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Transformational
Reminiscence
Copyright © 2007 Springer Publishing Company, LLC
All rights reserved.

No part of this publication may be reproduced, stored in a retrieval system, or

transmitted in any form or by any means, electronic, mechanical, photocopying,
recording, or otherwise, without the prior permission of Springer Publishing
Company, LLC.

Springer Publishing Company, LLC

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New York, NY 10036
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Acquisitions Editor: Sheri W. Sussman

Managing Editor: Mary Ann McLaughlin
Production Editor: Carol Cain
Cover design: Joanne E. Honigman
Composition: Apex Covantage, LLC

07 08 09 10/ 5 4 3 2 1

Library of Congress Cataloging-in-Publication Data

Transformational reminiscence : life story work / [edited by] John A. Kunz,
Florence Gray Soltys.
p. ; cm.
Includes bibliographical references and index.
ISBN-13: 978-0-8261-1540-9 (alk. paper)
ISBN-10: 0-8261-1540-3 (alk. paper)
1. Reminiscing in old age. 2. Older people—Psychology. 3. Psychology—
Biographical methods. I. Kunz, John A. II. Soltys, Florence Gray.
[DNLM: 1. Aged—psychology. 2. Mental Recall. 3. Psychotherapy—methods.
WT 150 T772 2007]
BF724.85.R45T73 2007
155.67—dc22 2006038957

Printed in the United States of America by Bang Printing.

Photographs with permission for use provided in part by Elders Share the Arts, Roots &
Branches, Stagebridge, Liz Lerman Dance Exchange, Memoirs, Inc., Life Story Services,
University of Wisconsin–Superior, University of North Carolina at Chapel Hill, and
University of British Columbia. Montage design by John A. Kunz and Patrick Lind.
 Contents

Contributors vii
Preface ix
Foreword by Robert N. Butler, MD xv
Acknowledgements xvii

ONE The Life Story Matrix 1

John A. Kunz

SECTION ONE: REMINISCENCE TO LIFE REVIEW

TWO Older Adult Development 19
John A. Kunz
THREE Reminiscence and Older Adults 41
Florence Gray Soltys and John A. Kunz
FOUR The Life Review: Historical Approach 67
Barbara K. Haight

SECTION TWO: PRIVATE TO PUBLIC

FIVE Reminiscence Group Work 85
Florence Gray Soltys and John A. Kunz
SIX Life Stories as Heirlooms:
The Personal History Industry 107
Anita Hecht and Mary O’Brien Tyrrell
SEVEN When Words Are Not Enough:
Art-Based Methods of Reminiscence 123
Renya T. H. Larson and Susan Perlstein

v
vi CONTENTS

SECTION THREE: CONTENT VERSUS PROCESS

EIGHT Cultural Aspects of Reminiscence
and Life Review 143
Daniel W. L. Lai
NINE Mental Health Applications of
Reminiscence and Life Review 155
John A. Kunz
TEN Traumatic Memories and Life Review 181
Marvin J. Westwood and Holly B. McLean
ELEVEN Reminiscence, Grief, Loss, and End of Life 197
Florence Gray Soltys
Index 215
 Contributors

Barbara K. Haight, DrPh, Professor Emeritus of Gerontological Nursing

at the Medical University of South Carolina, is a fellow in the American
Academy of Nursing, the Gerontological Society of America, and the Flor-
ence Nightingale Society and has presented and published nationally and
internationally on life review and reminiscence. She was co-editor with
Jeffery Webster of the Art and Science of Reminiscing: Theory, Research,
Methods, and Applications and Critical Advances in Reminiscence Work
From Theory to Application.

Anita Hecht, MSSW, LCSW, Director and Founder of Life History Ser-
vices, LLC, has conducted over 200 life history interviews over the past
10 years. Since 1996, Life History Services, LLC, has produced video,
audio, and printed archives for individuals, families, organizations, and
businesses. Hecht assists laypersons and professionals in life review, remi-
niscence, and life history training and projects. She works nationally and
internationally and is fluent in German, Spanish, and English. She served
for 6 years on the board of directors of the Association of Personal His-
torians, Inc., and is currently its international liaison. She is a licensed
psychotherapist, professional writer, lecturer, and yoga instructor.

Daniel W. L. Lai, PhD, received his doctoral degree in social work from
Case Western Reserve University. He is currently professor of social work
at the University of Calgary and holds the title of Alberta Heritage Health
Scholar funded by the Alberta Heritage Foundation for Medical Research.
For over 18 years, his teaching and research interests have been in cul-
ture and health of the aging population. As an expert in cultural diver-
sity issues, he has been awarded grants to conduct research with special
focuses on culture, ethnicity, healthy aging, and family caregiving.

Renya T. H. Larson, MA, is a training and organizational development

specialist with the Paraprofessional Healthcare Institute. She provides support
to nursing homes, home health agencies, and other long-term care employers

vii
viii CONTRIBUTORS

that seek to improve the quality of jobs for direct care workers and the qual-
ity of care for consumers. Larson also has over 10 years of experience as a
playwright and director of community-based theater, with particular interest
and expertise in projects based on oral history and reminiscence. She is the
former associate director of the National Center for Creative Aging.

Holly B. McLean, MA, is completing her doctorate in counseling psy-

chology at the University of British Columbia. Her dissertation research
is a narrative study of the spouses of soldiers healing from posttraumatic
stress, using a life story autobiographical method.

Susan Perlstein, MSW, is the founder and executive director of the

National Center for Creative Aging. She is also an educator, social work-
er, administrator, and artist. She has written extensively on creativity and
late-life learning. Her articles appear in numerous professional journals,
including Arts in the Public Interest and Gerontology, and in ASA’s Aging
Today, The Older LEARNer, and Dimensions. Perlstein is the author or
coauthor of several books, including Alert and Alive, Generating Com-
munity: Intergenerational Programs Through the Expressive Arts, and
Legacy Works: Transforming Memory Into Visual Art.

Mary O’Brien Tyrrell, MPH, BSN, president of Memoirs, Inc., has assist-
ed hundreds of elders to write and publish their life stories in hardcover
books that are distributed to family and friends at a book signing party. A
nurse for more than 40 years, in addition to practicing in hospitals, clinics,
and home care settings, she was employed as associate director of the Min-
nesota Board of Nursing, has published articles in professional journals,
and has coordinated health care research. In December 2003, her article
“Memoirist of Ordinary, Yet Extraordinary Elders” in Generations: The
Journal of the American Society on Aging was the first in the professional
gerontology literature to describe the burgeoning memoir industry.

Marvin J. Westwood, PhD, is a professor in the counseling psychology

program at the University of British Columbia (UBC) and is an associ-
ate member of the UBC Faculty of Medicine. His teaching and research
areas include group counseling and psychotherapy, trauma repair, and
therapeutic applications of life review. Westwood has developed several
personal development programs for professionals across a wide range
of groups (counselors/psychologists, nurses, physicians, soldiers, clergy,
etc.) using guided autobiography and group-based therapeutic enactment
methods. He has been invited to present his research at numerous nation-
al and international conferences. He taught at St. Francis University and
McGill University before coming to UBC.
 Preface

As our lives and those near and far from us unfold, we further develop, and
both we and they are transformed. Each time an individual tells part of his
or her life story, those who listen are like a mirror. The conversation not
only has an effect on the listener, but the listener’s reactions, questions, and
comments then have a reciprocal impact on the storyteller. Thus, the origi-
nal meaning and understanding of the story evolves into something new.
The telling of a humiliating experience may result in a new understanding
of the situation; for example, the feelings of humiliation may turn to anger
about or even pride in managing and surviving the past situation. This then
propels the individual telling the story to another level.
At the same time, listeners incorporate the storyteller’s experience
into their own knowledge, and their thinking also evolves. This may
stimulate a variety of emotions and reactions that lead them to change.
The sharing of life experiences is a universal part of human exis-
tence. This sharing of experiences happens in everyday conversations,
intimate and public exchanges, and through such formal venues as writ-
ing and performance.

ABOUT THIS BOOK

This book takes a close look at these transformational processes to iden-

tify the clear benefits, as well as the risks and responsibilities, of engaging
in life story work. The goal is to present clear and practical concepts and
approaches that will help readers understand the issues and opportuni-
ties so they can apply this information in their own work and lives. Each
chapter contains real-life examples of lessons learned from older adults.
These life stories help readers gain from the experiences of older adults,
and they also shape the storytellers’ knowledge and wisdom.
Each chapter begins with learning points that reflect content and
factual information contained in that chapter. These learning points pre-
pare readers for the content to follow, and they are useful for discussing

ix
x PREFACE

and teaching the content. Each chapter also contains one or more
exercises that can be done individually; in study groups, classrooms, and
workshops; or at conferences. The first exercise in chapter 1 is titled “Life
Story Interview” and has two phases. Phase 1 walks readers through their
own life review using a guided interview workbook. The second phase
of the exercise is designed to be completed after reading the entire book
and completing all of the other exercises. At that point, readers should
be prepared to do a life story interview with an older adult. As a safety
net and to further the learning process, readers are instructed on how to
select and utilize an experienced mentor to complete the exercise.
After the first and last assignments are completed, readers are invited
and encouraged to fill out a short, anonymous impact evaluation at
www.reminiscenceandlifereview.org. This survey will assist the authors
and others in the field with future endeavors and may be published or
presented at appropriate venues.

THE LIFE STORY MATRIX

Chapter 1 introduces a broad framework for conceptualizing and compar-

ing the many informal and formal ways that we reminiscence and review
our lives. The life story matrix describes continuums from reminiscence
to life review and from private to public with constant attention to the
reciprocal relationship and outcomes related to content versus process.
The remainder of the book is divided into three sections with particular
emphasis on each of the three dimensions of the life story matrix.

REMINISCENCE TO LIFE REVIEW

The first section, Reminiscence to Life Review, starts with a look at nor-
mal human psychosocial development and the continuum from reminis-
cence to life review.
Chapter 2 examines a number of theories about this subject—the
most famous being Maslow’s Hierarchy of Needs, Erik Erikson’s Stages
of Psychosocial Development, and successful aging through adaptation.
The concept of elementality is part of an appreciation of living and achiev-
ing an ultimate level of consciousness toward the end of life. Compelling
new brain research is included that suggests between the ages 60 and 80
the brain begins a new stage of cognitive and psychosocial development
in which reminiscence and life review play a critical role.
Chapter 3 includes a brief review of the literature followed by the Sol-
Cos Reminiscence Model, which provides a structural framework for the
 PREFACE xi

practice of reminiscence and life review as part of this dimension of the life
story matrix. This chapter includes a description and examples of the remi-
niscence engagement process that is essential for such work.
Chapter 4 presents a thorough and historical review of the literature
by one of the pioneers in the field of life review. This includes Haight’s
Life Review and Experience Form, which has served as an instrument in
hundreds of studies since it was first published almost 30 years ago.

PRIVATE TO PUBLIC

The second section, Private to Public, examines the continuum of the life
story matrix. It emphasizes the social importance of talking about life
experiences with others, sometimes in a controlled setting and sometimes
in a public manner.
Chapter 5 discusses the importance and uses of a variety of reminis-
cence group processes for older adults. It provides guidelines and sug-
gestions for what techniques to use and how much direction is needed
for different older adult populations. These include community-dwelling
older adults who want to learn and grow, have fun, or participate in a
personal growth process as well as older adults who may be participating
in day care or residential care and may be experiencing severe levels of
sensory or cognitive impairment.
Chapter 6 focuses on the emerging industry of documenting and pro-
ducing life story records through written word or other media. This trend
is described with a close look at what credentials are needed to ethically
carry out such work. All aspects of the production process are described
in detail, beginning with negotiating the form and use of the final product
and ending with the important celebration at its completion.
Chapter 7 looks beyond the written or audiovisual documentation
of an older adult’s life and focuses on art-based methods of reminiscence.
These include the stimulation of senses combined with verbal and non-
verbal processing of such stimulation, which leads to social engagement
and bolsters individual identity. This type of lifelong learning can better
integrate older adults into their communities.

CONTENT VERSUS PROCESS

The final section, Content Versus Process, looks at the third dimension of
the life story matrix, which examines the reciprocal relationship between
a focus on content as well as the experience of the process of telling one’s
life story.
xii PREFACE

Chapter 8 discuses how this process is impacted by the ever-present

and overshadowing multicultural influences of doing life story work.
This contributes significantly to how the interaction of content versus
process comes into play. How culturally appropriate is it to disclose what
information? What is the impact of an entire culture’s experience on the
telling of culturally specific life stories? How does society react to the tell-
ing of stories that challenge historical beliefs?
With culture in mind, chapter 9 discusses the intimate ways in which
reminiscence and life review can be used in the psychotherapeutic setting.
This is where the process is more important than the content, yet the
content should guide the process. Particular focus is on ways in which
reminiscence can help prevent, assess, and treat the full spectrum of men-
tal health problems faced by older adults. These approaches may be used
informally by caregivers or family members or may be integrated into
psychiatric and psychological treatment plans that use cognitive behav-
ioral therapy or other efficacious modes of individual, group, marital,
family, or milieu therapy.
Many older adults have experienced trauma during their lives. Chap-
ter 10 emphasizes competent ways to handle these memories to minimize
the risk of retraumatizing the individual. The trauma recovery process
is discussed with particular emphasis on prevention, management, and
healing.
Finally, chapter 11 examines the uses of reminiscence and life review
as part of the grief process and at end of life. Grief is described as a heal-
ing process that is individualistic, dynamic, and evolving. Reminiscing
with an individual or a group is a valuable way to explore and clarify
grieving. The chapter concludes with a discussion of how much or how
little reminiscence life review should be facilitated at the end of life to
help to sort out the ifs and whats of finishing life with peace and dignity
by letting go of and passing on what has been essential in one’s life.

WHO IS THIS BOOK FOR?

Health Care and Social Services

It is crucial that professionals working with elders understand the elders’
values concerning health care. Learning about their lives through remi-
niscences helps to clarify these wishes and assists in the professional’s
understanding of the individual. To know the person is often more impor-
tant than to know the disease. Interdisciplinary teamwork is essential
when working with frail elders, and the ability to learn from each team
member’s perspective provides a more complete picture of the situation.
 PREFACE xiii

Helping the individual look at past situations in which strengths were

utilized can help them recognize that they have the coping skills to face
current difficulties.

Assisted Living and Long-Term Care

Being able to share one’s successes and failures enables the exploration of
both past and current situations. It is important that assisted living and
long-term care staff understand the value of listening and affirming an
individual’s life. The need for reminiscence should be part of staff train-
ing, and the importance of knowing each individual should be a strong
value for the institution. When people are facing the end of their lives,
there needs to be an appreciation for their contribution and assistance in
facing closure as they pass.

Service Learning at Secondary, Postsecondary,

and Graduate Levels
There is a strong trend for high schools, colleges, and graduate schools
to incorporate formal service learning in their curricula to promote better
communities and provide learning experiences that are more than just vol-
unteer work. Nursing, health, social work, psychology, counseling, sociol-
ogy, anthropology, visual and communication arts, English and literature,
history, first nations, music, and many other disciplines can benefit by
doing some type of life story work. This book is an excellent resource
for students and instructors to help them prepare for and carry out this
important work. In these situations, creativity knows no bounds.

Civic Engagement
Retired individuals who volunteer in civic engagement activities involving
older adults want to do more than help out at a senior center. This book
can raise their awareness and inspire them and the agencies that recruit
them about the many ways they can give back to the community by doing
some sort of life story work. As this occurs, this book can serve as a
resource and guide as the agencies develop programs and approaches.

Oral Historians and Researchers

Oral history is said to be the “history of the people.” Families and com-
munities value the sharing of stories and happenings that define their lives.
These stories help us clarify who we are as a society and thus express our
xiv PREFACE

values. Those who ignore history tend to repeat past mistakes rather than
use them as a learning tool. Reminiscence is a strong method to achieve
and maintain personal histories.

Creative Arts Programs

The ability to express oneself through music, theater, dance, and paint-
ing is a joy. Reminiscence is a natural tool to enhance these expressions
through the chosen work. Many older individuals begin to express their
creativity after they have retired and have more time to pursue their latent
talents. Some of the world’s greatest music and paintings have been com-
pleted after the artist reached his or her later years. Sharing life experi-
ences through creative arts can be both fun and educational.

Businesses That Focus on Life Story Work

This book is essential for anyone who is going to do life story work
with older adults. It will help prepare individuals who want to volunteer
or make a profit by interviewing older people and documenting their
life stories. In fact, reading this book and doing the exercises could be
considered an important ethical step before undertaking such work.
Many individuals age 50 and older realize that they either will have to
work for another 20 years because of financial reasons or simply want to
keep working in some way. However, they want flexible hours, reward-
ing work experiences, and often something that helps them make use of
their creative talents. Many such individuals and others have begun work
documenting the life stories of others in various forms. This book will
help them feel more confident that they are prepared and competent to
offer such services.
We hope that you will be able to benefit from this book to continue
your own transformational reminiscence processes and to assist those
you know and love to further theirs.

John A. Kunz
Florence Gray Soltys
 Foreword

We struggle to understand the world in which we live. Questions about

the origins of the universe and the purpose of life remain beyond our
grasp. But with work and over time we can achieve some understanding
of the greater meaning of our individual lives.
Poet and essayist Patricia Hampl observed that “the memoir is the
signature genre of our age.” Yet as recently as 50 years ago people believed
that reminiscing was a sign of senility—what we now call Alzheimer’s
disease. In that era, many geriatrics researchers confined themselves
largely to the study of people who were long-term residents in chronic
disease hospitals and nursing homes. The results of these studies only
served to reinforce the stereotypes of old people as confused, decrepit,
and leading meaningless lives. Their reminiscences confirmed that they
were living in the past.
For 11 years I worked with healthy volunteers. In 1961 I postulated
the existence of the life review as a normal function of the later years
and not a pathological condition. Memories, reminiscence, and nostalgia
all play a part in the process. Far from living in the past or wandering,
as was commonly thought, older people were engaged in the important
psychological task of coming to terms with the life they had lived. They
sought to make amends for acts of omission and commission, resolve
conflicts, and reconcile alienated relationships.
Today, along with a greater understanding of the significance of
reminiscence we have seen the rising popularity of private memoirs in
various forms, from oral histories by universities to audio and videotapes
for family archives.
John A. Kunz and Florence Gray Soltys have made a major contri-
bution to the field by providing a framework for individuals and groups
engaged in this enriching and important work.

Robert N. Butler, MD

xv