Dr. Wayne Sotile Show Segment

We're happy to have you here in the Detroit area with us and I understand that this is your latest book. Can you tell us a little bit about "Heart Illness And Intimacy"?

A. Well my book really is about the subtitle, "How Caring Relationships Aid Recovery" and I'm traveling around the country these days speaking to communities and to medical providers about the importance of promoting caring connection between people in order to prevent illness, help people face the challenges of aging, and help people face the challenges of getting better if they encounter illness. What we know, and have known for years, is that stress can hurt you but the flip side of the stress research model is what I'm interested in. If stress hurts you, maybe positive emotions help heal you. What is more positive than getting along lovingly with people you care about and what hurts more than not getting along with people you care about.

Q. So how do we go about creating these communities? Do we start small, do we start big?

A. I think we start where people congregate. The primary source of support of the sort that matters in being able to cope with the challenges that come with life at any stage incidentally, but particularly the challenges that come with aging. The primary sources of support are church, medical providers and family and those need to be the targets of our attention I think as a culture, as a society, as a community, or just in our individual private lives if you're going to invest energy in anything, invest energy in understanding how you can lovingly help the people important to you whether they're biologically related or not, cope with the challenges that come with this state of life. This heart attack or this cancer or this aging or this transition into retirement or into a nursing home. If we can help people improve their sense of control over what they're facing and can respect them in their integrity and give them affection, that's what intimacy is about. Cooperation, caring, connection and affection.

Q. How do we change the, these organizations are usually known for service, providing services.

A. Correct.

Q. How do we change that to having them help a person, you know, become more empowered?

A. That's the crucial question because so much about task driven health systems break the spirit of older people particularly. I was reading interviews with residents of a nursing home recently and one woman said, "What I want is just to wake up every morning not feeling so afraid. The nursing shifts change first thing in the morning and the new nurse comes in. If I don't understand what she wants me to do she handles me roughly and then just leaves abruptly." Another said, "I would like to have some say so when I go to the bathroom rather than the schedule telling me when to go to the bathroom." We break the spirits of people when we strip them of control and on the other hand if we as systems, health care systems, administrative systems, would understand this, if you will just do small things that continue to respect the integrity of an aging person in our families if we remembered this too, do for people that which they can't do for themselves and nothing more and facilitate their choice making, number one they don't get sick as frequently. Number two if they do get sick, they recover more quickly, they remain more happy, more active, and more healthy. Now, this is profoundly important for families. Given that families provide 80% of the care for aging people in our culture and by the year 2010 we're going to be living, on average, in four generation families. Some of us in five generation families. An average 60 year old woman is going to spend more time providing hands-on care of her aging parents than she did raising her own children. I say women because the burden of responsibility for caring for the aged so often falls on the shoulders of women which is another perspective on aging. Talk about an over stressed group. There are less of those shoulders around than used to be. Because it used to be everybody had four or five children in their family. The folks who are coming of age now are from families with an average of two children. We baby boomer types who are soon to be facing diminished health care coverage, diminished financial resources for the aging but more aged people or our really over stressed lot so it's important for us to learn to corroborate with our family. It's important for health care professionals like me and physicians and nursing home administrators to learn to corroborate with patients and their families in promoting the right stuff. The right stuff is helping people know how to cope with that which faces them. My book, "Heart Illness and Intimacy" teaches families to embrace the fact that we are a team in sickness and in health. However well intended we might be sometimes we try to help each other in ways that don't work and quite the contrary they backfire. We nag, shame, police, monitor, or strip control from the person who is wanting to change or needing to change rather than facilitating. Rather than coaching, rather than teaching, rather than participating with our family member in facing the challenges that are filling our lives now.

Q. We've created kind of a sterile atmosphere in our lives and our homes and things like little kids saying, "Grandpa smells I don't want a hug him."

A. Yeah. Q. How do we change the attitude back to loving that these are people?

A. You know, I believe that if the, the systems within which we live, our work settings, our church settings, our family settings, would be run differently so to speak. The leaders of those systems need to demonstrate a changed attitude. It is, I grew up seeing all four of my grandparents almost every day of my life whether I wanted to or not, you know, and I thank God I did now that they're all gone but I don't insist that my children honor their grandparents the way my parents insisted that I honor my grandparents. And a great gift my parents gave me was saying even in your adolescent self centeredness or in your young man busyness, you need to go see your grandma and your grandpa. That's part of what you do in your life. We need to think about this because not only does it hurt peoples feelings, it's also just not practical, it's not pragmatic, it's foolish. We have to get our heads out of the sand. If we model respect as some cultures do of the elderly, the elderly thrive rather than just struggle to survive. Unfortunately what happens is the different stages of life collide. There's one generation who is compelled to go go go away from the family while another generation is compelled with the wisdom of the elders to reintegrate. I think older people need to be more assertive about what they want and what they think, what they feel, what they need, and for men and women, older men and women that translates into quite different things but as leaders of their family, those older men who have their chests bursting with pride and want to hug their sons when they see their sons, need to hug them. The son will get used to it. For those older women who are compelled to be the truth tellers, "I've been the caretaker for so long but now I have lived long enough and I deserve to say some things." need to speak out. Those steps I think, the middle generation looking in the mirror and rethinking this, "What is of value, who are you about, what is your life about?" and starting to walk the walk and not just talk the talk. People are always saying I do a lot of stress management kind of counseling and consultation with the industry and high powered executive types always say, "Oh I do everything I do for my family." Well my question is, "How much time do you spend with your family? Who is your family? Where the rubber hits the road of those 168 hours each week, how much time do you spend in the presence of people you love, whether your own children or your own parents?" That change in that generation, that middle generation has to occur I think. Also I encourage older people to claim their place. You have to be self respecting if you want other folks to respect you.

Q. I think that's something that's somehow dwindled too, you know. So how do we get them to be self empowered again? These were once the leaders and the shakers.

A. They once were the leaders and the shakers that created things and then they bought in to the discounting that this culture does and folks do this to themselves unfortunately all over the place. We're social beings. We tend to adhere to what we are told this is your role, we assigned it to you. We do that in reference to our sexuality, the culture segregates against particularly single women with white hair. We pretend that sexuality doesn't matter to you. That sense of femininity and so older women stop taking care of themselves in a way that they feel good about. The middle generation, the younger generation needs to be more honoring of your masculinity, your femininity admittedly but I think the older generation needs to be more honoring in part of themselves. There's a notion about self empowerment that's important. We need to select what we do more wisely as we get older. I select based on what I can do and accept the realities of what I can't do and then I need to optimize my performance. I used to be able to play golf using all these clubs. I'm not so good with some clubs so I'm going to use the ones I'm good with more and we need to in many ways compensate realistically. Given what I can do more comfortably or better or less comfortable and not so well. I used to be able to play 18 holes, well I can't but I'll keep playing. I'll play three holes using the clubs I want to use doing it the way I want to. The Gerontologist that taught us these are keys to aging well among many others but selecting wisely, optimizing your performance in whatever realm we're talking about and then compensating in ways that evolve, for example, using the best times when you have best energy or using the best strategies. Now we're not talking about playing golf, sexual behavior, caretaking of the chores in your home, I'm talking about it all. It applies in general.

Q. Do you have any words for those people who really aren't active and they're not involved. They're just kind of the couch potatoes of the older set and so they, they've lost the will to even become empowered?

A. The most tragic thing a person can do as they age is to stop being active and stop being involved. I encourage people to think of the A's of aging well. Stay Active, have a routine. That doesn't mean you have to become the President of General Motors but a day I do my shopping, a day I get my hair done, a day I oversee the mowing of the lawn or mow it myself, or a day I walk around the block, another day that I go and visit the community. Stay active. Stay involved in your community is a very very important thing. Get involved in things like organizations that require that you give something. Getting and giving affection is another. Volunteering. Attending church. A church community is tremendously important. These are things that motivate you to do other things. They keep you energized. Being authentic, telling the truth, expressing the truth of my affections, the truth of my opinions and adapting. Adapting realistically. Age is not just a bunch of losses. Aging involves a lot of opportunities and that's why I am traveling more and more around the country these days speaking about the opportunities that come with aging. The wisdom of the elders.

Q. What are those opportunities and how do we get wise?

A. Well I think we get wise number one by accepting the inevitability of some of the losses that come with aging and understanding we need to focus on what remains, not on what we've lost. Number two, we need to incorporate into the fold of our life some of the stuff psychologically and behaviorally that we simply either haven't had courage enough to incorporate thus fore or time enough to incorporate given what we're having to do in our lives. If you study women who age well, they a lot of times do stuff that's rather radical. They travel when their loved ones are saying, "Act your age Mother." or they decide to establish new friendships when somebody's saying, "Act your age, Mother." or they decide to be assertive rather than passive when people are saying, "Act your age, Mother." as one 78 year old woman I know finally said to her grown daughter who kept saying "Act your age, Mother." "I am acting my age. Problem is you're too young to understand how people like me are supposed to act." So, how do you age well, you dare to tell the truth about who you are. That's one of the opportunities. Truly one of the opportunities I think is as a leader in your own family or in your own community, whoever your family consists of in that community. Daring to show the people who know you acts of heroism day to day and I don't mean by doing extraordinary stuff. I mean by noticing the extraordinary stuff that tends to fill day to day life. Once again I show up on time when I said I was going to be there and once again I give you a word of encouragement. Once again I'm courteous to you and ask, "Would you like a glass of water? I'm going to get a glass of water." These are the day to day acts of heroism. Older people are able to show younger folks particularly again, we baby boomers are sort of encroaching on the age of 50 here, are paying a lot of attention and need some help in this culture I think in understanding really how to incorporate the different parts of ourselves into a life that works. We're more or less a turning back to religion in search of a higher level of meaning in life. One of the opportunities that comes with aging that can only come with aging is the opportunity to develop wisdom and to live according to that wisdom. The great thinkers have always told us, "No matter how precocious you are, no matter how smart you are, no matter how educated you are, you're only rehearsing for wisdom and maturity until you get around 45 or so.

Q. Can you tell us, can we develop a group of healing hands? You know, people that really do have healing hands or use touch.

A. One of the tragedies that happens in our culture particularly is that people stop touching, stop being touched as they age. Folks who believe in healing touch have remarkable tales to tell and they're not flaky, out in left field people typically. They're health care providers who have noticed how much more effective their work is if they caringly hold somebody's hand when they're speaking to them in a way that's respectful of the patient or caringly touch them as they're trying to soothe them. In our personal lives, think about the older people in your life. Think about your own life. How important it is to be hugged or have physical affection. We give that to our children and get that from our children when they're little and then as everybody starts aging, everybody starts touching less. We give that to each other and we get that from each other when we're all romantic and in love in our romantic relationships. But as those age we stop touching, you know, to the point, "You love me honey?" "Yeah I love you." "Well how do I know?" "Well, I told you." "Yeah but that was 30 years ago when we got married." "Well I'm still here aren't ?" "Yeah but you're sitting over there and I'm sitting over here. We don't touch anymore." One of the simple tangible doable things you can do many times a day is lovingly touch people and be touched in the process. I think that's tremendously tremendously important for older people. I remember visiting my grandmothers, particularly one of my grandmothers who lived and lived and lived until the day she died and the other, bless her heart, floundered in illness, but my grandmother who was bright and alert until the day she died, I'd go visit and I'd want to tell her all the stuff I'd been doing and she would just look at me, "Come sit by me." She'd sit and hold my hand and pet, she didn't care what I was doing, she just wanted to be in my presence. I wanted to be in her presence. That touch is so important and that's something we ought to give more freely to each other.

Q. Can you tell us a little more about your book. Suggest who should get out there and buy it.

A. My book has been an exciting thing in my life for a bunch of reasons. I appreciate the response that people have had to it. It's a guide for, particularly for couples who are wanting to understand how we can help each other deal with the stress of illness or the stress of the big life that we're living. When illness strikes a human victim often is the spouse of the identified patient. Spouse lies awake at night worrying about the patient and the tensions that develop in the family work against everyone adjusting. They're well intended steps that people take but they aggravate each other. So my book is a guide for couples who want to work cooperatively to help each other manage stress better, change health behaviors better and kind of take a family temperature engaging how children or grandchildren are responding to the changes in our family now that the stress or the illness is happening and it's filled with practical guidelines about how to maintain loving connection and cooperation through all the stages of life.

Q. Have a final word you'd like to tell our audience out there? All those people either taking care of older people or actually up in their 80's and 90's?

A. No matter what losses or painful stresses come with the stage of life that you find yourself grappling with or a loved one grappling with, I think the key for us is to remind ourselves to focus on the opportunities that also come. The opportunities to take this as a an opening. The most of defensive of individuals and the most defensive of families open to influence and open to a new kind of a way of being in the midst of crisis. Take advantage of those crisis to forgive what you need to forgive. Begin doing more of what you need to do more of. Do less of what you need to do less of. Take these crisis as opportunities to love each other more up close and personal. That's what we're losing in this day and time in this world and that's what we all are in search of.

Q. Thank you very much.

A. Thank you it's been my pleasure.