Cognitive decline and forgiveness

 Our Sunday school class has been going through a series on forgiveness. This week’s class focused on forgiveness and cognitive decline. (The majority of class members are over 60.) I found it enlightening. The teacher, Pat Stone, retired psychologist, gave me permission to share some of his material.

At the beginning of the class, Pat gave us a list of five words to remember, just like the nurse does in my annual wellness exam. The words were grass, computer, atom, lumber, fly. I can’t remember words or numbers out of context so I quickly made up a story I could visualize; I saw Adam (how I misheard atom) at his computer which was sitting on a piece of lumber out in the grass (the Garden of Eden), but he couldn’t get any work done because of a pesky fly. I managed to remember, but I couldn’t say the words without describing the picture. What does that say about my aging brain?

Pat told us that fluid intelligence is the ability to think, solve problems, and identify complex relationships. As our brain physically shrinks with age, this kind of intelligence decreases. This is true of everyone, whether or not they have dementia. The good news is that crystallized intelligence, the accumulation of a life-time of learning and experience, seems to become stronger with age. Wisdom can enter the picture. That’s hopeful.

Forgiveness, our teacher informed us, is a complex cognitive activity which is, of course, affected by age. Our ability to recognize we’ve hurt or have offended someone and therefore need to ask forgiveness can grow dim, as can our ability to remember that we have been forgiven. Along with that, the ability to forgive others gets more difficult as we tend to re-live old hurts.

Pat shared some characteristics of the aging brain, all of which affect our ability to forgive or to know that we need to be forgiven. These characteristics can increase as we grow older.

Perseveration is the retelling of the same thoughts and events that triggered negative emotions in the past. If it results in an endless mental/emotional loop, that makes forgiveness very difficult.

Confabulation is mixing the stories, putting together different unrelated events and thoughts from the past, resulting in a kind of personal mythology. How can one even know what to forgive?

Anxiety and depression can accompany the grieving process as the person faces what she’s lost. The inward focus precludes an attitude of forgiveness.

Disinhibition is the loss of ability to screen thoughts and emotions. The person can sound abrupt and insensitive. This characteristic goes along with impulsivity. Rather than Feel, Stop, Think, and then Act, the person is reduced to Feel, then Act. Family members need to understand and forgive.

Aphasia refers to the loss of ability to find the right word, or to have the word in the mind but not be able to say it. Years ago, I experienced this when I got soroche, or altitude sickness, in Bolivia. I knew what I wanted to say, but only nonsense came out my mouth. I was young at the time. Now I’m not, but I increasingly know the frustration of not being able to bring the right word to mind in a conversation. This may not be a full-blown case of aphasia, but it seems to be a common part of aging. How would that affect forgiveness?

Loss of executive functioning, of being able to think clearly, solve problems, or “put it all together,” also makes it difficult to seek or give forgiveness.

Other characteristics include putting on a social façade because the person doesn’t quite understand what’s going on, so chooses to pretend. Or he chooses withdrawal into silence. Both indicate a separation from the surrounding reality. A person who can’t respond can’t forgive or receive forgiveness.

And then there’s the need of the caregiver of the elderly. Compassion fatigue may make it hard to keep on an even emotional level. Patience and continual forgiveness can get difficult, especially if behavior triggers past hurts and emotions. That’s why it isn’t always a good idea for family members to be the caretakers.

As I read all this back, it seems so dark and negative, like a worse-cast-scenario. I think these characteristics describe tendencies some of which we’re all beginning to exhibit, but that they refer more to people at the end of life. The very old.  And not all of the very old exhibit all these characteristics. I think of friends and family members who lived into their eighties and nineties (and even beyond) who, while forgetful and a little distanced from reality, managed to keep the same sweet disposition they carried all their lives.

One thing the study highlights for me is the need to keep up-to-date on forgiving and asking for forgiveness—while we still have our wits about us. We may need to forgive people who have harmed us in the past, pardoning in our hearts if a face-to-face encounter is not possible. Or we may need to ask someone to forgive us. Now may be the right time.

I think of a very short poem by Canadian poet Suzanne Buffam:

On Forgiveness

It is best to forgive all sins in advance
Because afterward can be hard.

In this case in advance means “before we get too old.”

Even with the difficult connections between growing older and forgiveness, we do have the presence of the Holy Spirit who lives within us and changes seeming impossibilities into realities. And a God who understands us and loves us as much when we’re old as he ever did.

Pat ended the class with a wonderful teaching from the Apostol Paul:

“Therefore we do not lose heart. Though outwardly we are wasting away, yet inwardly we are being renewed day by day. For our light and momentary troubles are achieving for us an eternal glory that far outweighs them all. So we fix our eyes not on what is seen, but on what is unseen. For what is seen is temporary, but what is unseen is eternal.” 2 Corinthians 4:16-18