How to address ego integrity versus despair?

From the Guidelines

To address ego integrity versus despair, focus on life review and meaning-making activities that help integrate past experiences into a coherent narrative, as this approach has been shown to promote well-being and resilience in older adults 1.

Key Strategies

• Engage in reminiscence therapy by reflecting on accomplishments and accepting life choices, while sharing personal stories with loved ones or through journaling.
• Maintain social connections by participating in community activities, volunteering, or joining groups with shared interests to combat isolation.
• Pursue continued personal growth through learning new skills, mentoring others, or engaging in creative pursuits that provide purpose.
• Practice acceptance of life's limitations while celebrating achievements, and consider spiritual or philosophical exploration to find deeper meaning.

Evidence-Based Interventions

• Cognitive behavioral therapy (CBT) has been found to reduce suicidal ideation and behavior by more than 50% among a heterogeneous population including patients who had recently attempted suicide 1.
• Dialectical behavior therapy (DBT) has been shown to reduce nonsuicidal and suicidal self-directed violence among patients with borderline personality disorder and recent self-directed violence 1.
• Crisis response planning has been found to be effective in reducing suicide attempts and ideation, and involves a collaborative approach between patient and clinician to identify clear signs of crisis and develop a plan for managing them 1.

Regular Practice

Regular practice of these activities, ideally for 30-60 minutes several times weekly, can significantly improve one's sense of life satisfaction and reduce existential distress 1.

Additional Considerations

Other approaches, such as problem-solving therapy and Window to Hope, have also been found to be helpful for patients at risk for suicide, and may be considered as part of a comprehensive treatment plan 1.

From the Research

Ego Integrity vs Despair: Understanding the Concepts

• Ego integrity and despair are two concepts introduced by Erik Erikson, which represent the eighth and final stage of his theory of psychosocial development 2, 3, 4, 5.
• Ego integrity refers to the feeling of completeness and wholeness that comes from having lived a fulfilling life, while despair refers to the feeling of regret and disappointment that comes from not having achieved one's goals or having made mistakes in the past 2, 4.

Factors Influencing Ego Integrity and Despair

• Research has shown that personality traits such as extraversion and openness to experience are positively related to ego integrity, while neuroticism is positively related to despair 2.
• Additionally, factors such as well-being, need satisfaction, and sense of coherence (SOC) have been found to play a role in the development of ego integrity and the prevention of despair 3, 4.
• The COVID-19 pandemic has also been found to have an impact on older adults' well-being, with those who have higher levels of ego integrity and need satisfaction being more resilient to the challenges associated with the pandemic 3.

Addressing Ego Integrity vs Despair

• Cognitive-behavioral therapy (CBT) and psychodynamic psychotherapy have been found to be effective in addressing mental health issues related to ego integrity and despair 6.
• These therapies can help individuals to reframe their thoughts and behaviors, and to develop a more positive and realistic view of themselves and their lives 6.
• Additionally, promoting a sense of purpose and meaning, and encouraging individuals to engage in activities that bring them joy and fulfillment, can also help to promote ego integrity and prevent despair 4, 5.

Developmental Tasks and Ego Integrity

• Research has shown that the outcome of the Eriksonian crisis of integrity vs. despair is dependent on successful coping with four developmental tasks: maintenance of active involvement, reevaluation of life satisfaction, developing a sense of health maintenance, and reevaluation of the sense of coherence (SOC) 4.
• The generativity stage has been found to be the most relevant stage to ego integrity, and adulthood has been found to possess a higher influence on the elderly stage 5.