of someone unique, abiding by one’s own inner and personal time.

My first home call was to attend an 80 year-old woman with a broken femur. Due to an oversight, the Faculty of Physiotherapy had given no instruction in home and I had no skills to face a novel and frightening situation in direct contact with suffering elders and caretakers. I was adrift on the stormy ocean of professional endeavor where, beyond any consideration, competence was paramount. There was only me and a few budding skills. The illusory shield was a fictitious title of "doctor", effectively establishing the borderline between the immortal healer and the mortal suffering being. I was not aware, at the time, that a therapeutic relationship is a mutual process and my body had already built a protective shield which laid dormant my own suffering.

I did not know how vulnerability and insecurity undermine the path to self-knowledge. In striking a pose, looking for acceptance in established role models, we stress the body and manacle the soul, we are made less than human and robbed of our innate capacity to create and renew.

Time passed and step by step I began to dismiss the prevailing notion that the elder are brittle, “like porcelain". Obviously, more than a highly trained professional was needed and the breakthrough came with the insight that skills must be grounded on a compassionate heart and mind. Since I had been instructed on a mechanistic approach to the human condition, there were gaps in my judgments and, for a thorough assessment, a piece of the puzzle was always missing. Only later did I understand that the human condition is beyond preconceived ideas but, in the eagerness to relieve suffering, I blindly searched theoretical guidelines undermining the importance of looking deeply in those under my care. My doubts increased anxiety in hallucinating proportions.

The "patient"--the name ascribed to my partners in therapeutic adventure--had been bedridden and neglected since the accident. She was living with her son, daughter-in-law and grandchildren. Her darkened small room was in the back of the house, at her beside an old Singer sewing machine--with black wrought iron legs and pedal. The room was crammed with useless objects way laid by time: a rusty washing machine and a cupboard full of discarded trivia.

On this first house call, the first contact with exclusion and dismissal of a life story, I was frightened by the woman's appearance. How could a large and comfortable home with well-furnished living and dining rooms heartlessly dismiss the past in a crammed and dark room?

But, there she was, bedridden, covered by a dusty plaid blanket, her long hair falling over a dry complexion, senile warts growing in the wrinkles in her face. She was toothless and drooled and saliva and chewed food soiled the linen. She never joined the family for meals.

When the light, which was always off, was turned on, she lifted her head and blinked, vaguely looking in my direction as I entered the room. Even on a lovely and sunny day, the window was kept closed. It was impossible to know how long had it been since a burst of sunlight had entered her room. According to my professional training, weird and depressing was what old age was about and I was not to get emotionally involved. The stated purpose of the house call was to draft a therapeutic outline; I took to the helm rolling up my sleeves and putting into practice my scant knowledge.

Power exerts fascination, whereas a sensitive nature such as mine needed added support to take on the "responsibility." Later, I learned that responsibility is the gift of responding, quite the opposite of withholding the answer, as is often practiced. I sensed that the power attached to control would only increase the gap to self-awareness.

Day by day, this "lady" who had been unable to sit, took on some of her old routines; she straightened up and made the first tentative steps on her path to a new awareness. The window remained open; she could walk to the bathroom and began to feed herself. Meanwhile, her grooming required greater care; asked for new clothes, a denture, professional nail and hair care, oh yes, red lipstick!

Quite a transformation it was! Initially, the family appeared happy, however, as her requests increased to go on outings, or out for lunch with the family on weekends, they were distressed and tried to persuade her that as "an old lady" outings might be a strain and adversely affect her recovery. She remained adamant, not always successfully, and it was assumed that this new and unexpected behavior might be a sign of senility. They could not understand or accept the transformation on the old body striving for new ways to live, in fact, she was finding her lost freedom, and there was a price to pay.

At night, she would walk to the bathroom or to the kitchen to get a drink of water and this new freedom upset and worried the family; she was getting harder "to control", they said. One's movement invariably instigates another's body and this was more than they could accept. She might fall again, they argued, and placed a guard on her bed to keep her from getting up at night, eventually, during the day as well. It was useless, since her body was wise enough to go over the guard.

Shortly after, something even more drastic, they discontinued treatment arguing that it might be the cause for behavior. The cruel tactics upset me greatly and deeply affected my own values since I could not discriminate between right and wrong, good and bad. Having always felt that we are each responsible for the way we relate to one another, I had overlooked the fact that we are not isolated beings and must bow to whatever affects the whole. I could not, at the time, understand the complexity of family ties and had no true insight into the therapeutic process.

A few months later I learned of her death. Her life's learning accomplished, she departed, leaving a sweet memory of the time we shared.

Before we proceed, there is another important experience, shedding a light on the therapeutic principle of subject-subject relations, to be broached later and which is at the core of the process of bodily transformation applying to those who partake of the experience.

I remember having had access to sophisticated equipment used in physiotherapy to alleviate the pain of a 70-year-old woman who appeared to be suffering from rheumatoid arthritis. It had first appeared in her youth and continued through to her "old age" devastating her body. She had been bedridden for fifteen years, with marked deformities and crucial, on-going pain, so intense it caused a rupture with her husband and two children, who could not endure her suffering and moved out leaving her with a kindly, full-time caretaker.

Due to typical arthritic deformities of her joints, when we first met, she raised strong objections to my touch and I was at a loss as to how best to approach her body. Due to prolonged use of corticoids, her skin was transparent and burned at the touch of my fingers, her bones were brittle, her hands like claws; depression devastated her lingering beauty. It is impossible to fathom such pervasive suffering. Not even in textbooks had I learned of such extensive suffering and could not anticipate any measure of relief for her and looked in vain for ways to minimize her pain.

My mind raced in search of effective ways to help, the thought never left my mind and I would buy any gadget holding a promise of relieving her pain. She was completely wired and experienced various sensations such as tingling, pins and needles, electric shock, cold heat, and so on. I tried everything; at the most there was only an insignificant and short-term relief.

Step by step, I understood the dynamics of her process and, after exhaustive research, discarded the useless paraphernalia of wires and techniques to look deeply into her life story. Her case demanded a subtler approach, a heart-felt contact that no gadget could provide.

Actually, in my rush to reach the therapeutic objective, I was the one causing the difficulty overlooking her well-established limits; my touch was "heavy", as she said and so, I learned to respect and bow to her complaints and resentments, but only true compassion would reverse the picture. In the absence of a deep and personal involvement, there would be no compassion and when it did arise I was aware that she was no different from me, for neither of us wanted to suffer. If I had a right to be happy, she also had a right to be happy.

Refusing to deal with suffering, hers as well as mine, appealing to useless techniques to block my own suffering, I was missing my goal.

We truly came together when she, unable to bear her misfortune any longer, stated she did not wish to live. She was sad and restless, overwhelmed by her tense and painful body, with tears streaming down her face, as I had never seen her before. I was troubled, helpless and much moved because it was also my belief that death might best contribute to the unfolding of her life story. My reasoning and feelings led to an outburst: "I respect your decision, but you must know how deeply I care for you. Your presence allowed me to look at myself and made me more human, a better person for having gone deep into your own suffering whereas, before, I was stone-like, expecting tokens of recognition from others. So, please listen to my request, it may be my last one. Even if your wish is to give up on yourself, allow me to bring you out of the dark world where you dwell."

Raising her arms and looking deeply into my eyes she asked me to hold her in my arms. Unprepared as she was for warm intimacy, never had she allowed such closeness. Never had we experienced anything like it in our time together. I came closer and very gently held her in my arms in the stillness of the room.

After a few weeks, she was experiencing less pain and found more freedom in her movements. Months later, to my surprise and her doctor's own, with the help of a walker she took her first steps, experiencing a newfound freedom.

It was a major breakthrough in my career, a full turnabout in therapeutic orientation. Partaking of a solitary universe, where a frail body silently wept in a dark and dank room, I became a corporeity therapist.

I learned from my friend that, despite my own shortcomings, I was a part of her life story, that we are limitless beings in an infinitely connected universe.

However, our view of the world is still based on a fragmented model. We split up the manifest, breaking everything into categories, including humans, a practice issued from the misguided belief in stability. Under the false assumption that it contributes to our security we strive for stability in all undertakings. Blinded by a limited perception of reality we are forever splitting into pairs of opposites whatever manifests: good/bad, youth/old age, beauty/ugliness, similarities/differences striving in this way to better understand the world.

Splitting and maiming the various elements of our lives, we mortgage our health, which can only be achieved with wholesomeness in its broadest sense; that is, becoming whole, with nothing missing. It is the first step towards happiness and the upgrading of the quality of life, a lifelong and tireless pursuit.

Likewise, society is comprised of individuals woven into a vast, indivisible network of relationships. Its sheer complexity inspires solidarity and the quality of our life determines how we view our elders. The holographic model can best illustrate the point. It states that everywhere is the all and the all is to be found in the part, making for an indivisible whole. Accordingly, it makes no sense to try to separate any one part of our world, and makes no sense to separate body, mind and spirit. We are the whole and in believing that old age is a threat to the body, the individual and social standing, we are destined for a role we do not wish to play.

It is vital for the human organism to interact with its environment and with other human organisms. We are interrelated and interdependent social beings, who have to learn to welcome and express emotions in the body, as the only way of acquiring the indispensable means of adapting to the various circumstances of life. Based on this premise I will describe how elders are often exposed to the harmful consequences of exclusion and isolation veiled by a mute social complicity, which robs them of opportunities to fully experiment and experience life.

In the flow of the river there is no time or place, only continuity. The river is present all along its course at all times, linear time--past present and future--do not partake of it. To the eyes of the self-created observer, grounded in time and space, there is only the present moment and thus, he can only behold a fraction of the river and knows nothing of what lies beyond. However, doubt lingers on, what direction is it flowing? What is its final destination? There is no way of knowing, flow is about flowing and branching out when called upon. There is but one certainty, the river exists because of the beholder, in his absence, there is no river.

The invisible is the reflection of the beholder’s image leaning over the water beyond his reach, aware that a part of him, his mirror image, flows in the river. Being as one with the river and bearing witness to the river he carries the river within, even as the river carries the beholder. Spellbound in the overflow of clear water within, the beholder is a part of the whole. Both are boundless possibilities, sheer flow of the mystery of life.

He moves into new ground silencing his unease and fathoming its water-borne message with new insights and wisdom. His familiar visible world becomes a steppingstone into the invisible. Conscious that he is a part of the flowing river, he sees the shimmer of himself reflected in the waters, they are as one, joined in boundless possibilities, flowing with the mystery of life.

Here is the ground of life, movement, rhythm and whirling partners. Beyond, is the certainty of change, indeed, change and transformation will be part and parcel of the life of the beholder. Then, tuned to the murmur of the waters, the observer understands that life is the flowing river he beholds and permanence is in no way a part