A “life review” is where people systematically reflect on their past, through conversations or in writing, to identify character strengths and develop self-awareness and acceptance. Photo / Sonia Pulido, The New York Times
Reflecting on the past, through writing or conversation, can help us better appreciate where we are - and where we’re going.
Jodi Wellman was devastated when her mother died of a heart attack at the age of 58. Cleaning out her apartment made her feel even worse. Drawers and closets overflowed with abandoned projects: unpublished manuscripts and business cards for ventures that had never started.
“My mum was a wake-up call for me,” Wellman said. “She had these dreams that she didn’t act on.”
At the time, Wellman was in her early 30s, living in Chicago and working her way up the corporate rungs at a fitness club chain. But, over the course of five years, that work began to feel empty.
Determined not to stagnate like her mother, Wellman quit her job to become an executive coach, eventually entering a master’s degree programme in positive psychology. There, she developed a strategy for living fully: think about death, a lot.
Now also a speaker and the author of You Only Die Once, Wellman, 48, believes focusing on how short life is makes you less likely to squander it. To help her clients figure out how to spend their limited time, she asks them dozens of questions, organised by life phase – things such as what activities made them happiest as a child, and what they would change about their 40s and 50s.
Her approach is a twist on something called “life review”, where people systematically reflect on their past, through conversations or in writing, to identify character strengths and develop self-awareness and acceptance. The process can occur both with a partner or in small groups, and it typically unfolds in six to 10 weekly sessions.
Life review arose in the 1960s to help people at the end of their lives articulate and make peace with their legacies. But new research suggests the process of reflecting on previous experiences has value for people at all ages, including young adults and bereaved children. Actress and activist Jane Fonda, now 86, spent the year before turning 60 conducting a life review that she said helped her recognise patterns and cultivate confidence.
“It’s not only looking back,” said Gerben Westerhof, department chairman in psychology, health and technology at the University of Twente in the Netherlands, “but also looking forward at who you are. What could be the next chapter of your life?”
In the 1950s, Erik Erikson, an influential child psychoanalyst, published his theory that each stage of life is associated with a specific psychic challenge. The work of toddlerhood, for example, is to gain autonomy. The goal of young adulthood is to develop intimacy with others. Old age, he posited, is the time to gather one’s life experiences into a coherent narrative - what Erikson called integration. Those who fail, he wrote, risk falling into despair.
Dr Robert Butler, the first director of the National Institute on Ageing, built on Erikson’s concept. For older people who get stuck on regrets or disappointments, Butler proposed something called life review therapy.
Life review has since been studied in many contexts, such as in people diagnosed with cancer or facing terminal illness, as well as with older people in adult day care facilities or nursing homes. And research suggests the process has many potential benefits, such as reducing depression and anxiety and increasing life satisfaction.
“As people get older and they retire, they lose a sense of purpose sometimes,” said Juliette Shellman, an associate professor at the University of Connecticut School of Nursing. Life review, she explained, can give people “the opportunity to sit back and look at their accomplishments”.
A traditional life review unfolds through one-on-one or group conversations with a therapist or facilitator who helps people explore their childhood, their teenage years and later life stages. The facilitator asks questions designed to prompt reflection, such as “Do you remember your first attraction to another person?” and “What pieces of wisdom would you like to hand down to the next generation?”
The facilitator’s role is to build trust, offer interest and try to reframe difficult passages in a more positive light, said Shellman, who also serves as director of the International Center for Life Story Innovations and Practice. For example, a facilitator might help someone who experienced the death of a child explore the positive memories amid the tragedy.
The process begins by listening “in an appreciative way”, Westerhof wrote in an email. “Next we make offers for alternative views,” he explained, but the life reviewer has to determine whether those views are appropriate.
One of the most popular forms of life review is guided autobiography, whereby weekly sessions are organised thematically rather than chronologically - things such as family, money, work, health. Each week, the facilitator preps participants for the following week’s theme with questions such as “How did you get into your major life’s work?” or “Do you regard yourself as generous or stingy?” Participants pen brief autobiographical vignettes between sessions and read them aloud to one another.
Writing your story and having people hear it can be powerful, said Cheryl Svensson, director of the Birren Center for Autobiographical Studies. Some guided autobiography groups continue meeting on their own for years.
Although life review has been studied mostly in older people, there’s evidence this kind of intervention can benefit people at any age. In a 2022 study from Australia, 18 to 29-year-old people participated in group sessions where they shared two important memories and were coached by the facilitator to add more detail and connect with what they were feeling at the time. Follow-up assessments showed that recalling these positive memories in detail increased self-esteem, optimism and a sense of meaning in life.
Westerhof and a colleague recently completed a small study, as yet unpublished, in which adults aged 19 to 73 who were dealing with divorce, sudden illness, a new job or a break-up found relief from anxiety and depression after participating in a self-guided form of life review.
“Life transitions tend to put everything upside-down,” Westerhof wrote in an email. “The things that were important before are perhaps not that important anymore. Life review helps people accept changes and also to search for new commitments.”
You can work with a professional. The Birren Center for Autobiographical Studies has certified hundreds of guided autobiography instructors, who run in-person and remote classes. Instructors typically charge up to US$250 for a five to eight-week programme that involves weekly writing assignments, although prior writing experience isn’t necessary.
For a classic life review that unfolds as a conversation, the International Centre for Life Story Innovations and Practice at the University of Connecticut can recommend a trained therapeutic listener.
For a classic life review, Shellman suggested reading The Handbook of Structured Life Review by Barbara K. Haight and Barrett Haight, which explains how to be a therapeutic listener and provides questions for each life stage.
Writing Your Legacy by Svensson and Richard Campbell explores how to pursue a guided autobiography on your own and includes dozens of additional themes, including life values, food and drink, passions, friendships and cultural heritage.
Try including pictures or props. Keepsakes, photos or even poems can help spark recollections, said Bonnie Kellen, a New York City-based psychologist and life review therapist. And listening to music associated with an earlier time or returning to a location from your past can help, Shellman said.
Look out for difficult emotions. Deena Hitzke, a psychotherapist from Tucson, Arizona, uses life review to help people recover from trauma. She finds the format useful because so much of our ability to adapt and grow “depends upon the narrative that we’re telling ourselves about who we are,” she said. But not all life review facilitators have clinical training. If you find the process is stirring up difficult emotions, Shellman suggests consulting your doctor or nurse practitioner.
This article originally appeared in the New York Times.
Written by: Emily Laber-Warren.
Photographs by: Sonia Pulido.
©2024 THE NEW YORK TIMES
The average age of patients in the study was just 38, highlighting risks for younger adults.