Creativity and Aging

Gene Cohen

"Creativity and Aging" was first presented as a keynote address at the Grantmakers in Health 2000 Annual Meeting on Health Philanthropy. Although it comes from another field, Cohen's talk is rich with references to artists and writers. It is published here with permission from both Grantmakers in Health and Gene Cohen, M.D., Ph.D.

We are at a new turning point in the field of aging. The past twenty-five years have witnessed two major conceptual shifts that have fundamentally influenced the course of research, practice, and policy deliberations.

The first occurred in the mid-1970s when the major federal research programs on aging were launched. In many ways, research into aging became a phenomenon only since this time. Many of the negative aspects of aging came to be seen as problems with aging itself rather than with the aging people.

The second major shift, which is just beginning now, is the idea that there is great potential in later life. On this point, individuals, communities, and policymakers are far from up-to-speed. Until one fully understands the potential of later life, individual motivation to plan for the future will be stifled, creative community program planning will be inhibited, enlightened social policies will be stymied. So the challenge now, in addition to dealing with the problems, is to look at what is truly possible in aging.

When I headed the National Institute on Aging, I had the wonderful opportunity to interview the comedian George Burns who was ninety-seven years old at the time. I was there to present him a certificate acknowledging his positive contributions to images of aging, when he staged a joke on me. To fully appreciate the context of the joke, you have to understand the timing of the meeting. It was during the height of the Surgeon General's campaign against smoking, and I was there as a public health official from the federal government. So as I'm presenting him the certificate, he hands me this illegal Cuban cigar. At which point I said, "Not to worry, I don't inhale." And he said that he didn't either...and the more he thought about it, he was going to run for president.

He went on to explain how he was adapting to his own advanced age. He said he had begun to ask for his applause in advance, “just in case.” And he no longer purchased green bananas. I asked him, “What does your doctor say about your smoking and your drinking?” He said, “My doctor is dead.”

That meeting with him best captures the changing face of aging in the late twentieth, now twenty-first, century. Burns' agent was, understandably, very protective of him. But what I did not realize until I got there was that the agent himself was eighty-five years old. And the joke writer was in his seventies. The only young person was the car driver. They offer a remarkable picture of the changing face of aging in contemporary society.

Examining potential and looking at creativity in later life is critically important, not only from a quality of life standpoint but from a health perspective. Some of the latest research looks at the productivity of older people and finds that people who are socially connected and involved in some productive activity not only get important payback in terms of general life satisfaction, but also in terms of health. They have better health, less illness, and improved response to procedures like bypass surgery. And, of course, there is a broader opportunity here in terms of their potential contributions to family and society.

Franklin Delano Roosevelt pointed out that no society, however rich, can afford to waste its human resources. He could have easily made that statement about our older human resources.

Defining Creativity in Aging

In understanding creativity in aging, the definition that I use is deceptively simple. It is bringing something into existence that is valued.

Building on Howard Gardener's concepts, two aspects of creativity are important to appreciate. One is to look at creativity with a capital “C,” which is the typical way we look at it, the type of creativity that can influence the course of a community or culture. But equally important is creativity with a little “c,” the creative acts that can change the course for individuals or their families, and bring something new into existence in terms of how they deal with their jobs, a hobby, a new career, interpersonal relationships, family life, and community and volunteer work. These are ripe opportunities for creativity with a little “c.”

Also building on Gardener's ideas of multiple intelligences is the importance of looking at diverse forms of creativity, not just in the artistic realm, but also in the social realm. Across the history of civilization, older people have been keepers of the culture, and have shown remarkable social creativity. We see this in many roles today — older university professors, judges, and diplomats — where age and the accumulation of wisdom, emotion, and intelligence is important.

The Biological Basis of Creativity

The whole focus on creativity in later life is not just anecdotal. Indeed, the capacity for ongoing learning and creative potential in later life has a neurological foundation.

Picture two neurons, nerve cells of higher intellectual functioning in the brain. Humans have more than fifteen million neurons that are involved in memory and intellectual function. Communication among these cells relies on two fundamental factors: one, the cells' anatomy or their architecture of extensions known as dendrites (analogous to limbs on trees), and, two, the release of neurotransmitters, or chemicals, that move from one nerve cell to the other.

A remarkable set of studies, done initially by Marian Diamond and colleagues, looked at the impact of an enriched and challenging environment on the anatomy and physiology of the brain. What the researchers found startled the scientific community. They found that animals exposed to a challenging environment sprouted considerably more dendrites than those in a control group that were not exposed to the same challenges. The cells were like trees sprouting new branches. A single nerve cell can sprout hundreds or even thousands of these dendrites.

Picture these cells and their extensions like trees with limbs, and then picture the neurotransmitters like squirrels. Trees with more branches make it easier for squirrels to jump from one to another. In effect, cells that sprouted more dendrites made it easier for neurotransmitters to move from one cell to another. What the researchers also discovered was that the cells produced more of the transmitter acetylcholine, which is the neurotransmitter involved with memory and intellectual functioning. This is the neurotransmitter that is at deficit levels in Alzheimer's disease.

So here, in response only to environmental challenge, nothing physical, nothing pharmacologic, the anatomy of the animals changed dramatically. Their brain-cell bodies actually increased. In these animals, brain weight itself increased, as did the production of the neurotransmitter.

Even more exciting and relevant to this discussion is that all of these changes, all of them, continued independently of age. Older animals showed the same responses as younger ones. Subsequent research found that dendrites grew to their greatest length in humans from their early fifties to their late seventies. These changes turned upside-down our understanding of the brain's capacity to respond to challenge and of its ability to be modified. The findings set the stage for our biological understanding of the capacity for ongoing learning and, indeed, of the capacity for creativity regardless of age.

The Role of Education

Another major confounder has been at play in our understanding of creativity in aging. In the late 1960s and early 1970s in our culture, images of aging were probably at their lowest. This was when you often heard the phrase, “You can't trust anybody over thirty.” People talked about the “generation gap” and the “age gap.” But what was missed was the more fundamental explanation of what was going on: this was not an age gap but an education gap.

The late 1960s was the beginning of the space age. Sputnik had been launched and a revolution in education was going on that affected the young first. In 1970, the median years of education for persons beyond the age of sixty-five was only 8.7 years, less than a high school education. Twenty years later, in 1989, the group of those over sixty-five had a median education above a high school education. And one of the most rapidly growing groups of college graduates and graduate students was the fifty and older age group. In that twenty-year period, the sociologic literature shows an unparalleled increase in positive, constructive intergenerational relationships.

Stages in Later Life

Although we are witnessing some profound changes in our understanding of aging from biological and educational perspectives, we have not fully understood basic psychological development in later life. Here theory has been thin. In his theory of life-cycle stages, Eric Ericson had only one stage in later life.

In The Creative Age, I introduce another stage theory based on thirty years of research. I describe four stages. The lines separating them are not absolutely rigid — there is some overlap — but generally the stages follow chronologically.

  1. Reevaluation Phase
    First is the mid-life reevaluation phase that goes on throughout one's forties and fifties. In both genders, once people enter their forties they begin to think about how much time is left, instead of how much time has gone by. Children are always measuring their situation from birth. And, then, all of a sudden a profound psychological change occurs, and one begins to think: Where have I been? Where am I? Where am I going?

    In some, this triggers a mid-life crisis. But in a much larger group, it triggers constructive mid-life reevaluation, sort of like Odysseus or Ulysses. In his mid-forties, for example, Alex Haley began a twelve-year quest through Africa and ended up writing Roots.

  2. Liberation Phase
    The reevaluation stage is followed by what I describe as the liberation phase. Contrary to stereotypes about aging, many people, when they reach their sixties, know who they are. They know that if they make a mistake, it is not going to undo the view others have of them. More importantly, they know it is not going to undo the view they have of themselves. So they often feel free to do something that they have never done before. It is sort of an “If not now, when?” phenomenon.

    Building on my earlier points about creativity in the social realm, let me illustrate this with a contemporary example. Think of the Mideast Peace Agreement. It astounded everyone that these lifelong archenemies from Israel and Palestine could get together. Not just the countries, but the people. How could this happen?

    Well, I feel that one of the key dynamics was the phenomenon of social creativity in the liberation phase. All the major players were in their mid-sixties and early seventies. For the Israelis, Itzhak Rabin and Shimon Peres were in their early seventies. Arafat was approaching sixty-five. Being in the liberation phase, their age gave them courage to finally do the right thing: If not now, when? We have a whole history of social creativity, of older people as keepers of a culture — if they do not do it now, they could lose their culture, they would be in jeopardy. It is a powerful dynamic.

  3. Summing-up Phase
    As people get into their seventies and early eighties or beyond, the liberation phase is followed by a summing-up phase. We see a tremendous increase in storytelling and autobiography across all fields. In the process of looking back and summing up, many people think about what they have gained in life, and they give it back not only in storytelling but through volunteerism and philanthropy. They deal with unfinished business.

    I always try to test my theories. I once attended a talk on opera and the speaker was noting the fact that Verdi had composed Falstaff at age eighty. I rose from the audience and said “That is remarkable. Why do you think Verdi, at eighty, wrote Falstaff as opposed to something else?” The lecturer, like a psychiatrist, turned the question back to me and asked what I thought. I had just developed my theory about the summing-up phase and what's left undone. So I said, here is Verdi in his eighties. He is at the top of his field. He is looking back and thinking, what is unfinished? He realizes there is one thing that he has never really done right — comic opera. When he was in his twenties, he composed his only comic opera and it was a terrible flop. If I were Verdi at age eighty, I would want to set that picture straight. And sure enough, he composed Falstaff, a comic opera. Then, if I were Verdi, I would want to stage the opera in the same theater where the original opera flopped, if it still existed. The lecturer did not know the answer, but she had reference books with her and looked it up. It was the same theater — La Scala.

  4. Encore Phase
    Then comes the encore phase. People used to describe this as the “swan song.” This always bothered me for two reasons — there is a certain sadness about “swan song,” and it implies a single event. Instead I describe the stage as “encore,” which is more uplifting and allows for more than one. George Abbott, the playwright, gives us an illustration of the encore stage. It was remarkable enough that he wrote Damn Yankees when he was sixty-eight. But, as an encore, he revised it when he was 107.

The Dynamics of Aging

  1. Creative vision and risk-taking
    Despite our new knowledge of aging, we still have a proliferation or legacy of negative stereotypes and negative images. And they are often combined together. Two images of aging that are often heard together are the inevitability of a decline in creative vision and the disappearance of risk-taking — people become conservative, restrictive, and cautious.

    Let us look at creative vision and risk-taking in the Renaissance portrait painter, Titian. Consider first his remarkable painting, Man with a Glove, painted when he was thirty-nine years old. It is a great portrait. Many things can be said about the beauty, the power, the poignancy of the painting. But for purposes of our discussion, I'd like you to focus on how well-defined it is along the edges.

    Now let us double Titian's age and consider what he was doing when he was seventy-eight. A self-portrait that he did then is considered by art historians to be an equally great work of art, but a little controversial in the eyes of some who say that the self-portrait is a little less defined, a little more amorphous along the edges than Man with a Glove. But, then, people say, he was seventy-years old and you have to factor that in.

    Let us push this a little further and see what Titian was doing five years later with his famous painting of The Rape of Lucretia, the event that brought down the Roman Empire. This is a great painting, but quite controversial in the eyes of sixteenth century critics, who said this just is not a typical Titian portrait — it is very amorphous. But, then, they said, he is eighty-three-years old.

    Now before reaching a conclusion in any field, you should have a control group. Here, remarkably, Titian provided his own control. He did a second painting of Tarkin and Lucretia at the same age, eighty-three. Now I researched this very carefully. The difference in the form of the two paintings was not a matter of the master doing a sketch and having students complete the work. Titian did both of these paintings. In terms of how well-defined they are, one is indistinguishable from Man with a Glove; he showed he could still paint in the same style. Response to the other, “amorphous” one illustrates that if an older person does something that is not understood, there often is a rush to judgment — “Well, he is getting older, he is kind of losing it, his marbles are rolling out.”

    So how then can we explain the differences in the two paintings? Put yourself in the shoes of the greatest portrait painter of the Renaissance. Anybody who could afford a painting by Titian wanted the kind of painting that made him famous. But it was as if Titian, in his ninth decade, said, “I want to do something that I want to do. I want to explore new territory.” With this understanding, you can look at the painting and, rather than call it amorphous, you can say that it shows great creative vision, great risk-taking, and boldly anticipates by three centuries impressionist art of the nineteenth century.

    Some may ask, aren't artists like Titian and Picasso exceptions rather than the rule? Isn't this a bit of Ripley's Believe It or Not? This is a fair question. My own views and research on the subject were profoundly affected by a show that I saw in 1980 at the Corcoran Gallery of Art in Washington D.C. The show was a formal study of American folk art from 1930 to 1980. The show's curator and art historian were struck by the fact that almost half of the outstanding work done during that period was by minorities, particularly by African Americans, many of whom lived along the Mississippi-Alabama corridor.

    I went to the show not only with the eyes of somebody who appreciates art, but with those of a gerontologist. And I saw something the curator and historian had not described. The show included twenty outstanding black artists from the fifty-year period, many of whom had died. But what had been missed, and what struck me, was that sixteen of them, or 80 percent, were over the age of sixty-five when they either first began their work or reached their mature phase. Thirty percent were older than eighty when they began their work or reached their mature phase.

    After the show, I did my own in-depth study of folk art and I found that this pattern continued independently of racial and ethnic diversity. It is a field dominated by older artists. When a field is dominated by older persons, you can no longer trivialize interesting examples as outliers or exceptions rather than the rule. It says something inherently profound about the basic underlying potential for creative production in later years. Folk artists are particularly interesting because they seem to close the gap between the Picassos and everyday people, and this brings the point home even more strongly.

    Take, for example, Bill Traylor, who did his first work when he was eighty-five-years old. Traylor had been a slave and, after emancipation, continued to live on the plantation where he worked. He had a large family and wanted to stay until all his children reached maturity and independence, which finally happened. Then his wife died and he was the only person in his family left there. He was eighty-four-years old, and he felt he no longer had a reason to stay. So he moved to Montgomery, Alabama and got a job in a shoe factory. He was let go after a year when he developed arthritis and could no longer do the work demanded of him. Basically, he became a street person and tried all kinds of things to survive. One of these was to make drawings, which he began to hang on clotheslines. Almost overnight he was recognized as an extraordinary artistic talent. Within a year his work was being shown regionally and then nationally.

  2. Finally, enough time
    The liberation phase often intersects with retirement, which for many people acts like a patron. It gives them time to focus on activities other than having to meet ends. The external freedom and the internal freedom — a liberation — create a powerful partnership.

    Somerset Maugham was not only a gifted writer, he was also a medical school graduate. In looking at older persons, he brought to bear the intuitive insights of a gifted writer with the trained observations of a health professional. In his sixties he wrote Summing Up, which included this observation: “When I was young I was amused at Plutarch's statement that the elder Cato, who was a Roman statesman, began at the age of eighty to learn Greek. I am amazed no longer. Old age is ready to undertake tasks that youth shirked because they would take too long.”

    Shortly after I read Summing Up, I interviewed a woman who was eighty-one years old who had just graduated from high school. She said she finally had the time and the opportunity to get involved with her lifelong passion. She had had a large family and spent her earlier adulthood raising them. Three of her children had problems — two had severe health problems and one, marital problems. Finally she turned eighty, things settled down, and she was able to turn to her passion of reading historical and biographical novels, those huge 1,000-page books. She had read eighteen of them over the previous seven months. She finally had enough time.

    Psychoanalysts have weighed in on this as well. Psychoanalytic research finds that — contrary to stereotypes — older persons are more in touch with their dynamic psychological inner life than their younger counterparts are. Being able to draw upon one's inner life is a tremendous asset for an artist or any creative person.

    Another artist in the Corcoran show, William Edmundson, was a janitor in the 1930s and worked in a women's hospital in Nashville, Tennessee. The 1930s was the period of the Great Depression and hospitals were in great trouble, as many are today. The hospital folded and Edmundson was out of work. As he later described to a reporter, after losing his job he had the inspiration to carve. A photographer, captivated by these new carvings, sent a portfolio of Edmundson's work to the Museum of Modern Art (MOMA) in New York. And in 1937, at the age of sixty-seven, Edmundson's work became the first solo exhibition by a black artist in the history of the MOMA.

  3. Adding after taking away
    Another dynamic among older artists is captured in the late-life work and poetry of Carlos Williams. Most people know Carlos Williams as a poet, but he was also a physician. He was still practicing pediatrics in his sixties when he suffered a stroke. Those of us in the health field know that patients who have a stroke typically suffer damage in multiple domains: cognitive, physical, and emotional functioning. Fortunately, Carlos Williams did not have significant cognitive changes. He did have major motor and muscle changes, to the extent that he could no longer continue the practice of medicine. As for emotional changes, he developed severe depression, to the point that he was hospitalized for a year at the age of sixty-nine. However, he came out of it and began a new phase of poetry that culminated ten years later, at the age of seventy-nine, with the publication of Pictures from Brueghel which was awarded a Pulitzer Prize.

    In his late-life poetry, Carlos Williams wrote about an old age that adds as it takes away. There is nothing romantic about loss. But when loss occurs, it is part of the human condition to want to transcend it in some way. Later life contains much more loss than younger years, so you see many examples of older people dealing with loss and trying to transcend it — Bill Traylor with his arthritis, William Edmundson in losing his job, Carlos Williams with his stroke.

These examples also point out that a loss does not mean a life is over. Instead, for many people, the loss just moves them in an entirely new direction. Henri Matisse, in his early eighties, suffered from multisystems disease — cardiovascular disease, pulmonary disease, and gastrointestinal disease. They sapped his energy. He could no longer paint the way that he had before. This was not enough for him, so he moved in a new direction and launched his work with cutouts, which art historians describe as closing the gap between color and form. Matisse's shift shows the tremendous power, strength, and reserve of the human condition, independent of age and in the midst of many limitations.

New Metaphors

We need new metaphors about aging. We often hear about “the autumn of your life,” “the winter of your years,” the trees becoming barren, the sky clouding up. In her mid-seventies, Georgia O'Keefe had reached great fame as a painter. Throughout her life, she had several fears and one of them was a fear of flying. As her work came under greater demand, she was forced to fly more and more. One day, looking out the window of the airplane, she realized she no longer feared flying. She felt a tremendous exhilaration and launched a whole new body of work, entitled — and I give her full credit for the double entendre — Sky above Clouds.

The series was huge in number, almost one hundred pieces. For me, this work captures the changing face of aging. Rather than looking just at clouds, she saw blue sky above the clouds. Transcending the negative stereotypes, O'Keefe gives us a much more accurate picture of aging today in the twenty-first century.