Elderly Parents and the Pandemic

The pandemic is producing reconstituted families. Children who are back from college are now bemused (if somewhat discomfited) that their old rooms were (in their absence) turned into memorials to their long-forgotten selves. Grandparents follow, afraid to be alone but (like their grandchildren) bewildered as to where exactly they will fit in. In the middle, parents manage everyone (sort of).

I’m thinking of my patient Bob, who—like many wealthy New Yorkers—has decamped with his family to the Hamptons. His elderly father, Dan, lives alone in Boston, and desperately wants to spend time with his grandchildren. At 93, he fears that he hasn’t very much time left.

Bob drove to see Dan a couple of weeks ago, but Dan yearns for the whole family. He survived the Holocaust and World War II, and now frets about the world to come. “I hope Mildred is waiting for me.” Dan misses his wife, whom he lost last year.

Yet while Bob and his family want to see Dan, and think that he’d like the Hamptons, they wonder whether such a visit would be safe. Would permitting it even be responsible? We spoke about finding a sensible approach so that no one would feel guilty and no one would get hurt. My own complicated concerns about seeing my 80-year-old parents lurked in the background. For the longest time, I struggled to live up to my father’s example, and I knew how hard it can be to engage with one’s father man to man and help make objective choices.

So, I wondered how anyone (namely me) could advise anyone else concerning elderly parents in a pandemic—the situation is so personal, so bound up with one’s relationship to one’s parents. The most I could do was to help Bob think through his feelings.

In fact, and as I suspected, Bob’s feelings were not just about pandemic-based logistics. His attempt to assess his father’s visit was not—and could not be—objective, based on his complicated feelings. These went deep into his history with his father. Though Bob was not initially aware of why he was having such trouble deciding, we were finally able to discover it: his real concern was whether he could trust his own judgment (and treat his father accordingly), or whether his judgment would be colored by this history.

Bob had joined the family real estate business—a modest, if successful operation—and had built it into a fiefdom. Though Dan remained its titular head until a few years ago, Bob had made the quiet, lucrative deals that paid off as the City gentrified. But the company was still Dan’s. Until a formal reorganization transferred ownership of the business to Bob, everyone knew it was Dan’s. Bob assumed that people wondered why the transfer took so long. “Maybe they think I got here by default.” For a very long time, therefore, he felt that he had never “been the business,” as he liked to say, and that he had never been allowed to receive the recognition he deserved. “Why couldn’t my father just bow out gracefully?” he asked. “Why did he have to keep living his illusion—at my expense?”

In psychoanalysis, there is the idea of the Oedipus Complex, which originates from the Sophocles’ tragedy, Oedipus Rex. In the play, Oedipus unwittingly murders his father, King of Thebes, at its crossroad into the city. He then unwittingly marries his mother. When he realizes his crime, he blinds himself, and pursues a life of solitude and reflection. According to Freud, conflict with one’s father is inherent in the psychological development of the male child; it is embedded, unconsciously, in a man’s psychological structure. Accordingly, men always experience some competitive strivings with fathers and father figures for the love of the desired woman, their mothers.

I saw this pattern with Bob and his father. He was always a dutiful, respectful, even compliant son. But he harbored feelings of resentment about being under his father’s thumb, which especially rankled after he had exceeded his father’s accomplishments. I felt that these feelings inflected how he viewed his father’s potential visit to the Hamptons.

For sure, there were legitimate health concerns. What if his father should get infected with COVID-19 and die (COVID is especially lethal to the elderly)? Would Bob be at fault, even though his father asked to come? (Bob was in charge now, and his decisions carried greater weight). The children were beginning to socialize with other children. His wife owned a fashion store in town and came in contact with her clients. He occasionally met with clients, albeit out in the open.

Thus, the whole situation was complicated. While Bob had concerns that were reality-based, they were tied up with feelings of competition and resentment toward his father. When I told him so, he acknowledged that it was true. Such feelings had, in fact, surfaced during our years of working together, and had complicated other problems that he had faced. During the current crisis, people can rarely deal with health issues head-on; they are refracted through other issues that we carry around—indeed, that they have carried around for years.

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In facing COVID-19, we face multiple issues simultaneously. Some seem acute—like how we care for elderly parents—while others have just never gone away, like how our relationships with parents still bother us. All of these issues now appear to gang upon us, so that we can’t deal with anyone of them on its own. In a perverse multi-dimensional matrix, each makes the other harder to isolate and individually solve.

The pattern is a classic example of stress, where one stressor aggravates others—sometimes it’s impossible to tell which aggravates the other and, in fact, it rarely matters. For Bob, the immediate present (what to do about Dan) and the lingering past (the Oedipal remnants of their relationship) converged, leaving him uncertain. He wanted to make his father happy, but he was afraid that his judgment was unreliable—even warped—to his father’s detriment. “Can I trust my own judgment?” he asked.

At the very least, Bob understood his dilemma. He was self-aware ... but for that very reason, feeling immobilized.

He also found humor in how his fantasy- and quotidian lives merged like two images projected from opposite directions onto a screen. There was irony, he said, in how reality—the pandemic—had roused his Oedipal fantasies. “It’s like science meets the Loch Ness Monster,” he suggested. So how do you resolve this fix?

I found the dilemma fascinating. Often, it’s hard to know what the reality is from a patient’s description. As we dug deeper, we had to disentangle objective reality—the dangers to the elderly from COVID-19—from psychic, intersubjective reality. Once we did that, however, Bob thought he could put his Loch Ness Monster aside, and make a reasonable assessment of the risk. He plans to tell his father that the family will visit Boston very soon. It’s not ideal, since it means less time with Dan, but it will be less stressful for everyone else. During this period, it’s OK to act in the interest of stress reduction—especially, as in Bob’s case, where the result makes everyone at least minimally happy.