ON a recent Tuesday afternoon in Cambridge, Massachusetts, the queue rapidly lengthening outside the Brattle Theatre seemed likely to spill over into Harvard Square. There were more women than men waiting for the doors to open at 5.30 p.m. Most either had white hair or were skilfully disguising it. They swapped stories: how a mother's stroke had cost them job promotion; how a father's colon cancer had drained a savings account. All expected author and psychologist Mary Pipher, the Brattle's guest speaker that evening, to provide, if not answers to their family problems, then at least clues. "She explained my adolescent daughter tome," one woman joked, sipping coffee. "After that, I'll trust her on anything."
The reference is to Mary Pipher's 1994 bestseller, Reviving Ophelia, which examined how girls lose their identities in a society obsessed with looks and fashion. Hillary Rodham Clinton was so impressed that she invited Pipher to the White House. Oprah Winfrey interviewed her, Jane Fonda introduced her in Atlanta and harried parents worldwide wrote to thank her for saving their sanity.
Now 51-year-old Dr Pipher is tackling old age, something America typically conceals or sentimentalises. "We live in a culture that tends to avoid facing grimness," the Nebraska therapist observes, "And nothing in that culture guides us in a positive way towards the old. I've seen the elderly bossed around, treated like children or simpletons, and simply ignored."
Pipher's latest book, Another Country: Navigating the Emotional Terrain of Our Elders, is both an indictment of American society's rampant individualism and a field guide to the foreign landscape - physical and psychological - of old age. Examining how our generational attitudes and expectations are shaped, using case studies as examples, it concludes with modest proposals for change.
Mary Pipher is, above all, modest. A small, sturdy Midwesterner who walks on the prairie at sunset for relaxation and has lived in the same house in Lincoln, Nebraska for more than 20 years, she favours plain, saggy dresses and natural shoes. Pipher was unfazed when her publisher tactfully gave her an Eileen Fisher silk ensemble to wear on book tours. "Now I have two suits," she later told the Washington Post.
In Cambridge, Pipher acted nothing like a bestselling author, let alone a celebrity. Rarely smiling, listening intently to each question from the audience and patiently to those detaining her as the theatre emptied, she responded in the flat tones and jargon-free language of her native Midwest. "Lemme tell ya," she told one overburdened daughter, "I've a feelin' you're doin' an extremely difficult job without help." One outrageous story prompted her to exclaim mildly: "That's plain nuts."
But America's favourite therapist is not another homespun guru churning out Chicken Soup for the Soul tracts. Pipher may admit that she is "not interested in statistics," and Another Country may contain one folksy poem too many. But its research on ageing is solid, its insights are valuable and Pipher's advice to families is practical. The case histories of families in crisis - drawn from her 20 years in practice - have a composite quality, and some of the resolutions seem a little too neat, but they dramatise her point nicely. Individuals need to become acquainted with the language and culture of their elders. Society needs to reconsider its divisive policy of age-apartheid.
"What has changed most in our world is that we've gone from a communal culture to a culture in which people don't know one another," Pipher observes, "Values about community, individualism, and the whole landscape of mental health are quite different now than they were when our parents and grandparents were young. As the shadow of Freud moved across our continent, it changed enormously the way we feel, think and express ourselves. My generation views the world from a heavily therapised perspective. "
Speaking as she writes - plainly and deliberately - Pipher exudes enviable calm and an unguarded curiosity rare in professional listeners. In the middle of a gruelling nationwide tour and clearly fatigued by her Boston and New York engagements, she still wanted to hear how Ireland's social upheavals have affected the elderly. It is hardly surprising that she became deeply involved with the subjects she studied for Another Country. "I had originally planned to breeze in and out of their lives," she explains, "but once I got in, it was clear many of them needed me in some way. "For example, I'm taking an older woman I interviewed to the doctor next week. It's a much bigger time and emotional commitment than I had planned to make."
Time is something Pipher hears a lot about - from busy young parents who complain of having too little, from old people who spend days alone watching the clock. "Meanwhile, all over America we have young children hungry for lap-time," she writes. "They play with cyberpets while old women stare out their windows at empty streets."
The unquestioned assumption that people - whether toddlers, teenagers or the elderly - thrive when surrounded by others of their own age has, to a large extent, spawned retirement ghettoes in America's sun-belt and fortress-like assisted-living facilities nationwide. Families disintegrate, corporations profit and affluent American streets are populated solely by the young and the active. Pipher condemns such age-segregation and the resulting loss of collective memory. "Many old people are living in a world designed for young people," she observes, "They can't drive, walk through shopping malls or airports, or deal with rushed doctors in managed-care systems . . . Most were around when Henry Ford designed the first assembly lines, when sliced bread was invented, and when the first movie theatres opened. They were the last generation in this country to be raised in a communal culture and to grow up on pre-Freudian terrain."
On that terrain, depression is not a mental health problem but a time when money was tight; self-sacrifice is a virtue, not a sign of co-dependency; rich food is associated with security, not high cholesterol. "In the small-town world my parents inhabited all behaviour mattered," Pipher explains, "And that made sense because they would be dealing with the same people for most of their lives. Mature adults were expected to spare each others' feelings, to let a smile be their umbrella. Today that is suspect. We trust the miserable and doubt the perky. The pinnacle of good manners is leaving people alone."
As she develops her theory, Pipher neither sugar-coats the elderly nor minimises the challenge facing those who care for them. "Nobody becomes a perfect person with age," she stresses, "And families must adjust to each new lost inch as a parent's abilities fade." Often the language barrier between generations compounds that problem. "The elderly - women in particular - will go to incredible lengths not to express their wants or needs," she notes.
Pipher's aim in Another Country is to analyse what old people are feeling and to place it in a new context for their frustrated, often resentful, adult children. Here she makes the connection with her previous study of young girls. "While adolescence is about the loss of childhood," she writes, "old age is about the loss of adult status and power . . . In both stages, the true self is often isolated: in adolescence by a poisonous peer culture, in old age by the death of those who have common memories."
None of which, she agrees, interests the chronically selfish or the hopelessly self-involved. But she encountered few of those in her research. Most families she met - to a greater or lesser degree - wanted to do the right thing. Sadly, the task is more often solitary than shared. "Many of the problems stem from our culture letting us down," Pipher insists, referring to nursing homes as "the concrete embodiment of failed social and cultural policies toward the old," even as she praises those who make such last-resorts decent.
Pipher's audiences applaud her insights, but they crave her practical advice. She does not dismiss them with: "Be nicer to old people" or "Move your arthritic aunt into the garage". Urging families to start thinking and talking about their elders' living arrangements early on, she cites imaginative solutions such as struggling young families being matched with financially secure but infirm old people. And her own future? "I'm a simple person," she replies, "And I'm already practising to be old. I try not to want too much, and try to find something to appreciate in every new day." But she is also part of a demanding generation. "We baby-boomers are used to getting what we want," Pipher agrees, "We'll be very vocal about the right to die and health care."
In Another Country, Pipher has once again given America something to think about. "Caring for our elders is our generation's chance to grow up," she concludes. "It's our one chance to be heroic." Up the street in Harvard Square, however, where youth rules and dependency is a dirty word, it seems unlikely that they will answer Pipher's call. At least not yet.
Another Country: Navigating the Emotional Terrain of Our Elders is published in the US by Riverside Books.