# 37 - 32 Adulthood

# 01 - 32 Adulthood

# 32 Adulthood

32

Adulthood
For most of the history of developmental psychology, the predominant theory held that
development ended with childhood and adolescence. Adults were considered to be
finished products in whom the ultimate developmental states had been reached. Beyond
adolescence, the developmental point of view was relevant only insofar as success or
failure to reach adult levels or to maintain them determined the maturity or immaturity
of the adult personality.
In contradistinction were the long-recognized ideas that adult experiences, such as
pregnancy, marriage, parenthood, and aging, had an obvious and significant impact on
mental processes and experience in the adult years. This view of adulthood suggests that
the patient, of any age, is still in the process of ongoing development, as opposed to
merely being in possession of a past that influences mental processes and is the primary
determinant of current behavior. Although the debate continues, the idea that
development continues throughout life is increasingly accepted.
Development in adulthood, as in childhood, is always the result of the interaction
among body, mind, and environment, never exclusively the result of any one of the
three variables. Most adults are forced to confront and adapt to similar circumstances:
establishing an independent identity, forming a marriage or other partnership, raising
children, building and maintaining careers, and accepting the disability and death of
one’s parents.
In modern Western societies, adulthood is the longest phase of human life. Although
the exact age of consent varies from person to person, adulthood can be divided into
three main parts: young or early adulthood (ages 20 to 40), middle adulthood (ages 40
to 65), and late adulthood or old age.
YOUNG ADULTHOOD (20 TO 40 YEARS OF AGE)
Usually considered to begin at the end of adolescence (about age 20) and to end at age
40, early adulthood is characterized by peaking biological development, the assumption
of major social roles, and the evolution of an adult self and life structure. The successful
passage into adulthood depends on satisfactory resolution of childhood and adolescent
crises.
During late adolescence, young persons generally leave home and begin to function
independently. Sexual relationships become serious, and the quest for intimacy begins.
The 20s are spent, for the most part, exploring options for occupation and marriage or
alternative relationships and making commitments in various areas.
Early adulthood requires choosing new roles (e.g., husband, father) and establishing
an identity congruent with those new roles. It involves asking and answering the

questions “Who am I?” and “Where am I going?” The choices made during this time may
be tentative; young adults may make several false starts.
Transition from Adolescence to Young Adulthood
The transition from adolescence to young adulthood is characterized by real and
intrapsychic separation from the family of origin and the engagement of new, phasespecific tasks (Table 32-1). It involves many important events, such as graduating from
high school, starting a job or entering college, and living independently. During these
years, the individual resolves the issue of childhood dependency sufficiently to establish
self-reliance and begins to formulate new, young-adult goals that eventually result in
creation of new life structures that promote stability and continuity.
Table 32-1
Development Tasks of Young Adulthood
Developmental Tasks
Establishing a self that is separate from parents is a major task of young adulthood. For
most individuals, the emotional detachment from parents that takes place in
adolescence and young adulthood is followed by a new inner definition of themselves as
comfortably alone and competent, able to care for themselves in the real world. This
shift away from the parents continues long after marriage, and parenthood results in
the formation of new relationships that replace the progenitors as the most important
individuals in the young adult’s life.
Psychological separation from the parents is followed by synthesis of mental
representations from the childhood past and the young-adult present. The psychological
separation from parents in adolescence has been called the second individuation, and the
continued elaboration of these themes in young adulthood has been called the third
individuation. The continuous process of elaboration of self and differentiation from
others that occurs in the developmental phases of young (20 to 40 years of age) and
middle (40 to 65 years of age) adulthood is influenced by all important adult
relationships.
A number of different models have been proposed for understanding adult
development. They are all theoretical and somewhat idealized. They all use metaphors
to describe complex social, psychological, and interpersonal interactions. The models

are heuristic: They provide a conceptual framework for thinking about common
important experiences. They are descriptive rather than prescriptive; that is, they
provide a useful way of looking at what many persons do, not a formula for what all
persons should do. Some of the terms and concepts commonly used are explained in
Table 32-2. These periods involve individuation, that is, leaving the family of origin and
becoming one’s own man or woman, passing through midlife, and preparing in middle
adulthood for the transition into late adulthood.
Table 32-2
Psychological Development Concepts
Work Identity.
 The transition from learning and play to work may be gradual or
abrupt. Socioeconomic group, gender, and race affect the pursuit and development of
particular occupational choices. Blue-collar workers generally enter the workforce
directly after high school; white-collar workers and professionals usually enter the
workforce after college or professional school. Depending on choice of career and
opportunity, work may become a source of ongoing frustration or an activity that
enhances self-esteem. Symptoms of job dissatisfaction are a high rate of job changes,
absenteeism, mistakes at work, accident proneness, and even sabotage.
UNEMPLOYMENT. The effects of unemployment transcend those of loss of income; the
psychological and physical tolls are enormous. The incidence of alcohol dependence,
homicide, violence, suicide, and mental illness rises with unemployment. One’s core
identity, which is often tied to occupation and work, is seriously damaged when a job is
lost, whether through firing, attrition, or early or sometimes even regular retirement.
A young adult female patient had greatly enjoyed her 5 years in college and only
reluctantly accepted a job with a large real estate firm. During college, she had had
limited interest in her appearance, and she began work in clothing borrowed from
family and friends. She scoffed when her boss began to criticize her dress and gave her
an advance to buy an upscale wardrobe, but she then began to enjoy the fine clothing
and the respect engendered by her appearance and position. As her income began to

rise, work became a source of pleasure and self-esteem and the way to acquire some
of the trappings of adulthood. (Courtesy of Calvin Colarusso, M.D.)
Developing Adult Friendships.
 In late adolescence and young adulthood, before
marriage and parenthood, friendships are often the primary source of emotional
sustenance. Roommates, apartment mates, sorority sisters, and fraternity brothers, as
indicated by the names used to describe them, are substitutes for parents and siblings,
temporary stand-ins until more permanent replacements are found.
The emotional needs for closeness and confidentiality are largely met by friendships.
All major developmental issues are discussed with friends, particularly those in similar
circumstances. As marriages occur and children are born, the central emotional
importance of friendships diminishes. Some friendships are abandoned at this point,
because the spouse objects to the friend, recognizing at some level that they are
competitors. Gradually, there is movement toward a new form of friendship, couples
friendships. They reflect the newly committed status but are more difficult to form and
to maintain, because four individuals must be compatible, not just two.
As children begin to move out of the family into the community, parents follow.
Dance classes and Little League games provide the progenitors with a new focus and the
opportunity to make friends with others who are at the same point developmentally and
who are receptive to the formation of relationships that help explain, and cushion, the
pressures of young adult life.
Sexuality and Marriage.
 The developmental shift from sexual experimentation to
the desire for intimacy is experienced in young adulthood as an intense loneliness,
resulting from the awareness of an absence of committed love similar to that
experienced in childhood with their parents. Brief sexual encounters in short-lived
relationships no longer significantly boost self-esteem. Increasingly, the desire is for
emotional involvement in a sexual context. The young adult who fails to develop the
capacity for intimate relationships runs the risk of living in isolation and self-absorption
in midlife.
For most individuals in Western culture, the experience of intimacy increases the
desire for marriage. Most persons in the United States marry for the first time in their
mid- to late 20s. The median age of first marriage has been rising steadily since 1950 for
both men and women, and the number of persons who never marry has been increasing.
Today, approximately 50 percent of all adults ages 18 and older are not married,
compared with only 28 percent in 1960. The proportion of 30- to 34-year-olds who
never married has almost tripled, and the proportion of never-married 35- to 39-yearolds doubled.
INTERRACIAL MARRIAGE. Mixed-race marriages were banned in 19 states until a U.S.
Supreme Court decision in 1967. In 1970, such marriages accounted for only 2 percent
of all marriages. The trend has been steadily upward. Currently, interracial marriages

account for about 1.5 million marriages in the United States.
Despite the trend toward more interracial marriages, they still remain a small
proportion of all marriages. Most persons are more likely to marry someone from the
same racial and ethnic background. Marriages between Hispanic whites and nonHispanic whites and between Asians and whites are more common than those between
blacks and whites.
SAME-SEX MARRIAGE. Same-sex marriage is recognized as legal by many states in the
United States and by the U.S. Supreme Court, as well as in several countries around the
world (e.g., France and Denmark). It differs from same-sex civil unions granted by
states, which do not provide the same federal protection or benefits as marriage. No
reliable estimates are available for the number of same-sex marriages in the United
States; however, in 2013 it was estimated to be about 80,000. There is growing
consensus in the United States and around the world that homosexual persons should be
allowed the same marital rights and privileges as heterosexuals. Same-sex marriage can
be subject to more stress than heterosexual marriage because of continued prejudice
toward such unions among certain conservative political or religious groups who oppose
such unions.
MARITAL PROBLEMS. Although marriage tends to be regarded as a permanent tie,
unsuccessful unions can be terminated, as indeed they are in most societies.
Nevertheless, many marriages that do not end in separation or divorce are disturbed. In
considering marital problems, clinicians are concerned with both the persons involved
and with the marital unit itself. How any marriage works relates to the partner selected,
the personality organization or disorganization of each, the interaction between them,
and the original reasons for the union. Persons marry for a variety of reasons—
emotional, social, economic, and political, among others. One person may look to the
spouse to meet unfulfilled childhood needs for good parenting. Another may see the
spouse as someone to be saved from an otherwise unhappy life. Irrational expectations
between spouses increase the risk of marital problems.
MARRIAGE AND COUPLES THERAPY. When families consist of grandparents, parents,
children, and other relatives living under the same roof, assistance for marital problems
can sometimes be obtained from a member of the extended family with whom one or
both partners have rapport. With the contraction of the extended family in recent times,
however, this source of informal help is no longer as accessible as it once was. Similarly,
religion once played a more important role than it does now in the maintenance of
family stability. Wise religious leaders are available to provide counseling, but they are
not sought out to the extent they once were, which reflects the decline in religious
influence among large segments of the population. Formerly, both the extended family
and religion provided guidance for couples in distress and also prevented dissolution of
marriages by virtue of the social pressures that the extended family and religion exerted
on couples to stay together. As family, religious, and societal pressures have been
relaxed, legal procedures for relatively easy separation and divorce have expanded.

Concurrently, the need for formalized marriage counseling services has developed.
Marital therapy is a form of psychotherapy for married persons in conflict with each
other. A trained person establishes a professional contract with the patient-couple and,
through definite types of communication, attempts to alleviate the disturbance, to
reverse or change maladaptive patterns of behavior, and to encourage personality
growth and development.
In marriage counseling, only a particular conflict related to the immediate concerns of
the family is discussed; marriage counseling is conducted much more superficially by
persons with less psychotherapeutic training than is marital therapy. Marital therapy
places greater emphasis on restructuring the interaction between the couple, including,
at times, exploration of the psychodynamics of each partner. Both therapy and
counseling emphasize helping marital partners cope effectively with their problems.
Parenthood.
 Parenthood intensifies the relationship between the new parents.
Through their physical and emotional union, the couple has produced a fragile,
dependent being that needs them in the interlocking roles of father and mother. This
recognition expands their internal images of each other to include thoughts and feelings
emanating from the role of parent. As they live together as a family, the lovers’
relationship to each other changes. They become parents relating to one another and to
their children.
Parent–child problems do arise, however. In addition to the economic burden of
raising a child (estimated to be $250,000 for a middle-class family whose child goes to
college), there are emotional costs. Children may reawaken conflicts that parents
themselves had as children, or children may have chronic illnesses that challenge
families’ emotional resources. In general, men have been more concerned with their
work and occupational advancement than with child rearing, and women have been
more concerned about their role as mothers than with advancement in their occupation,
but this emphasis is changing dramatically for both sexes. A small, but growing, number
of couples are choosing to split a job (or work at two part-time jobs) and share childrearing duties.
Parenting has been described as a continuing process of letting go. Children must be
allowed to separate from parents and, in some cases, must be encouraged to do so.
Letting go involves separation from children who are starting school. School phobias
and school refusal syndromes that are accompanied by extreme separation anxiety may
have to be dealt with. Often, a parent who cannot let go of a child accounts for this
situation; some parents want their children to remain tightly bound to them
emotionally. Family therapy that explores these dynamics may be needed to resolve
such problems.
As children get older and enter adolescence, the process of establishing identity
assumes great importance. Peer relationships become crucial to a child’s development,
and overprotective parents who keep a child from developing friendships or having the
freedom to experiment with friends that the parents disapprove of can interfere with the
child’s passage through adolescence. Parents need not refrain from exerting influence

over their children; guidance and involvement are crucial. But they must recognize that
adolescents especially need parental approval; although rebellious on the surface,
adolescents are much more tractable than they appear, provided parents are not
overbearing or generally punitive.
SINGLE-PARENT FAMILIES. More than 10 million single-parent families exist with one or
more children under the age of 18; of these families, 20 percent are single-parent homes
in which a woman is the sole head of the household. The increase in number of singleparent families has risen almost 200 percent since 1980.
ALTERNATIVE LIFESTYLE PARENTING. Single, partnered and married homosexual men and
women are choosing to raise children. In most cases, such children are obtained through
adoption. Some, however, may be born to a lesbian woman through artificial
insemination or obtained from a willing mother surrogate. The number of such family
units is increasing. The data about the development of children in these homes indicate
that they are at no greater risk for emotional problems (or for a homosexual
orientation) than children raised in conventional households.
ADOPTION. Since the turn of the century, adoption or foster placement has replaced
institutional care as the preferred way to raise children who are neglected, unwanted, or
abandoned. Many couples who are unable to conceive (and some couples who already
have children) turn to adoption.
In addition to the full range of normal parent–child developmental issues, adoptive
parents face special problems. They must decide how and when to tell the child about
the adoption. They must deal with the child’s possible desire for information about his or
her biological parents. Adopted children are more likely to develop conduct disorders,
problems with drug abuse, and antisocial personality traits. It is unclear whether these
problems result from the process of adoption or whether parents who give up children
for adoption are more likely to pass along a genetic predisposition for these behaviors.
With widespread use of birth control and access to safe abortions, the number of
infants available for adoption has declined steeply. Wealthy parents may prefer to
arrange for private adoption rather than wait many uncertain years for an institutional
adoption. (In private adoptions, a biological mother is paid for her legal and medical
expenses but not for the baby. Baby selling is a felony in all states.) International
adoptions (especially from Bosnia, Latin America, eastern Europe, and China) have also
become more common. Questionable regulation in these countries has raised concern
that some infants put up for adoption in poor countries may not be orphans but are
being sold by destitute mothers.
MIDDLE ADULTHOOD (40 TO 65 YEARS OF AGE)
Middle adulthood is the golden age of adulthood, similar to the latency years in
childhood, but much longer. Physical health, emotional maturity, competence and power
in the work situation, and gratifying relationships with spouse, children, parents,
friends, and colleagues all contribute to a normative sense of satisfaction and well-

being. With regard to occupation, many persons begin to experience the gap between
early aspirations and current achievements. They may wonder whether the lifestyle and
the commitments they chose in early adulthood are worth continuing; they may feel that
they would like to live their remaining years in a different, more satisfying way,
without knowing exactly how. As children grow up and leave home, parental roles
change, and persons redefine their roles as husbands and wives.
Important gender-specific changes occur in middle adulthood. Many women who no
longer need to nurture young children can release their energy into independent
pursuits that require assertiveness and a competitive spirit, traits that were traditionally
considered masculine. Alternatively, men in middle adulthood may develop qualities
that enable them to express their emotions and recognize their dependency needs, traits
that were traditionally considered feminine. With the new balance of the masculine and
the feminine, a person may now be able to relate more effectively to someone of the
other sex than in the past. For a further discussion of adoption see Section 31.19b.
Transition from Young to Middle Adulthood
The transition from young adulthood to middle adulthood is slow and gradual, with no
sharp physical or psychological demarcation. The aging process picks up speed and
becomes a powerful organizing influence on intrapsychic life, but the change is gradual,
unlike during adolescence. Mental change is experienced in a similar fashion, slow and
imperceptible, without a sense of disruption.
Development in young adulthood is embedded in close relationships. Intimacy, love,
and commitment are related to the mastery of the relationships most immediate to
personal experience. The transition from young adulthood to middle age includes
widening concern for the larger social system and differentiation of one’s own social,
political, and historical system from others. Authors have described middle adulthood in
terms of generativity, self-actualization, and wisdom.
Developmental Theorists
Robert Butler described several underlying themes in middle adulthood that appear to be
present regardless of marital and family status, gender, or economic level (Table 32-3).
These themes include aging (as changes in bodily functions are noticed in middle
adulthood); taking stock of accomplishments and setting goals for the future; reassessing
commitments to family, work, and marriage; dealing with parental illness and death;
and attending to all the developmental tasks without losing the capacity to experience
pleasure or to engage in playful activity.
Table 32-3
Features Salient to Middle Adulthood

Erik Erikson.
 Erikson described middle adulthood as characterized either by
generativity or by stagnation. Erikson defined generativity as the process by which
persons guide the oncoming generation or improve society. This stage includes having
and raising children, but wanting or having children does not ensure generativity. A
childless person can be generative by (1) helping others, (2) being creative, and (3)
contributing to society. Parents must be secure in their own identities to raise children
successfully: They cannot be preoccupied with themselves and act as if they were, or
wished to be, the child in the family.
To be stagnant means that a person stops developing. For Erikson, stagnation was
anathema, and he referred to adults without any impulses to guide the new generation
or to those who produce children but don’t care for them as being “within a cocoon of
self-concern and isolation.” Such persons are in great danger. Because they are unable
to negotiate the developmental tasks of middle adulthood, they are unprepared for the
next stage of the life cycle, old age, which places more demands on the psychological
and physical capacities than all the preceding stages.
George Vaillant.
 In his longitudinal study of 173 men who were interviewed at 5year intervals after they graduated from Harvard, Vaillant found a strong correlation
between physical and emotional health in middle age. In addition, those with the
poorest psychological adjustment during college years had a high incidence of physical
illness in middle age. No single factor in childhood accounted for adult mental health,
but an overall sense of stability in the parental home predicted a well-adjusted
adulthood. A close sibling relationship during college years was correlated with
emotional and physical well-being in middle age. In another study, Vaillant found that
childhood and adult work habits were correlated, and that adult mental health and good
interpersonal relationships were associated with the capacity to work in childhood.
Vaillant’s studies are ongoing and represent the longest continuous study of adulthood
ever performed.
Calvin Colarusso and Robert Nemiroff.
 On the basis of their experience as
clinicians and psychoanalysts, Calvin Colarusso and Robert Nemiroff propose a broad
theoretical foundation for adult development by suggesting that the developmental
process is basically the same in the adult as in the child because, like the child, the adult

is always in the midst of an ongoing dynamic process, continually influenced by a
constantly changing environment, body, and mind. Whereas child development focuses
primarily on the formation of psychic structure, adult development is concerned with
the continuing evolution of existing psychic structure and with its use. Although the
fundamental issues of childhood continue in altered form as central aspects of adult life,
attempts to explain all adult behavior and pathology in terms of the experiences of
childhood are considered reductionistic. The adult past must be taken into account in
understanding adult behavior in the same way that the childhood past is considered. The
aging body is understood to have a profound influence on psychological development in
adulthood, as is the growing midlife recognition and acceptance of the finiteness of time
and the inevitability of personal death.
Developing Midlife Friendships
Unlike friendships in latency and adolescence and, to some extent, in young adulthood,
midlife friendships do not usually have the sense of urgency or the need for frequent or
nearly constant physical presence of the friend. Midlife individuals have neither the
need to build new psychic structure (as do latency-age children and adolescents) nor the
pressing need to find new relationships (as do young adults). They may have many
sources of gratification available through relationships with spouse, children, and
colleagues.
As their firstborn sons progressed through high school, two women in their mid-40s
became fast friends. In addition to raising money for the school activities in which
their sons were involved, thus maintaining a close involvement with the boys, they
spent many hours talking about the boys’ activities, girlfriends, and plans for college.
Their husbands, who liked each other, became acquaintances, not friends. They
directed their own feelings about their sons into other relationships. After the boys left
for college, the intensity of the friendship diminished, tending to peak again during
vacation periods. (Courtesy of Calvin Colarusso, M.D.)
Because of their unique position in the life cycle, midlife adults are easily able to
initiate and sustain friendships with individuals of different ages, as well as
chronological peers. In the face of a disrupted marriage or intimacy or the pressure of
other midlife developmental themes, friendships may quickly become vehicles for the
direct expression of impulses.
Reappraising Relationships.
 Midlife is a time of serious reappraisal of marriage
and committed relationships. In the process, individuals struggle with the question of
whether to settle for what they have or to search for greater perfection with a new
partner. For some, the conflict rages internally and is kept from others; others express it
through actions that take the form of affairs, trial separations, and divorce.

Recent research on happy marriage indicates that these couples, despite internal and
real conflict, have found or achieved a special goodness-of-fit between their individual
needs, wishes, and expectations. In the eyes of these couples, marital success is based on
the ongoing, successful engagement of a number of psychological tasks. Among the most
important are providing a safe place for conflict and difference, holding a double vision
of the other, and maintaining a satisfying sexual life.
The decision to leave a long-standing, committed relationship has great consequences,
not only for the two individuals involved, but also for their friends and loved ones. The
effect on children, in particular, is especially profound, extending far beyond childhood.
The effects on the abandoned spouse, parents, and close relatives may be nearly as
severe.
Various forms of therapeutic intervention, such as marital counseling, individual
psychotherapy, and psychoanalysis, can be extremely effective in helping uncertain
individuals decide what to do or in helping those who leave deal with the consequences
of their decision on the abandoned partner, children, and other loved ones. Problems
relating to intimacy, love, and sex can occupy a prominent position in an outpatient
practice.
The four case studies presented here by Calvin Colarusso, M.D., illustrate some of the
issues described above.
A couple in their late 50s sought treatment in order to make a decision about their
marriage. Both had been unhappy for years and wanted to divorce, feeling that they
had to act now while there was still time to begin new relationships that would fulfill
them. Their concerns were for their children and grandchildren. How would they
react? Would they respect their decision to end a relationship of more than 30 years
or attempt to stop the separation? As the work progressed, they decided that seeking
happiness in the hopefully 20 or 30 years that they had left to live had to come ahead
of the feelings of their loved ones. The fact that their decision was a mutual one was
the determining factor in the gradual acceptance by their family members of the
divorce.
A 43-year-old patient, Mr. S, was continually preoccupied with his marriage during
this 4-year psychoanalysis. Sexually inhibited during adolescence, he “married the
only girl in the world who knew less about sex than I did.” Both were virgins on their
wedding night. As the marriage progressed, the couple gradually developed a
“satisfactory” sex life, but the patient always wondered what he had missed. As his
sexual inhibitions were explored Mr. S’s sense of having “missed out on a lot of
opportunities” lead to visits to massage parlors and prostitutes. Eventually such
behavior ceased because of the recognition that his wife was a wonderful mother and
loving wife and not the cause of the lack of sexual experience that he brought into the
marriage. “I’ll always feel that I missed out when I was young, but I’ve got so much
going for me now, I’m not going to mess it up over something that I can’t change.”
A 38-year-old woman entered therapy after her husband discovered that she was

having sexual relations with men in their early and middle 20s. She explained that she
loved her husband but he seemed to take her for granted. He no longer made her feel
attractive and wanted. As the therapy progressed it became clear that she felt that as
long as she could attract younger men she was still young and sexually desirable.
Struggling with the early signs of physical aging, the realization that the young men
were only using her to satisfy their own sexual needs was sobering and distressing. As
she began to see that such behavior was self-destructive, she approached her husband
about starting marital therapy.
Fifty-year-old Mrs. T left her “wonderful” husband because “I’ve missed something. I
just have to get out on my own.” Married at 18 years of age, “after going from my
parents’ home to his home,” she recognized that her rage at her husband for “not
being all the other men I could have married, for closing off all the living I could have
done” was irrational but uncontrollable. “I have to live on my own for a while, to see
if I can do it, before it’s too late.” Fully intending to return to her husband, she
continued exploring the infantile and adult issues that precipitated the separation,
leaving the future of the marriage in doubt.
Sexuality
Whereas the young adult is preoccupied with developing the capacity for intimacy, the
midlife individual is focused on maintaining intimacy in the face of deterring physical,
psychological, and environmental pressures. In a long-standing relationship, these
pressures include real and imaginary concerns about diminished sexual capability,
emotional withdrawal because of preoccupation with developmental tasks, and the
realistic pressures related to work and providing for dependent children and, sometimes,
elderly parents as well. In relationships that begin in midlife, the maintenance of
intimacy can be compromised by the absence of a common past, age and generational
differences in interests and activities, and the difficulties involved in forming a
stepfamily.
For sexual intimacy to continue, the participants must (1) accept the appearance of
the partner’s middle-aged body, (2) continue to find it sexually stimulating, and (3)
accept the normative changes that occur in sexual functioning. For those who master
these developmental issues, the partner’s body remains sexually stimulating. Diminished
sexual ability is compensated for by feelings of love and tenderness generated over the
years by a satisfying relationship. Those who cannot accept the changes in the partner’s
body or their own stop having sex, begin affairs, or leave the relationship, usually in
search of a younger partner.
Normative changes in midlife sexual functioning include diminished sexual drive and
an increase in mechanical problems. Men have greater difficulty getting and sustaining
erections and experience a longer refractory period after ejaculation. Because of
diminished estrogen production, women experience a thinning of the vaginal mucosa, a
decrease in secretions, and fewer contractions at the time of orgasm. Women do not

reach their sexual prime until their mid-30s; consequently, they have a greater capacity
for orgasm in middle adulthood than in young adulthood. Women, however, are more
vulnerable than men to narcissistic blows to their self-esteem as they lose their youthful
appearance, which is overvalued in today’s society. During middle adulthood, they may
feel less sexually desirable than in early adulthood and, thus, feel less entitled to an
adequate sex life. An inability to deal with changes in body image prompts many
women and men to undergo cosmetic surgery in an effort to maintain their youthful
appearance.
The demands of raising children interfere with the privacy and emotional equilibrium
required for intimacy, as do the pressures and responsibilities of work. Fatigue and
diminished interest are common denominators in these circumstances. Patients with
deeply rooted problems with sexuality or relationships may use aging, work, and
relationships with children or elderly parents as a means of rationalizing their conflicts
and refusing to analyze them.
Climacterium
Middle adulthood is the time of the male and female climacterium, the period in life
characterized by decreased biological and physiological functioning. For women, the
menopausal period is considered the climacterium, and it may start anywhere from the
40s to the early 50s. Bernice Neugarten studied this period and found that more than 50
percent of women described menopause as an unpleasant experience, but a significant
portion believed that their lives had not changed in any significant way, and many
women experienced no adverse effects. Because they no longer had to worry about
becoming pregnant, some women report feeling sexually freer after menopause than
before its onset. Generally, the female climacterium has been stereotyped as a sudden or
radical psychophysiological experience, but it is more often a gradual experience as
estrogen secretion decreases with changes in the flow, timing, and eventual cessation of
the menses. Vasomotor instability (hot flashes) can occur, and menopause can extend
over several years. Some women experience anxiety and depression, but women who
have a history of poor adaptation to stress are more predisposed to the menopausal
syndrome. (Chapter 27 on reproductive medicine provides further discussion of
menopause and its management.)
For men, the climacterium has no clear demarcation; male hormones stay fairly
constant through the 40s and 50s and then begin to decline. Nevertheless, men must
adapt to a decline in biological functioning and overall physical vigor. About age 50, a
slight decrease in healthy sperm and seminal fluid occurs; not sufficient, however, to
preclude insemination. Coincident with the decreased testosterone level may be fewer
and less firm erections and decreased sexual activity generally. Some men experience a
so-called midlife crisis during this period. The crisis can be mild or severe, characterized
by a sudden drastic change in work or marital relationships, severe depression,
increased use of alcohol or drugs, or a shift to an alternate lifestyle.

Midlife Transition and Crisis
The midlife transition has been defined as an intense reappraisal of all aspects of life
precipitated by the growing recognition that life is finite and approaching an end. It is
characterized by mental turmoil, not action. For most people, the reappraisal results in
decisions to keep most life structures, such as marriages and careers, which have been
painstakingly built over time. When major changes are made, they are thoughtful and
considered, even when they include major shifts, such as divorce or a job change. The
developmentally aware clinician recognizes that every patient in this age group is
engaged in a midlife transition (whether the patient is talking about it or not) and
facilitates the process by making it conscious and verbal.
A true midlife crisis is a major, revolutionary turning point in life, involving changes
in commitments to career or spouse, or both, and accompanied by significant, ongoing
emotional turmoil for the individual and others. It is an upheaval of major proportions.
A period of internal agitation is followed by a flurry of impulsive actions; for example,
leaving spouse and children, becoming involved with a new sexual partner, and quitting
a job, all within days or weeks of each other. Although unrecognized warning signs may
have existed, those who are left behind are often shocked by the suddenness and
abruptness of the change.
Efforts by family members or therapists to get the individual to stop and to reconsider
usually fall on deaf ears. The overwhelming need is to avoid anyone who counsels
restraint and to ignore therapists who recommend examining motivations and feelings
before making such major decisions. Usually, in the midst of the crisis, the therapist is
left with the painful job of helping those who have been left to deal with their shock and
grief.
Empty-Nest Syndrome.
 Another phenomenon described in middle adulthood has
been called the empty-nest syndrome, a depression that occurs in some men and women
when their youngest child is about to leave home. Most parents, however, perceive the
departure of the youngest child as a relief rather than a stress. If no compensating
activities have been developed, particularly by the mother, some parents become
depressed. This is especially true of women whose predominant role in life has been
mothering or of couples who decided to stay in an otherwise unhappy marriage “for the
sake of the children.”
Other Tasks of Middle Adulthood
As persons approach the age of 50, they clearly define what they want from work,
family, and leisure. Men who have reached their highest level of advancement in work
may experience disillusionment or frustration when they realize they can no longer
anticipate new work challenges. For women who have invested themselves completely
in mothering, this period leaves them with no suitable identity after the children leave
home. Sometimes, social rules become rigidly established; lack of freedom in lifestyle
and a sense of entrapment can lead to depression and a loss of confidence. Also unique

financial burdens can occur in middle age, produced by pressures to care for aged
parents at one end of the spectrum and children at the other end.
Daniel Levinson described a transitional period between the ages of 50 and 55 during
which a developmental crisis may occur when persons feel incapable of changing an
intolerable life structure. Although no single event characterizes the transition, the
physiological changes that begin to appear may have a dramatic effect on a person’s
sense of self. For example, a person may experience a decrease in cardiovascular
efficiency that accompanies aging. Chronological age and physical infirmity are not
linear, however; those who exercise regularly, who do not smoke, and who eat and
drink in moderation can maintain their physical health and emotional well-being.
Middle adulthood is when persons frequently feel overwhelmed by too many
obligations and duties, but it is also a time of great satisfaction for most persons. They
have developed a wide array of acquaintances, friendships, and relationships, and the
satisfaction they express about their network of friends predicts positive mental health.
Some social ties, however, may be a source of stress when demands either cannot be met
or assault a person’s self-esteem. Power, leadership, wisdom, and understanding are
most generally possessed by persons who are middle aged, and if their health and
vitality remain intact, it is truly the prime of life.
DIVORCE
Divorce is a major crisis of life. Spouses often grow, develop, and change at different
rates; one spouse may discover that the other is not the same as when they first married.
In truth, both partners have changed and evolved, not necessarily in complementary
directions. Frequently, one spouse blames a third person for alienation of affections and
refuses to examine his or her own role in the marital problems. Certain aspects of
marital deterioration and divorce seem to be related to specific qualities of middle life—
need for change, weariness with acting responsibly, fear of facing up to oneself.
Types of Separation
Paul Bohannan, an anthropologist with expertise in marriage and divorce, described the
types of separations that take place at the time of divorce.
Psychic Divorce.
 In psychic divorce, the love object is given up, and a grief
reaction about the death of the relationship occurs. Sometimes a period of anticipatory
mourning sets in before the divorce. Separating from a spouse forces a person to become
autonomous, to change from a position of dependence. The separation may be difficult
to achieve, especially if both are used to being dependent on each other (as normally
happens in marriage) or if one was so dependent as to be afraid or incapable of
becoming independent. Most persons report such feelings as depression, ambivalence,
and mood swings at the time of divorce. Studies indicate that recovery from divorce
takes about 2 years; by then, the ex-spouse may be viewed neutrally, and each spouse
accepts his or her new identity as a single person.

Legal Divorce.
 Legal divorce involves going through the courts so that each of the
parties is remarriageable. Of divorced women and divorced men, 75 percent and 80
percent, respectively, remarry within 3 years of divorce. No-fault divorce, in which
neither person is judged to be the guilty party, has become the most widely used legal
mechanism for divorce.
Economic Divorce.
 Economic divorce involves major concerns to the division of
the couple’s property between them and economic support for the wife. Many men who
are ordered by the courts to pay alimony or child support flout the law and create a
major social problem.
Community Divorce.
 The social network of the divorced couple changes
markedly. A few relatives and friends are retained from the community and new ones
are added. The task of meeting new friends is often difficult for divorced persons, who
may realize how dependent they were on their spouses for social exchanges.
Coparental Divorce.
 Coparental divorce is the separation of a parent from the
child’s other parent. Being a single parent differs from being a married parent.
Custody
The parental right doctrine is a legal concept that awards custody to the more fit natural
parent and attempts to ensure that the best interests of the child are served. In the past,
mothers were almost always awarded custody, but custody is now given to fathers in
about 15 percent of cases. Custodial fathers are likely to be white, married, older, and
better educated than custodial mothers. Women who are granted custody have a better
chance of being awarded child support and of actually receiving payment than do men
who are granted custody. Nevertheless, women who receive payments still have lower
incomes than men who receive payment.
The types of custody include joint custody, in which a child spends equal time with
each parent, an increasingly common practice; split custody, in which siblings are
separated and each parent has custody of one or more of the children; and single
custody, in which the children live solely with one parent and the other parent has rights
of visitation that may be limited in some way by the court. Child support payments are
more likely to be made when parents have joint custody or when the noncustodial
parent is given visitation rights.
Problems can surface in the parent–child relationship with the custodial or the
noncustodial parent. The absence of the noncustodial parent in the home represents the
reality of the divorce, and the custodial parent may become the target of the child’s
anger about the divorce. The parent under such stress may not be able to deal with the
child’s increased needs and emotional demands.
The noncustodial parent must cope with limits placed on time spent with the child.
This parent loses the day-to-day gratification and the responsibilities involved with

parenting. Emotional distress is common in parent and child. Joint custody offers a
solution with some advantages, but it requires substantial maturity on the part of the
parents and can present some problems. Parents must separate their child-rearing
practices from their postdivorce resentments, and they must develop a spirit of
cooperation about rearing the child. They must also be able to tolerate frequent
communication with the ex-spouse.
Reasons for Divorce
Divorce tends to run in families and rates are highest in couples who marry as teenagers
or come from different socioeconomic backgrounds. Every marriage is psychologically
unique and so is each divorce. If a person’s parents were divorced, he or she may choose
to resolve a marital problem in the same way, through divorce. Expectations of the
spouse may be unrealistic: One partner may expect the other to act as an all-giving
mother or a magically protective father. The parenting experience places the greatest
strain on a marriage. In surveys of couples with and without children, those without
children reported getting more pleasure from their spouse than those with children.
Illness in the child creates the greatest strain of all, and more than 50 percent of
marriages in which a child has died through illness or accident end in divorce.
Other causes of marital distress are problems about sex and money. Both areas may be
used as a means of control, and withholding sex or money is a means of expressing
aggression. Also, less social pressure to remain married currently exists. As discussed
above, the easing of divorce laws and the declining influence of religion and the
extended family make divorce an acceptable course of action today.
Intercourse Outside of Marriage.
 Adultery is defined as voluntary sexual
intercourse between a married person and someone other than his or her spouse. For
men, the first extramarital affair is often associated with the wife’s pregnancy, when
coitus may be interdicted. Most of these incidents are kept secret from the spouse and, if
known, rarely account for divorce. Nevertheless, the infidelity can serve as the catalyst
for basic dissatisfactions in the marriage to surface, and these problems may then lead
to its dissolution. Adultery may decline, as potentially fatal sexually transmitted diseases
such as acquired immune deficiency syndrome (AIDS) serve as sobering deterrents.
ADULT MATURITY
Success and happiness in adulthood are made possible by achieving a modicum of
maturity—a mental state, not an age. The capacity for maturity, however, is a direct
outgrowth of the engagement and mastery of the developmental tasks of young and
middle adulthood. From a developmental perspective, maturity can be defined as a
mental state found in healthy adults that is characterized by detailed knowledge of the
parameters of human existence, a sophisticated level of self-awareness based on an
honest appraisal of one’s own experience within those basic parameters, and the ability
to use this intellectual and emotional knowledge and insight caringly in relation to one’s

self and others.
The achievement of maturity in midlife leads to emergence of the capacity for
wisdom. Those who possess wisdom have learned from the past and are fully engaged in
life in the present. Just as important, they anticipate the future and make the necessary
decisions to enhance prospects for health and happiness. In other words, a philosophy of
life has been developed that includes understanding and acceptance of the person’s
place in the order of human existence. Unfortunately, the joys of midlife do not last
forever. Old age lies ahead. Although the hope and statistical expectation is for many
years of mental competence and independence, physical and mental decline, increased
dependence, and, eventually, death must be anticipated. Late adulthood has its own
great pleasure, when there is a focus on continued mental and physical activity, a
dominant preoccupation with the present and the future, and involvement with and
facilitation of the young. Then, death can be met with feelings of satisfaction and
acceptance, the natural end point of human existence that follows a life lived and well
loved.
REFERENCES
Baxter J, Haynes M, Hewitt B. Pathways into marriage: Cohabitation and the domestic division of labor. J Fam Issues.
2010;31(11):1507–1529.
Bottiroli S, Cavallini E, Fastame MC, Hertzog C. Cultural differences in rated typicality and perceived causes of memory
changes in adulthood. Arch Gerontol Geriatr. 2013;57(3):271–281.
Colarusso CA. Adulthood. In: Sadock BJ, Sadock VA, Ruiz P, eds. Kaplan & Sadock’s Comprehensive Textbook of Psychiatry.
9th ed. Vol. 2. Philadelphia: Lippincott Williams & Wilkins; 2009:3909.
Diehl M, Chui H, Hay EL, Lumley MA, Grühn D, Labouvie-Vief G. Change in coping and defense mechanisms across
adulthood: longitudinal findings in a European American sample. Dev Psychol. 2014;50(2):634–648.
Gager CT, Yabiku ST. Who has the time? The relationship between household labor time and sexual frequency. J Fam
Issues. 2010;31(2):135–163.
Goldberg AE, Sayer A. Lesbian couples’ relationship quality across the transition to parenthood. J Marriage Fam.
2006;68(1):87–100.
Goldberg AE, Smith JZ. Predictors of psychological adjustment in early placed adopted children with lesbian, gay, and
heterosexual parents. J Fam Psychol. 2013;27(3):431.
Howlin P, Moss P, Savage S, Rutter M. Social outcomes in mid- to later adulthood among individuals diagnosed with
autism and average nonverbal IQ as children. J Am Acad Child Adolesc Psychiatry. 2013;52(6):572–581.
Jones PB. Adult mental health disorders and their age at onset. Br J Psychiatry. 2013;202(Suppl 54):s5–s10.
Joyner K, Kao G. Interracial relationships and the transition to adulthood. Am Sociol Rev. 2005;70:563–581.
Kornrich S, Brines J, Leupp K. Egalitarianism, housework, and sexual frequency in marriage. Am Sociol Rev.
2013;78(1):26–50.
Kwon, P. Resilience in lesbian, gay, and bisexual individuals. Person Soc Psychol Rev. 2013;17(4):371–383.
Masarik AS, Conger RD, Martin MJ, Donnellan M, Masyn KE, Lorenz FO. Romantic relationships in early adulthood:
Influences of family, personality, and relationship cognitions. Person Relation. 2013;20(2):356–373.
Nelson LJ, Barry CM. Distinguishing features of emerging adulthood: The role of self-classification as an adult. J Adolesc
Res. 2005;20(2):242–262.
Perrig-Chiello P, Perren S. Biographical transitions from a midlife perspective. J Adult Dev. 2005;12(4):169–181.

Schwartz SJ, Côté JE, Arnett J. Identity and agency in emerging adulthood: Two developmental routes in the
individualization process. Youth Soc. 2005; 37(2):201–229.
Tasker F. Lesbian mothers, gay fathers, and their children: A review. J Dev Behav Pediatr. 2005;26(3):224–240.
Turk JK. The division of housework among working couples: Distinguishing characteristics of egalitarian couples.
Contemp Perspect Fam Res. 2012;6:235–258.