Self-image and ageing: when your body and roles change

“I saw a woman in a shop window who looked tired and a little stooped. It took me a moment to realise it was me.”

I hear this sentence — or something very like it — more often than you might expect. A woman in her fifties says it, a man in his sixties, sometimes someone who has only just turned forty. Almost always with a smile meant to make it smaller. But under the smile there is something serious: the moment when the picture of ourselves we carry in our heads and the picture the glass gives back stop matching.

Ageing is one of the few transitions all of us go through, if we are lucky enough to live long enough. And yet we talk about it mostly in the language of loss: wrinkles, kilos, decline, “not any more”. In this post I want to look at what really happens to self-image in later life — and why what you think about ageing may be one of the most important factors in how you will age.

Self-image doesn’t disappear, but it shifts

Self-image is the picture we hold of ourselves: what we are like, what we can do, where we belong, how much we are worth. It is built from the body, from the roles we play and from the responses of the people around us. I have written more about the difference between self-image, self-worth and self-confidence in the post Self-image, self-worth, self-confidence: how they differ and how each is built.

As we age, all three shift at once. The body changes. The roles that defined us for decades — worker, mother of children who still come home for dinner, boss, the one who knows — come to an end. And other people’s responses become different: quieter, sometimes patronising, sometimes absent altogether. It is no wonder that many people in this period ask themselves something they last asked as teenagers: who am I, really?

That question is not a sign that something is wrong with us. It is a sign that we are in a transition — a period when the old shape no longer holds and the new one has not yet formed. The psychologist Erik Erikson described the last task of life as a tension between integrity and despair: can you accept your life as your own, with everything that was in it, or do you collapse into regret when you look back? This task does not begin at eighty. It begins with the first signs that time is not endless.

What the study that changed how we see ageing shows

In 2002 the psychologist Becca Levy of Yale University and her colleagues published a study that is still cited as one of the most surprising in the field. She used data from a long-running American study in Ohio in which people over fifty answered simple questions about their own ageing. They agreed or disagreed with statements such as “as I get older, I am less useful” or “I am as happy now as I was when I was younger”.

The researchers then looked at who was still alive two decades later. People with more positive attitudes towards their own ageing lived on average 7.5 years longer than those with negative ones. The difference held even after they took into account age, sex, financial situation, loneliness and physical health at the start of the study.

The number is big enough to be worth reading twice. Seven and a half years. Just because of how a person answered a few questions about what getting older meant to them.

Levy later developed an explanation she calls stereotype embodiment theory. We take in images of old age — that old people are slow, forgetful, useless, helpless — in childhood, from fairy tales, advertisements and jokes. For decades they don’t concern us, because they are about someone else, so we never test them. But when we grow old ourselves, these images turn inwards and become self-image. And self-image is not just a thought. It affects whether you go for a walk, whether you sign up for a course, how your body responds to stress, and whether, the first time you forget a name, you think “aha, here it starts”.

A body you no longer recognise

The body changes first, and that is also the most visible part. Skin loses its elasticity, muscles their strength, joints begin to make themselves known. Many people tell me it is not so much how they look that bothers them, but that their body no longer obeys them the way they are used to. That they are out of breath on the stairs. That after a bad night they need two days to recover.

Body image — how we experience our body — is not something superficial. It is part of how we feel in the world. You can read more about it in the knowledge base under body image. Research on body dissatisfaction long focused on young women, yet older women experience it very often too, and so do more and more men. The difference is that older people talk about it less, because it seems to them that “at their age” it is no longer appropriate to care.

But you do care. And that isn’t vanity. For decades your body was your home and your tool. When it changes, it is normal to grieve a little for what was. Grief isn’t reserved for the death of loved ones — we also grieve for abilities, for the face we knew, for an ease that is no longer there.

Menopause and “andropause”: hormones are not only a physical matter

For women, menopause is often the point at which ageing turns from an abstract idea into something very concrete. Hot flushes, poorer sleep, mood swings, changes in sexual desire and in body weight. Some women pass through this period almost without noticing, while for others it turns life upside down for a few years.

But menopause is not just a hormonal event. It also means the symbolic end of fertility — and in a culture that still often measures a woman’s worth by youth and attractiveness, that can cut deep. I notice that women in this period often don’t know how much of what they feel is “hormones” and how much is “me”. The answer is usually: both, intertwined.

For men the picture is different. The term “andropause” is disputed among experts, because in most men testosterone levels do not drop suddenly but slowly, over decades. Even so, many men in their fifties and sixties notice less energy, less sexual desire and a lower mood — and they talk about it even less often than women. When they link it to their worth (“I’m not a real man any more”), shame can do more damage than the hormones themselves.

I need to be clear here: if these physical changes trouble you a great deal, your first port of call is your GP or gynaecologist. Effective treatment exists for some of these difficulties, and there is no reason to suffer them in silence. Psychotherapy can help with what the changes mean to you — but it does not replace a medical examination.

Retirement: when you lose the answer to “what do you do?”

In Slovenia we like to introduce ourselves by our profession. “I’m a teacher.” “I work at a bank.” “I have my own company.” When you retire, that answer disappears — and with it, often, a part of your self-image you didn’t even notice until you lost it.

For many people the first months of retirement feel like a holiday. Then the silence comes. No more meetings, colleagues, deadlines, no more sense of being needed. People who built their worth mainly on work find this especially painful. I wrote about it in more detail in the post Retirement, the loss of a role and the question of meaning.

What I want to stress here is that losing a role is not the same as losing worth. The role was the way you lived and showed your worth. It was not the worth itself. That difference is easy to say and very hard to feel — especially if you grew up in a family where love was tied to achievement.

Invisibility: when people stop seeing you

One of the most common complaints I hear from women past fifty is that they have become invisible. The waiter overlooks them. The shop assistant turns to their younger colleague. In a meeting someone else repeats their idea and gets the praise. Men talk about it less, but they experience something similar — especially when they lose a position that used to guarantee them attention.

Invisibility hurts because self-image is built in other people’s eyes too. When people look at you, you see yourself. When they stop, you may begin to wonder whether you still exist in a way that counts.

Some women, though, also report something else: relief. When no one judges you by your looks any more, you are finally free. You can wear what you like. You can say what you think. Invisibility has this side too — a space in which you no longer have to perform for an audience.

How closely role and invisibility are linked is shown by a short conversation with a woman who had recently retired. It went something like this (a composite, not a real person):

“I used to be somebody. Now I’m just a grandmother who looks after the grandchildren on Wednesdays.”
“Just?”
“Well, you know what I mean. Nobody asks for my opinion any more.”
“Who used to ask you?”
“At work, everyone. At home … actually, no one. Not before either.”

Something important showed itself in that short answer. Her sense of being “somebody” came from her job — because she had never got it anywhere else. Retirement did not create an emptiness. It uncovered an emptiness that had been there before, only covered over by work. This is common. Old age rarely brings entirely new wounds. More often it reveals old ones.

And this is exactly where there is room for change. If you know where the feeling that you are no longer worth anything comes from, you can begin to build a worth that does not depend on a role — in relationships, in what matters to you, in what kind of person you are.

What relational family therapy says about this

In relational family therapy, in which I am training, we see self-image as something that is formed in relationships. Not only in childhood, but throughout life. When relationships change, the picture of ourselves changes too.

Ageing reshuffles family roles. The children you cared for begin to care for you. The partner with whom you were each busy with your own work for decades is now at home all day. Your parents, if they are still alive, need help. Each of these changes opens questions that concern not only you, but the whole family system. Who decides? Who is stronger? Who is allowed to be weak?

In therapy, we don’t look for answers for the individual alone when these questions come up. We look at how the patterns you brought from your family of origin have shaped the way you experience ageing today. If your mother grew bitter as she aged and always complained that nobody needed her, you may carry that image with you as a kind of prophecy. Once you notice it, you can begin to change it.

Exercise: check your images of ageing

This exercise takes about fifteen minutes. You will need a sheet of paper and a pen.

1. Write down five words that first come to mind at the words “an old person”. Don’t censor yourself.
2. Next to each word, write where you got it from. From home? From television? From your experience with your grandparents? From jokes at work?
3. Think of one person who aged differently from your five words. A neighbour who still goes hiking at eighty. An uncle who learned to play the guitar at seventy. Write down what you like about them.
4. Write down three things your body can still do today — and for which you may never have thanked it.
5. Write one sentence about your ageing that you would say to a good friend in your position. Then read it to yourself.

The point of the exercise is not to erase negative images or force yourself into optimism. The point is to see them for what they are: borrowed stories, not facts about you. Becca Levy’s research shows that attitudes to ageing can change — and that a great deal else changes with them.

Where this view is not enough

I want to be honest about what this post does not claim.

Positive attitudes are not a cure. Levy’s research showed a strong association, but attitudes are not the only factor. People fall ill and die even with the most hopeful thoughts about ageing. If anyone read these findings as “if you had been more optimistic, you would not have got ill”, they would be adding guilt to people who do not need it.

Some losses are real. Illness, chronic pain, the death of a partner, poverty in old age — these are not self-image problems that different thinking would solve. They are real circumstances that call for real support: medical, social and financial.

Age discrimination is not in your head. When an employer doesn’t hire you because of your age, or a doctor doesn’t take you seriously because “at your age that’s normal”, that is not your negative self-image. It is a social problem you cannot solve on your own.

Sadness is not always depression — but sometimes it is. If for several weeks you have had no will for anything, you sleep badly, have no appetite and feel that nothing makes sense any more, talk to your doctor. Depression in older people is often overlooked because we mistake it for “old age”. I wrote more about this in the post Depression in older people: when we mistake it for ageing itself.

What you can do now, whatever your age

The Stanford researcher Laura Carstensen has shown something that at first glance contradicts everything we think about old age: emotional life, on average, improves with age. Older people experience fewer negative emotions and are often more content than younger ones. Carstensen explains this by the fact that when we sense that time is not endless, we start choosing more carefully with whom and with what we spend it.

This may be the most important message of this post. Ageing is not only losing. It is also choosing. If you are in midlife and the thought of ageing frightens you — I wrote about this period in the post The midlife crisis is not a cliché — you can already ask yourself: what kind of old person do I want to be? Not in terms of looks, but in terms of relationships, curiosity and what matters to you.

And if in later life you are flooded by an inner voice telling you that you are no longer good for anything, it helps to know where that voice comes from. The post The inner critic: where the voice that constantly judges you comes from is about exactly that, and you can set self-compassion instead of self-criticism against it. In Slovenia there are also communities that offer a place for learning and company in the third age — from universities of the third age to pensioners’ associations. A new role is rarely born in isolation.

You did not choose the images of old age you carry. But you can decide which ones you will carry forward. It is one of the few things about ageing that is entirely in your hands — and research shows that this decision has noticeable consequences.

What to remember

• Self-image in later life is shaken because body, hormones, roles and other people’s gaze all change at once — this is a transition, not a fault.
• In Becca Levy’s study, people with more positive attitudes to their own ageing lived on average 7.5 years longer.
• We take in images of old age in childhood and don’t test them until they turn against us. You can notice them and change them.
• Retirement and children leaving home often don’t create an emptiness but reveal an old one. A role is not the same as worth.
• Physical complaints belong with a doctor, and age discrimination is not your fault — psychotherapy helps with meaning, it doesn’t replace treatment.