Last updated March 2011.

by Paul Fine, M.D.

Life Member LogoNative American and other traditional people identify elders as wisdom keepers for their way of life. Life Members of our Academy, by the same token, can play a role as wisdom keepers for Child and Adolescent Psychiatry. The challenge then is to define wisdom.

Eric Erikson's developmental theory is familiar to our generation and worth reviewing as a place to start. Erikson constructed an epigenetic matrix consisting of eight interrelated psychosocial tasks to encompass the human life cycle. Stages were biologically defined to include infancy, early childhood, adolescence, young adulthood, full adulthood and old age. Psychosocial opportunities and risks were then matched to each stage as developmental tasks. The tasks in sequence are basic trust vs. basic mistrust, psychosocially focal for infants, autonomy vs. shame and doubt for toddlers, initiative vs. guilt for preschoolers, industry vs. inferiority for middle childhood, identity vs. role confusion for adolescents, intimacy vs. isolation for young adults, generativity vs. stagnation for adults in their prime and ego integrity vs. despair for the elderly.

Erikson's formulation adds depth because it is a matrix rather than a list or isolated stair-steps. Each person's life at any particular time thus can be described in terms of a current psychosocial task, ongoing experiences related to previously focal developmental tasks, and ongoing experiences that reflect psychosocial tasks destined to become focal at a future stage. Personal experiences unfold throughout life, are most easily focal at a socially right time and continually interact each with the others as a whole.

Erikson later enriched his theory by matching ego strengths with the psychosocial tasks: hope, will and purpose, normally focal during infancy and early childhood; competence and fidelity for school-aged children and adolescents; love as in an ability to construct love by young adults; care, as in providing care by adults; and wisdom, the ability to overview the life cycle and face involution with courage. Each strength develops for better or worse throughout the entire lifespan, hopefully culminating in mature insights as a basis for wisdom. Erikson's wife, Joan, actually weaved a tapestry representing their life together to illustrate the point. (See Erikson, The Human Life Cycle Completed, Norton Press, New York, 1982.)

Erikson was a social psychologist and psychoanalyst rather than a child psychiatrist and his personal integration was singular. A brief biographical note is helpful to avoid idealization. Erik Erikson was born in Frankfurt Germany, 1902, the son of Karla Abramson and Valdeman Solomonson, both from well-off Jewish families. His parents separated while he was an infant. When he was three, his mother remarried, this time to an observantly Jewish pediatrician. Erik was adopted when he was 10. At school he was said to have been a poor student. Formal education ended at age 18 with graduation from the European equivalent of junior college. Art lessons and life as an itinerant portrait painter followed. Although he had assumed the name Homberger from his stepfather, Erik apparently harbored a fantasy that he was really the son of Scandinavian nobility.

Erikson's life became more stable after he joined Freud's circle in the late 1920's, first as a graphic artist and then to train as an analyst. He graduated the Vienna Psychoanalytic Institute, was analyzed by Anna Freud and later served on faculties at Harvard and Yale Universities, the University of California in Berkeley and the Austen Riggs Center. Part of his experience as a young man was at a Sioux reservation in South Dakota and with the Yurok tribe in California. His work became widely popular after he authored 14 books as well as numerous professional articles.

Erikson met his life partner, Sarah (aka Joan) Mowat Serson, the daughter of a Canadian minister, at a masked ball in old Vienna. They married in 1930, had babies and, in 1933, immigrated to the United States. In 1939 they accepted American citizenship using the self-invented name Erikson. Joan and Erik stayed compatibly married for 60 years and raised four children, one of whom was disabled. According to their daughter, Sue Erikson Bloland, herself a psychoanalyst, her father struggled with emotional conflicts lifelong, particularly with an exaggerated need for social recognition. (See Bloland, In the Shadow of Fame, Penguin Books, New York, 2005.) He lived to be 92 years old, she to 95.

There probably are as many interpretations of wisdom as there are elderly child and adolescent psychiatrist. Erikson's version of wisdom emphasized an overview of the life cycle, focal during the closing years of life. Most of us, I think, would agree that there is wisdom in sharing insights from experience, personal as well as professional.

Elders, of course, do not limit themselves to wise thoughts. Rather, we continue to express long-standing integrations for leadership, loving care, identity, competence, sociability, self-expression and trust. Life goes on in this way within the cycle of generations until, in good time, we become more attuned to that which may be spiritual or philosophic.

How quickly the years have passed! Now, it is a privilege to be a life member of the American Academy of Child and Adolescent Psychiatry. Some of our members have achieved significant recognition, by earning endowed chairs at great universities, cutting edge grants, and organizational leadership. Others contribute more prosaically, coping routinely with the complexities of child development and psychiatric therapy and the challenges of medical practice. Collectively there is much to offer.

Life members sponsor donations of time, energy and finances on behalf of the Academy. We help support quality care, mentoring for trainees, and even a twenty-first-century-style online network. Each year the Academy sponsors a Life Members Dinner at the annual meeting and a special presentation related to clinical wisdom. We are, after all, the collective long-term memory of the Academy and its wisdom keepers. There are so many interesting stories to tell and so little time to tell them. In turn, no doubt, more ways will be found to share thoughts and ideas within our group and with the generations of psychiatrists who follow.

Personally, for me the best part of life membership is to visit old friends, lend support, and celebrate work done together. Wisdom dictates that we not take ourselves too seriously, but perhaps, with luck we can continue to share the quiet satisfactions and collegial respect of our intriguing profession well into the future.